Patho Exam Two

A client with MS is frustrated by tremors associated with the disease. how should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS: A. Communication being sent through neurons is slowed B. Basal ganglia are not sending organized signals to your body C. Nerve damage results in no signals making it to certain muscles D. Nerve impulses are arriving to your muscles too quickly

A. Communication being send through neurons is slowed

Two years after chemotherapy and radiation therapy for lung cancer, a 72- year-old client reports being extremely tired all the time. The physician suspects the client may have developed aplastic anemia. The nurse assessing the client will likely find which clinical manifestation of aplastic anemia? Select all that apply. A. Complaints of weakness and fatigue B. Small spots of skin hemorrhages over entire body C. Excess bleeding from gums and nose D. Spoon-shaped deformity of the fingernails E. Hemolysis from renal dialysis treatments

A. Complaints of weakness and fatigue B. Small spots of skin hemorrhages over entire body C. Excess bleeding from gums and nose

The nurse is caring for a client with an altered level of consciousness and needs to assess the withdrawal reflex. which action should the nurse perform? A. Creating a painful stimulus to the clients extremities B. Asking the client to flex a limb while applying resistance C. Stroking the plantar aspect of the clients foot D. Producing a loud noise near the clients ear

A. Creating a painful stimulus to the clients extremities

A 41 year old woman diagnosed with MS is sharing her story with members of an MS support group made up of people recently diagnosed. Which aspects of her health problem should the woman warn others to expect at some point in the progression of the disease? Select all that apply A. Debilitating fatigue B. Progressive loss of visual acuity C. Gradual development of a resting tremor D. Loss of mental acuity E. Shuffling gait

A. Debilitating fatigue B. Progressive loss of visual acuity D. Loss of mental acuity

The nurse is planning care for a client in the acute recovery phase after an ischemic stroke. What interventions will the nurse prioritize when planning care? Select all that apply A. Deep vein prophylaxis B. Fall prevention C. Swallowing precautions D. Reorientation exercises E. Stroke prevention education

A. Deep vein prophylaxis B. Fall prevention C. Swallowing precautions

The parents of a 15 year old boy are frustrated at his persistent inability to fall asleep at a reasonable hour at night, as well as the extreme difficulty that they have rousing him in the morning. While sleepy after waking, the son claims to not feel drowsy after lunch or in the evening. What is the most likely classification of the boy's sleep disorder? A. Delayed sleep phase syndrome B. Non-24 hour sleep wake syndrome C. Advanced sleep phase syndrome D. Chronic insomnia

A. Delayed sleep phase syndrome

The nurse is caring for a client with jaundice. What evidence will the nurse use to determine if the cause of the jaundice is due to a hemolytic condition? A. Elevated unconjugated bilirubin B. Decreased hemoglobin C. Liver function tests D. Decreased conjugated bilirubin

A. Elevated unconjugated bilirubin

During a science class, a student asks "What is the difference between plasma and serum in the blood?" The nurse responds that the primary difference between plasma and serum is that plasma contains A. Fibrinogen B. Heparin C. White blood cells D. Hydrogen ions

A. Fibrinogen

During a physical exam, the nurse practitioner notes that the client's optic disk is very pale with a larger size/depth of the optic cup. At this point, the NP is thinking that the client may have: A. Glaucoma B. Diabetes retinopathy C. Macular degeneration D. Retinal tear

A. Glaucoma

Which salients signs and symptoms would allow a clinician to be most justifies in ruling out stroke as a cause? An adult A. Has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days B. Experienced a sudden loss of balance and slurred speech C. Has comities and complained of a severe headache D. States that her left arm and leg are numb and gait is consequently unsteady

A. Has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days

The unique clinical presentation of a 3 month old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis? A. Have you ever given your child honey or any products containing honey? B. Is there any family history of neuromuscular diseases? C. Has your baby ver been directly exposed to any chemical cleaning product? D. Is there any mold in your home that you know of?

A. Have you ever given your child honey or any products containing honey?

Which assessment and laboratory findings would be most closely associated with acute leukemia? A. High blast cell counts and fever B. Decreased oxygen partial pressure and weight loss C. Increased serum potassium and sodium levels D. Increased blood urea nitrogen and bone pain

A. High blast cell counts and fever

A client arrives at the emergency department with symptoms of a stroke. What evidence should the nurse gather to determine if the client is a candidate for thrombolytic therapy? Select all that apply A. History of stroke B. Age C. Blood pressure D. Heart rate E. Time of symptom onset

A. History of stroke C. Blood pressure E. Time of symptom onset

A client arrives in the emergency department reporting muscle cramps and spasms in the legs and feet; tingling in the fingers, toes, and lips; and anxiety. Serum calcium level is 4.8. Suspecting tetany, which medication should the nurse be prepared to administer? A. IV calcium gluconate B. Vitamin D C. Magnesium Sulfate IV D. Thiazide diuretic

A. IV calcium gluconate

The health care provider is ordering a complete blood count. What information should the nurse expect to be able to gather from the results? Select all that apply. A. If the client has anemia B. The presence of leukocytes C. If the client is deficient in clotting factors D. If there are common vitamin deficiencies E. Presence of thrombocytopenia

A. If the client has anemia B. The presence of leukocytes E. Presence of thrombocytopenia

When discussing the sequence of clot dissolution, the science instructor will talk about which item that begins the process? A. Plasminogen B. Dabigatran C. Platelets D. a2-plasmin inhibitor

A. Plasminogen

A 71 year-old male client with a history of myocardial infarction (MI) and peripheral vascular disease (PVD) has been advised by his family physician to begin taking 81 mg of aspirin once daily. Which statement best captures an aspect of the underlying rationale for the physician's suggestions? A. Platelet aggregation can e precluded through inhibition of prostaglandin production by aspirin. B. Aspirin helps to inhibit ADP action and minimizes platelet plug formation. C. Aspirin can reduce unwanted platelet adhesion by inhibiting TXA2 synthesis. D. Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.

A. Platelet aggregation can e precluded through inhibition of prostaglandin production by aspirin.

A client has been diagnosed with a brain tumor that cannot be removed surgically. During each office visit the nurse will be assessing the client for syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment would alert the clinic nurse that the client may be developing this complication? A. Report of decreased urine output, no edema noted in ankles, increasing headache B. Hyperglycemia, dry mucous membranes, projectile vomiting C. Fever, diarrhea, nausea D.Muscle cramps, tingling around the mouth/lips, unexplained bruising

A. Report of decreased urine output, no edema noted in ankles,increasing headache

A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the client that the venous blood supply to the penis is controlled by: A. Sacral prarsympathetic fibers B. The hypothalamus C. The vagus nerve d. the postganglioic sympathetic neurons

A. Sacral parasympathetic fibers

A 77-year-old female hospital client has contracted Clostridium difficile during her stay and is experiencing severe diarrhea. Which statement best conveys a risk that this woman is facing? A. She is susceptible to isotonic fluid volume deficit B. She is prone to isotonic fluid volume excess. C. She could develop third-spacing edema as a result of plasma protein losses. D. She is at risk for compensatory fluid volume overload secondary to gastrointestinal water and electrolyte losses.

