Patho

A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has:

A severe bacterial infection

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma Pco2 levels. What is a common cause of respiratory alkalosis?

Hyperventilation

An 81 year old male patient who has a diagnosis of orthostatic hypotension is experiencing an episode of particularly low blood pressure. The man's body has responded by increasing levels of angiotensin II in the bloodstream, a hormone which decreases glomerular filtration rate in the kidneys and contributes to an increase in blood pressure. Which of the following phenomena best describes what has occurred?

Negative feedback

What feedback system provides stability to the stress response?

Negative feedback mechanism

A patient has a fever that was induced by damage to the hypothalamus due to intercranial bleeding. The nurse plans care for the patient with which of the following types of fever?

Neurogenic

A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The patient's physician has ordered a complete blood count and white cell differential. Which of the following blood components would the physician most likely anticipate to be elevated?

Neutrophils

During lecture on wound care, the instructor mentions the final stage of the cellular response of acute inflammation. Of the following statements, which describes what physiologically occurs in the final stage?

Neutrophils, monocytes, and macrophages engulf and degrade the bacteria/cellular debris.

The client experienced a traumatic event in the past that has caused chronic nightmares in which the event is relived. The client may have increased levels of which of the following?

Norepinephrine

Which responsibility of the extracellular matrix (ECM) most accurate?

The ECM provides the scaffolding for tissue renewal.

The nurse is reviewing the admission assessment of a client admitted with jaundice and abdominal pain .The client tells the nurse that he injured the back about 6 weeks ago and has been taking 750 mg of acetaminophen every 4 hours each day for pain relief. The nurse recognizes that client may have sustained damage of the:

liver

When discussing cellular replication with a client with chronic kidney disease, the client asks, "Can't my body just repair or grow a new kidney?" The nurse responds, "The kidney is a stable tissue and has only limited replicative capacity. In humans, the exception to this is the:

liver

Which of the following best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?

mEq/L

The nurse is administering a unit of packed red blood cells to a patient and piggybacks the unit of blood through a solution of 0.9% NaCl. Blood cells placed in a solution of 0.9% saline will do which of the following?

neither shrink nor swell

The nurse caring for a client with metabolic acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's metabolic acidosis is improving?

pH has increased

The nurse would anticipate the laboratory results of a client experiencing metabolic alkalosis to include:

pH of 7.45 and HCO3 of 24 mEq/L

The nurse is assessing the wound of a postoperative client. The client has a 6-inch abdominal wound that is well approximated and closed with surgical suture. The wound does not display any redness or drainage. The nurse would document the healing process as:

primary infection

A client sustained an injury 3 days ago. The nurse is assessing the status of the wound. The nurse anticipates the phase of healing to be:

proliferative

The nurse is attempting to obtain the most accurate core body temperature of a patient. Which of the following methods should the nurse use?

rectal

The route considered the most accurate to measure a core body temperature is which of the following?

rectal

A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for:

redness

After many years of cigarette smoking, a client is admitted to have a "mass" removed from the lung. When explaining the surgery and recovery, the physician notes that the client is likely to have a good amount of fibrosis develop at the surgical area. After the physician leaves the room, the client asks the nurse what was meant by "fibrosis" in the lung. The nurse bases the response on the fact that tissue repair can:

result in replacement tissue in the form of connective (fibrous) tissue which leads to scar formation or fibrosis of the lung.

Following a severe automobile accident, a client is scheduled to have surgery to either repair or remove his spleen, pancreas, and stomach. The patient wants the organs repaired and not removed if at all possible. However, the nursing staff understands that extensive regeneration in parenchymal organs can only occur if:

the residual tissue is structurally and functionally intact.

A pregnant client is attending a nutrition class for first-time moms. During the class, the instructor stressed that they should avoid consumption of which food that may cause brain damage from methyl mercury exposure?

tuna

The nurse is assessing a client with diabetes and notes an area on the client's right foot as inflamed, necrotic, and eroded. The client states he accidentally slammed his foot in a door 2 weeks ago. The nurse would document this finding as a(n):

ulceration

During the synthesis phase of the cell cycle, the cell is:

undergoing a period of DNA synthesis and replication of the chromosomes.

Which temperature readings indicate to the nurse that the clients have fever? Select all that apply.

• 35-year-old with pulmonary artery reading of 37.9ºC (100.2ºF) • 19-year-old with oral reading of 38.4ºC (101.1ºF) • 3-day-old with rectal reading of 38ºC (100.4ºF)

Which of these reflects a positive outcome to interventions provided for a 20-year-old woman undergoing treatment for anorexia nervosa?

Client has monthly menses.

A patient is admitted with frostbite. Which of the following will the nurse tell the patient about the changes that have occurred due to cold exposure?

Cold increases blood viscosity and thrombosis.

An extremely obese patient has been researching bariatric surgery after trying to lose weight for many years with dietary changes and exercise, without success. The patient informs the nurse that he is interested in having the Roux-en-Y gastric bypass. Which of the following statements by the patient indicates the need for further education?

"After the surgery, I will be able to eat what I want and will still continue to lose weight."

