Patho Final
Which of the following can the nurse tell family members to best explain muscle atrophy of a family member who has been in a persistent coma?
"Cell size decreases as workload declines."
A student states, "It seems like helper T cells do a lot more than just 'help' the cellular immunity process". Which of the following responses listed below best conveys an aspect of the role of CD4+ helper T cells in immunity?
"Helper T cells play a major role in stimulating and regulating the whole process."
The mother of a child with Turner syndrome asks the nurse what the physician meant when the disease was explained as monosomy of the X chromosome. The nurse explains the syndrome as having which of the following characteristics?
"There is one X chromosome." Explanation: The nurse should explain that there is one X chromosome instead of the normal two X chromosomes (one from each parent).
A nurse is teaching a new mother diagnosed with HIV about the transfer of the infection to her newborn. The mother begins to cry and states, "It's too late, the lab tests on my baby are already positive for HIV." How should the nurse respond?
"Just because the test is positive for HIV does not mean your baby is infected with the virus."
When educating the family of an infant with a small, asymptomatic atrial septal defect (ASD), which of the following would be included in the education?
"Most infants do not need surgical repair for this." Explanation: Most infants do not need surgical repair for an ASD unless they are symptomatic. The hole will close spontaneously 87% of the time. The medication indomethacin is used to help close the opening of a PDA and the medication prostaglandin E1 is used to keep a patent ductus arteriosus (PDA) open. These medications are not used for ASDs.
A health educator is teaching a group of colleagues about the physiology of thermoregulation. Which of the following statements is most accurate?
"Prostaglandin E2 (PGE2) exerts a direct fever-producing effect on the hypothalamus."
A nursing student is caring for a patient who was recently diagnosed with breast cancer. Which of the following does the student explain what the doctor meant when the term "sentinel node" was mentioned?
"Sentinel node is used to describe the initial lymph node to which the primary tumor drains."
A patient with pulmonary hypertension has hypertrophy of the heart's right ventricle. Which of the following explanations is appropriate to tell the patient?
"The cells enlarge in your heart from the increased workload." Explanation: Hypertrophy is an increase in cell size due to increased work demands. A client with pulmonary hypertension has increased pressure in the lungs, which the right side of the heart must pump against. The increased work causes cells to increase in size.
A mother who is with her son when a cast is removed from his arm asks the nurse "What is wrong with my son's arm? It looks so small!" Which of the following is the nurse's best response?
"The cells have atrophied due to lack of use and will regain their size as he starts to use the arm."
A nurse educator is describing the way that cells involved in the inflammatory response find their way to the site of injury. Which description best reflects this physiologic mechanism?
"The process of chemotaxis is the process where cells wander through the tissue guided by secreted chemoattractants."
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.
An asymptomatic patient who is worried about developing breast cancer due to the fact that it runs in her family asks the nurse if she could have a mammogram to see if she has any lumps. The nurse informs the patient that a tumor usually is undetectable until it has doubled 30 times and contains more than 1 billion cells. This means that at this point it measures approximately which of the following sizes?
1 cm Explanation: Using conventional radiographic methods, a tumor usually is undetectable until it has doubled 30 times and contains more than 1 billion cells. At this point it is approximately 1 cm in size. A tumor that measures anything over 1cm including 3,4, and k5 cm would definitely be detectable using radiography.
A client is experiencing muscle atrophy following two weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the client's muscle cells?
A reduction of skeletal muscle use secondary to the traction treatment.
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
A nurse is providing care for several clients on a neurologic unit of a hospital. With which client is the nurse justified in predicting a problem with thermoregulation?
66-year-old man with damage to his hypothalamus secondary to a cerebral vascular accident.
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
A mother who has one mutant allele on the X chromosome and one normal allele asks the nurse what the percentage is of passing it on to a daughter to be a carrier. The best response would be:
50% Explanation: The common pattern of inheritance is one in which an unaffected mother carries one normal and one mutant allele on the X chromosome. This means that she has a 50% chance of transmitting the defective gene to her sons, and her daughters have a 50% change of being carrier of the mutant gene.
A nurse is overseeing the care of numerous clients. Which client is at the highest risk of developing metabolic alkalosis?
A 20-year-old man who has been regularly inducing himself to vomit following binge eating.
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 of the following is true about recessive gene inheritance?
A carrier is a non-affected person with a single copy of a recessive gene Explanation: Autosomal recessive disorders are manifested only when both members of the gene pair are affected. So, a carrier is a non-affected person with a single copy of a recessive gene. Dominant genes have greater expression than recessive ones. Because of the presence of a normal X gene, female heterozygotes rarely experience the effects of a defective gene, whereas all males who receive the gene are typically affected. Variability of gene expression is called variable expressivity.
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
A 41 year old female with a family history has had a baseline mammogram. She states that she performs monthly self breast exams but really has a hard time evaluating her lumps since she has numerous cysts. At her annual mammogram, the technician views a suspicious area and refers her to the radiologist. She asks the nurse in the office, "How can a lump appear so quickly?" The nurses response is based on which of the following principles?
A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells. Explanation: The ratio of dividing cells to resting cells in a tissue mass is called the growth fraction. The doubling time is the length of time it takes for the total mass of cells in a tumor to double. Tumors do no stay in the M phase of the cell cycle. Undifferentiated cancer cells do come in various shapes/sizes but this has nothing to do with the detection of the tumor by palpation. Breast cysts are fluid filled sacs but are usually not cancerous.
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
Which cellular dysfunction is responsible for the manifestations of cystic fibrosis?
Abnormal chloride channel proteins allow increased sodium and water reabsorption.
The nurse is administering a measles, mumps, and rubella (MMR) vaccination to a pediatric client. When the nurse explains immunity to the mother, which type of immunity will she explain that this vaccination provides?
Active artificial immunity
A nurse caring for a child with Down syndrome understands that the child has an increased risk for which of the following illnesses?
