Exam 3 3050

A client experienced asymptomatic UTIs while pregnant. The client asks the nurse if this places her at any risk for complications. Which would be the best response by the nurse?

"You are at risk for developing acute pyelonephritis.

A 35-year-old client is diagnosed with acute kidney injury (AKI) and is started on hemodialysis. The client is concerned with the diagnosis and wants to know what to expect in the progression of this disorder. Which statement best addresses the client's concern?

"Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

A nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by a participant should the nurse follow up first?

"I've had a little sore on the sole of my foot for a few days, but I'm sure it will eventually heal."

Describe the purpose of the Blood Brain Barrier

- protective mechanism provided by relatively impermeable capillaries - keep toxic substances out -electrolyte balance constant

The nurse is reviewing assessment data and determines which client is at highest risk for developing type 2 diabetes?

A 45-year-old obese female with a sedentary lifestyle

A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes?

A 78-year-old woman's GFR has been steadily declining over several years.

Which individual likely faces the greatest risk for the development of chronic kidney disease?

A client with a recent diagnosis of type 2 diabetes who does not monitor blood sugars or control diet

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

A hypermetabolic state

One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and:

ACTH

A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of:

An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve

A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding antiepileptic medications?

Antiepileptic medications should never be discontinued abruptly.

A client has been diagnosed with chronic kidney disease (CKD). Which drug category is usually administered to treat coexisting conditions that manifest early in CKD?

Antihypertensive medications

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells

A nurse is caring for a client with systemic lupus erythematosus (SLE). The client asks why a urinalysis is necessary. The best answer is that a urinalysis would determine whether which factor was present in the urine?

Blood or protein

Cranial Nerve facial VII

Both facial expression, taste

Cranial Nerve Vagus X

Both gas reflex, parasympathetic innervation

Cranial Nerve Glossopharyngeal IX

Both taste, gag reflex

A teenager has been in a car accident and experienced an acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?

Brain contusions and hematomas

The nurse encourages a female client with recurrent urinary tract infections (UTIs) to drink which liquid on a daily basis?

Cranberry juice

Which disorder is a result of excess cortisol?

Cushing syndrome

An older adult client with Parkinson disease has been diagnosed with neurocognitive disorder. Which assessment finding would the nurse correlate with this new diagnosis?

Dementia and slowness of movement and thought

Peripheral neuropathy occurs most commonly with which disorder?

Diabetes

A client affected by postural hypotension will likely display what symptoms?

Dizziness and pallor when moved to upright position

A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?

Dopamine

The underlying causative problem in Parkinsonism is:

Failure of dopamine release

Bradykinesia occurring in Parkinson disease places the Parkinson's client most at risk for:

Falls and injury

A sudden, traumatic, complete transection of the spinal cord results in what type of injury below the site?

Flaccid paralysis

A client has passed a kidney stone composed of uric acid (urate). Which of the following pathologic conditions is a contributing factor for the development of this type of kidney stone?

Gout

A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:

Graves disease

A nurse is caring for a client who has a recent history of passing calcium urinary stones. Which of the following is a priority nursing consideration for this client?

Hydration

A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?

Hypertension

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

Ischemic stroke

A nurse is giving discharge instructions for a client who was diagnosed with acute pyelonephritis 3 days previously. Which instruction is important for the nurse to discuss when teaching the client?

It is important that the client take the prescribed antibiotic for the duration of the prescription.

What is understood to be the cause of Huntington disease (HD)?

It is inherited as an autosomal dominant disorder.

Cranial Nerves Oculomotor III

Motor most eye movement

Cranial Nerve Accessory XI

Motor shoulder shrug

Cranial Nerve: Hypoglossal (XII)

Motor swallowing speech

A client diagnosed with Parkinson disease is displaying the following manifestations: tremor, rigidity, and slowness of movement. The nurse would interpret these as:

Normal manifestations of Parkinson disease

Surgical stone removal is indicated for which instance?

Obstruction of urine flow

After being thrown off the back of a bull, a bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is referred to as:

Paraplegia

What are the hallmark signs of diabetes mellitus?