Which of the following can the nurse tell a patient about antipyretic drugs during fever?

"Antipyretics help to protect the body."

A client who has been receiving cortisol as treatment for an illness states he "is constantly developing colds and fevers." What is the nurse's best response to the client?

"Cortisol inhibits the function of the immune system, making you more susceptible to disease."

The loss of heat from the body through the circulation of air currents is known as which of the following?

Convection

How does the nurse best define hardiness to a client?

"Hardiness describes a personality characteristic that assists in the stress response."

A client developed malnutrition while hospitalized for an illness. The client does not understand how that could have happened. The best response would be:

"Malnutrition is also common during illness, recovery from trauma, and hospitalization."

The nurse teaches the client with end-stage kidney disease and hyperphosphatemia to take sevelamer HCl (Renagel), a phosphate binder, with meals. How does the nurse explain the rationale for the timing of this medication?

"The medication should be taken at meal time to allow the binding of phosphate."

While studying for a pathophysiology exam on cells and tissue repair, a student asks, "What happens if, in the process of going through the cell cycle, a cell is damaged?" Which is the best response?

"There are built in checkpoints in the cell cycle to allow for defects to be edited and repaired."

The emergency department nurse evaluates the orientee's understanding of the acute stress response in a trauma patient. The nurse knows the orientee understands it when he states which of the following?

"There is facilitation of neural pathways mediating arousal, alertness, vigilance, cognition and focused attention."

A client asks, "Why do I keep getting these cold sores on my lips? Am I kissing people too much?" The nurse will base her response by saying:

"These sores usually develop when you are not sleeping well or are emotionally upset."

A dietitian is working with a morbidly obese client in an effort to facilitate weight loss. Which of the dietitian's following teaching points about the nature of adipose tissue should be included in the client education?

"Your fat cells can be considered to be one large energy-storage organ that also has a role in hormone production."

To calculate the H2CO3 content of the blood, the nurse needs to measure the Pco2 (partial pressure of CO2) by its solubility coefficient. What is the solubility coefficient of CO2?

0.03

Question: Place the four successive stages of fever in correct order.

1. prodromal 2. chill 3. flush 4. defervescence

Fat is a necessary part of the diet. The Food and Nutrition Board has set what adult AMDR for fats?

25% - 35%

The psychologist is leading a group session with clients who have recently undergone a variety of stressful events. Which of the following clients will have the best adaptation?

50-year-old female who sees her new life as a widow as a challenge rather than a threat

When counseling a group of overweight individuals, the nurse should stress that during parties, the oxidation of alcohol provides how many kilocalorie/gram to ones diet?

7 kcal/g.

A client states, "I heard that my healed wound tissue is stronger than my normal tissue. Is that true?" The nurse responds that roughly 3 months after a wound; the wound tensile strength is approximately what percentage from normal?

70% of normal

The nurse has just received the lab results of a client's calcium level. The nurse identifies a normal calcium level as:

9.0 to 10.5 mg/dL

A nurse is caring for four clients. Select the client at greatest risk for high blood levels of lead.

A 2-year-old anemic child who lives in a turn-of-the-century home

The nurse is caring for the following group of clients. Select the client most likely to be diagnosed with respiratory alkalosis.

A 26-year-old female with anxiety who has been hyperventilating

Which patient is at greatest risk for decreased wound healing?

A 30-year-old patient with type 1 diabetes and a foot ulcer

A nurse is providing care for several clients on a neurological unit of a hospital. With which of the following clients would the nurse be justified in predicting a problem with thermoregulation?

A 66 year old male with damage to his thalamus secondary to a cerebral vascular accident.

Which of the following clients will have the most efficient adaptation?

A client who has been noticing small amounts of blood in his stool over the past week

Which statement is true concerning energy requirements across the lifespan?

A newborn requires more kcal/kg of body weight than a 10 year old.

The nurse is caring for a client with an acid base imbalance. Which of these does the nurse recognize is correct regarding compensation?

A pH moves toward the normal range

The nurse in the obstetrics clinic is advising a pregnant woman about nutritional needs during pregnancy. Which of these should the nurse include in the teaching plan?

A pregnant woman needs an extra 300 kcal/day above the usual caloric intake.

A nurse suspects that a patient with a plasma magnesium level of 1.2 mg/dl may have which of the following factors in his history?

Abuse of alcohol

The client is hospitalized for four days with an acute myocardial infarction. After a coronary artery stent is placed, the client is discharged to home in stable condition. This would be an example of which pattern of stress?

Acute time limited

A nurse assisting in the assessment of a patient's cumulative effects of stress should include considering which of the following?

Allostatic load

Which of the following emergency department clients is most likely demonstrating clinical manifestations of acute stress? A client with:

An acute heightened sense of alertness to surroundings and personnel

Which of the following clients would be considered a good candidate for hyperbaric oxygen therapy?

An older adult with history of diabetes and intermittent claudication (poor circulation in the legs) who received a laceration while on the lawnmower

An 88 year old resident of a long term care home has been suffering from a three day onset of increasing shortness of breath and decreased oxygen saturation. At the hospital, an anterior-posterior chest X-ray and sputum culture and sensitivity has confirmed a diagnosis of bacterial pneumonia, yet the client's tympanic temperature has not exceeded 37.3°C (99.2°F). The health care team would recognize that which of the following phenomena likely underlies this situation?

