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CHAPTER 18 - DISORDERS OF BLOOD FLOW AND BLOOD PRESSURE, Da 5th one, Patho Chapter 34 Quiz Questions, Unit 8 Patho, Patho ch 15, Patho Chap 19, Ch. 34- Learning: Disorders Affecting Motor Function, Adaptive Quizzing-Exam 4, PrepU CH. 14, Patho Exam #...

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The nurse is instructing a patient about potential adverse effects of a prescribed ACE inhibitor. For which adverse effect should the patient seek immediate medical attention?

Angioedema

A nurse is reviewing the medication record of a patient with chronic kidney disease who developed hypertension. Which drug will the nurse anticipate administering daily?

Angiotensin II receptor blocker, ACE inhibitor

The nurse is teaching the staff about the renin angiotensin aldosterone system. Which statement should the nurse include when describing this process?

Angiotensinogen is catalyzed by renin into angiotensin I

There are two criteria that have to be met in order for a diagnosis of an infectious disease to occur. What are these two criteria?

Recovery of probable pathogen and documentation of signs and symptoms compatible with an infectious process.

A female client has been diagnosed with antiphospholipid syndrome. The nurse would anticipate the client to have a health history that may include:

Recurrent fetal loss, Hypertension during pregnancy, Uteroplacental insufficiency

The nurse is teaching the staff about the effects of CCBs. which described actions of CCBs?

Reduce force of heart contraction, Dilate peripheral arterioles and arteries, Suppress conduction through the AV node

The health care provider is preparing to assess a client who has been diagnosed with hypertrophic cardiomyopathy. The provider anticipates the assessment data will include:

Reduced chamber size

A client is suspected of having a parasitic infection with roundworms. For what laboratory testing will the nurse prepare the client to most rapidly identify this infection?

Stool exam for ova

The nurse is teaching the parent of a young child about administering ferrous sulfate to the child at home. Which teaching point should receive the highest priority?

Store the ferrous sulfate in a childproof container and keep it out of the child's reach

The health care provider is assessing a client to differentiate a herniated disk from other causes of acute back pain. The most important test for the provider to perform would be:

Straight-leg test

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?

Stupor

What term is used to describe a level of consciousness that sees a client responding only to vigorous and repeated stimuli and has minimal or no spontaneous movement?

Stupor

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with:

Subarachnoid hemorrhage

Proper perfusion of vital organs requires which of the following conditions?

Sufficient blood volume to fill the vascular compartment, Efficient cardiac pumping ability, Ability of organs to extract oxygen and nutrients from blood, Intact vascular system

The clinical picture, or presentation of a disease in the body, is called what?

Symptomatology of the disease

The primary healthcare provider prescribes niacin for a patient who has hyperlipidemia. What will the nurse assess for while caring for this patient?

Symptoms of pruritus

Neurons communicate with each other through which of the following structures?

Synapses

After neurotransmitters are synthesized, in which of the following structures are they stored in the axon terminal?

Synaptic vesicles

The adrenal medulla is innervated by parasympathetic nerve fibers.

False

True or false: All veins have internal valves to aid in the unidirectional flow of blood toward the heart

False

A patient is prescribed hydrazine for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient?

Fatigue, dizziness, headache

A nurse is preparing a prescribed medication to lower a hypertensive emergency in a patient. The provider states that this drug will maintain the patient's renal function. Which drug will the nurse administer?

Fenoldopam

A specific type of gram-negative bacteria contains endotoxin in the bacterial cell envelope. What is the likely clinical manifestation if these bacteria become pathogenic?

Fever

A nurse is assessing a client's apical pulse. The nurse is palpating the point of maximum impulse between which ribs?

Fifth and sixth

A client is very much concerned about the harmful effect that all microorganisms may have. The best response by the nurse would be:

"Not all interactions between microorganisms and humans are detrimental."

Regarding the pathophysiology of Parkinson disease, which statement is true?

Degeneration of the nigrostriatal dopamine neurons occurs.

The physician knows the client, G1P0 has correctly understood the prenatal education regarding sexually transmitted infection as evidenced by which of the following statements listed below?

"My baby could become infected either across the placenta or during the birth itself."

A client with a diagnosis of sepsis and has received intravenous immune globulin (IVIG) as partial treatment. The nurse knows which of the following client responses listed below would best suggest an accurate understanding of IVIG treatment?

"A big part of my IVIG treatment is actually stimulating and supplementing my immune system to do the work itself."

During a flu shot clinic, one of the questions asked relates to whether the client has a history of Guillain-Barré syndrome. The client asks, "What is that?" How should the clinician reply?

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

A nurse is instructing a client on the long-term use of antibiotics and antibiotic resistance. Which of the following statements by the client indicates that the teaching has been successful?

"Bacterial resistance to antibiotics can occur due to genetic mutations."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:

"Because the skull sutures are not fused there may be no brain damage."

A patient diagnosed with H pylori asks the nurse, "How an infection can occur in their stomach since it is an acid environment?" The nurse responds:

"H. pylori produces an enzyme called urease that converts gastric juices into ammonia which neutralizes the acidic stomach environment."

The unique clinical presentation of a 3 month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

"Have you ever given your child any honey or honey-containing products?"

A nurse is teaching parents of a child with scarlet fever. Which of the following statements indicates that the parents understand the treatment for the child?

"I will give the antibiotic for the full 10 days."

A nurse is teaching a parent group about the importance of regular childhood vaccines. The nurse evaluates that the teaching is successful based on which of the following statements?

"I will have my baby vaccinated as scheduled to reduce the senseless spread of vaccine-preventable illnesses."

The nurse knows which of the following statements below is appropriate to be included in an education session for a 21-year-old male with a diagnosis of malaria?

"The infectious organisms are considered tiny, single-celled animals, given their complete eukaryotic machinery."

A patient was recently diagnosed with acquired immunodeficiency syndrome (AIDS) and started on antiviral therapy. The nurse evaluates the patient's understanding of the antiviral drug when the patient correctly identifies which of the following as the pharmacological mechanism of action?

"The primary target of most antiviral compounds is viral RNA or DNA synthesis."

A client was unaware that intestinal flora are beneficial, stating, "I thought all bacteria were bad." Which is the nurse's most accurate response?

"The term 'mutualism' is applied to an interaction in which the microorganism and the host both derive benefits from the interaction."

A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The clinician will respond:

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

A client discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The client's spouse is extremely upset because the physician stated that the client cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. What is the nurse's most accurate response?

"Thrombolytics may cause cerebral hemorrhage."

A client has been diagnosed with herpes simplex virus. The client states that, "modern medicine produces more and more antivirals every year and so the treatment should be simple." Which of the following statements listed below is the best response?

"Treatment options for viruses are often limited because what destroys viruses often damages your own body cells."

A client tells the health care provider he has heard several myths about viruses. The most appropriate information for the nurse to provide would be:

"Viruses can produce symptoms of disease months to years later."

"Your son will be prone to heart problems and decreased lung function because of this."

The nurse is teaching a client about appropriate interventions for back pain. Select all that apply.

-Analgesics -Nonsteroidal anti-inflammatory drugs -Muscle relaxants

Much like brain death, there are criteria for the diagnosis of a persistent vegetative state which has lasted for more than 1 month. What are criteria for the diagnosis of persistent vegetative state? Select all that apply.

-Bowel and bladder incontinence -Lack of language comprehension -Variable preserved cranial nerve reflexes

Select the conditions that would place a client at risk for the development of hypoxia. Select all that apply.

-Carbon monoxide poisoning -Severe anemia

The nurse assessing a client with a traumatic brain injury assesses for changes in which neurologic component? Select all that apply.

-Cognition -Level of consciousness -Motor function -Sensory function

Which physiologic principle can cause hydrocephalus? Select all that apply.

-Decreased absorption of cerebrospinal fluid -Obstruction of cerebrospinal fluid

A client with a traumatic brain injury has developed extreme cerebral edema. Which clinical manifestations of brain herniation correlate to upward herniation of the midbrain known as uncal herniation? Select all that apply.

-Deep coma -Respiratory rate of 8 with intermittent sighs -Bilateral small, fixed pupils

The nurse is completing a Glasgow Coma Scale assessment on a client with a traumatic brain injury. Which of the following should the nurse include in the assessment? Select all that apply.

-Eye opening response -Verbal utterances -Motor response

Herniated disks put pressure on the nerve root. This type of injury occurs most often in the cervical and lumbar region of the spine. What is an important assessment technique for a herniated disk in the lumbar region?

-Hip flexion test -CT scan -Straight-leg test

Myasthenic crisis may be precipitated by which causes? Select all that apply.

-Infection -Pregnancy -Surgery

Manifestations of peripheral neuropathy include which of the following? Select all that apply.

-Muscle weakness -Muscle wasting -Sensory changes

Following a car accident in which the driver did not have his seatbelt on, the client is diagnosed with a traumatic brain injury requiring emergent craniotomy for severe cerebral edema. Which assessments should the nurse report immediately since they correspond to a supratentorial herniation progressing to midbrain involvement? Select all that apply.

-Pupils fixed at ~ 5 mm in diameter -Respiration rate of 40 breaths/min -Decerebrate posturing following painful stimulation of the sternum

A client comes to the clinic and informs the nurse that he believes he is suffering from Parkinson disease. What objective data assessed by the nurse would correlate with the client's concern? Select all that apply.

-Tremor -Rigidity -Bradykinesia

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options. A) Hiatus B) Duodenum C) Ileum D) Pylorus E) Jejunum F) Cecum

1 Hiatus 2 Pylorus 3 Duodenum 4 Jejunum 5 Ileum 6 Cecum

A client who came to the emergency room and was diagnosed with 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?

1 hour

The nurse knows that systolic hypertension is characterized by systolic pressure of ___ or higher

140

A local athlete is getting prepared for the upcoming national track and field championship. Since this athlete is performing extreme exercise, what would be the most probable cardiac output?

16-36 L/min

The heart is a four chambered pump. In one day, how many gallons of blood are pumped throughout the body?

1800

According to the Glasgow Coma Scale, opening one's eyes to only painful stimuli would receive which score?

A patient received desmopressin preoperatively to maintain hemostasis during a surgical procedure. Which postoperative assessment finding indicates the patient has experienced an adverse effect of the drug?

2+ edema of the extremities

What percentage of the body's oxygen does the brain consume?

20%

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

25-30%

A client has just begun to experience an ischemic stroke. The blood supply from the middle cerebral artery is being blocked by a large blood clot. How long before brain cells begin to die due to lack of ATP?

4 to 6 minutes

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?

300-400%

Which client best describes an example of infection originating with a fomite?

32-year-old man who contracts hepatitis B by sharing a syringe.

The nurse witnesses a client go into cardiac arrest. If the nurse delays intervention, when will the death of brain cells begin?

4-6 minutes

Which needle length and gauge should the nurse choose to administer subcutaneous heparin?

5/8 inch 25 gauge

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

55-75%

. 9.A client in an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is complaining of intense, diffuse pain in her abdomen. Which of the following physiological phenomena is most likely contributing to her complaint? A) Nociceptive afferents are conducting the sensation of pain along the cranial and spinal nerve pathways of the ANS. B) First-order neurons are inappropriately signaling pain to the dorsal root ganglion. C) The client is experiencing neuropathic pain. D) The client's C fibers are conducting pain in the absence of damaged Aδ fibers

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

12. A 20-year-old college student has presented to his campus medical clinic because of his unshakable despondency in recent months. He has been diagnosed with depression based on his signs, symptoms, and history. The nurse knows that which of the following treatments will likely be prescribed for this student? A) Medication that inhibits the reuptake of serotonin in his presynaptic space B) Drugs that inhibit the accumulation of cyclic adenosine monophosphate (cAMP) C) Benzodiazepines such as clonazepam that modulate his GABA receptors. D) Cholinesterase inhibitors that potentiate the action of available acetylcholine E) Antipsychotics such as olanzapine

12. Which of the following clients' signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult A) has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days. B) has experienced a sudden loss of balance and slurred speech. C) has vomited and complained of a severe headache. D) states that his left arm and leg are numb, and gait is consequently unsteady.

13. A psychiatrist is providing care for a 68-year-old female whose anxiety disorder is significantly decreasing her quality of life. The nurse knows that the client will likely benefit from which of the following pharmacologic therapies listed below? A) A drug that influences gamma-aminobutyric acid (GABA) levels B) An MAO inhibitor to increase the concentration of serotonin and norepinephrine C) An antipsychotic medication that blocks dopamine receptors D) A calcium channel-blocking agent

14. During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that a client has a sustained damage to her vagus (CN X) nerve. Which of the following assessment findings is most likely to lead the physician to this conclusion? A) The client has difficulty swallowing and has had recent constipation and hypoactive bowel sounds. B) The client is unable to turn her head from side to side, and her tongue is flaccid. C) The client has a unilateral facial droop, dry eyes, and decreased salivary production. D) The client is unable to perform any fine motor movements of her tongue

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

15. A 50-year-old woman has experienced devastating consequences in her family and work life as a result of her long-standing alcohol addiction. The levels and pathways of which of the following neurotransmitters in her body are likely to differ from an individual without addiction? A) Dopamine B) Acetylcholine C) Serotonin D) Norepinephrine

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

17. A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate? A) "Your prognosis will depend on whether we can surgically resect your tumor." B) "Our treatment plan will depend on whether your tumor is malignant or benign." C) "This is likely a result of a combination of heredity and lifestyle." D) "The major risk that you face is metastases to your lungs, liver, or bones

18.The nurse is educating the new mother about the sleep patterns of a newborn. Which of the following statements should she include in her education? A) "Newborns usually sleep approximately 16 to 20 hours/day." B) "Newborns generally sleep 6 to 8 hours/day and then are awake for 2 to 4 hours." C) "Don't worry about them sleeping too long; they will wake up when they are hungry." D) "Most newborns will have their days and nights mixed up.

19. A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the patient that the venous blood supply to the penis is controlled by A) sacral parasympathetic fibers. B) the hypothalamus. C) the vagus nerve. D) postganglionic sympathetic neurons.

19.A 5-year-old boy has starting sitting up in bed displaying signs of extreme anxiety. In the morning, when the parents ask the boy about this, he has no recollection. What should the nurse convey to the parents if this happens again? A) Assist the boy in settling down without awakening him after an episode. B) Watch him closely to see if he has any twitching or thrashing about. C) Bring him back to the clinic if this keeps happening, so we can prescribe some sleep medicine. D) Shake him to wake him up, and then comfort him and put him back in bed.

2. A client with a diagnosis of insomnia is surprised when his physician explains to him that his brain is still highly active during normal sleep. Which of the following statements best captures the character of brain activity during sleep? A) "Fewer neurons in your brain are firing when you're asleep, but they're more synchronized than when you're awake." B) "While you're obviously less aware of stimuli when you're asleep, your brain is actually more active when you're asleep than when you're awake." C) "There are four types of brain activity, and actually all of them occur at different stages of sleep." D) "Your brain alternates between periods of activity and periods of inactivity when you're asleep, and these correspond to your eye movement."

2. A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the bag other than the phone. The nurse knows that which of the following terms best describes one's ability to sense of shape and size of an object in the absence of visualization? A) Stereognosis B) Astereognosis C) Modalities D) Somesthesia

20. Which of the following is the most likely course of Wernicke syndrome? A) If the symptoms are correctly diagnosed, most of the effects of the disease can be reversed through better nutrition and supplemental thiamine. B) Wernicke syndrome is uniformly fatal, with death most often occurring within a few months of onset. C) Wernicke syndrome has no treatment, but drugs may be used to treat its associated dyskinesias and behavioral disturbances. D) The course of the disease is relentless, and most affected persons will die of infection within 2 to 10 years

4. When educating a patient about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be reexcited. Within the cell, the nurse understands that A) potassium channels open while sodium channels close, causing repolarization to the resting state. B) the influx of calcium is the primary stimulus for the repolarization of cardiac tissue. C) only the electrical activity within the heart will determine when repolarization occurs. D) the cell membranes need to stay calm resulting in muscle tissue becoming refractive.

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

5. A student notices that at certain times during his studying for final exams, he is more awake and his ability to think at a higher level is happening easier. The nurse knows that this experience may be attributed to which of the following neurological functions? A) Release of excitatory neurotransmitters such as glutamate B) Release of GABA, an inhibitory neurotransmitter C) Release of corticotrophin-releasing hormone D) Heightened precortex processes

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

8. A male newborn infant has been diagnosed with spina bifida occulta. Which of the following pathophysiological processes has most likely contributed to the infant's health problem? A) The neural groove failed to fuse and completely close across the top of the neural plate. B) The infant's spinal cord and meninges protrude through his skin. C) The child's central and peripheral nervous systems have insufficiently differentiated during embryonic development. D) The infant's soma and viscera are underdeveloped.

8. During an acute phase of schizophrenia when the patient is experiencing hallucinations and delusions, the nurse should anticipate that the physician will prescribe which of the following medication categories listed below? A) An antipsychotic like risperidone B) A benzodiazepine like lorazepam C) A cholinesterase inhibitor like donepezil D) An opioid receptor antagonist like naltrexone

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

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

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

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

Which of the following types of viral hepatitis is not associated with transmission through contact with infected blood?

A Feedback: Botulism in infants is frequently attributable to honey. Family history is not a relevant consideration given the bacterial etiology, and mold and chemical cleaning products are not known to predispose to botulism toxicity.

A Feedback: Guillain-Barré syndrome is an acute immune-mediated polyneuropathy. The majority of people report having had an acute, influenza-like illness before the onset of symptoms. It progresses along the ascending muscle weakness of the limbs, producing a symmetric flaccid paralysis. The rate of disease progression varies, and there may be disproportionate involvement of the upper or lower extremities. Option B is anaphylaxis following the flu shot. It is not a degenerative disease.

In which of the following patients would diagnostic investigations be least likely to reveal increased thrombopoietin production?

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

Which individual has the highest chance of having a primary central nervous system lymphoma?

A 24-year-old man with acquired immunodeficiency syndrome (AIDS) and behavioral and cognitive changes

Which statement accurately reflects the typical person afflicted with multiple sclerosis (MS)?

A 25-year-old woman

A 41-year-old woman was diagnosed with multiple sclerosis (MS) 7 years ago and is sharing her story with members of an MS support group, many of whom have been diagnosed recently. Which of the following aspects of her health problem should the woman warn others to expect at some point in the progression of the disease? Select all that apply. A) Debilitating fatigue B) Progressive loss of visual acuity C) Gradual development of a resting tremor D) Loss of mental acuity E) Shuffling gait

A B C

If the nurse suspects a spinal cord injury, the patient has developed autonomic dysreflexia. Which of the following assessments would confirm this complication? Select all that apply. A) BP 180/98 B) Skin covered with macular rash C) Pulse rate 49 D) Complains of a pounding headache E) Cold, cyanotic lower legs

A C D

Which patient is likely to be prescribed beta blockers?

A cardiac patient who has had a myocardial infarction

Which of the following scenarios best describes an example of infection originating with a fomite?

A client who contracted hepatitis C through sharing a contaminated syringe with an infected person.

The nurse is reviewing assessment data of four clients. Select the client who is at greatest risk for developing pernicious anemia.

A client who has undergone partial gastrectomy.

A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?

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

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

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

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?

A hyper cyanotic attack brought on by periods of stress

A client has been diagnosed with an abscess. Upon assessment of the client, the nurse would expect to find:

A localized pocket of infection composed of devitalized tissue, microorganisms, and the host's phagocytic white blood cells

A 44-year-old Caucasian woman is being treated in an airport infirmary after she developed a painful, swollen leg during a transatlantic flight in economy class. The woman is suspected of having deep vein thrombosis (DVT), and is questioning the paramedics about why this might be the case, given that she has twice previously had similar experiences. Which of the following teaching points be the airport medical staff would be most appropriate?

A lot of caucasians have an inherited inability to dissolve clots that form in their bodies

The nurse is teaching a client infected with the flu about viruses. Which of the following would the nurse use to describe a viral infection?

A parasitic relationship between an organism and host is present.

Which patient with angina would be at increased risk for adverse effects after the administration of beta blockers?

A patient with diabetes mellitus

Which patient is contraindicated for therapy with iron dextran?

A patient with hypotension

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? A) Genetic short stature B) Lack of IGF receptors in epiphyseal long bones C) A shortage of hypothalamic GHRH production D) Excess insulin production resulting in chronically low blood glucose levels

A shortage of hypothalamic GHRH production

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

A slow depolarization occurs when sodium is transported out of the cell and potassium moves back in resulting in resting membrane potential

A 28-year-old male who is 6 S11 c 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? A)My pituitary gland produced a much higher than normal amount of growth hormone when I was a child.¡¨ B) A tumor in my brain threw off my hormone levels after I was finished adolescence.¡¨ C) My liver is malfunctioning and produces too many of the hormones that ultimately cause growth.¡¨ D) The high sugar levels that go along with my diabetes made my pituitary gland overproduce the hormones that cause you to grow.¡¨

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

Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the emergency department with malaise, nausea, and yellow eyes. Serology has confirmed a diagnosis of hepatitis A (HAV), to the shock of the client. What teaching is most appropriate for this client? A)You can expect these symptoms to disappear after about 2 months, but you'll be a carrier of the disease indefinitely. B) A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time. C) You likely came in contact with blood or body fluids at some point, and you'll have to ensure no one is subsequently exposed to your own blood or body fluids. D) You likely got this by way of what we call the 'fecal oral' route; you will have chronic hepatitis now, but the symptoms can be controlled with medication

A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time.

A client comes to the physician's office after being bitten by a tic, with symptoms of headache, fatigue, joint pain and swelling. The physician determines which of the following as the mode of transmission for the infection?

A vector

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? Select all that apply. A) A bodily process can be the result of the combined effect of several different hormones from different sources.¡¨ B) A single hormone can act not only on one process or organ but often on several different locations or processes.¡¨ C) It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect.¡¨ D) Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions.¡¨ E) The regulation in homeostasis requires that hormones be absent from the body when their effect is not needed.¡¨

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

16. A 41-year-old woman was diagnosed with multiple sclerosis (MS) 7 years ago and is sharing her story with members of an MS support group, many of whom have been diagnosed recently. Which of the following aspects of her health problem should the woman warn others to expect at some point in the progression of the disease? Select all that apply. A) Debilitating fatigue B) Progressive loss of visual acuity C) Gradual development of a resting tremor D) Loss of mental acuity E) Shuffling gait

A, B, D Feedback: Fatigue, visual deficits, and cognitive disturbances are all noted manifestations of MS, while respiratory function and GI function are not normally affected. Shuffling gait is usually associated with Parkinson disease.

