Patho PrepU Exam 2

Epinephrine

The endocrine system is closely linked with the nervous system. What neurotransmitter can also act as a hormone?

"The major stimulus for calcitonin synthesis and release is an increase in serum calcium."

The endocrinologist knows the student understands calcitonin when the student states which of the following?

"Osteoblasts are bone-building cells that synthesize and secrete the organic matrix of bone."

The faculty member knows the student understands the function of bone cells when the student states which of the following?

Controls the direction of blood flow from the right side of the heart to the lungs

The heart valves control the direction of blood flow. What is the function of the pulmonic valve?

Negative feedback loop

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Hypophyseal portal system

The hypophysis is a unit formed by the pituitary and the hypothalamus. These two glands are connected by the blood flow in what system?

Cardiogenic

The nurse is caring for a client who has just experienced an acute myocardial infarction and is diagnosed with "pump failure." The nurse is aware that the client is experiencing which type of shock?

Beta-adrenergic blocking agent

Which classification of medication does the nurse prepare to administer to the client with hyperthyroidism that will block the effects of the hyperthyroid state on sympathetic nervous system function?

A 32-year-old postpartum client

Which client does the nurse recognize is at the most risk for the development of subacute thyroiditis?

Confirm within 2 months

The nurse obtains a blood pressure reading of 150/96 mm Hg from a patient at the clinic. What instructions for follow-up does the nurse anticipate giving to this patient?

57-year-old client who has recently been diagnosed with unstable angina

Which client should most benefit from treatment with antithrombin agents?

Vascular smooth muscle cells (SMCs)

Which of the following blood vessel cells form the predominant cellular layer in the tunica media and produce vasoconstriction and/or dilation of blood vessels?

Capillaries

Which of the following blood vessels function without the benefit of having walls comprised of three muscular layers?

Lipolysis

Which of the following body functions is regulated by several hormones?

Intestinal absorption slows as a natural aging process

A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that:

obesity

Which of the following inhibits growth hormone (GH)?

Chronic obstructive bronchitis and emphysema

Chronic obstructive pulmonary disease (COPD) is a combination of disease processes. What disease processes have been identified as being part of COPD?

Second messengers act as the intracellular signal that responds to the presence of a hormone.

Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system?

Glucose that exceeds metabolic needs is converted and stored by the liver.

Which of the following statements best describes an aspect of the normal process of glucose metabolism?

A slow depolarization occurs when Na+ is transported out of the cell and K+ moves back in, resulting in resting membrane potential.

Which of the following statements describes phase 4 of the action potential of cells in the sinoatrial (SA) node?

Peptides are degraded by enzymes in cells.

Which of the following statements is accurate regarding how hormones are metabolized and excreted?

Prolactin is unbound. Insulin is unbound. Glucocorticoids are bound

Which of the following statements is correct about hormone transport? Select all that apply.

Tidal volume × respiratory rate

The nurse is calculating the minute volume of a patient. Select the correct categories of measurement.

Extreme pain and swelling

A client has suffered a torn ligament. The client will most likely manifest:

Deep vein thrombophlebitis of the leg

From which one of the following sites is a fatal pulmonary thromboembolism most likely to originate?

Acute bronchiolitis Asthma

Which of the following is/are a lower airway disease? (Select all that apply.)

resistance to ejection of blood from the heart.

A client with aortic insufficiency is experiencing an increase in afterload. The client will experience fatigue and activity intolerance due to:

false

Rheumatoid arthritis is a chronic autoimmune system disease that affects a single joint.

Atelectasis

The patient with airway obstruction may experience perfusion of the lungs without ventilation due to what disorder?

Increased PCO2

Ventilation is driven by which alteration in arterial blood?

Hypothalamus

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?

4

A fully saturated hemoglobin molecule can hold how many oxygen molecules?

Hospital-acquired pneumonia.

A pneumonia that occurs 48 hours or more after admission to the hospital is considered:

The infant is using nasal flaring to take in more air.

An infant born prematurely is in the neonatal intensive care unit (NICU) for observation and to ensure hemodynamic stability when the nurse observes the infant beginning to have nasal flaring. What does the nurse understand that this may indicate?

Insulin is not available for use by the body.

The diagnosis of type 1 diabetes would be confirmed by:

Starvation

An adolescent boy asks the nurse what increases the secretion of growth hormone (GH). The best response would be:

"Do you tend to have a cough even when you don't feel sick?"

An adult client with a history of worsening respiratory symptoms has presented for care. Which assessment question will best allow the clinician to address the possibility of chronic bronchitis?

Increased amounts of bacteria in the lungs

As a result of dehydration, a client's epithelial cells are producing insufficient amounts of mucus. Consequently, the client's mucociliary blanket is compromised. Which of the following changes would the care provider anticipate as a direct result of this change?

weight and nutritional status.

An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should recognize the need to monitor the client's:

Right-sided heart failure

Assessment of an elderly female client reveals the presence of bilateral pitting edema of the client's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the client's lungs reveals clear air entry to bases, and the client's oxygen saturation level is 93%, and vital signs are within reference ranges. What is this client's most likely health problem?

A 20-year-old healthy female reporting an allergy to eggs

At an influenza vaccination clinic, a nurse is screening clients who are requesting the vaccine. The nurse determines that which of the following clients is unable to receive the vaccine?

70 to 75 mL/kg

Blood flow in the circulatory system depends on a blood volume that is sufficient to fill the blood vessels and a pressure difference across the system that provides the force to move blood forward. What is the total blood volume in an adult?

Polymalgia rheumatica

Giant cell arteritis is a comorbid condition of which of the following?

Decreased cardiac output

The nurse is developing a plan of care for a client with heart failure. The most important information for the nurse to consider would be:

P wave

Considering the PQRST complex of an electrocardiogram (ECG), which of the following letter designations represents atrial depolarization?

Pericardial effusion

Exudate in the pericardial cavity is a characteristic of which cardiac condition?

Patient is currently experiencing an MI

Five hours after presenting to the emergency department with substernal chest pain, a patient's laboratory results demonstrate that troponin I is elevated and the creatine kinase-myoglobin (CK-MB) levels are within normal range. Which of the following is the nurse's interpretation of these results?

Antimicrobial treatment depending on the microbe.

Following prosthetic joint replacement of the knee, the patient continues to complain of pain and discomfort above what would be expected. There is poor incisional healing. The clinic nurse is concerned when she sees that the incision is still draining after three weeks post-op. The nurse suspects a prosthetic joint infection. The nurse should anticipate the physician will prescribe:

Impaired immunological and inflammatory response

Following the identification of low blood levels of cortisol and low 24-hour urinary free cortisol, a 51-year-old female client has been diagnosed with a primary adrenal cortical insufficiency. Which of the following health consequences would be attributable to her low levels of cortisol?

They have the same compensatory mechanisms.

Heart failure and circulatory shock are both conditions of circulatory system failure. Which of the following statements regarding these conditions is correct?

During feeding

Heart failure in an infant usually manifests itself as tachypnea or dyspnea, both at rest and on exertion. When does this most commonly occur with an infant?

Moves freely

Select the statement that best describes a synovial or diarthrodial joint. The joint:

ribs

In the adult, hematopoietacally active bone marrow is located in which of the following bones?

Neutrophils, macrophages, and lymphocytes arrive Immune complexes phagocytized, releasing lysosomal enzymes Destructive changes in joint cartilage Inflammatory response Reactive hyperplasia of synovial cells and subsynovial tissues Vasodilation and joint swelling

Joint destruction in rheumatoid arthritis occurs by an obscure process. The cellular changes, however, have been documented. Place the process in the correct order.

Corticosteroids

Juvenile dermatomyositis is a chronic inflammatory myopathy that commonly manifests systemically. What is the treatment of choice for this myopathy?

Hypoxemia

The nurse is caring for a client diagnosed with pneumonia. The client's arterial blood gas results identify decreased level oxygen in the arterial blood and a decreased in the partial pressure of oxygen. The nurse would interpret this as:

Alcoholic cardiomyopathy

It is known that over 100 distinct myocardial diseases can demonstrate clinical features associated with dilated cardiomyopathy (DCM). What is the most common identifiable cause of DCM in the United States?

Β-Adrenergic-blocking drugs

Mitral valve prolapse occurs frequently in the population at large. Its treatment is aimed at relieving the symptoms and preventing complications of the disorder. Which drug is used in the treatment of mitral valve prolapse to relieve symptoms and aid in preventing complications?

Drug therapy directed toward decreasing the gland's function Eradication of the gland with radioactive iodine Surgical removal of part or the entire gland

Management of hyperthyroidism would include which interventions? Select all that apply.

Controls the direction of blood flow from the left side of the heart to the systemic circulation

The heart controls the direction of blood flow. What is the role of the aortic valve?

Fingers

Raynaud disease or phenonemon is a functional disorder caused by intense vasospasm of the arteries and arterioles in which of the following?

Amines and amino acids

Select the category of hormones that include norepinephrine and epinephrine.

Release nitric oxide

Sepsis is growing in incidence in the United States. Its pathogenesis includes neutrophil activation, which kills microorganisms. Neutrophils also injure the endothelium, releasing mediators that increase vascular permeability. What else do neutrophils do in sepsis?

Pulmonary embolism

The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent which of the following?

Thin extremities and muscle weakness

The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?

decreased after load

The health care provider has determined that a client diagnosed with cardiogenic shock will now require treatment with the intra-aortic balloon pump. The expected effect of the treatment is:

It is believed to play an active role in the pathogenesis of the atherosclerotic lesion.

The student attends a health fair and has his serum cholestrol checked. He has a high lipoprotein level (LDL). He understands which of the following about LDL cholesterol?

Parathyroid hormone produces a prompt increase in serum calcium levels.

The student is comparing the actions of parathyroid hormone (PTH) and calcitonin. Which of the following statements is most correct?

Haversian canals

The student is examining a wedge of compact bone tissue and its blood distribution. The spaces in the cortex that move parallel through the long axis of the bone and contain blood vessels are known as which of the following?

0mm Hg

The venous system is a low pressure system that returns blood to the heart. What is the normal right atrial pressure?

Osteoprogenitor

Which of the following bone cells are located in the growth plate?

500mL

What is the normal tidal volume for a person at rest?

Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.

Around three weeks after razing an old chicken house, a 71-year-old retired farmer has developed a fever, nausea and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis. Which of the following processes is most likely taking place?

Glottis, Epiglottis

Aspiration pneumonia is a serious and sometimes life threatening inflammation in the lungs caused by inhaling food, fluids, stomach contents, or other foreign substances. Identify the structures that protect the lungs from aspiration. Select all that apply.

mitral valve stenosis

A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His cervical lymph nodes are swollen, and he moves stiffly because his joints hurt. Throat cultures show infection with group A streptococci. This child is at high risk for:

Osteosarcoma

A 13-year-old girl and her father have come to emergency department for assessment of the girl's stiff and warm knee. The father reports that she hurt it sliding into base during a softball game, but later in the interview it becomes clear that the slide made an existing pain worse. Her knee had been stiff, warm, and shiny, and had been keeping her awake at night for a week or so before the game. Which condition might be the cause of the girl's symptoms?

Sympathetic nervous system

A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of which of the following?

Anaphylatic shock

A 20-year-old male client is experiencing a severe immunologically mediated reaction in which histamines have been released into the blood. Select the type of reaction most likely occurring with this client.

Exogenous insulin injections

A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment?

Dry and warm skin

A 30-year-old woman presents at a hospital after fainting at a memorial service and she is diagnosed as being in neurogenic shock. Which of the following signs and symptoms is she most likely to display?

Ventilation was occurring but perfusion was inadequate causing shortness of breath.

A 44-year-old woman has developed calf pain during a transatlantic flight. She is extremely short of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE) which resolved with anticoagulant therapy. Which of these statements best characterizes the underlying problem of her PE?

Infections that are less serious in healthy people are often more virulent in people with diabetes due to hyperglycemia and glucosuria.

A 45-year-old client with type 1 diabetes has just been admitted with osteomyelitis. Which reason for diabetic susceptibility to infection is the most significant?

Oral antihyperglycemic medications and weight loss measures.

A 46 year-old man who is obese has received news that he has type 2 diabetes. He is in the process of determining a plan of care with an interdisciplinary team at a hospital-based diabetes clinic. The nurse knows that the most likely treatment plan for the man will include:

"One of the risks that these steroids bring is the possibility that part of a bone might die."

A 51 year-old male with a history of hypertension has received a kidney transplant. The client's physician is explaining some of the consequences of the procedure, including the fact that he will need to be on long term steroid therapy. Which of the following teaching points should the physician emphasize?

Poor stress management and hyperpigmentation

A 51 year-old woman has been diagnosed with Cushing syndrome after a diagnostic workup that reveals cortisol hypersecretion. The nurse knows which of the following assessment findings would be inconsistent with her diagnosis?

Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells.

A 51 year-old woman has been experiencing signs and symptoms of perimenopause and has sought help from her family physician. A deficiency in estrogen levels has been determined to be a contributing factor. Which of the following phenomena could potentially underlie the woman's health problem?

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his physician. The patient's physician would anticipate that which of the following phenomena is most likely occurring?

Increased sympathetic stimulation of the heart and blood vessels

A 60-year-old woman is hospitalized after losing an extensive amount of blood in a work-related accident. She tells the nurse that she heard the doctor say that she would keep feeling faint until her brain made more blood. The nurse recognizes that when the woman's blood pressure dropped, the pressure in her carotid arteries decreased. This was detected by baroreceptors in the carotid arteries, with which subsequent effect?

Systemic vasoconstriction maintained the diastolic pressure

A 60-year-old woman who has lost an extensive amount of blood in a work-related accident says that when her blood pressure was checked in the hospital, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. The nurse recognizes that which of the following accounts for this lack of change in the diastolic pressure?

Helping the client make meaningful changes to his diet and activity level.

A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?

"I've been avoiding painkillers because I know they can mask damage that I might be inflicting on my knees."

A 64 year-old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. The client and his physician are discussing the affects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. Which of the following statements by the client would necessitate further teaching?

• Increased systolic pressure • Decreased diastolic pressure • Widened pulse pressure

A 65-year-old male patient is diagnosed with systolic hypertension. Stating that he always had normal blood pressure, he does not understand this new diagnosis. The nurse will explain that as the aging process occurs, stiffening of the large arteries occurs resulting in which of the following? Select all that apply.

Squamous cell carcinoma

A 65-year-old man has just been diagnosed with hypercalcemia with a chronic cough and hemoptysis. The physician suspects cancer. Which cancer is most likely?

Legionella pneumonia.

A 66-year-old male presents the emergency room accompanied by his wife who claims that he has been acting confused. The man is complaining of a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 102.8°F and his blood work indicates his sodium level at 126 mEq/L (normal 135-145 mEq/L). Based on this assessment, the nurse suspects the patient has:

Ventricular dilation and wall tension are significantly lower than normal

A 66-year-old obese man with diagnoses of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis?

House dust

A 9-year-old boy has been diagnosed with bronchial asthma. Which factor is most likely contributing to his condition?

Obesity Delayed skeletal muscle maturation Short stature

A child has been diagnosed with classic growth hormone deficiency. The child may experience: Select all that apply.

Performing a skin scrub on surgical site prior to incision with povidone-iodine solution

A newborn is found to have transient hypothyroidism after having a cesarean birth. What nursing interventions provided to the mother in preparation of the surgical procedure may have induced this newborn's condition?

the clients ventilation will be severely depressed

A nursing student asks if a client diagnosed with chronic obstructive pulmonary disease (COPD) is at risk if he receives oxygen at a level that increases the PO2 above 60 mm Hg. The best response would be:

Forced expiratory volume

A patient diagnosed with asthma is scheduled for a pulmonary function test. During the test, the technician instructs the patient to forcefully exhale air for 1 second to evaluate:

• Swell [edema] in their legs and feet. • Shortness of breath. • Decreased exercise tolerance.

A patient with pulmonary hypertension may display which of the following clinical manifestations? Select all that apply.

Broad, bulbous nose and a protruding lower jaw

Acromegaly is a disorder that is caused by the production of excessive GH in the adult. Because the person cannot grow taller, the soft tissues continue to grow, presenting a very distinctive appearance. What is it that is distinctive in a person with acromegaly?

surface tension of the respiratory membrane

An expectant mother of twins has been told there is a strong chance that she will go into labour early and her babies will be premature. In order to increase the chances of having healthy infants, she is given a dose of steroids to stimulate the production of surfactant in the infants' lungs. Surfactant is important for survival of the babies because it reduces:

Myxedematous coma

An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosus type of edema. For which life-threatening condition should his care team be prepared?

The pressure is excessive given that the right atrium should be at atmospheric pressure.

Analysis has shown that a client's right atrial pressure is 30 mmHG. What is the most likely conclusion that the client's care team will draw from this piece of data?

Venous blood measures the metabolic demands of the tissues rather than the gas exchange function of the lungs.

Blood transports both oxygen and carbon dioxide in a physically dissolved form to the tissues and organs of the body. It is the measurements of the components of the gases in the blood that are used as indicators of the body's status by health care workers. Why is common to measure the blood in the arteries rather than the blood in the veins?

Ossification

Bone formation occurs in two stages. Which of the following stages involves the formation of prebone or unmineralized bone?

They can undergo angiogenesis.

Bronchial blood vessels have several functions. They warm and humidify incoming air as well as distribute blood to the conducting airways and the supporting structures of the lung. What is it that makes bronchial blood vessels unique in the body?

chicken pox

Bronchiectasis is considered a secondary COPD, and, with the advent of antibiotics, it is not a common disease entity. In the past, bronchiectasis often followed specific diseases. Which disease did it not follow?

Calcitonin lowers blood calcium levels.

Calcitonin has what relationship to bone growth?

Radiologic findings Age Presence of coexisting disease

Community-acquired pneumonia can be categorized according to several indexes. What are these indexes? (Select all that apply.)

Enlarged clitoris, fused labia, and urogenital sinus

Congenital adrenal hyperplasia is a congenital disorder in which a deficiency exists in any of the enzymes necessary for the synthesis of cortisol. Infants of both sexes are affected, although boys are not diagnosed at birth unless of enlarged genitalia. Female infants often have ambiguous genitalia because of the oversecretion of adrenal androgens. What are the manifestations of the ambiguous genitalia caused by congenital adrenal hyperplasia?

Blood glucose level greater than 250 mg/dL; bicarbonate less than 15 mEq/L and pH less than 7.3

Diabetic ketoacidosis is a condition that mostly occurs in type 1 diabetics. What are the definitive diagnostic criteria for DKA?

foot problems

Diabetics are hospitalized for a number of reasons. What is the most common complication of diabetes requiring hospitalization?

"Have you ever been a smoker?"

Diagnostic testing has resulted in a diagnosis of small cell lung cancer in an older adult client. When exploring the etiology of the client's disease, what assessment question is most relevant?

Marked elevation in temperature

Elderly people are very susceptible to pneumonia in all its varieties. The symptoms the elderly exhibit can be very different than those of other age groups who have pneumonia. What signs and symptoms are elderly people with pneumonia less likely to experience than people with pneumonia in other age groups?

A GH suppression test

In an adult with acromegaly, a growth hormone (GH)-secreting tumor is suspected. What diagnostic test would be used for this client?

Few pain receptors are located in the synovial membrane.

Laparoscopic knee surgery on a 22 year-old basketball player has necessitated entry into the synovial cavity. The surgeon performing the procedure would be aware of which of the following relevant characteristics of synovial tissue?

Vasoconstriction

Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins?

• Tissue • Smooth muscle • Endothelial cells

Local control of blood flow is regulated by mechanisms that match blood flow to the metabolic needs of the tissue. Over the short term autoregulation controls flow through the synthesis of vasodilators and vasoconstrictors. Which components of the vascular system are involved in the short term control of blood flow? Select all that apply.

synovial joints

Most joints in the body are what types of joints?

• Triangular appearance to face • Blue or gray sclera • Scoliosis

Osteogenesis imperfecta is the most common hereditary bone disease. What are the manifestations of osteogenesis imperfecta? (Select all that apply.)

Vitamin D-rich diet and exposure to midday sun

Osteomalacia is a bone disease caused by one of two reasons: inadequate calcium absorption or phosphate deficiency. In the elderly, what is the least expensive and most effective long-term treatment for osteomalacia?

Dual-energy x-ray absorptiometry (DXA or DEXA) of the spine and hip

Osteoporosis is a disease caused by demineralization of bone. What is the clinical method of choice for diagnosing osteoporosis?

Nighttime awakening

Osteosarcoma is an aggressive malignancy of the bone. What is the primary clinical feature of osteosarcoma?

1 to 2 L/min via nasal cannula

Oxygen has been prescribed for a client with chronic obstructive pulmonary disease (COPD). Select the most appropriate treatment for the client.

Clawing of toes and denervation of the small muscles of the foot

Peripheral neuropathies occur in people with diabetes mellitus. With the loss of sensation in the lower extremities, diabetics become predisposed to what?

Indomethacin

Pleuritis, an inflammatory process of the pleura, is common in infectious processes that spread to the pleura. Which are the drugs of choice for treating pleural pain?

Short stature in adults

Precocious puberty is a disorder that occurs in both boys and girls. What does precocious puberty cause in adults?

Rapid and shallow breathing and chest retractions

Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD?

• Aortic stenosis can cause left-sided failure. • Cardiomyopathy is a common cause of heart failure. • Compensated heart failure may be clinically asymptomatic.

Regarding heart failure, the nurse knows that which of the following statements are correct? Select all that apply.

Because of the deformity it causes

Scoliosis is an abnormal curvature of the spine. Why is it first noticed?

A client who is receiving 100% oxygen via oxygen mask

Select the clinical situation that would result in increased diffusion of gases from the arterial blood into the alveoli.

Capillaries, venules, veins, right atrium

Select the correct sequence of blood return to the heart.

Prevents serum calcium from decreasing and phosphate from increasing above normal Maintained by serum levels of ionized calcium Maintains serum calcium by bone resorption

Select the correct statements that describe the function of PTH (parathyroid hormone). Select all that apply.

Pneumotaxic center

Select the group of respiratory neuron that turns off inspiration and assists in the control of the respiratory rate.

Normal levels of thyroid and growth hormone

Several factors can influence the growth of cells in the epiphyseal growth plate. Which factor does not affect this bone growth ?

Physical therapy Corticosteroid injections Anti-inflammatory agents

Shoulder and rotator cuff injuries usually occur from trauma or overuse. What orders would be given for conservative treatment of an injured shoulder? (Select all that apply.)

They are inactive in the bound state.

Since steroid hormones are bound to protein carriers for transport, this means:

Prevent friction on a tendon

Synovial membranes can form sacs, called bursae. What is the function of bursae?

Arthritis

Systemic lupus erythematosus has been called the great imitator because it can affect many different body systems. What is among the most commonly occurring symptoms in the early stages of SLE?

Interstitial lung disease

Talc lung can occur from injected or inhaled talc powder that has been mixed with heroin, methamphetamine, or codeine as a filler. What are people with talc lung very susceptible to?

Insulin Levodopa

Testing for short statue growth hormone (GH) problems can be done by pharmacologic means. Which of the following medications can be utilized to test for a rise in GH? Select all that apply.

Ventricles contract and blood is ejected from the heart.

The cardiac cycle describes the pumping action of the heart. Which statement is correct about systole?

300% - 400%

The cardiac reserve refers to the maximum percentage of increase in cardiac output that can be achieved above the normal resting level. What is the normal young adult's percentage cardiac reserve?

The low pressure pulmonary circulation links circulation and gas exchange in the lungs.

The circulatory system is a closed system that is divided into two parts. Which statement is correct about the closed system?

History and physical examination, x-ray studies, and laboratory findings that exclude other diseases

The client with a suspected diagnosis of osteoarthritis asks the health care provider how the diagnosis will be confirmed. The best response would be:

HIV-infected people Foreign-born people from countries with a high incidence of tuberculosis Residents of high-risk congregate settings

The community health nurse is developing a program to decrease the amount of pulmonary tuberculosis that has recently risen in her area. Which populations at risk will the nurse target? Select all that apply.

Administration of intravenous fluids

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL. The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Thirst Weight loss Blurred vision

The diabetes nurse educator is teaching a community education class for new diabetics. Which of these does the nurse include in the discussion of signs and symptoms of hyperglycemia? Select all that apply.

Influenza

The nurse is assessing a client who states he felt fine all day and then within five minutes, began to feel extremely weak and tired and began having a fever. What do these symptoms indicate that the client may be experiencing?

Constructing a genogram from the client's report of her family history

The nurse is assessing a client whose recent health history is suggestive of sarcoidosis. What assessment should the nurse prioritize?

Erythema Swelling Warmth Tenderness

The nurse is assessing a patient with rheumatoid arthritis. Which of the following would the nurse expect to find? Select all that apply.

Stretch receptors

The nurse is assessing a patient's respiratory status for lung expansion and airway resistance. The nurse is aware that changes in the pressure occurring in the walls of the airways will be adjusted by which of the following?

T-wave changes

The nurse is assessing the ECG of a client who is experiencing unstable angina. The nurse observes:

90/75

The nurse is assessing the blood pressure of a client who is experiencing cardiogenic shock. Which of the following blood pressure readings is most likely?

A 76-year-old client with cardiopulmonary disease

The nurse is assigned to care for four clients on a medical floor. Which client is most at risk for viral pneumonia after influenza?

cyanosis secondary to an anatomic shunt.

The nurse is caring for an infant with a large ventricular septal defect, also called a hole in the heart, which is a congenital heart defect causing a right to left shunt. The nurse illustrates for the parents how this compromises their child's ability to deliver oxygenated blood to the tissues causing

There is a risk of inducing acute coronary syndromes in the older adult client if a more rapid correction of thyroid levels is used.

The nurse is caring for an older adult client who is being treated for primary hypothyroidism. The medication therapy includes a "go low and go slow" regimen. What is the importance of this medication regimen for this client?

Mycobacterium tuberculosis

The nurse is developing a community program since a recent increase in admissions to the acute care facility with tuberculosis infection. What is the most frequent form of tuberculosis that the nurse should focus on?

Myocardial infarction prevention

The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client.

Apply sequential pneumatic compression devices to lower extremities

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of prevent deep vein thrombosis (DVT). The most important intervention for the nurse to implement would be:

There are no pain receptors in the lung tissue.

The nurse is interviewing a client who has come in for the first round of radiation treatment of a large, right upper lobe lung tumor. The client asks how the tumor could get so large without causing any pain. The most accurate explanation would be which of these?

Pressure rises with left ventricular contraction. Pressure falls with left ventricular relaxation.

The nurse is monitoring a patient's arterial blood pressure. Which of the following statements regarding arterial pressure are correct? Select all that apply.

Hypothalamus

The physician is assessing a client with a preliminary diagnosis of endocrine disorder. Further assessment findings identify abnormalities with emotion, pain, body temperature, and neural input. The physician determines the need to further assess the:

TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions.

The physician is considering prescribing an anti-tumor necrosis factor (TNF) like infliximab for a rheumatoid arthritis patient. Which of the following statements is accurate about the advantages of using a TNF inhibitor?

alveoli are ventilated but not perfused.

The physician mentions the patient has developed alveolar dead space. The nurse recognizes that this means:

Ortolani manoeuvre

The primary care provider has positioned an infant in the supine position with both knees flexed and applied gentle downward pressure to both knees. The knee and thigh have been abducted while an upward and medial pressure was applied to the proximal thigh. What examination technique has been performed on this infant?

Emphysema

The pulmonary rehabilitation specialist is educating medical students on a respiratory disease process that causes a severe compromise in exhalation due to air trapping. Air trapping is caused by the loss of elastic recoil, especially in the alveoli, which occurs after overstretching in which of the following diseases?

false

The radiologist knows that it is normal to see lamellar and woven bone in the adult skeleton.

short bones

The radiology student is studying x-rays of the wrist. The instructor explains that these irregularly shaped bones are known as which of the following?

C-reactive protein

The role of inflammation in the etiology of atherosclerosis has emerged over the last few years. Which lab test is a marker for systemic inflammation?

Caseating necrosis and cavitation

Tuberculosis is a highly destructive disease because the tubercle bacillus activates a tissue hypersensitivity to the tubercular antigens. What does the destructive nature of tuberculosis cause in a previously unexposed immunocompetent person?

Accumulated and encased the M. tuberculosis.

Tuberculosis is an infectious respiratory disease caused by the insoluble Myobacterium tuberculosis (M. tuberculosis). The nurse explains to the client, who has tested positive for the presence of M. tuberculosis but has a normal chest x-ray, that he does not have the active disease because his alveolar macrophages have:

• Blood cultures • Antibiotics • Monitoring for emboli

Two weeks after receiving a prosthetic mitral valve, a patient presents to the emergency department with fever, anorexia, and splinter hemorrhages of the nails. Which of the following interventions will the nurse implement? Select all that apply.

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

Deranged secretion of insulin Insulin resistance Increased glucose production by the liver

Type 2 diabetes is caused by metabolic abnormalities in the presence of insulin. What are these metabolic abnormalities? (Select all that apply.)

Impaired gas exchange

What is the underlying cause of respiratory failure in a child with bronchiolitis?

The compact bone

What part of the bone assists in protecting the bone?

"You will need to keep your joint immobilized for 4 to 6 weeks."

What should the nurse include in the teaching plan for a client with a grade 4 sprain?

Contusion

What term describes an injury to the soft tissue of the body?

Osteoblasts

What type of cell is responsible for building bone in the body?

restless, has clubbed fingers, and frequently drops items.

