Patho HESI quizzes
An x-ray film of a client's arm reveals a comminuted fracture of the radial bone. When determining an appropriate plan of care, the nurse considers that a comminuted fracture has what characteristics? Bone protrudes through a break in the skin. The bone has broken into several fragments, and the skin is intact. The bone is broken into two parts, and the skin may or may not be broken. Splintering has occurred on one side of the bone and bending on the other.
The bone has broken into several fragments, and the skin is intact.
Which physiologic activity is associated with the "proliferative phase" of normal wound healing?
epithelial cells grow over the granulation tissue bed
A nurse educates the client about the relationship between the kidneys and blood pressure. Which term should the nurse use to describe the part of the kidney that senses changes in blood pressure? calices glomerulus macula densa juxtaglomerular cells
macula densa
When planning discharge teaching for the parents of a child with asthma, what information should the nurse include? Avoid foods high in fat. Stay at home for 2 weeks. Increase protein and calorie intake. Minimize exertion and exposure to cold.
minimize exertion and exposure to cold
A client diagnosed with Bell palsy has many questions about the course of the disorder. Which information should the nurse share with the client?
most clients recover from the effects in several weeks
A woman arrives at the women's health clinic complaining of frequency and burning pain when voiding. The diagnosis is a urinary tract infection. What is important for the nurse to encourage the client to do? Void every 2 hours. Record fluid intake and urinary output. Pour warm water over the vulva after voiding. Wash the hands thoroughly after urinating and defecating.
wash the hands thoroughly after urinated and defecating
A client has been diagnosed as brain dead. The nurse understands that this means that the client has what?
no cortical functioning with some reflex breathing
The nurse is providing information about blood pressure to an unlicensed health care worker and recalls that the factor that has the greatest influence on diastolic blood pressure is what? renal function cardiac output oxygen saturation peripheral vascular resistance
peripheral vascular resistance
Which statement helps the nurse determine that a woman with genital herpes (HSV-2) understands her self-care in regards to this infection?
"I must be careful when I have sex because herpes is a lifelong problem"
Which gastrointestinal (GI) change may be found in the client with burn injuries?
abdominal distention
A client with emphysema experiences shortness of breath and uses pursed-lip breathing and accessory muscles of respiration. The nurse determines that the cause of the dyspnea is for which reason? Spasm of the bronchi that traps the air Increase in the vital capacity of the lungs Too rapid expulsion of air from the bronchioles Difficulty in expelling the air trapped in the alveoli
Difficulty in expelling trapped air in the alveoli
The nurse is teaching the client with chronic obstructive pulmonary disease (COPD) to use pursed-lip breathing (PLB). What is the rationale for the nurse's teaching? Prolonged exhalation to decrease air trapping Shortened inhalation to reduce bronchial swelling Increased respiratory rate to improve arterial oxygenation Decreased use of diaphragm to increase amount of inspired air
Prolonged exhalation to decrease air trapping
After a lateral crushing chest injury, obvious right-sided paradoxical motion of a client's chest demonstrates multiple rib fractures, resulting in a flail chest. Which complication associated with this injury should the nurse assess in this client? Mediastinal shift Tracheal laceration Open pneumothorax Pericardial tamponade
mediastinal shift
A nurse is caring for a client with acute pancreatitis. Which elevated laboratory test result is most indicative of acute pancreatitis? Blood glucose Serum lipase Serum bilirubin level White blood cell count
serum lipase
A 13-year-old adolescent is found to have idiopathic scoliosis. Because exercise and avoidance of fatigue are essential components of care, which sport should the nurse suggest as the most therapeutic for this preadolescent? Golf Bowling Swimming Badminton
swimming
A client has chronic obstructive pulmonary disease (COPD). To decrease the risk of CO 2 intoxication (CO 2 narcosis), what should the nurse do? Initiate pulmonary hygiene to clear air passages of trapped mucus Instruct to deep breathe slowly with inhalation longer than exhalation Encourage continuous rapid panting to promote respiratory exchange Administer oxygen at a low concentration to maintain respiratory drive
Administer oxygen at a low concentration to maintain respiratory drive
After a gastrojejunostomy (Billroth II) for cancer of the stomach, a client progresses to a regular diet. After eating lunch, the client becomes diaphoretic and has palpitations. What does the nurse conclude is the probable cause of these clinical manifestations? Intolerance to fatty foods Dehiscence of the surgical incision Extracellular fluid shift into the bowel Diminished peristalsis in the small intestine
Extracellular fluid shift into the bowel
A client reports left-sided chest pain after playing racquetball. The client is hospitalized and diagnosed with left pneumothorax. When assessing the client's left chest area, the nurse expects to identify which finding? Dull sound on percussion Vocal fremitus on palpation Rales with rhonchi on auscultation Absence of breath sounds on auscultation
The left lung is collapsed; therefore, there are no breath sounds. A tympanic, not a dull, sound will be heard with a pneumothorax[1][2]. There is no vocal fremitus because there is no airflow into the left lung as a result of the pneumothorax. Rales with rhonchi will not be heard because there is no airflow into the left lung as a result of the pneumothorax.