Which statement best describes the pathophysiology of Parkinson disease?

Degeneration of the nigrostriatal dopamine system

20. If the nurse suspects a spinal cord injury, the patient has developed autonomic dysreflexia. Which of the following assessments would confirm this complication? Select all that apply. A) BP 180/98 B) Skin covered with macular rash C) Pulse rate 49 D) Complains of a pounding headache E) Cold, cyanotic lower legs

A, C, D Feedback: Autonomic dysreflexia represents an acute episode of exaggerated sympathetic reflex responses that occur in people with injuries at T6 and above, in which CNS control of spinal reflexes is lost. It is characterized by hypertension (BP 180/98), skin pallor, vagal slowing of the heart rate (pulse 49), and headache ranging from dull to severe and pounding.

19. A 70-year-old woman has been brought to the emergency department by her daughter who noticed the woman is weak, confused, and forgetful in recent months, along with uncoordinated movements and visual disturbances at times. Which of the following questions by the physician are most likely to address her probable diagnosis? Select all that apply. A) "What medications is your mother currently taking?" B) "Does your mother drink alcohol?" C) "Does your mother have a history of stroke?" D) "Is your mother facing significant stressors right now?" E) "Is your mother lonely?"

A,B

20.A geriatrician is assessing an 84- year-old male recently admitted to a subacute medical unit of a hospital for rehabilitation following a recent fall resulting in a hip contusion. Which of the following aspects of the client's sleep history would the physician want to follow up with education? Select all that apply. A) "I make sure that I take a long nap each afternoon to compensate for my frequent waking at night." B) "I've got a bottle of diazepam at home, but I only take them once or twice a month." C) "I try my best to get out for a walk after breakfast or after supper." D) "I make it a rule not to drink any alcohol in the evening." E) "Once my head hits the pillow, I am fast asleep.

A,B

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

A,B,C

9. Which of the following clinical manifestations would the nurse assess in the patient with bipolar disorder who is experiencing mania? Select all that apply. A) Labile mood B) Highly distractible C) Inflated self-esteem D) Despondent when asked questions E) Excessive sleepiness

A,B,C

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

A,B,C,D

A,B,D

18. A brain tumor causing clinical manifestations of headache, nausea, projectile vomiting, and mental changes is likely located in which parts of the brain? Select all that apply. A) Intra-axially B) Extra-axially C) Brain stem D) Temporal lobe E) Frontal lobe

A,B,E

16. The nurse knows that the patient admitted for opioid addiction may benefit from which of the following treatment modalities? Select all that apply. A) Prescription for dolophine (Methadone) B) Administration of a long-term pain reliever like duragesic (Fentanyl) C) Involvement in a self-help group like Opioid Anonymous (an offshoot of Alcoholics Anonymous) D) Intense exercise therapy under supervision of a body builder E) Administering beta-blocking medications to minimize agoraphobia symptoms

A,C

10. A 20-year-old has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which of the following aspects of the client's history would be considered to have contributed to his stroke? Select all that apply. The client A) is an African American male. B) takes iron supplements for the treatment of chronic anemia. C) blood pressure has historically been in the range of 150s/90s. D) was diagnosed with type 2 diabetes 8 years ago. E) takes corticosteroids for the treatment of rheumatoid arthritis.

A,C,D

What can trigger myocardial ischemia even when there is adequate coronary blood flow?

Anemia, carbon monoxide poisoning, hypoxia

A,C,D

6. Match the pain theory to the correct physiologic basis for the pain. A. Specificity theory 1. Light touch applied to the skin would produce the sensation of touch through low-frequency firing of the receptor. B. Pattern theory 2. Repeated sweeping of a soft-bristled brush on the skin over or near a painful area may result in pain reduction for several minutes. C. Gate control theory 3. Proposes that the brain contains a widely distributed neural network that contains somatosensory, limbic, and thalamocortical components. D. Neuromatrix theory 4. Describes how an acute injury is predicted to be but does not take into account the person's feelings of how the pain feels to him or her

A-4,B-1,C-2,D-3

A patient with multiple sclerosis (MS) requires teaching on the effects of the health problem on body functions. Which nursing explanation describes the effects of MS plaque formation and demyelination of brain tissue? A. "Lesions or plaques occur in the white matter of the brain because of inflammation and the body's immune response, causing damage to the myelin sheath outside the nerve and delaying the transmission of nerve impulses in the body." B. "T cells and B cells block the immune response and inhibit the inflammatory process within the myelin sheath of the nerve, resulting in seizures." C. "Plaques develop in the brain and cause a risk for motor impairment and seizures." D. "Plaques in the brain occur because of increased low-density lipoproteins; an increased level impairs the brain's ability to use oxygen."

A. "Lesions or plaques occur in the white matter of the brain because of inflammation and the body's immune response, causing damage to the myelin sheath outside the nerve and delaying the transmission of nerve impulses in the body." In MS, lesions develop at different times and at different locations throughout the central nervous system. They typically occur in periventricular white matter, optic nerve, brainstem, and cerebellum. These lesions, or plaques, vary in size. There is no link between multiple sclerosis and low-density lipoprotein; this occurs in atherosclerosis, which leads to cardiovascular diseases such as myocardial infarction and cerebrovascular accident. Although MS can eventually result in motor impairment, the plaques do not directly cause this; seizures would be attributed to other conditions. T cells, B cells, and macrophages enter the brain and attack myelin. This is a result of an increased immune response and inflammatory process.

A patient with symptoms of multiple sclerosis (MS) is prescribed an MRI with gadolinium contrast. Which finding should the nurse expect? A. Demyelination or plaque B. Gray matter injuries C. Slowed conduction D. Axonal degeneration

A. Demyelination or plaque - MRI with gadolinium contrast is the test of choice to support the diagnosis of MS and can reveal the characteristic lesions of demyelination, or plaque. - It will not show gray matter injuries, axonal degeneration, or slowed conduction in the patient's brain.

The nurse observes a patient waiting to be seen in the community clinic. Which observation indicates the patient is experiencing symptoms of Huntington disease (HD)? A. Involuntary movements B. Closed eyes C. Foot shuffling D. Yawning

A. Involuntary movements The most common movement disorder in HD is chorea, which is a state of excessive spontaneous movements that are irregularly timed, randomly distributed, and abrupt. The other findings are not symptoms of HD.

A patient with a family history of Huntington disease (HD) has monthly health screenings to monitor previously detected brain changes. Which finding should the nurse expect on the brain scan report for this patient? A. Microscopic changes will develop into striatal atrophy. B. Hypertrophy of up to 40% of the brain is common. C. Extensive atrophy up to 50% of the brain will develop in the first 3 months. D. Striatal atrophy will be absent, but the caudate nucleus will remain unchanged.

A. Microscopic changes will develop into striatal atrophy. - Gross atrophy occurs in the caudate nucleus and putamen, accompanied by selective neuronal loss and gliosis. It is expected that striatal atrophy will be present and, depending on the grading for HD, the caudate nucleus will flatten out and then become concave. - The brain will shrink in volume by 40% in early HD. However, there is no time frame in months for this. - Hypotrophy, not hypertrophy, occurs in this condition.

A patient with amyotrophic lateral sclerosis (ALS) undergoes a pulmonary function test, which reveals a decrease in vital capacity to 50% of the predicted value during the test. Which health problem is this patient at risk for developing? A. Pneumonia B. Urine retention C. Low blood pressure D. Sleep apnea

A. Pneumonia - A decrease in vital capacity to 50% of the predicted value is associated with pneumonia. - Sleep apnea, low blood pressure, and urine retention are not associated with the decrease in vital capacity.

Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphagia, muscle weakness and spasticity, and dysphonia?

ALS is caused by both an upper motor neuron and lower motor neuron disturbance.

A patient with an elevated triglyceride level is prescribed a sustained release form of nicotinic acid. Which laboratory value is most important for the nurse to monitor in this patient?

ALT

Valves in the veins prevent retrograde flow. In which veins are there no valves?

Abdominal, thoracic

Which patient assessment would assist the nurse in evaluating therapeutic effects of a CCB?

Absence of chest pain

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

Acetylcholine

Which of the following are the main neurotransmitters of the autonomic nervous system (ANS)? Select all that apply.

Acetylcholine Epinephrine Norepinephrine

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated loss of which physiologic function?

Acetylcholine receptors

A patient's serum digoxin level is noted to be 0.5. Which action by the nurse is appropriate?

Administer the ordered dose of digoxin

A client taking oral corticosteroids is exposed to varicella. The client has never had the disease and has not received the varicella vaccine. What intervention should the nurse anticipate in order to prevent the client from developing varicella?

Administer varicella zoster immune globulin (VZIG).

Which intervention is essential for the nurse administering sodium ferric gluconate complex?

Administer with erythropoietin

What nursing intervention will decrease the flushing reaction of niacin?

Administering aspirin 30 minutes before niacin

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? A) Administration of 15 to 20 g of glucose in a concentrated carbohydrate source B) Administration of subcutaneous glucagon C) IV infusion of 50% dextrose and water solution D) Careful monitoring for level of consciousness and resolution of hypoglycemia

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

The nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics

A patient with hemophilia has complained of severe pain. Which is the most effective treatment?

Administration of morphine sulfate

A patient is diagnosed with hemophilia. Which is an essential intervention?

Administration of recombinant factors

Which are positive risk factors for ASCVD?

African american race, blood pressure higher than 140/90

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

Afterload

In reference to infectious disease, a patient cannot be which one of the following?

Agent

What is the correct type of isolation for the nurse to implement to prevent transmission of herpes zoster while caring for a client with an active chicken pox infection?

Airborne

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

Alcoholic cardiomyopathy

Which of the following hormones are derivatives of cholesterol? A) Epinephrine and norepinephrine B)Insulin and glucagon C) Aldosterone and testosterone D) Eicosanoids and retinoids

Aldosterone and testosterone

A patient with hemophilia is frightened about contracting HIV from therapy. How should the nurse respond to the patient?

All blood is screened for viruses

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body?

Alters vitamin K, reducing its ability to participate in the coagulation of the blood

The nursing instructor is teaching nursing students about niacin therapy for the treatment of different types of hyperlipidemia. What will the nursing instructor include in this teaching?

Always check the patient's medical history for gout, always check the patient's medical history for diabetes, it is always preferable to give the extended release dosage form of the drug to the patient

Which one of the following is a protozoan infection?

Amebic dysentery

Which medication promotes hemostasis in hemophilia A and hemophilia B by inhibition of fibrinolysis?

Aminocaproic acid

A 60-year-old male is being treated for significant denervation and muscle fiber atrophy. His movements are still smooth and he has no cognitive defects. Which likely diagosis is associated with these clinical manifestations?

Amyotrophic lateral sclerosis, a mixed UMN/LMN disorder

Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture? A) A 20-year-old football player who had an opposing player fall laterally on his leg B) An 8-year-old boy who fell out of a tree and on to his arm C) An 81-year-old woman with a history of osteoporosis who stumbled and fell on her hip D) A 32-year-old woman who fell awkwardly on her arm while skiing

An 8-year-old boy who fell out of a tree and on to his arm

The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture? A) A 77-year-old male who runs marathons and maintains a BMI of 25. B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom. C) A 64-year-old male with uncontrolled diabetes and chronic kidney disease on dialysis. D) A 73-year-old nursing home patient with long-term continence issues but able to walk the hallways for exercise.

An 82-year-old female with macular degeneration and uses a walker to go to the bathroom.

A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of:

An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve

Which is the priority nursing intervention for a patient receiving parenteral iron dextran infusion?

An intravenous test dose of 25 mg over 5 minutes must be administered.

Which is not correct about an opportunistic infection?

An opportunistic infection primarily affects a host with a normal immunity.

A client's primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this agent achieve its therapeutic effect? A) By decreasing vascular volume by increasing sodium and water excretion B) By blocking the release of antidiuretic hormone from the posterior pituitary C) By inhibiting the conversion of angiotensin I to angiotensin II D) By inhibiting the movement of calcium into arterial smooth muscle cells

Ans: A Feedback: Diuretics lower blood pressure initially by decreasing vascular volume (by suppressing renal reabsorption of sodium and increasing sodium and water excretion) and cardiac output. Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I, and calcium channels blockers inhibit the movement of calcium into arterial smooth muscle. Common antihypertensives do not act directly on the pituitary.

Which of the following is a nonmodifiable risk factor for the development of primary hypertension? A) African American race B) High salt intake C) Male gender D) Obesity

Ans: A Feedback: Hypertension not only is more prevalent in blacks than whites, but also is more severe, tends to occur earlier, and often is not treated early enough or aggressively enough. Blacks also tend to experience greater cardiovascular and renal damage at any level of pressure. High salt intake and obesity are modifiable risk factors for hypertension. Male gender is not identified as a risk factor for hypertension.

A client is receiving home care for the treatment of a wound on the inside of her lower leg that is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the client's legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this client's most likely diagnosis? A) Chronic venous insufficiency B) Deep vein thrombosis C) Varicose veins D) Peripheral arterial disease

Ans: A Feedback: In contrast to the ischemia caused by arterial insufficiency, venous insufficiency leads to tissue congestion, edema, and eventual impairment of tissue nutrition (development of a venous ulcer). The edema is exacerbated by long periods of standing. Necrosis of subcutaneous fat deposits occurs, followed by skin atrophy. Brown pigmentation of the skin caused by hemosiderin deposits resulting from the breakdown of red blood cells is common. DVTs, varicose veins, and PAD do not have this symptomatology.

Which of the following would be considered a major cause of secondary hyperlipoproteinemia since it increases the production of VLDL and conversion to LDL? A) High-calorie diet B) Diabetes mellitus C) Bile-binding resin D) Cholesterol ingestion

Ans: A Feedback: Obesity with high-calorie intake increases the production of VLDL, with triglyceride elevation and high conversion of VLDL to LDL. Excessive cholesterol intake reduces formation of LDL receptors. Diabetes is associated with high triglycerides and minimal elevation of LDL. Bile salt-binding resin is one treatment used to lower cholesterol levels.

A 29-year-old woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia-eclampsia in her second trimester. What should her care provider teach her about this change in her health status? A) "We don't really understand why some women get high blood pressure when they're pregnant." B) "This is likely a result of your nervous system getting overstimulated by pregnancy." C) "Hypertension is a common result of all the hormonal changes that happen during pregnancy." D) "Even though you're a healthy person, it could be that you have an underlying heart condition."

Ans: A Feedback: The cause of pregnancy-induced hypertension is largely unknown.

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which of the following physiologic processes? A) Peripheral vascular resistance B) Electrical impulses in the heart C) Release of stress hormones D) Rigidity of the ventricular walls

Ans: A Feedback: The systolic and diastolic components of blood pressure are determined by cardiac output and total peripheral vascular resistance and can be expressed as the product of the two (blood pressure = cardiac output × total peripheral resistance). The body maintains its blood pressure by adjusting the cardiac output to compensate for changes in peripheral vascular resistance, and it changes the peripheral vascular resistance to compensate for changes in cardiac output. Electrical impulses from the SA node regulate heart rate. Release of stress hormones and rigidity of the ventricular walls do not primarily influence BP; however, they may impact this secondarily.

Which of the following clients would be at high risk for developing primary varicose veins? Select all that apply. A) A 47-year-old waitress who works 12-hour shifts three or four times/week B) A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week C) A 56-year-old male who has been immobile due to back surgery and has developed a deep vein thrombosis D) A Marathon runner who has completed three marathons in the past 3 months E) A new peritoneal dialysis client who has been utilizing a home machine and performing dialysis every evening beginning at 8 PM

Ans: A, B Feedback: Prolonged standing and increased intra-abdominal pressure are important contributing factors in the development of primary varicose veins. Because there are no valves in the inferior vena cava or common iliac veins, blood in the abdominal veins must be supported by the valves located in the external iliac or femoral veins. Immobility may cause DVTs (a secondary cause of varicose veins). Peritoneal dialysis has no effect on the development of varicose veins.

Which of the following children may be considered high risk for developing hypertension? Select all that apply. A) Diagnosed with coarctation of the aorta as an infant B) Recent scan showing a pheochromocytoma C) Has a history of epilepsy with weekly seizures D) Takes cyclosporine daily since a kidney transplant E) Has a history of frequent sinus infections treated with antibiotics

Ans: A, B, D Feedback: Approximately 75% to 80% of secondary hypertension in children is caused by kidney abnormalities. Coarctation of the aorta is another cause of hypertension in children and adolescents. Endocrine causes of hypertension, such as pheochromocytoma and adrenal cortical disorders, are rare. The nephrotoxicity of the drug cyclosporine, an immunosuppressant used in transplant therapy, may cause hypertension in children after kidney transplantation. Epilepsy and sinus infections do not cause hypertension.

A client 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 client's increased blood pressure? A) Increased levels of adrenocortical hormones B) Activation of the renin-angiotensin-aldosterone mechanism C) Increased sympathetic stimulation by the autonomic nervous system (ANS) D) Coarctation of the client's aorta

Ans: B Feedback: Renovascular hypertension refers to hypertension caused by reduced renal blood flow and activation of the renin-angiotensin-aldosterone mechanism. It is the most common cause of secondary hypertension, accounting for 1% to 2% of all cases of hypertension. The reduced renal blood flow that occurs with renovascular disease causes the affected kidney to release excessive amounts of renin, increasing circulating levels of angiotensin II. Angiotensin II, in turn, acts as a vasoconstrictor to increase peripheral vascular resistance and as a stimulus for increased aldosterone levels and sodium retention by the kidney. One or both of the kidneys may be affected. A renal etiology is not associated with secondary hypertension due to hormonal factors, sympathetic stimulation, or coarctation of the aorta.

An elderly client newly diagnosed with systolic hypertension asks her health care provider why this happens. The most accurate response would be: A) "Everyone over the age of 50 tends to have their blood pressure creep up over the years." B) "With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer." C) "Your heart has to work harder to pump blood through your vessels as you get older." D) "If you slow down and rest more, your blood pressures will more than likely return to its normal level."

Ans: B Feedback: Systolic blood pressure rises almost linearly between 30 and 84 years of age, whereas diastolic pressure rises until 50 years of age and then levels off or decreases. This rise in systolic pressure is thought to be related to increased stiffness of the large arteries. With aging, the elastin fibers in the walls of the arteries are gradually replaced by collagen fibers that render the vessels stiffer and less compliant.

A client consistently has an elevated systolic BP greater than 150 mm Hg but a diastolic pressure in the 80s. The health care provider should be assessing for which of the following complications? A) Peripheral edema in lower legs from renal disease B) Crackles in bilateral lung bases caused by left-sided heart failure C) Ascites due to liver damage D) Confusion due to atherosclerosis of the carotid arteries

Ans: B Feedback: Systolic hypertension has been defined as a systolic pressure of 140 mm Hg or greater and a diastolic pressure of less than 90 mm Hg. Elevated pressures during systole favor the development of left ventricular hypertrophy, increased myocardial oxygen demands, and eventual left heart failure. Peripheral edema and ascites are usually associated with right-sided failure. Confusion due to blockages in carotid arteries can occur independent of hypertension.

Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is: A) Edema B) Calf pain C) Varicosities D) Strong pulse

Ans: B Feedback: The primary symptom of chronic obstructive arterial disease is pain with walking or claudication. Typically, persons with the disorder complain of calf pain because the gastrocnemius muscle has the highest oxygen consumption of any muscle group in the leg during walking. The extremity will be thin, dry (no edema), and have weak low-pressure pulses due to severely reduced blood flow to the distal vessels.

A client asks, "Why do I have clogged arteries but my neighbor has higher 'bad cholesterol' levels and yet he is just fine?" The health care provider bases the reply on which of the following physiological principles about lipoprotein? A) "Your neighbor probably has higher amounts of good cholesterol (HDL) as well." B) "You more than likely have small, dense type of 'bad cholesterol' (LDL)." C) "Your neighbor has larger 'bad cholesterol' particles that can move into blood vessels but park in joints/tendons." D) "You must have a genetic predisposition to having clogged arteries."

Ans: B Feedback: There are different types of LDL, and some people with markedly elevated LDL do not develop atherosclerotic vascular disease, whereas other people with only modest elevations in LDL develop severe disease. Small, dense LDL is more toxic or atherogenic to the endothelium than large, buoyant LDL. It is more likely to enter the vessel wall, become oxidized, and trigger the atherosclerotic process.

The most important complication of atherosclerosis that may cause occlusion of small heart vessels is: A) Ulceration B) Thrombosis C) Fatty streaks D) Fibrous plaque

Ans: B Feedback: Thrombus formations on complicated atherosclerotic lesions are the result of sluggish blood flow and turbulence in the ulcerated plaque region. Fatty streaks are preatherosclerotic plaque changes in vessels. Fibrous plaque is part of the atherosclerosis formation, not a complication of it.

A client with a history of disabling claudication now is in the emergency department with a lower limb that is turning dark purple to black associated with faint Doppler pedal pulses. The client will more than likely undergo: A) Surgery to remove the saphenous vein B) Percutaneous transluminal angioplasty and stent placement C) Injection of a potent anticoagulant into lower leg veins D) Whirlpool therapy with tight wrapping of lower legs immediately following

Ans: B Feedback: Treatment includes measures directed at protection of the affected tissues and preservation of functional capacity. Percutaneous or surgical intervention is typically reserved for the client with disabling claudication or limb-threatening ischemia. Surgery (i.e., femoropopliteal bypass grafting using a section of the saphenous vein) may be indicated in severe cases. Percutaneous transluminal angioplasty and stent placement, in which a balloon catheter is inserted into the area of stenosis and the balloon inflated to increase vessel diameter, is another form of treatment.

Because of its location, the presence of an abdominal aortic aneurysm may first be manifested as: A) Constipation B) Indigestion C) A pulsating mass D) Midabdominal pain

Ans: C Feedback: An abdominal aortic aneurysm may be noticed as a pulsating mass when the client is lying flat, once the aneurysm is rather large already. Although there may be pressure on the abdominal organs by the mass, it is not associated with constipation or indigestion. Severe midabdominal pain is a late sign of impending rupture.