A. She is susceptible to isotonic fluid volume deficit.

A client has been diagnosed with MS. What should the nurse include in client teaching to help reduce the frequency of exacerbations? Select all that apply A. Stay up to date with your vaccines B. Avoid stressful situations C. Avoid extremes of environmental temperature D. Do not take over the counter medicines E. Stay out of direct sunlight

A. Stay up to date with your vaccines B. Avoid stressful situations C. Avoid extremes of environmental temperature

A badly burned firefighter has been in an induced coma for 3 weeks. When he awakens, he thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose ? A. Thalamus B. Hypothalamus C. Corpus callosum D. Basal ganglia

A. Thalamus

The nurse takes a clients blood pressure in the primary care provider's office. The last three times the client has been in the office it has been high. What structure in the eye is this adverse effect of hypertension most likely to affect? A. Iris B. Retina C. Cilliary body D. Lens

B. Retina

A 66-year-old female client has presented to the emergency department because of several months of intermittently bloody stool which has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which situation is most likely? A. The woman has depleted blood volume due to her ongoing blood loss. B. She will have iron-deficiency anemia due to depletion of iron stores. C. The client will be at risk for cardiovascular collapse or shock. D. She will have delayed reticulocyte release.

B. She will have iron-deficiency anemia due to depletion of iron stores.

A hospital client is receiving intravenous infusion of heparin for treatment of a pulmonary embolus. Which phenomenon is most likely occurring, resulting in th drug's therapeutic effect? A. Inhibition of vitamin K synthesis in the liver B. Suppression of fibrin formation C. Deactivation of the intrinsic clotting pathway D. Inhibition of ADP-induced platelet aggregation

B. Suppression of fibrin formation

A client asks the health care provider why his lower legs look purple, The health care provider will base the response on which pathophysiologic principle? A. Too much trauma breaks capillaries and they bleed into the tissue. B. The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher. C. There is a problem with the plasminogen levels. D. Morbid obesity causes veins to enlarge and bleed into tissues due to stress the abdomen is placing on the vascular system.

B. The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher.

A client has started on interferon beta treatment of MS. What should the nurse include in teaching? Select all that apply A. Seek emergency treatment if you develop flu-like symptoms B. The medication will be given by subcutaneous injection C. This drug can reduce symptoms but will not alter disease activity D. Interferon beta alters your immune response E. Interferon beta beta does not have known side effects

B. The medication will be given by subcutaneous injection D. Interferon beta alters your immune response

Which statement best conveys a characteristic of red blood cells? A. They lack organelles and soluble enzymes B. They contribute to the maintenance of blood pH C. They help maintain the body's fluid balance D. They are self-replicating

B. They contribute to the maintenance of blood pH

The nurse is counseling a client who is going for major surgery and must stop taking aspirin to reduce the risk for bleeding. The nurse knows aspirin decreases platelet activity for the duration of the platelets lifespan. How many days prior to the surgery should the nurse tell the client to stop taking aspirin? A. 2 B. 5 C. 10 D. 14

C. 10

During a period of extreme excess fluid volume, a renal dialysis client may be administered which type of IV solution to shrink the swollen cells by pulling water out of the cell? A. 0.9% sodium chloride B. 5% dextrose and water C. 3% sodium chloride D. Lactated Ringer's Solution

C. 3% sodium chloride

Which individual would be expected to have the highest risk of developing sleep apnea? A. A woman with restless legs syndrome and chronic obstructive pulmonary disease B. A male client with a diagnosis of unstable angina and peripheral arterial disease C. A man with poorly controlled diabetes and hypertension D. A female with chronic insomnia and atrial fibrillation that is treated with warfarin.

C. A man with poorly controlled diabetes and hypertension

The nurse evaluates the ECG of a client who has developed hypokalemia secondary to diuretic use. Which manifestation of hypokalemia does the nurse anticipate on the ECG? A. Irregular heart rate and a peaked T wave B. A low T wave and an absent P wave C. A prominent U wave and a flattened T wave D. A narrow QRS complex and an absent U wave

C. A prominent U wave and a flattened T wave

A 47 year old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis. What assessments and interventions should the nursing staff of the unit prioritize in their care? A. Assessment and documentation of cognitive changes, including confusion and restlessness B. Regular pain assessment and administration of opioid analgesics as needed C. Assessment of swallowing ability and respiratory status D. Cardiac monitoring and administration of inotropic medications

C. Assessment of swallowing ability and respiratory status

When talking about the various types of granulocytes, which granule contains heparin, an anticoagulant? A. Neutrophils B. Eosinophils C. Basophils D. Lymphocytes

C. Basophils

A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which health problem? A. Jaundice B. Anemia C. Infections D. Blood clots

C. Infections

Following a serious bout of bacterial meningitis, the parents of a 14 month old have noted the child is not responding to verbal commands. The nurse will explain the pathophysiologic principle behind this by making which statement? A. This could be caused by the same organism that caused the meningitis infecting the child's tympanic membrane B. This may be due to a loss of hair cells ANS damage to the auditory nerve C. The ear and the lining of the brain that was infected are all connected together D. It is common for meningitis to use up all the natural killer cells and therefore increase the risk of having brain tumors develop

B. This may be due to a loss of hair cells ANS damage to the auditory nerve

A 21-year-old me is brought to the ED following a night of partying in his fraternity, His friends found him "asleep" and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the mans friends, the nurse begins by explaining that alcohol is: A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach B. very lipid-soluble and rapidly crosses the blood-brain barrier C. Able to reverse the transport of some substances to remove them from the brain D. Very likely to cause sedation and therefore the client just needs to sleep it off

B. Very lipid-soluble and rapidly crosses the blood-brain barrier

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? A. Delirium B. Coma C. Brain dead D. Vegetative State

B. Coma

A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can: A. Administer a psychotropic medication to help the client cope with the loss of his leg B. Explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site. C. Call the physician and request an order for a psychological consult D. Educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.

B. Explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.

Which scenario would be a example of a child born with congenital insensitivity to pain? A child who: A. Develops pins-and-needles sensation after jumping out of a tree B. Fell off a skate board and fractured ankle but did not feel any pain, just noted swelling in foot C. Skinned knee from a bike accident but only told parents when it started burning D. Cries every time the wind blows because it hurts his face and ears

B. Fell off a skate board and fractured ankle but did not feel any pain, just noted swelling in foot

A blood sample is ordered to be collected in a plasma-separator tube, but the nurse can only find a serum-separator tube. The nurse should be most concerned about the accuracy of which results if the serum-separator tube is used? A. Albumin and total protein levels B. Fibrinogen and clotting factor levels C. Immunoglobulin analysis D. Electrolyte measurements

B. Fibrinogen and clotting factor levels

A client at risk for febrile neutropenia related to chemotherapy treatments has been prescribed medication to prevent this reaction. Which medication should the nurse be prepared to administer? A. Prednisone, a corticosteroid B. Filgrastim, a granulocyte-colony stimulating factor (G-CSF) C. Epoetin alfa, an erythropoiesis-stimulating agents (ESAs) D. Immunoglobulin M (IgM) antibody

B. Filgrastim, a granulocyte-colony stimulating factor (G-CSF)

A client is brought to the emergency department with reports 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? A. Hyponatremia B. Fluid Volume Excess C. Hypocalcemia D. Hyperkalemia

B. Fluid Volume Deficit

When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatral node in the right atrium of the heart, it is: A. Positively charges B. Inhibitory C. Overstimulated D. Dormant

B. Inhibitory

While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia. Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is: A. Metabolic acidosis that occurs spontaneously following dysrhythmias B. Interruption of the blood/oxygen supply to the brain C. Massive cerebrovascular accident resulting from increased perfusion D. A blood clot coming from the heart and occluding the carotid arteries

B. Interruption of the blood/oxygen supply to the brain.

A client arrives for a scheduled bone marrow aspiration and biopsy. The nurse explains to the client that which positions are best for accessing the posterior iliac crest for aspiration? Select all that apply A. Supine B. Lateral decubitus C. Prone D. Trendelenburg E. Legs extended

B. Lateral decubitus C. Prone

A client with a diagnosis of end-stage liver failure has arterial blood gas results indicating altered pH. Which of these consequences of liver failure has most likely caused the acid-base disturbances? A. Conservative or formation of new HCO3 by the kidneys B. Low albumin and plasma globulin levels C. Transcompartmental exchange of H and potassium ions D. renal excretion of HCO3 in the presence of excess base

B. Low albumin and plasma globulin levels

The nurse is caring for a teenager with sickle cell anemia. When comparing new laboratory results with the client's baseline, which results should the nurse prioritize as requiring intervention? Select all that apply. A. Elevated serum bilirubin B. Low pH on an arterial blood gas C. Elevated serum osmolality D. Decreased hemoglobin E. Elevated white blood cell count

B. Low pH on an arterial blood gas C. Elevated serum osmolality E. Elevated white blood cell count

While working for a neurologist who is assessing a client experiencing restless legs syndrome (RLS), the nurse should be prepared to answer the question about why the client needs to have iron levels drawn? The nurses response should include: A. Many of the drugs we give for RLS can cause drastic decreases in your iron level B. many clients with RLS also have an iron-deficiency anemia as well C. You just took a little pale and so we want to make sure you have normal blood levels D. People with low iron levels do not have enough oxygen circulating to their legs

B. Many clients with RLS also have an iron-deficiency anemia as well

The nurse knows which phenomena listed below is an accurate statement about a axonal transport? A. Anterograde and retrograde axonal transpiration allow for the communication of nerve impulses between and neuron and the CNS. B. Materials can be transported to the nerve terminal by either fast or slow components. C. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens. D. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

B. Materials can be transported to the nerve terminal by either fast or slow components

A 30 year-old male's blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man's most likely diagnosis? A. Acute myelogenous leukemia B. Multiple myeloma C. Acute lymphocytic leukemia D. Hodgkin lymphoma

B. Multiple myeloma

The nurse is caring for a client with a longstanding diagnosis of hypocalcemia secondary to kidney disease. The nurse observes which clinical manifestations in this client? A. Loss of appetite and reports of nausea B. Muscular spasms and reports of tingling in hands/feet C. High fluid intake and copious amounts of dilute urine output D. Lethargy and change in level of consciousness

B. Muscular spasms and reports of tingling in hands/feet

If the anterior-posterior dimension of the eyeball is too long, the focus point for an infinitely distant target is anterior to the retina. This patient would be diagnosed as having A) hyperopia. B) myopia. C) cycloplegia. D) presbyopia

B. Myopia

A client visited his health care provider after finding an enlarged lymph node along the mediastinal border. The health care provider may be alerted to a possible diagnosis of Hodgkin lymphoma (HL) based on the client having which other clinical manifestations? Select all that apply. A. Yeast infection in the mouth B. Night sweats C. Unexplained pruritus D. Joint swelling E. Sore throat with pustules on tonsils.

B. Night sweats C. Unexplained pruritus

The nurse is caring for a client with traumatic brain injury and increased intracranial pressure. What findings should the nurse report due to the risk for increasing intracranial pressure? Select all that apply A. PaCO2 of 28mmHg B. PaCO2 of 50mmHg C. PaCO2 of 70mmHg D. PH of 7.25 E. Potassium of 3.3

B. PaCO2 of 50mmHg C. PaCO2 of 70mmHg D. PH of 7.25

Following head injury from a fall, the child's CT scan reveals a moderate brain injury contusion. Which manifestations will the nurse more than likely assess on this child that supports this diagnosis? Select all that apply. A. Coma with total paralysis B. Periods of unconsciousness C. Aphasia at times D. Nuchal rigidity E. Weakness or slight paralysis affecting one side of the body

B. Periods of unconsciousness C. Aphasia at times E. Weakness or slight paralysis affecting one side of the body

A 44-year-old hospitalized client with a diagnosis of end-stage acquired immunodeficiency syndrome (AIDS) has been placed on neutropenic precautions that limit his interaction with visitors, staff, and other clients. What is the underlying rationale for these precautions? A. His antibody-mediated immunity is compromised by his low production of neutrophils. B. Neutropenia limits the ability of his CD4+ helper cells to present antigens. C. Insufficient levels of neutrophils make him particularly susceptible to infections. D. Cyclic neutropenia limits his body's ability to fight various infections.

C. Insufficient levels of neutrophils make him particularly susceptible to infections.

The nurse should anticipate that she will need to teach the client newly diagnosed with MS how to give injections if which medication to assist with reducing exacerbations is prescribed? A. Corticosteroids B. Plasmapheresis C. Interferon beta D. Mixoantrone

C. Interferon beta

A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability? A. Pacinian corpuscles B. Ruffini end-organs C. Meissner corpuscles D. Free nerve endings

C. Meissner corpuscles

A group of nurses rotate between day shift and night shift hours. Following a very busy, traumatic 12 hour shift, which nurse should be given a ride home for personal safety? A. A nurse who is hyperactive following a frequent caffeine intake B. A nurse who is not going to sleep when arriving home to organize the child's birthday party C. Nurse who has been nodding off while charting and just seems sluggish D. Nurse who decides to go for a walk outside prior to driving home

C. Nurse who has been nodding off while charting and just seems sluggish

Which motor disorder of sleep can be life threatening? A. Narcolepsy B. Periodic limb movement C. Obstructive apnea D. Restless legs syndrome

