Patho exam 4
A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?
Placement of a shunt
The regulation of cerebral blood flow is accomplished through both autoregulation and local regulation. This allows for the brain to meet its metabolic needs. What is the low parameter for arterial blood pressure before cerebral blood flow becomes severely compromised?
60 mm Hg
Average blood sugar level
600
A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. The nurse determines further teaching is necessary when the client states:
"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."
A client discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The client's spouse is extremely upset because the physician stated that the client cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. What is the nurse's most accurate response?
"Thrombolytics may cause cerebral hemorrhage."
diabetic ketoacidosis
(DKA) -because insulin levels are too low, the body cannot use sugar and uses fat as fuel instead -byproducts of fat breakdown, called ketones, build up in the body -high levels are toxic
Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"?
A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL.
A patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient?
A young female patient who has been trying to get pregnant.
disorder of the mind that is subtle memory loss but progresses
Alzheimers
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
There are two main categories of glial tumors. One of the categories is:
Astrocytic
An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to the normal self. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?
Atherosclerotic lesions in cerebral vessels
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
The nurse knows that type 1 diabetes mellitus results from destruction of the pancreatic beta cells by two mechanisms. The mechanism for type 1A diabetes is _______ destruction.
Autoimmune
A client reveals that when in bed, changes in head position cause brief periods of vertigo, usually lasting less than 1 minute. Which condition is the client most likely experiencing?
Benign paroxysmal positional vertigo
A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly but her respiratory rate is 45 breaths per minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment?
Coma
The nurse is caring for a 31-year-old trauma victim admitted to the neurologic intensive care unit. While doing the initial assessment, the nurse finds that the client is flexing the arms, wrists, and fingers. There is adduction of the upper extremities with internal rotation and plantar flexion of the lower extremities. How would the nurse describe this in the notes?
Decorticate posturing
A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which medical diagnosis listed below may be associated with these clinical manifestations?
Encephalitis
When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs?
Erythropoietin
Classic sign of Hyperthyroidism
Exophthalmos
Acronym used for stroke procedure
Face (droops) Arms (drift) Speech (attn. to how they talk) Time (get them to stroke center asap) Time within 3-4 hours of onset symptoms
Which nursing intervention is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo?
Fall precautions
When sensors detect a change in a hormone level, the hormonal response is regulated by which mechanism that will return the level to within normal range?
Feedback
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.
Most common cause of hypothyroidism
Hashimoto's thyroiditis
Common pressure ulcer sights
Heels, elbows, back, hip, groin
A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?
Hypoglycemia
Neurons that connect sensory and motor neurons are known as which of the following?
Interneurons
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.
Stimulation tests
You can do eye to ear drops but not ear to eye drops.
True
Amblyopia, or lazy eye, occurs at a time when visual deprivation or abnormal binocular interactions occur in visual infancy. Whether amblyopia is reversible depends on which factor?
Maturity of the visual system at time of onset.
What are the hallmark signs of diabetes mellitus?
Polyuria, polydipsia, and polyphagia
Which visual deficit is a clinician justified in attributing to the normal aging process?
Presbyopia
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?
Random blood glucose 85 mg/dl
Hormones are chemical messengers that provide which function in the body?
Regulate body functions.
Thyroid and steroid hormones, which exert their effect on target cells by way of nuclear receptors, have which of the following characteristics?
The ability to cross the cell membrane of target cells
A client has started on interferon beta for treatment of multiple sclerosis. What should the nurse include in the teaching? Select all that apply.
The medication will be given by subcutaneous injection. Interferon beta alters your immune response.
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which of these does the nurse explain to the client is the role of the thyroid gland?
The thyroid gland is responsible for increasing the metabolic rate.
Sharp muscle convulsions, lose consciousness
Tonic- CLonic
A client in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which diagnosis best captures this pathophysiology?
Vasogenic edema
Classic symptom of Meneries Disease
Vertigo
While assessing a client with suspected Ménière disease, the nurse would expect which clinical manifestation?
Vertigo
Tinea pedis
athlete's foot
Impetigo
bacterial skin infection characterized by isolated pustules that become crusted and rupture
Severe phase of Alzheimer
bedridden, require total care
shear
bends blood vessels
Clonic seizure
bilateral, symmetric, rhythmic muscle contractions
Pressure ulcers
blood flow obstructed
tinea corporis
body
AU
both ears
OU
both eyes
If your cold and clammy you need some ____
candy
Albinism
complete/partial loss of pigment more likely for sunburn
Addisons hormones all ____
decrease
Diaper dermatitis
diaper rash
Dysphagia
difficulty swallowing
Retinopathy
disease of the retina small retinal blood vessels
otic
ear
ENT doctor
ear, nose, and throat doctor
HPV
genital warts over 80 cases
Islets of Langerhans
groups of pancreatic cells secreting insulin and glucagon.