Which of the following clients should most likely be assessed for orthostatic hypotension? A) A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-the-counter analgesics B) A 65-year-old client whose vision has become much less acute in recent months and who has noticed swelling in her ankles C) An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom D) A 42-year-old client who has a history of poorly controlled type 1 diabetes

Ans: C Feedback: Dizziness and syncope are characteristic signs and symptoms of orthostatic hypotension, and both predispose an individual to falls; this is especially the case among older adults. Headaches, edema, diabetes, and vision changes are not associated with orthostatic hypotension.

A client with persistent, primary hypertension remains apathetic about his high blood pressure, stating "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How could the nurse best respond to this client's statement? A) "Actually, high blood pressure makes you very susceptible to getting diabetes in the future." B) "That's true, but it's an indicator that you're not taking very good care of yourself." C) "You may not sense any problems, but it really increases your risk of heart disease and stroke." D) "You're right, but it's still worthwhile to monitor it in case you do develop problems."

Ans: C Feedback: Hypertension is a highly significant risk factor for heart disease and stroke. It would be inappropriate to promote monitoring without promoting lifestyle modifications or other interventions to lower the client's blood pressure, or teaching the client about the deleterious effects of hypertension. It is likely unproductive to simply characterize the client's hypertension as demonstrating that he does not "take care" of himself. Hypertension is not a risk factor for the development of diabetes mellitus.

A client asks why his blood pressure pills seem to make him go to the bathroom to urinate frequently when they are not water pills (diuretics). Which of the following physiologic processes explains the long-term regulation of blood pressure most accurately? A) Actions of the renin-angiotensin-aldosterone system B) Release of antidiuretic hormone (vasopressin) by the posterior pituitary C) Renal monitoring and adjustment of extracellular fluid volume D) Integration and modulation of the autonomic nervous system (ANS)

Ans: C Feedback: Long-term maintenance and control of blood pressure is accomplished primarily through the renal control of fluid balance. These mechanisms function largely by regulating the blood pressure around an equilibrium point, which represents the normal pressure for a given individual. Accordingly, when the body contains too much extracellular fluid, the arterial pressure rises and the rate at which water and sodium are excreted by the kidney is increased. When blood pressure returns to its equilibrium point, water and sodium excretion returns to normal. Hormonal influences, such as those of ADH and the RAA system, and neural controls are utilized in the shorter-term control of blood pressure.

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the client's following statements indicates a need for further health promotion teaching? A) "I've starting going to the gym before work three times a week." B) "I'm trying to cut back on the amount of salt that I cook with and add to my food." C) "I'm resolving to eat organic foods from now on and to drink a lot more water." D) "I'm planning to lose 15 pounds before the end of this year."

Ans: C Feedback: Weight loss, exercise, and salt reduction are all useful strategies in the management of hypertension. An organic diet and increased fluid intake are not known to reduce blood pressure.

A postsurgical client reports calf pain combined with the emergence of swelling and redness in the area, which have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this client? A) Analgesics and use of a pneumatic compression device B) Massage followed by vascular surgery C) Frequent ambulation and the use of compression stockings D) Anticoagulation therapy and elevation of the leg

Ans: D Feedback: Anticoagulants, immobilization, and elevation of the affected extremity are used in the treatment of DVT. Interventions that are used to prevent DVT (ambulation; compression stockings; compression devices) may be harmful when a DVT is present. Surgery is not normally required, and massage has the potential to dislodge a DVT.

Which elevated serum marker for systemic inflammation is now considered a major risk factor for atherosclerosis and vascular disease? A) Leukocytosis B) Homocysteine C) Serum lipoprotein D) C-reactive protein

Ans: D Feedback: CRP is an acute-phase reactant synthesized in the liver that is a marker for systemic inflammation. A number of population-based studies have demonstrated that baseline CRP levels can predict future cardiovascular events among apparently healthy individuals. High-sensitivity CRP (hs-CRP) may be a better predictor of cardiovascular risk than lipid measurement alone. Homocysteine and serum lipoprotein are also serum markers, but they do not identify inflammation. Leukocytosis is an indicator of infection rather than inflammation alone.

A health care provider was asked by a client, "Why do my hands turn blue when I drive my car in the winter without gloves?" Which of the following is the best response? A) "Nothing to worry about. We all develop this as we age." B) "We better order a CT scan. It might be due to a blood clot in your radial artery." C) "This sounds like an inflammation in the lining of your veins. You need to take some NSAIDs." D) "Your arteries in your hands/fingers are going into spasm, which decreases blood flow and circulating oxygen."

Ans: D Feedback: Raynaud disease is caused by vasospasms of small distal arteries; thromboangiitis obliterans is caused by an inflammatory process that affects veins and nerves.

In addition to direct invasion of the vascular wall by an infectious agent, this pathogenic mechanism is a common cause of vasculitis? A) Necrotizing granulomatous B) Tissue necrosis C) Mononuclear cells D) Immune-mediated inflammation

Ans: D Feedback: The two most common pathogenic mechanisms of vasculitis are direct invasion of the vascular wall by an infectious agent and immune-mediated inflammation. The most common mechanisms that initiate noninfectious vasculitis are pathological immune responses that result in endothelial activation, with subsequent vessel obstruction, and ischemia of the dependent tissue. In almost all forms of vasculitis, the triggering event initiating and driving the inflammatory process is unknown. Medium-size vessel vasculitides produce necrotic tissue damage. Large-vessel vasculitides involve mononuclear cells. Wegener granulomatosis is characterized by a triad of acute necrotizing granulomatous lesions of the upper respiratory tract (ear, nose, sinuses, and throat), necrotizing vasculitis of the affected small- to medium-sized vessels of the lungs and respiratory airways, and renal disease in the form of focal necrotizing glomerulonephritis.

The client is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the midcalf area. He has many of the manifestations of: A) Stasis ulcerations B) Arterial insufficiency C) Primary varicose veins D) Deep vein thrombosis

Ans: D Feedback: Venous insufficiency with deep vein thrombus formation is characterized by discoloration, edema, pain, tenderness, and warmth most commonly in the mid- or lower calf area of the legs. Immobility raises the risk for thrombus formation. The skin is intact, so venous stasis ulcerations are not present. Distended torturous veins (varicosity manifestations) are not present.

The nurse is preparing to administer diltiazem and atenolol. What is the priority nursing intervention before administering these two medications to the patient?

Assess the heart rate

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?

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

An 81-year-old female patient in a subacute medical unit of a hospital has developed an oral Candida albicans infection. Which of the following phenomena would the patient's nurse suspect as a key contributing factor to her infection?

Antibiotic therapy that eliminated normal bacterial flora.

A client is applying to nursing school and has come to the clinic with a request to be tested for immunity to hepatitis B. Which type of testing would be the best to determine immunity?

Antibody Titer

A client is having an edrophonium test. The client suddenly goes into respiratory arrest. Which priority medication should the nurse be prepared to administer?

Anticholinergic

A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding antiepileptic medications?

Antiepileptic medications should never be discontinued abruptly.

What medication teaching should be done for a woman of childbearing age with a seizure disorder?

Antiseizure drugs increase the risk for congenital abnormalities.

The circulatory system can be divided into two parts. What does the systemic circulation include?

Aorta, capillaries

Which disorder is a manifestation of a serious condition that causes new-onset back pain in persons age 50 years or older?

Aortic aneurysm

What does the nurse instruct a patient who is prescribed nitroglycerin patches to do to prevent the development of tolerance to nitrates?

Apply the nitroglycerin patch each day and remove it for 10 hours at night

A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:

Arms

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

Assessment of swallowing ability and respiratory status.

Which of the following cells provide protection and metabolic support to neurons? Select all that apply.

Astrocytes Ependymal cells Microglia cells Oligodendrocytes

The nurse is preparing to auscultate for a mitral valve stenosis murmur. Where is the best location to place the stethoscope?

At the apex of the heart

An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to acting normally. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?

Atherosclerotic lesions in cerebral vessels

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?

Auscultate for a murmur caused by the backward expulsion of blood through the atrioventricular valves

The parasympathetic nervous system is part of which of the following systems?

Autonomic nervous system

A client is taking a vacation in a foreign country. The nurse teaches the client about giardiasis, a common traveler's infection. Which of the following statements should be included in the teaching plan?

Avoid eating food and drinking beverages that might be contaminated.

10. A 44-year-old female has been diagnosed with major depression. Which of the following neuroimaging findings is most congruent with the woman's diagnosis? A) Decreased brain activity in the pons and brain stem B) Reduced activity and gray matter volume in the prefrontal cortex C) Atrophy and decreased blood flow in the amygdala D) Enlargement of the lateral and third ventricles and reduction in frontal and temporal volumes

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

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

15. A 9-year-old boy has been brought to the emergency department by his father who is concerned by his son's recent fever, stiff neck, pain, and nausea. Examination reveals a petechial rash. Which of the following assessment questions by the emergency room physician is most appropriate? A) "Is your son currently taking any medications?" B) "Has your son had any sinus or ear infections in the last little while?" C) "Does your son have a history of cancer?" D) "Was your son born with any problems that affect his bone marrow or blood?

16. A patient with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days post-op, the patient confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can A) administer a psychotropic medication to help the patient cope with the loss of his leg. B) explain that many amputees have this sensation and that one theory surmises that the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site. C) call the physician and ask him for an order for a psychological consult. D) educate the patient that this area has an usually abnormal increase in sensitivity to sensation but that it will go away with time

17. Which of the following statements best conveys an aspect of the role of cerebrospinal fluid (CSF)? A) It provides physical protection for the brain and ensures that leukocytes and erythrocytes are evenly distributed in the CNS. B) CSF cushions the brain and provides a near-water medium for diffusion of nutrients. C) CSF distributes plasma proteins throughout the superficial gray matter of the CNS. D) It ensures that the high metabolic and oxygenation needs of the brain are met, as well as absorbing physical shocks

17. Which of the following statements on the final diagnostic report regarding a computerized tomography (CT) of the head with contrast would lead health care providers to diagnose a patient with Alzheimer disease? A) Large area of ischemia noted in the temporal lobe B) Too numerous to count beta-amyloid (βA) deposits noted C) Ninety percent obstruction in the posterior cerebral artery D) Mural thrombus of vertebrobasilar arteries

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

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

19. A 7-year-old child had an emergency appendectomy during the night. When trying to assess his pain, the nurse should A) ask him to rate his pain on a scale of 0 to 10, with 0 = no pain and 10 = worse pain ever. B) show him a scale with faces of actual children and have him point to the picture that best describes how he is feeling. C) consider his pulse and BP readings to be the most specific indicators of the amount of pain he is experiencing. D) try to distract him by blowing bubbles to minimize the use of opioids so that he does not become addicted to the narcotic.

2. Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? A) "Your daughter has lost all her cognitive functions as well as all her basic reflexes." B) "Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change." C) "If you or the care team notices any spontaneous eye opening, then we will change our treatment plan." D) "Your daughter's condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions

20. A 26-year-old female is resting after a one-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced? A) A myoclonic seizure B) A tonic-clonic seizure C) An absence seizure D) A complex partial seizure

20. As you are walking in the park, a huge black Labrador (dog) runs up to you and places his paws on your shoulders. Immediately your heart starts racing, you feel palpations and anxiety, and your hands become a little shaky. The nurse knows that this response is primarily caused by A) fear of dogs that make you feel like your chest is being tightened and that you have lost control of the situation. B) increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level. C) response of the cholinergic muscarinic receptors on innervational targets of postganglionic fibers. D) stimulation of the release of β 2 -adrenergic receptors, which will open the airway and increase oxygenation

20. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbids that require several prescription medications. The nurse knows that which of the following factors is likely to complicate the clinician's assessment and treatment of the client's pain? A) Neural pain pathways in the elderly differ from those in younger adults and are less responsive to treatment. B) Assessment and treatment are possibly complicated by the large number of drugs that the client receives. C) Accurate pain assessment is not possible in clients with significant cognitive deficits. D) Frequent complaints of pain in older adults with dementia normally indicate hyperalgesia rather than an underlying physical problem

201. A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment? A) Delirium B) Coma C) Brain death D) Vegetative state

3. A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? A) The client has decreased deep tendon reflexes. B) The client displays increased muscle tone. C) The client's muscles appear atrophied. D) The client displays weakness in the distal portions of his limbs

3. An adult, who was sexually abused as a child, has been displaying some stress. She seems to complain of increasing medical problems when she is under more stress. The nurse would classify this as an example of A) vitamin deficiency. B) the stress-diathesis theory. C) mendelian research. D) parental disassociation

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

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

4. Which of the following observations of a female client in a sleep lab would indicate the clinicians that she is in REM sleep? A) Rolling eye movements are observed, and she has moderate muscle activity. B) Her motor movements are suppressed, and muscle tone is flaccid. C) Delta waves are evident on her EEG, and the heart and respiration rates are slowed. D) She has a low level of cerebral activity, and her EEG indicates low voltage and mixed frequencies

5. If the patient's dorsal columns are not functioning, the nurse will observe which of the following responses during neurotesting, where the nurse asks the patient to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points? A) Grimacing when body touched with sharp points B) No response to two-point discrimination C) Heightened proprioceptive response D) Inability to identify which way his finger was moved during the tes

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

7. Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti- inflammatory drug, for the control of pain. Which of the following drug actions is most likely to result in diminished sensation of pain for the player? A) The drug inhibits communication by third-order neurons between the thalamus and cerebral cortex. B) The drug inhibits the enzyme needed for prostaglandin synthesis. C) The drug changes the postexcitatory potential in C fibers, leading to pain sensitization. D) The drug slows the conduction velocity of myelinated Aδ fibers in the pain pathway.

7. When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is A) positively charged. B) inhibitory. C) overstimulated. D) dormant.

A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? A) The client has decreased deep tendon reflexes. B) The client displays increased muscle tone. C) The client's muscles appear atrophied. D) The client displays weakness in the distal portions of his limbs.

B Feedback: The etiology of myasthenia gravis involves a deficiency of acetylcholine receptors at neuromuscular junctions. Treatment can include corticosteroid therapy and intravenous immunoglobulins. Destruction of skeletal muscle cells, cerebellar lesions, and excess acetylcholinesterase are not noted to underlie the disease.

B Feedback: UMNs typically produce increased muscle tone, while hyporeflexia, muscle atrophy, and weakness in the distal portion of limbs are more commonly indicative of LMN lesions.

8. Following an injury where a child hit his head from a fall, the CT scan reveals a contusion that the doctor classifies as a moderate brain injury. Which of the following manifestations will the nurse more than likely assess on this child that support this diagnosis? Select all that apply. A) Coma with total paralysis B) Periods of unconsciousness C) Aphasia at times D) Nuchal rigidity E) Weakness or slight paralysis affecting one side of the bod

B,C,E

17. The nurse should anticipate she will need to teach the newly diagnosed multiple sclerosis patient how to give injections if he is prescribed which medication to modify the course of the disease by reducing exacerbations? A) Corticosteroids B) Plasmapheresis C) Interferon beta D) Mitoxantrone

3. Which of the following characteristics describe stage 2 non-REM sleep? Select all that apply. A) It occurs at the onset of sleep and lasts approximately 7 minutes. B) During this stage, theta waves are primarily seen on EEG. C) This stage is known as deep sleep where heart rate and BP are decreased. D) This stage has interruptions of spindle activity that helps with integration of new memories. E) Muscles of the body are relaxed.

B,D

A young woman diagnosed with prostacyclin deficiency is admitted to the hospital with recurrent deep vein thrombosis and an ovarian infarction asks the nurse why she keeps having these problems. Understanding the role of prostacyclin in hemostasis, the nurse explains that prostacyclin enables which of the following?

Blood vessel vasodilation and inhibition of platelet aggregation

A pregnant patient with a history of a seizure disorder stops taking medications because of concern the fetus will be harmed. Which advice should the nurse give to the patient? A. "Consider a homeopathic remedy for seizures while pregnant." B. "Continue taking medications because the risks of the medicines are minor compared with the risks of having a tonic-clonic seizure while pregnant." C. "Stay off the medications until in the last trimester of pregnancy." D. "Contact the healthcare provider immediately."

B. "Continue taking medications because the risks of the medicines are minor compared with the risks of having a tonic-clonic seizure while pregnant." - The risk of fetal birth defects associated with anti-seizure medications is minor in comparison to the potential complications associated with a tonic-clonic seizure during pregnancy. - Discontinuing medications until the last trimester puts the patient at risk for a seizure. The nurse is required to teach the patient about medications. - The healthcare provider does not need to be called at this time. - A homeopathic remedy or approach would need to be researched for its efficacy and its effects on the fetus.

Which patient has the most significant risk factor for the development of Parkinson disease (PD)? A. A 50-year-old woman with a high level of urate in the blood B. A 65-year-old man C. A 34-year-old patient who smokes and has a high caffeine intake D. A 23-year-old patient who works with pesticides on a farm

B. A 65-year-old man - Age is the most significant risk factor, and there is little difference in incidence between men and women before 60 years of age. After age 60, men are affected 1.5 times more often than women, and this difference becomes greater as the age of onset increases. - Cigarette smoking and caffeine intake are inversely related to the risk of PD. - Pesticides are also a risk factor, but the patient is 23 years old. - Even though high urate levels have been associated with the development of PD, a 50-year-old woman is at lower risk than a man is.

A patient reports a parent died of complications of amyotrophic lateral sclerosis (ALS). Which critical risk factors for ALS should the nurse identify for this patient? A. Marijuana use B. Age and family history C. Low-fat diet D. Alcohol intake

B. Age and family history - Recognized risk factors for ALS include age and family history. ALS is more common in white men and in people 60-69 years of age (although it may occur at younger ages). - There is some evidence that cigarette smoking is a risk factor. - There is weak and conflicting evidence that heavy metal exposure, repetitive muscle use, and trauma are also connected to the development of ALS. - Alcohol, low-fat diet, and marijuana use are not associated with the disorder.

A patient with a history of complex partial seizures is having anti-seizure medication adjusted. Which clinical manifestation is associated with complex partial seizures? A. Blank stare and unresponsiveness to the environment B. An aura preceding the seizure C. Continuous seizure activity D. No loss of awareness or consciousness

B. An aura preceding the seizure - Complex partial seizures are usually preceded by an aura, last 30 seconds to 2 minutes, and are followed by several hours of impaired consciousness after the seizure, as well as amnesia. - No loss of awareness or consciousness is associated with simple partial seizures. - Continuous seizure activity is status epilepticus. - A blank stare and unresponsiveness to the environment are seen in absence seizures.

An 18-month-old toddler who experienced a seizure at home is treated for a severe respiratory infection and is started on antibiotic therapy. Which type of seizure should the nurse suspect that the toddle experienced? A. Partial (focal) B. Febrile C. Absence D. Tonic-clonic

B. Febrile - Children who have one febrile seizure have a 40% chance of experiencing another one. Febrile seizures can occur before the appearance of an illness. The affected child may have a normal temperature before and during the seizure, and the seizure may be the first sign of illness. Because of the child's age and the presentation of the seizure with the proceeding illness a febrile seizure should be suspected. - Tonic-clonic seizures are the most common type in adults. - In a simple partial (focal) seizure, the patient does not lose consciousness. - An absence of seizure manifests as a sudden, brief cessation of motor activity. The patient stares blankly and is unresponsive to the environment for 5-30 seconds. - Absence seizures are more common in children.

An older adult patient is diagnosed with stage 1 Parkinson disease (PD). Which symptom should the nurse expect to assess in this patient? A. Tremors of both hands B. Tremor of one hand C. Inability to walk D. Muscle rigidity

B. Tremor of one hand - Stage 1 PD usually presents as tremor in one limb. - Stage 2 is marked by bilateral symptoms. - Stage 3 involves significant slowing of body movements. - Stage 4 includes muscle rigidity. - Stage 5 includes the inability to walk.

Sputum samples from a client with pneumonia contain an infective agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet. This client's pneumonia has what etiology?

Bacterial

Which of the following types of pneumonia listed below is best characterized by an infective agent that produces sputum samples with a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet?

Bacterial

Staphylococcus aureus commonly found in the skin, nares, and other body sites of patients without any signs and symptoms of infection is known as which of the following conditions listed below?

Bacterial colonization.

Calcium channel blockers work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors?

Beta 1

A practitioner is preparing to do a lumbar puncture on a patient with suspected meningitis. Which of the following areas on the spine does the practitioner choose to obtain a cerebrospinal fluid (CSF) sample?

Between L3 and L4

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:

Bicuspid valve

The nurse reviews the lab results of a client who has a thrombocyte count of 60,000. The client is at risk for:

Bleeding

A client with von Willebrand disease is admitted to the hospital for an elective surgical procedure. The nurse caring for this client will review which of the following labs to monitor the client's coagulation?

Bleeding time

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 which of the following? A) Bone cells, inorganic salts, and blood vessels B) Hydroxyapatite, calcium carbonate, and calcium fluoride C) Bone cells, blood vessels, and nerves D) Organic matter and inorganic salts

Bone cells, blood vessels, and nerves

Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students' following statements best captures an aspect of the two health problems?

Both of them involve low platelet counts but in TTP there can be more, not less, hemostasis

A patient is brought to the emergency room with complaints of facial muscle paralysis and increasing upper extremity weakness several hours after eating canned peppers. Histologic examination reveals a bacterial infection and further testing reveals a decrease in the release of the neurotransmitter acetylcholine from cholinergic neurons. The nurse explains to the patient that which of the following is the most likely cause of this illness?

Botulism exotoxin

Which cardinal assessment finding would lead the nurse to suspect a client has developed Parkinson disease?

Bradykinesia

Which components of the nervous system make up the central nervous system?

Brain and spinal cord

A teenager has been in a car accident and experienced an acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?

Brain contusions and hematomas

A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:

Brain death

Manifestations of brain tumors are focal disturbances in brain function and increased ICP. What causes the focal disturbances manifested by brain tumors?

Brain edema and disturbances in blood flow

A patient is prescribed digoxin for heart failure. The nurse instructs the patient to avoid consuming bran. What is the reason behind this instruction?

