NRSG 502 Patho Exam 3 (Ch 27, 22, 23, 24, 40, 41)

The nurse evaluating a client's bloodwork determines that a client has an increased risk for infection based on which of the following lab results? Absoulute neutrophil count of 800/uL Absoulute neutrophil count of 1000/uL Absolute neutrophil count of 1100/uL Absolute neutrophil count of 1200/uL

Absoulute neutrophil count of 800/uL

The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes? Acromegaly Hyperthyroidism Myxedema Cushing syndrome

Acromegaly Enlargement of the small bones of the hands and feet and of the membranous bones of the face and skull results in a pronounced enlargement of the hands and feet, a broad and bulbous nose, a protruding jaw, and a slanting forehead. Bone overgrowth often leads to arthralgias and degenerative arthritis of the spine, hips, and knees. Virtually every organ of the body is increased in size. Enlargement of the heart and accelerated atherosclerosis may lead to an early death. Hyperthyroidism results from excess thyroid hormone. Myxedema and Cushing syndrome are the result of adrenal abnormalities and do not cause these bone changes.

A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first? Start a normal saline infusion. Administer epinephrine (adrenaline). Complete a 12-lead ECG. Administer diphenhydramine.

Administer epinephrine (adrenaline). Treatment includes immediate discontinuation of the inciting agent or institution of measures to decrease its absorption; close monitoring of cardiovascular and respiratory function; maintenance of respiratory gas exchange, cardiac output, and tissue perfusion. Epinephrine is given in an anaphylactic reaction because it constricts blood vessels and relaxes the smooth muscle in the bronchioles, thus restoring cardiac and respiratory function.

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 90-year-old woman with a history of atrial fibrillation whose dysrhythmia has recently become more severe An 88-year-old man with a history of Alzheimer disease who has become increasingly agitated and is wandering around the facility more frequently A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis

An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold Loss of appetite and cold intolerance are characteristic symptoms of hypothyroidism. Dysrhythmias, agitation, and infections are not typically associated with hypofunction of the thyroid gland.

Which individual displays the precursors to acromegaly? An adult with an excess of growth hormone due to an adenoma A girl who has been diagnosed with precocious puberty An adult who has a diagnosis of Cushing syndrome A client who has recently developed primary adrenal carcinoma

An adult with an excess of growth hormone due to an adenoma When growth hormone (GH) excess occurs in adulthood or after the epiphyses of the long bones have fused, it causes a condition called acromegaly, which represents an exaggerated growth of the ends of the extremities.

When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:

Anterior pituitary gland Explanation: The pituitary gland has been called the master gland because its hormones control the functions of many target glands and cells. The anterior pituitary gland or adenohypophysis contains five cell types: (1) thyrotrophs, which produce thyrotropin, also called TSH; (2) corticotrophs, which produce corticotropin, also called ACTH; (3) gonadotrophs, which produce the gonadotropins, LH, and FSH; (4) somatotrophs, which produce GH; and (5) lactotrophs, which produce prolactin.

A child's history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child? Cardiac catheterization and corticosteroid therapy Implanted pacemaker and beta-adrenergic blockers (beta-blockers) Antibiotics and anti-inflammatory drugs Pain control and oxygen therapy

Antibiotics and anti-inflammatory drugs A diagnosis of rheumatic fever (RF) necessitates the use of antibiotics (usually penicillin) and anti-inflammatory drugs. These measures supersede the importance of pain control and oxygen therapy. Cardiac catheterization, corticosteroid therapy, pacemakers, and beta-adrenergic blockers are not common treatment modalities for RF.

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Antidiuretic hormone (ADH) and oxytocin Explanation: The posterior pituitary secretes ADH and oxytocin/vasopressin, while the anterior pituitary secretes the hormones listed in the other choices.

The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?

Autocrine Explanation: Hormones can exert autocrine action on the cells from which they were produced. Retinoids are compounds with hormone-like actions. Juxtacrine action involves a chemical messenger imbedded in a plasma membrane that interacts with a specific receptor on a juxtaposed cell. Arachidonic acid is a precursor for eicosanoid compounds (similar to retinoids).

When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism? Genetic predisposition Overuse of steroids, making pancreatic cells resistant to glucose Idiopathic, abnormally large pancreatic cells Autoimmune destruction of pancreatic beta cells

Autoimmune destruction of pancreatic beta cells Type 1 diabetes involves autoimmune destruction of beta cells. The pathophysiology of type 2 diabetes has both genetic and acquired factors.

What is the most common cause of hypothyroidism? Goiter Myxedema Thyroidectomy Autoimmune thyroiditis

Autoimmune thyroiditis The most common cause of hypothyroidism is Hashimoto thyroiditis, an autoimmune disorder in which the thyroid gland may be totally destroyed by an immunologic process. It is the major cause of goiter and hypothyroidism in children and adults. Myxedema is associated with severe hypothyroidism and is characterized by a non-pitting mucus-type edema caused by the accumulation of hydrophobic extracellular matrix substances in the connective tissues of a number of body tissues. Although the myxedema is most obvious in the face and other superficial parts, it also affects many of the body organs and is responsible for many of the manifestations of the hypothyroid state. Thyroidectomy, a rather uncommon surgical procedure, causes primary hypothyroidism. Goiter, an increase in the size of the thyroid gland, is a result (rather than a cause) of hypothyroid, euthyroid, or hyperthyroid states.

Following a bone marrow biopsy, which of the following assessments would indicate the patient is experiencing a complication as a result of this diagnostic procedure? BP 90/60, heart rate 132, excess bleeding and hematoma noted at insertion site. BP 130/80, oxygen saturation 95%, crackles heard on inspiration. Respiratory rate 24, complaining of pain at insertion site. Heart rate regular 64 bpm, Temperature 99.6 orally.

BP 90/60, heart rate 132, excess bleeding and hematoma noted at insertion site

Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences? Backup of blood from the right atrium into the superior vena cava Backflow from the right ventricle to the right atrium during systole Inhibition of the SA node's normal action potential Backflow from the left ventricle to left atrium

Backflow from the left ventricle to left atrium The mitral valve separates the left ventricle from the left atrium; failure of this valve would cause backflow from the former to the latter during systole. Valve function does not directly affect cardiac contractility.

A client with a new diagnosis of diabetes mellitus receives education about the diabetic diet plan. Which menu selection indicates the client understood the instruction? Cheeseburger, french fries, milk shake Green salad without dressing, an apple, and tea Baked chicken breast, cole slaw, and milk Oatmeal, bagel with jam, orange juice

Baked chicken breast, cole slaw, and milk Diet is a cornerstone of diabetes control. Meals and snacks should be eaten at regular intervals. Initial recommendations are for carbohydrates to make up between 45 percent and 60 percent, fats to be between 20 and 35 percent, and for protein to comprise about 10 to 20 percent of each meal. The cheeseburger meal contains too large an amount of fat. The salad and oatmeal menus are too high in carbohydrates without sufficient fat and protein.

A client is admitted to the intensive care unit suspected of having infective endocarditis. Which test is the most definitive diagnostic procedure that is done and used to guide treatment for this type of client? ECG Blood culture Echocardiogram CBC

Blood culture The blood culture remains the most definitive diagnostic procedure and is essential to guide treatment. An echo, ECG, clinical findings, and lab information are also used to help in the diagnosis.

The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. The nurse teaches the student that epinephrine will cause which effect on blood glucose levels? Blood glucose will elevate. Hypoglycemia will occur. An unusable form of glucose will be released. Gluconeogenesis will be suppressed.

Blood glucose will elevate. Epinephrine, a catecholamine, helps to maintain blood glucose levels during periods of stress. Epinephrine accelerates glycogenolysis and gluconeogenesis leading to increased endogenous blood glucose production, elevating blood glucose levels. Epinephrine also suppresses insulin release but does not alter the form of glucose to an unusable form. Epinephrine release reduces the risk for hypoglycemia.

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?

"A single hormone can act on not only one process or organ but often on several different locations or processes." Explanation: A single hormone can exert various effects in different tissues, or conversely, a single function can be regulated by several different hormones. Hormones act both distantly from their source and more locally, as in the case of autocrine and paracrine actions. Hormones are normally present at all times.

A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be: "Aspirin will help prevent blood clotting." "Aspirin prevents blood clotting by halting platelet production." "It will give you a steady relief of your chest pain." "Aspirin will prevent a heart attack."

"Aspirin will help prevent blood clotting." Aspirin (i.e., acetylsalicylic acid) is the preferred antiplatelet agent for preventing platelet aggregation in persons with ACS. Aspirin, which acts by inhibiting synthesis of the prostaglandin thromboxane A2, is thought to promote reperfusion and reduce the likelihood of re-thrombosis. This dose of aspirin is not appropriate for pain relief, and the final option does not demonstrate therapeutic communication.