Acute lymphoblastic leukemia Explanation: Children with Down syndrome have a higher risk for acute lymphoblastic leukemia and acute myelogenous leukema.
A client is admitted to hospital with signs of acidosis. Compensation takes place in the kidney as well as in the lungs. Which action takes place specifically at the respiratory membrane?
CO2 is eliminated
The mother is heterozygous for blue eyes, a recessive trait. The father is homozygous for brown eyes, a dominant trait. What colour eyes will their four children have?
All will have brown eyes. Explanation: A heterozygote with a dominant and a recessive allele will have the dominant phenotype. In Mary's case this will manifest itself in her brown eyes. A homozygote with two dominant alleles will have the dominant phenotype, so John also has brown eyes. To have blue eyes, the children would have to inherit two alleles for blue eyes. Because they will inherit, at most, one recessive allele for blue eyes, the children's eyes will be brown.
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.
The nurse is studying numeric disorders involving autosomes. Which of the following terms refers to having an abnormal number of chromosomes?
Aneuploidy Explanation: Having an abnormal number of chromosomes is referred to as aneuploidy. When a person inherits a dominant mutant gene, but fails to express it, the trait is described as having reduced penetrance. In mitochondrial gene disorders, some cells receive a mixture of normal and mutant DNA, known as heteroplasmy. Occasionally, mitotic errors in early development give rise to two or more cell lines characterized by distinctive karotypes, a condition referred to as mosaicism.
Substances foreign to the host that can stimulate an immune response are known as:
Antigens
Which of the following processes can cause cells adapt to changes in threats to survival? Select all that apply.
Atrophy Hypertrophy Hyperplasia Explanation: Cells are able to adapt to increased work demands or threats to survival by changing size (atrophy and hypertrophy), number (hyperplasia), and form (metaplasia). Necrosis and apoptosis are cell death, not adaptations.
Serum phosphorus level has a reciprocal relationship with which of the following serum electrolytes?
Calcium
A patient whose mother and grandmother both have had cancer is at a higher risk for also developing the disease. Which of the following tumor suppressor genes are associated with genetic susceptibility to breast cancer? Select all that apply.
BRCA1 BRCA2 Explanation: Two tumor suppressor genes called BRCA1 and BRCA2 have been identified in genetic susceptibility to breast and ovarian cancer.
An agricultural worker is picking fruit on a day when the air temperature is 106°F. Which of the following processes will most likely be occurring while he works?
Blood volume to his skin surface will be increasing to dissipate heat. Explanation: In response to high temperatures, blood volume at the surface increases in order to dissipate heat. Heat exchange between his body and the air is radiation, not conduction, and the sympathetic, not autonomic, nervous system will be in control of the sweating process. Because the air temperature exceeds his body temperature, he will not be able to lose heat in this way.
A pregnant woman carrying both a dominant (brown) and a recessive (blue) gene has a husband who has a recessive gene that pairs with her recessive gene. The woman asks what color eyes their baby will have. The best response would be:
Blue Explanation: When two recessive genes combine for the lighter color eyes, the child would have the lighter (blue) eyes. Despite the woman having a recessive and dominant gene, it would not alter the color of the baby's eyes to a different shade.
Mary is heterozygous for blue eyes, a recessive trait. John is homozygous for brown eyes, a dominant trait. What color eyes will their four children have?
Brown Explanation: A heterozygote with a dominant and a recessive allele will have the dominant phenotype. In Mary's case, this will manifest itself in her brown eyes. A homozygote with two dominant alleles will have the dominant phenotype, so John also has brown eyes. To have blue eyes, the children would have to inherit two alleles for blue eyes. Because they will inherit, at most, one recessive allele for blue eyes, the children's eyes will be brown.
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
Cadherins, selectins and some integrins, which are adhesion molecules, depend on which of the following to function in cell adhesion?
Calcium Explanation: Important classes of extracellular macromolecules are the adhesion molecules that maintain intercellular contacts. There are three classes of adhesion molecules that depend on extracellular calcium to function in cell adhesion: cadherins, selectins, and integrins (some of which are magnesium dependent).
The nurse in the oncology unit has just admitted a client with metastatic cancer. The client asks how cancer moves from one place to another in the body. What would the nurse answer?
Cancer cells enter the body's lymph system and thereby spread to other parts of the body. Explanation: Metastasis occurs by way of the lymph channels (i.e., lymphatic spread) and the blood vessels (i.e., hematogenic spread). In many types of cancer, the first evidence of disseminated disease is the presence of tumor cells in the lymph nodes that drain the tumor area. When metastasis occurs by way of the lymphatic channels, the tumor cells lodge first in the initial lymph node that receives drainage from the tumor site. Once in this lymph node, the cells may die because of the lack of a proper environment, grow into a discernible mass, or remain dormant for unknown reasons. If they survive and grow, the cancer cells may spread from more distant lymph nodes to the thoracic duct and then gain access to the blood vasculature. Because cancer cells have the ability to shed themselves from the original tumor, they are often found floating in the body fluids around the tumor. Cancer cells are not moved from one place to another by transporter cells. Cancer cells do not form a chain to grow to the new place in the body to form a new tumor.
When caring for a patient with hyperkalemia, the nurse prioritizes assessment of which of the following body systems?
Cardiovascular
The nurse is conducting a community class on the importance of early recognition of cancer. Screening mechanisms are available for which cancers? Select all that apply.
Cervical Prostate Breast Explanation: Cervical cancer is screened for with a Pap smear, while breast cancer can be screened with a self-examination monthly. Prostate cancer is screened with PSA testing. Currently, neither pancreatic nor lung cancers have a definitive screening mechanism.
The body regulates the pH of its fluids by what mechanism? (Select all that apply.)
Chemical buffer systems of the body fluids The lungs The kidneys
The nurse and nursing student are caring for a client with end stage renal disease (ESRD) whose blood gases reveal acidosis. The student notes the respiratory rate is 36 breaths/minute which the nurse mentor explains the rationale would include which of these concepts?