Bran decreases digoxin absorption

A client has been involved in a motor vehicle accident and has sustained spinal cord damage. The client has voluntary motor function loss on one side and a loss of pain and temperature sensation from the contralateral side below the level of the lesion. What type of cord syndrome does the nurse recognize the client has sustained?

Brown-Sequard syndrome

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

Neurotoxins such as the botulism organism can produce paralysis by what mechanism?

By blocking release of acetylcholine

17. A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which of the nurse's following questions is least likely to yield data that will allow for a confirmation or ruling out of migraines as the cause of his problem? A) "Does your son have a family history of migraines?" B) "When your son has a headache, does he ever have nausea and vomiting as well?" C) "Does your son have any food allergies that have been identified?" D) "Is your son generally pain free during the intervals between headaches?

10. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is 2 days posthemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which of the following guidelines should the nurse use for short-term and long-term treatment of the client's pain? A) Reconciling the client's need for opioid analgesics with the risk of addiction to these drugs B) Recognizing the client's pain is not likely self-limiting C) Knowing that the client's self-report of pain is the most reliable indicator of pain D) Realizing that chronic pain is likely to require innovative and complex treatment

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

11. Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his fingers and thumb but is still able to perform gross motor movements of his hand and arm. Which of the following components of his white matter has most likely been damaged? A) The inner layer (archilayer) B) The middle layer (paleolayer) C) The outer layer (neolayer) D) The reticular formation.

12. A 30-year-old female has suffered a third-degree burn to her hand after spilling hot oil on it in a kitchen accident. Which of the following teaching points by a member of her care team is most appropriate? A) "Tell us as soon as you sense the beginnings of a round of pain, and we will start with analgesics." B) "Opioids like morphine often cause constipation, but if this happens to you, we will discontinue opioids and change to another family of medications." C) "Opioids aren't without side effects, but we will take action to manage these side effects, so you can continue getting these drugs." D) "It's imperative that we prevent you from developing a tolerance for opioids while you're getting treatment for your burn."

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

14. The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client's medication regimen. What is the most likely focus of the pharmacologic treatment of the man's health problem? A) Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions B) Preventing demyelination of the efferent cerebellar pathways C) Increasing the functional ability of the underactive dopaminergic system D) Preventing axonal degradation of motor neurons

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

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

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

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

16. A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations? A) Rocky Mountain spotted fever B) Lyme disease C) Encephalitis D) Spinal infection

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

18. A 25-year-old woman who works as an air-traffic controller presents with facial pain and severe headache. She reports that she sometimes feels the pain in her neck or ear and that it is particularly bad during very busy times at the airport. What is the most likely diagnosis? A) Migraine headache B) Cluster headache C) Temporomandibular joint syndrome D) Sinus headache

18. A geriatrician and social worker are facilitating a family meeting for the children and wife of a 79-year-old man who has been diagnosed with Alzheimer disease. What goal of treatment will the clinicians most likely prioritize in their interactions with the family? A) Modest reversal of brain plaque formation and improved symptomatology through cholinesterase inhibitors B) Surgical treatment of the underlying ischemic changes that underlie the manifestations of the man's disease C) The use of medications such as donepezil and rivastigmine to slow the progression of the disease D) Cognitive and behavioral therapy to counteract the agitation, depression, and suspiciousness associated with Alzheimer disease

18. After being thrown off the back of a bull, the bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is usually referred to as A) tetraplegia. B) quadriplegia. C) paraplegia. D) anterior cord syndrome

19. Which of the following clients may be experiencing a sensory focal seizure that has sent an abnormal cortical discharge to the autonomic nervous system (ANS)? A) A 44-year old patient complaining of constant movement and pain in the legs that gets worse when he tries to sleep B) An 85-year-old patient experiencing drooping of the right side of the face and numbness in the right arm and leg C) A 56-year-old complaining of tingling sensations and has both an elevated pulse and BP D) A 22-year-old complaining of a stiff neck and achiness, along with some nausea and vomiting

2. A patient is asked to stand with feet together, eyes open, and hands by the sides. Then the patient is asked to close his eyes while the nurse observes for a full minute. What assessment is the nurse performing? A) Segmental reflex B) Posture C) Proprioception D) Crossed-extensor reflex

2. An adult male has a new diagnosis of Guillain-Barré syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)? A) The destruction of myelin causes fewer Schwann cells to be produced in the client's PNS. B) The axonal transport system is compromised by the lack of myelin surrounding nerve cells. C) Unless remyelination occurs, the axon will eventually die. D) A deficit of myelin predisposes the client to infection by potential pathogens.

211. Which of the following statements most accurately characterizes an aspect of the neurobiology of sleep? A) The hypothalamus stimulates the anterior and posterior pituitary to modulate sleeping-waking cycles. B) The pituitary releases melatonin at predictable points in the circadian rhythm in order to facilitate sleep. C) The reticular formation, thalamus, and cerebral cortex interact to integrate the sleep- wake cycle. D) Input from the retinas is interpreted by the cerebellum and contributes to maintenance of the circadian rhythm.

221. Which of the following statements best captures the current understanding of the etiology of mental illness? A) The role of "nurture," experiences, and relationships has been largely disproven. B) Mental illness can be attributed to organic brain changes and pathophysiological processes. C) Mental illness exists from the interplay of biologic factors and psychosocial influences. D) Current understanding of mental illness has shown that both biologic psychiatry and psychosocial psychiatry are incorrect.

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

3. Which of the following individuals would most likely experience global ischemia to his or her brain? A) A male client who has just had an ischemic stroke confirmed by CT of his head B) A woman who has been admitted to the emergency department with a suspected intracranial bleed C) A man who has entered cardiogenic shock following a severe myocardial infarction D) A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater

A 14-year-old girl has been thrown from the back of a pick-up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column?

Cannot breathe on own, needs ventilator assistance

4. A toddler brought up in a chaotic, nonnurturing environment may suffer neurological consequences if the parent does not achieve attachment with the child. The nurse knows that which of the following nervous systems listed below is the first to respond to the safety needs of the child? A) Parasympathetic nervous system B) Autonomic nervous system C) Sympathetic nervous system D) Limbic system

4. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents? A) "Your son's muscular dystrophy is a result of faulty connections between muscles and the nerves that normally control them." B) "He'll require intensive physical therapy as he grows up, and there's a good chance that he will outgrow this problem as he develops." C) "Your son will be prone to heart problems and decreased lung function because of this." D) "His muscles will weaken and will visibly decrease in size relative to his body size throughout his childhood."

6. Parents of a 16-year-old male who has been behaving in increasingly bizarre ways in recent months are distraught that he has been diagnosed with schizophrenia. Which of the mother's following statements about her son's diagnosis demonstrates an accurate understanding of the disease? A) "It's disturbing to know that what I did when I was pregnant and the way we raised Page 2 him contributed to this." B) "We are somewhat relieved that psychotherapy and a supportive environment will resolve most of the positive and negative symptoms." C) "This makes us even more worried about his younger brother and whether he might develop schizophrenia." D) "We're committed to lovingly but firmly convincing him that his delusions aren't based in reality."

6. The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state that A) it takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells. B) there is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane. C) the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable. D) the neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cel

6. Which of the following statements about over-the- counter (OTC) melatonin is accurate? A) It has received the FDA approval for effectiveness as a sleep aid. B) Long-term studies of melatonin conclude that it is nonaddicting. C) It produces phase-shifting changes in the circadian rhythm. D) Under strict clinical testing, potency and purity of melatonin have been shown to be consistent.

7. A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a "coup" injury. How will the nurse explain this to the family so they can understand? A) "It's like squeezing an orange so tight that the juice runs out of the top." B) "Your son has a huge laceration inside his brain where the bat hit his skull." C) "Your son has a contusion of the brain at the site where the bat hit his head." D) "When the bat hit his head, his neck jerked backward causing injury to the spine.

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

8. Which of the following individuals is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult A) who developed rhabdomyolysis and ischemic injury after a tourniquet application. B) who suffered a bone-depth laceration to the shoulder during a knife attack. C) who had his forearm partially crushed by gears during an industrial accident. D) who had nerves transected during surgery to remove a tumor from the mandible

9. A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell? A) Special somatic afferent fibers B) General somatic afferents C) Special visceral afferent cells D) General visceral afferent neurons

9. A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a patient having problems in his hand/wrist. In order to test Tinel sign, the nurse should give the patient which of the following directions? A) "Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose." B) "Hold your wrist in complete flexion; keep it in this position for 60 seconds; how does your hand feel after placing it in a neutral position?" C) "I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?" D) "I'm going to tap this tuning fork and place it on the side of your thumb; then tell me what you are feeling in your hand and wrist

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

A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a patient having problems in his hand/wrist. In order to test Tinel sign, the nurse should give the patient which of the following directions? A) "Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose." B) "Hold your wrist in complete flexion; keep it in this position for 60 seconds; how does your hand feel after placing it in a neutral position?" C) "I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?" D) "I'm going to tap this tuning fork and place it on the side of your thumb; then tell me what you are feeling in your hand and wrist."

A patient is asked to stand with feet together, eyes open, and hands by the sides. Then the patient is asked to close his eyes while the nurse observes for a full minute. What assessment is the nurse performing? A) Segmental reflex B) Posture C) Proprioception D) Crossed-extensor reflex

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

After being thrown off the back of a bull, the bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is usually referred to as A) tetraplegia. B) quadriplegia. C) paraplegia. D) anterior cord syndrome.

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

The nurse should anticipate she will need to teach the newly diagnosed multiple sclerosis patient how to give injections if he is prescribed which medication to modify the course of the disease by reducing exacerbations? A) Corticosteroids B) Plasmapheresis C) Interferon beta D) Mitoxantrone

The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents? A) "Your son's muscular dystrophy is a result of faulty connections between muscles and the nerves that normally control them." B) "He'll require intensive physical therapy as he grows up, and there's a good chance that he will outgrow this problem as he develops." C) "Your son will be prone to heart problems and decreased lung function because of this." D) "His muscles will weaken and will visibly decrease in size relative to his body size throughout his childhood."

Which of the following individuals is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult A) who developed rhabdomyolysis and ischemic injury after a tourniquet application. B) who suffered a bone-depth laceration to the shoulder during a knife attack. C) who had his forearm partially crushed by gears during an industrial accident. D) who had nerves transected during surgery to remove a tumor from the mandible

C Feedback: A positive Tinel sign will help diagnose carpal tunnel syndrome. The patient will have a tingling sensation radiating into the palm of the hand when lightly percussed over the median nerve at the wrist. Answer choice B relates to Phalen sign, which is also a test to help diagnose carpel tunnel syndrome. Answer choice D is not the medical test for carpal tunnel syndrome.

C Feedback: Antiparkinson drugs act by increasing the functional ability of the underactive dopaminergic system. The cerebellar pathways, acetylcholine levels, and axonal degradation are not components of the etiology of Parkinson disease.

C Feedback: Crushing-type injuries carry a higher possibility of nerve function recovery than do lacerations and insults resulting from ischemia.

C Feedback: Information from the sensory afferents is relayed to the cerebellum and cerebral cortex and is experienced as proprioception or the sense of body movement and position independent of vision. The knee-jerk reflex is a form of stretch reflex. The crossed-extensor reflex serves to integrate motor movements, so they function in a coordinated manner.

C Feedback: Interferon beta helps modify the course of treatment of MS. It may also reduce exacerbations in persons with relapsing-remitting MS. It is a cytokine that acts as an immune enhancer. It is administered by injection. The other medications are prescribed for MS but not given by injection.

C Feedback: Muscular dystrophy is associated with cardiac and respiratory complications. It does not involve the nervous system, and the problem will not dissipate with time. While muscles become weakened, pseudohypertrophy means that their size does not decrease.

C Feedback: SMA is a distinctive group of degenerative disorders involving LMNs that begins in childhood. Answer choice A relates to botulism. It is known which gene is involved in SMA. Answer choice D does not describe SMA.

C Feedback: Tetraplegia and quadriplegia are loss of motor or sensory function after damage to neural structures in the cervical segments of the spinal cord. Paraplegia refers to loss of motor or sensory function in thoracic, lumbar, or sacral segments. The arms function as normal. Anterior cord syndrome includes loss of motor function provided by the corticospinal tracts and loss of pain and temperature sensation from damage to the lateral spinothalamic tracts.

C Feedback: The late stages of ALS normally involve deterioration in swallowing and speech and in the respiratory musculature. Cognitive changes are not common complications, and pain and cardiac complications are not noted to be paramount in the course of ALS.

Which of the following endocrine functions are responsible for increased resorption of bone that results in a reduction of the number and function of osteoclasts? Select all that apply. A) Calcitonin secretion B) Decrease in estrogen levels C) Stimulation of excess thyroid hormone D) Release of catecholamines E) Increase movement of calcium and phosphate from bone into the extracellular fluid

Calcitonin secretion Decrease in estrogen levels

The nurse is reviewing the anatomy and physiology of the heart. What is the function of the right atrium?

Receives blood returning to the heart from the systemic circulation

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. A) Increasing the metabolic needs of body cells B) Promoting the breakdown of stored triglycerides C) Facilitating triglyceride synthesis from glucose in fat cells D) Inhibiting protein breakdown E) Promoting glucose uptake by target cells

C) Facilitating triglyceride synthesis from glucose in fat cells D) Inhibiting protein breakdown E) Promoting glucose uptake by target cells

Following a car accident of a male teenager who did not have his seatbelt on, he arrived in the emergency department with a traumatic brain injury. He has severe cerebral edema following emergent craniotomy. Throughout the night, the nurse has been monitoring and reporting changes in his assessment. Which of the following assessments correspond to a supratentorial herniation that has progressed to include midbrain involvement? Select all that apply. A) Clouding of consciousness B) Decorticate posturing with painful stimulation C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

181. While batting, a baseball player is struck in the ribs by a pitch. Place the following components of the player's pain pathway in the chronological order as they contribute to the player's sensation of pain. Use all the options. A) Thalamus B) Dorsal root ganglion body C) Dorsal root ganglion periphery D) Axon E) Cerebral cortex

C,B,D,A,E

12. A 17-year-old female is suspected of having narcolepsy. Which of the following aspects of her medical history and sleep analysis would contribute to a confirmation of the diagnosis? Select all that apply A) She repeatedly moves her large toe, ankle, and knee during sleep. B) She complains of a powerful urge to move her legs when in bed at night. C) She has frequently awakened unable to move or speak. D) She believes that she experiences auditory hallucinations when she awakens. E) Her sleep latency is normally around 1 hour.

C,D

5. Following a car accident of a male teenager who did not have his seatbelt on, he arrived in the emergency department with a traumatic brain injury. He has severe cerebral edema following emergent craniotomy. Throughout the night, the nurse has been monitoring and reporting changes in his assessment. Which of the following assessments correspond to a supratentorial herniation that has progressed to include midbrain involvement? Select all that apply. A) Clouding of consciousness B) Decorticate posturing with painful stimulation C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

C,D,E

Neurotransmitters exert their actions through specific proteins that are known as:

Receptors

A patient with idiopathic Parkinson disease (PD) asks if the problem will affect current children. Which response should the nurse make to this patient? A. "Idiopathic causes of PD are linked to the mutation of several genes." B. "Idiopathic causes are determined after a gene has been activated by a specific environmental stressor." C. "Idiopathic conditions are the result of an unknown cause and are not associated with a genetic predisposition to the disease." D. "Idiopathic conditions always have a genetic predeterminant or risk factor."

C. "Idiopathic conditions are the result of an unknown cause and are not associated with a genetic predisposition to the disease." Ninety percent of cases of PD are idiopathic (the result of an unknown cause); the other 10% have a genetic cause. Both unknown and genetic causes may be linked to specific risk factors for the disease, such as increased age, male sex, and environmental factors. It is unknown whether idiopathic causes have a genetic link. Mutations of the LRRK2, PARK2 and SNCA genes have been linked to PD.

A patient experiencing chorea associated with Huntington disease (HD) asks about medications to treat the movements. Which response should the nurse make to this patient? A. "Antidepressant therapy may be beneficial in reducing chorea symptoms." B. "Levodopa is a helpful adjunct therapy for chorea in its early stages." C. "Tetrabenazine is the only FDA-approved medication for Huntington chorea." D. "Clonazepam will help with any hallucinations or psychosis."

C. "Tetrabenazine is the only FDA-approved medication for Huntington chorea." - Chorea symptoms are treated when they cause physical injury or interfere with functions such as work or sleep. - Tetrabenazine is the only FDA-approved medication for HD chorea. - Antidepressant therapy or antipsychotic therapy is not indicated at this time. - Levodopa is given in late stages of HD if the patient presents with parkinsonian features.

A patient experiencing status epilepticus is intubated. Which prescription should the nurse complete next? A. Inserting an indwelling urinary catheter B. Initiating cardiac monitoring C. Administering 50% glucose D. Administering diazepam

C. Administering 50% glucose - The main dangers of status epilepticus are hypoxia, hypoglycemia, hyperthermia, acidosis, and exhaustion. After the airway is managed, glucose should be provided, then followed by antiseizure medication. Cardiac monitoring and urinary catheterization can be done at any time.

The public health nurse notes an increase in new cases of multiple sclerosis (MS) among women who are 20-30 years of age. Which is a significant risk factor for multiple sclerosis in women? A. More genetic links to the condition B. Increased rate of sunbathing C. Altered hormone levels D. Pregnancy

C. Altered hormone levels - Hormones are thought to play a role in the higher incidence of multiple sclerosis (MS) in women than in men. - The genetic link is not more pronounced in women. - Sunbathing is not an attributable risk factor for MS.

A patient takes levodopa for Parkinson disease (PD). Which adverse events are related to this medication? A. Drowsiness and memory loss B. QT-interval prolongation and cardiac dysrhythmias C. Hallucinations and orthostatic hypotension D. Tachycardia and chest pain

C. Hallucinations and orthostatic hypotension - Long-term drug therapy for PD is associated with serious adverse effects, which may include confusion, hallucinations, psychosis, orthostatic hypotension, motor fluctuations, and dyskinesia. - QT-interval prolongation and tachycardia/chest pain are not associated with levodopa. - Confusion is a common symptom, but levodopa is not associated with memory loss.

The nurse prepares to assess a patient with an early stage of amyotrophic lateral sclerosis (ALS). Which symptom should the nurse expect to find in this patient? A. Confusion regarding person, place, and time B. Difficulty swallowing C. Increasing difficulty buttoning clothes and tying shoes D. Muscle atrophy and wasting in the extremities

C. Increasing difficulty buttoning clothes and tying shoes - Upper motor neuron symptoms in ALS include slowness of movement, stiffness, incoordination, hyperreflexia, and spasticity. These symptoms commonly manifest in the hands as poor manual dexterity in such tasks as buttoning clothes and tying shoes. Lower neuron impairment is often demonstrated by tongue weakness that disrupts the oral phase of swallowing or, in later stages, atrophy and muscle wasting. - Confusion is not an overt sign; instead, poor insight and an inability to plan without overt dementia may occur, and cognitive impairment may be subtle.

A middle-aged woman experiences urinary incontinence, occasional vertigo, and new-onset visual disturbances. Which health problem should the nurse suspect is occurring with this patient? A. Amyotrophic lateral sclerosis (ALS) B. Parkinson disease (PD) C. Multiple sclerosis (MS) D. Myasthenia gravis (MG)

C. Multiple sclerosis (MS) - The most common initial symptoms of MS are paresthesia, weakness or clumsiness of a leg or hand, and visual disturbances. Other common early symptoms include difficulty with bladder control and vertigo. - Early symptoms of ALS include frequent tripping or stumbling and muscle twitching, cramping, stiffness, or weakness affecting only an arm or leg. - Manifestations of PD include rigidity without tremor, dementia, and sleep disorders. - Clinical manifestations of MG can be subtle, and the typical initial symptoms of fatigue and muscle weakness may be missed.

A patient with recent neurologic changes is suspected of having a decreased level of dopamine in the brain. Which disease should the nurse suspect? A. Multiple sclerosis (MS) B. Amyotrophic lateral sclerosis (ALS) C. Parkinson disease (PD) D. Huntington disease (HD)

C. Parkinson disease (PD) - PD is marked by progressive depletion of presynaptic dopamine in the basal ganglia, specifically in the substantia nigra and the pathways to the corpus striatum. This results in abnormal nerve-firing patterns that cause increased inhibition of the thalamus and reduced excitatory input to the motor cortex due to the imbalance of dopamine and acetylcholine. - MS is a chronic inflammatory disorder resulting in central nervous system dysfunction. - HD is an inherited disorder resulting in involuntary movement, dementia, and behavioral changes. - ALS causes neurodegeneration of the upper motor neurons found in the corticospinal tract and lower motor neurons found in the anterior horn cells of the spinal cord.

An older adult patient is diagnosed with stage 3 Parkinson disease (PD). Which symptom should the nurse expect to assess in this patient? A. Bradykinesia and rigidity B. Symptoms on one side of the body C. Slowing of body movements and early impairment of equilibrium on walking or standing D. Tremor of the hand

C. Slowing of body movements and early impairment of equilibrium on walking or standing - Stage 3 is marked by a significant slowing of body movements, early impairment of equilibrium, and generalized dysfunction that is moderately severe. - A tremor of the patient's right hand and symptoms on one side of the body are seen in stage 1. - Significant slowing of body movement is seen in stage 2. - Bradykinesia and rigidity are symptoms of stage 4.

A nurse educator is explaining basic neuroanatomy to a class of prospective nursing students. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?

CSF cushions the brain and provides a near-water medium for diffusion of nutrients.

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

CT scan

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include?

CT scan

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?

Cardiac tamponade

A client is experiencing pain, tingling, and numbness of the thumb and first, second, third, and half of the fourth digits of the hand. She states that she has pain in the wrist and hand, which worsens at night, and she has noticed that they have become clumsy. The nurse recognizes these manifestations as:

Carpal tunnel syndrome

Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy?

Carpal tunnel syndrome

Which of the following is an aspect of the bone growth and development that occurs during the first two decades of life? A) Most bone abnormalities can be traced to anomalies in the embryonic stage of development. B) The physiological effects of in utero positioning normally remain into late adolescence. C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells. D) Bone length increases through childhood, while bone diameter remains static.

Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells.

A patient has a prescription for hypertension that blocks both alpha and beta receptors. Which drug will the nurse administer?

