PATHO FINAL
A client presented to the emergency department after getting "hit in the head with a baseball" while watching his grandson play. An x-ray of the head reveals poor quality of bone. The ED physician suspects the client has Paget disease. Which signs/symptoms help confirm this diagnosis? Select all that apply. A. "I've had a lot of headaches lately." B. "Every now and then, I get a ringing in my ears." C. "Do you see my knuckles?...they have big growths on them." D. "My thumb joint has been cracking every time I rotate it." E. "I have gotten dizzy and had to sit down while shopping."
"I've had a lot of headaches lately." "Every now and then, I get a ringing in my ears." "I have gotten dizzy and had to sit down while shopping."
A postmenopausal client reports painful intercourse. Which information should the nurse provide the client? A. "Decreased estrogen levels can lead to vaginal dryness after menopause which can lead to painful intercourse." B. "Painful intercourse may be evidence of cervical cancer. When was your last pelvic examination done?" C. "Painful intercourse is usually due to psychological issues. Do you feel anxious about having intercourse?" D. "Menopause leads to a thickening of the vaginal tissue which can lead to painful intercourse."
"Decreased estrogen levels can lead to vaginal dryness after menopause which can lead to painful intercourse."
A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which question to rule out further complications? A. "Do you get cold sores very often?" B. "Do you have pain when you urinate or difficulty starting the stream?" C. "Have you noticed excessive swelling in your scrotum the last few days?" D. "Have you been experiencing flank pain and bloody urine?"
"Do you have pain when you urinate or difficulty starting the stream?"
A nurse holds an exercise class for older adults and knows which statement by a class member requires clarification? A. "Regular exercise can prevent the blood clots that cause many strokes." B. "Exercise can help you digest your food more quickly and efficiently." C. "Physical activity can help clients with diabetes stabilize their blood sugars." D. "Exercise can help to keep down the salt levels that cause high blood pressure."
"Exercise can help to keep down the salt levels that cause high blood pressure."
A nurse in a fertility clinic is taking a history from the couple. When asked what type of underwear the male wears, he responds by asking, "Why do you need to know this? It seems a little too personal." Which response by the nurse is most appropriate for the nurse to reply? A. "Tight fitting undergarments are best so sperm cannot move around too much to become deformed." B. "Only plain white undergarments are best. Chemicals from colored briefs may damage the sperm." C. "Since you live in your clothing the better part of the day, tight-fitting underwear is a must to prevent scrotal movement." D. "For sperm production, it is best if underwear is loose to keep scrotal temperatures 3.5 to 5°F (2 to 3°C) below body temps."
"For sperm production, it is best if underwear is loose to keep scrotal temperatures 3.5 to 5°F (2 to 3°C) below body temps."
The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding? A. "I will perform BSE on the first of every month during a shower." B. "I will let my partner examine my breasts on a monthly basis." C. "I will look in a mirror and call my doctor for breast asymmetry." D. "I will palpate my breasts for lumps a few days after my period."
"I will palpate my breasts for lumps a few days after my period."
A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective? A. "I will use antibacterial ointment on the area to relieve the pain." B. "I will use condoms for intercourse until the medication is all gone." C. "I will take the acyclovir every 8 hours for the next week." D. "I will need to take all of the medication to be sure the infection is cured."
"I will take the acyclovir every 8 hours for the next week."
Which report by a middle-aged woman should prompt a care provider to assess for the possibility of ovarian cancer? A. "I'm having a lot of vaginal discharge lately and it's quite foul." B. "My periods have become quite irregular since last winter." C. "I have had a sharp, stabbing pain on my side for the last few days." D. "I'm having a lot of indigestion and bloating, which I've never had before."
"I'm having a lot of indigestion and bloating, which I've never had before."
A nurse is teaching a newly-diagnosed client with rheumatoid arthritis (RA) about pharmacologic therapy with disease-modifying antirheumatic drug (DMARD) therapy. Which statement should the nurse include in the teaching? A. "Ideally, DMARDs should be started at time of diagnosis." B. "Corticosteroids are first-line medications, followed by nonsteroidal anti-inflammatory drugs (NSAIDs)." C. "NSAIDs should be avoided early in the course of the disease." D. "Surgery is used as a first-line treatment, rather than regular drug therapy."
"Ideally, DMARDs should be started at time of diagnosis."
A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate the client by making which statement? A. "After your cesarean section, it will be safest if you don't breast-feed your child." B. "If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with." C. "A vaginal delivery will be safe as long as intravenous antibiotics are given prior to, and during, labor." D. "We'll have to book you a cesarean delivery in order to ensure your baby isn't exposed to the virus."
"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."
A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of websites. Which statement that he has read is most plausible? A. "Testicular cancer is a leading cause of death among males who should be in the prime of their life." B. "Men with cryptorchidism — the term for an undescended testicle — are known to have a higher risk of developing testicular cancer." C. "For most men with testicular cancer, bloody urine is their first sign that something is wrong." D. "Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed."
"Men with cryptorchidism — the term for an undescended testicle — are known to have a higher risk of developing testicular cancer."
A 50-year-old woman experiencing hot flashes and other menopausal symptoms asks the nurse about the benefits of the traditional Chinese use of dong quai. What is the nurse's best response? A. "More research is needed on herbal remedies. Neither safety nor efficacy is guaranteed." B. "Each woman needs to make a choice about using herbals based on her personal beliefs." C. "You should not take herbal remedies but only the medications prescribed by your physician." D. "There is no evidence that any herbal products can benefit women with these symptoms."
"More research is needed on herbal remedies. Neither safety nor efficacy is guaranteed."