Chemoreceptors notice the pH change and increase the ventilation rate.
A physician is working with a 30 year old male client with Down syndrome who has been admitted to hospital with a diagnosis of acute leukemia. Which of the following physical assessment finding would the physician be more likely to find in an examination of this client than other clients without Down syndrome?
Congenital heart defects Explanation: Congenital heart defects are associated with Down syndrome. Hepatomegaly, visual disturbances, and diabetes are not associated.
Which of the following causes atrophy? Select all that apply.
Decreased blood flow Denervation Disuse
A patient comes to the clinic complaining of severe pain in the left great toe and is diagnosed with gout. What medication does the nurse anticipate educating the patient about that stops cell mitosis in the treatment of gout?
Colchicine Explanation: The plant alkaloid colchicine binds to tubulin molecules and prevents the assembly of microtubules. This compound stops cell mitosis by interfering with formation of the mitotic spindle and is often used for cytogenetic (chromosome) studies. It is also used in treating gout to prevent migration of neutrophils and to lower their ability to respond to urate crystals in the tissues.
Select the response that best describes a granulomatous inflammatory response to a foreign body:
Connective tissue encapsulates it and isolates it for removal. Explanation: Granulomatous inflammatory response to a splinter would involve the connective tissue encapsulating and isolating it for the removal. Each of the other options is part of the normal inflammatory response and would not apply in this situation.
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.
A patient has a splinter. The nurse expects a granulomatous inflammatory response. What does this involve?
Connective tissue encapsulating and isolating the splinter
The loss of heat from the body through the circulation of air currents is known as which of the following?
Convection
Which of the following diseases is caused by a genetic defect of chloride transport?
Cystic fibrosis Explanation: Cystic fibrosis is a single-gene inheritance disorder of membrane transport of chloride ions in exocrine glands causing lung and pancreatic disease. The other options are also single-gene inheritance disorders but do not involve chloride transport.
Which statements are true about the cell nucleus? Select all that apply.
DNA contains information used for protein synthesis. rRNA synthesizes proteins. All eukaryotic cells have at least one nucleus. Explanation: All eukaryotic cells have at least one nucleus. Deoxyribonucleic acid (DNA) contains all the instructions for building proteins essential to cell life. There are three types of ribonucleic acid (RNA). Messenger RNA (mRNA) copies and carries DNA instructions for protein synthesis to the cytoplasm. Ribosomal RNA (rRNA) is where protein synthesis occurs, and Transfer RNA (tRNA) transports amino acids to the site of protein synthesis.
The nurse is assessing a client who is experiencing hyperventilation. The nurse is aware that the client is at risk for:
Decreased PCO2
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
Which of the following factors can increase the absorption of lead into a patient's system?
Decreased calcium levels in the blood Explanation: A deficiency in calcium, iron, or zinc increases lead absorption.
The nurse knows high incidences of infectious illnesses among the older adults who reside in a long term care facility are most likely to have diminished immune capacity because of:
Decreased numbers and responsiveness of T lymphocytes
A middle-aged male with a history of cardiovascular disease has been admitted for cardiogenic shock. In the hours since admission, the client's arterial blood gases indicate acidosis. Which of the following clinical manifestations and diagnostic findings should his care team anticipate before acid-base balance is restored? Select all that apply:
Decreased pH Cardiac dysrhythmias Decreased alertness and cognition Nausea and vomiting
A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect?
Decreased pH below 7.35
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 Explanation: In an acute stress, a healthy or positive response to a diagnosis such as hypertension would be to redirect attention to promoting health (i.e., decreased sodium and fat intake). The other options are not positive responses.
An older adult's dysfunctional temperature regulator function places the client at greatest risk for:
Delayed initiation of appropriate treatment
Which of the following is the preferred drug for treating chronic diabetes insipidus?
Desmopressin acetate(DDAVP)
A client diagnosed with breast cancer is scheduled for surgery. The surgical procedure will include identification of the sentinel node. The data obtained from the procedure will:
Determine the extent of the disease Explanation: The term sentinel node is used to describe the initial lymph node to which the primary tumor drains. Because the initial metastasis in breast cancer is almost always lymphatic, lymphatic spread and, therefore, extent of disease may be determined through lymphatic mapping and sentinel lymph node biopsy. It will not determine cause, infection, or cause drainage.
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
Which responses of the adaptive immune system provides protection against virus-infected cells?
Distinct antigenic properties allow T cells to isolate specific organisms.
With increasing age, there is a greater chance of a woman having been exposed to damaging environmental agents such as drugs, chemicals, and radiation. These factors may act on the aging oocyte to cause what in a fetus?
Down syndrome Explanation: The risk of having a child with Down syndrome increases with maternal age—it is 1 in 1250 at 25 years of age, 1 in 400 at 35 years, and 1 in 100 at 45 years of age. The reason for the correlation between maternal age and nondisjunction is unknown, but is thought to reflect some aspect of aging of the oocyte. Although males continue to produce sperm throughout their reproductive life, females are born with all the oocytes they ever will have. These oocytes may change as a result of the aging process. With increasing age, there is a greater chance of a woman having been exposed to damaging environmental agents such as drugs, chemicals, and radiation. There is no correlation with maternal age and the other syndromes.
The cardiologist examines a client's echocardiogram and determines that the client has aortic stenosis. The cardiologist explains that a frequent cause of this valve disease is which of the following?
Dystrophic calcification Explanation: Dystrophic calcification is commonly seen in atheromatous lesions of advanced atherosclerosis, areas of injury in the aorta and large blood vessels, and damaged heart valves. Calcification of the aortic valve is a frequent cause of aortic stenosis in older adults. Metastatic calcification occurs in normal tissues as a result of increased serum calcium levels. Hyperplasia refers to an increase in the number of cells in an organ or tissue. Apoptosis is a process that eliminates injured and aged cells.