An older adult's hypothalamus has diminished thermoregulatory ability.

Which of the following statements is true regarding drug therapy and its effects on the body?

Antineoplastic cells directly damage cells.

Which of the following is an appropriate action by a nurse to take in attempting to decrease a patient's temperature through conduction?

Apply cooling blanket

The elderly client, with a history of congestive heart failure, is upset following the death of her husband yesterday. The practitioner observes the client for which of the following?

Arrhythmias

A health care provider suspects a client has developed posttraumatic stress disorder (PTSD). Select the necessary criterion to validate the diagnosis.

At least 1 month of clinically significant distress affecting a person after witnessing or experiencing a traumatic event that affects other parts of his or her life

The client has expressed a desire to explore stress-reducing strategies for chronic migraines. The provider explains one technique that involves electronic monitoring of physiologic responses to stress with immediate feedback. This is known as which of the following?

Biofeedback

Which of the following assessments should be prioritized in the care of a client who is being treated for a serum potassium level of 2.7 mEq/L?

Cardiac monitoring looking for prolonged PR interval and flattening of the T wave

When caring for a patient with hyperkalemia, the nurse prioritizes assessment of which of the following body systems?

Cardiovascular

Which of the following happens when a cell is confronted with a decrease in work demands?

Cell becomes smaller.

In a person with fluid volume deficit, there is a dehydration of brain and nerve cells. What can occur if fluid volume deficit is corrected too rapidly?

Cerebral edema occurs with potentially severe neurologic impairment.

Which of the following is an anion?

Chlorhide

A client reports fatigue and an inability to concentrate. The client has been unemployed for the second time in a year and is concerned about supporting the family. Select the type of stressor the client most likely experiencing.

Chronic sustained

The term used to describe oscillations with a frequency similar to that of the 24-hour light-dark solar day is which of the following?

Circadian

Which is an endocrine regulator of pituitary and adrenal activity and neurotransmitter involved in autonomic nervous system activity, metabolism, and behavior?

Corticotropin-releasing factor

Following a school shooting, many of the children want to talk about the traumatic event. The school nurse knows this is very therapeutic and would be called:

DEBREIFING

A hostage situation has occurred at a high school campus. The school superintendent and faculty are concerned about the students experiencing posttraumatic stress disorder (PTSD).The most important intervention would be:

Debriefing with a crisis team about the event as soon as possible

The nurse caring for the client with respiratory alkalosis and renal compensation determines which of these diagnostic findings is consistent with this disorder?

Decreased PCO2 and HCO3, and increased pH

A previously healthy 42-year-old client was recently diagnosed with hypertension. Select the response that best describes a positive reaction to the acute stress.

Decreasing dietary sodium and fat intake

Which of the following is the preferred drug for treating chronic diabetes insipidus?

Desmopressin acetate(DDAVP)

A patient's body temperature has been documented as follows: 12 noon: 37.0°C; 6 pm: 37.5°C; 3 am: 36.0°C. Which of the following actions should the nurse take?

Document the temperature

Pyrogens are substances that produce fever in the body. Substances such as bacterial products, bacterial toxins, or whole microorganisms enter the body and stimulate the host cells to produce certain mediators. What are these called?

Endogenous pyrogens

A nurse who is providing a staff development in-service determines that the participants understand the information when they state that which of the following aids heat conservation by reducing surface area for heat loss?

Erection of pilomotor muscles

Selye suggested that stress could have positive influences on the body, and these periods of positive stress are called:

Eustress

A client being evaluated in the emergency room is unable to speak logically or follow directions. The client's family states the client has been under a great deal of stress for about 6 months. The client is most likely experiencing:

Exhaustion

The client is exhibiting signs and symptoms of an autoimmune disease. Which stage of the general adaptation syndrome is represented?

Exhaustion stage

The nurse is reviewing assessment documentation of a client's wound and notes "purulent drainage." The nurse would interpret this as:

Exudate containing white blood cells, protein, and tissue debris

Most physiologic control systems function under positive feedback mechanisms.

False

Inflammation can be either local or systemic. What are the most prominent systemic manifestations of inflammation?

Fever, leukocytosis or leukopenia, and the acute phase response

A client asks the nurse why a scar developed after an injury. The best response would be:

Fibrous tissue

The nurse is caring for a patient with a tumor obstructing the lymphatic system. For which of the following consequences does the nurse assess?

Fluid accumulating in the interstitial spaces distal to the tumor

A client is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema and audible crackles in lower lung fields bilaterally. The nurse notifies the physician to obtain orders for which of these problems?

Fluid volume excess.

Which of the following measures would likely be rejected as part of a first-line weight loss plan for a client with a BMI of 30.2, type 2 diabetes, and hypertension?

Gastric bypass

A client asks how the body recognizes that enough food has been consumed during a meal. The best response would be:

Gastrointestinal stretch receptors

After exposure to poison ivy, the client has hives on his trunk and extremities. In an effort to decrease his immune response the practitioner places him on which of the following medications?