The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia often complicate renal failure? increase in bp decrease in erythropoetin increase in serum phosphate levels decrease in serum sodium concentration
decrease in erythropoietin
An infant who has a congenital heart defect with left-to-right shunting of blood is admitted to the pediatric unit. What early sign of heart failure should the nurse identify? cyanosis restlessness decreased heart rate increased respiratory rate
increased respiratory rate
The nurse is caring for a client with a body surface burn injury of 55%. Which information will the nurse consider when planning care for this client?
is prone to poor healing because of hypermetabolic state
The client is in atrial fibrillation. Which information should the nurse consider about atrial fibrillation when planning care for this client? loss of atrial kick no changes increased cardiac output decreased risk of pulmonary embolism
loss of atrial kick
Which term should the nurse use to describe bone loss greater than normal but less than that caused by osteoporosis? Osteopenia Osteomyelitis Osteomalacia Osteoarthritis
osteopenia
A 17-year-old adolescent was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family? "Your teen will need insulin injections for the rest of her life." "The most important interventions are good nutrition and portion control." "This is a condition where the body produces antibodies against its own cells." "This condition causes weight loss and increased appetite, thirst, and urination."
the most important interventions are good nutrition and portion control
When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?
they may occur in minor illnesses
A client admitted with the diagnosis of subarachnoid hemorrhage exhibits aphasia and hemiparesis. The nurse concludes that these neurologic deficits are caused primarily by which response?
vacular spasms
A nurse applies a cold pack to treat an acute musculoskeletal injury. Cold therapy decreases pain by doing what? Promoting analgesia and circulation Numbing the nerves and dilating the blood vessels Promoting circulation and reducing muscle spasms Causing local vasoconstriction, preventing edema and muscle spasms
Causing local vasoconstriction, preventing edema and muscle spasms
What is the most probable cause for Conn's syndrome in an adult client? Genetic cause Adrenal adenoma High level of angiotensin II Elevated level of plasma rennin
adrenal adenoma
The nurse is caring for a 76-year-old obese client with a history of epigastric distress, esophageal burning, binge drinking, and frequent episodes of bronchitis. A diagnosis of hiatal hernia is made. Which health problems most likely contributed to the development of the hiatal hernia? Select all that apply. Aging Obesity Bronchitis Esophagitis Binge drinking
aging obesity
The healthcare provider makes the diagnosis of transient ischemic attacks (TIAs). The client asks the nurse, "What causes TIAs?" When preparing a response in language the client will understand, the nurse considers that TIAs are caused by which factor?
atherosclerotic plaques within arteries
A nurse is caring for a client with end-stage renal disease. For which clinical indicator should the nurse monitor the client? Polyuria Jaundice Azotemia Hypotension
azotemia
Which combination of foods should the nurse encourage a child with glomerulonephritis to choose for a meal? Corn, roast chicken, peach Tuna salad, cheese melt, milk Hamburger, baked potato, banana Bologna sandwich, salad, vanilla malted
corn, roast chicken, peach
Which integumentary change is associated with delayed wound healing in a client?