Unbeknownst to her or her care team, a 51 year-old woman's breast cancer has an etiology rooted in the fact that tumor suppressing genes are present but have been silenced. Consequently, she has not synthesized normal cancer-suppressing proteins and neoplasia has resulted. What process has accounted for the woman's cancer?
Epigenetic mechanisms Explanation: Epigenetic mechanisms may "silence" genes, such as tumor suppressor genes, so that even though the gene is present, it is not expressed and a cancer suppressing protein is not made. This process does not involve defects in DNA repair or chromosomal translocation and while it may form a half of the "two-hit" hypothesis, this is not synonymous with epigenetic mechanisms.
Which cells block the entry of microbes and destroy them by secreting antimicrobial enzymes, proteins, and peptides within the mucous membrane linings of the gastrointestinal, respiratory, and urogenital tract?
Epithelial
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 Explanation: The nurse determines that the participants understand the information when they identify that erection of pilomotor muscles aids heat conservation by reducing surface area for heat loss.
The laboratory finds IgA in a sample of cord blood from a newborn infant. This finding is important because it signifies what?
Fetal reaction to exposure to an intrauterine infection
After studying genetic disorders, the pathophysiology student knows that which of the following is true?
Genotype determines phenotype Explanation: The genetic compostion of a person is called a genotype, whereas the phenotype is the observable expression of a genotype. Diabetes mellitus is caused by a multifactorial inheritance disorder and sickle cell anemia by a single gene defect. Many diseases caused by a single-gene defect have been identified.
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 Explanation: Glucocorticoids are know to suppress immune function, and pharmacologic doses of cortisol are used clinically to suppress the immune response. The other options do not decrease the immune response.
A client is experiencing a decrease in the number of circulating neutrophils (neutropenia) during an active bacterial infection. The nurse examines the client's lab results looking for which of the following cytokines, that is responsible for promoting growth and maturation of neutrophils during inflammatory reactions?
Granulocyte CSF (G-CSF)
The nurse caring for a client with metabolic alkalosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's metabolic alkalosis is improving?
HCO3- has decreased
The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of:
HCO3−
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
Which one of the following organisms causes peptic ulcers?
Helicobacter pylori
A nurse observes peaked, narrow T waves on the electrocardiogram of a patient suffering from renal failure. The nurse suspects that the client is experiencing which of the following conditions?
Hyperkalemia
A client with environmental allergies is experiencing respiratory inflammation. Which mediator causes vasodilation during the vascular stage of the inflammatory response?
Histamine
The nurse explains to prospective parents that AA or aa in a punnett square represent two alleles of a given pair are the same or
Homozygotes Explanation: When two alleles of a given pair are the same as in AA or aa, they are considered homozygotes.
A nurse is counseling a patient on how recessive disorders are transmitted from parent to child. The nurse knows that recessive disorders occur when which of the following alleles are present?
Homozygous recessive Explanation: Recessive disorders occur when the patient has homozygous (two copies) of the recessive allele present.
Metastatic calcification takes place in normal tissues as the result of increased serum calcium levels (hypercalcemia). Anything that increases the serum calcium level can lead to calcification in inappropriate places such as the lung, renal tubules, and blood vessels. What are the major causes of hypercalcemia?
Hyperparathyroidism and immobilization Explanation: Metastatic calcification occurs in normal tissues as the result of increased serum calcium levels (hypercalcemia). Almost any condition that increases the serum calcium level can lead to calcification in inappropriate sites such as the lung, renal tubules, and blood vessels. The major causes of hypercalcemia are hyperparathyroidism, either primary or secondary to phosphate retention in renal failure; increased mobilization of calcium from bone as in Paget disease, cancer with metastatic bone lesions, or immobilization; and vitamin D intoxication. Diabetes mellitus and hypoparathyroidism do not cause hypercalcemia; therefore, they cannot be a cause of metastatic calcification.
The nurse is teaching new nursing assistants on the unit about the phenomenon of muscle hypertrophy. Which of the following clients on the unit is most likely to experience muscle hypertrophy? A client with:
Hypertension, obesity and decreased activity tolerance.
The nurse explains to the hypertensive client that the increased workload required to pump blood against an elevated arterial pressure results in a progressive increase in left ventricular muscle mass. This is an example of which of the following?
Hypertrophy Explanation: In pressure overload, as occurs with hypertension, the muscle cells hypertrophy to increase the amount of functioning tissue.
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
A nurse is caring for a patient with hypoparathyroidism. Which of the following is a major concern for the patient?
Hypocalcemia
A nurse notices that a client's neck dressing is saturated with blood following thyroid surgery. The nurse suspects the client may be experiencing which electrolyte disturbances?
Hypocalcemia
When caring for a patient with hypomagnesemia, the nurse evaluates electrolytes that are commonly associated with which of the following conditions?
Hypocalcemia
A nurse is caring for a patient admitted with diabetic ketoacidosis who is being treated with intravenous (IV) insulin administration. The patient develops symptoms of anorexia, nausea, vomiting, constipation, and abdominal distension. Bowel sounds are hypoactive. Based on these symptoms, which of the following electrolyte alterations should the nurse monitor for?
Hypokalemia
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?
Hypothalmus
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
While taking their daily walk, the nurse is asked by a neighbor what centric fusion (robertsonian) translocation means. They tell you that a family member has been diagnosed with this and is now afraid to have children. Given this diagnosis, what may be potential risks for their offspring?
If chromosome 21 is involved, there is a high risk for producing a child with Down syndrome. Explanation: In centric fusion or robertsonian translocation, the break occurs near the centromere affecting the short arm in one chromosome (13and 14, or 14 and 21 most commonly). The short fragment is usually lost during subsequent divisions. In this case, the person has only 45 chromosomes, but the amount of genetic material lost is small. Difficulty arises during meiosis. The chief clinical significance arises when the translocation carriers involve chromosome 21 which may produce a child with Down syndrome.
The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory Ig that is found in the colostrum?