C. Obstructive apnea

A 5 year old needs to undergo a bone marrow biopsy. When educating the parents. Which site should the nurse state is the most commonly used? A. Sternum B. Spinous C. Posterior iliac crest D. Anterior iliac crest

C. Posterior iliac crest

A client has been suffering from fatigue and the health care provider suspects anemia. Which test results will the hcp consult when investigating the cause of the anemia? A. RBCs B. Hemoglobin C. RBC indices D. Hematocrit

C. RBC indices

A college junior calls his mother, a nurse, complaining of, "not being able to see." When questioned further, he describes, "A gray curtain just went down my right visual field. I don't know what to do." The nurse should recognize this symptom as which of the following conditions and have their teenager go to the emergency department immediately. A. Glaucoma B. Strabismus C. Retinal detachment D. Macular degeneration

C. Retinal detachment

A 54-year-old man presents with a temp of 101.8 F a racing heart, fatigue, and an upset stomach after spending an afternoon building a deck on a very hot, humid day. The physician assessing the man is performing a differential diagnosis as part of her assessment. Which finding would suggest fever rather than hyperthermia as a cause of the elevation in the man's temperature? A. Moist skin B. Dizziness C. Shivering D. Cognitive changes

C. Shivering

During surgery, the anesthesia personnel noticed the client is having a steady rise in end-tidal carbon dioxide level. At this time, the nurse anesthetist begins to assess the client for malignant hyperthermia. The initial assessment for this disorder may include: A. Hypotension B. Acute renal failure C. Skeletal muscle rigidity D. Sudden cardiac arrest

C. Skeletal muscle rigidity

A nurse at a long term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which statement best identifies future complications associated with TIAs? A. TIAs are an accumulation of small deficits that may eventually equal the effects of a full CVA B. TIAs are a relatively benign sign that necessitate monitoring but not treatment C. TIAs resolve rapidly but may place the client at an increased risk for stroke D. TIAs are caused by small bleeds that can be a warning sign of an impeding stroke.

C. TIAs resolve rapidly but may place the client at an increased risk for stroke

A 57 year old client has presented to a clinic exasperated by the effect that restless legs syndrome is having on sleep. The clinician has performed client teaching prior to choosing a treatment plan. Which response by the client demonstrates a sound understanding of the condition? A. Increasing my calcium intake is something simple that might help B. Transcutaneous electrical nerve stimulation might be a treatment that can help me avoid needing drugs for this C. This could be something that I am simply prone to genetically D. Ill try to get more exercise since there aren't really ant effective medications for restless legs syndrome

C. This could be something that I am simply prone to genetically

A toddler is displaying signs and symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscle atrophy. The client's family asks how he got this.the nurse will respond; A. This could result from playing in soil and then ingesting bacteria that is now attaching to motor neurons. B. No one really knows how this disease is formed. We just know that in time, he may grow out of it. C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait D. This is segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.

C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait

An adult male has a new diagnosis of Gullain-Barre Syndrome. The nurse knows which pathophysiologic process underlies the deficits that accompany the degeneration of myelin in his PNS. A. the destruction of myelin causes fewer Schwann cells to be produced in the clients PNS B. The axonal transport system is compromised by the lack of myelin surrounding nerve cells C. Unless remyelination occurs, the axon will eventually die D. A deficit of myelin predisposes the client to infection by potential pathogens

C. Unless reyelination occurs, the axon will eventually die

Amniocentesis has suggested that a couple's first child will be born with sickle cell disease. The parents are unfamiliar with the health problem and their caregiver is explaining the complexities. Which statement by the parents would suggest a need for further teaching or clarification? A. "Our baby's red cells are prone to early destruction because of their weak membranes." B. "Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so." C. "Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones." D. "Our son or daughter likely won't show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.'

D. "Our son or daughter likely won't show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.'

A client with a diagnosis of hemolytic anemia has gone to a community-based laboratory for follow-up blood work. The lab technician confirms with the client that hematocrit is one of the components of the blood work. The client replies, "I thought the point of the blood work was to see how many red blood cells I have today." How could the technician best respond to the client's statement? A. "This result will tell your care provider about the number of red blood cells in a given quantity of your blood plasma." B. "Your hematocrit measures the average size of your red blood cells, and indirectly measures your oxygen-carrying capacity C. "The result will indicate how many of your red blood cells are new and young, and will indicate your body's production rate of red cells." D. "The hematocrit measures the mass that your red blood cells account for in a quantity of your blood."

D. "The hematocrit measures the mass that your red blood cells account for in a quantity of your blood."

A 36-year old woman with a diagnosis of antiphospholipid syndrome is receiving a scheduled checkup from her nurse practitioner. Which teaching point would the nurse most likely prioritize? A. "It's important for you to do regular physical activity and maintain a healthy body weight." B. "Good nutrition and blood sugar control are important in your case." C. "You'll need to avoid taking nonsteroidal anti-inflammatory drugs when you have menstrual cramps." D. "We need to ensure your birth control pills don't contain estrogen."

D. "We need to ensure your birth control pills don't contain estrogen."

When talking about the lifespan of various blood components, the students should know that once a neutrophil moves into tissue, it lives approximately how long? A. 12 hours B. 24hours C. 2 days D. 4 days

D. 4 days

A medical student is familiarizing herself with recent overnight admissions to an acute medical unit of a university hospital. Which client would the student recognize as least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? A. A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident B. A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks C. A 30-year-old female with a diagnosis of left leg deep vein thrombosis and a pulmonary embolism D. A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

D. A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

In which client would diagnostic investigations be least likely to reveal increased thrombopoietin production? A. An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive B. A 55-year-old man with dehydration secondary to Crohn disease C. A 66-year-old woman with a diagnosis of lung cancer with bone metastases D. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

D. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

A 46 year old male has presented to the emergency department because of the eye pain, severe headache and blurred vision has followed an eye exam at an optometrist's office earlier in the day. The client tells the triage nurse that he received eye drops during the exam to "keep my pupils wide open". What differential diagnosis will the care team first suspect? A. Infectious conjunctivitis B. Keratitis C. Corneal trauma D. Angle-closure glaucoma

D. Angle-close glaucoma

A 16-year-old female has been brought to her primary care physician by her mother due to the girl's persistent sore throat and malaise. Which fact revealed in the girl's history and examination would lead the physician to rule out infectious mononucleosis? A. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. B. Her liver and spleen are both enlarged. C. Blood work reveals an increased white blood cell count. D. Chest auscultation reveals crackles in her lower lung fields bilaterally.