Which client is showing signs of chronic hypoxemia? A client who is

The interphalangeal joint between the proximal and middle phalanges of the fingers.

Which of the following is the best example of a diarthrodial joint?

Repeated blood pressure determinations

Which of the following is the best modality to diagnose hypertension?

Right atrium - bicuspid valve - right ventricle - pulmonary artery - lungs - pulmonary vein -left atrium - tricuspid valve - left ventricle - aorta

Which of the following is the correct sequence for blood flow through the heart?

Acetylcholine

Which of the following neurotransmitters is associated with the parasympathetic nervous system?

A girl who was born with toeing-in and who was in a breech presentation.

Which of the following newborn infants demonstrates the highest risk of presenting with developmental dysplasia of the hip (DDH)?

Magnetic resonance imaging (MRI) of the pituitary gland

Which of the following organ systems is matched with the preferred type of imaging?

Liver

Which of the following organs has larger capillary pores to allow the exchange of gases, nutrients, and/or waste products?

Compensated congestive heart failure may be clinically asymptomatic.

Which of the following statements regarding heart failure is true?

In compensated heart failure an increase of end-diastolic volume causes increased force of left ventricular contraction.

Which of the following statements regarding heart failure is true?

-Hypertension is more frequent among younger men than in younger women. -Hypertension is a major risk factor for cardiovascular disease. -Hypertension is one of the most common health problems for adults.

Which of the following statements regarding hypertension are correct? Select all that apply.

"A genetic pattern for this disease has not been established."

Which of the following statements will the nurse teach the parent of a child with Legg-Calvé-Perthes disease?

Troponin

Which serum biomarker is highly specific for myocardial tissue?

• There is a type of skeleton referred to as appendicular. • The skeletal system includes both bone and cartilage tissue. • Cartilage is prevalent in the prenatal fetal skeleton. • The skull is considered a part of the axial skeleton.

Which statements are true regarding the skeletal system? Select all that apply.

The size of the child has an impact on the seriousness of the symptoms. Impaired airflow and obstructions are common outcomes of these infections. Each exposure to a new pathogen results in an infection. An immature immune system is the usual trigger for such infections.

Which statements regarding childhood respiratory tract infection are true? Select all that apply.

Mitral valve stenosis

A 13-year-old boy has had a sore throat for at least a week and has been vomiting for two days. His glands are swollen, and he moves stiffly because his joints hurt. His parents, who believe in "natural remedies," have been treating him with various herbal preparations without success and are now seeking antibiotic treatment. Throat cultures show infection with group A streptococci. This child is at high risk for:

When there is a large separation between the knees greater than 15 degrees

A 2-year-old has bowing of the legs. Which of the following is when the health care professional should be concerned?

Septic

A 20-year-old college student being treated for a kidney infection developed a temperature of 104ºF in spite of treatment with antibiotics. Her pulse was high, her blood pressure was low, and her skin was hot, dry, and flushed. The nurse knows that this patient most likely is experiencing which of the following types of shock?

Stimulation test

A 21 year-old female is suspected of having inadequate function of her hypothalamic-pituitary-thyroid system. Her care provider is planning to inject thyrotropin-releasing hormone (TRH) and then measure her levels of TSH. Which of the following diagnostic tests is being performed?

His vocal folds are likely not performing their normal function.

A 21-year-old male client has suffered a head injury during a crash on his motorcycle, and a deficit that assessments have revealed is an impaired swallowing mechanism. He has also developed aspiration pneumonia. Which of the following statements most accurately captures an aspect of his condition?

• Decreased lubrication in the knee joint • Reduced shock absorption capacity • Decreased stability of the knee

A 22 year-old woman has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the woman expect over the course of recovery? Select all that apply.

Infusion of normal saline or Ringer's lactate to maintain the vascular space.

A 22-year-old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are likely to most benefit the man?

Infusion of normal saline or Ringer's lactate to maintain the vascular space

A 22-year-old man is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. Which immediate treatments are likely to most benefit the man?

Client has a history of hyperthyroidism

A 23-year-old woman goes to the drugstore to buy a medication to ease the symptoms of her cold. Her friends have told her to buy a medication with an antihistamine in it to help dry up her runny nose and make it easier to breathe. The woman talks with the pharmacist, who has known her many years. The pharmacist recommends that this young woman not buy a cold medication with a decongestant in it. Why would he do that?

Graves disease

A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:

"A tumor in my brain threw off my hormone levels after I finished adolescence."

A 28-year-old male who is 6'11" tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem?

Cool, humidified air to relieve airway spasms

A 3-year-old boy has been diagnosed with croup (acute laryngotracheobronchitis). The nurse anticipates the plan of care to include:

Low blood pressure

A 30-year-old male brought to the emergency department has the following admission data: Blood pressure 50/30, pulse 100, respiratory rate 12, temperature 101°F. The nurse does not know the exact cause but does know that patient is in shock because of which of the following readings?

Hypoglycemia

A 30-year-old male who manages his type 1 diabetes with glyburide presents at the emergency room complaining of headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half-marathon. Which of the following is likely to be the cause of his complaints?

hypoglycemia

A 30-year-old man who manages his type 1 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half marathon. Which phenomenon is likely to be the cause of his symptoms?

Her diagnosis might be attributable to a disordered immune response, nutritional factors, or infectious processes.

A 31-year-old African-American female who is in her 30th week of pregnancy has been diagnosed with peripartum cardiomyopathy. Which of the following statements best captures an aspect of peripartum cardiomyopathy?

The client will need education about the administration of INH and the importance of taking it as prescribed.

A 32-year-old client has had a positive reaction to a tuberculin skin test and the duration of exposure is unknown. What medication education will the nurse provide to the client?

Somatotrope adenoma

A 33-year-old female client who presents to the doctor's office with pronounced enlargement of her hands and facial features is diagnosed with acromegaly. The acromegaly is most likely the result of:

Echocardiogram, blood cultures, and temperature

A 34-year-old man who is an intravenous drug user has presented to the emergency department with malaise, abdominal pain, and lethargy. The health care team wants to rule out endocarditis as a diagnosis. Staff of the department would most realistically anticipate which of the following sets of diagnostics?

Echocardiogram, blood cultures, temperature

A 34-year-old man who is an intravenous drug user has presented to the emergency department with malaise, abdominal pain, and lethargy. The health care team wants to rule out endocarditis as a diagnosis. Staff of the department would most realistically anticipate which of the following sets of diagnostics?

Familial hypercholesterolemia

A 35-year-old man presents to the emergency department complaining of chest pain for the last 2 hours. He describes the pain as crushing, like a huge weight is on his chest. He also states that the pain goes up into his neck and down his left arm. An acute myocardial infarction (MI) is diagnosed. When taking his history, the following things are noted: ● Hyperlipoproteinemia for past 7 years ● Family history of early MI ● Cholesterol deposits along the tendons (diagnosed 1 year ago) ● Atherosclerosis (diagnosed 6 months ago) ● Diabetes mellitus (type 1) diagnosed at age 16 The nurse suspects which of the following diagnoses will be made?

"The worst part of this so far has been learning that there aren't any treatments for scleroderma."

A 36 year-old female who has experienced diverse symptoms for several years has finally had her health problems attributed to scleroderma (systemic sclerosis), and has committed herself to learning as much about the disease as she can. Which of her following statements would her nurse want to correct or clarify?

Periodic severe headache and marked variability in blood pressure.

A 37-year-old woman is admitted to the unit with a differential diagnosis of rule out pheochromocytoma. What are the most common symptoms the nurse would expect this client to exhibit?

Estrogen will continue to pass freely through the cellular membranes.

A 38-year-old woman takes clomiphene, an infertility drug that works by competing with, and thereby blocking, cellular receptors for estrogen. Which of the following statements is most likely to be true of this client?

Positive D-dimer

A 40-year-old male presents to the emergency department reporting chest pain and shortness of breath. The health care provider suspects a pulmonary embolism and orders several diagnostic tests. Select the test that would require further follow-up.

Acute lung injury

A 41 year-old male client has presented to the emergency department with an acute onset of increased respiratory rate and difficulty breathing. STAT chest X-ray indicates diffuse bilateral infiltrates of his lung tissue and ECG displays no cardiac dysfunction. What is this client's most likely diagnosis?

"You should breath deeply and cough to help your lungs expand as much as possible while you're in bed."

A 51 year-old female client who is two days post-operative in a surgical unit of a hospital is at risk of developing atelectasis as a result of being largely immobile. Which of the following teaching points by her nurse is most appropriate?

"LDL and VLDLs stimulate endothelial cell dysfunction."

A 55-year-old Caucasian man has been diagnosed with atherosclerosis. He understands that his lifestyle includes many of the risk factors for developing the disease, but he asks the nurse, "What actually caused my disease?" Which is the nurse's best scientific answer?

HDL cholesterol is often characterized as being beneficial to health

A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his physician. Which of the following aspects of hyperlipidemia would the physician most likely take into account when teaching the patient?

Prevention of pathologic fractures.

A 56 year-old female with a diagnosis of breast cancer has developed bone metastases, which her oncologist would like to treat with radiation therapy. What is her physician's most likely primary goal in the treatment plan of the metastases?

Vascular insufficiency has contributed to infection in both soft tissue and now his bone.

A 56 year-old male is obese and has poorly-controlled type 2 diabetes mellitus. The home care nurse who changes the dressing on his chronic foot ulcer three times weekly has noted that the client's bone is now visible in the wound bed. The client has a fever and has not complained of any notable increase in pain to his foot. Which of the following statements best captures what is likely occurring?

the axial skeleton and an abnormal autoimmune response.

A 56-year-old male has been dealing with chronic back pain his entire life. In recent months, the pain has begun to involve his shoulder as well. The client has been subsequently diagnosed with a seronegative spondyloarthropathy. When describing this disease to the client, the nurse should describe the involvement of:

Cholesterol 250 mg/dL and HDL 32 mg/dL

A 56-year-old male patient has been diagnosed with hypercholesterolemia. Which of the following are the lab results that support this diagnosis?

Sclerotherapy or surgery

A 56-year-old woman presents at the clinic complaining of the unsightliness of her varicose veins and wants to know what can be done about them. The nurse explains that the treatment for varicose veins includes which of the following interventions?

Legg-Calve-Perthes disease

A 6-year-old child has developed idiopathic osteonecrotic disease of the proximal (capital) femoral epiphysis. The health care provider would recognize this as:

Administration of 15 to 20 g of glucose in a concentrated carbohydrate source.

A 60 year-old man has long managed his type 1 diabetes effectively with a combination of vigilant blood sugar monitoring, subcutaneous insulin administration and conscientious eating habits. This morning, however, his wife has noted that he appears pale and clammy and appears to be in a stupor, though he is responsive. She suspects that he has made an error in his insulin administration and that he is experiencing a hypoglycemic episode. Which of the following actions should be the wife's first choice?

"This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens."

A 62-year-old female smoker is distraught at her recent diagnosis of small cell lung cancer (SCLC). How can her physician most appropriately respond to her?

Legionnaire disease

A 66-year-old man presents in the emergency room accompanied by his wife, who claims that he has been acting confused. The man reports a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 39.3°C, and his blood work indicates his sodium level is at 126 mmol/l (normal is 135 to 145 mmol/l). What will be the assessing physician's most likely suspicion?

• Irregular-irregular rhythm • Palpitations • Tachycardia

A 70-year-old client with a past medical history of diabetes type II and myocardial infarction (MI) is admitted to the hospital with sudden shortness of breath and palpitations. As the nurse is doing the admission assessment she notices that the apical pulse is very irregular with no pattern, vital signs include a heart rate of 130 and blood pressure of 100/60. The nurse suspects atrial fibrillation (AF) for which of the following reasons? Select all that apply.

Dowager hump

A 70-year-old female client tells the health care provider she is concerned because she is getting shorter and her posture is not as good as it used to be. The provider completes an assessment of her spine and notes a loss of height in the vertebral column and kyphosis. This assessment would be recognized as:

Synovial fluid allows for joint movement by minimizing friction.

A 71 year-old male with a suspected diagnosis of osteoarthritis is being scheduled for a knee aspiration. The client is surprised to learn that his knee joint contains fluid and asks the physician ordering the procedure what the main role of the fluid is. Which of the following statements best underlies the explanation that the physician will provide?

Decreased elastic recoil due to alveolar damage Increased anatomical dead space due to reduced tidal volume Increased alveolar dead space due to incorrect intrapleural pressure

A 71-year-old woman is dependent on oxygen therapy and bronchodilators due to her diagnosis of emphysema. Which of the following pathological processes occur as a result of her emphysema? Select all that apply.

Heart murmurs result from tumultuous flow through a diseased heart valve that is too narrow and stiff. This flow causes a vibration called a murmur.

A 72 year old female has been told by her physician that she has a new heart murmur that requires her to go visit a cardiologist. Upon examination, the cardiologist informs the patient that she has aortic stenosis. After the cardiologist has left the room, the patient asks, "What caused this [aortic stenosis] to happen now?" The clinic nurse responds:

Osteoporosis

A 75-year-old Caucasian female has been admitted to the hospital with a hip fracture. She states, "All I did was fall into my chair, not even very hard." Upon diagnostic testing, the client's bones shows loss of trabeculae from cancellous bone and thinning of the cortex. Which diagnosis is most likely?

• "Do you easily get tired?" • "Do you have swelling in your ankles?" • "Are you feeling depressed?" • "Do you get up often during the night to urinate?"

A 75-year-old patient is being evaluated for heart failure. Which questions will the nurse ask to confirm common signs and symptoms observed in older adults experiencing heart failure? Select all that apply.

The interphalangeal joint between the proximal and middle phalanges of the fingers

A 76-year-old male has been diagnosed with osteoarthritis. The nurse providing care for this client inquired as to whether the arthritis affects only diarthrodial joints. Which best exemplifies a diarthrodial joint?

Be a result of catecholamines released from SNS which could increase the myocardial oxygen demand

A 77 year old patient with a history of coronary artery disease and heart failure has arrived in the emergency room with a rapid heart rate and feeling of, "impending doom." Based on pathophysiologic principles, the nurse knows the rapid heart rate could:

Adenocarcinoma

A 77-year-old lifetime smoker has been diagnosed with a tumor in his lung at the site of an old tubercule scarring site, located in a peripheral area of his bronchiolar tissue. What is this client's most likely diagnosis?

"I'm going to start you on low-dose aspirin, and it will help greatly if you can lose weight and keep exercising."

A 78-year-old man has been experiencing nocturnal chest pain over the last several months, and his family physician has diagnosed him with variant angina. Which of the following teaching points should the physician include in his explanation of the man's new diagnosis?

• Tiotropium (Spiriva), anticholinergic. • Salmeterol (Serevent), a bronchodilator.

A COPD patient asks the nurse which of the following medications is prescribed to help their breathing. The nurse, looking at the list of medications, will educate the patient about which of the following medications to help their COPD in the long-term. Select all that apply.

Contusion

A basketball player collided hard with another player and suffered a soft tissue injury to the forearm from the impact though it did not break the skin. The nurse should recognize the presence of which type of injury?

severe asthma attack

A child is brought to the emergency department struggling to breathe with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which of the following is the most likely diagnosis?

Short-acting beta 2-adrenergic agonists such as albuterol (SABA)

A child is brought to the emergency department with an asthma attack. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which of the following drugs will the nurse anticipate administering first?

• The parent brings the child into the bathroom where a warm shower is running to provide humidification. • The parent takes a child outside in the cool air. • The parent turns on the cold water room humidifier in the child's room.

A child is having symptoms of spasmodic croup again after a previous admission to the hospital for the same diagnosis. What care does the parent provide at home that demonstrates understanding of the education received by the nurse at the hospital? Select all that apply.

Assess the child for pain and prepare for diagnostic studies.

A child presents to the emergency room with suspected trauma to the growth plate in the ankle during a soccer game. Which of the following steps is the best intervention?

Increasing intrapulmonary pressures

A client admitted to the hospital with an exacerbation of chronic obstructive pulmonary disease (COPD) asks the nurse what can be done to decrease the dyspnea. The nurse instructs the client to use pursed-lip breathing (PLB) to help keep airways open by:

• Protect the lungs • Remove foreign aspirate • Expel excess secretions

A client admitted to the hospital with aspiration pneumonia subsequent to having a recent stroke is requesting an antitussive medication to stop her productive cough. The nurse explains to the client that the purpose of her cough is which of the following? Select all that apply.

Onset before age 20 Abrupt onset of symptoms Autoimmune beta cell damage

A client admitted to the hospital with elevated blood glucose is diagnosed with type 1 diabetes mellitus. What characteristics commonly differentiate type 1 diabetes mellitus from type 2 diabetes mellitus? Select all that apply.

• Failure of the SA node • Incessant atrial tachycardia • Atrial fibrillation

A client admitted to the hospital with symptoms of Digoxin toxicity is told that a cardiac monitor will be necessary during the admission because the client may develop which of the following? Select all that apply.

The volume of air contained in the nose, pharynx, trachea, and bronchi

A client asks the nurse what anatomic airway dead space is. Which of the following would be the nurse's best response?

Sleep-wake cycles

A client asks the nurse what causes the secretion of growth hormone (GH) and adrenocorticotrophic hormone (ACTH) to fluctuate. The best response by the nurse would be:

"A definitive diagnosis of active pulmonary tuberculosis requires cultures or DNA amplification techniques."

A client calls the health care provider's office and frantically tells the nurse his TB test is red, and he is afraid this means he has tuberculosis. The best response by the nurse would be:

A suppression test

A client comes to a scheduled appointment in the endocrine clinic. The primary care physician referred the client, suspecting acromegaly. Knowing the usual testing involved, the nurse should educate the client about which lab/diagnostic procedure?

intravenous drug abuse and living on the streets.

A client comes to an urgent care center. The nurse notes that the client has a fever of 103.2 F (39.5 C), pleuritic pain with each breath, and enlarged lymph nodes in the neck and axilla area. The client also has a productive cough. The nurse should consider tuberculosis if the client's history includes:

Increased levels of ACTH

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?

Decrease in blood pressure Decrease in oxygen levels Decrease in stroke volume Risk for angina

A client comes to the emergency department with symptoms of a "racing" heart and feeling "anxious." The nurse places the client on a heart monitor and observes a heart rate of 134. The nurse monitors for which of the following complications related to tachycardia? Select all that apply.

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. The nurse determines further teaching is necessary when the client states:

"You can expect to take multiple drugs possibly for as long as 24 months or until all tubercle bacilli are eliminated."

A client diagnosis with tuberculosis asks the nurse how long the antitubercular medication will need to be taken. Which of the following is the best response?

Osteoprogenitor cells may be activated for remodeling

A client experienced a tibial fracture several days ago and his bone is now healing. Which physiologic process will contribute to the client's healing?

"Do you work in construction and dig soil?"

A client from Texas is suspected of being infected with coccidioidomycosis and has been admitted to the hospital with fever, cough, pleuritic chest pain, and skin lesions. When performing a health history, which question would be most valuable to assist with diagnosis?

The client was exposed to the tubercle bacillus at an indefinite point in the past.

A client had a tuberculin skin test (TST) performed as part of her immigration process and is surprised that the results are positive. How should the nurse best interpret this result?

Venous return to the heart

A client has a blood pressure of 68/38 and fainted after donating a unit of blood. The client is experiencing low preload from loss of blood volume. What is preload?

This is a fracture of the end of the bone.

A client has a fracture of an epiphyses. How will the nurse explain this fracture?

It is caused by overuse.

A client has a tendonitis. What will the nurse teach the client about this disorder?

Pulmonary congestion

A client has been admitted with bacterial pneumonia and is complaining of difficulty breathing. The nurse would explain the most likely reason for the dyspnea is that pneumonia interferes with lung compliance due to which of the following?

Tearing or ripping-type pain in the chest or back

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:

Hoarseness and difficulty swallowing

A client has been diagnosed with an advanced tumor that has invaded the mediastinum. The client would most likely manifest:

The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta

A client has been diagnosed with aortic stenosis and asks the nurse what this means. The most appropriate response would be:

"I should have my LDL monitored."

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

Pulmonary embolism

A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for:

Elevation of triglycerides

A client has been diagnosed with diabetes mellitus. Which of the following lab results would the practitioner expect?

Ca2+ levels in the myocardium

A client has been diagnosed with heart failure. The client's cardiac contractility will be primarily affected by which factor?

Increased visceral fat

A client has been diagnosed with metabolic syndrome and growth hormone (GH) deficiency. Physical assessment of the client would identify:

"Your mitral valve isn't opening up enough for blood to flow into the part of your heart that sends blood into circulation."

A client has been diagnosed with mitral valve stenosis following his recovery from rheumatic fever. Which of the following teaching points would be most accurate to convey to the client?

The spread of this bacteria, especially the antibiotic-resistant strain, is largely by healthy, colonized individuals.

A client has been diagnosed with pneumococcal infection. The nurse shares with the client which statement about the spread of the disease?

Bending forward, coughing, or sneezing

A client has been diagnosed with sinusitis. The nurses anticipate that the client may present with head pain that increases with:

Baked fish and whole milk

A client has been instructed to increase Vitamin D in his/her diet. What foods will the nurse make certain are included in the diet?

25%

A client has been placed on bed rest. Select the percentage of the blood volume that will be distributed to the client's pulmonary circulation.

Decrease vascular volume

A client has been prescribed a thiazide diuretic, hydrochlorothiazide (HCTZ), for the initial treatment of hypertension. What effect does the nurse know this drug will have to decrease blood pressure?

Iatrogenic Cushing syndrome

A client has been taking long-term glucocorticoid therapy for the treatment of asthma. What condition is the nurse aware that this client may develop in relation to this pharmacological therapy?

Function of the thyroid gland Function of the gonads Growth and metabolism Glucocorticoid hormone levels

A client has developed a tumor of the anterior pituitary gland. The nurse is aware that the client is at risk for alterations of: Select all that apply.

Antidiuretic hormone (ADH) and oxytocin

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Streptococcus pneumoniae

A client has developed bacterial pneumonia and is admitted to the hospital. The nurse obtains sputum cultures upon admission. What bacteria does the nurse anticipate finding when the results are complete?

Pain may develop. Movement may be limited. Bursitis develops where pressure is exerted. Swelling may occur.

A client has developed bursitis of the right knee. Select all that apply.

Constriction of the pulmonary vessels in response to hypoxemia

A client has developed chronic hypoxia and has developed pulmonary hypertension (HTN). The nurse recognizes that the most likely cause of pulmonary hypertension would be:

Age Coexisting health problems Severity of illness

A client has developed community-acquired pneumonia and is being treated at home. What does the nurse recognize are the methods in the diagnosis of community-acquired pneumonia? Select all that apply.

Diastolic dysfunction

A client has developed constrictive pericarditis and myocardial hypertrophy. Select the most likely cause.

Osteoclasts

A client has developed increased resorption of bone with removal of mineral content. This is most likely the result of:

Direct contamination of an open wound

A client has developed osteomyelitis and asks the health care provider how the problem occurred. The best response would be:

Increased heart rate and increased contractility

A client has experienced sympathetic nervous stimulation of the heart. The nurse is aware that the client may manifest which of the following?

proceed through the trachea, bronchi, and then bronchioles.

A client has inhaled, drawing air into the oropharynx. From this location, air will:

The most common cause is a staph infection.

A client has just been admitted to the cardiac intensive care unit with a diagnosis of infective endocarditis. His wife appears distraught and asks the nurse what caused this to happen to her husband. What would be the nurse's best response?

Tumour invasion of the mediastinum

A client has just been admitted with a chronic cough, shortness of breath, and wheezing. The irritation of his airway is severe enough to produce hemoptysis and diffuse pain in the chest area. He is diagnosed with large cell carcinoma. What is causing the symptoms that are listed?

Smoking cessation Dietary measures to reduce LDL levels Weight reduction if overweight

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. The best response would be: Select all that apply.

Infective endocarditis

A client has just been told that he has an infection of the inner surface of the heart. He is also told that the bacteria has invaded his heart valves. What term is used for this disease process?

the quality and quantity of blood flow to the site.

A client has sought care, reporting bone pain. Diagnostic testing reveals that the client has developed osteonecrosis. When addressing the most likely cause of this complication, the nurse should focus on:

Assist to high-Fowler's position and prepare for chest tube insertion.

A client has sudden severe dyspnea, fear, asymmetrical chest movement and decreased lung sounds on the right side. Which intervention is most appropriate?

skull

A client has sustained an injury to a synarthrotic joint. Where is a possible site of the client's injury?

Tendons connect muscles and bones

A client has tendon damage. What will the nurse teach the client about the function of tendons?

Further testing is needed before a diagnosis of gout can be made.

A client has undergone extensive diagnostic testing following several months of worsening joint pain and reduced range of motion. The client's results indicate hyperuricemia. What is the nurse's best interpretation of this finding?

Nosocomial hospital-acquired infection

A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that which of the following is the most likely cause of this infection?

Administer a beta2 agonist.

A client in the emergency department reports sudden onset of coughing with a feeling of chest tightness. Lung sounds are diminished with wheezing in all lung fields. The client is anxious and the skin is moist. What is the first intervention the nurse should implement?

Sepsis

A client in the intensive care unit died shortly after developing multiple organ dysfunction syndrome (MODS). Which health problem most likely preceded the client's MODS?

Mitral valve stenosis

A client is admitted for observation due to abnormal heart sounds, pulmonary congestion, nocturnal paroxysmal dyspnea, and orthopnea. Upon auscultation a low-pitched, rumbling murmur, best heard at the apex of the heart, is also heard. Which condition does the client likely have?

A membranous sac that encloses the heart

A client is admitted to the cardiac unit with a diagnosis of pericarditis. The nurse is teaching the patient about the anatomical location of the infection. The nurse evaluates the effectiveness of the teaching when the client correctly identifies which of the following as the location of the pericardium?

"A strain is a stretching injury. You need to rest your back."

A client is admitted to the emergency department with a muscle strain to the back. What is an appropriate statement for the nurse to make to this client?

O2

A client is admitted to the hospital following smoke inhalation. The nurse would anticipate the need for cellular metabolism and that the client would need supplemental:

Urine specimen

A client is admitted to the hospital suspected to have Legionnaire disease after a cruise. What type of specimen should the nurse collect that is a rapid test to detect the antigens of L. pneumophila?

AV nodal block

A client is admitted to the hospital with severe bradycardia, heart rate in low to upper 40s, after contracting Lyme disease. She asks the nurse why the heart rate is so slow. The most accurate response would be a possible disassociation between the atria and ventricles due which of the following?

Insertion of a large-bore needle or chest tube

A client is brought to the emergency department and immediately diagnosed with a tension pneumothorax. The priority intervention would be:

positive urine ketones low serum bicarbonate

A client is brought to the emergency department with a suspected diagnosis of DKA (diabetic ketoacidosis). Select the assessment/diagnostic data to confirm the diagnosis. Select all that apply.

"Vitamin D has little or no activity until it has been converted to physiologically active compounds."

A client is concerned about bone strength and development and asks the nurse if dietary sources of vitamin D will cause immediate activity within the skeletal system. The best response by the nurse would be:

"I will have to take my medication for the rest of my life."

A client is diagnosed with Addison's disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

Cortisol replacement therapy.

A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client?

A hypermetabolic state

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

Glycosylated hemoglobin 5.2%

A client is diagnosed with type 2 diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Tachycardia and rapid respiratory rate A goiter Ophthalmolopathy (exophthalmos)

A client is exhibiting signs of Graves' disease. What clinical manifestations of this disorder would the nurse document that would indicate this disease state? Select all that apply.

Relaxation of the bronchioles

A client is experiencing circulatory shock. The nurse is aware that compensation will occur with stimulation of the beta-2 (β2) receptors. The nurse anticipates the client will experience:

Growth hormone

A client is having radiation prior to having a pituitary tumor removed. Which loss of pituitary hormone is typically the first to be lost?

25% - 30%

A client is lying in a recumbent position. In this patient approximately how much total blood volume is in the central circulation?

During the first 3 days after the onset of symptoms

A client is preparing to travel for business and has developed the common cold. The client informs the nurse that she will be flying and does not want to give it to anyone else. When should the nurse inform the client is the most highly contagious period?

Will prevent the conversion of angiotensin I to angiotensin II

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have?

Anaphylactic

A client is rushed to the emergency department with symptoms of urticaria, wheezing, chest tightness, and difficulty in breathing. The client is most likely experiencing which type of shock?

whether the client is producing excessive hormone levels.

A client is scheduled for a suppression test as part of the diagnostic testing for his suspected endocrine disorder. The results of this test will help the care team determine:

Follicle stimulating hormone (FSH)

A client is seeking treatment for infertility. What decrease in hormone secretion from the anterior lobe of the pituitary gland that regulates fertility would the nurse recognize may cause this issue?

Pericarditis

A client is seen in the emergency room with complaints of sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have?

Aspiration

A client is suffering from severe gastroesophageal reflux disease (GERD) and has been admitted to the hospital with a diagnosis of pneumonia. Which of the following would be the most likely cause for the development of pneumonia?

Administer epinephrine (adrenaline).

A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first?

They can occur in diseased or healthy hearts.

A client is visiting the primary physician and appears extremely nervous. The intake nurse does his vital signs and notes an increase in both his heart rate and blood pressure. In an effort to better understand the client's presenting signs and symptoms the nurse asks the client about his concerns and the client states that the person who performed his pre-visit told him that he had an arrhythmia. Which is the most therapeutic response about cardiac arrhythmias that the nurse can make?