A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make? A. "Lupus is a disease of older individuals." B. "More women than men are affected by lupus." C. "Lupus is more common in white people." D. "Drug-induced lupus requires lifelong treatment."
"More women than men are affected by lupus."
Some skin problems occur in specific age groups. Which are problems common to older adults? Select all that apply.
- Keratoses - Lentigines - Skin tags
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement? A. "Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular." B. "Rheumatoid arthritis is a chronic autoimmune system disease that affects a single joint." C. "Only upper extremity diarthrodial joint can be involved." D. "The disease will not fluctuate in occurrence."
"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
Following a progressive onset of fatigue, aching, and joint stiffness over the last two years, a 69-year-old male has recently been diagnosed with rheumatoid arthritis (RA). Which teaching point should his primary care physician include during the office visit in which this diagnosis is communicated to the client? A. "The symptoms you've been experiencing are the result of damage inside your joints, but I'll start you on medications that will reverse this damage." B. "It's important that you maximize your level of activity, since decreasing your mobility will worsen the disease." C. "The best treatment plan is to try all other available treatments before resorting to using medications." D. "Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms."
"Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms."
The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate? A. "The circumcision will not be done now; the foreskin is needed for surgical repair." B. "The condition can be treated with topical medication; circumcision is not needed." C. "The circumcision will be done when the child reaches puberty." D. "The circumcision can be performed now."
"The circumcision will not be done now; the foreskin is needed for surgical repair."
A 57-year-old woman has been diagnosed with atrophic vaginitis and has expressed surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond? A. "The lower levels of estrogen since you've begun menopause make your vagina prone to infection." B. "Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause." C. "This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past." D. "The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria."
"The lower levels of estrogen since you've begun menopause make your vagina prone to infection."
A public health nurse has learned that a colleague has been screening for scoliosis during visits made to schools even though such screening is not mandated. How should the nurse best respond to the colleague? A. "The potentially harmful outcomes of screening have been shown to outweigh the benefits." B. "Screening for scoliosis has been proven to be inaccurate." C. "Screening is unnecessary now that we know scoliosis is a benign condition." D. "The low prevalence and incidence of scoliosis have made screening unnecessary."
"The potentially harmful outcomes of screening have been shown to outweigh the benefits."
When administering a corticosteroid to a client with rheumatoid arthritis, a nurse includes which education about the medication? Select all that apply. A. "Corticosteroids are taken for life to reduce inflammation." B. "Corticosteroids do not prevent joint destruction." C. "Corticosteroids may be given to inhibit tumor necrosis factor." D. "Pain is relieved with use of corticosteroid medications." E. "These drugs are for short-term use."
"These drugs are for short-term use." "Pain is relieved with use of corticosteroid medications." "Corticosteroids do not prevent joint destruction."
A faculty member is reviewing key information about malignant melanoma. Which statements by the students indicate correct information? Select all that apply.
- Malignant melanoma is seen in individuals who have made frequent visits to tanning salons. - Malignant melanoma occurs most frequently in areas exposed to the sun. - Malignant melanoma is a rapidly progressing metastatic form of cancer.
A 70-year-old male tells the health care provider he is now in a relationship with a younger woman who is capable of reproduction. The client asks if he may still be fertile. The best response would be: A. "Yes, some 80- and 90-year-old men have been known to father children." B. "No, fertility ends at 50 years of age." C. "Why do you want children at your age?" D. "Have you ever fathered a child before?"
"Yes, some 80- and 90-year-old men have been known to father children."
Which teaching point by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer? A. "Thanks to new treatment advances, there's a very good chance that I won't have to remove a testicle." B. "If steroid treatment fails, then we can consider surgery and/or chemotherapy." C. "You should know that there might be adverse effects on your sexual function after treatment is finished." D. "The advantage of performing an orchiectomy over other treatments is that it rules out recurrence."
"You should know that there might be adverse effects on your sexual function after treatment is finished."
The nurse is preparing a client for testing to determine if the client's gout is due to overproduction or underexcretion of uric acid. How should the nurse explain the process used? A. "Your serum uric acid levels will be compared to the urate content in your urine." B. "An aspirate of your joint fluid will be taken to examine for monosodium urate crystals." C. "A series of blood samples will be taken before and after consuming high purine foods." D. "We will collect a 24-hour urine sample to examine urate and creatinine clearance."
"Your serum uric acid levels will be compared to the urate content in your urine."
A client who has sustained partial-thickness or second-degree burns to 70% of total body surface area is arriving via ambulance to the emergency department. What aspects of care will the nurse prioritize for this client? Select all that apply.
- Blood pressure support - Infection control - Pain management
A client is admitted to the hospital with thermal injuries as a result of a fire. What type of damage of the skin can occur as a result of the thermal injuries? Select all that apply.
- Cause damage to the skin and subcutaneous tissue - Destroy the barrier function of the skin
The nursing educator is reviewing important information about malignant melanoma. Which statements by the students indicate further need for review of the topic? Select all that apply.
- Most malignant melanomas occur in clients with inheritable gene defects. - Broad, thin tumors are more dangerous than nodular ones.
The nurse is caring for a client with pneumonia and a severe case of psoriasis that is being treated with methotrexate. During the morning assessments, which laboratory values would alert the nurse that the client is experiencing a side effect to this medication? Select all that apply.
- Platelet count 37 x 10^3/μL (37 x 10^9/L) - White blood cell count 1.2 x 10^3/μL (1.2 x 10^9/L)
The nurse is caring for a client with a stage III decubitus ulcer that is being treated with an occlusive dressing. A family member says to the nurse, "It seems like that bandage is hardly ever changed and it looks wet underneath. I thought wounds should not be wet and bandages should be changed every day." What points related to occlusive dressings should the nurse include in the response? Select all that apply.