D. Chest auscultation reveals crackles in her lower lung fields bilaterally.

The blood work of a 44 year old male client with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which phenomenon would a clinician be most justified in anticipating? A. Impaired immune function B. Acid-base imbalances C. Impaired thermoregulation D. Fluid imbalances

D. Fluid imbalances

The nurse volunteering in the medical tent for a road race on a hot, humid day is asked to see a runner who has collapsed on the road. The nurse notes he has sunken eyes, a temperature of 100 F, an dizziness. These are signs of a fluid volume deficit. Recognizing fluid volume deficit, which of these interventions does the nurse carry out first? A. Offer water by mouth B. Begin cooling off his body by ice packs C. Give him a transfusion of FFP D. Give him an electrolyte solution by mouth

D. Give him an electrolyte solution by mouth

A Tad Kwon Do master is applying downward pressure just above the elbow joint on the attacker who immediately collapses to the ground. The TKD master knows the elbow joint can bend inwards towards the body, but not in the opposite direction. Which reflex is applicable to this example? A. Knife-clasp B. Withdraw C. Myotatic D. Inverse myotatic

D. Inverse myotatic

A nurse is exploring treatment options with a client living with sleep apnea. The noise should inform the client that the most common reason for treatment refusal with continuous positive airway pressure is because: A. Surgical options exist that are permanent so clients usually choose this over CPAP B. Using CPAP has not been shown to help with the negative effects of sleep apnea and is for comfort only C. Most clients learn how to manage sleep apnea with oral devices, making CPAP unnecessary D. Many clients find the treatment too uncomfortable and are unable or unwilling to use it regularly

D. Many clients find the treatment too uncomfortable and are unable or unwilling to use it regularly

When looking at a granulocyte under a microscope, the anatomy student would describe it as: A. Lacking granules B. Having a kidney-shaped nucleus C. Having no nuclei D. Shaped like a sphere with multi-lobar nuclei

D. Shaped like a sphere with multi-lobar nuclei

A geriatrician is following a number of clients on a subacute geriatric medical unit, some of whom require diagnostic blood work. Which client would be most likely to have an erythrocyte sedimentation rate screening test ordered? An adult with: A. A diagnosis of Alzheimer's disease and depression B. Orthostatic hypotension and syncopal episodes C. Congestive heart failure D. Systemic lupus erythematous

D. Systemic lupus erythematous

Distraught at the persistent ringing in his ears and his inability to alleviate it, a 50 year old man has visited his health care provider. After diagnostic testing, no objective cause (like impacted cerumen or vascular abnormality) was found. Given these testing results, which teaching point by the care provider is most appropriate? A. This is most often the result of a psychological disturbance and therapy is often useful in relieving tinnitus B. There are many drugs such as blood pressure pills, relaxants, heart medications and antihistamines that can cause tinnitus C. A specialist can listen with a sensitive microphone to determine whether you are actually hearing these sounds. D. There are some treatments like tinnitus retraining therapy, which includes the extended use of low-noise generators, which has shown good success.

D. There are some treatments like tinnitus retraining therapy, which includes the extended use of low-noise generators, which has shown good success.

A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which teaching points about chronic pain would his physician most likely emphasize to the client? A. if your pain comes and goes, then we wont characterize it as chronic and it will require treatment B. You need to remind yourself that this is a purely physical phenomenon that requires physical treatment C. Our challenge is to bring you relief but still treat the underlying back problem that your body is telling you about D. These pain signals your body is sending likely serve no real useful to protective function

D. These pain signals your body is sending likely serve no real useful to protective function

A business traveler has just arrived in Japan from the US. During a meeting with the customer the traveler begins to experience yawning and stretching with an inability to stay focused on the meeting. The traveler also has some eye irritation and has developed a headache. Based on these clinical manifestations, what diagnosis would most likely be causing these symptoms? A. Advanced sleep phase syndrome B. Delayed sleep phase syndrome C. Free-running sleep disorder D. Time zone change syndrome

D. Time zone change syndrome

A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment? A. To control his hypertension B. To increase the amount of oxygen distributed by his red blood cells C. To reduce the mean size of his red cells D. To reduce the viscosity of his blood

D. To reduce the viscosity of his blood

A 58-year-old woman comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as "like an electric shock". The pain occurs only on one side of her face; it seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. There is no numbness associated with pain. What is most likely causing her pain? A. Post-herpetic neuralgia B. Migraine headache C. Complex regional pain syndrome D. Trigeminal neuralgia

D. Trigeminal neuralgia

The nurse is planning care for a group of clients. Which client should the nurse assess first? A 25-year-old client with an absolute neutrophil count of 300/mm° (0.30 x 10°/L) B. An 82-year-old client with a hemoglobin of 9.0 g/dL (90 g/L) C. A 65-year-old client with a white blood cell count of 15,200/pL (15.2 x 10%/L) D. A 45-year-old client with a platelet count of 100,000/mm? (100 x 10°/L)

A 25-year-old client with an absolute neutrophil count of 300/mm° (0.30 x 10°/L)

Which client would be most likely to be experiencing an increase in renal erythropoietin production? A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD) B. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic C. A 68-year-old man with a long-standing diagnosis of polycythemia vera D. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior

A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD)

Following focal seizures that have damaged the dominant hemisphere of a patient's auditory association cortex, the nurse may observe the patient displaying A) receptive aphasia. B) facial drooping. C) auditory hallucinations. D) delusions of grandeur.

A) receptive aphasia.

After assessment, the nurse asks how long the client has had red, pinpoint hemorrhages on the lower legs. The client responds, "This is the first time I have noticed this. What is wrong with me that is causing these small hemorrhages?" Which response by the nurse is most accurate? A. "These hemorrhages are called petechiae and occur when platelets are deficit." B. "More than likely, you bumped something and these are a result of trauma to the vessel." C. "Your platelets are developing a deformity as they are being produced by the bone marrow." D. "You might have a pooling of all your platelets in the spleen. I will assess for that next."

A. "These hemorrhages are called petechiae and occur when platelets are deficit."

Which statement by a client who has a new diagnosis of non-Hodgkin lymphoma (NHL) demonstrates a sound understanding of the diagnosis and treatment of the health problem? A. "They confirmed my diagnosis with a lymph node biopsy and I'll get radiation treatment soon because it's fairly early stage." B. "They took a sample of my lymph nodes and I'll be having surgery soon that will hopefully cure my lymphoma. C. "My blood work came back positive for NHL, and I'm meeting with my oncologist to discuss chemotherapy soon. D. "Since the tests show NHL, I'm going to pursue my options for palliative care because I'm committed to dying with dignity.

A. "They confirmed my diagnosis with a lymph node biopsy and I'll get radiation treatment soon because it's fairly early stage."

The nurse is preparing to administer rasburicase to a client undergoing chemotherapy. How should the nurse explain the purpose of this medication to the client? A. "This drug helps reduce uric acid levels and protect your kidneys." B. "Rasburicase is a unique antiemetic that will reduce your nausea, C. "Chemotherapy causes high phosphate and this medication reduces this." D. "This medication protects your bladder from the toxic effects of chemotherapy."