Glucocorticoid

The nurse is caring for a client whose temperature is increasing. The nurse is aware that the client will also experience an increase in:

Heart rate

A nurse is caring for an 85-year-old patient. The nurse offers oral fluids to the patient every 2 hours understanding that older adults may experience hypodipsia despite which of the following?

Higher plasma sodium and higher osmolality levels

Select the statement the best describes apoptosis.

Highly selective in eliminating injured or aged cells

A nurse is caring for an adolescent with posttraumatic stress syndrome. The patient reports having difficulty concentrating and has an increased startle reflex. The nurse's documentation includes the presence of which of the following?

Hyperarousal

A patient asks why her breasts are enlarged during pregnancy. Which of the following is the best answer?

Hyperplasia due to estrogen stimulation

What is the most common cause of drug fever?

Hypersensitivity reaction to medication

A nurse is caring for a patient whose serum potassium level is 2.6 mEq/L. The nurse anticipates which of the following interventions will be prescribed?

IV infusion of 10 mEq potassium chloride in 100-mL normal saline solution over 1 hour times three doses

A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as an:

Increase in circulating neutrophils

The client is receiving chronic glucocorticoid therapy for chronic obstructive pulmonary disease (COPD). Which of the following lab results would the provider expect to see?

Increased blood glucose

In which of the following patients with a transecting spinal cord injury should the nurse anticipate an impaired ability for temperature regulation?

Injury at T2

While reviewing how tissue repairs itself after injury, the students note that it follows a certain pattern. Place the steps of the repair of tissue in their proper sequence of events.

Injury to connective tissue occurs. Fibroblasts migrate. Induction of fibroblast occurs and endothelial cell proliferate. Granulation tissue appears. Formation of a scar develops. Remodeling occurs with the reorganization of the fibrous tissue.

The body has built-in compensatory mechanisms that take over when correction of pH is not possible or cannot be immediately achieved. What are these compensatory mechanisms considered?

Interim measures that permit survival

Lymph fluid arises directly from which one of the following spaces?

Interstitial

A patient admitted to the hospital with severe diarrhea has a K+ level of 6.7 mEq/L and symptoms of paresthesia, restlessness, and dyspnea. Arterial blood gases reveal a low pH level. Which of the following interventions will the nurse anticipate administering to correct this condition?

Intravenous (IV) insulin

A client who has experienced posttraumatic stress disorder (PTSD) tells the nurse he now has "flashbacks" during waking hours or nightmares in which the past traumatic event is relived, often in vivid and frightening detail. The nurse recognizes this as:

Intrusion

A client has developed cell atrophy. The most likely cause would be:

Ischemia

The nurse is performing an assessment for a patient that is experiencing shortness of breath. The nurse notes a full and bounding pulse, crackles in the lung fields, and jugular vein distention. The nurse recognizes symptoms of which of these problems?

Isotonic fluid volume excess

When caring for a client with a pressure ulcer, the nurse collaborates with the provider to obtain an order for which of these interventions to promote wound healing?

Keep dressing of the wound bed moist.

The nurse is caring for a client with worsening respiratory acidosis. Which of these interventions does the nurse anticipate if the client's condition continues to deteriorate?

Mechanical ventilation

A child accidentally consumes a container of wood alcohol. The ED physician knows that the child is at risk of developing which of the following?

Metabolic acidosis

A patient admitted to the hospital with severe diarrhea has a K+ level of 6.7 mEq/L, symptoms of paresthesia, restlessness, and dyspnea. Which of the following could have caused his condition?

Metabolic acidosis

The nurse is caring for a client who has excessive diarrhea. Which of these acid base disturbances does the nurse anticipate uncovering during evaluation of the arterial blood gas?

Metabolic acidosis

A client with diabetes who is diagnosed with a gangrenous right heel ulcer presents with a wound that has no line of demarcation, is spreading rapidly, and has a foul odor. The health care worker recognizes these manifestations as:

Moist gangrene

A patient with an underlying heart condition is being admitted to the hospital with an upper respiratory infection. The nurse anticipates that this patient will be admitted to which unit?

Monitored/telemetry

Magnesium levels are important indicators to a variety of bodily functions. What is severe hypermagnesemia associated with?

Muscle and respiratory paralysis

The nurse at a long term care facility encourages the older adults to drink even though they may not feel thirsty at the time. Which of the following statements supports the nurse's action?

Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.

Water movement from the side of the membrane having a lesser number of particles and greater concentration of water to the side having a greater number of particles and lesser concentration of water is termed:

Osmosis

Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work?

Parathyroid hormone

A nurse is caring for a patient who has been admitted to an inpatient facility for the treatment of anorexia nervosa. When planning the care of this patient, which of the following personality traits does the nurse anticipate observing?

Perfectionistic and compulsive

The physical therapist is evaluating a male client who has increased his muscle mass by exercising. The therapist understands this physiologic process is known as which of the following?