- The wound fluid contains growth factors that aid in healing. - These dressings can help reduce the pain in the wound. - Being occlusive, it keeps bacteria out, reducing infections.
An older adult client is showing the nurse some changes in the skin that the client found while taking a shower. Which lesion(s) would give the nurse concern that it might be a precancerous lesion? Select all that apply.
-Several dry, brown, scaly lesions that are approximately 1 cm in diameter; a few of the lesions are showing some ulceration. -Tan-to-brown lesions commonly called 'liver spots" located on forearm and hands.
Which woman is most likely to have a sexually transmitted infection as a contributing factor to her health problem? A. A 29-year-old woman with a diagnosis of localized vulvodynia B. A 40-year-old with is being treated for vaginal cancer C. A 32-year-old who is undergoing diagnostics to rule out endometriosis D. A 41-year-old with a diagnosis of mucopurulent cervicitis
A 41-year-old with a diagnosis of mucopurulent cervicitis
The nurse is counseling a group of perimenopausal and postmenopausal women about the pros and cons of hormone therapy (HT). Which member of the group should the nurse identify as likely to benefit most from HT while incurring the least risk? A. A 49-year-old who is experiencing many menopausal symptoms B. A 62-year-old who continues to have menopausal symptoms C. A 58-year-old who no longer experiences symptoms of menopause D. A 45-year-old who is perimenopausal with few symptoms of menopause
A 49-year-old who is experiencing many menopausal symptoms
The nurse is reviewing the health histories of four clients. Select the client most at risk for developing secondary osteoporosis. A. A 60-year-old female taking prednisone for asthma B. A 22-year-old female taking oral contraceptives C. An 80-year-old male who resides in an assisted living facility D. A 42-year-old male with a healing leg fracture
A 60-year-old female taking prednisone for asthma
The parents of an 18-month-old child noticed a small vesicle on her face that ruptured a few days later and left a straw-colored crust on the child's face. New vesicles have prompted them to bring the child to the health care provider. Which treatment for the child's skin problem is most likely?
A topical antibiotic
A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would be most likely to lead clinicians to this diagnosis? A. A visible hematoma is present on the anterior portion of the knee. B. The woman experiences intermittent, painful locking of her joint. C. Computed tomography indicates a complete tear of her knee ligament. D. A X-ray shows that her femoral head and tibia are no longer articulated.
A visible hematoma is present on the anterior portion of the knee.
When a nurse is administering medications to a client with rheumatoid arthritis (RA), which medication interferes with tumor necrosis factor (TNF)-alpha? A. Aspirin B. Adalimumab C. Hydroxychloroquine D. Methotrexate
Adalimumab
The nurse is screening clients for risk factors associated with ovarian cancer. Which client has the greatest risk of developing ovarian cancer? A. Age 25, no children, undergoing in vitro fertilization cycles B. Age 35, four children, using oral contraceptives, no cancer history C. Age 55, no children, postmenopausal, two sisters with breast cancer BRCA1 positive D. Age 65, three children, postmenopausal, one aunt had ovarian cancer
Age 55, no children, postmenopausal, two sisters with breast cancer BRCA1 positive
A new client arrives at the clinic. The physician is suspecting the client may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and history of pleural effusions. The nurse should anticipate which diagnostic test will be a priority to facilitate with the diagnosis? A. Anti-DNA antibody test. B. Routine hemoglobin. C. C-reactive protein. D. B-cell lymphocytes.
Anti-DNA antibody test.
A 44 year-old woman who has a longstanding diagnosis of SLE has been able to control her symptoms with lifestyle modifications for several years, but has presented to her care provider due to recent exacerbation. Which pharmacologic treatment option is her care provider most likely to rule out first? A. Nonsteroidal anti-inflammatory drugs. B. Corticosteroids C. Antiplatelet aggregators D. Immunosuppressive drugs
Antiplatelet aggregators
The nurse is screening a newborn for developmental dysplasia of the hip. Which assessment finding supports this diagnosis? A. Asymmetrical gluteal and thigh folds B. Inability of the newborn to move one leg C. Discoloration of the leg D. Swelling of the hip
Asymmetrical gluteal and thigh folds
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed: A. Atrophic vaginitis B. Adenomyosis C. Endometrial cancer D. Cystocele
Atrophic vaginitis
Which hormone replacement therapy was traditionally prescribed for a postmenopausal woman diagnosed with an intact uterus? A. Estrogen and progesterone therapy B. Estrogen therapy C. Progesterone therapy D. Androgen therapy
Estrogen and progesterone therapy
Which assessment technique/sign should the nurse utilize on a newborn to screen for developmental dysplasia of the hip? A. Barlow B. Homans C. McMurray D. Babinski
Barlow
A client has been referred to the dermatology office for an evaluation of a suspected common malignant tumor of the skin. Which is the most common malignant tumor of the skin?
Basal cell carcinoma
Scoliosis is an abnormal curvature of the spine. Why is it first noticed? A. Because of the deformity it causes B. Because the child cannot stand straight C. Because of the pain it causes D. Because the child cannot walk straight
Because of the deformity it causes
The anatomy of the prostate gland is made up of three concentric areas surrounding the prostatic urethra, into which they open. The nurse understands that an overgrowth of the mucosal glands can cause which disorder in older men? A. Prostate cancer B. Neoplasm cells of the prostate C. Testicular cancer D. Benign prostatic hyperplasia
Benign prostatic hyperplasia
A nurse is teaching a client with psoriatic arthritis about treatment. Which statement should be included? A. Antibiotics are administered early in the disease diagnosis. B. Biologic response modifiers are beneficial in controlling the disease. C. A medication to decrease uric acid levels is often effective D. The only medication therapy that is effective are nonsteroidal anti-infective agents.