A. "This drug helps reduce uric acid levels and protect your kidneys."

The nurse on the cardiac unit has noted that the client's potassium level is 6.1. The nurse has notified the physician and removed the banana from the client's meal tray. When explaining the nursing actions to the client, which statement is appropriate? A. "Your potassium level is high so I need you to let me know if you feel numbness, tingling or weakness." B. "Your potassium levels in your blood are higher than they should be, which brings a risk of changes in kidney function." C. "I need to monitor you for signs of high potassium; tell me if you feel as if your heart is beating quickly." D. "The amount of potassium in our blood is too high, but I will change your intravenous fluids."

A. "Your potassium level is high so I need you to let me know if you feel numbness, tinging or weakness."

The nurse is caring for a client who is suspected to have multiple myeloma, What findings will the nurse use as evidence the client has multiple myeloma? Select all that apply. A. 20% plasma cells in bone marrow biopsy B. X-rays demonstrate bone loss C. Bence Jones proteins in urine D. Erythrocytosis E. Hyperkalemia

A. 20% plasma cells in bone marrow biopsy B. X-rays demonstrate bone loss C. Bence Jones proteins in urine

A client with a diagnosis of atrophic gastritis and consequent pernicious anemia is receiving high oral doses of vitamin B12. Following completion of his treatment, which lab finding demonstrates improvement in this condition? A. A decrease in mean corpuscular volume B. Increased serum bilirubin C. Increased folic acid levels D. Decreased free heme levels

A. A decrease in mean corpuscular volume

Which hospital client is most likely to be diagnosed with complex regional pain syndrome II? A. A man who has been admitted for treatment of continuing hyperalgesia after sustaining a nerve injury in a motor vehicle accident B. A woman who requires analgesia more than 3 months after an episode of shingles C. A male client with diabetes mellitus who requires analgesia prior to each dressing change on his chronic foot wound D. A female who has seemingly unprovoked attacks of pain that are accompanies by facial tics and spasms

A. A man who has been admitted for treatment of continuing hyperalgesia after sustaining a nerve injury in a motor vehicle accident

During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, what is that? How does the nursing student reply? A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles. B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well. C. A degenerative disease where you have trouble walking without the help of a cane or walker D. Influenza-like illness where you had fever and chills for 2-3 days after your last flu shot.

A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.

Which individuals would be considered at high risk for developing cataracts? Select all that apply A. An 88 year old female with osteoporosis and congestive heart failure B. A 51 year old female whose rheumatoid arthritis is controlled with oral corticosteroids C. A 50 year old male who takes nebulized bronchodilators four times daily for the management of his emphysema D. A 39 year old woman with a history of open angle glaucoma and poorly controlled diabetes E. A 29 year old artist who spends long hours in sunlight painting landscapes

A. An 88 year old female with osteoporosis and congestive heart failure B. A 51 year old female whose rheumatoid arthritis is controlled with oral corticosteroids D. A 39 year old woman with a history of open angle glaucoma and poorly controlled diabetes E. A 29 year old artist who spends long hours in sunlight painting landscapes

When explaining an upcoming test, a polysomnography, the nurse should include which duration points related to equipment the client will have placed on his or her body? Select all that apply A. An ECG with lots of chest leads will monitor heart rate and rhythm. B. A pulse oximeter placed on a finger is used to determine arterial oxygen saturation. C. An EOG will be placed on the skin near the eye to record eye movements D. An EMG patch will be placed under the chin to record muscle movements E. An actigraph device will be placed on the wrists and ankles to measure body motion

A. An ECG with lots of chest leads will monitor heart rate and rhythm. B. A pulse oximeter placed on a finger is used to determine arterial oxygen saturation. C. An EOG will be placed on the skin near the eye to record eye movements D. An EMG patch will be placed under the chin to record muscle movements E. An actigraph device will be placed on the wrists and ankles to measure body motion

A client is having an edrophonium test. The client suddenly goes into respiratory arrest. Which priority medication should the nurse be prepared to administer? A. Anticholinergic B. Acetylcholinesterase inhibitor C. Mixed alpha-beta adrenergic agonist D. Inhaled beta-2 agonist

A. Anticholinergic

A client is admitted for cardioembolic stroke. Which therapy to best prevent recurrence of emboli stroke should the nurse monitor for effectiveness? A. Anticoagulation therapy B. Blood pressure management C. Correction of dyslipidemia D. Antiarrhythmic therapy

A. Anticoagulation therapy

The nurse notes eosinophilia on the clients laboratory results. The nurse should interview the client about a history of which conditions? Select all that apply A. Asthma B. Exposure to parasites C. Allergic reactions D. Viral infections E. Bacterial infections

A. Asthma B. Exposure to parasites C. Allergic reactions

The nurse us caring for a client with an astrocytoma. The client asks "What do astrocytes do in the brain?" what is the nurses best response? A. Astrocytes have a protective and regulatory function in the grey matter of your brain B. These are the cells that produce the myelin needed by axons in your central nervous system C. Astrocytes re phagocytosis and clear away substances that should not be present in the brain D. These cells are responsible for producing synapses that result in thought and behavior

A. Astrocytes have a protective and regulatory function in the grey matter o your brain

Following a bone marrow biopsy, which assessment would indicate the client is experiencing a complication as a result of thus diagnostic procedure? A. BP 90/60, HR 132, excess bleeding, and hematoma noted at insertion site B. BP 130/80, oxygen saturation 95%, crackles heard on inspiration C. Respiratory rate 24, complaining of pain at insertion site D. Heart rate regular, 64 bpm, temp of 99.6f orally

A. BP 90/60, HR 132, excess bleeding, and hematoma noted at insertion site

A client is admitted to a rehab center after hospital treatment for an ischemic stroke. What aspects of the clients history are risk factors for ischemic stroke? Select all that apply A. Black male B. Takes iron supplements for the treatment of chronic anemia C. Blood pressure historically in the range of 150/90 to 160/100 D. Diagnosed with type 2 diabetes 8 years ago E. Takes corticosteroids for the treatment of rheumatoid arthritis

A. Black male C. Blood pressure historically in the range of 150/90 to 160/100 D. Diagnosed with type 2 diabetes 8 years ago

Following a collision while mountain biking, the diagnostic work up of a 22-year-old male has indicated the presence of an acute subdural hematoma. Which pathophysiologic process most likely underlies his diagnosis? A. Blood has accumulated between the man's dura and subarachnoid space. B. Vessels have burst between the clients skull and his dura C. A traumatic lesion in the frontal or temporal lobe has resulted in increased ICP D. Blood has displaced CSF in the ventricles as a consequence of his coup-contrecoup injury

A. Blood has accumulated between the man's dura and subarachnoid space.

A client arrives with symptoms of stroke. what should the nurse assess first? A. Capillary blood glucose B. Serum creatinine and urea C. Serum potassium D. Coagulation tests