A nurse educator is defining heart failure to a group of recent graduates who will begin providing care on a cardiac unit. The educator should describe which phenomenon? "Heart failure is a complex syndrome resulting from a lack of oxygen to the heart that results in or increases the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion." "Heart failure is a complex syndrome resulting from any disorder of the heart that results in or increases the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion." "Heart failure is a complex syndrome resulting in a structural disorder of the heart that ultimately results in pulmonary or systemic congestion." "Heart failure is a complex syndrome resulting from any functional or structural disorder of the heart that results in or increases the risk of infarction."

"Heart failure is a complex syndrome resulting from any disorder of the heart that results in or increases the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion." Heart failure is a complex syndrome resulting from any functional or structural disorder of the heart that results in or increases the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion. Disorders of oxygen delivery (ischemia, hypoxia) can cause MIs that will lead to HF but do not cause HF directly. Structural abnormalities will impede function but not cause failure.

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. Which statements by the client indicate a need for additional education? Select all that apply. "I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." "I can drink 8 to 10 glasses of water daily without concern for calories." "I need to limit the amount of foods that I eat that contain trans fats." "I need to avoid adding salt to my foods." "I need to carefully limit my protein consumption."

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." "I need to carefully limit my protein consumption." The client needs more education regarding all carbohydrate sources. Protein consumption should remain normal for optimal nutrition. All the other statements are correctly stated and demonstrate good understanding of dietary needs for type 2 diabetes.

A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which statement demonstrates an accurate understanding of his new diagnosis? "I'll be sure to take my beta-blocker whenever I feel short of breath." "I'm going to avoid as much physical activity as I can so that I preserve my strength." "I know it's healthy to drink a lot of water, and I'm going to make sure I do this from now on." "I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

"I'm trying to think of ways that I can cut down the amount of salt that I usually eat." Salt and fluid restrictions are indicated for most clients with heart failure (HF). Beta-blockers do not address shortness of breath, and cardiac medications are not normally taken in response to acute symptoms. Clients should be encouraged to maintain—and increase, if possible—physical activity within the limits of their condition.

A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which explanation is most appropriate to share? "You must be drinking way too many liquids. Your kidneys cannot filter all that you are drinking during the day." "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water." "Your heart muscle is overstretched, so it's not able to pump all the blood out. The prescribed 'water pills' help by decreasing your weight." "Since your heart function is impaired, the lungs are not able to oxygenate the blood and your kidneys are wearing out."

"Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water." In heart failure with a reduced ejection fraction, a decrease in cardiac output and renal blood flow leads to increased sodium and water retention by the kidney with a resultant increase in vascular volume and venous return to the heart and an increase in ventricular end-diastolic volume. Drinking water may increase volume but is not the physiologic reason for retention of fluid. Diuretics do decrease weight as a result of diuresis, but weight loss is not the purpose for giving diuretics. The lungs are not the primary cause of heart failure.

A client awaiting a heart transplant is experiencing decompensation of her left ventricle that will not respond to medications. The physicians suggest placing the client on a ventricular assist device (VAD). The client asks what this equipment will do. The health care providers respond: "Pull your blood from the right side of the heart and run it through a machine to oxygenate it better, and then return it to your body." "Measure the pressures inside your heart continuously to asses pumping ability of your left ventricle." "Have a probe at the end of a catheter to obtain thermodilution measures, so cardiac output can be calculated." "This device will decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure."

"This device will decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure." Refractory heart failure reflects deterioration in cardiac function that is unresponsive to medical or surgical interventions. Ventricular assist devices (VADs) are mechanical pumps used to support ventricular function. VADs are used to decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure. This decreases the workload on the ventricle and allows it to rest and recover. The rest of the distractors relate to the monitoring in an ICU of cardiac functioning. Invasive hemodynamic monitoring may be used for assessment in acute, life-threatening episodes of heart failure. With the balloon inflated, the catheter monitors pulmonary capillary pressures (i.e., pulmonary capillary wedge pressure or pulmonary artery occlusion pressure), which reflect pressures from the left ventricle. The pulmonary capillary pressures provide a means of assessing the pumping ability of the left ventricle. One type of pulmonary artery catheter is equipped with a thermistor probe to obtain thermodilution measurements of cardiac output.

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? "If you exercise weekly, you won't need injections." "You could regulate your diet, exercise regularly, and lose weight." "Diabetes management is complicated; you can't avoid injections." "A support group could help you cope with stress and learn helpful tips."

"You could regulate your diet, exercise regularly, and lose weight." Diabetes management is based on dietary regulation, exercise, and medications. Many clients with type 2 diabetes mellitus can avoid injections if they exercise regularly, follow dietary guidelines, and manage their weight.

The nurse is caring for of a 6-month-old infant diagnosed with iron deficiency anemia. The nurse determines further teaching is necessary when the mother states: -"I know this anemic condition can be resolved with good nutrition." - "I must stop breast-feeding my baby because of the anemia." -"I need to feed my baby cereals with fortified iron." -"I need to decrease my baby's intake of whole milk to provide the best nutrition."

- "I must stop breast-feeding my baby because of the anemia."

A client is newly diagnosed with impaired platelet function, thrombocytopathia. Which of the following questions is most appropriate for the nurse to ask in order to determine the possible cause of this problem? -"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?" -"Have you recently vacationed out of the country?" -"Have you recently been exposed to any organic pesticides?" -"Do you have a family history of hemophilia?"

-"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"

A woman who has given birth 12 hours ago is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client's husband is confused as to why a disease of excessive coagulation can result in bleeding. Which of the nurse's explanations best characterizes DIC? -"So much clotting takes place that there are no available clotting components left and bleeding ensues." -"Massive clotting causes irritation, friction, and bleeding in the small blood vessels." -"Excessive activation of clotting causes an overload of vital organs, resulting in bleeding." -"These same hormones and bacteria that cause clotting also cause bleeding."

-"So much clotting takes place that there are no available clotting components left and bleeding ensues."

The process of clot retraction squeezes serum from the clot, thereby joining the edges of the broken vessel. Through the action of actin and myosin, filaments in platelets contribute to clot retraction. Failure of clot retraction is indicative of what? -Absence of factor Xa -A low platelet count -An overabundance of factor Xa -A high platelet count

-A low platelet count

The client comes to the emergency department with sudden onset of dizziness. The client's hemoglobin and hematocrit suddenly dropped due to an aplastic crisis. Which treatment should the nurse prepare to administer for this crisis? -Administration of a blood transfusion -Emergent pancreas removal -IV antibiotics -Stem cell transplantation

-Administration of a blood transfusion

The nurse reviews the lab results of a client who has a thrombocyte count of 60 ×103/µL (60 ×109/L). The client is at risk for: -Bleeding -Deep vein thrombosis -Hypercoagulation -Disseminated intravascular coagulation

-Bleeding

An elderly client asks the nurse why so many older people develop anemia. The best response would be: -Chronic disease -Stress -Increased erythropoiesis -Cor pulmonale

-Chronic disease

The practitioner notes the client with hemolytic anemia has Raynaud phenomenon. Which of the following causes this type of anemia? -Cold-reacting antibodies -Warm-reacting antibodies -Deficiency of glucose-6-phosphate dehydrogenase (G6PD) -Prosthetic heart valve

-Cold-reacting antibodies

A nurse is caring for a client diagnosed with immune thrombocytopenic purpura (ITP). Which of the following medications does the nurse anticipate administering to treat this disorder? -Corticosteroids -Heparin -Vitamin K -Aspirin

-Corticosteroids

A nurse working in an ambulatory care unit is working with a patient who has recently been diagnosed with a V Leiden mutation. The nurse tells the patient the importance of smoking cessation to avoid which of the following? -Essential hypertension -Coronary artery disease -Deep-vein thrombosis (DVT) -Pulmonary hypertension

-Deep-vein thrombosis (DVT)

The nurse is admitting a 90-year-old client with a history of heart failure, coronary artery disease, prostate cancer, diabetes, and hypercholesteremia. Which conditions in this clients history place the person at high risk for thromboembolic complications? Select all that apply. -Diabetes -Coronary artery disease -Hypercholesteremia -Prostate cancer -Congestive heart failure

-Diabetes -Coronary artery disease -Hypercholesteremia

The practitioner notes the client has a yellowish discoloration of the skin. Which lab result would the practitioner expect to see? -Elevated red blood cells -Elevated congugated bilirubin -Decreased platelets -Elevated unconjugated bilirubin

-Elevated unconjugated bilirubin

A pregnant woman contacts her physician because she has developed sudden, severe pain and swelling in her left lower leg. The physician explains to her that her past medical includes an inherited defect in factor V Leiden, which predisposes her to the development of which of the following? -Abnormal bleeding -Excessive clotting -Thrombocytopenia -Platelet disorders

-Excessive clotting

A client has been diagnosed with inherited hypercoagulability. Select the most likely cause. -Factor V gene mutation -Prolonged immobility -Myocardial infarction -Hyperestrogenic state

-Factor V gene mutation

The provider notes that the client's hemaglobin is 8.2g/dL. Which of the following supplements will the provider recommend to the client? -Ferrous sulfate -Magnesium oxide -Potassium chloride -Calcium carbonate

-Ferrous sulfate

The nurse is caring for a postsurgical client who is recovering from knee replacement surgery secondary to rheumatoid arthritis. When planning the client's care, the nurse should include what action? -Passive range of motion exercises to the nonsurgical joints to prevent hemorrhage. -Frequent assessment for signs of thrombosis or hemorrhage. -Administration of vitamin K injections as ordered. -Administration of a platelet transfusion, if deemed necessary.