Biologic response modifiers are beneficial in controlling the disease.
A client who is a recent immigrant from a developing country visits the clinic with a low-grade fever, elevated white blood count, and pain in the back and hips. Which test will confirm the diagnosis of spinal tuberculosis (TB)? A. X-ray B. Magnetic resonance imaging (MRI) C. Biopsy D. Complete blood count (CBC)
Biopsy
When explaining to the client diagnosed with gout how the xanthine oxidase inhibitors work, the health care provider would include which statement? A. Blocks the production of uric acid by the body B. Increases elimination of uric acid by the kidneys C. Prevents flare-up during the first few months of starting medication D. Can be given intravenously to rapidly decrease serum uric acid levels
Blocks the production of uric acid by the body
Which test should be included when screening a client for potential causes of rickets? A. Blood urea nitrogen (BUN) and creatinine B. White blood cell count C. Platelet count D. Blood cultures
Blood urea nitrogen (BUN) and creatinine
A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. Which phenomenon most likely contributed to her present condition? A. Unprotected sex with a new partner who is a carrier of the relevant bacteria. B. Autoinoculation from a cold sore, wart, or oral fungal infection. C. A sharp reduction in the number of lactobacilli in the client's vaginal flora. D. Proliferation of sexually transmitted protozoa.
C. A sharp reduction in the number of lactobacilli in the client's vaginal flora.
Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has: A. C. albicans B. T. vaginalis C. C. trachomatis D. N. gonorrhoeae
C. albicans
A 71-year-old man has visited his family physician for a checkup, during which the physician has initiated a discussion about the client's sexual function. Which phenomenon is the physician most likely to consider a pathologic rather than an age-related change? A. The presence of relative or absolute hypogonadism B. A decrease in the size and firmness of the client's testes C. Cessation of follicle-stimulating hormone (FSH) production D. A decrease in the force of the man's ejaculation
Cessation of follicle-stimulating hormone (FSH) production
A nurse is caring for an adolescent female who is undergoing diagnostic studies for systemic lupus erythematosus (SLE). Which assessment findings does the nurse recognize as being consistent with childhood SLE? Select all that apply. A. Child is of Asian descent. B. Child is between 8 and 15 years of age. C. Child is fatigued and generally feels "under the weather." D. Child has gained 20 lb (9.1 kg). E. Child has increased serum creatinine.
Child is between 8 and 15 years of age Child is fatigued and generally feels "under the weather" Child has increased serum creatinine
A client with polycystic ovary syndrome (PCOS) visits a fertility clinic. Which intervention will best improve the chance for a successful pregnancy? A. Weight loss B Metformin C. Clomiphene D. Spironolactone
Clomiphene
A client with a history of polymyalgia rheumatica is admitted with a suspected stroke and is permitted nothing by mouth (NPO). Given this client's prescribed medications, what parenteral medication will the nurse prioritize as most important to request from the health care provider? A. Immunosuppressant B. Corticosteroid C. Nonsteroidal anti-inflammatory (NSAID) D. Analgesic
Corticosteroids
A client arrives in the emergency department complaining of severe pain in the left testicular area with nausea and vomiting for 2 hours. The left testicle is large and tender to palpation and radiating to the inguinal area. Which of the following reflexes can the nurse assess the absence of to indicate testicular torsion? A. Fluid wave B. Superficial neurologic reflex C. Abdominal reflex D. Cremasteric reflex
Cremasteric reflex
The nurse is working with an older adult client who wishes to implement an exercise program. Which exercise regimen provides the most complete plan? A. Walking a mile every day and meditation B. Swimming four times a week and attending church C. Cycling and lifting weights with a yoga class. D. Bowling and ballroom dancing with a dining club
Cycling and lifting weights with a yoga class.
A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms, he has experienced over the last several days. He reveals that he has had a few new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last two days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's priority? A. Chancroid B. Syphilis C. Chlamydia D. Gonorrhea
D. Gonorrhea
A nurse is evaluating a client's response to instruction about exercise. Which level of activity meets the recommendations by the Centers for Disease Control (CDC) for a client who is 75 years old? A. Daily walking and weight training with a heart rate of 90 B. Swimming 5 days a week with a heart rate of 100 C. Cycling and gardening 3 days a week with a heart rate of 75 D. Dancing and bingo twice a week with a heart rate of 82
Daily walking and weight training with a heart rate of 90
A nurse monitors for side effects in a female client receiving endometriosis treatment with the gonadotropin-releasing hormone (GnRH) agonist leuprolide. Which adverse effect would be caused to limit duration of treatment? A. Decreased bone density B. Muscle spasms C. Hot flashes and night sweats D. Nosebleed and cough
Decreased bone density
An 80-year-old female with a diagnosis of osteoporosis receives daily supplements of calcitonin in the form of a nasal spray that she instills each morning. Which phenomenon would her care providers expect to result from her supplementation? A. Decreased serum calcium levels B. Increased bone resorption C. Acceleration of osteoclast action D. An increase in bone formation
Decreased serum calcium levels
A client has been diagnosed with an anterior pituitary tumor. Synthesis and release of follicle-stimulating hormone (FSH) has become deranged. What are the potential consequences of this alteration in endocrine function? A. Dysfunction of spermatogenesis B. Overproduction of luteinizing hormone C. Inhibition of testosterone synthesis D. Impaired detumescence
Dysfunction of spermatogenesis
If a male has a history of impaired blood flow in his vascular system, he may be prone to developing: A. Premature ejaculation B. Erectile dysfunction C. Penile engorgement D. Vascular clots in pudendal arteries
Erectile dysfunction
A pregnant client who is taking risperidone, an antipsychotic prescribed for bipolar disorder, is at high risk for developing which hormonal adverse effects? A. Increased growth hormone production B. Decreased human chorionic gonadotropin levels C. Excess prolactin secretion D. Decreased follicle-stimulating hormone secretion