A. Capillary blood glucose

When explaining how carbon dioxide combines with water to form carbonic acid as part of an acid-base lecture , the faculty instructor emphasizes that which enzyme is needed as a catalyst for this reaction? A. Carbonic anhydride B. Phenylalanine hydroxylase C. Hydrolases D. Trypsin

A. Carbonic anhydrase

A 31 year old female has been recently diagnosed with type 2 diabetes mellitus, and is attending a diabetes education class. Which statement by the woman demonstrates an accurate understanding of her health problem? A. Ill have to control my blood sugars, my blood pressure, and my cholesterol in order to make sure I don't develop sight problems B. I'm grieving the fact that I won't be able to get pregnant without causing permanent damage to my vision C. It is surprising that sugar in my blood can accumulate on the lens of my eye and cause a loss of sight D. I want to avoid going through the treatments for sight restoration that I would need if my diabetes causes damage to my vision

A. Ill have to control my blood sugars, my blood pressure, and my cholesterol in order to make sure I don't develop sight problems

Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which result is most likely to be considered unexpected by the health care team? A. Increased thrombopoietin levels B. Decreased platelet count C. Normal vitamin K levels D. Normal leukocyte levels

A. Increased thrombopoietin levels

Misinterpreting her physician's instructions, a 69-year-old woman with a history of peripheral artery disease has been taking two 325 mg tablets of aspirin daily. How has this most likely affected her hemostatic status? A. Irreversible acetylation of platelet cyclooxygenase activity has occurred. B. The client's prostaglandin TXA2 levels are abnormally high. C. She is at risk of developing secondary immune thrombocytopenic purpura (ITP). D. The binding of an antibody to platelet factor 4 produces immune complexes.

A. Irreversible acetylation of platelet cyclooxygenase activity has occurred.

Which diagnostic finding is likely to result in the most serious brain insult? A. Mean arterial pressure (MAP) that equals intracranial pressure (ICP) B. Moderate decrease in brain tissue volume secondary to a brain tumor removal C. Increased ICP accompanied by hyperventilation D. High intracellular concentration of glutamate

A. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

An adult female, newly diagnosed with possible leukemia, arrived for a bone marrow biopsy. The admission laboratory work includes; RBC; 3.4x10^6; WBC 2,500; platelet count of 80x10^3; all below normal values. What assessment is the highest priority for this client? A. Monitoring for any type of bleeding B. Forcing fluids to maintain renal function C. Checking breath sounds twice a day for signs of pneumonia D. Assessing heart sounds for any new murmurs

A. Monitoring for any type of bleeding

Following an injury resulting in a small cut from a knife, the first cell to go to the area of the cut would be the; A. Neutrophils B. Erythrocytes C. Albumin D. Basophils

A. Neutrophils

The nurse is caring for a client with leukemia and a blast count of 100,000 cells/uL (100 x 10%/L). What client reports should prompt the nurse to take immediate action? Select all that apply. A. New onset dyspnea B. Increased urine output C. Headache D. Lethargy E. Bleeding from gums

A. New onset dyspnea C. Headache D. Lethargy

A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint? A. Nociceptive afferents are conducting the sensation of pain along the cranial and spinal nerve pathways of the ANS B. First order neurons are inappropriately signaling pain to the dorsal root ganglion C. The client is experiencing neuropathic pain D. The clients C fibers are conducting pain in the absence of damaged A delta fibers

A. Nociceptive afferents are conducting the sensation of pain along the cranial and spinal nerve pathways of the ANS

The nurse is educating a group of clients about why routine screening for open-angle glaucoma is important. What information should the nurse include? Select all that apply A. Open-angle glaucoma is an asymptomatic condition B. Increasing intraocular pressure damages the optic nerve C. Surgical intervention is required as son as it is identified D. The chance for cure is increased if diagnosed early in the disease E. Early intervention can prevent vision loss

A. Open-angle glaucoma is an asymptomatic condition B. Increasing intraocular pressure damages the optic nerve E. Early intervention can prevent vision loss

A client with hyper cal Emma and hypercalciuria has just passed a kidney stone. The nurse recognizes which of these laboratory studies should also be assessed? A. Parathyroid Hormone level B. Bone Scan C. Plasma phosphate levels D. serum magnesium level

A. Parathyroid hormone levels

Nurses regularly rotate between day shift hours and overnight work hours. Following an overnight shift, nurses frequently exhibit which manifestation? Select all that apply. A. Unable to sleep for long periods of time during the day B. Falling asleep while sitting in front of a computer charting during the night C. Finding it difficult to sleep when having a night off D. Heightened alertness and reflexes on drive home after work E. Increase hunger and thirst in the middle of the night

A. Unable to sleep for long periods of time during the day B. Falling asleep while sitting in front of a computer charting during the night C. Finding it difficult to sleep when having a night off

The nurse is performing passive-range of motion exercises with a client who suffered an ischemic stroke 2 weeks ago and has hemiparesis. The client says, "what is the point of doing these exercises if I will never be able to use that arm again?" What should the nurse include when responding to the client? Select all that apple A. You may still regain use of this arm, and these exercises may help with this recovery B. These exercises help to prevent painful shoulder complications after a stroke. C. Doing these exercises helps to prevent blood clots from forming in the arteries of your arm D. It is important for you to keep a positive outlook as it will help with your recovery E. We want to ensure your shoulder joint remains flexible while you recover.

A. You may still regain use of this arm, and these exercises may help with this recovery B. These exercises help to prevent painful shoulder complications after a stroke. E. We want to ensure your shoulder joint remains flexible while you recover.

A client asks what to expect when undergoing a sleep study. Which instructions is most accurate for the nurse to relay to this client? Select all that apply A. You will have an electrode near your eye to record eye movements B. They will place a catheter into your veins to give you medication if need be C. A urinary catheter will be placed in your bladder in your bladder so you will not have to get out of bed to void D. You will have electrodes placed on your leg muscles to record movement while sleeping E. You will have electrodes placed on your scalp to record brain activity while sleeping

A. You will have an electrode near your eye to record eye movements D. You will have electrodes placed on your leg muscles to record movement while sleeping E. You will have electrodes placed on your scalp to record brain activity while sleeping

The nurse is collecting a blood sample for an ordered CBC. The required tube contains EDTA so the nurse will: A. invert the tube several times to prevent the blood from coagulating. B. place the tube immediately on ice to preserve the action of the EDTA on the sample. C. Invert the tube several times to promote clotting so serum can be fully separated. D. Avoid inverting the tube to prevent hemolysis, which could affect the accuracy of the results.

A. invert the tube several times to prevent the blood from coagulating.

Which client has an absolute neutrophil count (ANC) that is critically low and the standard of care would recommend placement on neutropenic precautions? A. Client on long-term steroids for rheumatoid arthritis with WBC of 7000/L (7 x 10°/L). B. 37-year-old client with leukemia being treated with chemotherapy with ANC of 400 (0.40 x 10°/L). C. 65-year-old client with prostate cancer receiving radiation therapy with neutrophil count of 2,000/pL (2.0 x 10°/L). D. 75-year-old client with renal failure receiving epogen for anemia with hemoglobin level of 9.7 g/dL (97 g/L).