-Frequent assessment for signs of thrombosis or hemorrhage.

The nurse is planning care for a 70-year-old client who has lived with severe hemophilia since childhood. For what complications of hemophilia should the nurse prioritize assessing? Select all that apply. -Hepatitis -Arthritis -Cardiovascular disease -Hypertension -Thrombosis

-Hepatitis -Arthritis -Cardiovascular disease

A pediatric nurse is treating a 2-day-old infant for jaundice. The treatment involves exposing the infant's skin to fluorescent light at 420 nm to 470 nm wavelengths. What does the light do to the bilirubin? -It converts the bilirubin into a soluble form that is easily excreted in the stool and urine. -The light bleaches the bilirubin, causing it to naturally break down. -Fluorescent light activates the liver to increase its metabolism of bilirubin. -The light causes vasoconstriction and forces more of the bilirubin out of the liver for metabolism.

-It converts the bilirubin into a soluble form that is easily excreted in the stool and urine.

The practitioner is examining a client and notes that he has small, punctate skin hemorrhages on his abdomen and chest. This finding is suggestive of which of the following lab results? -Low platelets -Low red blood cells -Low white blood cells -Low neutrophils

-Low platelets

A 40-year-old patient has been admitted to the cardiac intensive care unit after having an anterior wall myocardial infarction (MI). The nurse is reviewing modifiable risk factors with the patient to avoid the redevelopment of thromboembolic complications, possibly leading to a second MI. Which of the following increases this risk? -Oral contraceptives -Caffeine intake -Hypoglycemic states -V Leiden mutation

-Oral contraceptives Modifiable risk factors for the development of thrombosis include oral contraceptive, prolonged bed rest, smoking, and obesity. Nonmodifiable risk factors include V Leiden mutation, myocardial infarction, coronary artery disease, and cancer.

Heparin is an anticoagulant given by injection to prevent the formation of blood clots. How does heparin work? -Binds to factor X -Promotes the inactivation of clotting factors -Binds to factor Xa -Promotes the inactivation of factor VIII

-Promotes the inactivation of clotting factors

The nurse is caring for a client diagnosed with sickle cell disease. Select the most important factor for the nurse to be aware of that may cause the cells to sickle. -Reduced oxygen tension while the client sleeps -Rapid administration of intravenous fluids -Presence of pain in the client's joints -Acute chest syndrome

-Reduced oxygen tension while the client sleeps

The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which of the following organs? -Spleen -Lungs -Heart -Pancreas

-Spleen

A nurse is treating a client with aplastic anemia. Due to the replacement of normal bone marrow with malignant cells, the nurse teaches the client to prevent scratches, scrapes, and cuts. What root cause likely underlies the client's increased risk for hemorrhage? -Neutrophilia -Disseminated intravascular coagulation (DIC) -Polycythemia -Thrombocytopenia

-Thrombocytopenia

The coagulation cascade is the third component of the hemostatic process. The other two are: (Select all that apply.) -Vessel spasm -Platelet aggregation -Hematopoiesis -Agglutination

-Vessel spasm -Platelet aggregation

A client with an apparent clotting disorder is admitted to hospital. His health record reveals that he has been treated for complications of chronic alcoholism for the past 10 years. The nurse should suspect what cause of his clotting disorder? -Von Willebrand disease -Hemophilia -Vitamin K deficiency -Immune thrombocytopenic purpura (ITP)

-Vitamin K deficiency

A 10-month-old infant has begun to take his first steps and his mother has brought him for assessment because of swelling in his ankles and knees. The mother also states that he was eager to walk but has now regressed and cries when she tries to encourage it. The clinician should: -assess the child for signs and symptoms of hemophilia A. -prescribe a trial of desmopressin acetate (DDAVP) to rule out von Willebrand disease. -order testing to rule out disseminated intravascular coagulation (DIC). -administer vitamin K STAT.

-assess the child for signs and symptoms of hemophilia A.

A client who came to the emergency room and was diagnosed with ST-segment elevation myocardial infarction (STEMI) experienced "sudden death." The emergency room nurse explains sudden death from a STEMI as death that occurs within what time frame of symptom onset? 15 minutes 30 minutes 1 hour 2 hours

1 hour Sudden death from STEMI is death that occurs within one hour of symptom onset.

A male client is being evaluated for metabolic syndrome. Which are diagnostic criteria for this syndrome? Select all that apply. Client's body mass index (BMI) is 31. Client's high-density lipoprotein (HDL) cholesterol is 25. Client's resting heart rate is 90 to 95 beats per minute. Client's blood pressure (BP) is 150/90 mm Hg. Client does less than 30 minutes of strenuous physical activity each week.

Client's body mass index (BMI) is 31. Client's high-density lipoprotein (HDL) cholesterol is 25. Client's blood pressure (BP) is 150/90 mm Hg. Diagnostic criteria for metabolic syndrome include BP of greater than 130/85 mm Hg, low HDL, and obesity (BMI greater than 30 constitutes obesity). Sedentary lifestyle and high resting heart rate are associated with other health problems, including diabetes, but these are not diagnostic criteria for metabolic syndrome.

Which of the following describes surgical correction of tetralogy of Fallot? Closure of the ventricular-septal defect and relief of the right ventricular outflow obstruction An arterial switch procedure Redirection of systemic venous return to the pulmonary arteries Resection of the narrowed segment of the aorta and end-to-end anastomoses of healthy tissue

Closure of the ventricular-septal defect and relief of the right ventricular outflow obstruction The surgical treatment of tetralogy of Fallot would include the repair of the ventricular-septal defect and relief of the ventricular outflow obstruction. An arterial switch procedure is the treatment for transposition of the great arteries. Resection of the narrowed segment of the aorta is the treatment for coarctation of the aorta.

The nurse is planning a prevention program for infectious mononucleosis. The best target audience for the program is which of the following? College students living in a dorm Parents of preschool children Older adults living in a senior apartment building Employees of a large factory

College students living in a dorm

What should the nurse teach the pregnant woman about congenital heart defects? Congenial heart defects occur prior to conception as a result of exposure to toxins. Congenital heart defects cannot be prevented. Congenital heart defects occur between the 3rd and 8th weeks of development before you know you are pregnant. Congenital heart defects occur during conception.

Congenital heart defects occur between the 3rd and 8th weeks of development before you know you are pregnant. Congenital heart defects occur during the 3rd week as the heart is the first functional organ system to develop. This may be before a woman realizes she is pregnant. Congenital heart defects can, to some degree, be prevented. They do not occur prior to conception or during conception, but during the growth of the fetus.

The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium? Acute pericarditis Constrictive pericarditis Pleural effusion Mediastinal radiation

Constrictive pericarditis In constrictive pericarditis, fibrous, calcified scar tissue develops between the visceral and parietal layers of the serous pericardium. Acute pericarditis is due to inflammation of the pericardium. Pericardial effusion is caused by accumulation of fluid and can lead to cardiac tamponade.

When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI? Conversion from aerobic to anaerobic metabolism Overproduction of energy capable of sustaining normal myocardial function Conversion from anaerobic to aerobic metabolism Inadequate production of glycogen with mitochondrial shrinkage

Conversion from aerobic to anaerobic metabolism The principal biochemical consequence of MI is the conversion from aerobic to anaerobic metabolism with inadequate production of energy to sustain normal myocardial function. As a result, a striking loss of contractile function occurs within 60 seconds of onset.