decreased cell division
Which clinical manifestation is seen in a male client due to deficiency of gonadotropin? Decreased fertility Increased muscle mass Increased bone density Decreased urine specific gravity
decreased fertility
A client who has had a myocardial infarction experiences a noticeably decreased pulse pressure. What does this indicate to the nurse? increased blood volume hyperactivity of the heart increase cardiac sufficiency decreased force of contraction
decreased force of contraction
What is the nurse's priority concern when caring for an infant born with exstrophy of the bladder? Urine retention Excoriation of the skin Impending dehydration Development of an infection
development of an infection
A nurse is caring for two clients. One has Parkinson disease, and the other has myasthenia gravis. For which common complication associated with both disorders should the nurse assess these clients?
difficulty swallowing
Electrocardiography (ECG) is scheduled for an infant who has tetralogy of Fallot. The mother asks the nurse what type of test this is and why it is done. What is the best response by the nurse?
electrical activity in the baby's heart is recorded, then printed on graph paper
An infant is being admitted to a pediatric unit with bacterial meningitis. What is the priority nursing action?
implementing respiratory isolation precautions
A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused the ascites should the nurse consider when planning care? Increased secretion of bile salts Increased pressure in the portal vein Increased interstitial osmotic pressure Increased production of serum albumin
increased pressure in the portal vein
A nurse is preparing a teaching plan for the parents of a child with celiac disease. What information on the basic problem in celiac disease does the nurse include? Green stools Intolerance of gluten Absence of intestinal villi Susceptibility to severe dehydration
intolerance of gluten
The school nurse is attending to a student athlete who reports muscle pain after a practice session. Which should the nurse identify as a cause of this pain when providing instruction to the student? Lactic acid Acetoacetic acid Hydrochloric acid Beta-hydroxybutyric acid
lactic acid
A client with cystic fibrosis asks why the percussion procedure is being performed. The nurse explains that the primary purpose of percussion is to do what? Relieve bronchial spasms Increase depth of respirations Loosen pulmonary secretions Expel carbon dioxide from the lungs
loosen pulmonary secretions
Which part of the female reproductive system produces testosterone in females? Uterus Ovary Fallopian tube Ovarian follicle
ovary
Which hormone is released from the posterior pituitary gland? Oxytocin Prolactin Growth hormone Luteinizing hormone
oxytocin
The nurse is educating student nurses about the anatomy and physiology of the kidneys. What term does the nurse explain is used for the tip of the pyramid of a kidney? Calyx Papilla Renal pelvis Renal column
papilla
The laboratory report of a client reveals increased serum cholesterol levels. Which other finding indicates growth hormone deficiency in the client? Scalp alopecia Intolerance to cold Pathological fractures Increased urine output
pathological fractures
A dehydrated older adult is admitted to the hospital from a nursing home. The transfer form documents a history of liquid fecal incontinence. Which intervention by the nurse will facilitate identification of the cause of this incontinence? Perform abdominal percussion. Perform a digital rectal examination. Collect urine culture and sensitivity test. Order a pelvic and abdominal ultrasound.
perform a digital rectal exam
Which gland secretes melatonin? Pineal gland Thyroid gland Adrenal gland Parathyroid gland
pineal gland
A client with cancer of the prostate requests the urinal at frequent intervals but either does not void or voids in very small amounts. Which does the nurse conclude is most likely the causative factor? Edema Dysuria Retention Suppression
retension
A 3-year-old child is admitted to the burn unit with partial- and full-thickness burns over 30% of the body. For what complication should the nurse assess the child during the first 48 hours?