Cold sores
herpes simplex
If your hot and dry your sugar is ____
high
Phenom occurs when too much circulating thyroid hormone
hyperthyroid
Aphasia
inability to speak/ understand words
Following a head injury on the football field, the medical team is concerned because the athlete is showing this earliest sign of decreased level of consciousness?
inattention
Cushings hormones all ____
increase
cellulitis
inflammation of skin cells in the dermis of subq tissue
Tumor malignant in the melanocyte
melanoma
Mineral corticoid that had major influence on adrenal gland
mineral corticoid
Signs/symptoms of Cushing's
moon face, purpura, hair , muscle weakness, hypertension
loss of cosciousness + awareness
multi-hemisphere
The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense:
muscle position
myoclonic seizure
muscles of the face, trunk, extremities contract
macular degeneration
progressive damage to the macula of the retina loss of central vision
As the nurse is performing a physical assessment of a client, the client begins to have seizure activity including loss of consciousness and limb jerking. The nurse's priority is to:
protect the client from injury.
AD
right ear
OD
right eye
tinea capitis
ringworm of the scalp
Hyperglycemic Hyperosmolar State (HHS)
same state of DKA but no ketones spilling into the bloodstream
Initial phase of Alzheimer
short term memory loss
Dysarthria
slurred speech
Ringing of the ears
tinnitus
Retinal detachment
two layers of the retina separate from each other
Tonic seizure
voluntary muscles of the legs and arms contract
Verrucae
warts
Why does a stroke reoccur?
weakened vessels, in bed with no exercise, if you have one you'll likely have another.
Cardiovascular problems that cause a stroke
Hypertension
Hormones that have major effect on your adrenal glands?
Salt, Sugar, Sex Mineral corticoid, glucco corticoid, and sex hormones
Atonic seizure
lack of normal muscle tone
AS
left ear
OS
left eye
Signs/symptoms of Addison's
lethargic, elevated potassium levels, loss of weight, hypotension
does not lose consciousness / awareness
limited to one hemisphere
Absent seizure
still conscious - tend to space out NO convulsion
Which gland is often referred to as the master gland because it secretes many hormones?
Pituitary
The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?
Beta cells
Which components of the nervous system make up the central nervous system?
Brain and spinal cord
The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:
Decreased level of oxygen
During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which component of her nervous system contains the highest level of control of her arm and hand action?
Frontal lobe
The nursing student who is studying pathophysiology correctly identifies the condition that characteristically has an increase in the aqueous humor that fills the anterior and posterior chambers of the eye. What is this disease called?
Glaucoma
Which substance provides the majority of the fuel needs of the neurologic system?
Glucose
A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:
Glycosylated hemoglobin, hemoglobin A1C (HbA1C)
When educating a patient about glargine (Lantus), the nurse should explain that this medication:
Has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours.
During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?
Hyperglycemia
A diabetic client was visiting the endocrinologist for annual checkup. The client's blood work reveals an increased level of which lab result that reveals early signs of diabetic nephropathy?
Microalbuminuria
What could cause a patients skin to sheer?
Moving the sheets under them
Which is the primary component of white matter?
Myelinated Fibers
For which common manifestation of acute meningococcal meningitis should the school nurse be assessing students?
Petechiae
While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' diabetes? Select the best answer.
Promote glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids.
While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is:
Sebum, secreted by the sebaceous gland
Herpes zoster
Shingles; painful red blisters
The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?
Stupor
Cradle cap
a skin condition known for yellowish, crusty patches on the scalp
A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced?
a tonic-clonic seizure
Ischemic Stroke
a type of stroke that occurs when the flow of blood to the brain is blocked (80%)
Sugar puts the body in what state?
acidic
2nd degree burns
epidermis + dermis
Moderate phase of Alzheimer
everything becomes impaired
Polyphasia
excessive hunger/ eating too much
Polydipsia
excessive thirst
polyurea
excessive urination
Hemorrhagic Stroke
occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed (15%)
Adrenal
on top of the kidneys; prepares the body for action, controls the heart rate and breathing in times of emergency.
1st degree burns
only epidermis is damaged
Inflammation of the outer ear
otitis externa
vitilligo
patches of skin without pigment; benign condition with no known cause
More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by which portion of the frontal lobe?
premotor cortex
When testing nociceptive stimuli to elicit a withdrawal reflex in the body, what stimuli are commonly used?
pressure from a sharp object
What can make a patients blood sugar spike during hospitalization
stress
Cerebral Edema
swelling of the brain
Glaucoma
a condition of increased pressure within the eyeball, causing gradual loss of sight.
The nurse is caring for a client with Guillain-Barré syndrome. Which clinical manifestations are expected with this diagnosis? Select all that apply.
Flaccid paralysis of extremities Pain Loss of tendon reflexes
optic
eye
aqueous humor
fluid in the eye, found between the cornea and the lens delivers food and oxygen to the lens and cornea
tonic-clonic seizure
generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups
otitis media
inflammation of the middle ear (cause children to have tubes placed in)
3rd degree burns
into subcutaneous tissue. damage bone, blood vessels
puritis
itching
1st sign of congenital hypothyroidism
jaundice
Staph or strep can damage
kidneys