141 mm Hg

A client lives in Calgary, where the high elevation results in an atmospheric pressure of 672 mm Hg. What is the partial pressure of oxygen where this client lives?

• Treatment goals • Education • Posture • Physical rest • Therapeutic use of heat and cold

A client newly diagnosed with rheumatoid arthritis is crying and tells the nurse she does not know how to manage the disease. Select the most important information for the nurse to provide. Select all that apply.

Iron

A client presents to his physician complaining of severe fatigue and intermittent shortness of breath. The physician is concerned that the client has developed anemia, a decreased oxygen carrying capacity of the blood, and has ordered blood work. A deficiency in which of the following would support the diagnosis of anemia secondary to a decrease in oxygen's ability to bind with hemoglobin?

Recent weight loss Polyuria Blurred vision

A client presents to the emergency room with fatigue, weakness, dehydration and thirst. What additional symptoms would correlate with a diagnosis of type 1 diabetes mellitus? Select all that apply.

The wrist or ankle

A client presents with a fracture of a short bone. What is the most likely location of the client's fracture?

Sudden sharp pain in one side made worse by deep breathing

A client reports chest pain to the nurse. Which characteristics of the pain indicate pleuritis?

Systemic vasoconstriction maintained the diastolic pressure.

A client says that when the hospital checked his blood pressure after he lost a lot of blood in a work-related accident, the top number (systolic pressure) was lower than usual but the bottom number (diastolic pressure) was about the same. Why is this?

• Tracheal deviation to the right • Hyperresonance on the left • Diminished breath sounds on the left • Subcutaneous emphysema

A client seen in the emergency department after a motor vehicle accident complains of increasing shortness of breath. A left tension pneumothorax is suspected. What manifestations support the diagnosis? Select all that apply.

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?

Assess the child for pain and prepare for diagnostic studies.

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.

Glycosylated hemoglobin, hemoglobin A1C (HbA1C)

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes .The best diagnostic indicator that would support the client's response would be:

"This can be a complication of the infection; we need to let the health care provider know."

A client tells the nurse he was diagnosed with a sinus infection about 7 days ago. He is now experiencing facial swelling and has also had periods of confusion. His family told him he is not remembering things. The best response by the nurse would be:

Healing with deformity, angulation, or rotation that is visible on x-ray films

A client tells the nurse she is very concerned because the health care provider informed her that her fractured arm is healing with malunion. The nurse recognizes this as:

A diagnosis of chronic bronchitis requires a history of a chronic productive cough that has persisted for at least 3 consecutive months in at least 2 consecutive years.

A client tells the nurse that he is concerned he may be developing chronic bronchitis and asks how the diagnosis is made. The most appropriate information for the nurse to provide would be:

Decreased myocardial contraction Increased cardiac cycle speed

A client took a weight loss drug that activated the sympathetic nervous system. Which of the following manifestations would the nurse expect to occur? Select all that apply.

Reactive arthritis

A client was diagnosed with Salmonella 1 week ago and is now experiencing joints that are warm, swollen, and tender. The client also reports experiencing fever and weight loss. The health care provider would interpret these manifestations as:

The client will need early reduction of the dislocation to prevent complications.

A client was involved in an auto accident and is brought to the hospital by ambulance. The admitting diagnosis is right hip dislocation. Select the most appropriate intervention for this client:

All nerves that cross articulations innervate each joint of an extremity.

A client who has a fractured ankle is complaining of knee and hip pain. What is the most likely cause of these symptoms?

Cardiac tamponade

A client who has been admitted to the ICU with a diagnosis of pericardial effusion begins to experience severe tachycardia. Upon assessment the nurse finds that his central venous pressure is increased, he has jugular vein distention, his systolic blood pressure has dropped, and there is a narrow pulse pressure. His heart sounds appear to be very muffled. Which diagnosis should the nurse suspect the physician will make?

• For its vasodilatation effect • To relieve coronary pain

A client who has been admitted to the emergency room with symptoms of a STEMI is given nitroglycerine. The nurse explains to the client's wife that this medication is given for which of the following reasons? Select all that apply.

• Congenital defects • Rheumatic heart disease • Trauma • Ischemic heart disease • Inflammation • Degenerative changes

A client who has just been diagnosed with atrial stenosis asks his nurse what can cause a problem with heart valves. Which of the following does the nurse tell this patient can cause a dysfunction of the heart valves? Select all that apply.

Genetic abnormalities

A client who has just been diagnosed with dilated cardiomyopathy asks the nurse what caused the condition. The most appropriate response would be:

• It is a defect of the mitral valve which causes obstruction of blood flow.

A client who has just been diagnosed with mitral valve stenosis tells the nurse that he has heard of the disease but he does not know anything about it. He asks the nurse what it means. What would be the nurse's best response?

Repeat ECG with proper lead placement.

A client who has just received angioplasty for a blocked coronary artery following a myocardial infarction has an order for 12-lead ECGs every morning for three days. On the second day the nurse reads the ECG and notices a distinct difference in the QRS morphology from the previous ECG. Which of the following would be the best action to take?

He has developed constrictive pericarditis.

A client who has just recently completed his second series of radiation therapy for lung cancer was admitted yesterday to an acute care facility with ascites. He begins to have jugular vein distention, pedal edema, and dyspnea upon exertion as well as fatigue. What should the nurse suspect?

Thyroid crisis

A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these manifestations as:

empyema

A client who was hospitalized with bacterial pneumonia has now developed an infection in the pleural cavity. The nurse would recognize this as:

Glucocorticoids

A client with Graves' disease has had radioiodine treatment with worsening of ophthalmopathy. What medication does the nurse prepare to administer that the client will use for several weeks to decrease these symptoms?

"With treatment of the hyperthyroid state, the opthalmopathy usually tends to stabilize."

A client with Graves' disease has opthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

A cardiac glycoside

A client with a diagnosis of heart failure has returned from a visit with his primary care provider with a prescription for a change in his daily medication regimen. Which of the following drugs is likely to improve the client's cardiac function by increasing the force and strength of ventricular contractions?

formation of a bony callus.

A client with a fractured clavicle is told that the bone will heal well if immobilized for the next 6 to 8 weeks, but there will be a large "bump" where the break occurred. This bump will be caused by:

"Aspirin will help prevent blood clotting."

A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be:

Up-regulation has increased the sensitivity of the body to particular hormone levels.

A client with a history of an endocrine disorder exhibits signs and symptoms of hormone deficiency. Which of the following processes would the client's care team most likely rule out first as a contributing factor?

Irritant receptors

A client with a history of asthma comes to the clinic complaining of wheezing and difficulty in breathing when harvesting the field. The assessment findings include use of accessory neck muscles, prolonged expiration, intercostal retractions, decreased breath sounds, and expiratory wheezes. Based on these finding the nurse determines which of the following anatomical receptors in the lungs have been stimulated?

• At the onset of influenza-like symptoms, the client is eligible to begin antiviral medications within the first 36 hours. • The antiviral drug of choice is oral oseltamivir.

A client with a history of chronic obstructive pulmonary disease (COPD) has developed influenza. Which statements about possible treatments is accurate for this client. Select all that apply.

Implantation of a ventricular assist device

A client with a history of heart failure has been assessed and the care team has determined that a reduction in myocardial workload would benefit his prognosis. Which intervention is most likely to meet this client's needs?

Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4)

A client with a suspected diagnosis of primary hypothyroidism would most likely demonstrate which of the following serum laboratory values?

Decreased compliance of the lung tissue

A client with asbestosis-induced pulmonary fibrosis asks the nurse why breathing is so difficult at times. The nurse explains that the scar tissue in the client's lung tissues causes which of these?

accessory muscles can assist in ventilation

A client with chronic asthma is experiencing a severe asthma attack and is becoming increasingly agitated. The nurse supports the client's ability to move more air in and out of the lungs by instructing the client to stabilize his accessory muscles. The nurse understands that by stabilizing the accessory muscles the:

Brisk walking three times per week on a flat surface

A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:

• Increase protein intake • Increase pancreatic enzymes

A client with cystic fibrosis reports recent weight loss without fever or cough. What interventions will the nurse implement to promote health for the client? Select all that apply.

Short acting

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 12.1 mmol/l and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?

check blood glucose at 2am

A client with diabetes mellitus reports morning hyperglycemia for several days. What action should taken?

Maintain healthy blood pressure and blood sugar levels.

A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information?

55% - 75%

A client with heart disease has the left ventricular ejection fraction measured. What is the normal left ventricular ejection when determined by angiocardiography?

have negative feedback regulation.

A client with hyperthyroidism is being treated with medication that blocks the activity of thyroid-stimulating hormone. Her care team has determined that she has been overproducing TSH. This client will have lost her ability to:

Coarse and dry skin and hair Intolerance to cold Decreased sweating

A client with hypothyroidism has not taken medication for several months, informing the nurse that she lost her insurance and is unable to afford the medication. When assessing the client's temperature tolerance and skin, what does the nurse anticipate finding? Select all that apply.

Diffusion capacity

A client with lung cancer is scheduled for the removal of the right lung. The nurse should anticipate that after surgery the client will experience a significant decrease in which of the following?

Headache and confusion

A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms?

inhibiting prostaglandin synthesis.

A client with osteoarthritis states that every morning "it gets harder and harder to loosen up". The client's main therapy to this point is the use of over-the-counter nonsteroidal anti-inflammatories (NSAIDs). These drugs reduce the client's pain by:

Orange juice orally

A client with severe hypoglycemia is unconscious. Which method of providing glucose should be avoided?

Slow rewarming of the client to prevent vasodilation and vascular collapse

A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client?

Using an insulin infusion pump

A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Ghon focus

A client's chest x-ray and pathology report identify a granulomatous lesion that contains the tubercle bacilli. The health care provider would interpret this as:

Bicuspid valve

A client's echocardiogram identified a narrowed valve that has resulted in a decreased blood flow between the left atria and left ventricle. The nurse would interpret this as the:

teach the client about the safe and effective use of synthetic thyroid hormones.

A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:

The client reports being "really sensitive to sunshine." The client states that she is highly prone to mouth sores. The client is known to have arthritis in her knees. The client has elevated creatinine and blood urea nitrogen (BUN) levels.

A client's presentation and recent health history are suggestive of systemic lupus erythematosus (SLE). Which findings would support this diagnosis? Select all that apply.

Central receptors

A client's respiratory rate is being primarily influenced by carbon dioxide levels. What receptors are responding to the CO2?

"This diagnostic procedure will let the doctor know if you have any mestastatic lesions in your body."

A client, newly diagnosed with lung cancer, asks the nurse why the health care provider has ordered a positron emission tomography (PET) scan. Which response by the nurse is best?

structural scoliosis

A curvature of the spine that does not correct with bending is known as

Mouldy grain dust

A farmer is admitted with hypersensitivity pneumonitis. Which factor could have caused his condition?

Increased friction on the tendons of the shoulder joint.

A female tennis player has suffered an injury to her shoulder that has affected her bursae in the joint. Which of the following consequences would be most expected from this aspect of her injury?

"We'll likely need to start putting the first of a series of casts on her legs quite soon."

A female toddler has been diagnosed with toeing-in (metatarsus adductus). What teaching should the pediatrician provide to the parents of the child about her diagnosis?

Does not heal after injury

A football player who was admitted to the emergency department is awaiting results of a CT scan. The physician suspects injury of the hyaline cartilage. Select the statement that best describes hyaline cartilage.

Increase sympathetic stimulation of the heart and blood vessels

A grandmother, a cook at a nearby school, was recently hospitalized when she lost an extensive amount of blood in a work-related accident. The grandmother tells the nurse that she heard that she would keep feeling faint until the brain made more blood. The nurse knows that when the blood pressure dropped, the pressure in the carotid arteries decreased. This was detected by baroreceptors in the carotid arteries. What did the baroreceptors do?

the first small lump after the BIG spike

A group of nurses is taking a critical care course in cardiac electrophysiology. The instructor is reviewing action potential and the risk of arrhythmias and states that if an electrical impulse fires just after the relative refractory period, during the supernormal excitatory period, cardiac arrhythmias could result. Locate the supernormal excitatory period on the first complex on the rhythm strip.

decreased ventricular filling time

A group of nursing students is discussing ventricular arrhythmias and one student is unsure why a client with frequent premature ventricular complexes (PVCs) has an irregular radial pulse. One of the other students explains that premature ventricular complexes often do not produce a palpable pulse due to:

"actually, people who have the latent form of the disease won't be sick and can't spread it either."

A health educator is performing a health-promotion workshop with the staff of a large, urban homeless shelter, and a component of the teaching centers around tuberculosis. One of the staff members comments, "Anyone who's had contact with tuberculosis in the past can give it to any of the other residents of the shelter, even if they didn't get sick themselves." How could the educator best respond to this comment?

Ventricular repolarization

A male patient with a history of angina has presented to the emergency department with uncharacteristic chest pain. His subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle?

Large numbers of alveolar macrophages in septal connective tissue

A male, lifetime smoker has died as a result of chronic obstructive pulmonary disease. Which of the following phenomena regarding his alveoli would his care team expect in the weeks prior to his death?

Hypoglycemia

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

The growth hormone level will not be suppressed following glucose load.

A middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which of the following results?

cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that:

Surfactant

A neonate delivered at 36 weeks gestation is in respiratory distress and requires ventilation. Tests reveal prematurity of the lungs and an underdevelopment of Type II alveolar cells. Based on these results the nurse will anticipate the administration of which of the following to improve respiratory function?

"Musculoskeletal screening is important to identify anything that needs intervention."

A new mother asks, "why are you examining my babies' hips?" Which of the following is the nurse's best response?

The infant will have dosage levels adjusted as he grows.

A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant's taking thyroid hormone supplement, what should be included in the education?

Vertebrae

A newly admitted client's health record states that the client's health history includes tubercular osteomyelitis. Where is the most likely anatomical site of this infection?

A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

A number of clients have presented to the emergency department in the last 32 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following clients is least likely to have an ST-segment myocardial infarction (STEMI)?

"Too much alcohol, too little exercise and too much body fat all contribute to high blood pressure."

A number of older adults have come to attend a wellness clinic that includes both blood pressure monitoring and education about how to best control blood pressure. Which of the leader's following teaching points is most accurate?

A 69-year-old woman who has entered ventricular fibrillation.

A number of patients on an acute cardiac care unit of a hospital have diagnoses of impaired cardiac conduction. Which of the following patients is most deserving of immediate medical attention?

Grade 2

A nurse admitting a patient to the emergency department with a suspected fracture notes a deep abrasion with bruising. The patient reports receiving a hard tackle during a football game. Which of the following grades of tissue damage accompanies this fracture?

• Dyspnea • Peripheral cyanosis • Syncope

A nurse assesses a patient with normal biomarkers who reports angina. Which of the following additional manifestations are late signs of aortic stenosis? Select all that apply.

PEF 400 ml in AM, 390 ml at noon, symptoms occur twice a week

A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has mild intermittent asthma?

Dead space

A nurse educator is explaining a client's lung disease and describing how some of the air that he is moving with each breath is not actually participating in gas exchange. The nurse is describing what phenomenon?

Tongue falling back and blocking the airway

A nurse experiences a person having seizure activity in the grocery store. Once the seizure activity has subsided the nurse places the person in a side lying position to avoid occlusion of the airway, which could cause cessation of ventilation due to which of the following?

Temperature Nutritional status Stress

A nurse has just completed an explanation of how hormones are normally regulated by feedback mechanisms to a client. The client asks if anything can alter the regulation. The best response by the nurse would be: Select all that apply.

Dyspnea, cough

A nurse in a nursing home is concerned that a resident may be developing left heart failure. Manifestations of left heart failure would include which of the following symptoms?

Radiation Smoke inhalation Fat embolism

A nurse in the emergency department is preparing a presentation about acute respiratory distress syndrome (ARDS) for new nurses. What are common causes of ARDS that should be included? Select all that apply.

Statins

A nurse is administering medication to treat hypercholesterolemia. Which of the following medications reduces or blocks the hepatic synthesis of cholesterol?

Diuretic, ACE inhibitor, beta-blocker

A nurse is administering morning medications to a number of patients on a medical unit. Which of the following medication regimens is most suggestive that the patient has a diagnosis of heart failure?

Respiratory stridor and barking cough

A nurse is assessing a 1-year-old child diagnosed with croup. Which of the following manifestations would most likely be present?

Grunting during expiration

A nurse is assessing a 2-week-old infant with pulmonary edema. Which of the following symptoms indicates the infant is experiencing respiratory distress?

Mucous membrane

A nurse is assessing a child who has a congenital heart defect for cyanosis. Select the most important area for the nurse to assess.

Central venous pressure

A nurse is assessing a client and becomes concerned that the client may be experiencing heart failure. Which of the following would be the best indicator to determine pressure being exerted on the right side of the heart?

Orthopnea

A nurse is assessing a client diagnosed with severe mitral valve stenosis. The nurse anticipates the assessment will include:

• Lips • Nails • Ears • Cheeks

A nurse is assessing a client for cyanosis. The most appropriate areas for the nurse to assess would be: Select all that apply.

Continuous measurement of urine output

A nurse is assessing a client in shock for complications of acute renal failure. The most important assessment for the nurse to obtain would be:

Lymphedema

A nurse is assessing a female client and notes that her left arm is swollen from the shoulder down to the fingers, with non-pitting edema. The right arm is normal. The client had a left-sided mastectomy one year ago. Which of the following does the nurse suspect is the problem?

Hypoglycemia Hyponatremia Lactic acidosis Hypoventilation

A nurse is assessing an elderly woman diagnosed with chronic hypothyroidism who has developed myxedematous coma. The nurse is aware that the client may manifest: Select all that apply.

Increase the IV fluid infusion rate.

A nurse is caring for a client following surgery. The central venous pressure (CVP) monitor indicates low pressures. Which action is a priority for the nurse to take?

Tendons

A nurse is caring for a client who injured her knee while playing basketball. Tests reveal a torn connective tissue that connects muscles to bones. Based on this finding, the nurse prepares to teach the client about which of the following anatomical structure that is injured?

Hyperuricemia.

A nurse is caring for a patient undergoing antineoplastic chemotherapy for acute leukemia. Which of these diagnostic studies does the nurse monitor to detect the consequences of the rapid lysis of cancer cells?

Posterior portions of the lungs

A nurse is caring for a patient who has been ordered complete bed rest. The nurse determines the area of this client's lungs that experience the most ventilation as which of the following?

Ulcers of the lower extremities

A nurse is caring for a patient who has developed vasculitis as a result of a rheumatology disorder. Which of the following factors does the nurse expect to uncover in assessing this patient?

"To prevent cartilage atrophy, slowly and gradually resume exercising."

A nurse is caring for a patient with a fractured elbow. Which of the following instructions is important to give the patient to prevent cartilage degeneration while the elbow is immobilized?

RA has an autoimmune and genetic predisposition.

A nurse is caring for a patient with rheumatoid arthritis (RA) who states she "caught" this from her mother. Which of the following statements is the correct explanation of how this type of arthritis develops?

Ventilation perfusion mismatch

A nurse is conducting a class on healthy living with COPD and presents potential complications with the disease. Many clients with COPD have bronchospasms, airway inflammation, and excess mucus production which contribute to obstruction to the alveoli. Which of the following physiologic conditions could result from the obstruction?

Systemic vascular resistance (SVR)

A nurse is evaluating a client to determine the effectiveness of medications given to reduce left ventricular afterload. Which hemodynamic parameter is most appropriate for the nurse to monitor?

Race Family history

A nurse is evaluating hypertension risk factors with an African American male who is a lawyer in a busy legal firm. He reports that he eats fairly well, usually having red meat and potatoes daily. His father and older brother have hypertension. His paternal grandfather had a stroke. The lawyer drinks about four beers and eats salted popcorn while watching television in the evening and has gained 15 pounds in the past year. Which of the following are nonmodifiable risk factors associated with this diagnosis? Select all that apply.

Excessive alcohol consumption Obesity

A nurse is evaluating hypertension risk factors with an African American male who works as a lawyer in a busy legal firm. He reports that he eats fairly well, usually having red meat and potatoes daily. His father and older brother have hypertension. He paternal grandfather had a stroke. He drinks about four beers and eats salted popcorn while watching television in the evening and has gained 15 pounds in the past year. Which of the following are modifiable risk factors associated with this diagnosis? Select all that apply.

A 45-year-old obese woman with a sedentary lifestyle

A nurse is evaluating patients for the risk of developing type 2 diabetes. Which of the following patients has the highest risk?

Sinoatrial node (SA), internodal pathways, AV node, AV bundle, Purkinje fibers

A nurse is explaining the conduction system of the heart to a client who is experiencing an arrhythmia. Which would be the most appropriate explanation?

"I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?

Cardiac output and systemic vascular resistance

A nurse is planning a community education program on hypertension. Which of the following parameters should be included to explain the regulation of arterial blood pressure?

-Consume a diet rich in fruits, vegetables, and low-fat dairy products. -Reduce dietary sodium intake. -Stop smoking. -Limit alcohol consumption.

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which of the following topics should be included in the teaching plan? Select all that apply.

Consume a diet rich in fruits, vegetables, and low-fat dairy products. Reduce dietary sodium intake. Stop smoking. Limit alcohol consumption

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which of the following topics should be included in the teaching plan? Select all that apply.

Promoting adequate nutrition for a patient with a recent fracture

A nurse is planning care for patients with musculoskeletal disorders. Which of the following goals is appropriate for the patients?

• Recurrent chest infections • Production of purulent sputum • Low hemoglobin levels

A nurse is providing care for a client who has been admitted to a medical unit with a diagnosis of bronchiectasis. Which of the following signs and symptoms should the nurse expect to find during physical assessment of the client and the review of the client's history? Select all that apply:

Assessment of motor and sensory function with the goal of identifying compartment syndrome.

A nurse is providing care for a client who has had a cast applied to her fractured arm 6 hours prior. The client is now complaining of severe pain that she describes as "even worse than when I broke my arm." What would be the nurse's best course of action?

The client complains of sharp pain exacerbated by deep inspiration.

A nurse is providing care for a patient who has been admitted with a newly diagnosed bilateral pleural effusion. Which of the following findings from the nurse's initial assessment of the patient is incongruent with the patient's diagnosis and would require further investigation?

The patient will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles.

A nurse is providing care for an older, previously healthy adult male who has been diagnosed today with pneumococcal pneumonia. Which of the following signs and symptoms is the nurse most likely to encounter?

pressure pulses

A nurse is teaching a client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are:

Eye health and visual acuity

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves' disease. Which assessments should the nurse prioritize?

β-adrenergic-blocking medications to reduce sympathetic nervous stimulation

A nurse on a medical unit is providing care for a 37-year-old female patient who has a diagnosis of Graves' disease. Which of the following treatments would the nurse most likely anticipate providing for the client?

a nasogastric (NG) tube attached to suction

A nurse on an acute medical unit is providing care for a number of patients with a variety of diagnoses. Which of the following patients most likely exhibits risk factors for impaired coughing? A patient with:

Smoking cessation techniques Identification of high cholesterol foods Importance of exercise on managing hypertension Signs and symptoms of type 2 diabetes mellitus

A nurse preparing education on managing the risk factors for coronary artery disease (CAD) will stress which information? Select all that apply.

"It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions." "A single hormone can act on not only one process or organ, but often on several different locations or processes." "A bodily process can be the result of the combined effect of several different hormones from different sources."

A nurse who works in the office of an endocrinologist is orientating a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? Select all that apply.

"A single hormone can act on not only one process or organ but often on several different locations or processes."

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?

Blood outflow into the pulmonary circulation is restricted by pulmonic valve stenosis.

A nurse who works on a pediatric cardiology unit of a hospital is providing for an infant with a diagnosis of tetralogy of Fallot. Which of the following pathophysiologic results should the nurse anticipate?

has pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain.

A nurse will be providing care for a female patient who has a diagnosis of heart failure that has been characterized as being primarily right-sided. Which of the following statements best describes the presentation that the nurse should anticipate? The client:

the relationship between venous return and stroke volume.

A nurse working with a client in heart failure is explaining why the symptoms of the heart failure were not evident for a long period of time. When describing the Frank--Starling mechanism, the nurse will explain:

"Red bone marrow is the site of blood cell formation."

A nursing faculty member is explaining the function of red bone marrow to students. Which of the following statements made by a student indicates that teaching was successful?

Norepinephrine

A nursing instructor is explaining the role of vascular smooth muscle cells in relation to increases in systemic circulation. During discussion, which neurotransmitter is primarily responsible for contraction of the entire muscle cell layer thus resulting in decrease vessel lumen radius?

Paracrine

A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students' recognize the local action of hormones as:

conductivity

A nursing student is studying the properties of cardiac rhythm to better understand what causes arrhythmias to occur. The student begins to understand that there is a programmed ability for certain cells to conduct impulses. Interruption in this ability can result in abnormalities of cardiac rate and rhythm; this property would be:

Macrophages

A nursing student is studying the respiratory airways in the lungs, in particular the alveoli. A fellow student asks which of the following cells is most instrumental in the destruction of foreign substances that may enter the alveoli with inspired air. The most accurate response would be alveolar which of the following?

false

A nursing student who is studying about disorders of the skeletal system is heard making the following statement, "Many skeletal disorders of early infancy are caused by intrauterine positions and need to be surgically fixed." Is this statement true or false?

Dry lips, excess urine output, and seizures.

A pancreatitis patient is admitted with weight loss, nausea, and vomiting. To maintain nutrition, the physician orders parental nutrition to be started. Knowing that a major side effect of parenteral nutrition is a hyperosmolar hyperglycemic state, the nurse should assess the patient for which clinical manifestations (listed below)?

Significant genital enlargement

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Watery, clear nasal secretions Coughing Mild fever

A parent brings a child into the urgent care clinic. The practitioner suspects the child has a "cold" based on which clinical manifestations? Select all that apply.

• Fever • Redness • Periosteal elevation

A parent brings a child to the clinic because the child has a notable limp and states there is a lot of leg pain. There was no history of injury. Which of the following assessment data corresponds to a diagnosis of osteomyelitis? Select all that apply.

A closed, comminuted fracture

A parent brings his child to the emergency department after the child sustains a fall from a tree. The child has severe right arm pain. A radiograph shows a complete break in the humerus with multiple pieces of bone at the fracture line and the skin is not broken. This type of fracture is classified as which of the following?

Since the head of the femur has only limited collateral circulation, interruption in the blood flow from the fracture causes necrosis and irreversible damage.

A patient asks the nurse why their hip fracture (head of the femur) bone has died (osteonecrosis). The nurse responds based on which of the following pathophysiological principles?

High-dose corticosteroid therapy and cytotoxic immunosuppressant agents

A patient comes to the clinic complaining of anorexia, weight loss, fever, fatigue along with paresthesias, pain, and weakness of the lower extremities. Assessment findings include reddish blue, mottled areas of discoloration to the skin of the lower extremities. Laboratory findings include an elevated erythrocyte sedimentation rate, leukocytosis, anemia, and abnormal liver function tests. A diagnosis of necrotizing vasculitis is confirmed through biopsy. The nurse anticipates treatment with which of the following medications?

Hypoxemia

A patient diagnosed with congestive heart failure has an arterial blood oxygen level (PaO2) of 89%. Which of the following terms should the nurse use to document a reduced oxygenation of arterial blood?

• Myocardial hypertrophy • Ischemic heart disease • Constrictive pericarditis

A patient diagnosed with diastolic heart failure asks the nurse to explain why this has developed. The nurse knows that which of the following are often associated with diastolic failure? Select all that apply.

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." "I need to carefully limit my protein consumption."

A patient diagnosed with type 2 diabetes has been instructed about managing her condition with diet. Which of the following statements by the patient indicates a need for additional education? Select all that apply.

A young female patient who has been trying to get pregnant.

A patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient?

Electrocardiogram (EKG) Cardiac computed tomography (CCT) Echocardiography Chest x-ray

A patient exhibits signs and symptoms of heart failure, including fatigue and shortness of breath. Which of the following tests are suggested to support a diagnosis of heart failure? Select all that apply.

Decreased adrenocorticotropic hormone (ACTH)

A patient experiences an increase in cortisol as a result of Cushing's disease. Which of the following hormonal responses demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH)

A patient experiences an increase in thyroid hormone as a result of a thyroid tumor. Which of the following hormonal responses demonstrates the negative feedback mechanism?

Performing a neurovascular assessment (NVA)

A patient had a closed reduction of a wrist fracture and had a plaster cast applied. Which of the following nursing actions is the highest priority immediately after the procedure?

Headaches, dizziness, change in level of consciousness.

A patient has been admitted with diabetic ketoacidosis. The Emergency Department starts an IV to improve circulatory volume. If there is a sudden change in extracellular fluid osmolality which results in a too rapid blood glucose lowering, the nurse will likely observe which of the following clinical manifestations?

"Genetic predisposition is very likely."

A patient has been diagnosed with rheumatoid arthritis (RA). Which of the following will the nurse tell the patient about this disorder's etiology?

Raynaud's phenomenon

A patient has been diagnosed with scleroderma. Which of the following assessment findings does the nurse expect?

Preload

A patient has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the patient's end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this?

Hypertension

A patient has developed atherosclerosis. The nurse knows that a major cause for this disorder is which of the following?

Myocardial infarction

A patient has developed cardiogenic shock. The most frequent cause of this type of shock is which of the following?