shock
A nurse is assessing two clients. One client has ulcerative colitis, and the other client has Crohn disease. Which is more likely to be identified in the client with ulcerative colitis than in the client with Crohn disease? Inclusion of transmural involvement of the small bowel wall Higher occurrence of fistulas and abscesses from changes in the bowel wall Pathology beginning proximally with intermittent plaques found along the colon Involvement starting distally with rectal bleeding that spreads continuously up the colon
Involvement starting distally with rectal bleeding that spreads continuously up the colon
A client with late-stage dementia of the Alzheimer type aspirates gastric contents and develops acute respiratory distress syndrome (ARDS). Which phase characterized by signs of pulmonary edema and atelectasis should the nurse consider when planning care? Fibrotic Exudative Reparative Proliferative
Exudative
A nurse is assessing a client with a diagnosis of kidney failure for clinical indicators of metabolic acidosis. What should the nurse conclude is the reason metabolic acidosis develops with kidney failure? Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate Depressed respiratory rate due to metabolic wastes, causing carbon dioxide retention Inability of the renal tubules to reabsorb water to dilute the acid contents of blood Impaired glomerular filtration, causing retention of sodium and metabolic waste products
Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate
A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding? Promotes the formation of calculi in the cystic duct Stimulates the pancreas to secrete more insulin than it can immediately produce Alters the composition of enzymes so they are capable of damaging the pancreas Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas
Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas
A client with a femoral fracture associated with osteomyelitis is immobilized for 3 weeks. The nurse assesses for the development of renal calculi. What is the rationale for the nurse's assessment? The client's dietary patterns have changed since admission. The client has more difficulty urinating in a supine position. Lack of weight-bearing activity promotes bone demineralization. Fracture healing requires more calcium, which increases total calcium metabolism.
Lack of weight-bearing activity promotes bone demineralization.
A nurse is planning to assess the vomitus of an infant with pyloric stenosis. Why does the nurse anticipate that the vomitus will be white rather than bile-stained? The bile duct is obstructed by the pyloric sphincter. There is an obstruction above the opening of the common bile duct. The bile duct sphincter is connected to the hypertrophied pyloric muscle. There is a constriction of the cardiac sphincter that obstructs the flow of bile.
There is an obstruction above the opening of the common bile duct.
Which client would have relatively smaller tidal volumes due to limited chest wall movement? A client with asthma A client with pneumonia A client with pulmonary fibrosis A client with phrenic nerve paralysis
a client with phrenic nerve paralysis
A client's laboratory report shows altered serum calcium concentration. Which hormones are responsible for this condition? Select all that apply. calcintonin thyroxine glucocorticoids growth hormone parathyroid hormone
calcitonin, parathyroid hormone
While assessing an immobilized client, the nurse notes that the client has shortened muscles over a joint, preventing full extension. What is this condition known as? osteoarthritis osteoporosis muscle atrophy contracture
contracture
A client is in cardiogenic shock. Which explanation of cardiogenic shock should the nurse include when responding to a family member's questions about the condition? irreversible phenomenon failure of the circulatory pump usually a fleeting reaction to tissue injury
failure of the circulatory pump
A nurse is assessing a client for possible malabsorption syndrome. Which stool assessment finding will support this diagnosis? Melena Frank blood Fat globules Currant jelly consistency
fat globules
Which secondary skin lesion may include athlete's foot as an example?
fissure
A client is admitted to the hospital with severe diarrhea, abdominal cramps, and vomiting after eating. These symptoms have lasted 5 days. Upon further assessment, the primary healthcare provider finds that the symptoms occurred after the client ate eggs, salad dressings, and sandwich fillings. Which food borne disease would be suspected in this client? Listeriosis Shigellosis Salmonellosis Staphylococcus
salmonellosis
Which hormone is released from the pancreas? Oxytocin Prolactin Calcitonin Somatostatin
somatostatin
An adolescent is admitted to the burn unit with partial-thickness burns of both arms and the chest. What information about burns should guide the nurse's plan of care?
spontaneous epithelial regeneration occurs within several weeks
A nurse provides education to a client about how to prevent constipation. The nurse concludes that the teaching is understood when the client makes which statements? Select all that apply. "I may eat potatoes at dinner daily." "I should drink at least six glasses of water every day." "I must eat eggs for breakfast three times a week." "I can include bran muffins in my breakfast daily." "I will walk every day as part of my exercise regimen."
"I should drink at least six glasses of water every day." "I can include bran muffins in my breakfast daily." "I will walk every day as part of my exercise regimen."
A nurse is teaching skin and basic care to the mother of a 6-month-old infant with eczema. Which statement indicates that the mother needs further teaching?
"Ill have to be careful not to cut my baby's nails short."