IgA
A client has been diagnosed with an intestinal parasite. The nurse monitors laboratory test levels for which cells necessary for the activation of eosinophils that, along with IgE, functions in the control of helminths?
IgE and IL-5 cells
The nurse is aware that the only class of immunoglobulins to cross the placenta is:
IgG
Which of the following immunoglobulins (Ig) is the most abundant of circulating antibodies?
IgG
Three days ago, a mother delivered her full-term infant who had been identified as having an in utero infection. The infant is receiving antibiotic and phototherapy, and the mother is breastfeeding. Which of the following types of immunoglobulins could most reasonably be expected to predominate in the infant's immune system?
IgG, IgA, IgM
The most important function of the thymus is:
Immune cell production and maturation
A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as an:
Increase in circulating neutrophils Explanation: Leukocytosis, or the increase in white blood cells, is a frequent sign of an inflammatory response, especially those caused by bacterial infection. Leukocytosis occurs due to an increase in circulating neutrophils and eosinophils. Leukocytosis does not occur because of increased cell production, and blood supply is typically increased as part of the inflammatory process.
Which of the following causes hypertrophy?
Increase in workload Explanation: Hypertrophy represents an increase in cell size and with it an increase in the amount of functioning tissue mass, resulting from an increased workload imposed on an organ.
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 Explanation: Cortisol, a glucocorticoid, maintains blood glucose levels (increases them) by antagonizing the effects of insulin. It also suppresses hematopoiesis, protein and collagen synthesis and immune responses (decreases white blood count).
Which of the following aspects of a patient's site of inflammation would help the care provider rule out chronic inflammation?
Increased neutrophils
Which of the following would help a nurse best describe a finding of hypertrophy on a lab report?
Increased size of the cell
A nurse notes that a patient with a fever has begun to shiver. The nurse should assess for which of the following events?
Increased temperarture
An 8-month-old has a ventricular septal defect. Which nursing diagnosis below would best apply?
Ineffective tissue perfusion related to inefficiency of the heart as a pump Explanation: A ventriculoseptal defect permits blood to flow across a septum, creating an ineffective pump.
Some messengers, such as thyroid hormone and steroid hormones, do not bind to membrane receptors but move directly across the lipid layer of the cell membrane and are carried to the cell nucleus. What do they do at the cell nucleus?
Influence DNA activity Explanation: At the membrane of the cell nucleus, both thyroid and steroid hormones cross into the cell nucleus itself, where they influence DNA activity. Ion channel-linked receptors transiently open or close ion channels. Thyroid and steroid hormones act within the cell nucleus to increase transcription of mRNA to alter cell function.
A client has developed dystrophic calcification as a result of macroscopic deposition of calcium salts. The tissue that would be most affected would be:
Injured tissue
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
A client has been diagnosed with osteomyelitis and admitted to the hospital. The client's fever persists throughout most of the day but returns to normal at least twice a day. Which pattern of fever is this client displaying?
Intermittent
A client has developed cell atrophy. The most likely cause would be:
Ischemia
What should the nurse teach the patient about an autosomal dominant disorder?
It has varied gene penetration and expression. Explanation: Autosomal dominant disorders are characterized by variable gene penetrance (degree to which the trait is displayed) and expression (differences in how the trait is displayed). Aneuploidy is not a single-gene disorder and does not follow the Mendelian pattern of inheritance. Deficiencies of enzyme synthesis are common in autosomal recessive disorders. X-linked inheritance can be dominant or recessive but it is not autosomal.
Which statements are true regarding chronic inflammation? Select all that apply.
It is usually a result of persistent irritants. The inflammatory agent is usually resistant to phagocytosis. It involves the presence of mononuclear cells like lymphocytes.
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 nurse is reviewing laboratory data for the client with an anion gap of 17. The nurse recognizes which of these conditions are associated with an increased anion gap mEq/L?
Lactic acidosis
The nurse is assessing a prepubertal male with fragile X syndrome. Assessment findings would include:
Large testes Explanation: The most distinctive feature that is present in 90% of prepubertal males with fragile X syndrome is macroorchidism or large testes. Someone with fragile X syndrome typically has a long face with large mandible and large, everted ears. Cleft palate is not associated with fragile X syndrome.
A client with a history of heavy alcohol use has been admitted to a hospital with ABGs that indicate an acid--base imbalance. Which situation is most likely to result in an inappropriate pH for this client?
Low albumin and plasma globulin levels
The nurse evaluating the bloodwork results of a client with an infected leg ulcer. The white blood cell count is 18,000 cells/uL. The nures inteprets this as:
Leukocytosis
When caring for a client who has developed bacterial pneumonia, the nurse assesses for which of these abnormalities that supports presence of infection?
Leukocytosis
The provider receives fetal karotype results on one of his patients. The karotype describes an absence of all or part of the X chromosome. Which condition does the fetus exhibit?
Turner syndrome
The cardinal signs of inflammation include swelling, pain, redness, and heat. What is the fifth cardinal sign of inflammation?
Loss of function
The nurse is teaching about hypertension management at a community health fair. The nurse discusses reducing sodium in the diet by avoiding which of these?
Luncheon meats Sodium, which can raise blood pressure, is found in table salt, cured meats, milk, olives which are to be avoided in those with hypertension. Clients should be instructed to read labels to determine sodium content of food.
A hospital client with a diagnosis of sepsis is in need of a specific response to microorganisms and a long-lasting immunity to the pathogens in question. Which component of the client's immune system is most able to meet these criteria?
Lymphocytes
A blood smear is being examined and a stain has been added that will identify granulocytes. Which cell types will be visible with the stain? Select all that apply.
Neutrophil Basophil Eosinophil
A nursing instructor sees the need for further instruction when one student makes which of the following statements concerning cancer?
Malignant neoplasms tend to grow slowly. Explanation: Malignant neoplasms, which invade and destroy nearby tissue and spread to other parts of the body, tend to grow rapidly and spread widely and have the potential to cause death.