• Thrombotic occlusion occurs in small and midsized blood vessels. • Bleeding may accompany coagulation. • Generation of thrombin increases. • Endogenous anticoagulation mechanisms are suppressed.

A patient has developed disseminated intravascular coagulation (DIC). The nurse knows that which statements regarding DIC are true? Select all that apply.

Myocardial infarction

A patient has developed left heart failure. Which of the following symptoms might have precipitated this condition?

Diastolic dysfunction

A patient has developed pericarditis. The nurse knows that this condition will increase the risk for development of which condition?

Cushing's syndrome Oral contraceptives Aortic coarctation Pheochromocytoma

A patient has developed secondary hypertension. The nurse knows that causes of secondary hypertension include which of the following? Select all that apply.

Glucose uptake by muscle and adipose tissue Fat storage Protein synthesis

A patient hospitalized with type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following are processes of insulin? Select all that apply.

"The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs."

A patient in the nursing home wonders why he is having these signs and symptoms of left-sided failure. Which of the following explanations will the nurse give the patient?

Change in level of consciousness and profound hypotension

A patient is admitted to the hospital in Addisonian crisis one month after a diagnosis of Addison's disease. The nurse knows which of the following clinical manifestations would support this diagnosis?

Work in a coal mine for 20 years

A patient is admitted with pneumoconiosis. His history most likely reveals which of the following?

Increase in PCO2

A patient is brought into the emergency department with severe crushing injuries to the chest wall and signs of respiratory failure following a motor vehicle accident. Which of the following laboratory values would be expected?

• Beta-adrenergic blockers • Angiotensin-converting enzyme inhibitors (ACEI) • Digitalis • Diuretics

A patient is diagnosed with heart failure. Which of the following types of drugs is to be used to manage this disorder? Select all that apply.

Hyperglucagonemia Glycosuria and dehydration Hepatic glycogenolysis Insulin deficiency

A patient is diagnosed with hyperglycemic hyperosmolar state (HHS). Which of the following factors contribute to the severe hyperglycemia that precipitates HHS? Select all that apply

Hypertriglyceridemia Body mass index (BMI) greater than 30 Coronary artery disease Elevated fasting blood glucose (FBG)

A patient is diagnosed with metabolic syndrome. Frequent concomitants of this syndrome include which of the following? Select all that apply.

• Antihypertensives • Psychotropics • Diuretics

A patient is diagnosed with orthostatic hypotension. The nurse knows that drugs which can predispose a patient to orthostasis include which of the following? Select all that apply.

Chest pain and dyspnea

A patient is diagnosed with pulmonary embolism. Which of the following symptoms would most likely be present?

• Decreased tidal volume • Increased respiratory rate • Nonproductive cough • Clubbing of fingers

A patient is diagnosed with restrictive lung disease caused by fibrosis. Which of the following clinical manifestations is expected? Select all that apply.

Weight gain

A patient is diagnosed with right-sided heart failure. The nurse knows that a frequent sign of this type of failure is peripheral edema, evidenced by which of the following?

Sustained systolic pressure equal to or greater that 160 mm Hg

A patient is diagnosed with stage 2 hypertension. The nurse knows that which of the following is characteristic of stage 2 hypertension?

Left ventricular hypertrophy

A patient is diagnosed with systolic hypertension. The nurse knows that this patient is at risk for which of the following?

High afterload because of backpressure against the left ventricle

A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon?

The patient is achieving normal glycemic control.

A patient is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL and a hemoglobin A1C of 5%. Based on these findings, which of the following can the nurse assume?

• Take ibuprofen for pain. • Bend knees to pick up objects. • Reduce activity for a few days.

A patient is seen in the emergency department and is diagnosed with a strained back. Which of the following instructions should the nurse provide? Select all that apply.

Valvular regurgitation

A patient is told that she has cardiac valve leaflets, or cusps, that are floppy and fail to shut completely, permitting blood flow even when the valve should be completely closed. The nurse knows that this condition can lead to heart failure and is referred to as which of the following?

Raynaud's disease

A patient presents to the emergency department with complaints of bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. Which of the following is a potential diagnosis for this patient?

Assessing the patient's pain and history

A patient presents with arthralgia and arthritis. Which of the following is the priority nursing action?

Muscle-strengthening exercises to support joints

A patient presents with joint pain and suspected rheumatoid arthritis (RA). Which of the following is the appropriate nursing action?

"Extra-articular manifestations may include anemia and deformities of the affected joints."

A patient recently diagnosed with rheumatoid arthritis (RA) tells the nurse she is glad there is nothing "really wrong with her" but some joint swelling. Which of the following information should the nurse tell the patient about RA?

Prevention of the development of a deep vein thrombosis

A patient recently had surgery for a hip fracture. Which of the following nursing interventions would be most effective for preventing pulmonary emboli in this patient?

X-ray shows minimal calcification at the fracture.

A patient returns to the doctor's office for evaluation 6 weeks after a tibial fracture. Which of the following assessments indicates the potential for nonunion?

Applying ice and sitting out the rest of the game

A patient suffers a musculoskeletal injury while participating in a sporting event. Which of the following is the appropriate initial treatment?

Swelling Discoloration Abnormal mobility Loss of function

A patient sustains a musculoskeletal injury of the right foot. In addition to pain, which of the following manifestations would accompany a fracture? Select all that apply.

Pain and stiffness

A patient sustains a musculoskeletal injury of the wrist. Which of the following manifestations would the nurse expect to accompany the strain?

Decreased level of consciousness

A patient who experienced an ST elevation myocardial infarction (STEMI) received fibrinolytic therapy with streptokinase. Which of the following manifestations alerts the nurse to a developing complication?

pH 7.31 (normal 7.35 to 7.45) PCO2 of 58 mm Hg (normal 38 to 42). Serum HCO3of -33 mEq/L (normal 22 to 28).

A patient who has been on a high-protein diet comes to the emergency department with respiratory symptoms. Upon analysis of arterial blood gases (ABGs), the patient is diagnosed with hypercapnia. The nurse will note the ABG results that confirm this diagnosis include: Select all that apply.

• Assist the client to ambulate in the morning. • Medicate the client for muscle spasms. Provide nonsteroidal anti-inflammatory medications.

A patient who has had ankylosing spondylitis for several years is admitted to the hospital. Which of the following interventions will best assist this patient while in the hospital? (Select all that apply.)

Biopsy

A patient 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 of the following tests will confirm the diagnosis of spinal tuberculosis (TB)?

Barrel chest

A patient with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior-posterior chest diameter. Which of the following terms should the nurse use to document this finding?

Redness and heat at fracture site

A patient with a compound fracture of the femur is in balanced skeletal traction. Which of the following assessment data must be reported immediately?

Activation of the renin-angiotensin-aldosterone mechanism

A patient with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the patient's increased blood pressure?

Cyanosis

A patient with chronic obstructive pulmonary disease presents to the emergency department with difficulty breathing. Physical examination reveals bluish skin, nail beds, and mucous membranes. Which of the following terms correctly describes this condition?

Glargine (Lantus)

A patient with diabetes asks the nurse for advice in controlling between-meal blood glucose levels. Which of the following might the nurse suggest as a long-acting insulin to provide a consistent basal level?

Chronic neuropathies Vascular impairment

A patient with diabetes has been injured. The nurse will tell the patient that healing of the injury may be delayed due to which of the following diabetic complications? Select all that apply.

Loss of feeling or touch in the feet.

A patient with distal symmetric polyneuropathy usually begins by complaining of:

• Headache • Palpitations • Tremor • Fatigue

A patient with hypertension is suspected to have a pheochromocytoma. The nurse knows that symptoms of this condition include which of the following? Select all that apply.

Direct acting vasodilators Alpha adrenergic blockers Centrally acting adrenergic agonists

A patient with persistent primary hypertension is unhappy with the adverse effects of his current antihypertensive regimen. The nurse will tell the patient that there are several types of antihypertensive drugs having different mechanisms of action and different adverse effect profiles. The physician can vary regimens until an acceptable one is found. Which of the following are antihypertensive medications which the physician might select to use? Select all that apply.

• Surfactant inactivation • Intrapulmonary shunting • lung stiffens • Alveolar collapse

A patient with sepsis secondary to pneumonia develops acute respiratory distress syndrome (ARDS) and a low ventilation-perfusion ratio. Which of the following alterations in the lungs occurs as the disease progresses? Select all that apply.

Defibrillate the patient

A patient's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The patient is unconscious and without a pulse. Which of the following priority interventions should the nurse take?

Prescribing a tapering dose of the medication over weeks

A patientreceives steroids for several months to treat an inflammatory condition. Which of the following actions by the primary healthcare provider indicates an understanding of the negative feedback mechanism when the patient no longer needs the medication?

Venous return to the heart

A person with blood pressure of 68/38 fainted after donating a unit of blood. The blood bank technician stated that the person was experiencing low preload from loss of blood volume. The nurse knows that preload refers to which of the following?

Potassium is central to establishing and maintaining the resting membrane potential of cardiac muscle cells.

A physician has ordered the measurement of a cardiac patient's electrolyte levels as part of the client's morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient's heart?

• Airway obstruction • Increased Na+ absorption • Impaired Cl- transport • Recurrent pulmonary infections • Decreased water content of mucociliary blanket

A physician is providing care for a child who has a diagnosis of cystic fibrosis (CF). Place the following events in the etiology of CF in ascending chronological order. Use all the options.

"Tension and vessel thickness increase proportionately."

A physician is teaching a group of medical students about the physiological basis for damage to the circulatory and neurological system that can accompany hypotension. Which of the following responses by a student would warrant correction by the physician?

The client is 89 years old and takes a diuretic medication for his congestive heart failure.

A physiotherapist is measuring the lying, sitting, and standing blood pressure of a patient who has been admitted to hospital following a syncopal episode and recent falls. Which of the following facts about the patient best relate to these health problems?

"A decrease in estrogen levels, which occurs at menopause, results in increased resorption of bone."

A post-menopausal female client diagnosed with osteoporosis asks the nurse how a decrease in estrogen can cause problems with bone density. Which of the following statements is the best response from the nurse?

"This may be a normal response to pregnancy. What are you usually doing when you experience this feeling?"

A pregnant client at 26 weeks of gestation states that she is "not really short of breath" but feels aware of the need to breathe. What is the nurse's best reply?

27 weeks

A pregnant client has experienced episodes of premature labor and is concerned about her unborn child's lung development. The client asks the nurse when the fetus begins to produce sufficient surfactant. The best response would be:

blood pressure 160/100 and proteinuria during the 30th week of pregnancy

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Airborne droplets

A prison inmate contracted tuberculosis during a recent outbreak. The nurse caring for these inmates correctly identifies which of the following as the mode of transmit for this disease?

Pleuritis related to infection

A short, nonsmoking middle-aged man presents to the emergency room with left-sided chest pain and a cough. He says that the pain started abruptly, just after lunch, and that breathing and coughing make it worse. He denies recent injury. He is breathing shallowly and rapidly and expresses fear that he may be having a "heart attack." Breath sounds are normal, and he is not cyanotic. Which condition is most likely causing his symptoms?

Surgical treatment may have the consequence of weakening the client.

A social worker is counselling the family of an 85-year-old woman who has just been diagnosed with non-small cell lung cancer. What concerns should she convey to the family regarding the unintended effects of treating the disease?

The child has fusion of the epiphyses of the long bones and increased growth hormone levels.

A very tall 8-year-old child is brought by a parent to the clinic for a follow-up visit after diagnostic testing reveals a diagnosis of gigantism. What objective assessment data gathered would the nurse recognize correlates with the child's condition?

glyburide insulin

A woman in her 28th week of pregnancy develops gestational diabetes mellitus and has persistent elevated blood glucose when using the diet plan. What medications are appropriate? Select all that apply.

Production of fatty acids and glycerol Ketone production by the liver Breakdown of triglycerides Decrease in pH Low serum insulin levels

A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options.

ewing sarcoma

A young adult has been diagnosed with a tumor of the femur, and the health care provider suspects a malignancy. Upon further assessment, the client states that he experiences bone pain, limitation of movement, and tenderness over the involved bone area. Select the most likely diagnosis.

Pleuritis

A young adult is brought to the urgent care by a parent. The client states that he just does not feel good. Upon further assessment, the health care provider notes the following: • Unilateral chest pain when the client is asked to cough or move • Rapid respiratory rate • Splinting of the chest • Decreased tidal volume The provider would interpret these manifestations as:

Ventilation

A young child is brought to the ER with CPR in progress. The parent found the child lying on the kitchen floor without respirations, although a heartbeat was initially detected. The triage nurse anticipates the most likely cause of the situation is an obstruction of the conducting airways which caused an interruption in

Hypertrophic cardiomyopathy

A young college football player was bought to the emergency room after collapsing on the football field during practice. When arriving he was unconscious and his ECG was abnormal. Subsequently he died after arresting in the emergency room. What does the physician suspect is the likely cause of this?

A quick decline in lung function is likely, and the client is likely to face an early death.

A young man and his friend started a business sandblasting and refinishing wrought iron. Following a rapid onset of respiratory symptoms, the client was diagnosed with silicosis. What aspect of silicosis should underlie the nurse's care planning?

"If you make sure to keep yourself warm, it will have a fairly minimal effect; I'll also give you pills to enhance your circulation."

A young woman has been diagnosed by her family physician with primary Raynaud disease. The woman is distraught, stating, "I've always been healthy and I can't believe I have a disease now." What would be her physician's most appropriate response?

• Rapid onset • Increase in respiratory rate • Hypoxemia refractory to treatment

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is distinguishable between the two by the extent of hypoxemia involved. What is the clinical presentation of ARDS? (Select all that apply.)

• Frothy blood-tinged sputum • Respiratory crackles • Confusion • Rapid pulse

Acute pulmonary edema often occurs with heart failure. Which of the following signs of acute pulmonary edema should be monitored? Select all that apply.

Aluminum-sparing antacids

Adult rickets can result from several disorders. It can also have a pharmacologic basis for its onset. Which medication can cause rickets in an adult?

GH suppression test

Advances in technology have made it possible to assess hypothalamic-pituitary function by newly developed imaging and radioimmunoassay methods. When baseline tests are not sufficient, what suppression test gives information about combined hypothalamic-pituitary function?

• Cardiac disease • Hypertension

All of the following clients are exhibiting manifestations of a common cold. At the pharmacy, the pharmacist should advise which clients to avoid decongestant drugs from over-the-counter? Client with a history of: Select all that apply.

Epinephrine (Adrenalin).

All of the following interventions are ordered stat for a patient stung by a bee who is experiencing severe respiratory distress and faintness. Which priority intervention will the nurse administer first?

Increased GH secretion

An adult patient is scheduled for testing of a suspected growth hormone (GH)- secreting tumor. Which of the following results from the glucose suppression test would confirm the condition?

No increase in TSH

An adult patient with suspected hypothyroidism is scheduled for a thyrotropin-releasing hormone (TRH) stimulation test to evaluate pituitary response. Which of the following test results would confirm secondary hypothyroidism?

Vascular stiffness

An elderly client asks the nurse why so many older people develop heart failure. The best response would be increased:

blocking the conversion of angiotensin I to angiotensin II.

An elderly client has been diagnosed with chronic heart failure. He is prescribed an ACE inhibitor to treat the symptoms and improve his quality of life. This drug will alleviate the client's symptoms of heart failure by:

Bronchopulmonary dysplasia

An infant who was born prematurely and developed respiratory distress syndrome was placed on mechanical ventilation for several weeks. What condition should the nurse monitor the infant for related to the long-term ventilatory support?

Laryngeal edema

Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often accompanies the vascular response in anaphylaxis?

Emotional stress.

Angina pectoris is a chronic ischemic CAD that is characterized by a symptomatic paroxysmal chest pain or pressure sensation associated with transient myocardial ischemia. What precipitates an attack of angina pectoris?

Worse when lying

Ankylosing spondylitis is a disease that typically manifests in late adolescence and early adulthood. What is the characteristic of the pain in ankylosing spondylitis?

"The blood pressure varies widely between arteries and veins and between pulmonary and systemic circulation."

As part of pre-surgical teaching for patients who are about to undergo a coronary artery bypass graft, a nurse is performing an education session with a group of surgical candidates. Which of the following teaching points best conveys an aspect of the human circulatory system?

true

Bone may take up toxic substances from the circulation, which can be viewed as a protective mechanism.

CO = SV X HR

Cardiac output (CO) is used to measure the efficiency of the heart as a pump. What is the equation used to express CO?

Ability to increase cardiac output during physical exercise

Cardiac reserve refers to which of the following events?

Pulsus paradoxus

Cardiac tamponade is a serious life-threatening condition that can arise from a number of other conditions. What is a key diagnostic finding in cardiac tamponade?

• Hypertrophic cardiomyopathy • Left ventricular noncompaction

Cardiomyopathies are classified as either primary or secondary. The primary cardiomyopathies are further classified as genetic, mixed, or acquired. Which of the following are genetically based? (Select all that apply.)

• Stroke volume • Resistance in arterioles • Aortic elasticity

Changes in systemic blood pressure are a reflection of which of the following properties of the cardiovascular system? Select all that apply.

• Pyruvate converted to lactic acid • Cellular edema • Deranged sodium/potassium balance • Impaired cellular production of adenosine triphosphate (ATP)

Circulatory shock is characterized by an inability of the circulatory system to provide adequate oxygen to body tissues. Which of the following damaging effects at the cellular level can cause hypoxia? Select all that apply.

Pseudomonas aeruginosa and Staphylococcus aureus

Cystic fibrosis (CF) is an autosomal recessive disorder involving the secretion of fluids in specific exocrine glands. The genetic defect in CF inclines a person to chronic respiratory infections from a small group of organisms. Which organisms create chronic infection in a child with cystic fibrosis?

the pulse decreases rather than increases in amplitude

Downstream peripheral pulses have a higher pulse pressure because the pressure wave travels faster than the blood itself. What occurs in peripheral arterial disease?

Directing blood flow away from the lung regions that are hypoxic

Due to complications, a male postoperative patient has been unable to mobilize secretions for several days following surgery and develops atelectasis. Which of the following processes would his care team anticipate with relation to his health problem?

Redirection of blood flow into the lung regions that are hypoxic.

Due to complications, a postoperative client has been unable to mobilize for several days following surgery and has developed atelectasis. Which process would his care team expect?

Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.

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 of the following phenomena most likely underlies the woman's situation?

Epiphyseal growth plate

During the first two decades of life, the skeleton undergoes general overall growth. Select the structure that promotes this process.

Most ECG-detected ischemic events are clinically silent.

ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this?

Position and movement

Each joint capsule has tendons and ligaments. What are the tendons and ligaments of the joint capsule sensitive to?

The man's α and β adrenergic receptors have been activated resulting in vasoconstriction and increased heart rate.

Emergency Medical Technicians respond to a call to find an 80-year-old man who is showing signs and symptoms of severe shock. Which of the following phenomena is most likely taking place?

• Large amount of pink, frothy sputum and new onset of murmur. • Tachypnea with respiratory distress. • Frequent ventricular arrhythmia unrelieved with Amiodarone drip. • Complaints of facial numbness and tingling.

Following a ST-segment myocardial infarction (STEMI), the nurse should be assessing the patient for which of the following complications? Select all that apply.

Increased white cell count and audible crackles on chest auscultation.

Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto's thyroiditis. In light of this diagnosis, which of the following assessment results would constitute an unexpected finding?

Chronic obstructive pulmonary disease (COPD), sitting in bed with cyanosis and pulse oximeter reading 57%

For a client with which of the following is the use of oxygen at a rate above 2 L/minute inappropriate?

Carbon monoxide poisoning

For which client condition will a pulse oximeter reading be inaccurate?

Graves' disease Type 1 diabetes mellitus Hypoparathyroidism Addison's disease

For which of the following endocrine disorders would autoimmune antibody testing be appropriate? Select all that apply.

Distributive shock

For which of the following types of shock might intravenous antibiotic therapy be indicated?

An 80-year-old woman whose pain started at 6 a.m. shortly after awakening and was not relieved by nitrates or rest; the ECG showed ST-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose

Four patients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which patient most likely experienced myocardial infarction?

Finding of monosodium urate crystals in the synovial fluid

Gout, or gouty arthritis, cannot be diagnosed on the basis of hyperuricemia. What is the diagnostic criterion for gout?

Increases insulin levels Facilitates the rate of protein synthesis Enhances fatty acid mobilization

Growth hormone exerts its effects on the body in many ways. Which of these are effects of GH? (Select all that apply.)

25 minutes

How long is the half-life of the hormone aldosterone, which is only 15% protein bound?

Receptors in each cell will increase.

How will cell receptors change in the absence of a particular hormone?

Whole blood Packed red cells Plasma volume expanders Crystalloids

Hypovolemic shock is characterized by a loss of blood volume or extracellular fluid. Administering which of the following would manage a patient with hypovolemic shock? Select all that apply.

Thyroid scan

Imaging has proven useful in both the diagnosis and follow-up of endocrine disorders. Two types of imaging studies are useful when dealing with endocrine disorders: Isotopic imaging and nonisotopic imaging. What is an example of isotopic imaging?

A growth plate

In a child, the epiphyses and metaphysis are separated by which of the following?

Increasing dietary consumption of vitamin D

In a patient diagnosed with osteomalacia, which of the following would be recommended to aid with improvement of the condition?

decreasing cardiac output due to less ventricular filling time.

In the ICU, the nurse hears an emergency cardiac monitor go off. The nurse looks at the telemetry and notices the patient has gone into ventricular tachycardia. The nurse will likely assess for signs/symptoms of:

Adipose cells

In the adult, red blood cell production decreases and red marrow is gradually replaced by yellow bone marrow. Yellow marrow is composed largely of which of the following?

ankles wrists

In what anatomical areas are irregularly shaped bones located? Select all that apply.

A client who has been diagnosed with Hashimoto thyroiditis

In which client would the nurse identify a primary endocrine disorder?

Around the capsule that forms the knee joint.

In which of the following locations would a clinician expect to find a ligament?

Canalicular

In which period of fetal lung development does type II alveolar cells begin to produce surfactant?

A client is helped out of bed and stands up

In which situation is blood most likely to be rapidly relocated from central circulation to the lower extremities?

NPO before surgery

In which situation would an increase of glucagon be expected?

Hypertrophy

Increased cardiac workload with left heart failure can result in which of the following change to the myocardial cells?

Low cardiac output

Increased secretion of renin in heart failure is caused by which of the following events?

Initiation of a pandemic

Influenza A subtype H5N1 (avian flu) has been documented in poultry in both East and Southeast Asian Countries. This form of avian flu is highly contagious from bird to bird but rarely is passed from human to human. There is a large amount of concern that the H5N1 strain might mutate, making it easier to be passed from human to human, carrying with it a high mortality rate. What is the main concern if the H5N1 strain does mutate?

"Displays of aggression, confusion and restlessness when the resident has no history of such behavior can be a sign of heart failure."

Knowing the high incidence and prevalence of heart failure among the elderly, the manager of a long term care home has organized a workshop on the identification of early signs and symptoms of heart failure. Which of the following teaching points is most accurate?

Elevated fibrinogen levels and hyperinsulinemia

Macrovascular disease includes coronary artery disease, cerebrovascular disease, and peripheral vascular disease. People with both type 1 and type 2 diabetes are at high risk for developing macrovascular disease. What are the risk factors for macrovascular disease in diabetics?

Eradication of the gland with radioactive iodine Surgical removal of part or the entire gland Drug therapy directed toward decreasing the gland's function

Management of hyperthyroidism would include which interventions? Select all that apply.

Fatigue Exercise intolerance Cyanosis Malnutrition

Manifestations of heart failure are due to the decreased pumping ability of the heart. The nurse will monitor for which of the following signs and symptoms of heart failure? Select all that apply.

Radioimmunoassay methods

Many hormones are measured for diagnostic reasons by using the plasma levels of the hormones. What is used today to measure plasma hormone levels?

Amiodarone

Many pharmaceutical agents may cause pulmonary damage. The nurse knows the following cardiac medication has been associated with toxic effects in the lungs:

Prevent pathologic fractures Promote survival with maximum functioning Maintain mobility and pain control

Metastatic bone diseases are the most common malignancies of osseous tissue. They occur at a time when primary tumors in the lungs, breasts, and prostate seed themselves (metastasize) to the musculoskeletal system. What are the primary goals of treatment for metastatic bone disease? (Select all that apply.)

Call for emergency assistance utilizing hospital protocol.

Mr. V. has been admitted for exacerbation of his chronic heart failure (HF). When the nurse walks into his room, he is sitting on the edge of the bed, gasping for air, and his lips are dusty blue. Vital signs reveal heart rate 112, respiratory rate 36, and pulse oximeter reading of 81%. He starts coughing up frothy pink sputum. The priority intervention is:

Increased glomerular filtration Decreased renal reabsorption of sodium and water Inhibition of endothelin action

Natriuretic peptides (NP) are part of the compensatory response to heart failure. Which of the following are actions of NP? Select all that apply.

Have the client sit up and lean forward

Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis?

Heart rate slower than normal; skin warm and dry.

Neurogenic shock, or spinal shock, is a phenomenon caused by the inability of the vasomotor center in the brain stem to control blood vessel tone through the sympathetic outflow to the blood vessels. In neurogenic shock, what happens to the heart rate and the skin?

Milliseconds.

Neurotransmitters like catecholamines (ex. dopamine and epinephrine) have a reaction time of:

Nitric oxide

Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues?

Synthesize bioactive products and produce paraneoplstic syndromes

Non-small cell lung cancers (NSCLCs) mimic small cell lung cancers (SCLCs) through their abilities to do what?

Alveoli

Nursing students in an anatomy class are observing lung tissue under the microscope in order to identify regions of the lung. The slide shows a basement membrane, capillary lumen, macrophages, and brush cells. This tissue is identified as which of the following regions of the lung?

Afterload

Of the following factors, which one represents the contractile force used by the muscle in order to move blood into the aorta?

Peripheral edema weight gain

On a holiday trip home, the nurse's mother states that the nurse's father was diagnosed with right heart failure. Which of the following manifestations exhibited by the father does the nurse know might have preceded this diagnosis?

"One of your heart valves is not opening properly. We need to do an echocardiogram to see which valve is having problems."

On a routine physical exam visit, the physician mentions that they hear a new murmur. The patient gets worried and asks, "What does this mean?" The physician responds:

Thickening of patellar tendon

Osgood-Schlatter disease is a disease that strikes children between the ages of 11 and 15. This disease involves microfractures, where the patellar tendon inserts into the tibial tubercle. What is Osgood-Schlatter disease characterized by?

Effects of gravity and body position

Our ability to oxygenate the tissues and organs of our bodies depends on our ability to ventilate, or exchange, gases in our respiratory system. The resultant distribution of ventilation or the areas of the body open to the exchange of gases in our respiratory system depends on what?

Fibrocartilage

Our bodies contain three types of cartilage: elastic, hyaline, and fibrocartilage. Which of these types of cartilage is found in the symphysis pubis?

Initiates calcium release from bone, Enhances intestinal absorption of calcium Activates conservation of calcium by the kidney.

Parathyroid hormone functions to maintain serum calcium levels. How does it fulfill this function? (Select all that apply.)

Early activation of the hypothalamic--pituitary--gonadal axis

Parents of a 7-year-old girl are concerned about their daughter because she has begun to develop secondary sexual characteristics. What etiologic factor is most likely to underlie the child's condition?

Severely depressed ventilation

Patients with chronic diseases such as chronic obstructive pulmonary disease (COPD), when given oxygen at a level that increases PO2 above 60 mmHg would experience which of the following?

Tidal volume Inspiratory reserve volume Expiratory reserve volume

Pulmonary function studies are an essential tool in the diagnosis of pulmonary disorders. A spirometer is used in these studies and through direct measurement provides valuable information on which of the following? Select all that apply.

Pulmonary vessels constrict

Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is their response?

Somogyi effect

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

Fever, Pain, Emotion

Respiration has both automatic and voluntary components that are sent to the respiratory center of the brain from a number of sources. What physiologic forces can exert their influence on respiration through the lower brain centers? (Select all that apply.)

Pulmonary artery

Reviewing pathology for an exam on pulmonary vasculature, the nursing student states that blood enters the right side of the heart via vena cava's, then to the right atrium, right ventricle, and then which vessel carries the deoxygenated blood into the pulmonary system?

Action decreases metabolic demands of the heart

ST-elevated myocardial infarction is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI?

Cortisol

Select the hormone that requires protein as a transport carrier.

Increased serum calcium

Select the major stimulus for calcitonin synthesis and release.

The spread of some strains of pneumococci is through healthy colonized individuals.

Select the statement that best describes pneumococcal infection.

canaliculi

Since diffusion does not occur through the calcified matrix of bone, which of the following serves as communicating channels for the exchange of nutrients and metabolites between the osteocytes and the blood vessels on the surface of the bone layer?

• Dilation of the bronchioles • Blood vessel constriction

Some nursing students are studying normal respiratory physiology in relation to stimulation of the sympathetic nervous system. As they reflect on the fight or flight syndrome, they determine that which of the following would happen? Select all that apply.

A hypercyanotic attack brought on by periods of stress

Tetralogy of Fallot is a congenital condition of the heart that manifests in four distinct anomalies of the infant heart. It is considered a cyanotic heart defect because of the right-to-left shunting of the blood through the ventricular septal defect. A hallmark of this condition is the "tet spells" that occur in these children. What is a tet spell?

• Diuretics reduce blood volume and myocardial oxygen demand. • Decrease in cardiac output causes an increase in preload. • Excessive stretch on the ventricular wall will decrease preload.