Carvedilol

The nurse is administering a drug to a patient with heart failure and states this drug can help you live longer. Which medication did the nurse administer?

Carvedilol

A nurse is educating a parent group on childhood infectious diseases and various modes of pathogen transmission. Which of the following should be included in the teaching plan? Select all that apply.

Caution parents about children playing barefoot on dirt. Avoid giving children unpasteurized milk or dairy products. Instruct children to avoid sharing grooming articles such as combs and brushes with friends.

A client who has been living with Alzheimer disease and spouse are at the doctor's office and the spouse asks the nurse why the client cannot remember much of anything from the past. The best response by the nurse is that Alzheimer disease affects which part of the brain?

Cells located in the hippocampus

Myelinated neurons are found in which of the following component(s) of the nervous system?

Central and peripheral

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?

Central venous pressure

A middle-aged woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady, her speech is slurred, and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which health problem most likely underlies her present state?

Cerebellar damage caused by a cerebrovascular accident

An older adult has had a recent decrease in coordination, with gait being described as wide-based, unsteady, and lacking in fluidity, although the client's muscle tone appears normal. This client requires further assessment for which condition that is involved with coordination of movement?

Cerebellar disorder

The nurse is conducting a community education program on concussions. The nurse evaluates that the participants understand the education when they state that which of these offers the brain protection from external forces?

Cerebrospinal fluid

Which intracranial volume is most capable of compensating for increasing intracranial pressure?

Cerebrospinal fluid

The nurse will most likely assess which of the following clinical manifestations in a client was diagnosed with Creutzfeldt-Jakob disease?

Change in behavior and memory, loss of coordination leading to encephalopathy.

Neurons communicate through the use of synapses. These synapses may link neurons into functional circuits. What is the most common type of synapse?

Chemical synapse

A nurse is assessing a client who has just been admitted to the unit with a diagnosis of acute pericarditis. The client would most likely manifest:

Chest pain, pleuritic pain, pericardial friction rub, fever

Which of the following patients would be at risk for developing nonthrombocytopenic purpura?

Child adopted from India and displaying malaise, lethargy and petechiae all over body, 55 year old patient diagnosed with Cushing disease displaying bruises, weight gain with a buffalo hump and moon face

The nurse assesses the client with Huntington disease demonstrating irregular wriggling and writhing movements. The client is also having facial grimacing, raising the eyebrows, and rolling the eyes. How would the nurse document this finding?

Chorea

A patient tells the nurse that the primary care provider prescribed an antibiotic. The patient was instructed to take the antibiotic three times a day for ten days. After the 4th day, the patient was feeling much better and decided to stop taking the medication. What complication could result from stopping the antibiotic early?

Chronic infection

Fibrinolysis is part of the hemostasis process and requires a series of steps. Which of the following is true of the process?

Circulating plasmin is rapidly inactivated, which limits the fibrinolytic process to the local clot

Which description does the nurse recognize fits a client in the prodromal stage of an infection?

Client is experiencing vague symptoms of fatigue and low grade fever.

The nurse is monitoring therapy for a patient with hemophilia B. Which evaluation criterion is most important to determine whether the medication dosage is effective?

Clinical response

A nurse is caring for a patient who suffered a massive heart attack followed by the development of congestive heart failure (CHF). As the nurse is reviewing with the patient medications taken at home, the patient states concern that the doctor discontinued the Nexium. The nurse explains that taking Nexium with some medications can cause adverse cardiac events. Which of the following medications would be of possible concern?

Clopidogrel

A client's emergency room report includes the presence of a contrecoup injury. The nurse plans care for a client with which of the following?

Closed head injury opposite the area of impact

A nurse is teaching a client about nutritional components needed for erythropoiesis. Which of the following is essential for DNA synthesis and nuclear maturation of a red blood cell?

Cobalamin

1. The parents of an active 9-year-old are leaving the emergency department (ED) following cast placement for their son's 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 and symptoms? Select all that apply. A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg. C) Swelling in the lower leg has remained the same since they left the ED 12 hours ago. D) Pulses are palpable below the level of the cast. E) Bruising noted in the lower foot and toes.

Cold, pale toes on the side with the cast. Patient complaining of tingling and numbness in the casted leg.

The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemic drug would be most beneficial for the patient?

Colesevelam

A patient with hyperlipidemia is prescribed atorvastatin; however, the patient does not want to take a pill and prefers powder form. What alternative medication available in powder form would be most beneficial for the patient?

Colestipol

Select the function of the occipital lobe.

Color, motion, and depth perception

1. A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment? A) Delirium B) Coma C) Brain death D) Vegetative state

Coma

Which statements best describe communicable disease? Select all that apply.

Communicable diseases are spread from person to person. Blood is a common carrier for communicable diseases. Communicable diseases are caused by infections that live and reproduce in a human host

The clinician suspects a spinal cord injury client is developing autonomic dysreflexia. Which assessment findings would confirm the development of this complication? Select all that apply.

Complains of pounding headache, BP 180/98, pulse rate 49

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

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

Which type of seizure begins in a localized area of the brain but may progress rapidly to involve both hemispheres?

Complex partial

The distensibility of the blood vessel is the major factor in which of the vessel's characteristics?

Compliance

A client has been diagnosed with amyotrophic lateral sclerosis, a disease resulting in the loss of efferent signals. Which aspect of neurologic function will be primarily affected by this client's condition?

Conduction of information away from CNS

Infections that are transmitted vertically from mother to infant are known as:

Congenital

Which of the following characterizes a function of the parasympathetic nervous system (PNS)?

Conservation of energy

Which of the following best describes the structure of a virus?

Consists of a capsid that surrounds a nucleic acid core

The nurse would question an order for colesnvelam if the patient has which condition in the medical history?

Constipation

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?

Constricive pericarditis

A patient who has received iron dextran is complaining of chest pain. What is the nurse's best action?

Consult with the healthcare provider to assess the ECG

A hospitalized client's progress has been noted as the convalescent stage. Select the statement that best describes this stage.

Containment of infection, progressive elimination of the pathogen, repair of damaged tissue, and resolution of associated symptoms

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:

Continuous measurement of urine output

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

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

Several months ago, a 20 year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?

Conus medullaris syndrome

When an acute MI occurs, many physiological changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI?

Conversion from aerobic to anaerobic metabolism

The cerebellum, separated from the cerebral hemispheres by the tentorium cerebelli, lies in the posterior fossa of the cranium. What is one of the functions of the cerebellum?

Coordinates smooth and accurate movements of the body

The nurse is caring for a patient with hypertension who is receiving verapamil. The patient has a healthy heart. What pharmacodynamic effects would the nurse expect from this drug?

Coronary vasodilation, Peripheral vasodilation

The thick area of myelinated axons that connects the two sides of the cerebral cortex is known as which of the following components?

Corpus callosum

The provider prescribes a sodium nitroprusside intravenous infusion to manage a patient's blood pressure of 230/120. Which actions should the nurse take?

Cover solution from light, Monitor blood pressure continuously during infusion

Select the laboratory blood test that would be a used to suggest a diagnosis of muscular dystrophy (MD).

Creatine kinase

Which medication is used to treat acute attacks of multiple sclerosis (MS)?

Corticosteroids

A patient is admitted to the hospital to rule out secondary thrombocytosis after suffering recurrent episodes of deep vein thrombosis and pulmonary embolisms. The admitting nurse is obtaining a medical history. Which of the following conditions would make anticoagulation contraindicated?

Crohn's disease

For which medication order should the nurse notify the healthcare provider?

Cyanobalamin 100 mag IV every month

10. A nursing student having trouble moving his head from side to side is likely experiencing a problem with which type of neurons? A) General visceral efferent neurons B) Preganglionic neurons C) Parasympathetic postganglionic neurons D) Pharyngeal efferent neurons

11. A 60-year-old male office worker presents to a clinic complaining of new onset of lower back pain that has been worsening over the last 6 weeks. The nurse knows which of the following components of his physical assessment and history is most indicative of a serious pathological process (like aortic aneurysm or cancer)? A) His pain is relieved by extended bed rest. B) When supine, passive rising of his leg to 90 degrees results in hamstring pain. C) He has needed regular nonsteroidal anti-inflammatory drugs to control the pain in recent weeks. D) His onset of pain has been gradual, and he has no prior history of lower back problems

11. A female client with bone metastases secondary to lung cancer is admitted for palliative radiation treatment and pain control. The client is presently experiencing pain that she rates at 9 out of 10. Which of the following nonpharmacological treatments is most likely to be a useful and appropriate supplement to pharmacological analgesia at this point? A) Teaching the client guided imagery and meditation B) Initiating neurostimulation C) Heat therapy D) Relaxation and distraction

11. After surviving an ischemic stroke, a 79-year-old male has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings with exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which of the following brain structures? A) The man's occipital lobe B) The client's temporal lobe in general and Wernicke area in particular C) The man's parietal lobe D) The components of the client's limbic system

11.An adult client is experiencing chronic insomnia related to a recent divorce and child custody proceedings. The client is requesting a renewable prescription for "sleeping pills." The nurse knows that which of the following interventions listed below will provide the most beneficial treatment for this client? A) Sedatives and hypnotic drugs will not provide safe relief of the client's health problem. B) The client is suffering from primary insomnia. C) Melatonin supplements will be the safest and most effective long-term pharmacological treatment. D) Behavioral therapies and education regarding sleep hygiene will provide assistance for the client

12. A middle-aged woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady; her speech is slurred; and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which of the following health problems most likely underlies her present state? A) Multiple sclerosis B) Guillain-Barré syndrome C) Myasthenia crisis D) Cerebellar damage caused by a cerebrovascular acciden

12. Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which of the following phenomena has facilitated the rapid movement of her hand in response to the painful stimulus? A) Her midbrain has rapidly responded to the nociceptive stimuli and induced arm flexion. B) The withdrawal reflex of her peripheral nervous system has quickly mediated between afferent and effector neurons. C) The forebrain has mediated a protective spinal cord reflex. D) Her CNS has enacted a protective response received by neurons that innervate her arm muscles

13. A 70-year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult? A) Flaccid loss of muscle tone B) Difficulty in starting movement, stopping movement, and maintaining rhythmic movements. C) Tremor, rigidity, and bradykinesia D) Unsteady gait and difficulty in speaking and swallowin

13. A Tae Kwon Do (TKD) master is applying downward pressure just above the elbow joint on an attacker who immediately collapses to the ground. The TKD master knows the elbow joint can bend inward toward the body but not in the opposite direction. Which of the following reflexes is applicable to this example? A) Knife-clasp B) Withdrawal C) Myotatic D) Inverse myotatic

13. The nurse knows that which of the following treatment plans listed below is most likely to be prescribed after a computed tomography (CT) scan of the head reveals a new-onset aneurysmal subarachnoid hemorrhage? A) Stat administration of tissue plasminogen activator (tPA) B) Administration of a diuretic such as mannitol to reduce cerebral edema and ICP C) Monitoring in the ICU for signs and symptoms of cerebral insult D) Craniotomy and clipping of the affected vessel

14. A woman has a long-running compulsion to repeatedly check if the doors of her home are locked and has received a diagnosis of obsessive-compulsive disorder (OCD). Her husband is at a loss to understand her irrational behavior and has sought help from a therapist himself to deal with the effect that his wife's OCD is having on their daily lives. Which of the husband's following statements would require correction? A) "It's a relief to know that this can be changed if she continues with therapy and the medications she's been prescribed." B) "It's odd that someone like her and someone who's depressed might both respond positively to the same drugs." C) "I thought that this was something exceedingly rare, but I'm actually a bit relieved to learn that others have this disorder as well." D) "I'm glad that this is something that's a result of life stressors and is not associated with any dysfunction in her brain

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

17. A 77-year-old woman is concerned because she has occasionally found her husband sleepwalking in the last several weeks. What is her care provider's most appropriate response to her concerns? A) "This is not an uncommon event that often accompanies older age." B) "I'll likely prescribe a benzodiazepine for this when I next see your husband." C) "This is understandably upsetting for you, but as long as the environment is safe, it's likely not significant." D) "There may be something else going on with your husband such as delirium or a problem with his medications."

19. Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced? A) Anterior cord syndrome B) Brown-Séquard syndrome C) Central cord syndrome D) Conus medullaris syndrome

191. During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action? A) Cerebellum B) Thalamus C) Basal ganglia D) Frontal lobe

2. As part of a diagnostic workup of a 22-year-old male with recently diagnosed schizophrenia, a neurologist wants to examine the levels of metabolic activity in particular areas of the client's brain. Which of the following diagnostic procedures is the physician most likely to order? A) Computed tomography (CT) B) Electroencephalography (EEG) C) Magnetic resonance imaging (MRI) D) Positron emission tomography (PET)

5. A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse? A) Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses. B) Communication between a neuron and the single neuron it is connected with will be facilitated. C) The neurotransmitter will cross gap junctions more readily. D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

5. The nurse knows that which of the following observations of a client during a sleep study would be most likely considered a pathological finding? A) The client experiences periods of apnea of 5 to 15 seconds in duration. B) The client's intrinsic clock involves a sleep-wake cycle that is consistently 2 hours longer than the actual length of a day. C) The client's PCO 2 level is increased, and his PO 2 level decreased during deep sleep. D) The client spends the majority of his sleeping hours in deep REM sleep

6. A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which of the following diagnoses best captures this pathophysiology? A) Focal hypoxia B) Cytotoxic edema C) Hydrocephalus D) Vasogenic edem

7. Which of the following is a negative symptom of schizophrenia? A) Hallucinations B) Incoherence C) Word salad D) Affective flattening

8. A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which of the following teaching points about chronic pain would his physician most likely emphasize to the client? A) "If your pain comes and goes, then we won't characterize it as chronic, and it will require different treatment." B) "You need to remind yourself that this is a purely physical phenomenon that requires physical treatment." C) "Our challenge is to bring you relief but still treat the underlying back problem that your body is telling you about." D) "These pain signals your body is sending likely serve no real, useful, or protective function.

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

A 60-year-old male office worker presents to a clinic complaining of new onset of lower back pain that has been worsening over the last 6 weeks. The nurse knows which of the following components of his physical assessment and history is most indicative of a serious pathological process (like aortic aneurysm or cancer)? A) His pain is relieved by extended bed rest. B) When supine, passive rising of his leg to 90 degrees results in hamstring pain. C) He has needed regular nonsteroidal anti-inflammatory drugs to control the pain in recent weeks. D) His onset of pain has been gradual, and he has no prior history of lower back problems.

A 70-year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult? A) Flaccid loss of muscle tone B) Difficulty in starting movement, stopping movement, and maintaining rhythmic movements. C) Tremor, rigidity, and bradykinesia D) Unsteady gait and difficulty in speaking and swallowing

A middle-aged woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady; her speech is slurred; and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which of the following health problems most likely underlies her present state? A) Multiple sclerosis B) Guillain-Barré syndrome C) Myasthenia crisis D) Cerebellar damage caused by a cerebrovascular accident

When red blood cells age, which of the following organs are responsible for their destruction?

Spleen

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action? A) Cerebellum B) Thalamus C) Basal ganglia D) Frontal lobe

Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced? A) Anterior cord syndrome B) Brown-Séquard syndrome C) Central cord syndrome D) Conus medullaris syndrome

D Feedback: An unsteady gait characterizes cerebellar ataxia, and both swallowing and speaking are partly the domain of the cerebellum. Flaccid loss of muscle tone is not noted to accompany cerebellar insult, and difficulties with starting movement, stopping movement, and maintaining rhythmic movements are indicative of basal ganglia disorders. Tremor, rigidity, and bradykinesia are associated with Parkinson disease.

D Feedback: Cerebellar damage can resemble the effects of alcohol, because alcohol affects the cerebellum. This woman has not been drinking, but her high blood pressure puts her at risk for cerebrovascular accident.

D Feedback: Functional deficits resulting from conus medullaris syndrome usually result in flaccid bowel and bladder and altered sexual function. Sacral segments occasionally show preserved reflexes if only the conus is affected. Motor function in the legs and feet may be impaired without significant sensory impairment. Anterior cord syndrome and Brown-Séquard syndrome include a loss of pain and temperature sensation, while central cord syndrome manifests in spastic paralysis and is more common among older adults.

D Feedback: The gradual onset of back pain unrelated to injury and initial presentation after age 50 are considered red flags for more serious pathologies such as aortic aneurysm, malignancy, or compression fracture. Pain that is aggravated by lying down is a red flag for malignancy or infection. The onset of hamstring pain at 90 degrees of hip flexion is a normal finding. The need for and use of NSAIDs for lower back pain relief are not indicative of a serious pathology in and of itself.

1. During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action? A) Cerebellum B) Thalamus C) Basal ganglia D) Frontal lobe

D Feedback: While intentional movement involves input from various components of the nervous system including the cerebellum, thalamus, and basal ganglia, primary control and coordination are controlled by the motor cortex in the frontal lobe.

A child has been diagnosed with thalassemia. Which of the following co-morbidities may occur as a result of having thalassemia?

Splenomegaly

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. A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity D) microorganisms in the synovial capsule E) Rapid restoration of the cartilage cells in the meniscus

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

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis (MS) is the result of which pathophysiologic event?

Decreased oligodendrocytes

Warfarin has been prescribed for a client. The nurse expects that the client will have:

Decreased prothrombin and other pro coagulation factors

The diagnosis is septic shock. The nurse knows that administration of insulin to this patient will provide which of the following beneficial effects?

Decreased risk of infection, Better wound healing

A patient with amyotrophic lateral sclerosis (ALS) avoids monthly medical appointments. Which recommendation should the nurse make to help monitor the progression of ALS and prevent complications associated with respiratory failure? A. "A decrease in vital capacity to 20% of predicted value is associated with the development of respiratory symptoms such as pneumonia." B. "It is important to develop a pattern for screening before the dementia associated with the condition develops." C. "A decrease in vital capacity to 50% is associated with respiratory failure and sudden death." D. "It is important that respiratory function is assessed every 3 months and you are monitored for pneumonia and respiratory failure."

D. "It is important that respiratory function is assessed every 3 months and you are monitored for pneumonia and respiratory failure." - Patients with ALS require respiratory evaluation at least every 3 months. This aids staging of disease progression and helps the provider monitor the patient for such complications as pneumonia or respiratory failure. - A decrease in vital capacity of 50% of predicted value is associated with the development of pneumonia; a vital capacity of 25-30% of predicted value is associated with respiratory failure and sudden death. - Frequent checks are required for respiratory function; dementia is not a concern with this condition.

A 4-year-old child with a history of febrile seizures experiences another seizure. Which question should the nurse ask the patient's parent about the febrile seizure? A. "Does anyone in your family have a history of seizures after the age of 6?" B. "Did the febrile seizure occur a day after the fever resolved?" C. "Was there any evidence of an infection?" D. "What was your child's age when the febrile seizure occurred?"

D. "What was your child's age when the febrile seizure occurred?" - Children who experience febrile seizures have a 40% chance of future febrile seizures. Febrile seizures usually occur in children between the ages of 6 months and 5 years, peaking in incidence during the second year of life. Febrile seizures may occur at the time of a fever, or the fever may occur a few hours after the seizure. - Family history is an indicator for risk of fever, but it is in children aged 6 months to 5 years.

A group of nursing students is discussing ventricular arrhythmias and one student is unsure why a client with frequent 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:

Decreased ventricular filling time

A client has been diagnosed with inherited hyper coagulability. Select the most likely cause.

Factor V gene mutation

A patient with recently diagnosed amyotrophic lateral sclerosis (ALS) seeks curative therapy at a foreign clinic. Which statement should the nurse make in response? ANSWER A. "Out-of-country clinics sometimes work for the treatment of ALS, so it's worth a try. I had a friend who recently was successful in treating cancer with oxidative therapy." B. "ALS does not progress to end stages in all people. It's important to remember that you may not experience the most severe symptoms associated with the disease." C. "There is no cure for ALS; you need to accept that you'll die of this disease and make plans for your future." D. "You have the right to seek therapeutic options for your condition, but it's important to remember that ALS is a chronic condition that will require monitoring for its progression and symptoms."

D. "You have the right to seek therapeutic options for your condition, but it's important to remember that ALS is a chronic condition that will require monitoring for its progression and symptoms." It is important that the patient understands that ALS is a chronic condition and there is an expected clinical path it will take as it progresses. This understanding is important because the patient needs to recognize the symptoms and understand how day-to-day life will be affected. - The nurse should not use personal experience or anecdotal evidence to support the patient's decision. - Telling the patient the "hard truth" is not supportive of the patient's right to seek other treatment. ALS is a progressive disease and moves through its four stages.

A patient with a seizure disorder is alert in bed, displaying repetitive behaviors without any awareness, and smacking the lips repeatedly. Which type of seizures should the nurse suspect in the patient? A. Status epilepticus B. Simple partial C. Absence D. Complex partial

D. Complex partial - Complex partial seizures are usually preceded by an aura, last 30 seconds to 2 minutes, and impair consciousness for several hours; amnesia follows the seizure. The individual may display repetitive behaviors such as lip smacking or flipping a light switch on and off without awareness. - No loss of awareness or consciousness is associated with simple partial seizures. - Continuous seizure activity is status epilepticus. - A blank stare and unresponsiveness to the environment are seen in absence seizure.

A patient with amyotrophic lateral sclerosis (ALS) is experiencing dysphagia. Which problem should the nurse identify as the most appropriate for this patient? A. Possible skin breakdown B. Possible immobility C. Possible difficulty with thought processes D. Possible aspiration

D. Possible aspiration - Upper motor neuron dysphagia results in slow, uncoordinated contractions of the swallowing muscles, whereas, lower motor neuron dysphagia results in tongue weakness and disrupts the oral phase of swallowing. These symptoms result in poor nutrition and dehydration and possibly choking on or aspiration of food or the patient's own secretions. - Altered mobility and the risk of impaired skin integrity occur because of weakness and muscle atrophy. - Patients do not experience altered thought processes as a direct result of ALS.