Excess prolactin secretion
A child has a notable limp and states there is "a lot of leg pain." There was no history of injury. Which assessment data corresponds to a diagnosis of osteomyelitis? Select all that apply. A. Fever B. Redness C. Periosteal elevation on X-ray D. Bone shortening E. Fracture
Fever Redness Periosteal elevation on X-ray
Gout, or gouty arthritis, cannot be diagnosed on the basis of hyperuricemia. What is the diagnostic criterion for gout? A. Finding of tophaceous deposits B. Finding of monosodium urate crystals in the synovial fluid C. Finding of leukocyte crystals in the tissues D. Finding of calcium crystal deposits in the synovial fluid
Finding of monosodium urate crystals in the synovial fluid
The nursing students are studying about testosterone and androgens and the role they play in the male. The student correctly identifies which scenario to be a situation where hormone replacement is recommended? A. For athletes who want to increase athletic ability B. For bodybuilders who want bigger muscles C. For aging men with low androgen levels D. For teenagers who want to get big "faster"
For aging men with low androgen levels
A nursing student studying obstetrics asks the faculty, "How does the sperm get so much energy to swim up the fallopian tubes?" The instructor responds based on which pathophysiologic principle? A. Usually the ejaculation is so powerful that it propels the sperm far up into the fallopian tubes. B. Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm. C. The seminal vesicles secrete fluid for the semen, and they can secrete catecholamines that energize the sperm. D. Estrogen that is being secreted when the ova are ripe and ready for penetration assists by attracting the sperm in the right direction.
Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm.
A client has undergone extensive diagnostic testing following several months of worsening pain in the first metatarsophalangeal joint with reduced range of motion. The client's results indicate hyperuricemia. What is the nurse's best interpretation of this finding? A. The client is likely to experience an acute attack of gout. B. Further testing is needed before a diagnosis of gout can be made. C. The client most likely has some degree of renal impairment. D. Enteropathic arthritis is likely the cause of the problem.
Further testing is needed before a diagnosis of gout can be made.
The nurse suspects a newborn may have developmental dysplasia of the hip (DDH) based on which assessment finding? A. Gluteal fold asymmetry B. Lengthening of the thigh C. Joint capsule tightness D. Delay of knee crawling
Gluteal fold asymmetry
A client sustains a musculoskeletal injury of the left ankle. In addition to pain, which clinical manifestations would accompany a sprain? Select all that apply. A. Swelling B. Discoloration C. False motion D. Limited movement E. Joint locking F. Heat
Heat Swelling Discoloration Limited movement
A client comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. What should the nurse suspect, this client may have? A. Spermatocele B. Varicocele C. Hematocele D. Hydrocele
Hematocele
Select the factor that would increase a male's risk for the development of testicular cancer. A. History of cryptorchidism B. Exposure to ultraviolet A radiation C. Occupational exposure to soot D. Improper hygiene practices
History of cryptorchidism
The nurse is performing an admission assessment to a rehabilitation unit. Which assessment tools should she utilize to determine an alert client's normal activities, perceived level of activity tolerance, or level of fatigue? A. Human Activity Profile B. Ergometry C. Fatigue Severity Scale D. Mini-Mental Examination
Human Activity Profile
A 29-year-old woman has been trying for many months to become pregnant, and fertilization has just occurred following her most recent ovulation. What process will now occur that will differentiate this ovulatory cycle from those prior? A. Human chorionic gonadotropin will be produced, preventing luteal regression. B. The remaining primary follicles will provide hormonal support for the first 3 months of pregnancy. C. The corpus luteum will atrophy and be replaced by corpus albicans. D. The basal layer of the endometrium will be sloughed in preparation for implantation.
Human chorionic gonadotropin will be produced, preventing luteal regression.
In primary dysmenorrhea, when contraception is not desired, what is the treatment of choice? A. Aspirin B. Ibuprofen C. Acetaminophen D. Metformic acid
Ibuprofen
The ovaries secrete both estrogen and progesterone. What is one function of progesterone in the body? A. Causes moderate retention of sodium and water B. Increases body temperature at ovulation C. Reduces levels of renin D. Enhances the coagulability of blood
Increases body temperature at ovulation
A 15-year-old male client reports severe pain in the inguinal area and nausea. What action does the nurse take first? A. Inspect the client's genitalia. B. Assess the client's abdomen. C. Request a prescription for antiemetic. D. Request a prescription for analgesia.
Inspect the client's genitalia.
A nurse is caring for a client with discoid lupus. Which system does the nurse set as a priority for the nursing assessment? A. Integumentary assessment B. Hematologic assessment C. Peripheral vascular assessment D. Rheumatologic assessment
Integumentary assessment
An 18-year-old woman presents at the clinic complaining of new-onset breakthrough bleeding, even though she is taking contraceptives. What contraceptive use, along with new-onset breakthrough bleeding, has been associated with pelvic inflammatory disease? A. Intrauterine device B. Depo-Provera C. Spermicidal foam D. Diaphragm
Intrauterine device
A 54-year-old diabetic client has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required bypass graft 3 years ago, hypertension, and gout. The nurse practitioner is reviewing his record to prescribe medication. The practitioner is considering prescribing sildenafil. Which home medication is contraindicated if taken concurrently with sildenafil? A. Diltiazem, a calcium channel blocker B. Amiodarone, an antiarrhythmic C. Isosorbide mononitrate, a vasodilator D. Furosemide, a diuretic
Isosorbide mononitrate, a vasodilator
Clinical investigation of a 40-year-old female client with diverse dermatologic signs and symptoms has focused on the woman's basement membrane. Which skin function would a clinician most likely attribute to a region of the integument other than the basement membrane?