The Frank-Starling mechanism is a compensatory response to heart failure that can support cardiac output but also worsen heart failure. Which of the following statements regarding this mechanism are correct? Select all that apply.

Osteonecrosis

The client with sickle cell disease is at risk for development of which bone complication?

Juvenile dermatomyositis (JDMS)

The health care provider is assessing a child and suspects an inflammatory myopathy. The assessment data include muscle weakness and a characteristic rash, primarily involving the skin and muscle. The health care provider would document this as:

spine

The health care provider is assessing a client with a history of ankylosing spondylitis, to note progression of the disease. The most important area for the provider to assess would be:

Aggressive; malignant bone tumor

The health care provider is caring for a client who has just been diagnosed with an osteosarcoma. Select the response that best describes the diagnosis.

The condition is getting progressively worse.

The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as:

Berry aneurysm

The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as:

Osgood-Schlatter disease

The health care provider reviews the following assessment data of a client: • Pain in the front of the knee that is associated with inflammation and thickening of the patellar tendon • Pain during specific activities such as kneeling, running, bicycle riding, or stair climbing • Swelling, tenderness, and increased prominence of the tibial tubercle Based on these findings, the provider determines that the most likely diagnosis would be:

Improving quality of life by relieving symptoms

The health care team is developing a plan of care for a client diagnosed with congestive heart failure (CHF). The primary treatment goal would be:

-aortic -pulmonary

The heart consists of four valves. Which are the semilunar values? Select all that apply.

1800

The heart is a four-chambered muscular pump. In one day, how many gallons of blood are pumped throughout the body?

pumps blood through the lungs

The heart is a four-chambered pump. What is the function of the right ventricle?

Loss of diaphragmatic function

The home care nurse is caring for a client who has sustained phrenic nerve damage from a skiing accident. The nurse understands that the client must be on a ventilator for which of the following reasons?

An intubated client who is ventilator dependent following a traumatic head injury

The infection control nurse at a large hospital has instituted a new education campaign aimed at reducing the incidence of hospital-acquired pneumonia (HAP). The nurse should identify which client as being particularly susceptible to hospital-acquired pneumonia?

Synovium

The joint capsule in a diarthrodial joint consists of two layers. Which of the following is one of these layers?

Inhibition of the renin-angiotensin-aldosterone system

The most recent blood work of a client with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What is the most likely effect of these peptides on the client's physiology?

Cretinism

The newborn-nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?

Perform a heel stick to obtain a drop of blood for a T4 and TSH.

The newborn-nursery nurse is preparing to perform a required neonatal screening for congenital hypothyroidism. What should the nurse do to obtain the necessary sample?

Testosterone Aldosterone

The non-vesicle-mediated pathway has a role in synthesis and release of which of the following hormones? Select all that apply.

To decrease airway inflammation

The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication?

Limiting the size of the infarction

The nurse administers nitroglycerin to a patient with acute coronary syndrome. Which of the following is the best explanation of the expected outcome?

Blood glucose will elevate.

The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. Which of these effects on blood glucose levels does the nurse teach the student epinephrine will cause?

Glucocorticoids Oral contraceptives Loop diuretics

The nurse and nursing student are performing medication reconciliation. Which of these medications taken by the client does the nurse teach the student are implicated in causing hyperglycemia? Select all that apply.

P wave above the baseline

The nurse assesses the electrocardiogram for depolarization of the atria. What does the nurse expect to assess?

Raynaud's phenomenon

The nurse assessing a patient with scleroderma with CREST variant would include an assessment for which of the following?

Rickets

The nurse caring for a child with a deficiency of vitamin D knows that the deficiency places the child at risk for which of the following?

Decreased tidal volume

The nurse caring for a client with bilateral rib fractures explains to the client that the pain causes him to take more shallow respirations which will contribute to feeling SOB due to a

Severe accessory muscle retractions Nasal flaring Grunting on expiration

The nurse caring for a male child with respiratory problems is concerned he may be developing respiratory failure. Upon assessment, the nurse knows that which of the following are clinical manifestations of respiratory failure? Select all that apply.

Prepare for pericardiocentesis

The nurse caring for a patient 12 hours post coronary bypass graft notes a sudden decrease in the amount of chest tube drainage, a rapidly narrowing pulse pressure, paradoxical pulse, and shortened amplitude of the QRS complex on the electrocardiogram monitor. Which of the following should the nurse do next?

"Men are more likely to have osteoarthritis than women."

The nurse determines further teaching is necessary when a client diagnosed with osteoarthritis states:

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

The nurse determines that additional patient education is needed when a patient with gout makes which one of the following statements?

"Angina may result from exertional activity or emotional stress and be relieved within minutes by rest or by nitroglycerin."

The nurse determines that teaching has been effective when a client diagnosed with chronic stable angina states:

Liver

The nurse determines that the capillary pore exchange of a client's gases, nutrients, and/or waste products would be best facilitated by which of the following?

Supervision of hourly deep breathing exercises

The nurse develops a plan to prevent atelectasis in a postsurgical client. Which intervention will be effective?

9

The nurse educates a patient newly diagnosed with diabetes regarding diet and energy requirements. The nurse knows that one gram of fat will provide _____ kcal of energy.

Left side of the heart to the right side of the heart

The nurse has just completed teaching a client about acyanotic congenital heart disease. The nurse determines that teaching was effective when the client states that blood is shunted from the:

Lispro

The nurse has just completed teaching a client newly diagnosed with type 1 diabetes about rapid-acting insulin. The nurse determines that teaching was effective when the client selects:

"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."

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 states:

Ascites

The nurse is assessing a client for early signs of constrictive pericarditis. The most likely manifestation would be:

• Constant R to R intervals • A p before every QRS wave • A rate between 60 and 100 beats per minute

The nurse is assessing a client said to be in sinus rhythm. What does the nurse expect to find when evaluating the electrocardiogram? Select all that apply.

Action of releasing hormones from hypothalamus

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Sparse axillary and pubic hair

The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. The nurse anticipates the client will manifest:

Acromegaly

The nurse is caring for a 42-year-old male client who is admitted for treatment of heart failure. He has abnormally large hands and feet and a broad face with a protruding jaw. Based on these signs and symptoms, the nurse identifies which of the following endocrine disturbances as the most likely cause for these physical changes?

increase the amount of oxygen in the dissolved state

The nurse is caring for a client admitted with carbon monoxide (CO) poisoning. The client is extremely agitated, dyspneic, and confused. The nurse understands that the treatment of choice would be a hyperbaric chamber with 100% oxygen administration which will:

Somatic neuropathy

The nurse is caring for a client diagnosed with diabetes mellitus who is reporting burning pain of his feet. The nurse would interpret this as:

Deep, throbbing, unrelenting pain

The nurse is caring for a client several fractures that have been immobilized. Which of the following assessment data would be most indicative of a potential complication?

Bronchial blood vessels.

The nurse is caring for a client suffering from multiple pulmonary embolisms who is concerned that her lungs will be permanently destroyed. The nurse reassures the client that collateral circulation is formed to protect the lung tissue until the embolisms resolve by means of:

Neck vein distention Syncope when coughing Edema of the eyelids Choking

The nurse is caring for a client who has a multinodular goiter. The nurse is aware that the client may be at risk for: Select all that apply.

Prophylactic treatment with isoniazid

The nurse is caring for a client who has a positive tuberculin test and a negative chest x-ray. The most appropriate treatment for the client would be:

Suppression of the client's hypothalamic-pituitary-target cell system

The nurse is caring for a client who has been diagnosed with severe chronic obstructive pulmonary disease and has been taking oral steroids for several years. The nurse is aware that the client is at risk for:

Give the client a concentrated carbohydrate.

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

Compartment syndrome

The nurse is caring for a client who states that he is suddenly having severe pain at a leg fracture site. The nurse notes increased swelling in the limb and difficulty palpating a pulse. The nurse suspects that the client may have which of the following?

Fat embolism syndrome (FES)

The nurse is caring for a client who sustained a femur fracture three days before. The nurse notes that the client, who was previously oriented, now doesn't know where he is. The nurse suspects which of the following conditions?

Femur

The nurse is caring for a client with a fracture in his appendicular skeleton. Which of the following bones is in this skeleton?

Positive anti-thyroid peroxidase antibodies

The nurse is caring for a client with a tentative diagnosis of Hashimoto thyroiditis. Which of these test results does the nurse anticipate will be present in autoimmune thyroiditis?

The glottis, which contains both the vocal cords and the space between them, reacts with a sphincter function quickly preventing the passage of anything other than air into the larynx.

The nurse is caring for a client with aspiration pneumonia related to paralysis of the epiglottis after suffering a stroke. Identify the second structure that protects the airway from foreign substances.

The drug level will be elevated as lack of protein allows more free drug to circulate.

The nurse is caring for a client with decreased serum protein levels secondary to liver failure. When administering medications that are highly protein bound, the nurse anticipates the resulting drug level will respond in which of these ways?

Vomiting after eating

The nurse is caring for a client with diabetes who has developed gastroparesis. Which of these symptoms does the nurse expect the client to report?

Elevated carbon dioxide levels and decreased oxygen saturation Fluid and electrolyte imbalance Hypothermia

The nurse is caring for a client with primary hypothyroidism who is being monitored for the complication of myxedema coma while thyroid level therapy is started. What does the nurse understand are the three major aspects of myxedema coma?

Client states, "I feel as though I am going to vomit." Client states, "I don't feel like eating anything." The client states that she feels weak

The nurse is caring for a client with secondary adrenal insufficiency. What subjective assessment data obtained by the nurse would correlate with this client's condition?

"OA is a disease of the weight-bearing joints."

The nurse is caring for a patient diagnosed with osteoarthritis (OA). Which of the following does the nurse teach the patient about the disease?

Type II alveolar cells

The nurse is caring for a patient with adult respiratory distress syndrome. The nurse knows that the pathophysiology of this disorder is related to what type of pulmonary alveolar cells?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

The nurse is caring for a patient with newly diagnosed systemic lupus erythematosus (SLE). Which of the following over-the-counter medications does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis?

Proteinuria Periorbital edema

The nurse is caring for a patient with systemic lupus erythematosus who has developed interstitial nephritis. Which of the following assessment findings is consistent with lupus nephritis? Select all that apply.

• Topical alpha-adrenergic decongestant • Guaifenesin • Intranasal corticosteroid

The nurse is caring for an adult client diagnosed with acute rhinosinusitis. The nurse anticipates that the client will more than likely receive prescriptions for which medications? Select all that apply.

Cardiovascular system

The nurse is caring for an adult client with growth hormone deficiency. When performing an assessment of this client, which system should the nurse be sure to assess for complications related to this disorder?

Hypoglycemia and seizures

The nurse is caring for an infant in the neonatal intensive care unit who has growth hormone deficiency. What critical issues should the nurse carefully monitor for in this infant?

A 62-year-old male postop repair of a fractured femur

The nurse is caring for four clients. Select the client at risk for the development of a pulmonary embolism.

The client who is postop total knee replacement and receiving client-controlled analgesia

The nurse is caring for the following clients. Select the client at highest risk for the development of atelectasis.

Smoking, high protein diet, alcoholism, and excessive caffeine intake.

The nurse is conducting a community education class on prevention of osteoporosis. The nurse concludes that the participants are understanding the information when the participants identify which of the following as risk factors? Select all that apply

Obesity is a strong risk factor for developing OA.

The nurse is conducting a health promotion class on osteoarthitis (OA). Which of the following statements should the nurse include?

LDL

The nurse is counseling a client regarding a high cholesterol level. The nurse teaches the client that which of the following lipoproteins is the main carrier of cholesterol?

Pursed-lip breathing

The nurse is educating a client suffering from advanced emphysema on how to improve expiratory flow rates. Which of the following breathing techniques would the nurse describe as most effective?

Manipulation of the thyroid gland Stress Physical or emotional trauma

The nurse is educating a client with hyperthyroidism who has recovered from thyrotoxicosis (thyroid storm) and is preparing for discharge. What can the nurse inform the client that this hypermetabolic state can be caused by in order to decrease exacerbation? Select all that apply.

The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.

The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?

• The incidence is greater in women with twin fetuses. • It is a dilated cardiomyopathy. • It is a disorder that can occur in the last month of pregnancy.

The nurse is evaluating a client who is in her last month of pregnancy and at risk for peripartum cardiomyopathy. Select the most appropriate information for the nurse to consider. Select all that apply.

Intervertebral disks

The nurse is explaining to a client that there are "cushions" in his back to absorb any jarring movement of the spine. Which of the following anatomical structures is the nurse referring to?

Deficiency of Surfactant

The nurse is explaining to the parents of a 23-week premature infant the reason their baby needs to be on mechanical ventilation. The education is successful when the parents state that they understand their baby was born before the type II alveolar cells could mature which has caused a

Pleural effusion.

The nurse is hearing diminished breath sounds and a "grating" sound during respirations. This is consistent with excess collection of fluid in the pleural cavity. The medical term for this is:

20 mL/hour

The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is:

Carbon dioxide, Oxygen, pH

The nurse is monitoring trends in the patient's arterial blood gases and recognizes that changes in ventilation will result from which of the following? Select all that apply.

"Do you have a history of smoking, and if so, how much?"

The nurse is performing a health history for a male client who is having a series of diagnostic test to determine the presence of squamous cell carcinoma. What question would be most beneficial for the nurse to ask that would correlate with this suspicion?

There is an increase in pharyngeal soft tissue accumulation.

The nurse is performing a health history from a client with acromegaly. The client informs the nurse that he is waking up several times a night and has been told he has sleep apnea. What does the nurse inform the client is the rationale for this syndrome?

Heart rate 110 and bounding

The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?

Productive cough Night sweats Weight loss

The nurse is performing an assessment for a client who is suspected of having chronic histoplasmosis. What clinical manifestations reported by the client are consistent with this diagnosis? Select all that apply.

Altered fat metabolism

The nurse is performing an assessment for a client with Cushing syndrome and observes a "buffalo hump" on the back, a moon face, and a protruding abdomen. What does the nurse understand contributes to the distribution of fat in these areas?

Dexamethasone

The nurse is preparing a client for a test that will measure negative feedback suppression of ACTH. Which medication will the nurse administer in conjunction for this test?

24-hour urine secretion of cortisol Dexamethasone suppression test Plasma levels of ACTH

The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process? Select all that apply.

The client just smoked a cigarette

The nurse is preparing to auscultate a client's blood pressure. Which information obtained from the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading?

At the apex of the heart

The nurse is preparing to auscultate for a mitral valve stenosis murmur Where is the best location to place the stethoscope?

Administration of corticosteroids as ordered

The nurse is providing care for a client who has a recent history of visual disturbances, facial pain and erythema in the region of the temporal artery. Which aspect of care is most appropriate?

bone density testing on a scheduled basis.

The nurse is providing care for an adult client whose current medication regimen includes calcitonin and a bisphosphonate. The nurse should recognize the likely need for:

The client should be strongly urged not to smoke.

The nurse is providing discharge instructions for a client with Graves' disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?

Unknown

The nurse is providing education for a patient diagnosed with essential hypertension. The nurse will state that the cause of this disorder is which of the following?

Heavy lifting

The nurse is providing education to a client diagnosed with varicose veins. The nurse determines that teaching has been effective when the client states that the most likely cause of the varicosities is:

The client should eat and exercise on a regular schedule.

The nurse is providing education to a client with Addison's disease who has been treated for hyponatremia and hypoglycemia related to the disease. What should the nurse inform the client should be done to ensure control of these conditions?

Antipyretic medications and rest

The nurse is providing instructions to a client for the treatment of a common cold. The most appropriate information would be:

The injections will be given only 3-4 times per year because they can increase joint destruction.

The nurse is providing patient education related to intra-articular corticosteroid injections. Which of the following should the nurse include?

Receives blood returning to the heart from the systemic circulation

The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium?

• The arterial system distributes oxygenated blood to the tissues. • The venous system collects deoxygenated blood from the tissues .

The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system? Select all that apply.

A 60-year-old female taking prednisone for asthma

The nurse is reviewing the health histories of four clients. Select the client most at risk for developing secondary osteoporosis.

Patient with LDL cholesterol 205 mg/dL, HDL 40 mg/dL, and triglyceride level 150 mg/dL

The nurse is reviewing the lipid results of four clients. Select the client at greatest risk for cardiovascular disease.

The volume of air exhaled vigorously and quickly after maximum inspiration

The nurse is reviewing the near-drowning client's pulmonary function tests and is concerned that the forced vital capacity (FVC) is decreased. Which of the following accurately describes FVC?

Asymetrical gluteal and thigh folds

The nurse is screening a newborn for developmental dysplasia of the hip. Which of the following assessment findings supports this diagnosis?

Going for a brisk walk with a friend and talking to him about continuing to exercise regularly

The nurse is teaching a class on reduction of cardiovascular disease. Which of the following demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?

Hydrocortisone

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Select the pharmacologic agent that would be prescribed.

Preload represents the volume work of the heart.

The nurse is teaching a client diagnosed with heart failure about preload. Which of the following would be the most appropriate information to provide?

Increasing dietary consumption of vitamin D

The nurse is teaching a client diagnosed with osteomalacia about treatments to improve the condition. The best information for the nurse to provide would be:

The thyroid gland is responsible for increasing the metabolic rate.

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which of these does the nurse explain to the client is the role of the thyroid gland?

Loop diuretics Oral contraceptives Total parenteral nutrition Antipsychotics

The nurse is teaching a client with diabetes about medications that will increase the blood glucose level. The most important information for the nurse to provide would be: Select all that apply.

The brain relies on blood glucose as its main energy source.

The nurse is teaching a client with diabetes and the family about the signs and symptoms of hypoglycemia. The client asks what produces signs and symptoms of headache, disturbed behavior, coma, and seizures. The best response would be:

It is the most common cardiovascular disorder. The incidence increases with age. The systolic pressure is greater than or equal to 140 mm Hg.

The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state: Select all that apply.

Blood pressure in arms 20 mm Hg higher than in the legs

The nurse knows that coarctation of the aorta can be a secondary cause of hypertension. Which of the following blood pressure findings can be characteristic of this condition?

• Preload • Afterload • Myocardial contractility

The nurse knows that factors that affect stroke volume include which of the following? Select all that apply

Decreased cardiac output

The nurse knows that in heart failure, the increase in renal secretion of renin is caused by which of the following?

Thrombosis Damage to elastic elements of blood vessel walls Atherosclerosis Risk for aneurysm

The nurse knows that systolic hypertension carries risk for which of the following cardiovascular events? Select all that apply.

140

The nurse knows that systolic hypertension is characterized by systolic pressure of ____mm Hg or higher.

reduced ventricular efficiency

The nurse knows that the basic pathophysiology of heart failure is best described as which of the following?

140/90

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below which of the following?

The kidneys

The nurse knows that the primary long term regulation of blood pressure is exerted by which of the following?

Adrenergic (sympathetic) stimulation Decreased blood sodium Fall in blood pressure Decreased blood volume

The nurse knows that the renin-angiotensin-aldosterone system (RAAS) is an important mechanism in blood pressure control. Which of the following events will activate this system? Select all that apply.

Amphetamines Decongestants Oral contraceptives Cocaine

The nurse knows that which of the following drugs can cause secondary hypertension? Select all that apply.

82 year old female with macular degeneration and uses a walker to go to the bathroom.

The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture?

A 25-year-old African-American man

The nurse knows that which of the following persons is at greatest risk for malignant hypertension?

• African Americans often experience greater renal damage from hypertension. • Hypertension is more severe among African Americans compared to other ethnic groups. • Hypertension in African Americans is often treated less aggressively.

The nurse knows that which of the following statements regarding blood pressure in African-American persons are correct? Select all that apply.

In compensated failure, an increase in preload causes an increase in ventricular contractility.

The nurse knows that which of the following statements regarding heart failure is correct?

-Sodium may increase the responsiveness of the cardiovascular system to adrenergic (sympathetic) stimulation. -Reduction in sodium intake often produces a reduction in blood pressure. -In the INTERSALT study, urinary sodium excretion and systolic blood pressure are closely correlated.

The nurse knows that which of the following statements regarding sodium and hypertension are correct? Select all that apply.

-Intravascular fluid retention -Elevated renin levels -Systemic vasoconstriction

The nurse knows that which of the following would put a patient at risk of developing hypertension, if everything else in the body remained unchanged? Select all that apply.

• Improve cardiac output • Regulate blood volume • Increase coronary perfusion • Correct pulmonary edema

The nurse must achieve which of the following objectives for a patient in cardiogenic shock? Select all that apply.

Pulse Oximetry

The nurse needs to assess the oxygen status of a client who is suddenly experiencing shortness of breath. The most appropriate noninvasive measurement techniques would be:

A reading that is too high

The nurse observes a client care technician obtain a blood pressure on an obese client using a BP cuff that is too small. The nurse is aware that this will result in:

PTH is a regulator of calcium and phosphate.

The nurse recognizes that parathyroid Hormone (PTH) has what relationship to bone formation?

Arterioles

The nurse recognizes that there are many factors that influence blood flow within the systemic circulation. In the circulatory system, which of the following are called resistance vessels?

Random blood glucose 195 mg/dl

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary healthcare provider for further evaluation?

• Nitroprusside (Nitropress) • Nitroglycerin • Dobutamine (Dobutrex) • Milrinone (Primacor)

The nurse should suggest which of the following medications for a patient in cardiogenic shock? Select all that apply.

"These tests results will be used to assess any risk I could have due to the anesthesia."

The nurse teaches a patient scheduled for surgery about pulmonary function testing (PFT). Which statement, if made by the patient, indicates teaching was effective?

Exertional dyspnea Orthopnea Cheyne-Stokes respiration Chronic dry cough

The nurse will monitor which of the following respiratory manifestations of heart failure? Select all that apply.

Dyspnea and crackles in bilateral lung bases

The nurse working in the ICU knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which of the following clinical manifestations?

morphine

The nurse working in the emergency room triages a client who comes in with complaints of chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myodardial infarction. The client is given a nitrate, which does nothing for his pain. Which of the following medications should the nurse suspect the doctor will order next for the pain?

Pericardiocentesis

The nurse working on the cardiac floor identifies which of the following to be the initial treatment of choice for small pericardial effusions and mild cardiac tamponade?

Measure his blood pressure and show him how much higher it is when he is smoking.

The nurse's brother is not convinced that he should quit smoking. He asks his sister (the nurse) to demonstrate for him the more immediate effects of smoking on his health. Which of the following could be used to help convince the brother to stop smoking?

Genetic

The nursing instructor is teaching about cardiomyopathies in class. Which type does she tell the students is the most common cause occurring in young athletes?

Constrictive pericarditis

The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which of the following disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?

The disabling effects that result from involvement of heart valves

The nursing instructor is teaching the students about rheumatic fever. She tells the students that it is an important cause of heart disease and is very serious mainly for which reason?

Percutaneous coronary intervention (PCI) Coronary artery bypass grafting (CABG) Fibrinolytic therapy

The nursing instructor when teaching about disorders of cardiac function informs the students that all people presenting with ST-segment elevation myocardial infarction (STEMI) should be assessed for reperfusion therapy as quickly as possible. Reperfusion therapy includes which of the following? Select all that apply.

Atherosclerosis

The nursing instructor, when teaching the students about coronary artery disease (CAD), identifies which of the following as the the main cause of CAD?

Heart rate

The nursing instructor, while teaching the physiology of the heart, informs the students that there are 3 major determinants of myocardial oxygen demand, which include the heart rate, left ventricular contractility, and systolic pressure. Which does she tell them is the most important factor in myocardial oxygen demand?

• Cigarette smoking • Elevated LDL • Diabetes • Abdominal obesity

The nursing student correctly identifies which of the following as major risk factors for coronary artery disease? Select all that apply.

Viral infections

The nursing student has learned in class that pericarditis is an inflammatory process of the pericardium. Which of the following is known to be the main cause of pericarditis?

Impaired coronary blood flow

The nursing student has learned in his class that coronary artery disease (CAD) is heart disease caused by which of the following?

• Genetic • Mixed • Acquired

The nursing student when studying cardiomyopathies learns that the primary ones are classified into which of the following groups? Select all that apply.

• Endocrine conditions • Malabsorption disorders • Malignancies • Alcoholism • certain medications

The nursing student who is studying about osteoporosis correctly identifies which of the following to be conditions associated with secondary osteoporosis? Check all that apply.

Chronic ischemic heart disease Acute coronary syndrome

The nursing student, when studying about coronary artery disease, learns that it is commonly divided into different types of disorders which include which of the following? Select all that apply.

You have a 25% chance that your next child will have CF.

The parents of a child diagnosed with cystic fibrosis (CF) ask about the risk of any future children having the condition. How should the nurse respond?

Chromosomal abnormalities GH deficiency Protein-calorie malnutrition Malabsorption syndromes

The parents of a child who is diagnosed with short stature ask what may have caused the abnormality. The best response are: Select all that apply.

"This harness allows your baby some mobility as it slowly brings the leg back into abduction."

The parents of a newborn who has been diagnosed with developmental dysplasia of the hip ask the nurse about the reason this harness has to be on their child. The nurse responds:

Cold, pale toes on the side with the cast. Patient complaining of tingling and numbness in the casted leg.

The parents of an active 9-year old is leaving the emergency department (ED) following cast placement for their sons lower extremity as a result of a fall in soccer. The nurse should emphasize that assessment of the cast is important and that they should bring their son back to the ED if they note which of the following signs/symptoms? Select all that apply.

Asthma

The parents of an infant bring the child to the emergency room three hours after they put the child to bed in apparent good health. The child is restless, the pulse is 140 beats/ minute, and lung sounds are diminished in all lung fields with intercostal retractions. What is the most likely cause of these symptoms?

Respiratory dysfunction

The pathogenesis of multiorgan dysfunction syndrome (MODS) is not clearly understood at this time. Supportive management is currently the focus of treatment in this disorder. What is not a major risk factor in MODS?

compensatory mechanisms

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output.

Long-term compensatory regulation of blood flow

The physician states that a client has adequate collateral circulation. The nurse interprets this as:

Stimulation tests

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.

64 mm Hg

The physician's order states, "Calculate the pulse pressure of the client's B/P." The blood pressure reading is as follows: systolic pressure of 146 mm Hg and a diastolic pressure of 82 mm Hg. The pulse pressure would be:

Kussmaul sign

The scar tissue that occurs between the layers of the pericardium becomes rigid and constrictive from scar tissue in constrictive pericarditis. What is a physiologic sign of constrictive pericarditis?

Exchange gases, nutrients and wastes

The school nurse is doing a health class on the functional organization of the circulatory system. What is the function of the capillaries in the circulatory system?

Follicle-stimulating hormone Antidiuretic hormone Dopamine

The vesicle-mediated pathway has a role in synthesis and release of which of the following hormones? Select all that apply.

a c v

There are three main atrial pressure waves that occur during the cardiac cycle. What are the three main atrial pressure waves? Select all that apply.

a

There are three main atrial pressure waves that occur during the cardiac cycle. Which wave occurs during the last part of diastole and is caused by atrial contraction?

The woman complains of aching and morning stiffness in her neck, shoulder and pelvis.

Though the client's primary care provider has downplayed the symptoms, a geriatrician suspects that an 82 year-old female has polymyalgia rheumatica. Which characteristic symptomatology would most likely have led the specialist to suspect this health problem?

Pulmonary embolism

Three days following surgical repair of a hip fracture a client becomes anxious and complains of sudden shortness of breath. What disorder is the client most likely experiencing?

• Abdominal • Thoracic

Valves in the veins prevent retrograde flow. In which veins are there no valves? Select all that apply.

Stasis of blood, hypercoagulability, vessel wall injury

Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include which of the following?

liver kidneys

Vitamin D has little or no activity until it has been converted to a physiologically active form. Which of the following organs are involved in this activation process? Select all that apply.

Fluid retention Fatigue

What are the signs and symptoms of heart failure? (Select all that apply.)

• Amount of fluid • Rapidity with which it accumulates • The elasticity of the pericardium

When a client suffers from a pericardial effusion which of the following are considered to be factors that will influence what effects it will have on cardiac function? Select all that apply.

Avoiding ultraviolet light (UV)

When a nurse is caring for a patient newly diagnosed with systemic lupus erythematosus (SLE), which of these behaviors will best help prevent exacerbations of the disease?

Autoimmune process

When a nurse is caring for a patient who has systemic lupus erythematosis (SLE), which of the following causes the disease?

Stretch on baroreceptors in the heart and blood vessels

When a person rises from a lying to a standing position, heart rate increases. What description would the nurse use to explain the physiological basis for this response?

Creatine kinase Troponin T Troponin 1

When a physician suspects a patient has suffered an acute myocardial infarction, which serum biomarkers should he order? Select all that apply.

• "Corticosteroids do not prevent joint destruction." • "Pain is relieved with use of corticosteroid medications." • "These drugs are for short-term use."

When administering a corticosteroid to a patient with rheumatoid arthritis, a nurse includes which of the following in educating the patient about the medication? Select all that apply.

Conversion from aerobic to anaerobic metabolism

When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI?

• Headaches • Intermittent tinnitus • Vertigo • Hearing loss

When assessing a patient diagnosed with Paget disease focused in the skull, the nurse should anticipate which of the following findings?

• Redness and swelling of the affected joint • Pain and swelling in one joint • Intake of alcohol

When assessing a patient with gout, for which of these signs and symptoms does the nurse assess? Select all that apply.