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 10-year-old male whose grandmother has type 2 diabetes A 40-year-old male who has liver disease due to hepatitis A 60-year-old female with a history of gestational diabetes

A 45-year-old obese female with a sedentary lifestyle The person most at risk for developing type 2 diabetes is the 45-year-old obese female with a sedentary lifestyle. Other risk factors include family history, over age 40, and history of gestational diabetes. The 60-year-old would have developed it before age 60, if there were additional risk factors. Diabetes and metabolic syndrome are due to pancreatic problems, not liver problems.

The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty? A 9-year-old white female who has small breast buds A 5-year-old black female with developing breasts and pubic hair A 14-year old white female who has not yet developed secondary sex characteristics A 10-year-old black female who has begun menstruating

A 5-year-old black female with developing breasts and pubic hair Precocious puberty is now defined as the appearance of secondary sexual development before the age of 7 years in white girls and 6 years in black girls. In boys of both races, the lower age limit remains 9 years. However, it is recognized that puberty can develop earlier in boys with obesity.

Which pediatric assessment finding would the nurse recognize as an example of precocious puberty? A 7-year-old female with early menarche A 12-year-old male with advanced growth A 13-year-old female with menarche and a recent growth spurt A 16-year-old male with genital enlargement and pubic hair growth

A 7-year-old female with early menarche The 7-year-old needs to be evaluated. Precocious puberty is defined as the appearance of secondary sexual development before the age of 8 years in girls. There is a shift toward a "new normal" of earlier ages of puberty, with black girls entering puberty earlier than white girls and children who are obese entering puberty at earlier ages than children of normal body weight for age. In boys of both races, the lower age limit remains 9 years; however, it is recognized that puberty can develop earlier in boys with obesity. The assessment findings of the 12-, 13-, and 16-year-olds are not of concern because they are normal findings.

A client with a new diagnosis of heart failure has received a new prescription. Which medication category is likely to improve the client's cardiac function by increasing the force and strength of ventricular contractions? A beta-adrenergic blocker (beta-blocker) A diuretic A cardiac glycoside An ACE inhibitor

A cardiac glycoside Cardiac glycosides improve cardiac function by increasing the force and strength of ventricular contractions. Beta-adrenergic blockers decrease left ventricular dysfunction associated with activation of the sympathetic nervous system. ACE inhibitors block the conversion of angiotensin I to II, whereas diuretics promote the excretion of fluid.

Tetralogy of Fallot is a congenital condition of the heart that manifests in four distinct anomalies of the infant heart. It is considered a cyanotic heart defect because of the right-to-left shunting of the blood through the ventricular septal defect. A hallmark of this condition is the "tet spells" that occur in these children. What is a tet spell? A stressful period right after birth that occurs without evidence of cyanosis A hyperoxygenated period when the infant is at rest A hypercyanotic attack brought on by periods of stress A hyperpneic attack in which the infant loses consciousness

A hypercyanotic attack brought on by periods of stress The degree of obstruction may be dynamic and can increase during periods of stress causing hypercyanotic attacks ("tet spells"). None of the other answers occur in association with tetralogy of Fallot or tet spells.

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

ACTH One of the earliest signs of Cushing syndrome, a disorder of cortisol excess, is the loss of diurnal variation in CRH and adrenocorticotropin hormone (ACTH) secretion, with corticotropin-releasing hormone (CRH) controlling the release of ACTH. The adrenal sex hormone dehydroepiandrosterone (DHEA) contributes to the pubertal growth of body hair, particularly pubic and axillary hair in women. Thyroid-stimulating hormone (TSH) levels are used to differentiate between primary and secondary thyroid disorders. Although secretion of growth hormone (GH) has diurnal variations over a 24-hour period, with nocturnal sleep bursts occurring 1 to 4 hours after onset of sleep, it is unrelated to ACTH and/or CRH secretion.

What are the physiologic clinical manifestations of cardiogenic shock? Select all that apply. Decrease in mean arterial blood pressures Increased urine output related to increased renal perfusion Rise in central venous pressure (CVP) Hypercapnic lips and nail beds Increased extraction of O2 from hemoglobin

Decrease in mean arterial blood pressures Rise in central venous pressure (CVP) Increased extraction of O2 from hemoglobin Signs and symptoms of cardiogenic shock include indications of hypoperfusion with hypotension, although a preshock state of hypoperfusion may occur with a normal blood pressure. The lips, nail beds, and skin may become cyanotic because of stagnation of blood flow and increased extraction of oxygen from the hemoglobin as it passes through the capillary bed. Mean arterial and systolic blood pressures decrease due to poor stroke volume, and there is a narrow pulse pressure and near-normal diastolic blood pressure due to arterial vasoconstriction. Urine output decreases due to lower renal perfusion pressures and the increased release of aldosterone. Elevation of preload is reflected in a rise in CVP and pulmonary capillary wedge pressure. Neurologic changes, such as alterations in cognition or consciousness, may occur due to low cardiac output and poor cerebral perfusion. The other physiologic occurrences are not signs or symptoms of shock.

In heart failure, what causes the increase in renal secretion of renin? Increased metabolic demand Decreased cardiac output Increased renal perfusion Hypertension

Decreased cardiac output Low cardiac output results in decreased renal perfusion, which activates the renin-angiotensin-aldosterone system (RAAS). The resultant vasoconstriction due to angiotensin II and the retention of sodium and water due to aldosterone attempt to support cardiac output. Hypertension and increased metabolic needs do not activate the RAAS.

The nurse is caring for a client who has a low levels of T lymphocytes. The nurse plans care for a client with which of the following? Decreased immune response Decreased hematocrit Anemia Infection

Decreased immune response

A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH) Explanation: Negative feedback occurs when secretion of one hormone causes a reduction in the secretion of the hormone that stimulates production of the first hormone. In this case, TSH, which is manufactured by the anterior pituitary gland, would normally stimulate release of thyroid hormones, but with the increase of those hormones by the secreting tumor, enough thyroid hormones flood the system that there should be a reduction in TSH levels.

A patient diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be: Dexamethosone, a corticosteroid. Cisplatin, a chemotherapeutic. Vincristine, a Vinca alkaloid. Doxorubicin, a cytotoxic antibiotic.

Dexamethosone, a corticosteroid

The vesicle-mediated pathway has a role in synthesis and release of which hormones? Select all that apply.

Dopamine Follicle-stimulating hormone Antidiuretic hormone Explanation: The protein hormones and some of the nonpolypeptide hormones, such as dopamine, epinephrine, and norepinephrine, use the vesicle-mediated pathway. Steroids use the non-vesicle-mediated pathway.

Which type of imaging is preferred to evaluate the bone density of a client with hyperparathyroidism?

Dual energy x-ray absorptiometry (DXA) scan Explanation: Preferred types of scans for endocrine tissues include MRI of the pituitary gland and hypothalamus, CT scan of the adrenal glands, DXA scan of bone density, and ultrasound of possible nodules of the thyroid gland. Bone density may be decreased in a client with hyperparathyroidism.

A 16-year-old male client who has been diagnosed with infectious mononucleosis asks the health care provider what caused the condition. The best response would be: Epstein-Barr virus (EBV) Human immunodeficiency virus (HIV) Abnormal cell nucleus development Non-Hodgkin lymphoma

Epstein-Barr virus (EBV)

Which of the following colony-stimulating factors (CSFs) is given to ESRD patients to help with their chronic anemia? Erythropoietin (EPO). Thrombopoietin (TPO). Neupogen. Interleukin.

Erythropoietin (EPO).

Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by: Fixed coronary obstruction Increased collateral circulation Intermittent vessel vasospasms Excessive endothelial relaxing factors

Fixed coronary obstruction Chronic stable angina is caused by fixed coronary obstruction that produces an imbalance between coronary blood flow and the metabolic demands of the myocardium. Endothelial relaxing factors relax the smooth muscle in the vessel wall and allow increased blood flow; treatment for chronic stable angina is with a vasodilating agent, such as nitroglycerine, that relaxes the vessels and enhances coronary blood flow. Intermittent vessel vasospasms, in conjunction with coronary artery stenosis, cause the vasospastic type of angina. Increased formation of collateral vessels is a compensatory response that allows adequate blood circulation to tissues distal to an obstruction.

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas. Explanation: The levels of hormones such as insulin and antidiuretic hormone (ADH) are regulated by feedback mechanisms that monitor substances such as glucose (insulin) and water (ADH) in the body. None of the other examples are accurate examples of this feedback mechanism.

The nurse's plan of care for a client with multiple myeloma should include interventions to prevent which of the following? Fractures Urinary tract infections GI bleed Diarhhea

Fractures

Which hormone is produced by the anterior pituitary gland?