Physiologic hypertrophy

When educating students about the differences between brown fat versus white fat, the instructor will share that brown fat has iron in its mitochondria that will facilitate:

Production of a protein that releases the energy generated from metabolism as heat

A patient with schizophrenia is admitted to the behavioral health department and is observed drinking copious amounts of water and voiding large amounts of dilute urine. The nurse recognizes this behavior is consistent with which of these problems?

Psychogenic polydipsia

The nurse needs to assess a 1-year-old child for fever. Which approach will produce the most accurate reading?

Rectal

The presence of granulation tissue at a wound site is identified by:

Red, moist tissue

A client who had an implantable cardioverter-defibrillator (ICD) returns the next week with a fever, chills, and elevated WBC. The physician suspects the wound is infected. If this wound does not respond to antibiotic therapy, the nurse can anticipate the client will undergo:

Removal of device

The nurse is caring for a client who complains of headache and blurred vision. The nurse recognizes these symptoms, accompanied by increased plasma partial pressure carbon dioxide (PCO2) level and decreased pH level are consistent with which of these diagnoses?

Respiratory acidosis

The nurse is caring for a patient in septic shock. The nurse knows that which of the following is a compensatory mechanism for this acid-base imbalance?

Respiratory rate of 32

A nurse is assessing a client for the classic signs of acute inflammation. The nurse would assess the client for:

Rubor, swelling, and pain

A client has developed systemic inflammatory response syndrome. The nurse is aware that this results from:

Severe bacterial infections (sepsis)

When caring for patients with disorders of sodium balance, the nurse asks the provider which of the following findings are consistent with hypernatremia?

Sodium 158 mEq/L and serum osmolality of 320 mOsm/kg

The nurse is caring for a client who is experiencing an increased level of aldosterone secretion. The nurse anticipates that the client may develop:

Sodium and water retention

A family member asks the nurse, "What do they mean when they start taking about stem cells?" Which is the nurse's best response?

Stem cells are undifferentiated cells with the capacity to generate multiple different cell types.

While sponging a client who has a high temperature, the nurse observes the client begins to shiver. At this point, the priority nursing intervention would be to:

Stop sponging the client and retake a set of vital signs

The fight-or-flight response is a manifestation of the stress reaction caused by which part of the nervous system?

Sympathetic

A client who has just had a "fight-or-flight" reaction asks the nurse what causes the quick changes that he experienced. The best response would be the:

Sympathetic nervous system

The psychologist is counseling a client who is overwhelmed by losing his job and the recent death of a parent. Which strategy would be effective for stress reduction?

Teaching the client to systematically contract and relax major muscle groups

What is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder?

The client will compensate with the respiratory system.

When explaining to a patient admitted for stress-induced supraventricular tachycardia, the nurse will incorporate which of the following statements about what happens in the body as a result of excess stress?

The corticotrophin-releasing factor stimulates the release of norepinephrine, which is responsible for "fight-flight" reaction to stress.

Which of the following is true regarding apoptosis?

The endotoxin found in the outer cell membrane of gram-negative bacteria may activate the extrinsic pathway.

An electrician who has been working 14 to 16 hour days for several weeks in order to ensure the financial survival of his business presents to his family physician with complaints of persistent headaches and insomnia. His family physician attributes the physical complaints to the ongoing stress that the man has been undergoing. Which of the following factors has most likely contributed the most to the man's response to this stressful period of his life?

The fact that he has previously had difficulty coping with stress.

A nurse caring for an older adult who has been diagnosed with a urinary tract infection checks the patient's temperature on admission and finds that it is 96.6°F. Which of the following describes how the nurse should interpret the finding?

The patien tmay be exhibiting a blunted or absent febrile response.

A nurse caring for an older adult who has been diagnosed with a urinary tract infection checks the patient's temperature on admission and finds that it is 96.6°F. Which of the following describes how the nurse should interpret the finding?

The patient may be exhibiting a blunted or absent febrile response.

The nurse is caring for a client with an infected wound that is left to heal by secondary intention. Which of these observations does the nurse expect to make during assessment of the wound area?

The wound is healing slowly with epithelial and scar tissues present.

A nurse is teaching a class on health promotion and includes information about the risk from ultraviolet radiation. Which of the following should be included? Select all that apply.

UV radiation increases the risk of skin cancer AND UV radiation damages DNA

Select the statement that best describes stem cells.

Undifferentiated cells of continuously dividing tissues that have the capacity to generate multiple cell types

A client is undergoing a bioelectrical impedance test to estimate body fat. The nurse will explain to the client that this test involves:

Using electrodes to send harmless current through the body to measure resistance to estimate body fat

A client who has developed a fever is now complaining of a headache. The nurse would recognize this manifestation as a result from the:

Vasodilatation of cerebral vessels

The nurse is caring for a client with a chronic wound. The most important intervention for the nurse to include in the plan of care would be:

Vitamin C and Zinc supplements

The poison control nurse is helping calm a hysterical mother who called because her child ingested 10 tablets of B-complex vitamins. The mother keeps repeating over and over again, "Is my child is going to die?" Which of these should the nurse convey to the mother?

Water-soluble vitamins are excreted into the urine, making toxicity less likely.