Dual-energy x-ray absorptiometry (DEXA)

When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which of theses diagnostic tests?

Erythropoietin

When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs?

Flat with one pillow

When caring for a patient with ankylosing spondylitis, in which position does the nurse place the patient for sleep?

Gentle exercise

When caring for a patient with ankylosing spondylitis, the nurse tells the patient that stiffness may be relieved by which of the following interventions?

Brain

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which of these organs does the nurse recognize is reliant on glucose as the major energy source?

Elevate the head of the bed

When developing the plan of care for a child with respiratory distress, what nursing intervention can the nurse provide that will facilitate respiratory movements and avoid airway compression?

Has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours.

When educating a patient about glargine (Lantus), the nurse should explain that this medication:

"To destroy this bacterium, you must strictly adhere to a long-term drug regimen."

When educating a student who lives in a crowded apartment and diagnosed with tuberculosis, the college school nurse will emphasize:

200 amino acids.

When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. They talk about small hormones and hormones as large and complex as growth hormone (GH) which has approximately how many amino acids involved?

Development of collateral circulation that build channels between some of the smaller arteries usually when the flow is decreased gradually.

When explaining to a patient why they only had minimal muscle damage following 99% occlusion of the left anterior descending artery, the nurse will explain this is primarily due to:

Autocrine and paracrine

When hormones act locally rather than being secreted into the bloodstream, their actions are termed what?

Elderly individuals Older women Obese people

When teaching a community education class on osteoarthritis (OA), the nurse should include which of the following in discussing which individuals are at risk for this problem? Select all that apply.

Risk for falls

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which of the following important differences when caring for the older adult?

Ultraviolet light (UV)

When teaching a patient recently diagnosed with systemic lupus erythematosus (SLE), which of the following does the nurse teach the client to avoid to prevent exacerbations?

Autologous antibodies

When teaching a patient with rheumatoid arthritis (RA), which of the following factors does the nurse explain is an underlying cause of this disease?

Hashimoto thyroiditis

When the assessment of thyroid autoantibodies is performed, what is the suspected diagnosis?

Increase in appetite

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptoms does the client report that the nurse would find associated with this disorder?

Left ventricle

When the semilunar valves open it signals the onset of the ejection period. The aortic pressure reflects changes in the ejection of blood from which part of the heart?

Destructive lung disease or heart failure

When there is a mismatching of ventilation and perfusion within the lung itself, insufficient ventilation occurs. There is a lack of enough oxygen to adequately oxygenate the blood flowing through the alveolar capillaries, creating a physiologic shunt. What causes a physiologic right-to-left shunting of blood in the respiratory system?

Activated cells that release free radical oxidize LDL which is harmful to the lining of your blood vessels.

When trying to educate a patient about the release of free radicals and the role they play in formation of atherosclerosis, which of the following statements is most accurate?

Tend to grow very slowly without destroying the supporting tissue.

When trying to explain to a patient diagnosed with a benign bone tumor, the nurse should emphasize the fact that benign tumors primarily:

Promotes actions of parathyroid hormone on resorption of calcium and phosphate from bone

When vitamin D is metabolized it breaks down into various metabolites. 1,25(OH)2D3 is the most potent of the vitamin D metabolites. What is the function of this metabolite of vitamin D?

Aspiration, risk for related to swallowing impairments.

When working with a patient with diffuse scleroderma who is exhibiting a 'stone face' expression, the nurse should consider which of the following to be a priority nursing diagnosis for this patient?

Increased arterial blood bicarbonate

Which alteration in acid-base balance could be expected as a compensatory response for a client with severe chronic respiratory impairment?

A client with COPD and a 35 pack-year smoking history.

Which client most likely faces the highest risk of developing secondary pulmonary hypertension?

The client with an avulsion

Which client should be seen first?

Adult with a respiratory virus and reflux

Which client with a diagnosis of asthma is at greatest risk for developing an asthma attack?

• Bricklayer • Coal miner • Farmer • Flour miller

Which clients are at greatest risk of developing an occupational lung disease? Select all that apply.

Cardiac structures increase in size

Which complication of acromegaly can be life threatening?

Chronic bronchitis from smoking

Which condition places the client at risk for hypercapnia if given high-flow oxygen as treatment for a ventilation perfusion mismatch?

Shortness of breath, non-productive cough, and chest pain

Which description of symptoms would the nurse expect to obtain from a client with exacerbation of sarcoidosis?

Suddenly onset

Which description of the onset of symptoms is most characteristic of epiglottitis?

Epiglottitis

Which diagnosis places a child at the greatest risk for airway obstruction?

Juvenile dermatomyositis

Which disease presents with an inflammatory myopathy primarily involving skin and muscle with a characteristic rash?

• torn meniscus in left knee at age 19 • obesity following pregnancy at age 24 • hip dislocation at age 35

Which events in a client's history increase risk of developing osteoarthritis? Select all that apply.

History of tobacco use History of asthma

Which factors increase the risk that a client will develop chronic obstructive pulmonary disease (COPD)? Select all that apply.

Preventing falls

Which goal is a priority for a nurse caring for a patient diagnosed with orthostatic hypotension?

Follicle-stimulating hormone (FSH)

Which hormone is secreted based on a cyclic rather than a diurnal manner?

Estrogen

Which hormone triggers the positive feedback mechanism that controls the secretion of luteinizing hormone (LH) levels?

A 51-year-old male who has been diagnosed with glomerulonephritis

Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential?

Hemoglobin A1c 9.1% 2 hour oral GTT 245 mg/dl

Which laboratory values for a newly admitted client indicate a diagnosis of diabetes mellitus? Select all that apply.

Cyanosis

Which manifestation of left-sided heart failure can be diagnosed by examination of the lips and mucous membranes?

• Peripheral edema • Increased mucus secretion • Cyanosis

Which manifestations are most common in clients with COPD that is predominantly chronic bronchitis? Select all that apply.

Aspirin

Which medication order should the nurse question for a client with hyperthyroidism who is experiencing signs of impending thyroid storm?

Ventricular tachycardia with left bundle branch block pattern. T-wave inversion in the right precordial leads

Which of the following ECG patterns would the nurse observe in a patient admitted for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D)? Select all that apply.

Falling on a ski hill with bindings that do not release

Which of the following activities is most likely to create a spiral fracture?

Epinephrine Norepinephrine

Which of the following are examples of amines? Select all that apply.

• Rheumatoid arthritis • Postraumatic disorders • Metabolic disorders • Collagen disorders

Which of the following are potential causes of osteoarthritis? (Select all that apply.)

Ventricular fibrillation

Which of the following arrhythmias is considered to be the most fatal and requires immediate treatment?

Positive anti-DNA antibody test.

Which of the following assessment findings best confirms the diagnosis of systemic lupus erythematosis (SLE)?

Rotational deformity of the proximal tibia

Which of the following assessment findings leads the nurse to believe a child has Blount's disease?

The man's blood pressure is 178/102, and he has abnormal liver function tests.

Which of the following assessment findings of a newly admitted 30-year-old male client would be most likely to cause his physician to suspect polyarteritis nodosa?

Joint stiffness Finger and hand pain Wrist pain Limited joint mobility

Which of the following assessment findings will help the nurse to confirm the diagnosis of rheumatoid arthritis? Select all that apply.

The disorder occurs when the target organ is normal, but stimulating hormones alter its function.

Which of the following best describes a secondary disorder of endocrine function?

Much longer to reduce the concentration of the hormone by one half.

Which of the following best describes the half-life of a highly protein bound drug such as thyroxine (99% protein bound)? The half-life would be:

Laminar

Which of the following blood flow patterns reduces friction, allowing the blood layers to slide smoothly over one another?

Tunica media

Which of the following blood vessel layers is composed primarily of smooth muscle cells?

• Epiphyseal separation • Blood vessel rupture • Nutritional deficiencies • Thyroid hormone deficiency

Which of the following can influence the growth of cells in the epiphyseal growth plate? Select all that apply.

Immobilized following orthopedic surgery A smoker and who takes oral contraceptives

Which of the following clients are displaying known risk factors for the development of pulmonary emboli? A client who is: (Select all that apply)

Circulatory shock Heart failure

Which of the following conditions reflect failure of the circulatory system? Select all that apply.

periosteum

Which of the following covers bones and has an inner layer that contains osteoprogenitor cells?

Histamine

Which of the following enzymes has a powerful vasodilator effect on arterioles and increases capillary permeability?

HDL

Which of the following facilitates the clearance of cholesterol from the periphery (including atheromatous plaques) and transports it to the liver where it may be excreted?

preload

Which of the following factors represents the amount of blood that the heart must pump with each beat and is determined by the stretch of the cardiac muscle fibers and the actions of the heart prior to cardiac contraction?

Myocardial hypertrophy

Which of the following health problems can contribute to diastolic dysfunction heart failure?

Aldosterone and testosterone

Which of the following hormones are derivatives of cholesterol?

parathyroid hormone

Which of the following hormones increases the number and resorptive function of "bone-chewing" cells?

Parathyroid hormone (PTH) Prolactin

Which of the following hormones or ion concentrations influence the regulation of vitamin D activity? Select all that apply.

Norepinephrine

Which of the following hormones will elicit a more rapid response than the others?

A 40 year-old man who has a contusion to the left temporal bone of his skull following a motor vehicle accident.

Which of the following individuals demonstrates a health problem with his or her axial skeleton?

A 79 year-old man who is immunocompromised following a bone marrow transplant.

Which of the following individuals is likely to have the highest risk of developing tuberculosis osteomyelitis?

A 78 year-old man who has fallen and is suspected of having a "slipped disc" in his back.

Which of the following individuals who have recently presented to a hospital emergency department is displaying an injury that involves his or her fibrocartilage?

• "Limit exposure to alcohol." • "Do not take any medication without first talking to your healthcare provider."

Which of the following information would the nurse include when teaching potential parents about prevention of congenital deformities? Select all that apply.

Estradiol and follicle-stimulating hormone (FSH)

Which of the following is an example of a positive feedback system?

Venous thrombosis

Which of the following is associated with stasis of blood, increased blood coagulability and vessel wall injury?

sinoatrial node

Which of the following is called the pacemaker of the heart?

SA node - AV node - bundle of His - bundle branches - Purkinje fibers

Which of the following is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction?

Abnormalities present at birth

Which of the following is the definition of a congenital deformity?

It documents only current cardiac function.

Which of the following is the greatest diagnostic limitation of an electrocardiogram (ECG)?

Small intestine

Which of the following is the site of chylomicron synthesis?

It is a low-pressure system that allows for improved gas exchange.

Which of the following is true regarding pulmonary circulation?

Loss of motion in the spinal column and eventual kyphosis.

Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis?

10-year-old boy with Legg-Calvè-Perthes disease 57-year-old man with long history of alcohol abuse 79-year-old woman taking alendronate (Fosamax)

Which of the following patients are at increased risk for developing avascular necrosis? Select all that apply.

A 66-year-old post-surgery patient on bed rest

Which of the following patients is at greatest risk for orthostatic hypotension?

Teenager with untreated strep throat

Which of the following patients is at the greatest risk of developing rheumatic heart disease?

Young adult with compound fracture of the humerus

Which of the following patients is most likely to experience complications in bone healing?

A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F

Which of the following patients who presented to a walk-in medical clinic is most likely to be diagnosed with a rhinosinusitis rather than a common cold?

One with an ejection fraction of 25% and atrial fibrillation

Which of the following patients with cardiomyopathy does the nurse identify as having the greatest risk for a complication?

• 22 year old patient recovering from an auto accident where they incurred a fracture of their femur. • 55 year old prostate cancer patient undergoing radiation therapy for bone metastasis.

Which of the following patients would the nurse expect to find woven bone scaffolding in place to facilitate healing?

A single-capillary network exists and the lungs are capable of respiration.

Which of the following phenomena is most likely occurring during a child's alveolar stage of lung development?

Increased aortic pressure

Which of the following phenomena would be most likely to accompany increased myocardial oxygen demand (MVO2)?

An 8 year-old boy who fell out of a tree and on to his arm.

Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture?

An 81 year-old male who has a productive cough and recurrent respiratory infections.

Which of the following residents of a long-term care facility is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?

The health care provider is explaining the course of treatment to the parents of a 2-day-old infant born with clubfeet. The most appropriate information to provide would be:

Which of the following should the nurse teach a patient about syndactyly?

Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen.

Which of the following situations is most likely to result in an increased binding affinity of hemoglobin for oxygen?

A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting.

Which of the following situations would be most deserving of a pediatrician's attention?

• It is a leading cause of death in the United States. • Symptoms appear when the condition is in its advanced stage. • A family history of the disorder is generally present. • Age is considered a risk factor.

Which of the following statements are true concerning atherosclerosis? Select all that apply.

It innervates the heart. Its effects are facilitated by the vagus nerve. Bradycardia is a result of this system.

Which of the following statements are true regarding the parasympathetic nervous system and its effect on the cardiac system? Select all that apply.

The pituitary gland communicates with the adrenal cortex through the release of ACTH.

Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system?

Chemical mediators are released from presensitized mast cells.

Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma?

The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.

Which of the following statements best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function?

The adrenal cortical hormones are primarily steroids and sex hormones.

Which of the following statements best captures the role of the adrenal cortex in maintaining homeostasis?

Negative intrapleural pressure holds the lungs against the chest wall.

Which of the following statements best conveys an aspect of the respiratory pressures that govern ventilation?

With constant pressure, a small increase in vessel radius results in an exponential increase in blood flow.

Which of the following statements most accurately captures a principle of blood flow?

Elevated creatine kinase and troponin, both of which normally exist intracellularly rather than in circulation

Which of the following statements provides blood work results and rationale that would be most closely associated with acute coronary syndrome?

• Myocardial hypertrophy causes diastolic dysfunction. • Ischemic heart disease causes systolic dysfunction. • Valvular insufficiency causes systolic dysfunction.

Which of the following statements regarding causes of systolic and diastolic dysfunction are correct? Select all that apply.

Synovial fluid

Which of the following substances helps maintain a smooth surface in joint cartilage?

"The plaque that builds up in your heart vessels obstructs the normal flow of blood and can even break loose and lodge itself in a vessel."

Which of the following teaching points would be most appropriate for a group of older adults who are concerned about their cardiac health?

Abdominal aortic

Which of the following types of aortic aneurysms is the most common?

Dual energy x-ray absorptiometry (DEXA) scan

Which of the following types of imaging is preferred to evaluate the bone density of a patient with hyperparathyroidism?

Tunica media

Which of the following vessel layers is made primarily of muscle?

It forms on the wall of a vessel.

Which one of the following is characteristic of a thrombus?

Small intestine and liver

Which one of the following organs are the two primary sites of lipoprotein synthesis?

extreme pain swelling

Which patient reports would support a diagnosis of a torn ligament? Select all that apply.

66-year-old Caucasian female with history of alcoholism

Which person is most at risk for hip fractures?

• It is connected to bone by hyaline cartilage. • It has little or no range of motion. • It is found primarily in the lower extremities.

Which statement are true regarding synarthroses? Select all that apply.

A slow depolarization occurs when Na+ is transported out of the cell and K+ moves back in, resulting in resting membrane potential.

Which statement describes phase 4 of the action potential of cells in the sinoatrial (SA) node?

It joins the ribs to the sternum.

Which statement is correct about hyaline cartilage?

Generalized stunted growth can occur.

Which statement is true regarding the development of juvenile idiopathic arthritis?

• Osteoclasts gradually remove dead bone. • Mineralized bone is present along the lines of the injury.

Which statements are true regarding bone remodeling? Select all that apply.

It is the primary type of bone marrow found in infants. It is primarily present in the vertebrae, ribs, and sternum. It is the site of blood cell formation.

Which statements are true regarding red bone marrow? Select all that apply.

vitamin d phosphate

Which substances are not involved in preventing the release of calcium from the bone? Select all that apply.

Vitamin D

Which vitamin has little or no activity until it has been converted to physiologically active compounds?

Spirometer

Which would be the most appropriate measurement tool to determine lung volume and lung capacity of a patient?

• Client with allergy to eggs • Client with Guillain-Barre syndrome

While administering influenza vaccines for the general public, the nurse will advise which clients to avoid taking the flu shot? Select all that apply.

Ortolani maneuver

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:

"It looks like a mild to moderate sprain and you'll need to keep it immobilized for a few weeks."

While being tackled, a 20 year-old football player put out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Paracrine

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

"The earliest symptoms relate to a chronic cough and shortness of breath."

While educating a smoking cessation class, a client asks the nurse, "If I can still get lung cancer, what should I be looking for?" Which response by the nurse is best?

"This bone is hollowed out and the inside of the shaft produces marrow where red blood cells are formed."

While explaining to the parents of a 5-year old why the child's fractured femur has so much swelling and bruising, the nurse will include which of the following statements?

Decreased heart rate as a result of parasympathetic innervation of the heart

While intubated for surgery, a patient has inadvertently had his vagus nerve stimulated. What effect would the surgical team expect to observe?

Observation and no active treatment.

While measuring the height of a 12 year-old girl during an office visit, the primary care physician noted a deviation of the girl's spine. This was subsequently quantified as being a right curve scoliosis of approximately 10 degrees deviation. Which of the following treatment options is most clearly indicated?

Reducing the reabsorption of phosphate.

While reviewing the role of the parathyroid hormone in the balance of calcium and phosphate levels, the nursing faculty will emphasize that the kidney responds to parathyroid stimulation by:

Hypoventilation may exist, resulting in increased PCO2 and hypoxemia that may require mechanical ventilation.

While rock climbing, a 22 year-old male has endured a severe head injury. Which of the following statements best captures expected clinical manifestations and treatments for his immediate condition?

It's an inflammatory response

While studying the heart the nursing instructor teaches about pericarditis. Which of the following does she tell the student best defines this disease?

The aortic pressure Autoregulatory mechanisms Compression of the intramyocardial vessels

While studying the physiology of the heart, the nursing students have learned that which of the following influence the blood flow in the coronary vessels that supply the myocardium? Select all that apply.

Intubation and mechanical ventilation

While working in the newborn ICU, the nurses receive a call that an infant, gestational age of 23, is being air-flighted to their level three trauma nursery. The priority intervention for this infant would be:

Aseptic necrosis of a bone segment caused by interruption of the blood supply

The health care provider is evaluating a client who is at risk for the development of osteonecrosis. The client is at risk for:

Heart rate

What is the most important factor in myocardial oxygen demand?

Elevated right heart pressure

What is the primary physiologic result of obstructive shock?

Shock absorption

What is the purpose of the meniscus?

Benign

What is the term use to describe a tumor that while growing slowly does not destroy the surrounding tissues?

Keep the ankle elevated for the first 24 hours

What would be the best treatment option for a soft tissue contusion on the right ankle?

"The bone is partially out of the joint when it is subluxated."

What would the nurse include in the teaching plan of a client who asks "What is a subluxation?"

The woman experiences intermittent, painful locking of her joint.

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 conclusion?

Cancellous

A group of student nurses are reviewing the bones in the human body. What is the name for spongy bone?

Prompt diagnosis and treatment of streptococcal infections

A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be:

β-adrenergic agonist

A 10-year-old male is experiencing an acute exacerbation of his asthma. The most appropriate treatment for this client would be:

Vital capacity will equal the patient's combined inspiratory reserve, expiratory reserve, and tidal volume.

A 60-year-old male hospital patient with a diagnosis of chronic obstructive pulmonary disease (COPD) is undergoing lung function tests to gauge the progression of his disease. Which of the following aspects of the lung volumes will the respiratory therapist be most justified in using to guide interpretation of the test results?

"Even though it's hard to do, you need to continue so you don't go blind or need a kidney transplant down the road."

A 15 year-old boy with type 1 diabetes is exasperated by his regimen of blood sugar monitoring and insulin administration, and has told his mother that he wants to scale both back. Which of the following responses by his mother is most accurate?

Immune response

A 16 year-old boy has been diagnosed with ankylosing spondylitis. Which of the following etiologies is responsible for his health problem?

bursae

A 16-year-old hockey player is driven into the boards by an opposing player. The impact damages the client's knee, and fluid-filled sacs in the knee have been damaged. Where is this client's injury?

Closed comminuted fracture

A 16-year-old male football player suffered a fracture of his radius and ulna. Assessment of the fracture includes the following data: the fracture does not protrude through the skin, and both bones broke completely through into two pieces. Select the best description of the injury.

Parainfluenza virus, treated with a mist tent and oxygen therapy.

A 3-year-old boy has developed croup following a winter cold. His care provider would recognize that which of the following microorganisms and treatments are most likely to be related and effective, respectively?

Providing cool, moist air for the child to breathe

A 3-year-old child has been admitted to the pediatric unit for the treatment of croup. The nurse should include which action in the child's plan of care?

Paget Disease

A 42-year-old client is admitted to the hospital with severe back pain, intermittent tinnitus, constant headache, and vertigo. He states that the back pain has been a problem for a number of years, but the other symptoms are quite new. Upon further examination, it is noted that he has unexplained hearing loss, and his femur and tibia have begun to bow. What condition does this client most likely have?

Antiplatelet aggregators

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 of the following pharmacological treatment options is her care provider most likely to rule out first?

"I'm resolving to eat organic foods from now on and to drink a lot more water."

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the patient's following statements indicates a need for further health-promotion teaching? Select all that apply

Troponin assays

A client comes to the emergency room with all the symptoms of a myodardial infarction. Which lab value does the nurse suspect the physician will order which is known to have a high specificity for myocardial tissue and has become the primary biomarker test for diagnosing an MI?

Hypertrophy of the myocardium Sympathetic nervous stimulation Increased renin--angiotensin--aldosterone system (RAAS) function Increased preload

A 60-year-old woman has just been diagnosed with heart failure and her primary care provider is describing the concept of adaptation. Which compensatory mechanisms may have masked the client's heart failure? Select all that apply.

• Inflammatory response • Interaction between rheumatoid factor (RF) and IgG • T-cell mediated immune response • Pannus invasion • Destruction of articular cartilage

A 68 year-old woman has had her mobility and quality of life severely affected by rheumatoid arthritis (RA). Place the following pathophysiological events involved in her health problem in the correct order that they most likely occurred. Use all the options.

"Vitamin D is important in order for your body to absorb the calcium that you consume in your diet."

A 70 year-old woman's family physician has recommended a vitamin D supplement. The woman states that she tries hard to take as few pills as possible and questions her physician on the rationale and necessity of the hormone. How can the physician most accurately reply to the client's concerns?

Decreased estrogen levels

A 70-year-old female client comes to the clinic with back pain. An x-ray reveals vertebral fractures and she is diagnosed with osteoporosis. Which of the following factors most likely contributed to her condition?

Atherosclerotic occlusive disease necessitating thrombolytic therapy

A 70-year-old male client presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. The nurse knows that the client is likely experiencing which of the following medical diagnosis/possible treatment plan listed below?

Dry, warm skin Bradycardia

A 70-year-old woman presents at a hospital after fainting at the funeral of a loved one. She is diagnosed as being in shock. Which signs and symptoms is she most likely to display? Select all that apply.

"The root problem is that the top chambers of your heart and the bottom chambers of your heart aren't coordinating to pump blood efficiently."

A 71-year-old man is slated for pacemaker insertion for treatment of a third-degree AV block. The man's nurse has been educating him around his diagnosis and treatment and answering the numerous questions he has about his health problem. Which of the following teaching points should the nurse include in this patient teaching?

The presence of a deviated trachea

A 76-year-old male client is admitted to the emergency department after a fall. His assessment reveals a bruised left hip, shortness of breath, and shallow respirations with a respiratory rate of 30. What additional physical assessment finding would lead to a possible diagnosis of tension pneumothorax?

Cerebral palsy

A child has been diagnosed with myopathic neuromuscular scoliosis. What other concurrent diagnosis may the child have?

"The prognosis of the child depends on an improvement in behavior and catch-up growth."

A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse?

Increased turbulence of air moving through the obstructed airways

A child has developed respiratory stridor and is displaying a crowing sound. The parents ask the nurse what is causing this sound. The best response would be:

The hypothalamus secretes GHRH.

A child is born with dwarfism to normal-sized parents. The physician is explaining how growth hormone (GH) plays a central role in the increase in stature that characterizes childhood and adolescence. What is the first step in the growth hormone chain of events?

Pain in front of the knee

A child with Osgood-Schlatter disease most often presents with which of the following assessment findings?

Blood culture

A client is admitted to the intensive care unit suspected of having infective endocarditis. Which of the following tests is the most definitive diagnostic procedure that is done and used to guide treatment for this type of client?

• "Does bending forward exaggerate the headache?" • "When you sneeze, does it make the headache worse?" • "Does your neck feel stiff along with the headache?"

A client arrives at the clinic stating he is having "terrible headaches." What questions would be appropriate for the nurse to ask that may indicate the headaches are related to sinusitis? Select all that apply.

T4 and TSH

A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?

The use of antibiotics

A client arrives in the clinic with a cough, fever, and chest discomfort and is diagnosed with community-acquired pneumonia. What education does the nurse anticipate providing prior to discharging the client from the clinic?

Calcitonin

A client asks the nurse if drinking more milk will prevent the release of calcium from her bones. The best response by the nurse would be that the release of calcium from the bone into the extracellular fluid is regulated by:

Influenza transmission occurs by inhalation of droplet nuclei.

A client asks the nurse if it is possible to contract influenza by being exposed to wound secretions. On what knowledge should the nurse base her response to the client?

• Acute myocardial infarction

A client comes to the emergency room with complaints of chest pain. When the nurse reads his ECG she sees changes which include T-wave inversion, ST-segment elevation, and an abnormal Q wave. What should she suspect?

Analgesics Cough medicine Antiviral medication Rest

A client diagnosed with influenza asks the nurse what treatment he can do to feel better. The nurses' response should include: Select all that apply.

Mist humidification Nasal irrigation Saline nasal spray

A client diagnosed with rhinosinusitis asks the nurse what type of nonpharmacologic measures can be used to reduce the nasal stuffiness that occurs with the disorder. What suggestion can the nurse give to the client? Select all that apply.

Rebound symptoms

A client diagnosed with the common cold has been taking an over-the-counter antihistamine for the control of symptoms. What should the client be aware may occur if the drugs are used too frequently over too many days?

Adrenocorticotropic hormone (ACTH) Growth hormone (GH) Luteinizing hormone (LH) Thyroid-stimulating hormone (TSH)

A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which of the following hormones may be affected? Select all that apply.

The client's hypothalamic--pituitary--adrenal (HPA) system will require recovery time before normal function is restored.

A client has presented to a clinic for the treatment of severe dermatitis after contact with poison ivy on a camping trip. The client has been prescribed prednisone, a corticosteroid, for the treatment of his skin condition. The client's care provider has emphasized that dosages of the drug will be gradually tapered off rather than stopped upon resolution of the symptoms. Which rationale is the most accurate for this dosing protocol?

Respiratory distress with audible crackles

A client has presented to the emergency department in distress and is being rapidly assessed by the care team. Which assessment finding would prompt the team to consider the possibility of acute heart failure?

-Right sided heart failure

A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins?

have elevated lactic acid levels due to anaerobic metabolism.

A client is being treated in the emergency department after being exposed to caustic vapours in a workplace accident. The client's arterial blood gases indicate severe hypoxemia and hypercapnia, so the nurse knows that the client will:

Central chemoreceptors

A client is brought into the ER with rapid, deep respirations at a rate of 25 breaths per minute and decreased level of consciousness. A stat MRI shows a lesion in the brain stem which may have infiltrated which of the following regulators of respiratory function responsible for detecting changes in carbon dioxide levels?

Serum uric acid levels

A client is experiencing an episode of gout. The nurse recognizes that the condition is a result of:

PEF 350 ml in AM, 200 ml at noon, symptoms occur continuously

A nurse caring for a client with asthma monitors respiratory function. Which data indicate the client has severe persistent asthma?

The client is achieving normal glycemic control.

A client is managing his diabetes with exercise and diet. The health care provider reviews the client's most recent lab results: fasting blood sugar level at 80 mg/dL and a hemoglobin A1C of 5%. Select the response that best identifies the client.

Vigilant blood pressure monitoring

A client is pregnant for the first time and is considered to be at high risk for preeclampsia. The care team should prioritize which intervention?

Evaluate anesthetic risk

A client is preparing for a hip replacement surgery and his physician orders pulmonary function tests (PFTs) to be done pre-surgical. Upon arrival to the lab for the PFTs, the client is anxious and asks the nurse why his physician would order these tests since he does not have any pulmonary diseases. The nurse responds that although the client should speak with his physician, the most likely reason is which of the following?

The lesion has eroded blood vessels in the lungs.

A client presents to the physician's office with a chronic cough, shortness of breath, and wheezing that has gotten progressively worse, with recent episodes of hemoptysis. Diagnostic tests reveal a lung mass. Based on these symptoms, the nurse is anticipates which of the following has occurred?

"Regeneration of most cartilage is slow. These injuries can take a long time to heal."

A client recently diagnosed with an injury to the articular cartilage of the knee asks the nurse how long it will take the injury to heal. Which of the following statements is the best response from the nurse?

1 hour

A client who came to the emergency room and was diagnosed with ST-segment elevation myocardial infarction (STEMI) experienced "sudden death." The emergency room nurse explains sudden death from a STEMI as death that occurs within what time frame of symptom onset?

Obstructive shock

A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this client at risk of experiencing?

Short, shallow breaths.

A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. Upon assessment of the lungs, what clinical manifestations should the nurse expect?