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:

Decreasing cardiac output due to less ventricular filling time

The underlying causative problem in Parkinsonism is:

Failure of dopamine release

Bradykinesia occurring in Parkinson disease places the Parkinson's client most at risk for:

Falls and injury

The nurse assists a patient having a tonic-clonic seizure. Which symptoms should the nurse expect to observe in the postictal period? A. The patient has slowed and shallow respirations. B. Hyperventilation occurs, the patient's eyes roll back, and frothing at the mouth may be noted. C. The patient has notable pallor and cyanosis. D. The patient is sleepy but can be aroused, and breathing is quiet and relaxed.

D. The patient is sleepy but can be aroused, and breathing is quiet and relaxed. - The postictal period follows the tonic-clonic phase of a seizure. The patient is often sleepy but can be aroused; the breathing is quiet and relaxed. The patient will regain consciousness but may be confused or disoriented. It is common for the patient to sleep for several hours after the seizure. - Hyperventilation, eye rolling, and frothing at the mouth are associated with the clonic phase. - Skin pallor and cyanosis are associated with the tonic phase. T - he patient should not demonstrate respiratory distress or decreased effort in the postictal phase.

A pregnant patient with a family history of Huntington disease (HD) learns the fetus has the gene for the disorder. Which information should the nurse provide to the patient about the disorder? A. Symptoms appear before 35-44 years of age. B. Most people survive 25-40 years with the disease. C. The onset of HD typically occurs before the age of 10 years. D. There is a 50% chance of the child's inheriting the gene mutation that causes the disease.

D. There is a 50% chance of the child's inheriting the gene mutation that causes the disease. - It is important to know that the child has a 50% chance of inheriting the gene mutation that causes HD. - It is rare for symptoms of the disease to appear before age 10. - Onset of the disease is before 35-44 years of age. - Most people will survive 10-25 years with the disease.

A patient who takes valproic acid seeks medical attention for ongoing seizures that cause a loss of consciousness and muscular activity. Which type of seizure should the nurse suspect this patient is experiencing? A. Complex partial B. Simple partial C. Absence D. Tonic-clonic

D. Tonic-clonic - A tonic-clonic seizure is the most common type of seizure. Medications used to prevent this type of seizure include valproic acid. - A complex partial seizure typically has an aura, lasts 30 seconds to 2 minutes, and results in impaired consciousness for several hours, often with amnesia after the seizure. - A simple partial seizure does not result in a loss of consciousness; recurrent muscle contractions or numbness or tingling may occur. - An absence seizure results in a brief cessation of all motor activity, a blank stare, and unresponsive to the environment for 5-10 seconds, but it may last up to 30 seconds and cause impaired consciousness.

A home health care nurse is visiting a patient who has recently discharged from the hospital taking warfarin therapy following a massive pulmonary embolism. The patient asks why more frequent blood tests are being done, as an antibiotic was started. The best response from the nurse would be that antibiotics can do which of the following?

Decrease intestinal flora

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

Decrease vascular volume

While intubated for surgery, a patient has inadvertently had his vagus nerve stimulated. What effect would the surgical team expect to observe?

Decreased heart rate as a result of parasympathetic innervation of the heart

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

A patient presents to the emergency department with symptoms of acute myocardial infarction. After a diagnostic workup, the healthcare provider prescribes a 15 mg IV bolus of alteplase, a tPA, followed by 50 mg infused over 30 minutes. In monitoring this patient, which finding by the nurse most likely indicates an adverse reaction to this drug?

Decreasing level of consciousness

A woman complains to the nurse that she has developed a yeast infection. The woman does not understand how she could get a yeast infection since she has been on antibiotics for a urinary tract infection. What is the rationale for this patient's complaint?

Destroying one type of resident flora (bacteria) can allow over proliferation of another competing type (yeast).

Peripheral neuropathy occurs most commonly with which disorder?

Diabetes

The admitting nurse on a hospital medical surgical unit is admitting a 90 year old patient with a history of congestive heart failure, coronary artery disease, prostate cancer, diabetes, and hypercholesteremia. The nurse realizes that the client is at high risk for thromboembolic complications due to a medical history with conditions that could increase platelet function. Which of the following conditions would contribute to this risk?

Diabetes, Hypercholestermia, Prostate cancer

The thalamus is located in which of the following parts of the brain?

Diencephalon

The nurse developing a plan of care for a client with a cerebral cortex injury should include assessment for which of the following?

Difficulty concentrating

After being taught about digoxin, which statement from the staff indicates more teaching is needed?

Digoxin is a first line drug for heart failure

The spirochete, leptospires is primarily transmitted to farmers by:

Direct contact with infected animals.

The charge nurse is teaching a student nurse about antihypertensive drugs and the RAAS. Which information from the student nurse indicates a correct understanding of the teaching?

Direct renin inhibitors stop the changing of angiotensinogen into angiotensin I

The nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding most likely relates to an adverse effect of heparin?

Discolored urine

The nurse is caring for a patient with hypercholesterolemia who is taking 20 mg of simvastatin as prescribed. After a few days, the patient's urinalysis reports indicated the presence of myoglobin. What instruction would the nurse receive from the primary healthcare provider?

Discontinue administering the medication

A nurse is caring for a client with high-level paraplegia with known vasovagal response associated with severe bradycardia. Which preventive measure should not be included in the treatment plan for this client?

Discouraging use of stimulants such as caffeine

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia have which effect on motor ability?

Disrupt movement without causing paralysis

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

Distributive shock

A client affected by postural hypotension will likely display what symptoms?

Dizziness and pallor when moved to upright position

Verapamil has been administered to a patient. The nurse should closely monitor for which adverse effects of this drug?

Dizziness, headache, ankle edema, heart block evidence on cardiac monitor

A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications? A) Do you get cold sores very often? B) Do you have pain when you urinate or have difficulty starting the stream? C) Have you noticed excessive swelling in your scrotum the last few days? D) Have you been experiencing flank pain and bloody urine?

Do you have pain when you urinate or have difficulty starting the stream?

A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?

Dopamine

A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?

Dopamine nigrostriatal system

Which one of the following meninges provides the major protection for the brain and spinal cord?

Dura mater

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 on which of the following pathophysiological principles?

During apnea periods the patient experiences hypoxemia which stimulates chemoreceptors to induce vasoconstriction

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?

During feeding

A nurse assesses a patient with normal biomarkers who reports angina. Which of the following additional manifestation are late signs of aortic stenosis?

Dyspnea, peripheral cyanosis, syncope

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

Which structures do neurons communicate with? Select all that apply.

Electrical synapses Chemical synapses

What is the primary physiologic result of obstructive shock?

Elevated right heart pressure

A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?

Encephalitis

Which is an appropriate nursing intervention for the patient who is taking hydrochlorothiazide?

Encourage the intake of foods rich in potassium

Which one of the following is found in the cell wall of gram negative bacteria?

Endotoxin

The nurse is administered iron dextran by IV infusion to a patient with iron deficiency. Which is the priority nursing action during the administration of this drug?

Ensure that epinephrine is available as needed

The CT scan report identified that a client with a skull fracture has developed a hematoma that resulted from a torn artery. The report would be interpreted as:

Epidural hematoma

Which of the following catecholamines is formed in the adrenal gland?

Epinephrine

An adolescent is diagnosed with Epstein-Barr virus. What information should the nurse provide to the parents? Select all that apply.

Epstein-Barr virus can cause infectious mononucleosis. Epstein-Barr virus can be spread by saliva. The Epstein-Barr virus invades and replicates within the salivary glands.

A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which of his statements is most accurate? A) If you've been exposed to the herpes virus in the past, then there's no significant risk of reinfection. B) The worst case scenario is that you'll develop cold sores, since this is the type of herpes virus that I've got. C) If you've had cold sores when you were younger, it means that you've got antibodies against this D) Even when I'm not having a recurrence, I could still pass the virus on to you.

Even when I'm not having a recurrence, I could still pass the virus on to you.

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?

Exchange gases, nutrients, and wastes

The Rh negative mother who has become sensitized during a previous birth gives birth to a Rh positive infant. Which method will the practitioner choose to prevent kernicterus in the infant?

Exchange transfusions

Which of the following potentials, when combining a neurotransmitter with a receptor site, causes partial depolarization of the postsynaptic membrane?

Excitatory postsynaptic

Excessive activity of the excitatory neurotransmitters and their receptor-mediated effects is the cause of which type of brain injury?

Excitotoxic

A family consumed some undercooked hamburger at a picnic and has since developed bloody diarrhea. The nurse knows which of the following statements listed below is correct regarding the infectious process?

Exotoxins that damage vascular endothelial causing bleeding and low platelet counts.

The nurse is teaching a patient prescribed captopril for the treatment of hypertension. Which instruction should the nurse include?

Expect a persistent dry cough, Avoid potassium salt substitutes, Report difficulty in breathing immediately

A patient is taking minoxidil and develops hypertrichosis. Which area should the nurse assess first?

Face

An emergency room nurse receives a report that a client's Glasgow Coma Scale (GCS) is 3. The nurse prepares to care for a client with which of the following?

Flaccid motor response

A sudden, traumatic, complete transection of the spinal cord results in what type of injury below the site?

Flaccid paralysis

The spinal cord contains the basic factors necessary to coordinate function when a movement is planned. It is the lowest level of function. What is the highest level of function in planning movement?

Frontal cortex

In what part of the body does the highest level of motor function occur?

Frontal cortex of the brain

Frontal lobe

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which component of her nervous system contains the highest level of control of her arm and hand action?

Frontal lobe

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

Frothy blood tinged sputum, Respiratory crackles, Confusion, Rapid pulse

A home health nurse is visiting an elderly client, who is exhibiting signs of an upper respiratory infection but denies contact with an infected person. The nurse evaluates the home and recommends air conditioner duct cleaning as a precautionary measure against which of the following pathogens?

Fungi

The nurse is caring for a patient who has elevated triglyceride levels and is unresponsive to HMG-CoA reductase inhibitors. What does the nurse expect the primary healthcare provider to prescribe to the patient?

Gemfibrozil

A campus-based peer counseling group is conducting an information blitz on sexually transmitted diseases. Which of the following statements about genital warts requires correction? A) Genital warts can take up to a month after exposure to first become visible. B) There is no existing treatment that can eradicate the virus once it's contracted. C) Condoms do not necessarily prevent the transmission of the virus that causes genital warts. D) There are a number of subtypes of the virus that cause genital warts, but current vaccines protect against most common causes of them.

Genital warts can take up to a month after exposure to first become visible.

When a 4-year-old boy stands erect with his medial malleoli touching, the distance between his knees is 2 inches. What is the child's most likely diagnosis and treatment? A) Genu varum, which can be treated by bracing B) Flatfoot, which will require orthopedic shoes C) Genu valgum necessitating a series of surgeries D) Femoral torsion, which will spontaneously resolve before puberty

Genu varum, which can be treated by bracing

A client is having an upper endoscopy to determine the presence of a gastric ulcer. After the procedure is performed, the nurse instructs the client that he cannot have anything to eat or drink until the return of the gag reflex. Which nerve is the nurse testing for return of function?

Glossopharyngeal

Nutrition students are studying the nervous system, which has a high rate of metabolism. Which of the following is its major fuel source?

Glucose

The nurse measures a blood glucose level of 40 mg/dL for a client with diabetes type I. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client?

Glucose is not stored in the brain and is a major fuel source for brain function.

Which of the following statements best describes an aspect of the normal process of glucose metabolism? A) Blood glucose levels are primarily a result of the timing, quantity, and character of food intake. B) Ingested glucose that is not needed for cellular metabolism circulates in the blood until it is taken up to meet cellular needs. C) Blood glucose levels are kept in a steady state by selective excretion and reuptake by the kidneys. D) Glucose that exceeds metabolic needs is converted and stored by the liver.

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

The bacteriologist is staining the slides of a client diagnosed with scarlet fever and rheumatic fever. The slide identifies S. pyogenes and stains purple by crystal violet dye. The result would indicate:

Gram-positive organism

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. A) Formation of red blood cells B) Growth and remodeling of bone C) Anchorage point for blood vessels D) Repair of bone E) Supply nerves to the bone matrix

Growth and remodeling of bone Repair of bone

Select the assessment data that place a client most at risk for the development of an opportunistic infection. A client with/who: Select all that apply.

Has a diagnosis of malnutrition • Has a compromised immune system • Just completed 6 weeks of radiation therapy • Is currently receiving chemotherapy

1. A 9-year-old boy has been brought to the emergency department by his father who is concerned by his son's recent fever, stiff neck, pain, and nausea. Examination reveals a petechial rash. Which of the following assessment questions by the emergency room physician is most appropriate? A) Is your son currently taking any medications? B) Has your son had any sinus or ear infections in the last little while? C) Does your son have a history of cancer? D) Was your son born with any problems that affect his bone marrow or blood?

Has your son had any sinus or ear infections in the last little while?

The nurse knows which of the following statements best describes characteristic trait of risckettsiae related to Rocky Mountain spotted fever? Rickettsiae:

Have both RNA and DNA.

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?

Have the client sit up and lean forward

Which nursing intervention is essential for a patient receiving intranasal cyanocobalamin?

Have the patient avoid hot foods within an hour after administration

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

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

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?

He has developed constrictive pericarditis

A patient with angina pectoris has been prescribed nifedipine. Which possible adverse effects should the nurse expect with this medication?

Headache, Edema of ankles and feet, Overgrowth of gum tissue

Before discharge, the nurse provides teaching related to adverse effects of terazosin to the patient and caregivers. Which adverse effects should the nurse include in the teaching about this drug?

Headache, Nasal congestion, Reflex tachycardia, Orthostatic hypotension

The nurse should understand that patients receiving nitroglycerin are at risk for which adverse effects?

Headache, dizziness, tachycardia

A high school student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome and ask them to watch for and report which manifestations of its presence?

Headaches and poor concentation

A client has sustained damage to cranial nerve VIII. The nurse recognizes that the client may experience difficulty with:

Hearing

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 causes this aortic stenosis to happen now? The clinic nurse responds:

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.

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?

Heart rate

What is the most important factor in myocardial oxygen demand?

Heart rate

Which one of the following organisms causes peptic ulcers?

Helicobacter pylori

Which of the following infectious agents listed below would be a site-specific pathogen and not spread throughout the body via the circulatory system? Patient diagnosed with:

Helicobacter pylori diagnosed after an endoscopic procedure.

When platelets adhere to the vessel wall, they release growth factors that cause smooth muscle to grow. This is a major factor in causing atherosclerosis. What are the factors that influence platelets to adhere to the vessel wall?

Hemodynamic stress, High cholesterol, Diabetes, Smoking

A patient arrives in the emergency department with symptoms of extreme fatigue, shortness of breath, and a yellowish discoloration to the skin. The nurse interprets these findings as being which of the following types of anemia?

Hemolytic anemia

The nurse is studying hemostasis. She knows that which of the following are true?

Hemostasis refers to the body's ability to control bleeding, Vessel constriction or spasm is a factor in effective hemostasis, Hemostasis results in the formation of a platelet plug, Hemostasis occurs in established stages

Nitroglycerin therapy is ineffective in preventing angina in a patient and so the patient is prescribed ranolazine. Which assessment finding in the patient will the nurse report to the primary healthcare provider?

Hepatic impairment

Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which of the following phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?

Her CNS has enacted a protective response received by neurons that innervate her arm muscles.

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?

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

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

High after load because of back pressure against the left ventricle

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?

High dose corticosteroid therapy and cytotoxic immunosuppressant agents

A 60-year-old male office worker presents to a clinic complaining of new-onset of lower back pain that has been worsening over the last 6 weeks. The physician knows that which component of his physical assessment and history is most indicative of a serious pathologic process (like aortic aneurysm or cancer)?

His onset of pain has been gradual and he has no prior history of lower back problems.

Which of the following enzymes has a powerful vasodilator effect on arterioles and increases capillary permeability?

Histamine

Anaphylactic shock causes severe hypoxia very quickly because of which of the following reasons?

Histamine release causes massive vasodilation

The nurse is assessing a patient with hemophilia for complication of clotting factor administration. Which assessment findings would indicate an adverse effect of this treatment?

Hives and urticaria, bethesday titer of 40 units

A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food?

Home-grown and canned vegetables

What has been the greatest impediment to the development of antiviral medication?

Host toxicity

The male client with liver cancer is being treated with chemotherapy. The provider notes that the client is fatigued and has a hemoglobin of 9.5 and a normal ferritin level. Which of the following medications does the practitioner prescribe?

Human erythropoietin

The nurse should recognize that which drug only dilates arterioles?

Hydralazine

When monitoring patients receiving antihypertensive agents, the nurse realizes which medication could have a side effect similar to systemic lupus erythematous?

Hydralazine

A nurse is reviewing the health history and medication list of a client admitted with thrombocytopathia. The nurse determines which of the client's home medications predisposes the client to bleeding?

Hydroclorothiazide, Colchicine, Aspirin, Amidarone

The nurse is suctioning a client with a C3 spinal cord injury when the client's heart rate drops from 86 bpm to 42 bpm. What intervention does the nurse understand should be provided prior to suctioning to prevent this vasovagal response from occurring?

Hyperoxygenate prior to suctioning.

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?

Hypertrophic cardiomyopathy

A client arrives in the clinic after having a tongue piercing performed and is unable to control the movement of the tongue. The nurse is aware that which nerve may have been damaged from the piercing?

Hypoglossal

A client is unable to stick out his tongue as a result of injury to cranial nerve XII. The nurse recognizes that the client has sustained as damage to which nerve?

Hypoglossal

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? A) Diabetic ketoacidosis B) Hyperosmolar hyperglycemic state C) Hypoglycemia D) Somogyi effect

Hypoglycemia

A calcium channel blocker has been ordered for a patient. Which condition in the patient's history is contraindicated with this medication

Hypotension

A phosphodiesterase type 5 inhibitor has been ordered for a patient. Which condition in the patient's history is a contraindication to this medication?

Hypotension

Maintenance of blood gas concentrations, water balance, and food consumption are controlled by which of the following parts of the brain?

Hypothalamus

The health care provider is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which assessment finding is congruent with the client's diagnosis?

Hypotonia

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

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?

I should report episodes of dizziness or fainting

The nurse is teaching a patient with essential hypertension who has a new prescription for verapamil. Which statements by the patient indicate that the teaching was effective?

I will increase my intake of fluid and foods high in fiber, I will call my healthcare provider if I notice swelling in my ankles

Which statement indicates the patient understands discharge instruction regarding cholestyramine?

I will take Question with water, fruit juice, or soup

A patient is receiving desmopressin for hemophilia. Which patient statement requires immediate action by the nurse?

I will take my medication at the same time each day

A 78 year old man has been experiencing nocturnal chest pain over the last several months and his family physician has diagnosed him variant angina. Which of the following teaching points should the physician include in his explanation of the man's new 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 clinician working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the clinician should give the client which direction?

I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?

A nurse is preparing a presentation on factors that lead to increased coagulation and thrombosis. Which of the following factors should be included in the teaching plan?

IBD, Steroid therapy, Oral contraception, Smoking

A nurse practitioner is providing care for a male client with a long-standing hiatal hernia. Which of the following statements most accurately captures an aspect of the pathophysiology of hiatal hernias? A) Paraesophageal hiatal hernias are common and are normally not treated if the client is asymptomatic. B) The root causes of hiatal hernias are normally treatable with medication. C) If esophageal acid clearance is impaired, esophagitis can result. D) An incompetent pyloric sphincter and high-fat diet are commonly implicated in the development of hiatal hernias.

If esophageal acid clearance is impaired, esophagitis can result.

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate to include which of the following accurate statements? A) After your caesarean section, it will be safest if you don't breast-feed your child. B) If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with. C) A vaginal delivery will be safe as long as you are consistent with taking your valacyclovir. D) We'll have to book you a caesarian delivery in order to ensure your baby isn't exposed to the virus.

If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with.

Which statement is most appropriate for the nurse to include in the discharge teaching plan for a 30 year old woman beginning a new prescription of clonidine?

If you stop taking this drug abruptly, your blood pressure might go up very high

Every one in the family except the mother currently has influenza. What should the nurse tell the mother are appropriate measures to avoid this infection? Select all that apply.

Immunization Frequent hand washing Avoid close contact with family members

Which current multiple sclerosis drug treatments are designed to slow the progress of myelin degeneration?

Immunomodulators

A 9 year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. The nurse knows which of the following aspects of the nervous system listed below would her healthcare providers focus their diagnostic efforts?

Impaired function of her hypothalamus

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the client's temperature is 102°F (38.9°C). Which other clinical manifestations may lead to the diagnosis of encephalitis?

Impaired neck flexion resulting from muscle spasm

What are the common side effects of fenofibrate, a fibric acid derivative?

Impotence, nausea and abdominal pain, increase in gallstone formation

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

Neurotransmitters are small molecules that exert their actions through specific proteins, called receptors, embedded in the postsynaptic membrane. Where are neurotransmitters synthesized?

In the axon terminal

The spouse of a patient with a history of hepatitis C who is admitted to the hospital with upper gastrointestinal bleeding asks the nurse why these bleeding episodes occur. Having reviewed the patient's laboratory work, and noting a severe vitamin K deficiency, the best response would be that the low vitamin K levels will contribute to which of the following?

Inactive clotting factors

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?

Increase sympathetic stimulation of the heart and blood vessels

Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which of the following results is most likely to be considered unexpected by the health care team?

Increased thrombopoietin levels

Increasing the functional ability of the underactive dopaminergic system

Which of the following sequences accurately describes the stages of a disease?

Incubation, prodromal, acute, convalescent, and resolution.

A fomite is which one of the following?

Infection transfer agent

What is the term for parasitic relationships between microorganisms and the human body in which the human body is harmed?

Infectious disease

Which disease can result in symptoms that can occur when a brain tumor causes damage to the nigrostriatal pathway?

Parkinson disease

Which pathophysiologic process occurs in cases of bacterial meningitis?

Inflammation allows pathogens to cross into the cerebrospinal fluid.

A medical surgical nurse is studying risk factors for the development of secondary thrombocytosis before taking a certification exam. Which of the following situations would the nurse determine would increase a patient's risk?

Inflammatory bowel disease, Lung cancer, Rheumatoid arthritis

Select the option that best describes the mediation of the systemic inflammatory response that occurs in DIC.

Inflammatory mediators and cytokines

A patient with hypercholesterolemia has been prescribed simvastatin. Which action should the nurse perform while caring for the patient?