Growth hormone (GH) Explanation: GH is among the hormones produced and released by the anterior pituitary. Oxytocin is a posterior pituitary hormone, whereas CRH is produced by the hypothalamus. Norepinephrine and epinephrine are produced by the adrenal medulla.

What is the most important factor in myocardial oxygen demand? Heart rate Respiratory rate Degree of anxiety Hyperthermia

Heart rate The heart rate is the most important factor in myocardial oxygen demand since, as heart rate increases, myocardial oxygen demands increase. The degree of effect the other options have on myocardial oxygen demand is related to how much effect they have on heart rate.

Anaphylactic shock causes severe hypoxia very quickly because of which reason? Generalized vasoconstriction reduces venous return. Metabolic rate is greatly increased. Histamine release causes massive vasodilation. Heart rate and contractility are reduced.

Histamine release causes massive vasodilation. Anaphylactic shock, a severe allergic reaction, rapidly causes severe hypoxia as histamine release results in massive vasodilation. The volume of blood is no longer able to fill the greatly dilated vascular compartment. The other answers are not part of anaphylaxis.

A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a patient suspected of having a lymphoma. The nurse interprets the report as indicating which of the following? Hodgkin's lymphoma Non-Hodgkin's lymphoma Multiple myeloma Leukemia

Hodgkin's lymphoma

Which physiologic process allows hormones to exert influence upon some cells and not others?

Hormone receptors Explanation: Hormone receptors are complex molecular structures (usually proteins) that are located either on the cell surface or inside target cells. The structure of these receptors is specific to a particular hormone, which allows target cells to respond to one hormone and not to others. For example, receptors in the thyroid are specific for thyroid-stimulating hormone, and receptors on the gonads respond to the gonadotropic hormones. Positive feedback control occurs when rising levels of a hormone cause another gland to release a hormone that is stimulating to the first. Protein binding describes the ability of proteins to form bonds with other substances. Pituitary-hypothalamic feedback describes negative feedback.

When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?

Hormone stimulation Explanation: Stimulating hormone can be given to identify (determine hypofunction) if the target gland is able to increase hormone response to increased stimulation. Agglutination with enzymes is a way of measuring hormone antigen levels. The 24-hour urine sample measures hormone metabolite excretion. Radioactive hormone-antibody binding levels provide a method of measuring plasma levels.

A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure? Hypertrophic cardiomyopathy Dilated cardiomyopathy Mitral valve prolapse Atrial regurgitation

Hypertrophic cardiomyopathy HCM is an autosomal dominant heart disease caused by mutations in the genes encoding proteins of the cardiac sarcomere. HCM is the most common cause of sudden cardiac death (SCD) in young athletes. Dilated cardiomyopathy, mitral valve prolapse, and atrial regurgitation all lead to heart failure but much later in life.

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which disorder was the player's most likely cause of death? Takotsubo cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) Hypertrophic cardiomyopathy (HCM) Dilated cardiomyopathy (DCM)

Hypertrophic cardiomyopathy (HCM) The most frequent symptoms of HCM are dyspnea and chest pain in the absence of coronary artery disease. Syncope (fainting) is also common and is typically postexertional, when diastolic filling diminishes and outflow obstruction increases. Ventricular dysrhythmias are also common, and sudden death may occur, often in athletes after extensive exertion. Risk factors for sudden cardiac death among clients with HCM include a family history of syncope or sudden cardiac death, certain mutations, and extreme hypertrophy of the left ventricle. HCM is characterized by a massively hypertrophied left ventricle with a reduced chamber size.

Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?

Hypothalamus Explanation: The activity of the hypothalamus is regulated by both hormonally mediated signals (e.g., negative feedback signals) and by neuronal input from a number of sources. Neuronal signals are mediated by neurotransmitters such as acetylcholine, dopamine, norepinephrine, serotonin, gamm-aminobutyric acid (GABA), and opioids. Cytokines that are involved in immune and inflammatory responses, such as the interleukins, also are involved in the regulation of hypothalamic function. This is particularly true of the hormones involved in the hypothalamic-pituitary-adrenal axis. Thus, the hypothalamus can be viewed as a bridge by which signals from multiple systems are relayed to the pituitary gland. This cannot be said of the other options.

A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?

Hypothalamus Explanation: The hypothalamus is the coordinating center of the brain for endocrine, behavioral, and autonomic nervous system function. It is at the level of the hypothalamus that emotion, pain, body temperature, and other neural input are communicated to the endocrine system. The anterior pituitary regulates several physiologic processes, including stress, growth, reproduction, and lactation. The cerebellum is involved in motor control, and the cerebral cortex is associated with sensory, motor, and association.

An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?

Hypothyroidism Explanation: Thyroid hormone is necessary for metabolism at all ages, as well as growth and development during childhood. Uncorrected thyroid insufficiency in childhood leads to cretinism, a condition with marked physical and intellectual disability. Myxedema is the term used for thyroid insufficiency in adults.

Which of the following is the main job of lymphocytes? Degranulation Phagocytosis Immune reaction Apoptosis

Immune reaction

A client has just been told that he has an infection of the inner surface of the heart. He is also told that the bacteria has invaded his heart valves. What term is used for this disease process? Pericarditis Myocardial infarction Infective endocarditis Cardiomyopathy

Infective endocarditis Infective endocarditis is a serious and potentially life-threatening infection of the inner surface of the heart. Pericarditis involves an inflammatory response of the pericardium. Myocardial infarction is a heart attack while cardiomyopathy is a heart disorder that is confined to the myocardium and can sometimes represent myocardial changes that occur with a variety of systemic disorders.

A client diagnosed with septic shock who is experiencing tissue hypoxia likely will activate which pathophysiologic process? Inflammatory mediators Anaphylactic response Preexisting coagulation disorder Aerobic metabolism

Inflammatory mediators In sepsis and septic shock, tissue hypoxia produces continued production and activation of inflammatory mediators, resulting in further increases in vascular permeability, impaired vascular regulation, and altered hemostasis. Anaerobic metabolism is caused by tissue hypoxia, not aerobic. The other options do not facilitate the process.

A 22-year-old man is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. Which immediate treatments are likely to most benefit the man? Resolution of compensatory pulmonary edema and heart dysrhythmias. Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility. Infusion of normal saline or Ringer's lactate to maintain the vascular space. Administration of oxygen and epinephrine to promote perfusion.

Infusion of normal saline or Ringer's lactate to maintain the vascular space. Maintenance of vascular volume is the primary goal in the treatment of hypovolemic shock and can be achieved in the short term through intravenous administration of saline solution or Ringer's lactate. Resolution of pulmonary edema and heart dysrhythmias and infusion of vasodilators are associated with treatment of cardiogenic shock, while oxygen and epinephrine would address anaphylactic shock.

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 Rotate insulin injection sites once a week Wear comfortable, open-toed shoes Decrease daily walking activity

Inspect the feet for blisters daily A client with neuropathy is at risk for damage to his or her feet, such as blisters or ulcers, as the clients are unable to feel this damage. Clients need to inspect their feet daily, wear foot coverings (such as closed-toe shoes) to prevent injuries, and continue the exercise patterns to promote improved circulation.

Which type of macrophages are found in the liver? Histiocytes Kupffer cells Microglial cells Monocytes

Kupffer cells

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student aks, "What cells do paracrine actions affect?" Which response is correct?

Local Explanation: Paracrine actions are hormonal interactions with local cells other than those that produce the hormone; autocrine actions are with self-cells (cells from which they were produced). Both autocrine and paracrine hormonal actions affect target cells. Neither paracrine nor autocrine actions affect cell storage.

Increased secretion of renin in heart failure is caused by which event? Hypertension Increased renal blood flow Low cardiac output Dysrhythmias

Low cardiac output Low cardiac output reduces renal blood flow, which activates the renin-angiotensin-aldosterone system (RAAS). This system produces the vasoconstrictor angiotensin-ll and aldosterone, which increases sodium and water retention. Both of these actions attempt to increase renal perfusion. Hypertension and dysrhythmias do not activate RAAS.

Which of the following is the most common leukocyte in normal blood? Platelet Neurophilic granulocyte Lymphocyte Monocyte

Lymphocyte

Which factor contributes to an infant developing macrosomia (large body size)? Maternal diabetes Maternal nutrition Fetal gene disorder Fetal chromosome disorder

Maternal diabetes A mother with diabetes during pregnancy is more likely to have a larger fetus, especially if the diabetes is uncontrolled. The other factors may cause the infant to be small for gestational age (SGA).