Short, shallow breaths

A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. What should the nurse anticipate when observing her breathing?

• Physical exertion • Exposure to cold • Emotional stress

A client who previously has suffered a myocardial infarction comes to clinic for a routine checkup. He tells the nurse that he has started to experience more episodes of angina pectoris than he had before. The nurse should tell this client that which of the following can precipitate his angina pectoris? Select all that apply.

It is usually caused by a viral infection.

A client who was admitted to the cardiac intensive care unit with a diagnosis of myocarditis asks the nurse what caused his disease. What would be the nurse's best response?

Beta adrenergic blocker

A client who was diagnosed with hypertension is now taking a medication that decreases heart rate and cardiac output. The nurse determines that the medication is a:

Diarrhea Tachycardia Hyperthermia

A patient with hyperthyroidism took aspirin for a headache. Which of the following complications could develop? Select all that apply.

"You should not take this medication; it can cause problems."

A client with a history of hypertension and diabetes mellitus has developed a cold and tells the nurse he purchased an OTC (over-the-counter) nasal decongestant. The most important information for the nurse to provide would be:

Staphylococcus aureus

A client with a known history of intravenous drug abuse has been diagnosed with infective endocarditis. Select the most likely cause of infection.

Onset of STEMI

A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experienced any relief. The client is most likely experiencing:

With input from various sensors, hormone production and release are adjusted based on existing hormone levels.

A client with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which of the following statements most accurately underlies the dominant regulation process of hormone levels in the body?

"You could regulate your diet, exercise regularly, and lose weight."

A client with a new diagnosis of type 2 diabetes mellitus states, "I am really worried that I might need to take injections. Is there something I can do to avoid that?" What is the best response by the nurse?

"I will need to take my medication for about 6 to 12 months, or until my adrenal function returns."

A client with a pituitary adenoma has had a transsphenoidal removal, successfully. What statement made by the client after education by the nurse indicates the client understands pharmacological treatment?

Loss of proprioception and reflex control of the muscles

A client with a spinal cord injury has experienced contractures and destructive changes in the joints of the lower extremities. The nurse determines which of the following is the most likely cause?

Check blood glucose

A client with diabetes mellitus has sudden onset of slurred speech, incoordination, and cool, clammy skin. What will the nurse do first?

Fever and diaphoresis

A client with heart failure has just had an automatic defibrillator installed in her chest wall. When the nurse is performing follow-up assessments in the coming months, which finding is most likely the result of a complication?

Paroxysmal nocturnal dyspnea

A client with heart failure tells the nurse that he is frustrated and is unable to get "a good night's rest." The client relates that he falls asleep and is suddenly awakened and feels as though he is having a hard time breathing and is suffocating. The nurse recognizes this assessment as:

Chicken salad, refried beans, and guacamole

A client with hypercapnia needs to increase calorie intake without increasing work of breathing. What menu selection is the best choice?

Cor pulmonale

A client with primary lung disease has developed right heart failure. The health care provider would document this as:

Atrial fibrillation

Dysrhythmias can occur in patients with heart failure. The dysrhythmia that occurs most frequently in heart failure is which of the following?

Pleural fluid protein/serum protein ratio >0.5

A diagnosis of exudative pleural effusion would be based on which of the following?

Loss of intrapleural pressure

A distressed, confused client is admitted to the hospital ER with a penetrating right chest stab wound. The nurse assesses the patient and notes a lack of breath sounds in the right lung due. The nurse knows this is likely the result of:

Raynaud phenomenon

A female client tells the health care provider that she has recently been experiencing episodes of changes occuring in the color of her fingertips especially when she experiences cold temperatures. She further states that the tips become pale, turn a bluish color, and then become reddened. The client is most likely experiencing:

Her thoracic cage is less flexible than when she was healthy.

A female patient is requiring supplementary oxygen by face mask due to her reduced lung compliance. Which of the following pathophysiological processes is most likely to be a contributor to her low lung compliance?

Temporal arteritis

A group of vascular disorders called vasculitides cause inflammatory injury and necrosis of the blood vessel wall (i.e., vasculitis). These disorders are common pathways for tissue and organ involvement in many different disease conditions. What is the most common of the vasculitides?

the fact that a lower pH of the body fluids (ketoacidosis) reduces insulin binding.

A homeless individual is brought to the emergency department (ED) after the police could not wake the person. The client's breath is fruity and others state that the client has been acting "different." Initial blood work identifies a blood glucose level of 642. The client is admitted to the ICU in ketoacidosis. The client is prescribed an insulin drip (IV infusion). The rationale for this is related to:

Moderate short stature Thin build Delayed sexual maturation

A male child, age 13, is brought to the clinic for a wellness checkup who has been diagnosed with constitutional short stature. What assessment data obtained by the nurse correlates with this diagnosis? Select all that apply.

Lack of follicle-stimulating hormone (FSH) Insufficient androgens

A male patient has been diagnosed with a low sperm count. Which of the following endocrine imbalances could contribute to this condition? Select all that apply.

Cardiomyopathy

A nurse educator explains a type of cardiac condition as "a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually exhibit inappropriate ventricular hypertrophy or dilation and often lead to cardiovascular death or progressive heart failure." Which condition fits this definition?

"I've had a little sore on the sole of my foot for a few days, but I'm sure it will eventually heal."

A nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by participants should the nurse follow up first?

Cigarette smoke

A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which of the following most likely had the greatest impact on development of the lung cancer?

may take days for the full effect to occur, based on the mechanism of action.

A middle-aged female client has been diagnosed with thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases the answer on the knowledge that thyroid hormones:

Hyaline cartilage has been disrupted

A mixed martial arts fighter takes a strong punch to the nose. As a result, the nose "breaks." What is the etiology of the client's injury?

Blood filling approximately one third of the pleural space

A moderate hemothorax diagnosis would be confirmed by the presence of which of the following?

"The shoulder joint is complex and can take up to a year to heal completely."

A month after surgical repair of a rotator cuff tear of the shoulder, a patient tells the nurse, "This is not getting any better. I still have a lot of pain and limited motion." Which of the following is the nurse's best response?

Using a tongue depressor to assess the child's tonsils

A nurse is caring for a child with an airway obstruction. It is most important for the nurse to avoid:

Fever

A nurse is caring for a child with systemic-onset juvenile idiopathic arthritis (JIA). On which of following symptoms should the nurse focus?

"It facilitates the entrance of calcium for the excitation-contraction mechanism that couples the electrical activity with muscle contraction."

A nurse educator is explaining normal cardiac conduction and action potentials to a nursing cohort. How can the nurse best describe the term "slow response" (calcium current) to the students?

"The contraction of the ventricles and the atria can range from 400 to 600 beats/minute."

A nurse educator is teaching a group of nurses at a long term care facility about atrial fibrillation in light of its prevalence in older adults. Which of the following statements by the nurses would the educator most want to correct?

Measurement of urine output and mental status assessment

A nurse educator on a geriatric medicine unit of a hospital is teaching a group of new graduates specific assessment criteria related to heart failure. Which of the following assessment criteria should the nurses prioritize in their practice?

Elevated atrial natriuretic hormone

A nurse examines the laboratory values of a patient in heart failure. Which of the following values indicates a compensatory hormone mechanism?

ligaments

A nurse is caring for a client who twisted his ankle while running. Tests reveal damaged connective tissue that connects the movable bones of the joint. Based on this finding, the nurse prepares to teach the client about which of the following anatomical structure that is injured?

Pulmonary arterial pressure (PAP)

A nurse is caring for a client with right heart failure caused by pulmonary hypertension. Which hemodynamic parameter is most appropriate for the nurse to monitor?

Systemic lupus erythematosus

A nurse is caring for a patient admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which of the following disease processes?

Asymmetrical chest movements, esp. on inspiration. • Diminished breath sounds over painful chest area. • Respiratory rate 34.

A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations leads the nurse to suspect a pneumothorax? Select all that apply.

Irritant receptors

A nurse is instructing a class for people with newly diagnosed asthma to encourage healthy life style choices. The nurse explains that stimulation of certain lung receptors with things such as smoke, cigarette smoke, inhaled dust, or cold air can lead to constriction of the conducting airways resulting in rapid, shallow breathing. How does the nurse identify these receptors?

PR interval >0.20 seconds

A nurse is monitoring the electrocardiogram (ECG) of a patient with a recent right ventricular infarction. The ECG reveals a first-degree arterioventricular (AV) block, which is characterized by which of the following?

Blacks and South Asians

A nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups?

Auscultate for a murmur caused by the backward expulsion of blood through the atrioventricular valves

A nurse is reviewing an echocardiogram for a client with a congenital defect in the papillary muscles of the heart. Based on this result, which of the following assessments should the nurse complete?

"More women than men are affected by lupus."

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which of the following statements does the nurse is likely to make?

"The synovial fluid in my joint capsule acts as a lubricant and helps the movement of the joint's articulating surfaces."

A nurse is teaching a patient diagnosed with osteoarthritis about the joint capsule. Which of the following statements made by the patient indicates that teaching was successful?

Diuretics

A nurse is teaching a patient with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the patient understands when the patient correctly matches which of the following drug categories to the action of decreasing vascular volume by suppressing renal reabsorption of sodium and increasing salt and water excretion?

Biologic response modifiers are beneficial in controlling the disease.

A nurse is teaching a patient with psoriatic arthritis about treatment. Which of the following statements should be included?

"My child will need to use crutches until the hip heals."

A nurse is teaching the parent of a child with a diagnosis of Legg-Calvè-Perthes disease about the prescribed treatment. Which of the following statements by the parent indicates adequate understanding?

Anemia

A nurse is teaching the patient about extra-articular manifestations of rheumatoid arthritis (RA). Which of the following will the nurse include in the teaching plan?

Monitor the patient and document the findings

A nurse notes that the PR interval on a patient's electrocardiogram tracing is 0.22 seconds. Which of the following actions should the nurse take?

Raising the head of the bed to a high Fowler's position

A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Which action by the new RN indicates a need for more education?

Epiglottitis

A parent calls 911 and states her child is having trouble breathing. The child is rushed to the emergency department. Upon assessment, the child appears pale, toxic, and lethargic and assumes a distinctive position—sitting up with the mouth open and the chin thrust forward. The parent states that the child just developed a sore throat and fever today. The health care provider determines that the child is experiencing:

Lack of parathyroid hormone

A patient develops hypocalcemia after thyroid surgery. Which of the following hormonal imbalances caused this complication?

Elevating legs for 20 minutes daily

A patient with mitral valve regurgitation and left heart failure reports shortness of breath and fatigue with activities of daily living. Which of the following instructions by the nurse will be ineffective in reducing these symptoms?

Drinks carbonated sodas daily

A patient with osteoporosis is prescribed calcitonin (Miacalcin). Which of the following actions by the patient requires further instruction?

Coarctation of the aorta

A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect?

"The potentially harmful outcomes of screening have been shown to outweigh the benefits."

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?

"Most hip fractures are actually a break at the very top of the thigh bone."

A public health nurse is conducting a health promotion teaching session at a seniors' drop-in center. Which of the following teaching points about hip fractures in older adults is most justified?

Pleuritic pain

A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain, and increased respiratory rate. What is a classic sign of pulmonary infarction?

The client will experience a negligible decrease in oxygen saturation.

A respiratory therapist is describing the characteristics of the oxygen--hemoglobin dissociation curve to a group of nurses caring for some respiratory clients. The respiratory therapist is describing what will happen to a client's oxygen saturation level if the partial pressure of oxygen decreases from 100 to 95 mm Hg. What will happen if this occurs?

• Fatigue • Loss of appetite • Aching • Stiffness

A rheumatology nurse is teaching a patient about extra-articular signs and symptoms of rheumatoid arthritis (RA). Which of the following does the nurse include in the teaching session? Select all that apply.

Etanercept

A seronegative inflammatory arthropathy is psoriatic arthritis. What drug has been found to be beneficial in controlling both the psoriasis and the arthritis in these clients?

There is no definitive test for diagnosing RF

A teenager comes to the emergency room with a history of strep throat and symptoms that lead the staff to suspect rheumatic fever. Which of the following tests can best establish a diagnosis of rheumatic fever?

Rheumatic fever

A teenager is seen in the emergency room with complaints of a sore throat, headache, fever, abdominal pain, and swollen glands. His mother tells the nurse that he was seen three weeks before in the clinic and treated with antibiotics for a strep throat. He was better for a few days but now he seems to have gotten worse in the last two days. What should the nurse suspect is wrong with this client?

"The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin."

A three year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes?

Cortisol, a glucocorticoid

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.20 F

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

The parents describe a "bad cold" for several days that has become much more severe. The infant's parents state that crying and feeding make the symptoms worse.

An 8-month-old infant has been brought to the emergency department in respiratory distress. When obtaining the infant's history of present illness from his parents, which finding is most suggestive of acute bronchiolitis?

Decreased serum calcium levels

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 of the following phenomenon would her care providers expect to result from her supplementation?

Surgical hip replacement and early mobilization

An 80-year-old client is admitted to the hospital with a displaced intracapsular hip fracture. The physician explains to the client's family that this type of fracture is best treated by which of the following?

• Organs affected include kidneys, lungs, liver, brain, and heart. • Homeostasis is disrupted. • Risk factors for development of MODS include severe trauma, hepatic dysfunction, and prolonged hypotension. • Treatment is primarily supportive of the affected organs

An acutely ill patient is developing multiple organ dysfunction syndrome (MODS). The nurse knows that which statements regarding multiple organ dysfunction syndrome are true? Select all that apply.

Peak mass occurs in early adulthood.

An adolescent asks the nurse about peak bone mass. The most appropriate response would be:

Carpal tunnel syndrome

An adult client with growth-hormone deficiency related to hypopituitarism has been taking replacement therapy for several months. The client informs the nurse that she is having pain in the hand and wrist almost constantly. What does the nurse understand is a common side effect of this therapy that seems to have affected this client?

Acute viral rhinosinusitis

An adult comes to the urgent care clinic reporting facial pain, headache, and copious amounts of thick purulent nasal discharge. Based on these symptoms, the nurse practitioner suspects the client is experiencing which condition?

Compression therapy to help facilitate blood flow back to the vena cava

An elderly patient arrives to the healthcare provider's office complaining of a "sore" that won't heal on their lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the patient that the usual treatment is:

Compression therapy to help facilitate blood flow back to the vena cava.

An elderly patient arrives to the healthcare provider's office complaining of a "sore" that won't heal on their lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the patient that the usual treatment is:

Dizziness and fainting.

An elderly patient is diagnosed with orthostatic hypotension. For which of the following clinical manifestations should the nurse assess?

"One of the causes of emphysema is a history of cigarette smoking that causes damage to the lungs. Have you ever smoked?"

An elderly patient who was recently diagnosed with emphysema asks the nurse what caused the disease. Which of the following statements is the best response?

severity and duration of shock.

An important factor in the mortality of severe shock is acute renal failure. What impacts the extent of renal damage in shock?

Increased estradiol production causes increased gonadotropin (FSH) production.

An instructor is teaching the class about positive feedback mechanism. The best example would be:

Relative refractory period ends

An intensive care unit nurse is caring for a 50-year-old client who was admitted 8 hours before, following an anterior wall myocardial infarction (MI). The nurse notes frequent premature ventricular complexes on the client's ECG monitor and is concerned that the client could develop a lethal arrhythmia if one of the premature ventricular complexes fires just after which of the following?

Implementing falls prevention measures

An older adult client has been diagnosed with metastatic bone disease. Which aspect of the client's care plan most directly addresses a common complication of this disease?

Serum phosphorus level of 0.55 mmol/l (normal 1.0 to 1.5 mmol/l) Serum calcium level of 1.4 mmol/l (normal 2.1 to 2.6 mmol/l) 25-hydroxy vitamin D level of 10.1 nmol/l (normal 19.4 to 137 nmol/l)

An older adult's primary care provider has deemed the client to be at a high risk for developing osteomalacia. What current laboratory findings would support this conclusion? Select all that apply.

"Use caution when choosing over the counter drugs for your cold; most people do best with rest and anti-fever medications."

As part of a public health initiative, a nurse is teaching a group of older adults about ways to promote and maintain their health. Recognizing that the common cold is a frequent source of ailment, the nurse is addressing this health problem. Which of the following teaching points about the common cold is most accurate?

Cardiac contractility Heart rate Preload Afterload

As the needs of the body change, the heart's ability to increase output needs to change too. This ability in the heart depends on what factors? (Select all that apply.)

Acute adrenal insufficiency

At times, it is necessary to give medications that suppress the adrenal glands on a long-term basis. When the suppression of the adrenals becomes chronic, the adrenal glands atrophy. What does the abrupt withdrawal of these suppressive drugs cause?

Away from the affected lung

Atelectasis is the term used to designate an incomplete expansion of a portion of the lung. Depending on the size of the collapsed area and the type of atelectasis occurring, the nurse may see a shift of the mediastinum and trachea. Which way does the mediastinum and trachea shift in compression atelectasis?

Hypercholesterolemia

Atherosclerosis begins in an insidious manner with symptoms becoming apparent as long as 20 to 40 years after the onset of the disease. Although an exact etiology of the disease has not been identified, epidemiologic studies have shown that there are predisposing risk factors to this disease. What is the major risk factor for developing atherosclerosis?

Bone cells, blood vessels, and nerves

Bone is connective tissue, in which the intercellular matrix has been impregnated with inorganic calcium salts, that has great tensile and compressible strength but is light enough to be moved by coordinate muscle contractions. One third of the dry weight of bone is composed of the following:

• No weight bearing on the femur. • Bedrest. • Traction.

Child/parents are coming into the physician's office to get the results of some diagnostic testing relating to their knee pain and unusual stiffness and fatigue. The physician suspects the child may have slipped capital femoral epiphysis. The nurse should anticipate that the treatment will involve: (Select all that apply).

A subjective sensation felt when experiencing difficulty breathing

Dyspnea can best be described by which of the following?

Multiple sclerosis

Dyspnea is defined as an uncomfortable sensation or difficulty in breathing that is subjectively defined by the client. Which of the following disease states is not characterized by dyspnea?

rapidly degraded by enzymes in circulation and at the tissue.

During a near-miss accident while cycling, a client marvels at how fast he was able to react. He attributes this to his fight/flight response but then wonders why it lasts for only a short period. The client had a short burst of catecholamine activity because catecholamines are:

Depolarization of smooth muscle relies largely on extracellular calcium.

During a physiology lecture, a nursing student hears about the different forms of muscle tissue. Which description best describes vascular smooth muscle?

The client has increased pressure related to right heart failure.

During an assessment of a client with ankle swelling, the nurse observes jugular venous pulsations 5 cm above the sternal angle when the head of his bed is elevated 45 degrees. Which of the following is the correct interpretation of this finding?

Veins

During an automobile accident where the patient is bleeding heavily, which vascular component is the most distensible and can store large quantities of blood that can be returned to the circulation at this time of need?

• Growth and remodeling of bone. • Repair of bone.

During pathophysiology class, a nursing student asks the faculty what purpose do the osteoprogenitor cells serve. From the following list, identify the purpose of these cells. Select all that apply.

Hyperglycemia

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?

Damage or destruction of cilia

During the admission interview the client, who is admitted with bacterial pneumonia, reveals a 20 pack per year smoking history. The nurse relates the possible cause of this pneumonia to the decreased defense of the pulmonary system caused by cigarette smoking. Smoking affects the pulmonary defense system by which of these?

Osteoblasts

Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83 year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace, and that the man will regain full function after healing and rehabilitation. Which of the following cells are most responsible for restoring the integrity of the man's broken bone?

Osteoblasts

Following a fall, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace, and that the man will regain full function after healing and rehabilitation. Which cells are most responsible for restoring the integrity of the man's broken bone?

Left ventricle

The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?

Androgens and estrogens

Hormones can be synthesized by both vesicle-mediated pathways and non-vesicle-mediated pathways. What hormones are synthesized by non-vesicle-mediated pathways?

Histamine

Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability.

Endothelial damage

Hypertension is a risk factor for atherosclerosis. The nurse knows that which of the following is the initial lesion in the pathogenesis of atherosclerosis?

Delirium Tachycardia Very high fever

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? (Select all that apply.)

Tachycardia Very high fever Delirium

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? (Select all that apply.)

Muscle weakness Dehydration Altered mental status Vascular collapse

In an acute adrenal crisis, the onset of symptoms is sudden and, in the case of Addison disease, can be precipitated by exposure to a minor illness or stress. What are the manifestations of acute adrenal crisis? (Select all that apply.)

Neurogenic Septic Anaphylactic

In distributive shock, there are abnormalities in vascular resistance. Which of the following types of shock display the same distributive pattern? Select all that apply.

False

In general, children are not affected by rheumatic diseases, such as arthritis, that occur in adults.

• Vasoconstriction • Increased heart rate • Activitation of the renin angiotensin system (RAAS)

In heart failure patients, the nurse knows that many compensatory mechanisms attempt to support cardiac output. Included among these mechanisms are which of the following? Select all that apply.

20 mL/hour

In hypovolemic shock, renal perfusion and urinary output decline. The nurse will monitor urinary output and knows that output below which of the following levels indicates inadequate renal perfusion?

Vasoconstrictive drugs

In hypovolemic shock, the main purpose of treatment is correcting or controlling the underlying cause of the hypovolemia and improving the perfusion of the tissues and organs of the body. Which of the following treatments is not a primary form of therapy for hypovolemic shock?

Renal artery thrombosis

In infants and children, secondary hypertension is the most common form of hypertension. What is the most common cause of hypertension in an infant?

Intercostal and abdominal muscles

People with emphysema often have a difficult time with air trapping, which is air left in the lungs following expiration, often due to the destruction of the alveoli. Pulmonary rehabilitation educates people who suffer from this disease to use which of the following to help air leave the lungs more effectively?

Mass spectrometry with liquid chromatography

Prior to running the marathon, an athlete is tested for the use of performance-enhancing agents. Which type of lab/diagnostic testing should the nurse review with this athlete?

• Sufficient blood volume to fill the vascular compartment • Efficient cardiac pumping ability • Intact vascular system • Ability of organs to extract oxygen and nutrients from blood

Proper perfusion of vital organs requires which of the following conditions? Select all that apply.

Disease of young, heavy cigarette smokers occurring before the age of 35

Select the statement that best describes Buerger disease.

The formation of autoantibodies and immune complexes (type III hypersensitivity)

Select the statement that best describes systemic lupus erythematosus (SLE). SLE is characterized by which of the following?

Provide a better measure of hormone levels during a designated period.

Select the most accurate statement regarding measurements of urinary hormone:

Inspect the feet for blisters daily

Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.

Hormones function as modulators of cellular and systematic responses.

Select the most appropriate statement that describes the function of hormones.

Polydipsia Polyuria Polyphagia

Select the most common symptoms of diabetes. Select all that apply.

inflammatory mediators and cytokines

Select the option that best describes the mediation of the systemic inflammatory responses that occurs in disseminated intravascular clotting (DIC).

Supplies the blood supply for the conducting airways and supporting structures

Select the primary function of bronchial circulation.

Administration of sodium nitroprusside and β-adrenergic blocking medications

Select the priority of care for the medical management of a client with a dissecting aortic aneurysm.

Golgi complex

The anatomy instructor is presenting a lecture on hormone synthesis. The instructor determines that instruction was effective when students identify the site of prohormone to hormone conversion as the:

"There is an extra, abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly, in a circular pattern, causing the heart to beat too fast."

The cardiologist just informed a patient that they have a reentry circuit in the electrical conduction system in their heart. This arrhythmia is called Wolff-Parkinson-White (WPW) syndrome. After the physician has left the room, the patient asks the nurse to explain this to them. Which of the following statements most accurately describes what is happening?

Aorta Capillaries

The circulatory system can be divided into two parts. What does the systemic circulation include? Select all that apply.

Right heart Pulmonary artery Pulmonary veins

The circulatory system is divided into two parts. What does the pulmonary circulation include? Select all that apply.

inhalation of droplet nuclei.

The client ask the nurse how influenza is spread from person-to-person. The nurse educates her client that influenza is transmitted by:

"It refers to realigning the bone."

The client asks, "What is reduction"? How will the nurse respond?

Knee

The client experiences a meniscus injury. The physical therapist understands this involves which of the following joints?

Pain that is experienced as hip pain

The client experiences a twisting knee injury. Which type of pain would the provider expect the client to have?

The client must protect the entire body from cold, not just the extremities

The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client?

• Edema • Brown pigmentation of the skin • Status dermatitis

The client has been diagnosed with venous insufficiency after having a deep vein thrombosis (DVT). Which signs and symptoms would the nurse expect to see? Select all that apply.

Giant cell temporal arteritis

The client has symptoms of a focal inflammatory condition of medium-sized and large arteries which includes diplopia. Which condition does the client have?

Intravenous sodium nitroprusside

The client reports a sudden onset of excruciating pain in the anterior chest and describes it as "tearing or ripping." The physician is unable to palpate a pulse in the client's right arm. Based on the client's history and physical examination, which treatment would be implemented?

A pulsating mass in the abdomen

The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which of the following initial signs of this condition?

Fibrous atheromatous plaque

The client undergoes a cardiac catheterization to evaluate symptoms of chest pain and shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as which of the following?

• Severe burns • Fifteen percent blood volume loss • Severe dehydration

The diagnosis is hypovolemic shock. The nurse knows that causes of hypovolemic shock include which of the following? Select all that apply.

Liver

The diagnosis is right-sided heart failure. The nurse knows that which organ is primarily affected in this type of heart failure?

Decreased risk of infection Better wound healing

The diagnosis is septic shock. The nurse knows that administration of insulin to this patient will provide which of the following beneficial effects? Select all that apply.

"I should avoid fats that are manufactured from vegetable oils and used to extend the shelf life of fast foods."

The dietitian is teaching a client about cholesterol reduction strategies. Which comment, by the client, indicates that he understands the teaching?

Glucose is unused without insulin, so body fats are used for energy.

The family of a client in the hospital with diabetes mellitus out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond?

A T-cell mediated response to an immunologic trigger, such as a microbial agent

The health care provider has determined that a client has developed rheumatoid arthritis. The provider is aware that the client may experience joint inflammation that involves of immunologic mediation triggered by:

"Take the medication 15 to 30 minutes before each meal."

The health care provider has prescribed Repaglinide 2 mg for a client diagnosed with type 2 diabetes. The most important information for the nurse to give the client would be:

Propranolol, a β-Adrenergic blocker

The initial medical management for a symptomatic patient with obstructive hypertrophic cardiomyopathy (HCM) would be administering a medication to block the effects of catecholamines. The nurse will anticipate administering which of the following medications?

• Osteoblasts • Nerves • Blood vessels

The intercellular matrix of bone is composed of two types of substances: organic matter and inorganic salts. Which of the following are organic matter? Select all that apply.

Stimulates calcium absorption from the intestine

The kidney produces 1,25-dihydroxyvitamin D. This form of vitamin D is responsible for which action in the body?

30 to 35cm/second

The linear velocity of blood flow in the circulatory system varies widely. What is the linear velocity in the aorta?

convert angiotensin I to angiotensin II. Serve as reservoir for blood storage

The lungs are the working structures of the respiratory system, and they have several functions. What are the functions of the lungs? (Select all that apply.)

Junctions of the subclavian and internal jugular veins

The lymph system correlates with the vascular system without actually being a part of the vascular system. Among other things, the lymph system is the main route for the absorption of fats from the gastrointestinal system. The lymph system empties into the right and left thoracic ducts, which are the points of juncture with the vascular system. What are these points of juncture?

calcium

The major stimulus for calcitonin synthesis is the release of an increase in what serum element?

It reduces pulmonary hypertension and polycythemia associated with chronic lung disease

The management of cor pulmonale is directed at the underlying lung disease and heart failure. Why is low-flow oxygen therapy a part of the management of cor pulmonale?

Check the patient's O2 saturation level.

The nurse determines that the client has clubbing of the fingertips. Which is the best intervention?

A shortage of hypothalamic GHRH production

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which of the following phenomena would the physician most likely suspect as contributing factor to the boy's short stature?

"Insulin is destroyed by the stomach contents and has to be administered by injection."

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

24-28 weeks.

The neonatal ICU nurse is aware that Type II alveolar cells produce surfactant and they usually develop at how many weeks gestation?

To stimulate contraction of the uterus

The nurse explains to a client in labor who has demonstrated ineffective contractions impeding progression of labor that the health care provider has added oxytocin infusion to the orders. Which of these does the nurse teach the client is the purpose of oxytocin?

• Muscle weakness • Bed rest • Surgery • Paralysis

The nurse has just completed a respiratory assessment on a postoperative patient who has undergone repair of a large abdominal aneurysm. Which conditions may impair the patient's cough reflex? Select all that apply.

Tunica media

The nurse identifies the blood vessel layer that constricts to regulate and control diameter as which of the following?

Lower back pain

The nurse is assessing a patient with ankylosing spondylitis (AS). Which of the following does the nurse expect to find?

Immediate defibrillation

The nurse is assisting a patient who had a myocardial infarction 2 days ago during a bath. The patient suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the patient was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. Which of the following is a priority intervention at this time?

Fludrocortisone acetate

The nurse is caring for a child with congenital adrenal hyperplasia and has depletion of sodium levels. What pharmacological therapy does the nurse anticipate administering to this child?