Inform the patient that this drug may cause nausea

A patient is receiving sodium ferric gluconate complex. What should the nurse do while administering this medication?

Infuse the drug slowly

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 patient with a history of cancer and recent chemotherapy was hospitalized with fever, weakness, shortness of breath and productive cough. A bronchoscopy with transbronchial biopsy showed granulomas containing the fungus Histoplasma. Based on patient history and the biopsy results, a nurse can conclude that the most likely cause of this infection was due to which of the following?

Inhalation of fungi and decreased host defenses permitting an opportunistic infection.

A school age child with a history of asthma has brought a note home from school stating there has been one case of meningitis (Neisseria meningitides) in the school. Since the mother is a nurse, she is very concerned since she knows the portal of entry of this pathogen is:

Inhalation via the respiratory tract such as through breathing or yawning.

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?

Inhibition of the renin angiotensin aldosterone system

The nurse should anticipate that she will need to teach the client newly diagnosed with multiple sclerosis how to give injections if which medication to assist with reducing exacerbations is prescribed?

Interferon beta

Reflexes are basically "hard-wired" into the CNS. Anatomically, the basis of a reflex is an afferent neuron that synapses directly with an effector neuron to cause muscle movement. Sometimes the afferent neuron synapses with what intermediary between the afferent and effector neurons?

Interneuron

Neurons that connect sensory and motor neurons are known as which of the following?

Interneurons

The nurse expects that loss of respiratory effort occurs with a spinal injury at which level?

Interneurons

Which neuron connects sensory and motor neurons?

Interneurons

While assessing a critically ill patient in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat which develops into ventricular tachycardia (VT). Immediately, the patient became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:

Interruption of the blood/oxygen supply to the brain.

Which organ regulates the body's iron stores?

Intestines

A client has a suspected infection by a particular microorganism in question cannot be cultured. Which of the following processes listed below is most likely to result in an accurate diagnosis for the client?

Introduce cultured, marked antibodies to the client and observe for a reaction with antigens in the client.

A client who is being treated for colorectal cancer has developed anemia. The nurse should first suspect what potential causes of this client's anemia?

Iron deficiency, Chemotherapy

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?

Ischemic heart disease, degenerative changes, congenital defects, inflammation, trauma, rheumatic heart disease

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

Ischemic stroke

A patient of african american heritage with heart failure is unable to tolerate ACE inhibitors and ARBs. Which medication is an appropriate alternative for this patient?

Isosorbide denigrate and hydralazine

Antibiotics target bacteria. If an antibiotic is bactericidal, how does it affect the bacteria?

It causes irreversible and lethal damage to the bacterial pathogen.

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle? A) It holds organs in place. B) It attaches the jejunum and ileum to the abdominal wall. C) It has lots of mobility and moves around in the peritoneal cavity with D) It is mainly there to prevent any noxious substance from inner into the gut.

It has lots of mobility and moves around in the peritoneal cavity with peristaltic movements.

What is the mechanism of action of ezetimibe?

It inhibits absorption of dietary and biliary cholesterol in the small intestine

The nurse is caring for a patient prescribed aliskiren. How does this medication lower blood pressure?

It inhibits the conversion of angiotensinogen to angiotensin I

Which of the following is true regarding pulmonary circulation?

It is a low pressure system that allows for improved gas exchange

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?

It is usually caused by a viral infection

While being tackled, a 20-year-old football player puts 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? A) This strain will likely resolve itself with sufficient rest. B) You've suffered a severe sprain, and you might need a cast. C) Your wrist contusion will have to be observed for bleeding under the skin surface. D) It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks.

It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks.

A 40-year-old man who uses heroin intravenously was diagnosed with hepatitis C (HCV) 1 year ago and is now considered to have chronic viral hepatitis. Which of the following statements by the client to his care provider would warrant correction? A) I know the medications to treat this aren't fantastic, but at least there are some options for controlling the virus. B) It's at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms. C) Even though I'm sick, at least I won't feel sick most of the time. D) I'm not looking forward to all the side effects of the drug treatments for my HCV, but I hope I don't end up needing a liver transplant.

It's at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms.

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?

Junctions of the subclavian and internal jugular veins

After reviewing medication administration records, the nurse should hold eplerenone for patients receiving which medications?

Ketoconazole, salt substitues, potassium supplements, potassium sparing diuretic

The health care provider is performing a spinal tap on a client with suspected infection. The provider would perform the procedure at:

L3 or L4

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?

LDL

Vascular smooth muscle cells produce vasoconstriction or dilation of blood vessels. Smooth muscle contraction and relaxation can occur in response to local tissue factors. Which are examples of local tissue factors?

Lack of oxygen, Increased hydrogen ion concentrations

A patient takes megadoses of vitamins and folic acid daily. Which is essential for the nurse to teach the patient?

Large doses, taken long term, can increase cancer risk

The nurse reading a client's lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted?

Large number of polymorphonulcear neutrophils

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?

Laryngeal edema

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?

Left ventricle

Feelings of dread, high anxiety, or exquisite pleasure can be elicited by stimulation of areas in which of the following structures?

Limbic system

The nurse is caring for a patient with bipolar disorder treated with lithium. The patient has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?

Lithium level

The diagnosis is right-sided heart failure. The nurse knows that which organ is primarily affected in this type of heart failure?

Liver

What condition increases the patient's risk for the development of MI and DIC when receiving anti-inhibitor coagulant complex?

Liver disease

A nurse is teaching a patient with advanced renal insufficiency about hypertensive drugs. Which information from the patient indicates a correct understanding of the teaching?

Loop diuretics are good for me

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?

Low blood pressure

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

Low cardiac output

The emergency room doctor suspects a client may have bacterial meningitis. The mostimportant diagnostic test to perform would be:

Lumbar puncture

Which goal should the nurse document in the plan of care for a 63 year old patient with hypertension?

Maintain blood pressure below 150/90

A patient who is receiving NTG intravenously by way of an infusion pump has a blood pressure of 92/60. Which is the nurses's priority intervention to maintain the patient's blood pressure?

Maintain tissue perfusion by maintaining fluid balance

The nurse is aware that the primary function of the sympathetic nervous system is:

Maintenance of vital functions and responding when there is a critical threat to the integrity of the individual

Which of the following teaching points would be most appropriate with a client who has a recent diagnosis of Von Willebrand disease?

Make sure that you avoid taking aspirin

The nurse is caring for a patient receiving a nitroprusside IV infusion. The patient's wife asks why furosemide is being prescribed along with this drug. The nurse's response should be based on which concept?

Many vasodilators cause retention of sodium and water

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

Materials can be transported to the nerve terminal by either a fast or slow component.

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

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

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?

Measurement of urine output and mental status assessment

Which statement is true concerning factor VIII administration for hemophilia A treatment?

Medication is given intravenously

Which structures are part of the brain stem? Select all that apply.

Medulla oblongata Pons Midbrain

The student correctly associates microcytic and misshapen red blood cells with which type of anemia?

Megaloblastic

The nurse is reviewing the client's laboratory data showing an increased mean corpuscular volume and a normal corpuscular hemoglobin concentration. The client most likely has which of the following types of anemia?

Megaloblastic anemia

When the nurse is monitoring patients receiving antihypertensive agents, which drugs should be identified as those that affect only the arterioles?

Minoxidil, Hydralazine

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:

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?

Mitral valve stenosis

The nursing student when studying cardiomyopathies learns that the primary ones are classified into which of the following groups?

Mixed, genetic, acquired

A patient has been receiving intravenous heparin. The nurse notes that today's aPTT result is elevated. What is the nurse's best action?

Monitor the patient and check the therapeutic range

1. A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse? A) Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses. B) Communication between a neuron and the single neuron it is connected with will be facilitated. C) The neurotransmitter will cross gap junctions more readily. D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse?

More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Multiple sclerosis (MS)

The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?

Muscle atrophy

The nurse in the emergency department knows clients exposed to Clostridium botulinum, an agent of bioterrorism, would likely be exhibiting which of the following clinical manifestations listed below?

Muscle weakness in extremities eventually leading to paralysis of respiratory muscles.

Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category?

Myasthenia gravis

Which disease is thought to be caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction?

Myasthenia gravis

Which of the following diseases is associated with fewer acetylcholine receptors, resulting in a lower-amplitude endplate potential, muscle weakness, and fatigability?

Myasthenia gravis

Which of the following is the primary component of white matter?

Myelinated fibers

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

Myocardial infarction prevention

A patient with hyperlipidemia has been prescribed simvastatin. While caring for the patent, the nurse unknowingly administers niacin along with simvastatin. Which complication may the patient have due to the drugs interaction?

Myopathy

Which peripheral nerve injury will likely result in cellular death with little chance of regeneration?

Nerve fibers destroyed close to the neuronal cell body

During embryonic development, which of the following structures develops into the central nervous system (CNS)?

Neural tube

A patient comes to the clinic and is diagnosed with gouty arthritis. When the nurse looks over the patient's medication list, what medication could have caused this adverse effect?

Niacin

A patient has a SAH from an intracranial aneurysm. Which dihydropyridine would the nurse anticipate being prescribed?

Nimodipine

Which nitrate preparation or dosage form has the longest duration of action?

Nitroglycerin transdermal patch

The density of voltage-gated channels is greatest in which of the following components of the neuron?

Nodes of Ranvier

A patient is in Stage C of heart failure. Which prescription should the nurse question?

Nonsteroidal anti inflammatory drugs

Rapid removal of a neurotransmitter, once it has exerted its effect on the postsynaptic membrane, is necessary to maintain precise control of neural transmission. Which of the following transmitters is largely removed by the reuptake process?

Norepinephrine

A client diagnosed with Parkinson disease is displaying the following manifestations: tremor, rigidity, and slowness of movement. The nurse would interpret these as:

Normal manifestations of Parkinson disease

A patient diagnosed with a pulmonary embolism is reaching a continuous heparin infusion at 1000 units/hr. The nurse will immediately notify the healthcare provider of which findings?

Nosebleeds, aPTT of 40 seconds, aPTT of 100 seconds

What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?

Notify the healthcare provider of nausea, vomiting and visual changes

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?

Obstructive shock

While there is no laboratory test that is diagnostic for multiple sclerosis, some clients have alterations in their cerebrospinal fluid (CSF) that can be seen when a portion of the CSF is removed during a spinal tap. What finding in CSF is suggestive of multiple sclerosis?

Oligoclonal patterns

The nurse is caring for a patient receiving clopidogrel to prevent blockage of coronary artery stents. Which other drug on the patient's medication administration record may reduce the anti platelet effects of clopidogrel?

Omeprazole

The nurse is reviewing hospital discharge instruction with a patient who has been diagnosed with secondary thrombocytosis and who also suffers from chronic ulcerative colitis, making anticoagulation inadvisable. The nurse stresses to the patient that the patient should avoid which of the following?

Oral contraceptives, Smoking, Immobilization

Which statement by the nursing student about the use of organic nitrates indicates understanding?

Organic nitrates dilate all blood vessels

The patient is taking an alpha 1 blocker. What potentially disturbing side effect should the patient be made aware of?

Orthostatic hypotension

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 is most responsible for restoring the integrity of the man's broken bone? A) Osteocyte B) Osteoclast C) Osteoblast D) Osteoma

Osteoblast

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?

PAP

A nurse is monitoring the ECG of a patient with a recent right ventricular infarction. The ECG reveals a first-degree AV block, which is characterized by which of the following?

PR interval >0.20 seconds

Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding?

Paralysis

A client who has experienced a spinal cord injury still has use of the arms but has impaired motor and sensory function of the trunk, legs, and pelvic organs. Which term best describes how this injury is classified?

Paraplegia

After being thrown off the back of a bull, a bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is referred to as:

Paraplegia

What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?

Parkinson disease

A client asks the nurse what happens when a pathogen enters the body. Select the best response.

Pathogens that enter the intestinal mucosa can cause diseases in the lungs or liver.

Transmission of the rabies virus from a dog bite would be best described by which of the following mechanisms of entry?

Penetration

A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon x-ray it is determined that he 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client to be suffering?

Pericardial effusion

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

Pericardial effusion

Which occurrence in the action potential process causes polarization?

Period of action potential during which the nerve is not transmitting impulses

A nursing student having trouble moving their head from side to side is likely experiencing a problem with which type of neurons?

Pharyngeal efferent neurons.

The nurse observes redness and swelling on the forearm where epinephrine was administered IV. The nurse anticipates administration of which medication to counteract the effects on the surrounding tissue at the IV site?

Phentolamine

A patient develops hypotension after administration of verapamil. Which intervention is appropriate?

Place in modified Trendelenburg's position

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his family physician to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the physician's suggestion?

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

A nurse is caring for a patient who was recently diagnosed with primary thrombocytosis. The patient does not understand why hydroxyurea is given. The best explanation would be that this medication decreases which of the following?

Platelet counts

A nurse is assessing a child brought to the clinic with multiple petechiae and excessive bruising covering his body. Laboratory tests reveal a low platelet count. The nurse is aware that these clinical manifestations are caused due to of which of the following pathological processes?

Platelets function to form the platelet plug to help control bleeding after injury. Without enough platelets, the blood cannot clot properly and bleeding occurs.

A patient is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory results should the nurse monitor?

Platelets, aPTT

Which structural change can contribute to mixed sensorimotor deficit?

Polyneuropathies involving demyelination of peripheral nerves

Guillain-Barré syndrome is characterized by which form of neuron damage?

Polyneuropathy

Multiple sclerosis is characterized by what type of neuron damage?

Polyneuropathy

Which parts of the brain make up the brain stem?

Pons and medulla oblongata

Which treatment should take place immediately in a client experiencing autonomic dysreflexia?

Position the client in upright position, and correct the initiating stimulus.

The nurse is performing an assessment for a client suspected of having symptoms that correlate with carpal tunnel disorder. The client states he feels a tingling sensation that radiates into the palm of the hand when the nurse lightly percusses over the median nerve. How would the nurse document this finding?

Positive Tinel sign

Duchenne muscular dystrophy usually does not produce any signs or symptoms until age 2 to 3. What muscles are usually first to be affected in Duchenne muscular dystrophy?

Postural muscles of the hip and shoulder

A patient is receiving cyanocobalamin for the treatment of pernicious anemia. Which electrolytes should the nurse monitor as a result of this treatment?

Potassium

When educating a patient about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:

Potassium channels open and while sodium channels close causing repolarization to the resting state.

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?

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

The nurse is caring for a patient who takes spironolactone and quinapril for treatment of heart failure. Which finding indicates a potential additive effect between these two drugs?

Potassium level of 5.7

A patient has a new prescription for an ACE inhibitor. During a review of the patient's list of current medications, which medications should alert the nurse to a possible interaction with this new prescription?

Potassium supplement, potassium sparing diuretic, nonsteiroidal anti inflammatory drug

After reviewing the chart of a patient with hypertension who is receiving angiotensin converting enzyme inhibitors, which finding will cause the nurse to notify the provider?

Pregnancy test positive

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?

Preload

The nurse is teaching the staff about the effects of vasodilators. Which statements indicate a correct understanding of the teaching?

Preload is decreased, Vasodilators reduce after load, Some vasodilators dilate arteries or veins while others dilate both

The nurse knows that factors that affect stroke volume include which of the following?

Preload, after load, myocardial contractility

A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside infusion. What interventions are essential before the nurse administers nitroprusside?

Prepare for arterial line insertion, Cover the solution with an opaque bag, Obtain a baseline weight and weigh daily

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

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

Release of neurotransmitters occurs at which of the following locations in the neuron?

Presynaptic terminal

Which of the following best describes the number of active disease cases at any given time?

Prevalence

Transmissible neurodegenerative diseases such as Creutzfeldt-Jakob disease are associated with:

Prion

Which one of the following infective agents contains no DNA or RNA?

Prions

A client newly diagnosed with the neurodegenerative disease Creutzfeldt-Jakob disease (CJD) asks why antibiotics are not part of the treatment plan. How should the nurse respond?

Prions are not affected by antibiotics.

A client complains of general malaise and fatigue and has a mild fever. The nurse would evaluate this stage of disease as the:

Prodromal stage

As a client explains to the nurse what occurred prior to the onset of seizure activity, the client describes perceiving a feeling or warning that the seizure would occur. The nurse documents the perceived warning as which of the following?

Prodrome

What is the role of a neuromodulator when it acts on a postsynaptic receptor?

Produces slower and longer-lasting changes in membrane excitability

The nurse is teaching the staff about the effects of aldosterone. Which information should the nurse include in the teaching session?

Promotes vascular fibrosis, Promotes myocardial remodeling, Promotes baroreceptor dysfunction

1. A patient is asked to stand with feet together, eyes open, and hands by the sides. Then the patient is asked to close his eyes while the nurse observes for a full minute. What assessment is the nurse performing? Segmental reflex Posture Proprioception Crossed-extensor reflex

Proprioception

A client is asked to stand with feet together, eyes open, and hands by the sides. Then the client is asked to close the eyes while the clinician observes for a full minute. What assessment is the clinician performing?

Proprioception

A patient was diagnosed with HIV. The nurse is teaching the patient about types of drug therapy. Which of the following antiviral agents is developed solely for the treatment of HIV infections and works by inhibiting an HIV-specific enzyme that is necessary for late maturation events in the virus life cycle?

Protease inhibitors

After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem? A) Surgical correction of the incompetent pylorus B) Antacids; avoiding positions that exacerbate reflux; a soft-textured diet C) Weight loss and administration of calcium channel blocking medications D) Proton pump inhibitors; avoiding large meals; remaining upright after meals

Proton pump inhibitors; avoiding large meals; remaining upright after meals

Which one of the following agents is the cause of malaria?

Protozoan parasite

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD), in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur? A) Decreased absorption of ingested foods and fluids B) Impaired control of the gastric emptying rate C) Protrusion of the stomach or regurgitation of stomach contents into the esophagus D) Inappropriate release of gastric enzymes

Protrusion of the stomach or regurgitation of stomach contents into the esophagus

A 48-year-old woman has been diagnosed with extrahepatic cholestasis following a thorough history, ultrasound, and blood work. Which of the following symptoms most likely caused her to seek medical treatment, and what consequence to her health problem would the medical team anticipate? A) Complaints of lower flank pain with consequences of impaired fat metabolism B) Anorexia with consequences of impaired drug metabolism and blood filtration C) Skin xanthomas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors D) Pruritus with consequences of deficient levels of fat-soluble vitamins

Pruritus with consequences of deficient levels of fat-soluble vitamins

The parent of a toddler with Duchenne muscular dystrophy reports that the child has an increase in muscle size but a decrease in strength. The nurse documents this using which medical term?

Pseudohypertrophy

A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?

Psychological manifestation due to involvement of white matter of cerebral cortex

Which assessment is most important for the nurse to obtain prior to administering digoxin to a patient with heart failure?

Pulse

The heart is a four-chambered pump. What is the function of the right ventricle?

Pumps blood to the lungs

The nurse is teaching the staff about the actions of angiotensin II. Which describe the actions of angiotensin II?

Raises blood pressure, Causes cardiac remodeling, Stimulates aldosterone release

Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?

Reading

Which of the following is the period during repolarization when a portion of the recovery period is where the membrane can be excited, although only by a stronger-than-normal stimulus?

Relative refractory period

A staff member asks how CCBs work. Which response should the nurse provide?

Relax vascular smooth muscle

The transmission of impulses at the neuromuscular junction is mediated by which action?

Release of neurotransmitter acetylcholine from autonomic nerve endings

A patient is prescribed an angiotensin converting enzyme inhibitor for hypertension. The nurse knows that ACEIs are contraindicated by which clinical condition?

Renal artery stenosis

Potassium outflow from the cell is characteristic of which of the following phases of the action potential?

Repolarization

The nursing assistant reports to the registered nurse that a client with a brain tumor has a blood pressure of 180/100 mm Hg and a pulse of 50 bpm. Which action is the correct nursing intervention?

Report to physician the client's signs of increased intracranial pressure.

Select the actions of β2 receptors. Select all that apply.

Respiration Delaying labor

A client has started having uncontrolled seizures that are not responding to usual medications. Nurses working with the client must pay special attention to which priority aspects of this client's care? Assessment of:

Respiratory status and oxygen saturation

A client with a diagnosis of myasthenia gravis underwent a mastectomy. The surgery was a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which priority measure should the care team initiate immediately?

Respiratory support and protection of the client's airway

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client?

Respiratory ventilation assessment and prevention of aspiration pneumonia

Cerebellar tremor is exhibited by which symptom?

Rhythmic movement of the finger or toe that worsens as a target is approached

Which one of the following is responsible for Rocky Mountain spotted fever?

Rickettsia

The infectious agents that cause Rocky Mountain spotted fever and epidemic typhus are transmitted to the human body via vector such as a tick. What are these infectious agents?

Rickettsiae

Which instruction should the nurse include when developing a teaching plan for a patient prescribed diltiazem for atrial fibrillation?

Rise slowly from a lying to a sitting position, Notify the healthcare provider if a skin rash develops

The mother of an infant born with profound mental retardation and hearing loss tells the nurse that she had a viral infection in the first trimester of her pregnancy. The nurse identifies which of the following congenital infections as the cause of the fetal defects?

Rubella

Which of the following is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction?

SA node, AV node, Bundle of His, Bundle branches, Pukinje fibers

A 45 year old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the patient that the venous blood supply to the penis is controlled by:

Sacral parasympathetic fibers.

A health care provider is providing information to a client about ectoparasites. The most prominent human ectoparasite would be:

Scabies

Which types of cells are supporting cells of the peripheral nervous system?

Schwann cells

Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system? A) Second messengers act as the intracellular signal that responds to the presence of a hormone. B) Endocrine-producing cells must release both a hormone and a second messenger in order to exert a distant effect. C) Second messengers act to supplement hormone effects on cell receptors when the desired hormonal effect must be either increased. D) Second messengers provide an alternative pathway for endocrine effects on a cell that bypass the normal receptor pathways.

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

A patient with a diagnosis of myelogenous leukemia is being admitted to the hospital with an exacerbation of Crohn's disease. Laboratory results include a white blooc cell count of 200,000/μL and a platelet count of 600,000/μL. The nursing assessment reveals swelling and pain in the right leg. The nurse suspects the presence of which of the following conditions?