The nurse is explaining the physiologic reasons for taking vitamin D and calcium supplements to a client with renal failure. Which statement made by the nurse is appropriate? "There will be a decrease in the inactive forms of vitamin D in your body." "There will be a decrease in the active metabolite of vitamin D in your body." "There will be an increase in the conversion of skin cholesterol into vitamin D." "There will be an increase in the vitamin D associated intestinal absorption of calcium."
"There will be a decrease in the active metabolite of vitamin D in your body."
A mother whose infant was found to have cerebral palsy at 6 months of age asks why she was not told that her baby had cerebral palsy when the infant was born. How should the nurse respond?
"Until there's control of voluntary movement, a diagnosis can't be confirmed"
A client has chest tubes attached to a chest tube drainage system. What should the nurse do when caring for this client? Clamp the chest tubes when suctioning. Palpate the surrounding area for crepitus. Change the dressing daily using aseptic technique. Empty the drainage chamber at the end of the shift.
Leakage of air into the subcutaneous tissue is evidenced by a crackling sound when the area is gently palpated; this is referred to as crepitus. Although hemostats should be readily available for any client with chest tubes in the event of a break in the drainage system, clamping the tube is not otherwise necessary and could cause backpressure. The dressing is not routinely changed to minimize the risk for pneumothorax. The system is kept closed to prevent the pressure of the atmosphere from causing a pneumothorax; drainage levels are marked on the drainage chamber to measure output. The chambers are not emptied; if they are filled, a new system will be attached.
A client with vesiculopustular lesions with honey-colored crusts on the face visits a primary healthcare provider. Which bacterial condition is suspected?
impetigo
A client comes to the emergency department reporting chest pain and difficulty breathing. A chest x-ray reveals a pneumothorax. Which finding should the nurse expect to identify when assessing the client? Distended neck veins Paradoxical respirations Increasing amounts of purulent sputum Absence of breath sounds over the affected area
When the lung is collapsed, air is not moving into and out of the area, and therefore breath sounds are absent. Distended neck veins are associated with failure of the right side of the heart and can occur with a mediastinal shift, but there is no evidence of either. Paradoxical respirations occur with flail chest, not pneumothorax. Purulent sputum is a sign of infection, not pneumothorax.
An adolescent comes to the school nurse complaining of a 2-day history of low-grade fever, exhaustion, and lack of energy and appetite. He has been tardy to school twice in the past week. Which assessment should the nurse use to identify the possible origin of the problem?
checking for lymphadenopathy
An adolescent with Duchenne muscular dystrophy has received care at the pediatric clinic since early childhood. Of which body system should the nurse perform a focused assessment to identify life-threatening complications as the child ages? Neurologic Gastrointestinal Musculoskeletal Cardiopulmonary
cardiopulmonary
A 17-year-old student with type 1 diabetes asks the nurse which hormone causes the blood glucose level to rise. When responding, the nurse should explain in language that the client can understand that liver glycogenolysis is stimulated by a hormone secreted by the islets of Langerhans. Which hormone is this? Adrenocorticotropic hormone (ACTH) Insulin Glucagon Epinephrine
glucagon
Which hormones are involved in building and maintaining healthy bone tissue?
growth hormone and insulin
A client is experiencing a myocardial infarction. What should the nurse identify as the primary cause of the pain experienced by a client with a coronary occlusion? arterial spasm heart muscle ischemia blocking of coronary veins irritation of nerve endings in the cardiac plexus
heart muscle ischemia
A nurse discovers lower extremity pitting edema in a client with right ventricular heart failure. Which information should the nurse consider when planning care? decreased plasma colloid osmotic pressure increased tissue colloid osmotic pressure increased plasma hydrostatic pressure decreased tissue hydrostatic pressure
increased plasma hydrostatic pressure
A 15-year-old adolescent is found to have type 1 diabetes. What should the nurse include when teaching the adolescent about type 1 diabetes? It does not always require insulin. It involves early vascular changes. It occurs more often in obese adolescents. It has a more rapid onset than does type 2 diabetes.
it has a more rapid onset than does type 2 diabetes