Lack of sensory nerve impulse conduction
Which assessment findings will help the nurse to confirm the diagnosis of rheumatoid arthritis? Select all that apply. A. Asymmetrical joint involvement B. Joint stiffness C. Finger and hand pain D. Wrist pain E. Limited joint mobility
Limited joint mobility joint stiffness wrist pain finger and hand pain
Which skin locations create particular risk factors for tumor invasion and metastasis due to squamous cell carcinoma? Select all that apply.
Lip Ear Back of the hand
Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which phenomenon most likely underlies the woman's situation? A. Inappropriate T-cell mediated immune responses have resulted in articular cartilage degeneration. B. Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself. C. Excessive collagen deposits have accumulated in the woman's synovial joints. D. Bone overgrowth in synovial joints has resulted in fusing of adjacent bones that normally articulate.
Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.
A 39-year-old male client has been recently diagnosed with primary hypogonadism. Which lab result would be most indicative of this diagnosis? A. Normal levels of free testosterone; low levels of total testosterone B. Low free testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels C. Low levels of gonadotropin-releasing hormone (GnRH) D. Low testosterone levels; high levels of LH and FSH
Low testosterone levels; high levels of LH and FSH
A male client presents at the clinic with flulike symptoms and reports a weight loss of 10 pounds without trying. On physical examination, the client is found to have splenomegaly and large, tender, fluctuant inguinal lymph nodes. While taking the nursing history, it is discovered that the client prefers male sexual partners, and that 2 weeks ago the client had small, painless papules. What disease would the nurse suspect the client has? A. Genital herpes B. Chancroid C. Syphilis D. Lymphogranuloma venereum
Lymphogranuloma venereum
The relative of a client with osteoarthritis asks how to avoid developing the condition. Which response by the nurse is most accurate? A. Maintain your weight near ideal. B. Perform repetitive exercise daily. C. Avoid use of tobacco products. D. Consume a diet high in protein.
Maintain your weight near ideal.
The nurse assessing for signs and symptoms of perimenopause in a woman should assess for: A. Menstrual irregularity B. Cessation of menstruation C. Decreased FSH level D. Elevated estrogen levels
Menstrual irregularity
When counseling a client who is 3 months' pregnant and who recently went on a vacation to South America where she received several mosquito bites, the biggest complication the provider should prepare her for is delivering a child with which type(s) of defect? Select all that apply. A. Bilateral hip dysplasia B. Microcephaly C. Eye concerns D. Hearing problems E. Spina bifida
Microcephaly Eye concerns Hearing problems
The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis? A. Nonsteroidal anti-inflammatory drugs (NSAIDs) B. Hydroxychloroquine C. Cyclophosphamide D. Belimumab
Nonsteroidal anti-inflammatory drugs (NSAIDs)
When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease? A. Sedentary life style B. Obesity C. Smoking D. Hypertension
Obesity
While an infant is in the supine position with both knees flexed, the clinician applies gentle downward pressure to both knees, and the knee and thigh are abducted as an upward and medial pressure is applied to the proximal thigh. This examination technique, used to screen for a reducible dislocation, is called: A. Galeazzi test B. Ortolani maneuver C. Clubfoot test D. Trendelenburg test
Ortolani maneuver
The nurse is conducting a community education program on menopause. Which condition will require medical follow-up? A. Osteoporosis B. Hypertrophic uterine C. Pendulous breasts D. Vaginal dryness
Osteoporosis
A 40-year-old black client is at increased risk of developing prostate cancer, because his father was diagnosed with the disease at age 60 and his brother at age 56. What diagnostic measures should be undertaken? A. PSA and DRE starting before the age of 50 B. Transrectal ultrasonography starting immediately C. PSA and DRE starting at age 50 D. Transrectal MRI starting at age 45
PSA and DRE starting before the age of 50
A client sustained a fall that resulted in an injury to the right shoulder, and the emergency doctor suspects a rotator cuff injury. The client would most likely manifest: Select all that apply. A. Pain B. Muscle atrophy C. Difficulty abducting the affected arm D. Increased ability to rotate the arm E. Increased active range of motion
Pain Muscle Atrophy Difficulty abducting the affected arm
The nurse inserts a Foley catheter in an uncircumcised male client for the treatment of urinary retention and does not place the foreskin back over the glans penis. Several hours later, the client complains of severe pain at the catheter site and, when assessed, the nurse is unable to retract the foreskin. Which problem does the nurse know has occurred? A. Phimosis B. Hypospadias C. Balanitis D. Paraphimosis
Paraphimosis
A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client? A. Peyronie disease B. Cavernosa disease C. Balanitis D. Paraphimosis disease
Peyronie disease
An older adult reports waking up in the morning with pain/stiffness in the neck/shoulders. Laboratory work reveals an elevated erythrocyte sedimentation rate (ESR). Following a short trial of prednisone with significant improvement, the health care provider likely will diagnose which disorder? A. Polymyalgia rheumatica B. Psoriatic arthritis C. Reiter syndrome D. Ankylosing spondylitis
Polymyalgia rheumatica
A young adult client presents with "stiffening of the spine." Which diagnostic laboratory result leads the health care worker to diagnose ankylosing spondylitis? A. Elevated serum calcium level of 15.1 mg/dL (3.77 mmol/L) B. Increased production of antibodies against self and non-self antigens C. Presence of HLA-B27 allele marker D. Elevated serum uric acid level
Presence of HLA-B27 allele marker
An adult client asks the nurse how a moderate program of weight training would promote health. Which information about weight training is correct to include in the education? Select all that apply. A. Promotes bone density B. Decreases glucose tolerance C. Stimulates insulin sensitivity D. Raises basal metabolism E. Lowers white blood cells
Promotes bone density Stimulates insulin sensitivity Raises basal metabolism
A nurse is caring for a client with rheumatoid arthritis (RA) who states she "caught" this from her mother. Which statement is the correct explanation of how this type of arthritis develops? A. RA is caused by a virus, transmitted in utero. B. RA has an autoimmune and genetic predisposition. C. RA is a disease of older adults, especially women. D. RA is related to overuse of a joint.