A client is admitted for observation due to abnormal heart sounds, pulmonary congestion, nocturnal paroxysmal dyspnea, and orthopnea. Upon auscultation a low-pitched, rumbling murmur, best heard at the apex of the heart, is also heard. Which condition does the client likely have? Aortic valve prolapse Mitral valve prolapse Mitral valve stenosis Aortic valve stenosis

Mitral valve stenosis Mitral valve stenosis represents the incomplete opening of the mitral valve during diastole, with left atrial distention and impaired filling of the left ventricle with associated symptoms. Mitral prolapse and aortic valve disorders will lead to the development of cardiomyopathies.

Which treatment regimen is most likely to result in stable blood glucose levels for a client with a diagnosis of type 1 diabetes? Perform a daily moderate exercise routine prior to insulin administration Wait until after eating the first meal of the day before checking blood glucose and then calculate insulin dose Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed Initially try to control blood glucose levels with diet and exercise routines along with weight reduction

Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed Because of the loss of insulin response, all people with immune-mediated type 1 diabetes require exogenous insulin replacement to reverse the catabolic state, control blood glucose levels, and prevent ketosis.

The nurse working in the emergency room triages a client who comes in reporting chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myocardial infarction. The client is given a nitrate, which does nothing for his pain. Which medication should the nurse suspect the doctor will order next for the pain? Demerol Morphine Fentanyl Codeine

Morphine Although a number of analgesic agents have been used to treat pain of myocardial infarction, morphine is the drug of choice and is usually indicated if chest pain is unrelieved with oxygen and nitrates.

A client has developed cardiogenic shock. The most frequent cause of this type of shock is: Hypertension Heart failure Myocardial infarction Allergic reaction

Myocardial infarction Cardiogenic shock is a loss of cardiac pumping ability. The most frequent cause of this shock is myocardial infarction, as ischemic damage greatly reduces left ventricular contractility.

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Negative feedback loop Explanation: The level of many of the hormones in the body is regulated by negative feedback mechanisms.

In distributive shock, there are abnormalities in vascular resistance. Which types of shock display the same distributive pattern? Select all that apply. Neurogenic Cardiogenic Septic Hypovolemic Anaphylactic

Neurogenic Septic Anaphylactic In distributive shock, the capacity of the vascular compartment is greatly enlarged so that a normal blood volume becomes insufficient. In neurogenic shock, loss of sympathetic (adrenergic) control of blood vessels is lost and extreme vasodilation occurs. In anaphylactic shock, a severe allergic reaction, massive release of histamine induces extreme vasodilation. In septic shock, a response to severe infection, there is vascular dilation. Cardiogenic shock is a loss of ventricular contractility. Hypovolemic shock is a loss of blood volume.

The physician reviews a client's lab results and notes that the neutrophil count is 900/uL. This is known as which of the following? Leukopenia Neutropenia Agranulocytosis Aplastic anemia

Neutropenia

A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged, resulting in a pulmonary embolism. Which type of shock is this client at risk of experiencing? Cardiogenic shock Hypovolemic shock Obstructive shock Distributive shock

Obstructive shock Obstructive shock results from mechanical obstruction of the flow of blood through the central circulation, such as the blockage that characterizes a pulmonary embolism.

A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students recognize the local action of hormones as:

Paracrine Explanation: When hormones act locally on cells other than those that produced the hormone, the action is called paracrine. Hormones can also exert an autocrine action on the cells in which they were produced. Pancreatic and hormonal are not actions.

A teen with newly diagnosed pituitary dwarfism asks the nurse why growth hormone must be taken as an injection rather than a pill like the steroids used for arthritis. Which response best answers the client's question?

Peptide proteins will be digested instead of entering the bloodstream. Explanation: Although each of the foregoing statements about hormones is true, only one directly answers the client's question. Hormones can be placed into three categories according to structure: Amines and amino acids are the first group and include norepinephrine, epinephrine, and the thyroid hormones. The second group contains most of the hormones and consists of peptides and proteins. The third group is steroids that are made from cholesterol. These hormones are not degraded by the gastrointestinal enzymes. Growth hormone is a large protein in the class of peptides and proteins—the group with bonds that can be digested in the gastrointestinal tract.

A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client is suffering? Pericarditis Myocardial infarction Pericardial effusion COPD

Pericardial effusion Pericardial effusion refers to the accumulation of fluid in the pericardial cavity, usually as a result of an inflammatory or infectious process. A sudden accumulation of even 200 mL of fluid may raise intracardiac pressure to levels that will cause symptoms similar to right-sided heart failure. Pericarditis is inflammation of the pericardium while COPD is a respiratory disease.

A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have? Myocardial infarction Abdominal aortic aneurysm Pericarditis Pneumonia

Pericarditis This client is demonstrating signs and symptoms of pericarditis, which includes a triad of chest pain, pericardial friction rub, and EKG changes. Other signs are that the pain is usually abrupt in onset, occurs in the pericardial area, and may radiate to the neck, back, abdomen or side. It is usually worse with deep breathing and swallowing, and the person often finds relief when sitting up and leaning forward.

On a holiday trip home, the nurse's mother states that the nurse's father was diagnosed with right-sided heart failure. Which manifestation exhibited by the father does the nurse know might have preceded this diagnosis? Vertigo, headache Weakness, palpitations Dyspnea, cough Peripheral edema, weight gain

Peripheral edema, weight gain In right-sided heart failure, blood backs up into the venous side of the circulatory system causing increased hydrostatic pressure in capillaries and leakage of plasma, which forms peripheral edema and becomes apparent as weight gain. The other manifestations listed are not characteristic of right-sided failure.

Which gland is often referred to as the master gland because it secretes many hormones?

Pituitary Explanation: The pituitary gland has been called the master gland because its hormones control the functions of many target glands and cells. That is not a term used to refer to the other options.

Which structure controls the functions of the greatest number of target glands and cells?

Pituitary gland Explanation: The pituitary gland has been called the master gland because its hormones control the functions of many target glands and cells. It supersedes the importance of the thyroid, adrenal cortex, or pancreas in this regulatory role.

What are the hallmark signs of diabetes mellitus? Polyuria, polydipsia, and pheochromocytoma Polyuria, polyphagia, and polycythemia Polyuria, polydipsia, and polyphagia Polycythemia, polydipsia, and pheochromocytoma

Polyuria, polydipsia, and polyphagia The most commonly identified signs and symptoms of diabetes are referred to as the three polys: (1) polyuria (i.e., excessive urination), (2) polydipsia (i.e., excessive thirst), and (3) polyphagia (i.e., excessive hunger). Pheochromocytoma and polycythemia are not hallmark signs of diabetes mellitus.

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?

Prevent accumulation Explanation: Continuous inactivation of secreted hormones is necessary to prevent accumulation that could disrupt the feedback mechanism. Increased secretion stimulates production of more receptor sites. Metabolic waste absorption is not a function of the endocrine system.

A nurse is caring for a client with a new diagnosis of rheumatic fever. What is the highest priority goal of treatment during the acute phase? Prevent cardiac complications Reduce inflammation Eliminate the infection Promote nutrition

Prevent cardiac complications Rheumatic fever poses great risk to the client for long-term heart disease. Interventions to prevent cardiac complications include anti-inflammatories and antibiotics. Adequate nutrition is appropriate for healing but is not the highest priority goal.

A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?

Prolactin Explanation: The anterior pituitary gland or adenohypophysis contains five cell types: (1) thyrotrophs, which produce thyrotropin, also called TSH; (2) corticotrophs, which produce corticotropin, also called ACTH; (3) gonadotrophs, which produce the gonadotropins, LH and FSH; (4) somatotrophs, which produce GH; and (5) lactotrophs, which produce prolactin that is involved with breast growth and milk production.

A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Which action by the new RN indicates a need for more education? Placing a pulse oximeter on the client to monitor oxygenation status Raising the head of the bed to a high Fowler's position Administration of 2L of oxygen by nasal cannula Inserting an IV to begin a normal saline infusion

Raising the head of the bed to a high Fowler's position Treatment measures include close monitoring of cardiovascular and respiratory function; maintenance of respiratory gas exchange, cardiac output, and tissue perfusion; and the administration of oxygen, antihistamine drugs, and corticosteroids. The person should be placed in a supine position. This is extremely important because venous return can be severely compromised in the sitting position. This in turn produces a pulseless mechanical contraction of the heart and predisposes to arrhythmias. In several cases, death has occurred immediately after assuming the sitting position.