Polyuria, polydipsia, and polyphagia

A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?

Psychological manifestation due to involvement of white matter of cerebral cortex

Cranial Nerves Optic II

Sensory Vision

Cranial Nerve Vestibulocochlear VIII

Sensory hearing, balance

Cranial Nerves Olfactory 1

Sensory smell

The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?

Serum creatinine

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with:

Subarachnoid hemorrhage

The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?

The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.

An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?

The client's blood pressure has historically been in the range of 150/90 to 160/100 mm Hg.

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

While caring for a client with Alzheimer dementia, the family asks about the medication. Which advantage of the cholinesterase inhibitors should the nurse mention?

They have been shown to slow the progression of the disease.

The nurse is teaching a newly diagnosed client with diabetes about fingerstick blood glucose testing. When the client obtains a premeal fingerstick reading of 206 mg/dL (11.43 mmol/L), which teaching by the nurse is most appropriate?

This is an elevated reading - let's talk about adherence to insulin and diet.

A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Using an insulin infusion pump

Which is the most important factor in reducing hospital-acquired (nosocomial) urinary tract infections?

Using urinary catheters only when necessary and their prompt removal when no longer needed

Cranial Nerve V Trigeminal

both face sensation, mastication

cerebrospinal fluid (CSF)

cushion that helps protects your brain and spinal cord from sudden impact or injury

A high school student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome and ask them to watch for and report which manifestations of its presence?

headaches and poor concentration

Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:

is morbidly obese (defined as greater than 100 pounds over ideal weight).

As the nurse is performing a physical assessment of a client, the client begins to have seizure activity including loss of consciousness and limb jerking. The nurse's priority is to:

protect the client from injury.

A nurse is caring for a client experiencing muscle fasciculations. Fasciculations appear as:

spontaneous contractions of muscle fibers presenting as twitching.

The most common cause of ischemic stroke is:

thrombosis

A client with a new diagnosis of type 2 diabetes mellitus states, "I am really worried that I might need to take injections. Is there something I can do to avoid that?" What is the best response by the nurse?

"You could regulate your diet, exercise regularly, and lose weight."

Which client would be considered to be exhibiting manifestations of "prediabetes"?

A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL (10.49 mmol/L).

Which resident of a long-term facility is exhibiting clinical manifestations of hypothyroidism?

An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

Thrombolysis

Monroe-Kelly Hypothesis/Doctrine

•Doctrine: the cranial compartment is encased in a nonexpandable case of bone → the volume inside the cranium is fixed. •In an incompressible cranium, the blood, CSF, and brain tissue exist in a state of volume equilibrium, such that any increase in volume of one of the cranial constituents must be compensated by a decrease in volume of another. •ICP is generally measured in mm Hg to allow for comparison with MAP and to enable quick calculation of CPP. •7-15 mm Hg in adults who are supine (lower in children), with pressures over 20 mm Hg considered pathological

A nurse caring for a client in myasthenic crisis identifies a priority concern as:

maintenance of airway and respiration

Cranial Nerve Abducens VI

motor abducts the eye

Cranial nerve IV trochlear 4

motor moves eyes to look at nose

Which effect of thyroid hormone deficit alters the function of all major organs in the body?

Decrease metabolism

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

A client is to receive a radiocontrast media as part of a diagnostic scan. Which intervention is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate prior to the exam

A nurse is assessing a client's risk for developing a hospital-acquired urinary tract infection (UTI) and determines that which of the following places the client at greatest risk?

Indwelling urinary catheter

Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.

Inspect the feet for blisters daily

Which neuron connects sensory and motor neurons?

Interneurons

The transmission of impulses at the neuromuscular junction is mediated by which action?

Release of neurotransmitter acetylcholine from autonomic nerve endings

A client has started having uncontrolled seizures that are not responding to usual medications. Nurses working with the client must pay special attention to which priority aspects of this client's care? Assessment of:

Respiratory status and oxygen saturation

A client with a diagnosis of myasthenia gravis underwent a mastectomy. The surgery was a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which priority measure should the care team initiate immediately?

Respiratory support and protection of the client's airway

A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?

T4 and TSH