Which symptom indicates the next stage of a fever after a prodrome?

a chill

Which of the following is an example of wound healing by secondary intention?

an infected burn of the arm

As a nurse prepares to change a patient's dressing,the patient states that she is afraid that it will be painful. Noting that the patient's heart rate and respiratory rate has increased, the nurse adjusts the plan of care to reflect care for a patient in which phase of Selye's general adaptation syndrome?

alarm

Serum phosphorus level has a reciprocal relationship with which of the following serum electrolytes?

calcium

The nurse is caring for a client whose temperature is increasing. The nurse is aware that the client will also experience an increase in:

heart rate

The nurse is caring for a client with an accumulation of 2.5 cm. of darkened tissue scar over the area of a 3 mm. injury. How does the nurse correctly document this finding in the medical record?

keloid

By reabsorbing HCO3- from the glomerular filtrate and excreting H+ from the fixed acids that result from lipid and protein metabolism, the kidneys work to return or maintain the pH of the blood to normal or near-normal values. How long can this mechanism function when there is a change in the pH of body fluids?

days

A nurse is reviewing laboratory values for an elderly patient admitted for changes in mental status. The laboratory values are a urine-serum ratio of 4:1 and urine osmolality of 1100 mOsm/kg H2O. Based on these lab results, the nurse anticipates treatment for which of the following problems?

dehydration

A group of teenagers spent an entire day on the beach without using sunscreen. The first night, their skin was reddened and painful to touch. The second day, they awoke to find large fluid-filled blisters over several body areas. The nurse recognizes the development of blisters as which type of inflammatory response?

delayed response

The nurse caring for a client with a large leg wound notes that the client's past medical history includes diabetes, chronic atrial fibrillation, asthma controlled by maintaninence medication, and neuropathy. Which one has the greatest potential to negatively impact the healing of the client's wound?

diabetes

Select the option that most accurately describes the process resulting in specialized cells.

differentiation

A patient's body temperature has been documented as follows: 12 noon: 37.0°C; 6 pm: 37.5°C; 3 am: 36.0°C. Which of the following actions should the nurse take?

document the temperature

Pyrogens are substances that produce fever in the body. Substances such as bacterial products, bacterial toxins, or whole microorganisms enter the body and stimulate the host cells to produce certain mediators. What are these called?

endogenous pyrogens

A nurse instructing unlicensed personnel on temperature regulation includes that core body and skin temperatures are sensed by which of the following parts of the brain?

hypothalamus

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications?

increase IV fluids

A nurse notes that a patient with a fever has begun to shiver. The nurse should assess for which of the following events?

increased temperature

In which of the following patients with a transecting spinal cord injury should the nurse anticipate an impaired ability for temperature regulation?

injury at T2

The radiologist is reviewing potential types of radiation therapy for a client. Select the type of radiation that directly breaks down chemical bonds in a cell.

ionizing radiation

Which clients are showing manifestations of infection? Select all that apply.

• A 75-year-old, temperature 37.3°C (99.2°F), declining mental status, weakness and fatigue • A 25-year-old, temperature 40°C (104°F), sweating, shivering, states generalized pain • A 2-month-old, temperature 38.3°C (100.4°F), lethargy, poor feeding, and cyanosis

Which of the following clients will be more able to adapt to a stressor based on an individual's ability to adapt? Select all that apply.

• An infant with decreased water intake due to diarrhea • A male client producing increased corticotropin-releasing factor (CRF) • A client with known CAD, expressing problems affording all his prescribed medication

A very ill client has been admitted to the hospital for testing for possible septic shock. The client reports light-headedness, dizziness, and tingling/numbness of the fingers and toes. The nurse understands that this is likely due to which physiological phenomenon?

• Decrease in cerebral blood flow • Gain in bicarbonate

A nurse is caring for a patient who has developed diarrhea a few hours after starting full-strength enteric feeding. The nurse informs the healthcare prescriber and receives a prescription to dilute the feeding to half strength. The nurse understands that the rationale for this intervention is to do which of the following? (Select all that apply.)

• Decrease the osmotic concentration of the feeding • Decrease the pulling of water into the intestinal track

A nurse is caring for an elderly patient admitted with fever of unknown origin and changes in mental status due to advanced Alzheimer's disease. The patient is receiving bolus tube feedings every 8 hours and IV antibiotics and is experiencing frequent loose stools. Which of the following conditions place the patient at risk for developing hypernatremia? Select all that apply.

• Diarrhea • Tube feedings • Confusion

During a lecture on stem cells, the professor mentions that the first few cells produced after fertilization are totipotent and divide into which types of cells? Select all that apply.

• Embryonic cells • Extraembryonic cells

Which of the following organs are involved in the general adaptation syndrome (GAS)? Select all that apply.

• Hypothalamus • Pituitary gland • Adrenal gland

The effective circulating volume is the major regulator of water balance in the body. What else does it regulate?

sodium

A child has been experiencing hypoglycemic episodes. "How does the body know when to secrete insulin and when to stop secreting it?" The best response by the nurse, explaining the physiologic background, would be:

"The body knows that if the blood glucose level falls, it will inhibit insulin secretion and release glycogen to release glucose from the liver."