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome? Glycosylated hemoglobin 7.2% (.07) Gained 5 lb in one week 1% ketones present in urine Random blood glucose 85 mg/dL (4.72 mmol/L)

Random blood glucose 85 mg/dL (4.72 mmol/L) The goals of the nutritional plan for gestational diabetes mellitus (GDM) include normal glucose levels, no ketosis, proper weight gain for the pregnancy, and adequate nutrition for fetal health.

Hormones are chemical messengers that provide which function in the body?

Regulate body functions Explanation: Hormones regulate and integrate body functions. Hormones act on specific target cells, but they cause a variety of effects on tissues. Hormones do not transport other substances; hormones are transported and present in body fluids at all times.

A teenager is seen in the emergency room with reports of a sore throat, headache, fever, abdominal pain, and swollen glands. His mother tells the nurse that he was seen 3 weeks before in the clinic and treated with antibiotics for strep throat. He was better for a few days but now he seems to have gotten worse in the last 2 days. What should the nurse suspect is wrong with this client? Flu Meningitis Rheumatic fever Mononucleosis

Rheumatic fever Rheumatic fever is an immune-mediated inflammatory disease that occurs a few weeks after a group A strep (sore throat). It can manifest as an acute, recurrent, or chronic disorder.

A 20-year-old college student being treated for a kidney infection developed a temperature of 104ºF (40°C) in spite of treatment with antibiotics. Her pulse was high, her blood pressure was low, and her skin was hot, dry, and flushed. The nurse knows that this client most likely is experiencing which type of shock? Septic Neurogenic Cardiogenic Anaphylactic

Septic Septic shock can result with the body's response to a severe infection. Neurogenic shock is a loss of sympathetic (adrenergic) control of systemic blood vessel tone. Cardiogenic shock is a loss of cardiac efficiency, and anaphylactic shock is a severe allergic reaction.

The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock? Anaphylactic shock Septic shock Cardiogenic shock Hypovolemic shock

Septic shock Septic shock is a subtype of distributive shock. The treatment of sepsis and septic shock focuses on control of the causative agent and support of the circulation and the failing organ systems. The administration of antibiotics that are specific for the infectious agent is essential. Swift and aggressive fluid administration is needed to compensate for third spacing, though which type of fluid is optimal remains controversial. Equally, aggressive use of vasopressor agents, such as norepinephrine or epinephrine, is needed to counteract the vasodilation caused by inflammatory mediators.

A child has been diagnosed with classic growth hormone deficiency. Which physical findings may occur in this child? Select all that apply. Short stature Delayed skeletal muscle maturation Obesity Below normal intelligence Early puberty Mature facial features

Short stature Delayed skeletal muscle maturation Obesity Children with classic GH deficiency have normal intelligence, short stature, obesity with immature facial features, and some delay in skeletal maturation. Puberty often is delayed, and males with the disorder have microphallus (abnormally small penis), especially if the condition is accompanied by gonadotropin-releasing hormone (GnRH) deficiency.

A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?

Stimulation testing Explanation: Introduction of TRH tests the pituitary gland's ability to produce TSH, and is an example of a stimulation test. Suppression testing examines a gland's response to a stimulus that would normally result in decreased hormone production. RIA and autoantibody testing are examples of direct and indirect measurement of serum levels of a hormone.

What is the primary cause of heart failure in infants and children? Idiopathic heart disease Structural heart defects Hyperkalemia Reactions to medications

Structural heart defects Structural (congenital) heart defects are the most common cause of heart failure in children.

The nurse is assessing the ECG of a client who is experiencing unstable angina. The nurse observes: T-wave changes Significant ST-segment elevation Deep Q waves Peaked T waves

T-wave changes Unstable angina/non-ST-segment elevation myocardial infarction (UA/NSTEMI) is a clinical syndrome of myocardial ischemia ranging from angina to myocardial infarction. The ECG pattern associated with NSTEMI may display normal or ST-segment depression (or transient ST-segment elevation) and T-wave changes. The degree of ST-segment deviation from baseline is an important measure of ischemia and indicator of prognosis. Abnormal Q waves occur with ACS.

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? Troponin and myoglobin levels LDL and HDL levels BUN and creatinine T4 and TSH

T4 and TSH Diagnosis of hypothyroidism is based on history, physical examination, and laboratory tests. A low serum T4 and elevated TSH levels are characteristic of primary hypothyroidism.

While studying the physiology of the heart, the nursing students have learned that which of the following influence the blood flow in the coronary vessels that supply the myocardium? Select all that apply. The aortic pressure Autoregulatory mechanisms Hypothalamus Compression of the intramyocardial vessels Thyroid gland

The aortic pressure Autoregulatory mechanisms Compression of the intramyocardial vessels Blood flow in the coronary vessels that supply the myocardium is influenced by the aortic pressure, the autoregulatory mechanisms, and compression of the intramyocardial vessels by the contracting heart muscle.

A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?

The hypothalamic-pituitary-target cell system Explanation: The levels of many of the hormones are regulated by feedback mechanisms that involve the hypothalamic-pituitary-target cell system. Positive feedback control refers to rising levels of a hormone that causes another gland to release a hormone that is stimulating to the first. The hypophyseal portal system connects the supraoptic and paraventricular nuclei of the hypothalamus with the posterior pituitary gland. Exogenous forms of hormones (given as drug preparations) can influence the normal feedback control of hormone production and release.

When explaining factors that influence the number of receptors present on target cells, the instructor will likely mention which concepts? Select all that apply.

The role antibodies may have on receptor proteins. A decreased hormone level may produce increased receptor numbers. A sustained excess hormone level brings about a decrease in receptor numbers. Explanation: Target cell response varies with the number and affinity of the relevant receptors. The number of hormone receptors on a cell may be altered for any of several reasons. Antibodies may destroy or block the receptor proteins. Increased or decreased hormone levels often induce changes in the activity of the genes that regulate receptor synthesis. For example, decreased hormone levels often produce an increase in receptor numbers by means of a process called up-regulation; this increases the sensitivity of the body to existing hormone levels. Likewise, sustained levels of excess hormone often bring about a decrease in receptor numbers by down-regulation, producing a decrease in hormone sensitivity.

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?

The thyroid gland is responsible for increasing the metabolic rate. Explanation: The thyroid gland produces thyroid hormones, T3 and T4. These hormones increase the metabolic rate; increase protein and bone turnover; increase responsiveness to catecholamines; are necessary for fetal and infant growth and development. The parathyroid gland regulates calcium metabolism. The adrenal glands regulate "flight or fight" and the testes or ovaries regulate development of secondary sex characteristics

A client who is relatively healthy is seen in the clinic for a regular checkup. While there he tells the nurse that he is worried that he may develop a heart condition. When the nurse asks him why he is worried he tells her that his mother had aortic valve stenosis and is afraid that he might get it. He then asks to be tested for the disease. What should the nurse tell this client about diagnosing a valvular defect? An ECG can be done to rule out this disease. Blood work can help to diagnose a valvular defect. An MRI, which is more expensive, can be helpful in this diagnosis. Valvular defects usually are detected through cardiac auscultation.

Valvular defects usually are detected through cardiac auscultation. Although valvular heart disease can result from congenital defects, rheumatic heart disease, trauma and other causes, atrial stenosis is usually first diagnosed with auscultation of a loud systolic murmur or a single-split second heart sound. Other tests are not used initially.

Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins? Vasoconstriction Vasodilation Diuretic Natriuretic

Vasoconstriction Endothelins are secreted by many cell types, including the endothelial lining of the circulatory system. Clients with heart failure may have increased blood levels of endothelins as the body tries to compensate for a decrease in cardiac output. However, most actions of endothelins—for example, vasoconstriction and sodium and water retention—are counterproductive in heart failure.

A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect? Vasodilating effects reducing preload and afterload Decreased heart rate and increased stroke volume Increased preload Reduction of cardiac refractory periods

Vasodilating effects reducing preload and afterload Nitroglycerin produces its effects by releasing nitric oxide in vascular smooth muscle of the target tissues, resulting in relaxation of this muscle and increased blood flow. Nitroglycerin's effect on the vessels decreases venous return (reduce preload) and arterial blood pressure (reduce afterload). This drug does not decrease heart rate. Because it vasodilates, it decreases preload. Nitroglycerine does not affect cardiac refractory periods.

A 14-year-old boy has been diagnosed with infectious mononucleosis. Which pathophysiologic phenomenon is most responsible for his symptoms? The Epstein--Barr virus (EBV) is lysing many of the boy's neutrophils. Viruses are killing some of his B cells and becoming incorporated into the genome of others. EBV inhibits the maturation of white cells within his peripheral lymph nodes. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.

Viruses are killing some of his B cells and becoming incorporated into the genome of others.