Increasing the spread of surfactant

The nurse is caring for a client who is 2 days postop following a total hip replacement. The client is refusing to participate in physical therapy, complaining of extreme fatigue and severe pain with any movement. The nurse administers pain medication and then encourages the client to sit up to more effectively cough and deep breathe to increase ventilation by:

Anesthetics Analgesics Sedatives

The nurse is caring for a client who is in a severely hypothyroid state. Which medications should be avoided related to the inability to metabolize these drugs? Select all that apply.

Alveoli

The nurse is caring for a client who is now 2 days post near-drowning. The focused assessment would involve which of the following areas of the lung involved in gas exchange?

Reduction in ACTH

The nurse is caring for a client who is receiving exogenous corticosteroids for rheumatoid arthritis. Recognizing that hormone levels are regulated by negative feedback, which of these laboratory test results does the nurse anticipate uncovering when reviewing the medical record?

serious depression of respirations

The nurse is caring for a client with end stage chronic obstructive pulmonary disease (COPD). The client is extremely agitated and dyspneic, demanding that the oxygen be turned all the way up. The nurse states that this situation must be very frustrating for the client and then explains that the consequence of increasing the oxygen could cause:

Propylthiouracil (PTU)

The nurse is caring for a client with hyperthyroidism and is preparing to administer the morning medications. Which medication will the nurse administer in order to block the conversion of T4 to T3 in the tissues?

The medication will be given daily during the period of active growth and can be continued into adulthood.

The nurse is educating a parent of a child with short stature caused by growth hormone (GH) deficiency about the administration of GH. What should the nurse include when educating the parents about administration?

Reduction of nasal swelling

The nurse is educating the client with a cold about the use of over-the-counter decongestants. What expected outcome does the nurse anticipate with the use of this medication?

Diazepam (Valium) Phenytoin (Dilantin) Aspirin

The nurse is receiving physician orders when admitting a client to the inpatient facility with cirrhosis of the liver. Which medications ordered by the physician should the nurse question since they may affect the binding of thyroid hormone to normal concentrations of binding proteins? Select all that apply.

Injures the endothelial cells lining the blood vessels, thereby promoting thrombus development

The nurse is reviewing a client's history and recognizes that the client smokes cigarettes. The nurse is concerned because smoking does which of the following?

A 45-year-old obese female with a sedentary lifestyle

The nurse is reviewing assessment data on four clients. Select the client at highest risk for developing type 2 diabetes.

A 7-year-old female with early menarche

The nurse is reviewing the assessment data of four clients. Select the client who would be diagnosed with precocious puberty.

"I should report episodes of dizziness or fainting."

The nurse is teaching a patient with a diagnosis of hypertrophic cardiomyopathy and aortic valve stenosis. Which of the following statements by the patient shows that the patient understands this condition?

Vascular granulation tissue that destroys cartilage and bone

The nurse is teaching a patient with rheumatoid arthritis about pannus, which develops in the affected joint area. Which of the following does the nurse include to describe pannus?

A 5-year-old African-American female with developing breasts and pubic hair

The nurse is working in a pediatric clinic. Which of the following children would the nurse recognize as having isosexual precocious puberty?

• Causes of heart failure in older adults include coronary heart disease and mitral valve dysfunction. • Sensitivity of beta adrenergic receptors decreases resulting in decreased ventricular contractility. • It is more difficult to diagnose because of underlying chronic diseases.

The nurse knows that advanced age is a risk factor for heart failure. Which statements regarding heart failure in older adults are true? Select all that apply.

During apneic periods the patient experiences hypoxemia which stimulates chemoreceptors to induce vasoconstriction.

The nurse practitioner working in an overnight sleep lab assessing and diagnosing patients with sleep apnea. During this diagnostic procedure, the nurse notes that a patient's blood pressure is 162/97. The nurse explains this connection to the patient based on which of the following pathophysiological principles?

LDL level

The nurse practitioner's examination of a client reveals xanthomas along the client's tendons. Which of the following tests will the practitioner order?

Woman with a family history of diabetes

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which of these risk factors in the teaching?

"The child's measurements fit within the acceptable assessment period; treatment is not necessary at this time."

The parents of a 6-year-old child diagnosed with bilateral genu valgum (knock knees) ask the health care provider when treatment will begin to correct the problem. The best response would be:

"Children can be affected with almost all of the rheumatic diseases that occur in adults."

The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:

The sweat test measures the concentration of salt in the infant's sweat

The parents of a child with cystic fibrosis ask the nurse to explain the sweat test performed on their newborn. How should the nurse respond?

Early diagnosis can reduce the inappropriate use of antibiotics

The school nurse is providing education to parents of school-age children during flu season. What should the nurse teach about the importance of early diagnosis of influenza?

60%

The semilunar valves of the heart open at the onset of the ejection period. Approximately what percentage of the stroke volume is ejected during the first quarter of systole?

Bones provide protection for internal organs.

The skeletal system is composed of bone and cartilage. Which of the following statements regarding the skeletal system is most accurate?

Sympathetic

The smooth muscle cells produce vasoconstriction of blood vessels due to innervation by which part of the nervous system?

The sympathetic nervous system responds rapidly to a fall in cardiac output. The sympathetic nervous system increase in heart rate and force of contraction support cardiac output. The sympathetic nervous system increase in cardiac workload and oxygen use can cause ischemia and worsening of heart failure.

The sympathetic (adrenergic) nervous system is an important compensatory mechanism in heart failure. Which of the following statements regarding the sympathetic nervous system response to heart failure are correct? Select all that apply.

Troponin T and troponin I

The troponin complex is one of a number of important proteins that regulate actin-myosin binding. Troponin works in striated muscle to help regulate calcium-mediated contraction of the muscle. Which of the troponin complexes are diagnostic of a myocardial infarction?

Bile and urine

To prevent the accumulation of hormones in our bodies, the hormones are constantly being metabolized and excreted. Where are adrenal and gonadal steroid hormones excreted?

ECG pattern serum biomarkers.

Unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI) is a clinical syndrome that ranges in severity between stable angina and MI. It is classified according to its risk of causing an acute MI and is diagnosed based on what? (Select all that apply.)

• Size of lipid-rich core • Presence of inflammation • Thickness of fibrous cap

Unstable plaque, a condition of atherosclerotic heart disease, occurs in unstable angina and myocardial infarction. Unstable plaque can rupture, causing platelet aggregation and thrombus formation. What are the major determinants of the vulnerability of plaque to rupture? (Select all that apply.)

Skull.

While reviewing the bones in anatomy class, the instructor discusses this type of bone that protects the underlying structures. A good example of a flat bone is:

• Grunting • Respiratory rate of 95 breaths/minute • Sternal retraction • Central cyanosis

Which assessment findings concern the presence of respiratory distress in an infant? Select all that apply.

Bursae

What are the closed sacs that are formed from the synovial membrane but are not part of the joint called?

• Joint involvement • Serology • Acute phase reactants • Duration of symptoms

What are the criteria categories required for the diagnosis of rheumatoid arthritis (RA)? Select all that apply.

Decreased mean arterial blood pressures Increased CVP Increased extraction of o2 from hemoglobin

What are the physiologic signs and symptoms of cardiogenic shock? (Select all that apply.)

• Loss of function • Pain • Swelling

What are typical assessment findings the nurse expects to find in a client with a simple fracture of the leg? Select all that apply

• Anemia • Carbon monoxide poisoning • Hypoxia

What can trigger myocardial ischemia even when there is adequate coronary blood flow? Select all that apply.

Airways are obstructed by mucus, causing hypoxemia.

What description is characteristic of the pathology of chronic bronchitis?

Airways become stiff and resist expansion, leading to hypoxemia.

What description is characteristic of the pathology of interstitial lung disease?

A high degree of pain

What does the nurse expect to assess in a client that has a torn ligament?

Corticosteroids

What intervention is appropriate for a client with sarcoidosis?

"Try to balance your rest and exercise." "Using heat or cold to relieve pain may be helpful." "Losing weight or maintaining your ideal weight reduces stress on your joints." "A walker may be helpful to avoid excess pressure on your hips."

When planning care for the client with severe osteoarthritis (OA) of the hip, the nurse includes which of the following in a teaching session with the patient?

An ejection fraction of 40%

When reviewing diagnostic test results and physical assessment data for a client with a history of stage II hypertension, which of the following would be of most concern to the nurse?

Sputum or bronchial cultures

When talking to a group of homeless women living in a shelter, the nurse should educate about risk for developing tuberculosis. The nurse should emphasize which lab/diagnostic test as considered to be the "gold" standard for diagnosing tuberculosis?

Metatarsals Instep Heel

When teaching a patient about areas of the body typically affected by gout, the nurse should include which of the following areas? Select all that apply.

Elevated anti-nuclear antibodies (ANA)

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?

Decrease in secretion of thyroid stimulating hormone (TSH) Increased levels of thyroid hormone Stimulation of sensors in the anterior pituitary gland Stimulation of sensors in the hypothalamus

Which events are involved in the negative feedback mechanism that keeps the serum thyroid hormone level within appropriate range? Select all that apply.

• Administration of high concentrations of oxygen • Difference in the partial pressures of the gas on either side of the membrane • Diffusion characteristics of the gas • Surface area available for diffusion • Thickness of the alveolar-capillary membrane

Which factors influence diffusion of gases in the lungs? Select all that apply.

Pituitary

Which gland is often referred to as the master gland because it secretes many hormones?

Frequent monitoring of cardiac functions Initiation of thyroid replacement therapy Oxygen therapy to support ineffective respirations Reversal of hypoglycemia

Which interventions would be included in the plan of care for a client experiencing myxedematous coma? Select all that apply.

Reversal of hypoglycemia Frequent monitoring of cardiac functions Initiation of thyroid replacement therapy Oxygen therapy to support ineffective respirations

Which interventions would be included in the plan of care for a client experiencing myxedematous coma? Select all that apply.

• Vitamin D supplements • Regular exposure to sunlight

Which of the following intervention should the nurse recommend to best minimize the risk of nutritional rickets in an infant whose culture supports long-term breast feeding without the introduction of foods? Select all that apply.

Treatment within 6 months of life

Which of the following interventions is necessary for a child with developmental dysplasia of the hip?

Warms and humidifies incoming air

Which of the following is a function of the bronchial circulation?

It does not require serum collection for an accurate reading.

Which of the following is an advantage of assessing hormone levels through collection of a 24-hour urine?

Somatostatin and thyroid-stimulating hormone Insulin and glucagon Calcium and parathyroid hormone Cortisol and adrenocorticotropic hormone

Which of the following is an example of a negative feedback system? Select all that apply.

A 34-year-old male with damage to his upper and lower pons following a blow to the back of the head.

Which of the following neurological patient's is most likely to have abnormalities in breathing regulation?

6-year-old with a compound fracture of the right wrist

Which of the following patients is at greatest risk for developing osteomyelitis?

• Jugular vein distention • 2+ pitting edema in feet • Warm moist skin

Which symptoms accompanying shortness of breath indicate a client has cor pulmonale? Select all that apply.

• Evidence of nail changes • Characteristic skin changes are evident

Which symptoms are required for a diagnosis of psoriatic arthritis? Select all that apply.

Fine-needle aspiration biopsy

Which test can the nurse prepare the client for to determine the differentiation between a benign and a malignant thyroid disease?

Comminuted fracture

Which type of fracture involves healing of more than two pieces of bone?

Lipid-soluble steroid hormones

Which type of hormone is released as soon as they are synthesized?

Stretch

Which type of lung receptor monitors for lung inflation?

• Cartilaginous • Compact • Densely calcified

Which type of materials are not included in a cancellous bone? Select all that apply.

Promote glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids.

While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' diabetes? Select the best answer.

Synovial fluid aspiration indicates the presence of monosodium urate crystals.

While reviewing the following diagnostic findings on a group of patients with joint complaints, which finding would be a priority for further investigation and possible medical intervention?

sperm production.

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males, this hormone is responsible for the:

Decongestants

Which classification of medications used to self treat the common cold should be avoided by those with a history of hypertension?

sitting in bed resting elbows on overbed table, expiratory wheezes noted.

Which client is exhibiting signs of advanced chronic obstructive pulmonary disease (COPD)? The client who is

A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin--angiotensin--aldosterone system.

Which client is most likely to be experiencing vasodilation?

refractory asthma, PEF 210 ml out of best PEF 450 ml, diminished wheezing.

Which client will the nurse see first? The client with

2 hour oral GTT 175 mg/dl

Which manifestation indicates a client is at risk for developing diabetes mellitus?

Complete failure of insulin secretion

Which of the following criteria about insulin would prompt a diagnosis of type 1 diabetes?

They bind to receptors.

Which of the following describes how water-soluble peptides such as parathyroid hormone, or glucagon, exert their effect on cells?

Articulating areas are nourished indirectly by the synovial fluid.

Which of the following describes the blood supply to a synovial joint?

Rheumatoid arthritis

Which of the following diagnoses puts a patient at risk for developing an immunologic form of interstitial lung disease?

Drug overdose

Which of the following diagnoses will present the highest risk for hypercapnic/hypoxemic respiratory failure?

Temporal

A client reporting a headache is diagnosed with giant cell arteritis. The nurse is aware that the vessels most commonly affected are the:

dull pain in mid-chest that is worse when coughing

A client reports chest pain to the nurse. Which characteristics of the pain indicate bronchial irritation?

Prevent cardiac complications

A nurse is caring for a patient with a new diagnosis of rheumatic fever. Which of the following is the highest priority goal of treatment during the acute phase?

Kyphosis

A nurse is caring for a patient with ankylosing spondylitis. For which of these associated symptoms does the nurse assess?

Integumentary assessment

A nurse is caring for a patient with discoid lupus. Which of the following systems does the nurse set as a priority for the nursing assessment?

Renal artery stenosis

A patient is prescribed an angiotensin converting enzyme inhibitor (ACEI) for hypertension. The nurse knows that ACEIs are contraindicated by which clinical condition?

Dyspnea

A patient is reporting difficulty breathing when walking to the bathroom. The nurse documents this as:

Pericardial effusion

A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250ML of fluid in the pericardial cavity. Which disease should the nurse suspect this client to be suffering?

"It may have developed after you had aspiration pneumonia."

A client recently diagnosed with bronchiectasis asks what may have caused the condition. Which response by the nurse is accurate?

"I'm really nervous about having to get surgery and chemo."

A 17 year-old male has been diagnosed with osteosarcoma of the upper tibia following several months of leg pain. Which of the following statements by the client demonstrates that he has an accurate understanding of his diagnosis?

Hypertrophic cardiomyopathy

A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?

Promoting glucose uptake by target cells. Inhibiting protein breakdown Facilitating triglyceride synthesis from glucose in fat cells

A 30 year-old man with a diagnosis of type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which of the following physiological processes are actions of insulin? Select all that apply.

Proportionately, the infant will have more red marrow and less yellow marrow than his mother.

A 30 year-old woman has just given birth to boy. How will the mother's bone marrow differ from that of her son?

Immune response

A 30-year-old man has been diagnosed with ankylosing spondylitis. Which etiology is responsible for his health problem?

The client states that he has been unable to maintain an erection in recent years. The client complains of bloating after eating a meal, and states that he is unable to eat much food at any one sitting. He states that his bowel movements are almost always loose.

A 54 year-old male who lives alone and has poorly controlled type 1 diabetes has been admitted to hospital for treatment of sepsis resulting from a chronic foot ulcer. Which of the other findings from the man's admission assessment and history would his care team be likely to attribute to his diabetes? Select all that apply.

Periorbital edema

A child with rhinosinusitis should be monitored for complications. Which of the following assessment findings would alert the nurse that a complication is developing?

Nosocomial pneumonia

A client was admitted 3 days ago and is developing signs and symptoms of pneumonia. Select the correct documentation of the diagnosis.

Dyspnea

A client who has no previous history of respiratory disease describes a sensation of shortness of breath and the feeling of not being able to pass enough air during exercise that has just developed over the past month. The client would be documented as having which of these?

Intravenous

A client who has suffered a myocardial infarction is being treated in the emergency room. His pain remains severe even though he was given nitrates and oxygen. The physician now orders morphine for the pain. What method should the nurse to administer the morphine?

See the doctor for evaluation immediately

A client who is experiencing angina at rest that has been increasing in intensity should be instructed to do which of the following?

The hypothalamic-pituitary-target cell system

A client who is referred to the endocrinologist's office for an evaluation of his hormone levels asks what regulates the hormone levels. The best response would be that hormone levels in the body are primarily regulated by:

Valvular defects usually are detected through cardiac auscultation

A client who is relatively healthy is seen in the clinic for a regular checkup. While there he tells the nurse that he is worried that he may develop a heart condition. When the nurse asks him why he is worried he tells her that his mother had aortic valve stenosis and is afraid that he might get it. He then asks to be tested for the disease. What should the nurse tell this patient about diagnosing a valvular defect?

Troponin level

A client with a suspected MI is brought to the emergency department by ambulance. The nurse caring for this client would expect to receive an order for which laboratory test to confirm a diagnosis of MI?

"I could come down with viral or bacterial pneumonia as a result of a bad flu bug."

A family physician is performing patient teaching about the influenza virus with each patient who has come to the clinic to receive that year's vaccine. Which of the following statements by the patient best reflects an accurate understanding of the flu virus?

"Your tumor in your vagina is secreting a hormone called adenocorticotropic hormone (ACTH) which is responsible for these signs/symptoms."

A female patient presented to her primary care physician with classic signs/symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the healthcare providers explain her Cushing syndrome signs/symptoms to this patient?

• The client has a "butterfly rash" on her nose and cheeks. • She complains of intermittent joint pain. • The client has been hospitalized twice in the past for pleural effusions. • Blood work indicates low red cells, white cells and platelets.

A physician is attempting a differential diagnosis of a 30 year-old female who is suspected of having systemic lupus erythematosus (SLE). Which of the following aspects of the physician's assessment and the client's history would be considered potentially indicative of SLE? Select all that apply.

Prompt diagnosis of streptococcal infections with a throat culture

A preventative measure to decrease the risk of developing rheumatic heart disease includes which of the following?

Random blood glucose 85 mg/dl

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Hyperventilation

An asthmatic patient comes to the emergency department very anxious due to increasing shortness of breath. Physical assessment reveals tachypnea, and an arterial blood gas shows decreased carbon dioxide levels and hypoxemia. Which of the following is the most likely cause?

osteoblast activity

An elderly female is admitted with a hip fracture. Her lab test reveals an increase in serum levels of alkaline phosphatase. The nurse determines which of the following is causing this lab level to rise?

many people live with atrial fibrillation without even knowing they have it.

An 80-year-old male client arrives for his yearly physical without any complaints and following the checkup the physician explains that he has noted atrial fibrillation (AF) on the client's ECG. Before the physician can explain the disorder the client becomes very upset and states he thinks he is going to die. The physician explains that atrial fibrillation involves the top chambers of the heart and that:

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

An 81-year-old female client of a long term care facility has a history of congestive heart failure. The nurse practitioner caring for the client has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the client's condition?

Less than or greater to 18 to 20 bpm

An 82-year-old man with chronic obstructive pulmonary disease (COPD) is at the clinic for a regular checkup. Because of his diagnosis, the nurse would expect his respiratory rate under normal circumstances to be what?

Increased vascular stiffness

An 86-year-old male client is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure?

Systemic emboli, especially to brain.

An IV drug abuser walks into the ED telling the nurse that, "they are sick." They look feverish with flushed, moist skin; dehydrated with dry lips/mucous membranes; and, fatigued. The assessment reveals a loud murmur. An echocardiogram was order that shows a large vegetation growing on their mitral valve. The patient is admitted to ICU. The nurse will be assessing this patient for which possible life-threatening complication?

"When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of growth hormone (GH). Which of the following teaching points about the client's future health risks is most accurate?

Red blood cells.

An example of a single hormone that can exert effects in different tissues, erythropoietin, made in the kidney stimulates the bone marrow to produce:

Development of type II alveolar cells

An expectant mother is 23 weeks into her pregnancy when she goes into labour. Regarding fetal lung development, what is of greatest concern to the attending medical team?

Staphylococcus aureus

An immunocompromised host is open to pneumonia from all types of organisms. There is, however, a correlation between specific types of immunologic deficits and specific invading organisms. What organism is most likely to cause pneumonia in an immunocompromised host with neutropenia and impaired granulocyte function?

stimulation of irritant receptors causes bronchoconstriction.

An individual has sensitivity to perfumes and experiences shortness of breath when exposed to them. This occurs because:

Bronchopulmonary dysplasia

An infant born 10 weeks premature was placed on mechanical ventilation. Eight weeks later a nursing assessment reveals a barrel chest, tachycardia, rapid and shallow breathing, hypoxemia, hypercapnia, and poor weight gain. Based on this assessment which of the following is the most likely diagnosis?

Mental retardation Impaired physical growth

An infant born with congenital hypothyroidism who does not receive care from any healthcare provider is likely to develop which of the following complications? Select all that apply.

Histamine release causes massive vasodilation

Anaphylactic shock causes severe hypoxia very quickly because of which of the following reasons?

The client will require exogenous supplements of cortisol.

Diagnostic testing has revealed that a client has pituitary hypofunction, resulting in deficient production of ACTH. The nurse should recognize what implication of this finding?

"Your baby could become too large or have low blood sugars if we're not vigilant about controlling your sugars."

Following an oral glucose tolerance, a 36 year-old mother of 4 has been diagnosed with gestational diabetes mellitus (GDM), a problem that was not present in any of her previous pregnancies. What should her primary care provider tell her about this new health problem?

• Muffled heart tones. • Narrowed pulse pressure. • Low BP—84/60.

Following cardiac surgery, the nurse suspects the patient may be developing a cardiac tamponade. Which of the following clinical manifestations would support this diagnosis? Select all that apply.

The man has a chronic platelet deficiency and is occasionally anemic.

Following a long history of fatigue, weakness and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source?

Adjustment according to the level of the substance a hormone regulates

Following a meal, a woman's blood glucose level has increased. In addition, her pancreas has increased the amount of insulin produced and released. Which of the following phenomena has occurred?

"Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms."

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 of the following teaching points should his primary care physician include during the office visit in which this diagnosis is communicated to the client?

To increase the amount of oxygen carried in the dissolved state

Following a winter power outage, a client who had been using a home gasoline generator began to experience dizziness and headaches and was diagnosed with carbon monoxide poisoning. What is the goal of hyperbaric oxygen treatment for carbon monoxide poisoning?

• Decreasing mean arterial pressure (MAP). • Low BP reading of 86/60. • Urine output 15 mL last hour. • Periods of confusion.

Following coronary bypass graft (CABG) surgery for a massive myocardial infarction (MI) located on their left ventricle, the ICU nurses are assessing for clinical manifestations of cardiogenic shock. Which of the following assessment findings would confirm the client may be in the early stages of cardiogenic shock? Select all that apply.

Secondary

Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder?

"You'll need to be very careful to avoid causing fractures to his fragile bones."

Following genetic testing and a thorough history from the child's mother and father, a 5 month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father?

Stroke volume × heart rate

The health care provider is concerned that a client has developed a decrease in cardiac output. Cardiac output may be calculated as:

• Eating fish on a regular basis • Drinking irradiated milk

Which are efficient dietary ways to aid in intestinal absorption of calcium? Select all that apply.

They can fragment and cause cerebral emboli.

In infective endocarditis, vegetative lesions grow on the valves of the heart. These vegetative lesions consist of a collection of infectious organisms and cellular debris enmeshed in the fibrin strands of clotted blood. What are the possible systemic effects of these vegetative lesions?

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy

In pregnancy, which of the following data are diagnostic for pre-eclampsia and eclampsia?

Asthma

In the early morning, an African-American woman brings her 5-year-old son to the emergency room. The boy is wheezing, short of breath, and has a dry cough. The mother states that he has always been very healthy. He went to bed with only a slight cold and a runny nose but woke her with his coughing shortly after 4 a.m. His symptoms worsened so dramatically that she brought him to the hospital. The care team would most likely suspect that he has:

• Diaphoresis • Tachycardia

Which are the earliest manifestations that a client is developing hypoxemia? Select all that apply.

Receptor binding

Select the process that allows hormones to exert influence upon some cells and not others.

baroreceptors

Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.

Hormone receptors recognize a specific hormone and translate the signal into a cellular response.

Select the statement that best explains the function of hormone receptors.

History of cigarette smoking and elevated blood pressure

The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be:

Osteoprogenitor

Which bone cell is responsible for continual replacement of worn out bone tissue?

Serum biochemical markers

The diagnosis of chronic stable angina is based on a detailed pain history, the presence of risk factors, invasive and noninvasive studies, and laboratory studies. What test is not used in the diagnosis of angina?

Rapid onset of profound malaise

The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections?

Including fish in the diet on a routine basis

The elderly nursing home resident has a fractured humerus. In order to promote healing, the physician recommends which of the following?

Sleeplessness

The elderly population needs special consideration in the treatment of the arthritic diseases. The NSAIDs, a first-line group of drugs used in the general population for arthritic diseases, may not be well tolerated by the elderly. What side effects of NSAIDs might be seen in the elderly?

Repolarization of the ventricles

The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?

C4 area

The emergency department is awaiting the arrival of a spinal cord injured patient. Knowing the innervation of the diaphragm, a patient with which type of injury may be in need of immediate mechanical ventilation? Injury to the:

Bisphosphonates Selective estrogen receptor modulators (SERMs) Calcitonin RANKL inhibitor denosumab Recombinant parathyroid hormone

The health care provider has evaluated a client diagnosed with osteoporosis and determined that pharmacological therapy will benefit the client. Select the medication options that the provider may prescribe. Select all that apply.

Spine

The health care provider is assessing a client with a history of ankylosing spondylitis, to note progression of the disease. The most important area for the provider to assess would be:

A uniform and well-defined area with well-demarcated edges

The health care provider is evaluating a client with a suspected benign bone tumor. The provider confirms the diagnosis after evaluation of the client's x-ray results. Select the best description of the results.

ACTH peaks in the morning and declines throughout the day.

The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.

Hypertension

The health care provider is teaching a client about modifiable risk factors for atherosclerosis. The most appropriate information to provide would be:

Breakdown of proteins and fats

The health care provider is teaching a client about the metabolic effect of cortisol. The most appropriate information to provide would be:

inflammation of a tendon

The health care provider notes that a client has a history of tendonitis. Select the best description of tendonitis.

Fractured or dislocated ribs

The health care provider suspects a newly admitted client may have a hemothorax. The client most likely experienced:

-tricuspid -mitral

The heart consists of four valves. Which are the heart's atrioventricular valves? Select all that apply.

• Rapid, shallow breathing • Chest retractions with accessory muscle use • Clubbing of the fingers

The neonatal ICU nurse is assessing a client with severe bronchopulmonary dysplasia (BPD). The nurse knows that this client will likely exhibit which clinical manifestations? Select all that apply.

The specific gravity of the pleural exudate is greater than 1.020.

The nurse is teaching a group of nursing students about exudative pleural effusion. The nurse determines that teaching was effective when the students' state:

Protects and maintains soft tissues in their proper position Contains hematopoietic tissue Maintains the body's shape

The pathophysiology student explains that the skeletal system does which of the following? Select all that apply.

Formation of a large clot; neovascularization; continued formation of the callus; reconstruction

The pathophysiology student is reviewing the stages of the healing process. The student explains that the process follows which order?

Outer fibrous layer

The pericardium is a tri-layer sac. Which layer prevents acute dilation of the heart chambers and exerts a restraining effect on the left ventricle?

"Ligaments join one bone to its articulating mate."

The physical therapy student is studying how the knee moves. The instructor knows the student understands the structure when she states which of the following?

red blood cells

The physician has scheduled a bone marrow biopsy for a client diagnosed with severe anemia. The purpose of the test will be to analyze the ability of bone marrow to produce:

Calcitonin

The physician is reviewing lab results for his client with cancer and finds the client to be hypercalcemic. Which of the following will the physcian prescribe?

obesity

When a nurse is assessing a patient with osteoarthritis, which of the following factors poses a risk factor for the disease?

Chemical nature of dust particle Size of dust particle Ability of particle to incite lung destruction

What etiologic determinants are important in the development of the pneumoconioses? (Select all that apply.)

Teach the client about X-ray examination

What intervention will the nurse perform first for the client who has a new fracture of their leg?

Blood supply to the femoral head

What is a priority concern for a client who has a hip dislocation?

Alcohol abuse

What is the most common identifiable cause of secondary cardiomyopathy?

Negative feedback

What is the most common mechanism of hormone control?

• Alteration in carbon dioxide production • Abnormalities in respiratory function • Disturbance in gas exchange function • Changes in neural control of respiration

When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. What factors contribute to hypercapnia? (Select all that apply.)

Genu varum, which can be treated by bracing

When a 4 year-old boy stands erect with his medial malleoli touching, the distance between his knees is two inches. What is the child's most likely diagnosis and treatment?

Adalimumab

When a nurse is administering medications to a patient with rheumatoid arthritis (RA), which of the following medications interferes with tumor necrosis factor (TNF)-alpha?

• Aching diffuse pain in the involved area • Grating sensation palpated upon movement • Presence of Heberden nodes

When a nurse is assessing a patient with osteoarthritis, which of the following does the nurse note are consistent with this disorder? Select all that apply.

Treatment needs to be individualized.

Which of the following statements is true about treatment of developmental dysplasia of the hip?

Observation and no active treatment

While measuring the height of a 12-year-old girl, the primary care provider noted a deviation of the girl's spine. This was quantified as being a right curve scoliosis of approximately 10 degrees deviation. Which treatment option is most appropriate?