Following an injury that resulted in a major wound, the client notes that on day 2, the wound looks a little different. The client also notes that if he just brushes the skin accidentally with a towel, it bleeds easily. The client asks why this happens. Which is the best response by the nurse?

"There is new granulation tissue forming that contains many newly developed, fragile capillary buds ."

A patient has been exercising his arms repeatedly. Which of the following explains the increase in the size of the arms?

"Your cells have hypertrophied in response to increased workload."

A client has experienced an acute inflammatory response with an elevation of white blood cells. The nurse is reviewing the client's most recent lab results to determine if the counts have returned to a normal range. Select the result that suggests the client is now within normal range.

4000 to 10,000 cells/μL

In order to prevent muscle wasting, what is the minimal range of carbohydrates that must be consumed per day?

50 to 100 grams

A patient tells the nurse that he or she is going on a low carbohydrate diet in order to lose weight. Which of the following should the nurse inform the patient what the carbohydrate intake should be to prevent tissue wasting and ketosis?

50-100 g/day

A client with a complete tear of the rotator cuff in the right shoulder was given the choice between surgery and stem cell transplant. The client chose to try the stem cell injection. The client asked the health care provider, "How does this work on my shoulder?" The best response would be:

Bone marrow stem cells have been shown to generate cartilage, bone, and muscle when injected directly into the injured site.

A nurse is caring for a group of patients. Which of the following patients has the greatest caloric needs?

Breast-feeding mother who delivered 1 month ago

A client asks the nurse the best way to estimate protein utilization by the body. The best response would be:

By measuring the amount of nitrogen excreted in the urine

Researchers wish to reactivate the cell cycle in nonproliferating cells to assist the body to repair tissue. To reactivate the cycle, which substance will the researchers need to remove from the cell?

CDK inhibitors

The nurse recognizes the role of the lungs in acid-base balance is regulation of which of the following?

CO2

The nurse caring for a client with respiratory acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's respiratory acidosis is improving?

CO2 has decreased

A patient has been diagnosed with a brain tumor that cannot be removed surgically. During each office visit the nurse will be assessing the patient for syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessments would alert the clinic nurse that the patient may be developing this complication?

Complaints of urine output is decreased, no edema noted in ankles, increasing headache.

Digested dietary carbohydrates are primarily converted to:

Glucose

Biologic agents differ from other injurious agents in that they are able to replicate and can continue to produce their injurious effects. How do Gram-negative bacteria cause harm to the cell?

Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability.

Which therapy guides the client to focus on creating a specific mental image designed to bring about positive physical and/or emotional effects to combat stress?

Guided imagery

The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of:

HCO3-

A nurse is caring for a patient with hypoparathyroidism. Which of the following is a major concern for the patient?

Hypocalcemia

The nurse is caring for a patient who is 1 day postoperative for a thyroidectomy. The patient complains of tingling of the hands and feet and around his mouth. The nurse suspects these symptoms are a manifestation of which electrolyte disturbance?

Hypocalcemia

A community health nurse who is attending a marathon recognizes which of the following types of hypotonic hyponatremia is likely when a patient reports muscle weakness, cramping, and general fatigue in spite of adequate water hydration during the run?

Hypovolemic

A patient is admitted with an alteration in arterial blood gases. Cellular injury is most likely to result from which of the following aspects of this abnormality?

Hypoxia

The rehabilitation nurse is caring for a client who is recovering from a cerebrovascular accident (CVA) with hemiplegia. The family asks the nurse if the paralysis will be permanent. Upon which of these physiologic rationales should the nurse base the response?

It is likely that paralysis is permanent, as nerve cells do not normally regenerate.

Small amounts of lead accumulate to reach toxic levels in the human body. Lead is found in many places in the environment and is still a major concern in the pediatric population. What would the nurse teach the parents of a child who is being tested for lead poisoning?

Keep your child away from peeling paint.

A patient on a diet that is very low in carbohydrates and high in protein submitted a urine specimen for analysis. Which of the following does the nurse expect to see when the results come back?

Ketones

A client has these arterial blood gas values: anion gap 20 mEq/L, pH 7.29, pCO2 37mm Hg, HCO3- 11 mEq/L, base excess -6 mEq/L. With what condition do these values correspond?

Lactic acidosis

The parents of an anemic 4-year-old child tell the pediatrician that the child has been behaving differently and having abdominal discomfort. Realizing that the family lives in an older, urbanized community, the provider tests the child for which of the following?

Lead

A normal response to fever is an elevated heart rate. A client with a fever who is not exhibiting an elevated heart rate would indicate to the nurse that the cause of the fever might be which of the following?

Legionnaires disease

When caring for a client who has developed bacterial pneumonia, the nurse assesses for which of these abnormalities that supports presence of infection?

Leukocytosis

There are two types of diabetes insipidus (DI): neurogenic and nephrogenic. In nephrogenic DI, there is an inability of the kidney to concentrate urine and to conserve free water. Nephrogenic DI can be either genetic or acquired. What are the causes of nephrogenic DI?