A telehealth nurse is talking with a client who has a history of right-sided heart failure. The nurse should question the client about which assessment finding that would indicate the client's condition is worsening? Weight gain Copious urination Shortness of breath Decreased blood pressure

Weight gain In right-sided heart failure, blood backs up into the venous system and increased capillary hydrostatic pressure forces plasma out of the circulatory system, resulting in edema. The accumulation of fluid is evidenced by rapid weight gain. Shortness of breath and decreased renal perfusion and output are characteristic of left-sided failure.

A high school teenager comes to the emergency room with symptoms that include the abrupt onset of severe pharyngitis and a high fever. The teenager reports that in the previous four days he has "just not felt well." The nurse anticipates orders to include which of the following? Intravenous antibiotics White blood cell count Chest X-ray CT scan

White blood cell count

The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider? Monocytes 4% Basophils 2/µL Platelet count 168,000/µL White blood cells (WBCs) 18,500/µL

White blood cells (WBCs) 18,500/µL

Mitral valve prolapse occurs frequently in the population at large. Its treatment is aimed at relieving the symptoms and preventing complications of the disorder. Which drug is used in the treatment of mitral valve prolapse to relieve symptoms and aid in preventing complications? beta-adrenergic blocking drugs (beta-blockers) Calcium-channel blocking drugs Antianxiety drugs Broad-spectrum antibiotic drugs

beta-adrenergic blocking drugs (beta-blockers) Persons with palpitations and mild tachyarrhythmias or increased adrenergic symptoms and those with chest discomfort, anxiety, and fatigue often respond to therapy with the beta-adrenergic blocking drugs. None of the other types of drugs are used in the treatment of mitral valve prolapse to relieve symptoms or prevent complications.

An older adult client has been diagnosed with chronic heart failure. He is prescribed an ACE inhibitor to treat the symptoms and improve his quality of life. This drug will alleviate the client's symptoms of heart failure by: selectively blocking the synthesis of renin in the kidneys. blocking the conversion of angiotensin I to angiotensin II. enhancing inotropy by maximizing calcium channel function. promoting cardiac output through a reduction in afterload.

blocking the conversion of angiotensin I to angiotensin II. ACE inhibitors block the conversion of angiotensin I to angiotensin II. They do not directly affect renin synthesis, calcium channel function, or afterload.

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output. aortic hypertrophy compensatory mechanisms electrical conductivity parasympathetic system

compensatory mechanisms The pathophysiology of heart failure involves an interaction between two factors: a decrease in pumping ability of the heart with a consequent decrease in the cardiac reserve and the compensatory mechanisms that serve to maintain the cardiac output while also contributing to the progression of heart failure. Myocardial muscle hypertrophy has an important role in long-term adaptation to hemodynamic overload. Stimulation of the sympathetic nervous system plays an important role in the compensatory response to decreased cardiac output and to the pathogenesis of heart failure. Heart failure is a muscle contractility problem, unrelated to the electrical conduction that stimulates it.

A nurse is teaching a client with newly diagnosed dilated cardiomyopathy (DCM) about associated treatments. The nurse determines that the knowledge is understood when the client correctly matches which drug category to the primary action of decreasing preload by suppressing renal reabsorption of sodium and increasing salt and water excretion? diuretics angiotensin-converting enzyme (ACE) inhibitors calcium channel blockers beta-blockers

diuretics The treatment of DCM is directed toward relieving the symptoms of heart failure and reducing the work of the heart. Diuretics, such as the thiazides, loop diuretics, and the aldosterone antagonist (potassium-sparing) diuretics, lower blood pressure initially by decreasing vascular volume (by suppressing renal reabsorption of sodium and increasing salt and water excretion), thereby decreasing preload and cardiac output. Although ACE inhibitors also lower the reabsorption of sodium and water by reducing the amount of circulating levels of aldosterone (through reducing the conversion of angiotensin 1 to angiotension 2), they also prevent vasoconstriction, so the effects on sodium and water retention is not this class of drug's only or primary effect. Calcium channel blockers prevent vasoconstriction as thier primary mechanism of actions, and beta-blockers primarily reduce cardiac output by reducing heart rate and contractility.

A nurse is concerned that a resident of a long-term care facility may be developing left-sided heart failure. The nurse would communicate which set of manifestations as possible evidence of left-sided heart failure? diarrhea, nausea, vomiting dyspnea, cough, fatigue fatigue, headache, weight loss weakness, slowed heart rate, confusion

dyspnea, cough, fatigue In left-sided heart failure, dyspnea and cough, especially when lying supine (orthopnea), results from increased pulmonary capillary pressures contributing to pulmonary congestion. Fatigue is common due to reduced cardiac output and inadequate tissue perfusion. A slowed heart rate, or bradycardia is not expected. Often the heart rate increases to compensate for the decrease in cardiac output. Weight gain due to fluid retention from the activation of renin-angiotensin-aldosterone is expected rather than weight loss. Although some gastrointestinal fullness may be experienced by some clients with heart failure, vomiting and diarrhea is not expected.

Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who: was diagnosed with placenta previa early in her pregnancy. is gravida five (in her fifth pregnancy). has BP of 130/85 mm Hg and pulse rate of 90 beats/minute. is morbidly obese (defined as greater than 100 pounds over ideal weight).

is morbidly obese (defined as greater than 100 pounds over ideal weight). Obesity is among the risk factors for gestational diabetes mellitus (GDM). Obstetric complications, multiple pregnancies, high triglycerides, and hypertension are not specific risk factors for GDM.

The nurse is assessing a client involved in a motor vehicle collision who has bruising across the sternum from seat belt pressure. The nurse notes muffled heart sounds, and the client's blood pressure is 100/85 mm Hg. The nurse notifies the health care provider to present these findings as evidence of which condition? cardiomyopathy pericarditis pulmonary hypertension pericardial effusion

pericardial effusion Pericardial effusion is the accumulation of fluid in the pericardial cavity and may develop with neoplasms, cardiac surgery, or trauma. Pericardial effusion presents with tachycardia, jugular venous distention, a fall in systolic blood pressure, narrowed pulse pressure (little difference between systolic and diastolic blood pressure), muffled heart sounds, and if tamponade develops, signs of circulatory shock. A friction rub (a sound resulting from rubbing between the inflamed pericardial surfaces) rather than muffled heart sounds is characteristic of acute pericarditis. Cardiomyopathy has many causes, but trauma is not one of them. Also, it does not result in muffled breath sounds or a narrow pulse pressure. Pulmonary hypertension results from respiratory or congenital disorders and is not associated with trauma and does not alter pulse pressure.

Assessment of an older adult client reveals bilateral pitting edema of the client's feet and ankles; difficult to palpate pedal pulses; breath sounds clear on auscultation; oxygen saturation level of 93% (0.93); and vital signs normal. What is this client's most likely health problem? right-sided heart failure pericarditis cardiogenic shock cor pulmonale

right-sided heart failure A major effect of right-sided heart failure is the development of peripheral edema. A client who is in shock would not have stable vital signs. Cor pulmonale would be accompanied by manifestations of lung disease. Pericarditis is an inflammation of the pericardium exhibited by fever, precordial pain, dyspnea, and palpitations.

A client who is experiencing angina at rest that has been increasing in intensity should be instructed to: take a second nitroglycerine. give it 5-10 minutes more to see if there is relief. see the doctor for evaluation immediately. not worry about it as this is common for someone who has already had a myocardial infarction.

see the doctor for evaluation immediately. Angina that occurs at rest, is of new onset, or is increasing in intensity or duration denotes an increased risk for myocardial infarction and should be seen immediately using the criteria for acute coronary syndrome (ACS).

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:

sperm production. Explanation: FSH in males stimulates sperm production. GH stimulates growth of bone and muscle. LH stimulates secretions of testosterone. Androgens affect the development of male sex organs.

A client with many nonspecific complaints has been ordered a positron emission tomography (PET) scanning for evaluation of:

tumors located on the endocrine glands. Explanation: Positron emission tomography (PET) scanning is being used more widely for evaluation of endocrine tumors. PET scans do not calculate the pancreas response to insulin. A DEXA is used for diagnosis and monitoring of osteoporosis (bone density). Isotopic imaging includes radioactive scanning of the thyroid (using radioiodine) and parathyroids.

In major athletic competition, athletes are required to submit to liquid chromatography testing looking for:

use of performance-enhancing agents to increase the chances of winning. Explanation: For some steroid or peptide hormones, mass spectrometry is becoming increasingly useful and can be combined with other analytical techniques, such as liquid chromatography. These approaches provide definitive identification of the relevant hormone or compound according to its chemical or physical characteristics (e.g., unequivocal detection of performance-enhancing agents in sports).