RA has an autoimmune and genetic predisposition.
Determining the extent of the injury when a fracture occurs is important. During diagnosis of the fracture, which items are considered important to determine during the history taking? Select all that apply. A. Someone else in the family prone to fractures B. Recognition of symptoms C. Any treatment initiated D. Mechanism of injury E. What client has eaten
Recognition of symptoms Any treatment initiated Mechanism of injury
A client with a recent fracture visits the doctor's office to monitor bone healing. X-ray reveals new calcium deposits at the fracture site with the fracture line still evident. At which stage in the healing process is this fracture? A. Hematoma formation B. Inflammatory phase C. Reparative phase D. Remodeling phase
Reparative phase
A client has been admitted with a fractured pelvis that occurred in an auto accident just a few hours ago. The nurse has noticed a slight change in behavior. Which other clinical manifestations would lead the nurse to suspect the client has developed a fat emboli? Select all that apply. A. Reports of substernal chest pain B. Reports of pain in the lower abdomen and back C. Pulse rate 120 with temperature of 99.7°F (37.6°C) D. Profuse diaphoresis with pallor noted E. Urine output of 30 mL/hour
Reports of substernal chest pain Pulse rate 120 with temperature of 99.7°F (37.6°C) Profuse diaphoresis with pallor noted
The nurse is assessing a client who arrived to the emergency department reporting pain at 8 of 10 and swelling of the upper arm after a fall. Which intervention will the nurse perform first? A. Request an X-ray be performed. B. Request a surgical consult. C. Assess the client's strength and range of motion. D. Prepare the client for the application of a cast.
Request an X-ray be performed.
When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult? A. Need for pain relief B. Stiffness in the morning C. Risk for falls D. Muscle weakness
Risk for falls
A 7-month-old child has developed onset of high fever, inflamed tympanic membranes, and cold-like symptoms for 3 to 4 days. The symptoms improved at the same time a characteristic maculopapular rash covering the trunk and spreading to the appendages appeared. The baby has most likely developed:
Roseola infantum
Which infectious childhood diseases that are characterized by rashes have vaccines available? Select all that apply.
Rubella Rubeola Varicella
A client is admitted with suspected soft tissue injury during a soccer game. What is the best intervention? A. Send the client for an X-ray B. Send the client for an MRI C. Send the client for a physical exam. D. Have the client come back based on their symptoms
Send the client for an MRI
A client with ankylosing spondylitis wants to begin an exercise program. Which sport would the nurse recommend? A. Jogging B. Swimming C. Bowling D. Golfing
Swimming
While reviewing the following diagnostic findings on a group of clients with joint complaints, which finding would be a priority for further investigation and possible medical intervention? A. A male client has elevated levels of serum uric acid but lacks symptoms. B. Synovial fluid aspiration indicates the presence of monosodium urate crystals. C. A man reveals that he eats organ meat 2 to 3 times weekly. D. A 55-year-old male reveals that it takes a day or two for oral colchicine's to relive his attacks of gout.
Synovial fluid aspiration indicates the presence of monosodium urate crystals.
A 31-year-old client with breast cancer is concerned about being prescribed a hormonal medication to help block the effects of estrogen on the growth of breast cancer cells. The nurse should provide education about which likely medication? A. Trastuzumab, a biologic therapy B. Tamoxifen, a nonsteroidal antiestrogen C. Progesterone, a hormone. D. Anastrozole, an aromatase inhibitor.
Tamoxifen, a nonsteroidal antiestrogen
A male client is receiving testosterone for primary hypogonadism. What assessment would indicate successful treatment? A. Testosterone level increases B. LH and FSH levels are low C. Sperm count 10 million/mL D. Elevated gonadotropin-releasing hormone
Testosterone level increases
A child's history and a subsequent physical document that the child has a grade I metatarsus adductus deformity. When assessing the child, the nurse anticipates finding which result? A. The foot can be manipulated into a straight position. B. Only the lateral border of the foot can be straightened. C. A rigid deformity of the foot that cannot be straightened.. D. The foot is directed inward when walking.
The foot can be manipulated into a straight position.
The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include? A. The injections will be given only 3 to 4 times per year because they can increase joint destruction. B. There will be minimal discomfort because the injections are placed in the subcutaneous tissue. C. The client or a family member will be taught to administer the injections daily. D. There will be immediate relief with one injection and daily running can be resumed.
The injections will be given only 3 to 4 times per year because they can increase joint destruction.
A nurse is inspecting the scrotum and testes of a 43-year-old male client. Which finding requires additional evaluation? A. The skin on the scrotum is hard, taut, and shiny. B. The left testicle hangs lower than the right testicle. C. The scrotal skin has folds. D. The testes move close to the body in cold temperatures.
The skin on the scrotum is hard, taut, and shiny.