Lithium and hypokalemia

The nurse is administering the medications to a patient on the cardiac unit. Giving which of the following medications causes the nurse to be alert for hypokalemia?

Loop diuretic

The nurse is caring for a client with renal failure experiencing shortness of breath and increased respiratory rate. The arterial blood gas reflects a pH of 7.10 and a HCO3 level of 18 mEq/L. How does the nurse interpret these findings?

Metabolic acidosis

A client asks why his temperature is always below 98.6°F. The nurse responds:

Normal core temperature varies between individuals within the range of 97.0°F to 99.5°F.

An occupational health officer who works in the context of a large police force is attempting to understand the role that stress may play in the health of his clients. According to Selye, which of the following statements best captures an aspect of the phenomenon of stress?

Periods of stress can be developmentally positive or negative.

The health care provider is teaching a client about the ability of the body to function and maintain homeostasis under conditions of change in the internal and external environment. The most important regulation is controlled by which system?

Physiologic

Place the four successive stages of fever in correct order.

Prodromal Chill Flush Defervesvence

When a patient asks why some body fat is good, the nurse responds based on what fact?

The body stores energy in adipose tissue

Which of the following children is at greatest risk of lead toxicity?

The child with a lead level of 10 μg/mL

The nurse is assessing a client who is in the prodromal stage of a fever. The nurse anticipates the client will exhibit:

fatigue

A client asks the nurse what is the most common objective symptom of systemic inflammation during the acute-phase response. The best response would be:

fever

The manifestations of the stress response are strongly influenced by which of the following systems?

nervous

While reviewing the phases of wound healing, the students note that the first cells to arrive after the injury are the:

neutrophils

Hypothalamic sensory neurons that promote thirst when stimulated are called which of the following?

osmoreceptors

A client with chronic obstructive pulmonary disease (COPD) receives oxygen in the emergency department at a rate of 4 L/min for acute respiratory distress. Later, the nurse finds the client unresponsive with a respiratory rate of 8/minute. What ABG values would the nurse expect to obtain?

pH 7.29, pCO2 67mm Hg, HCO3- 26 mEq/L, pO2 64mm Hg

When caring for the client with a hyperkalemia, the nurse recognizes the body should respond in which of these ways?

secrete potassium in the distal tubules for excretion

A 77 year-old female hospital patient has contracted Clostridium difficile during her stay, and is experiencing severe diarrhea. Which of the following statements best conveys a risk that this woman faces?

she is susceptible ti isotonic fluid volume deficit

A nurse is caring for a patient in fluid volume excess and expects to find which of the following signs and symptoms that may be present?

• Increase in central venous pressure • Decreased hematocrit • Weight gain

Respiratory acidosis occurs at a time when the plasma pH falls below 7.35 and arterial Pco2 rises above 50 mm Hg. Because CO2 easily crosses the blood-brain barrier, what signs and symptoms of respiratory acidosis might the nurse see? (Select all that apply.)

• Irritability • Muscle twitching • Psychological disturbances

A client with a history of heart and kidney failure is brought to the emergency department. Upon assessment/diagnosis, it is determined the client is in decompensated heart failure. Of the following assessment findings, which are associated with excess intracellular water? Select all that apply.

• Lethargy • Confusion • Seizures

The nurse is caring for a patient whose lab values reflect hypercalcemia. The nurse understands that causes of hypercalcemia include which of the following? (Select all that apply.)

• Malignant neoplasm • Prolonged immobilization • Lithium therapy

The first goal of treatment of stress disorders is to aid clients in avoiding those coping mechanisms that cause their health to be at risk. Secondly, the treatment of stress disorders should engage them in alternative strategies that reduce stress. Which are nonpharmacologic treatments of stress disorders? (Select all that apply.)

• Music therapy • Massage therapy

During a discussion of different cell types in the body, the instructor mentions that which types of cells renew themselves continuously throughout life?

• Neurons • Cells lining the GI tract

Diagnosing the primary cause is one of several methods used to treat fever. What are some other methods? (Select all that apply.)

• Protection of vulnerable body organs and systems • Modification of external environment to increase heat transfer from the internal to the external environment • Support of hypermetabolic state that accompanies fever

The physiology instructor asks the students, "How does growth factor affect cell proliferation?" Which students have the most accurate responses? Growth factors: Select all that apply.

• Regulate the inflammatory process • Act as a chemoattractant for many cells like neutrophils and macrophages • Stimulate new blood vessel growth

The nurse is teaching a client who has been placed on an angiotensin receptor blocker. The nurse explains this medication will block the renin-angiotensin-aldosterone system (RAAS) which, when activiated, causes which of the following? Select all that apply.

• Renal retention of sodium and water • Increase in peripheral vascular tone

A patient informs the nurse that he or she would like to begin a healthier dietary intake and would like to limit carbohydrate consumption. Understanding that the patient must have carbohydrates to avoid tissue wasting and ketosis, Which of the following forms of carbohydrate should the nurse suggest? Select all that apply.

• Vegetables • Fruits • Whole grains

Which arterial blood gas (ABG) values tell the nurse a client is in respiratory alkalosis? Select all that apply.

• pCO2 of 27mm Hg • pH 7.52