Mendelian inheritance characteristics are most closely associated with which one of the following?
Marfan syndrome Explanation: Marfan syndrome is an autosomal dominant disorder caused by a mutant allele at a single gene locus and follows Mendelian patterns of inheritance. Congenital heart disease and diabetes mellitus are multifactorial inheritance disorders. Turner syndrome is a chromosomal disorder.
A nurse is teaching a prenatal group about the benefits of breastfeeding. The nurse determines teaching has been effective based on which of the following statements?
Maternal IgA from colostrum provides immunity through the mucosal membranes for the intestinal system.
When caring for a patient with diabetes insipidus (DI), the nurse plans to evaluate which of the following laboratory studies?
Measurement of antidiuretic hormone (ADH) and plasma/urine osmolality
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
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
The nurse is reviewing the following lab results of a client diagnosed with renal failure: pH: 7.24 PCO2: 38 mm Hg HCO3:18 mEq/L The nurse would interpret this as:
Metabolic acidosis
A nurse is caring for a patient with bulimia nervosa who has been admitted to the hospital with weakness, hypotension, and abdominal discomfort. Which of the following types of acid-base imbalance should the nurse assess the patient for?
Metabolic acidosis Potassium, chloride, and hydrogen are lost in the vomitus of those with bulimia nervosa, and frequent vomiting predisposes the patient to metabolic acidosis with hypokalemia.
A client tells the nurse that the client has been taking Alka-Seltzer (bicarbonate—antacid) four times a day for the past 2 weeks for an upset stomach. Upon assessment of the client, the nurse notes hyperactive reflexes, tetany, and mental confusion. Arterial blood gases reveal pH 7.55; serum HCO3− 37. The nurse suspects the client may be experiencing:
Metabolic alkalosis
For which acid-base imbalance will the nurse monitor for a client taking large doses of loop diuretics?
Metabolic alkalosis
The nurse is counseling a heavy smoker about the dangers of smoking. The nurse tells the smoker that the due to persistent irritation of the lungs from carcinogens, columnar cells may turn into squamous cells as a method of adaptation known as which of the following?
Metaplasia
The provider explains to the client, who smokes, that cells in the trachea are substituted with cells that are better able to survive. This process is known as which of the following?
Metaplasia
A patient with hyperparathyroidism has hypercalcemia. Which of the following is a likely consequence?
Metastatic calcification Explanation: Metastatic calcification occurs in normal tissues as the result of increased serum calcium levels or hypercalcemia. Dystrophic calcification is the deposit of calcium salts in injured tissues. Cell hypertrophy and atrophy is not a direct consequence of hypercalcemia.
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
Cancer prognosis has improved most dramatically when treatment plans include which of the following?
Multiple types of treatment Explanation: Treamtent plans that use more than one type of therapy, ofen in combination, are providing cures for a number of cancers that a few decades ago had a poor prognosis, and are increasing the life expectance in other types of cancer. The remaining options can be components of a multi-pronged treatment plan.
Which of the following exemplifies physiologic hypertrophy?
Muscle mass increase with exercise
The nurse is assessing a client for early manifestations of hyponatremia. The nurse would assess the client for:
Muscle weakness
The nurse is caring for a client with a longstanding diagnosis of hypocalcemia secondary to kidney disease. For which of the following clinical manifestations does the observe in this patient?
Muscular spasms and complaints of tingling in hands/feet.
Which intravenous solution would be appropriate to treat metabolic acidosis?
NaHCO3
Which of the following types of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk
Naturally acquired passive immunity
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.
What happens as a cell's workload declines? Select all that apply.
Oxygen consumption decreases. Protein synthesis decreases. Cell size decreases.
When educating the family of an ill infant with a large, symptomatic ventricular septic defect (VSD), which of the following would be included in the education if the doctor is planning on performing palliative care until the infant is healthier?
Palliative pulmonary artery banding should help the infant grow. Explanation: Palliative pulmonary artery banding should help the infant grow enough so that the large VSD can be repaired. The pulmonary artery banding will help, but the defect will still need to be fixed. Most infants will need surgery for a large, symptomatic VSD. The medication indomethacin is used for a PDA.
A client with hypercalcemia and hypercalcuria has just passed a kidney stone. The nurse recognizes which of these laboratory studies should also be assessed?
Parathyroid hormone level
Following several days in an acidotic state, a client has returned to desired pH. Which process could have contributed to the resolution of the client's health problem?
Phosphate and ammonia buffer systems in the renal tubules
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
The nurse is reviewing lab results of a client diagnosed with metabolic acidosis. The most important electrolyte for the nurse to assess would be:
Potassium (K+)
The renal control mechanism of restoring the acid-base balance is accomplished through which process?
Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms.
Homozygotes are what people are called in whom the two alleles of a given pair are the same (AA or aa). Heterozygotes are what people are called who have different alleles (Aa) at a gene locus. What kind of trait is expressed only in homozygous pairing?
Recessive trait Explanation: A recessive trait is one that is expressed only when a two homozygous people have a child. A dominant trait is one expressed in either a homozygous or a heterozygous pairing. A single-gene trait and a penetrant trait do not exist. However, single-gene inheritance does exist.
A client has been inhaling viruses periodically while on a cross country flight. Which of the following situations listed below would most likely result in the stimulation of the client's T lymphocytes and adaptive immune system?
Recognition of a foreign peptide bound to a self major histocompatibility complex (MHC) molecule.
The physician examines a client who has been in a motor vehicle accident and sustained head and chest injuries. Which would be considered compensatory responses to this acid-base imbalance?
Renal compensation with increased H+ excretion and increased HCO3- reabsorption
A patient arrives in the emergency department by ambulance with a family member stating, "He took an overdose of sleeping pills and I found him breathing very shallowly." For which of the following types of acid-base disturbance will the nurse anticipate this patient will be treated?