A 40-year-old woman has been identified to have a deficiency in estrogen. Which physiologic phenomenon is most likely to remain unaffected? A. Parathyroid hormone antagonism and the rate of bone resorption. B. The regulation of uterine endothelial development. C. The maintenance of normal skin and blood vessel structure. D. The synthesis and release of adrenal glucocorticoids.
The synthesis and release of adrenal glucocorticoids.
The nurse notes that a client is not responding well to health care providers and is constantly complaining. How can a tool such as the Human Activity Profile help this client? A. The tool may help the client become interested in care. B. The tool may help the health care provider understand the client's quality of life. C. The tool will help to diagnose depression. D. The tool will assist in determining the client's health care needs.
The tool may help the health care provider understand the client's quality of life.
The client with osteoporosis asks the nurse to explain what a bisphosphonate medication does. The nurse will respond: A. This medication helps prevent bone resorption, which in turn will help prevent fractures. B. These drugs increase your phosphorus levels and thereby help with your calcium levels as well. C. This medication stimulates your parathyroid gland to increase osteoclastic activity. D. This medication plays an important role in bone remodeling.
This medication helps prevent bone resorption, which in turn will help prevent fractures.
A nurse practitioner is examining a female client who presents with symptoms of pain during intercourse. The nurse notes the presence of small hemorrhagic areas on the cervix. Based on this observation, which sexually transmitted infection does the nurse suspect? A. Trichomoniasis B. Chlamydia C. Gonorrhea D. Syphilis
Trichomoniasis
Select the condition that contributes to the risk of infertility in males. A. Trichomoniasis B. Chancroid C. Genital warts D. Herpes simplex
Trichomoniasis
An older adult man reports recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which clinical manifestations would the health care provider expect prior to the resolution of this health problem? A. Urinary frequency and urgency and pain B. Development of renal calculi and renal cysts C. Unilateral hydronephrosis and pain D. Development of glomerulonephritis or nephritic syndrome
Urinary frequency and urgency and pain
The nurse is teaching a client with rheumatoid arthritis about pannus, which develops in the affected joint area. What does the nurse include to describe pannus? A. Muscles in the area that atrophy from disuse B. Vascular granulation tissue that destroys cartilage and bone C. Microorganisms that attack the joint space causing stiffness D. Reversible calcium deposits affecting the joints
Vascular granulation tissue that destroys cartilage and bone
A 24-year-old male client with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds: A. Probably not since your spinal cord has been completely severed. B. A urologist may be able to insert a needle into your testes and withdraw some sperm. C. With proper stimulation of your genitals, you may be able to produce an erection and ejaculation. D. It takes sympathetic innervation to produce an erection and ejaculation, which is lost with your type of injury.
With proper stimulation of your genitals, you may be able to produce an erection and ejaculation.
The nurse is caring for a client who has been prescribed calcitonin. The current serum calcium level is 6.4 mg/dL (1.6 mmol/L). What is the nurse's best action? A. Withhold the calcitonin until speaking with the health care provider. B. Administer the calcitonin as prescribed and document appropriately. C. Assess client for nausea, constipation, and altered level of consciousness. D. Obtain order for bolus of intravenous fluids and bisphosphonates.
Withhold the calcitonin until speaking with the health care provider.
An older adult male client is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the client may have a problem with: A. kidney stones. B. an enlarged prostate gland. C. blood clots clogging the urethra. D. calcium sediment in the bladder.
an enlarged prostate gland.
A nurse is caring for a client with a stage II pressure injury with little exudate. Which treatment option will the nurse to implement for this client?
application of semipermeable or occlusive dressing
The nurse knows which teaching statement listed below best captures an aspect of chronic fatigue syndrome (CFS)? There are no: A. treatments for CFS. B. biological markers for the diagnosis of CFS. C. established diagnostic criteria for CFS diagnosis. D. objective assessment findings that appear with CFS.
biological markers for the diagnosis of CFS.
Which statement best captures an aspect of the role of progesterone? Progesterone: A. production begins shortly after conception and peaks prior to delivery. B. is responsible for the stimulation of lactation in the postpartum period. C. levels peak after ovulation and are present throughout the menstrual cycle. D. is the primary hormone responsible for the development of female secondary sex characteristics.
levels peak after ovulation and are present throughout the menstrual cycle.
A client with a yeast infection asks the nurse how clinicians diagnose this infection. The nurse will base her response knowing this is primarily diagnosed by: A. the look and smell of the secretions. B. looking at the spores on a wet-mount slide using 20% potassium hydroxide. C. looking for lactobacillus species under the microscope. D. sending a blood test to lab for DNA testing on the specimen.
looking at the spores on a wet-mount slide using 20% potassium hydroxide.
The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to: A. move the testes into the scrotum. B. maintain testicular temperature. C. empty fluid from the seminal vesicles into the genital ducts. D. move sperm from the ampulla to the penis.
maintain testicular temperature.
Following a knee replacement surgery, a nurse's next door neighbor asks, "I don't think I am healing right. Can you come look at my knee?" Upon assessment, the nurse notices the client is warm to touch and has a fever. The incision is inflamed and not well approximated with foul-smelling drainage around the incision line. At this point, the nurse tells the client she needs to go see her surgeon because the client may have: A. contaminated the wound with MRSA. B. osteomyelitis. C. an abscess in the pocket of the incision. D. potential bone cancer.
osteomyelitis
The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The mechanism of action of most of these medications is that the medication: A. promotes nerve signaling to penile vessels. B. promotes trapping of blood in the corpora cavernosa. C. promotes arousal by eliminating depression or other psychological factors. D. promotes increase in blood flow to the corpora cavernosa.
promotes increase in blood flow to the corpora cavernosa.