B. 37-year-old client with leukemia being treated with chemotherapy with ANC of 400 (0.40 x 10°/L).

While working at the triage desk in the local emergency department, which client is likely having a medical emergency and needs to be seen first? A. 17 year old high school student who has a red itchy eye B. 55 year old truck driver complaining of sudden onset of ocular pain and blurred vision C. 45 year old schoolteacher complaining of a red eye that is draining yellow secretions D. Infant with red eyes who is irritable and refusing to eat

B. 55 year old truck driver complaining of sudden onset of ocular pain and blurred vision

A health care provider specializes in treating conditions classifies as parasomnias. Which client should the nurse the nurse refer to this provider? A. A 5 year old who wets he bed at night B. A 25 year old who sleepwalks C. A 50 year old with restless legs syndrome D. A 68 year old with chronic insomnia

B. A 25 year old who sleepwalks

A 22 year old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem? A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids. B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins C. Cerebellar lesions; surgical and immunosuppressive treatment D. Excess acetylcholinesterase production; treatment with thymectomy

B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins

A student makes the statement to a colleague, "Blood plasma is essentially just a carrier for the formed cells like red blood cells and white blood cells." What would be the most accurate response to this statement? A. That is not really true. Plasma is crucial in the immune and inflammatory responses B. Actually, plasma plays a significant role in nutrient and waste transport C. Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis D. Actually, plasma is integral to the proper function of the liver and maintenance of acid-base balance

B. Actually, plasma plays a significant role in nutrient and waste transport

The nurse is caring for a client who has been living with Parkinson's disease for the past 10 years and is being treated with levodopa-carbidopa. The client often leaves the unit with family for extended periods. What should the nurse prioritize when teaching the client? A. It is essential that you eat a healthy diet with adequate amounts of protein if dining out B. Your medication needs to be taken at equal intervals to reduce symptom fluctuation C. Frequent assessments are needed to prevent complications related to your condition D. Due to your risk for falls it is recommended you do not leave the unit with your family

B. Your medication needs to be taken at equal intervals to reduce symptom fluctuation

A mother is placing her child into the bathtub. The child immediately jumps out of the tub and begins to cry, stating her feet are "burning". The nurse in the ED knows that the child's response is based on which pathophysiologic principle listed below? A. Child react much quicker to contact with hot water than adults B. The tactile sensation occurs ell in advance of the burning sensation. The local withdrawal reflex reacts first C. It takes a long time for thermal signals to be processed before the brain can send a signal through the spinal cord and tell the foot to withdraw D. The thermal processing center is located on the rapid-conducting anterolateral system on the same side of the brain as the injury

B. the tactile sensation occurs well in advance of the burning sensation. The local withdrawal reflex reacts first

Not realizing that it surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. which phenomena has facilitated the rapid movement of her hand in response to the painful stimulus? A. Her midbrain has rapidly responded to the nocioceptive stimuli and induced arm flexion. B. the withdraw reflex, a spinal motor reflex, has quickly mediated a quick removal of the body part away from the offending stimulus C. the forebrain has mediated a protective spinal cord reflex. D. Her ANS has enacted a protective response received by neurons that innervate her arm muscles

B. the withdraw reflex, a spinal motor reflex, has quickly mediated a quick removal of the body part away from the offending stimulus

A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy's spleen. Which teaching point would be most accurate? A. "We believe that your son's spleen is causing the destruction of many of his blood platelets, putting him at a bleeding risk." B. "Your son's spleen is inappropriately destroying the platelets from his blood and needs to be removed." C. "Your son's spleen is holding on to too many of his platelets so they're not available for clotting. D. "We think that his spleen is inhibiting the production of platelets by his bone marrow.

C. "Your son's spleen is holding on to too many of his platelets so they're not available for clotting.

A 62-year-old female with a diagnosis of acute and chronic renal failure secondary to diabetes mellitus is receiving her weekly injection of epoetin, a supplementary form of erythropoietin. Which statement best captures the necessity of this medication? A. Erythropoietin is needed in order for stem cells to proliferate into committed erythroid precursors. B. Erythropoietin is necessary for the accurate sensation of hypoxia that stimulates erythropoiesis. C. Erythropoietin causes the erythrocyte colony-forming units to proliferate and mature. D. Erythropoietin facilitates the extrusion of the reticulocyte nucleus and the formation of true erythrocytes.

C. Erythropoietin causes the erythrocyte colony-forming units to proliferate and mature.

As part of the health promotion initiative, a public health nurse is meeting with a group of older adult residents of an assisted living facility. Which of the following teaching points about hearing loss in the elderly should the nurse include in the teaching session? A. It is actually a myth that seniors have worse and worse hearing as they age B. Most hearing loss in older adults is the result of easily-fixed problems, such as impacted ear wax C. Experts don't quite know what causes seniors to lose their hearing with age, but drugs like aspirin can contribute to the problem. D. With older adults, the goal is to adjust lifestyle to accommodate diminished hearing rather than try to treat the hearing loss itself

C. Experts don't quite know what causes seniors to lose their hearing with age, but drugs like aspirin can contribute to the problem.

A college student has been experiencing frequent headaches that he describes as throbbing; he is reporting difficulty concentrating when studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which pathophysiologic concept is likely responsible for his symptoms? A. Increased tissue perfusion at the site of the malformation B. Hydrocephalus and protein in the cerebrospinal fluid C. High pressure and local hemorrhage of the venous system D. Localized ischemia with areas of necrosis noted on CT angiography

C. High pressure and local hemorrhage of the venous system

A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. On which aspect of the nervous system listed below would her health care providers focus their diagnostic efforts? A. her afferent and efferent cranial nerve function B. Possible damage to her pons and medulla C. Impaired function of her hypothalamus D. Potential damage to the girl's cerebellum

C. Impaired function to her hypothalamus

A client with poorly controlled diabetes mellitus presents to the emergency department with suspected ketoacidosis. Which diagnostic results would be most likely to confirm this diagnosis? A. Low O2 levels, increased anion gap, base excess B. High ammonia levels, decreased anion gap, high potassium C. Increased anion gap, base deficit D. Decreased anion gap, decrease urine ammonium level

C. Increased anion gap, base deficit

The geriatrician providing care for a 74 year old man with diagnosis of Parkinson's Disease has recently changes the clients medication regimen. What is the most likely focus of the pharmacological treatment of the mans health problem? A. Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions B. Preventing demyelination of the efferent cerebellar pathways C. Increasing the functional ability of the under active dopaminergic system D. Preventing axonal degradation of motor neurons

C. Increasing the functional ability of the under active dopaminergic system