Respiratory acidosis
The nurse enters a patient's hospital room and finds the patient breathing rapidly, stating, " I must be having a stroke, my fingers are tingling!" Which of the following acid-base balance disorders is this patient experiencing due to hyperventilation?
Respiratory alkalosis
Hearing impairment, blindness and adverse neurodevelopment in newborns can be prevented by vaccination against which of the following?
Rubella Explanation: Although the introduction of the rubella vaccine has virtually eliminated the congenital rubella syndrome in most developed countries, it remains endemic in many developing countries, where it is the major preventable cause of hearing impairment, blindness and adverse neurodevelopmental outcome. The other options are infectious agents implicated in fetal anomalies, but do not have vaccines.
A nurse is assessing a client for the classic signs of acute inflammation. The nurse would assess the client for:
Rubor, swelling, and pain Explanation: The classic signs of inflammation are rubor (redness), tumor (swelling), calor (heat), and dolor (pain). The remaining options are more characteristic of symptomatology resulting from circulatory dysfunction.
Select the woman who is most at risk of having a child with Down syndrome.
Select the woman who is most at risk of having a child with Down syndrome. Explanation: The risk of having a child with Down syndrome increases with maternal age. It begins to rise sharply at about age 30, reaching 1 in 25 births at 45 years of age.
A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which of the following labs to determine if an allergy is present?
Serum IgE
The nurse is assessing a client who has developed hypocalcemia. The nurse anticipates the assessment data will demonstrate which findings? Select all that apply.
Serum calcium less than 8.5mg/dL (2.1 mmol/L) Bone pain Tetany
The effective circulating volume is the major regulator of water balance in the body. What else does it regulate?
Sodium
What information will the nurse need to know in order to calculate a client's anion gab (AG)? Select all that apply.
Sodium Chloride Bicarbonate
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 condition of a client with metabolic acidosis from an intestinal fistula is not improving. The pulse is 125 beats/min and the BP 84/56mm Hg. ABG values are: pH 7.1, HCO3- 18 mEq/L, PCO2 57mm Hg. What IV medication should the nurse expect to provide next?
Sodium bicarbonate
A nurse is caring for a patient with a low sodium level and increased water retention. Hematocrit and blood urea nitrogen levels are decreased, urine osmolality is high, and serum osmolality is low. A chest x-ray shows a possible lung mass. Based on these findings, which of the following problems could the patient be diagnosed with?
Syndrome of inappropriate antidiuretic hormone (ADH)
Blood-borne cancerous cells have recent spread from a woman's primary pancreas tumor to her bones. Which components of the woman's immune system are likely to be directly involved in the attempt to eradicate the potential metastasis? Select all that apply.
T lymphocytes Macrophages Natural killer (NK) cells B lymphocyte cells Explanation: During the S phase, DNA synthesis occurs, causing 2 separate sets of chromosomes to develop. Antimetabolites can cause abnormal timing of DNA synthesis. Because of their S-phase specificity, the antimetabolites are more effective when given as a prolonged infusion.
Which of the following explains how T lymphocytes and B lymphocytes differ?
T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.
A 42-year-old female client with breast cancer has a tumor that is minimal in size and extension, has minimal regional lymph nodes involved, and has no distant metastasis. Using the TNM system the tumor is staged as:
T1, N1, and M0 Explanation: This client has T1—minimal size and extension of the tumor; N1—minimal regional lymph node involvement; and M0—no distant metastasis.
Which of the following conditions follows a Mendelian pattern of recessive inheritance?
Tay-Sachs disease Explanation: Tay-Sachs disease is an autosomal recessive disorder of Mendelian or single-gene inheritance. Coronary artery disease is a multifactorial inheritance disorder. Down syndrome is a numeric disorder involving autosomes. Marfan syndrome follows Mendelian inheritance but is autosomal dominant.
A patient is experiencing anorexia, myalgia, arthralgia, headache, and fatigue. The nurse should assess for which of the following?
Temperature
A patient is admitted with an electrical burn and a fractured arm. Which cause related to the burn likely is responsible for the fracture?
The client had violent muscle contractions during the electrical injury. Explanation: The most likely scenario is that the client had an injury with alternating current (AC) that is usually more dangerous than direct current as it causes violent muscle contractions that can result in fractures and dislocations.
A client has undergone extensive diagnostic testing and has been diagnosed with breast cancer staged as T3, N0, M0. What conclusion can the nurse draw from the staging of the client's breast cancer?
The client has a sizable tumour but there is no lymphatic involvement. Explanation: This client's staging indicates a tumour of significant size but no evidence of lymph node involvement or metastasis. The "3" in "T3" does not denote a specific size of 3 mm, however. Metastasis is not currently present, but this does not mean that it is not a future possibility if left untreated.
The nurse is assessing a client with an abnormal blood gas values. Which of these interpretations does the nurse make regarding the client's physiologic status?
The client has abnormalities in his buffer system.
A nurse practitioner (NP) is assessing a client who wishes to become pregnant. What assessment finding represents the most significant risk for Down syndrome?
The client is 43 years old and has been pregnant 4 times. Explanation: Age is among the most significant risk factors for the development of Down syndrome. Previous pregnancies, abortions, smoking and occupational hazards are not noted to be major risk factors in the etiology of Down syndrome.
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.
A pregnant client is just completing her first trimester and has opted for a-fetoprotein (AFP) and human chorionic gonadotropin (hCG) testing. The nurse should identify what implication from this client's decision?
The client wishes to know about her fetus' risk of having a trisomy. Explanation: AFP and hCG testing are most often performed to determine the risks of a trisomy. Multifactorial disorders are not revealed by this form of testing and the nurse should not presume that the client will choose to have an abortion if the results are positive. The use of AFP and hCG testing does not preclude the use of amniocentesis.
All wounds are considered contaminated at the time they occur. Usually, the natural defenses in our bodies can deal with the invading microorganisms; however, there are times when a wound is badly contaminated and host defenses are overwhelmed. What happens to the healing process when host defenses are overwhelmed by infectious agents?
The formation of granulation tissue is impaired.
Potassium is the major cation in the body. It plays many important roles, including the excitability of nerves and muscles. Where is this action particularly important?
The heart
Which statements are TRUE regarding humoral immunity? Select all that apply.
The memory response occurs on subsequent exposures to the antigen. B lymphocytes (B cells) are vital to the functioning of this type of immunity. Two types of responses (primary and secondary) occur.
When caring for a client with bipolar disorder who takes lithium, the nurse observes an excess of clear, unconcentrated urine output in a 24-hour period of time as well as an intake of 3L of fluid in the same time frame. Which of these does the nurse recognize is consistent with side effects of this medication?
The patient is exhibiting characteristic signs of nephrogenic diabetes insipidus.
The nurse notes that a patient's core body temperature is 43°C. Which of the following is the correct interpretation by the nurse?
The patient's body's ability to thermoregulate is impaired.
In an attempt to best explain the innate immune system to a class of first-year nursing students, the instructor should describe what characteristic?
The response of the innate immune system is rapid, usually within minutes to hours, and prevents the establishment of infection and deeper tissue penetration of microorganisms.
Which of the following describes how atrophied cells survive?
Through decreased oxygen consumption Explanation: When confronted with a decrease in work or adverse conditions, cells can atrophy to a smaller size and use less oxygen to survive.
When the mother of an adolescent with Turner syndrome asks the nurse why the physician is prescribing estrogen therapy, the nurse tells the mother which of the following?
To promote secondary sex characteristics Explanation: Estrogen therapy is initiated in adolescents to girls with Turner syndrome to promote the development of secondary sex characteristics.
Which of the following statements describes a difference between transcription and translation?
Transcription occurs in the cell nucleus and translation occurs in the cytoplasm. Explanation: Transcription occurs in the cell nucleus and involves the synthesis of RNA from a DNA template. Translation occurs in the cytoplasm of the cell and involves the synthesis of a protein using its messenger RNA template.
The genetic counselor is explaining structural changes in chromosomes that result from breakage and rearrangement of chromosome parts. The pattern that occurs when there are simultaneous breaks in two chromosomes, from different pairs, with exchange of chromosome parts is which of the following?
Translocation Explanation: Translocation occurs when there are simultaneous breaks in two chromosomes, from different pairs, with exchange of chromosome parts. Isochromosome formation occurs when the centromere, or central portion, of the chromosome, separates horizontally instead of vertically. Ring formation results when deletion is followed by uniting of the chromatids to form a ring. Inversion requires two breaks on a single chromosome with inversion to the opposite side of the centromere or with the fragment inverting but remaining on the same arm.
The sodium-phosphate cotransporter (NPT2) creates the action by which phosphate is reabsorbed from the filtrate in the proximal tubule. Which condition can cause an overproduction of phosphatonin resulting in hypophosphatemia?
Tumor-induced osteomalacia
A health care professional works in a context where there are a large number of clients who live with genetic disorders. Which of the following circumstances would be most likely to involve an individual who has a genetic disorder?
Two chromosomes of the same number have been inherited from one parent. Explanation: When two chromosomes are inherited from one parent, the result can be the disorder of uniparental disomy. Answers A, C, and D all relate normal genetic processes.
Mendelian, or single-gene, patterns of inheritance include autosomal dominant and recessive traits that are transmitted from parents to their offspring in a predictable manner. A recessive trait occurs when:
Two copies (homozygous) of the recessive allele are present Explanation: A recessive trait is one expressed only when two copies (homozygous) of the recessive allele are present. Dominant traits are expressed with either homozygous or heterozygous pairing of the alleles.
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
Which of the following processes would most likely be considered an anomaly during the cellular phase of inflammation?
Vasoconstriction
A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which of the following statements should the nurse include in the teaching plan for the client?
Your newborn has maternal IgG antibodies that were transferred through the placenta before birth, providing some protection from infection.
Knowing that persons with blonde hair exhibit the phenotype of a recessive gene, which of the following genetic scenarios would be most likely to underlie such a trait?
aa. Explanation: A recessive trait is expressed solely in a homozygous pairing, such as AA. A heterozygous pairing, in which there are different alleles at a gene locus, will not express a recessive trait. Aa is an example of a heterozygous pairing.
When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower, more efficient level of functioning that is compatible with survival. This decrease in cell size is known as:
atrophy
A client with COPD controlled with long-term corticosteroids has developed an infection following bowel surgery. The nurse anticipated this complication since steroids:
impair the phagocytic property of leukocytes.
While reviewing the phases of wound healing, the students note that the first cells to arrive after the injury are the:
neutrophils.
A patient informs the nurse of a problem with acid indigestion and has been taking large amounts of calcium carbonate antacids daily but still has no relief. The patient states that he can consume a bottle of 100 antacids in 4 days. Which of the following blood gas results does the nurse anticipate assessing?
pH 7.6
The nurse caring for a client with respiratory alkalosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's respiratory alkalosis is improving?
pH has decreased
The nurse is reviewing a client's arterial blood gas (ABG) results. The nurse interprets the client's pH level as normal when the results identify a:
pH of 7.35 to 7.45
The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis?
pH of 7.50 and HCO3 of 45 mEq/L
The nurse examining laboratory values for a client notes that both the plasma bicarbonate (HCO3-) and CO2 levels have increased. What is the expected impact on the pH levels?
pH would remain unchanged
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
The nurse is caring for a client receiving colchicine for treatment of gout. The nurse knows the drug is effective because it:
stops microtubules from forming. Explanation: Colchicine works by interfering with formation of the mitotic spindles made from microtubules that are necessary for cell mitosis. It also prevents migration of neutrophils and lowers their response to urate crystals in the tissues. The axoneme is part of the cell that produces mobility for cilia and flagella. The proteasomes are cell mechanisms for regulating the protein quality.