Secondary thrombocytosis

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply. A) Secretion of mucus to lubricate and protect the inner surface of the alimentary canal B) Smooth muscle cells that facilitate movement of contents of the GI tract C) Holding the organs in place and storage of fats D) Barrier to prevent the entry of pathogenic organisms E) A cushioning to protect against injury from sports or car accidents

Secretion of mucus to lubricate and protect the inner surface of the alimentary canal Barrier to prevent the entry of pathogenic organisms

Which is a complication of infection in which pathogens gain access to the blood?

Septicemia

The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril. Which laboratory result indicates an adverse effect of this drug?

Serum creatinine level of 2.3

The clinician is caring for a client who suffered a spinal injury at T4 several years ago. The client develops a flushed neck, reports feeling unwell, and has an elevated blood pressure. What are the clinician's priority actions? Select all that apply.

Sit client in upright position, remove compression stockings

Which complication of spinal cord injury is the most preventable in a paraplegic client?

Skin breakdown

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which abnormality in the client's gait?

Slow to start walking and has difficulty when asked to "stop" suddenly

What is the most common clinical presentation of amyotrophic lateral sclerosis?

Slowly progressive weakness and atrophy in distal muscles of one upper extremity

When trying to explain to a new dialysis patient the movement of substances through the capillary pores, the nurse will explain that in the kidneys, the glomerular capillaries have:

Small openings that allow large amounts of smaller molecular substances to filter through the gomeruli

Which of the following statements best captures an aspect of the role of hormones in the body? A) Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems. B) Hormones directly initiate many of the processes that contribute to homeostasis. C) Control of body processes is ensured by the fact that a single hormone can only exert one effect on one specific system or tissue. D) Each hormone that exists in the body is produced by only one specific endocrine gland.

Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems.

Which of the following statements is an accurate descriptor of the role of viruses in human infections?

Some viruses are capable of transforming normal host cells into malignant cells.

A client has developed an infection from an exogenous source. The nurse recognizes this as acquired from:

Sources in the external environment, such as the water, food, soil, or air

A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell?

Special visceral afferent cells

A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell? A) Special somatic afferent fibers B) General somatic afferents C) Special visceral afferent cells D) General visceral afferent neurons

Special visceral afferent cells

Which of the following afferent (sensory) neurons in the dorsal root ganglia innervate specialized gut-related receptors, such as taste buds and receptors of olfactory mucosa?

Special visceral afferents

Through what specific component do neurotransmitters exert their action?

Specific proteins

The vertebral column provides protection of: Select all that apply.

Spinal cord Spinal nerves Supporting structures

The nurse is reviewing a medication history on a patient taking an ACE inhibitor. The nurse will contact the healthcare provider if the patient is also taking which medication?

Spironolactone

A nurse at a long-term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the client's TIAs?

TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.

The nurse is assessing a patient who has been prescribed atorvastatin. What instruction should the nurse provide for the patient to ensure proper administration of the medication?

Take the drug in the evening

Which of the following is the lobe of the brain with functions of perception, long-term memory, and recognition of auditory stimuli?

Temporal lobe

The nurse assesses the patient's PT time to determine the effectiveness of anticoagulant therapy and notes that it is 32 seconds. How will the nurse interpret this value?

The PT is significantly elevated

The nurse assesses the patient's aPTT to determine the effectiveness of the heparin regimen and notes that it is 35 seconds. How will the nurse interpret this value?

The aPTT is significantly decreased

The nurse is reviewing the circulatory system. Which statements are correct about the functional organization of the circulatory system?

The arterial system distributes oxygenated blood to the tissues, The venous system collects deoxygenated blood from the tissues

The nurse is aware that some drugs may be prevented from entering the brain as a function of:

The blood-brain barrier

The nurse is explaining to a client's family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be:

The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

Following bone density scanning and diagnostic imaging, a 4-year-old boy has been diagnosed with Legg-Calvé-Perthes disease. Which of the following findings, signs, and symptoms would lead clinicians to this conclusion? Select all that apply. A) The boy has significant difficulty in walking. B) The boy's feet toe-in when standing upright. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic. E) There are numerous microfractures where his patellar tendon and tibia articulate.

The boy has significant difficulty in walking. The child has limited abduction of the affected hip. His femoral head region is noted to be necrotic.

A patient asks their healthcare provider why their lower legs look purple. The healthcare provider will base their response on which pathophysiological principle?

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

When explaining the role of liver Kupffer cells to a group of nursing students, which of the following statements about the function of these cells is most accurate? A)The primary function of Kupffer cells is to secrete bile. B) These cells are the functional unit of the liver and are responsible for all liver secretions. C) The cells are capable of removing and phagocytizing old and defective blood cells. D) The role of the Kupffer cells is to provide at least 50% of cardiac output each minute to each lobular of the liver.

The cells are capable of removing and phagocytizing old and defective blood cells.

1. A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? A) The client has decreased deep tendon reflexes. B) The client displays increased muscle tone. C) The client's muscles appear atrophied. D) The client displays weakness in the distal portions of his limbs.

The client displays increased muscle tone.

A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which assessment finding would suggest a possible upper motor neuron (UMN) lesion?

The client displays increased muscle tone.

The nurse is caring for a client with myasthenia gravis. Which symptoms displayed by the client would indicate to the nurse that the client may be experiencing mysasthenia crisis?

The client has a sudden onset of severe weakness.

The nurse is performing a test to determine a client's neurological function related to a suspected lesion in the parietal lobe. What would the nurse determine is a normal finding after assessment?

The client is able to determine correctly that the item placed in his hand is a paper clip.

Which information obtained by the nurse caring for a client with antiphospholipid syndrome should be immediately communicated to the health care provider?

The client is difficult to arouse

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?

The client just smoked a cigarette

An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?

The client's blood pressure has historically been in the range of 150/90 to 160/100 mm Hg.

A 60-year-old office worker has presented to a clinic reporting recent episodes of lower back pain. Which component of the client's assessment and history would be most indicative of a serious pathologic process?

The client's onset of pain has been gradual and the client has no prior history of back problems.

The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state:

The combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

A client has been recovering from a stroke for several weeks and has been reluctant to participate in physical therapy. As a result, the client has experienced disuse atrophy. The nurse should recognize that the client is experiencing the consequences of which physiologic process?

The diameter of the client's muscle cells has decreased

A nurse is providing education to a client newly diagnosed with Guillain-Barré syndrome. Which statement reflects accurate information about the course of the disease?

The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.

The nurse is caring for a patient who is being treated with dabigatran. The nurse is monitoring the patient's laboratory test results and notes that the creatinine clearance is 25 mL/min. Based on this information, the nurse anticipates which change to the medication regimen?

The dose of the medication will be decreased

A nurse is going over preoperative instructions with a patient who is having coronary bypass surgery the following week. The patient asks why the aspirin has to be discontinued. The best response is that there could be excessive bleeding during surgery because the effect that aspirin has on the platelets is which of the following?

The effect is not reversible for the life of the platelet

The neonate displays a yellow discoloration of her skin of the third day of life. The neonatologist explains this condition to the parents. Which of the following statements is most accurate?

The increase in bilirubin which causes jaundice is related to the increased red blood cell breakdown

A client is being treated for the ingestion of a neurotoxin that interferes with the depolarization phase of action potentials. What physiologic process will be disrupted?

The inflow of sodium ions

The nurse knows that the primary long term regulation of blood pressure is exerted by which of the following?

The kidneys

A 51-year-old male has been diagnosed with alcohol-induced liver disease. He admits to the nurse providing his care that, I know what the lungs do, and I know what the heart does, but honestly I have no idea what the liver does in the body. Which of the following statements would best underlie the explanation that the nurse provides? A)The liver is responsible for the absorption of most dietary nutrients as well as the production of growth hormones. B) The liver contributes to the metabolism of ingested food and provides the fluids that the GI tract requires. C) The liver metabolizes most components of food and also cleans the blood of bacteria and drugs. D) The liver maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals, and vitamins.

The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.

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

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

When it is determined that a patient's RBCs have a biconcave shape, which of the following will be the nurse's reaction?

The nurse will be please as that shape allows fro increased oxygen diffusion.

The clinical test report of a patient who is prescribed ranolazine indicates toxicity. On assessment, the nurse finds that the patient has taken the dose as prescribed. What could be the cause of toxicity in the patient?

The patient consumes grapefruit juice

A patient with hypercholesterolemia is prescribed lovastatin. After reviewing the patient's medical history, the nurse discovers that the medication is not safe to prescribe for the patient and reports this finding to the healthcare provider. What did the nurse find in the patient's medical history?

The patient has hepatic disease

The nurse reviews the history for a patient taking atorvastatin. What will the nurse act on immediately?

The patient is on oral contraceptives

An elderly patient with hypertension and hyperlipidemia who has been prescribed a statin medication comes for a follow up visit after 4 months of therapy. The patient's lab reports show elevated blood cholesterol levels and the urine examination reveals rhabdomyolysis. What could be the reasons for this condition?

The patient is taking cyclosporine along with statins, the patient is taking grapefruit juice along with statins, the patient is taking amiodarone along with statins

Which patient receiving losartan should be monitored closely while receiving this therapy?

The patient with an elevated creatinine level

The spinal cord does not hang freely within the spinal column. What is it supported by?

The pia mater and the denticulate ligaments

Which of the following statements best captures an aspect of the function of the hypothalamic¡Vpituitary¡Vadrenal (HPA) system? A) Adrenocorticotropic hormone (ACTH) released by the hypothalamus controls to release of cortisol. B) The pituitary gland communicates with the adrenal cortex through the release of ACTH. C) The adrenal cortex receives corticotrophin-releasing hormone (CRH) and in turn releases cortisol. D) The pituitary gland causes a release of CRH from the hypothalamus, which promotes hormone release from the adrenal cortex.

The pituitary gland communicates with the adrenal cortex through the release of ACTH.

A 3-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? A) The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin.¡¨ B) It's not known exactly why your daughter has completely stopped making insulin, and treatment will consist of your rigidly controlling her diet.¡¨ C) This tendency to produce insufficient amounts of insulin is likely something that she inherited.¡¨ D) Environmental and lifestyle factors are known to play a part in the fact that her pancreas secretes and withholds insulin at the wrong times.¡¨

The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin

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

The pulse decreases rather than increases in amplitude

The administration of topical nitroglycerin ointment has resulted in skin inflammation. The nurse documents the reaction but does not stop the medication. What is the reason for the nurse's action?

The reaction is a contact dermatitis

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:

The relationship between venous return and stroke volume

The nurse is working with a client who has an addiction to cocaine. The nurse is aware that the high associated with cocaine is due to the inhibition of reuptake. What physiologic phenomenon is affected?

The resorption of the neurotransmitter to remove it from action

A patient has been receiving a sodium nitroprusside infusion for the last 4 days for management of severe hypertension. Based on the duration of therapy, what is most essential for the nurse to evaluate?

The serum cyanide level

Where in the body is lipoprotein synthesized?

The small intestine, The liver

A cardiac nurse is describing to a colleague the relationship between the law of Laplace and a client's peripheral vascular disease. To express the law of Laplace in an equation, the nurses need to know which values?

The tension that exists in the walls of a blood vessel, The radius of a particular blood vessel, The pressure that exists in the lumen of a vessel

Coordinated muscular movement requires proper functioning of four areas of the nervous system. Which system controls posture and balance?

The vestibular system

A patient taking sublingual nitroglycerin complains of flushing and headaches. What instruction does the nurse give the patient?

These effects will subside over time

A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies:

They are looking for the presence of antibody or complement on the surface to the RBC

Which of the following is true during the phase where polarized cells are not transmitting?

They are more negative inside the cell as compared to the outside of the cell.

Which are characteristics of resident flora? Select all that apply.

They live on nonsterile areas of the body. They do not cause harm to the body. They provide a type of natural immunity.

The nursing instructor determines that the student nurse understand the rationale for administration of an ACE inhibitor for treatment of hypertension if which statements are made?

They reduce after load, SVR is decreased

A client with otitis media is ordered to receive amoxicillin (Amoxil). The client questions the nurse on how the drug works. Which of the following statements describes how penicillin works?

This drug causes interference with a specific step in bacterial cell wall synthesis.

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

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

1. A 20-year-old male has presented to a health clinic with multiple genital lesions that are filled with a viscous, creamy exudate and has subsequently been diagnosed with molluscum contagiosum. What is his care provider most likely to tell him about the plan for treating the diagnosis? A) This kind of infection often subsides on its own and doesn't grow more serious over time. B) These lesions usually respond well to oral antiviral medications. C) Treatment of this problem is usually successful, but if untreated, it can lead to sterility. D) The bacteria that cause this disease are often latent for several years at a time, and you would be contagious for the entire period.

This kind of infection often subsides on its own and doesn't grow more serious over time.

The nurse is providing teaching to an elderly male patient who has been prescribed extended released doxazosin. Which statement should the nurse include?

This medication carries some cardiovascular risk, Be especially careful when changing positions after your first dose of the medication

A patient with hypertension and left ventricular hypertrophy takes losartan daily. What is a benefit of this therapy for a patient with hypertension?

This medication decreases the risk of stroke.

A patient is prescribed aminocaproic acid. Which statement is true concerning this therapy?

This medication is for serious bleeding

1. Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? A) Your daughter has lost all her cognitive functions as well as all her basic reflexes. B) Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change. C) If you or the care team notices any spontaneous eye opening, then we will change our treatment plan. D) Your daughter's condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.

Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

Thrombolysis

The most common cause of an ischemic stroke is which of the following?

Thrombosis

For which purpose should the nurse administer aliskiren to a patient with hypertension?

To reduce blood pressure

The sympathetic and the parasympathetic nervous systems are continuously at work in our bodies. This continual action gives a basal activity to all parts of the body. What is this basal activity referred to as?

Tone

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?

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

A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing:

Transient ischemic attack (TIA)

Which of the following increase(s) the permeability of the blood-brain barrier? Select all that apply.

Trauma Infection Newborn child

The nurse teaches a client about a new diagnosis of astrocytoma. Which statement indicates an accurate understanding?

Treatment is hard since glial cells support neurons and blood vessels in the brain.

Which of the following nerves exits the pons and conveys the modalities of pain, temperature, touch, and proprioception to the superficial and deep regions of the face?

Trigeminal nerve

When a physician suspects a patient has suffered an acute myocardial infarction, which serum biomarkers should he order?

Troponin 1, creatinine kinase, troponin T

The arachnoid membrane is the middle layer of the three meninges.

True

The vertebral column provides protection for the spinal cord, spinal nerves, and supporting structures.

True

A client diagnosed with autosomal dominant vWF is experiencing mild to moderate bleeding. The health care provider would classify the diagnosis as:

Type 2

1. An adult male has a new diagnosis of Guillain-Barré syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)? A) The destruction of myelin causes fewer Schwann cells to be produced in the client's PNS. B) The axonal transport system is compromised by the lack of myelin surrounding nerve cells. C) Unless remyelination occurs, the axon will eventually die. D) A deficit of myelin predisposes the client to infection by potential pathogens.

Unless remyelination occurs, the axon will eventually die.

An adult male has a new diagnosis of Guillain-Barre syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)?

Unless remyelination occurs, the axon will eventually die.

A 70 year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which clinical finding would be most closely associated with cerebellar insult?

Unsteady gait and difficulty speaking and swallowing

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on which region of the brain?

Upper and lower motor neurons

The nurse is teaching a group of clients how to avoid transmission of bacterial infection by spirochetes. Which information is correct? Select all that apply.

Use a barrier method during sexual intercourse.

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?

Valvular regurgitation

Dopamine is an intermediate compound made during the synthesis of norepinephrine. It is the principal inhibitory transmitter of the internuncial neurons in the sympathetic ganglia. What other action does it have?

Vasodilates renal and coronary blood vessels when given intravenously

In circulatory shock, the adrenergic nervous system is activated. The nurse knows that stimulation of beta-2 adrenergic receptors will result in which responses?

Vasodilation of the skeletal muscle vascular bed, Dilation of the bronchioles

1. A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood brain barrier and been transferred from the vascular space into the client's interstitial space. Which of the following diagnoses best captures this pathophysiology? Focal hypoxia Cytotoxic edema Hydrocephalus Vasogenic edema

Vasogenic edema

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Vasospasms and hypertension

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?

Veins

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

Ventricles contract and blood is ejected from the heart

An HIV-positive mother passes the virus to her infant during delivery. This type of transmission is known as:

Vertical transmission

A 21 year old male is brought to the ED following a night of partying in his fraternity. His friends found him "asleep" and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the roommates in the fraternity, the nurse begins by explaining that alcohol is:`

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

Ion channels in nervous system cells generate action potentials in the cells. What are the ion channels guarded by?

Voltage-dependent gates

The natriuretic peptides serve to protect the cardiovascular system from which condition?

Volume overload

A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistulae (EA/TEF). Which of the following explanations should the care team provide to the infant's parents? A) We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally. B) This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time. C) The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration. D) The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs.

We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally.

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? A) She will likely walk later than most children, but it will resolve itself with time. B) We'll likely need to start putting the first of a series of casts on her legs quite soon. C) The best time to perform the surgery that's needed will be at age 3 or 4. D) While there's no effective treatment for her toeing-in, most children learn to accommodate the problem and walk independently.

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

A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which pathophysiologic condition has contributed to this client's diagnosis?

Weakness in the muscular wall of an artery

A nurse is teaching a group of hikers about Lyme disease prevention. Which of the following statements should be included in the teaching?

Wear long sleeves and pants tucked into socks while hiking.

A client asks the nurse when during embryonic growth the nervous system develops. The best response would be:

Week 3

Global infectious diseases are now being recognized. These diseases, known as endemic to one part of the world, are now being found in other parts of the world because of international travel and a global marketplace. Which of the following is considered a global infectious disease?

West Nile virus

Which accurately reflects Starling's law as applied to a healthy heart?

When venous return increases cardiac output increases, The right and left ventricles pump the same amount of blood, Cardiac output is equal to the volume of blood delivered by the veins

A nurse is caring for a client in the intensive care unit who has sustained severe trauma and now has developed DIC. The nurse is aware that the client is experiencing?

Widespread coagulation and bleeding in the vascular compartment

Which of the following types of reflex is stimulated by a nociceptive stimulus?

Withdrawal reflex

Select the option that best describes a single-celled organism that reproduces by a budding process.

Yeast

Which is a single celled organism that is about the size of a red blood cell and reproduces by a budding process?

Yeast

The nurse is teaching a patient with vitamin B12 deficiency caused by a precious gastrectomy and lack of intrinsic factor. Which statement by the nurse is the most appropriate to include in the teaching plan?

You may be prescribed a high dose of oral vitamin B12

After 3 weeks of therapy with oral ferrous sulfate, a patient calls the clinic nurse complaining of continuous nausea and vomiting with this drug. Which is the most appropriate response to this patient?

You may need a lower dose; I will contact your primary healthcare provider and call you back

A pediatrician is teaching a group of medical students about some of the particularities of heart failure in children as compared with older adults. Which of the physician's following statements best captures an aspect of these differences?

You'll find that in pediatric patients pulmonary edema is more often interstitial rather than alveolar so you often won't hear crackles

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? A) His skeleton is prone to breakage, and we'll begin hormone therapy to treat this. B) His hips are extremely susceptible to dislocation, so rough play is out of the question. C) You'll need to commit to calcium supplementation for the duration of his development. D) You'll need to be very careful to avoid causing fractures to his fragile bones.

You'll need to be very careful to avoid causing fractures to his fragile bones.

A teenage girl, seen in the clinic, is diagnosed with nonthrombocytopenic purpura. The girl states, "You have taken a lot of blood from me. Which of my tests came back abnormal?" How should the nurse respond?

Your CBC with differential showed a normal platelet count

The clinician is caring for client who has been living with Parkinson disease for the past 10 years and is being treated with levodopa-carbidopa. The client often leaves the unit with family for extended periods. What should be prioritizedwhen teaching the client?

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

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?

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

1. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents? A) Your son's muscular dystrophy is a result of faulty connections between muscles and the nerves that normally control them. B) He'll require intensive physical therapy as he grows up, and there's a good chance that he will outgrow this problem as he develops. C) Your son will be prone to heart problems and decreased lung function because of this. D) His muscles will weaken and will visibly decrease in size relative to his body size throughout his childhood.

Your son will be prone to heart problems and decreased lung function because of this.

A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy's spleen. Which of the following teaching points would be most accurate?

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

A female patient presented to her primary care physician with classic signs and symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the health care providers explain her Cushing syndrome signs and symptoms to this patient? A) Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms.¡¨ B) We are going to have to run some more tests. We think you might have a problem with your pituitary gland.¡¨ C) There is no connection between the Cushing syndrome and the vaginal carcinoma. You have two very distinct problems occurring at the same time.¡¨ D) We need to check your thyroid. Your Cushing syndrome may be caused by hypofunction of this gland.¡¨

Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms

Infections that are passed from animals to humans are known as:

Zoonotic

A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to:

administer IV tissue plasminogen activator (tPA).

The spouse of a client admitted to the hospital after a motor vehicle accident reports to the nurse that the client has become very drowsy. The nurse should:

assess the client for additional signs/symptoms of increased intracranial pressure.

The nurse is caring for a client experiencing a seizure. During the seizure the nurse notes that the client repetitively rubs his/her clothing. When contacting the client's physician, the nurse notes that the client exhibited:

automatisms.

A client has been diagnosed with multiple sclerosis. What should the clinician include in client teaching to help reduce the frequency of exacerbations? Select all that apply.

avoid stressful situations, avoid extreme temperatures, stay up to date with vaccines

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.

A client has been diagnosed with syphilis and will be treated with penicillin. The client's medication will achieve a therapeutic effect through:

interference with cell wall synthesis.

A client suffering global cerebral ischemia a week after a suicide attempt by hanging is in the intensive care unit receiving treatment. The parent asks the nurse why it is necessary to keep the client paralyzed with medications and on the ventilator. The most appropriate response would be that these therapies:

decrease metabolic needs and increase oxygenation.

The parents of an infant born with hydrocephalus are concerned about the size of the baby's head. The doctors are telling them that the infant needs the surgical placement of a shunt. The nurse caring for the infant in the neonatal intensive care unit explains that placement of a shunt will:

decrease the likelihood of further neurological deficits.

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by A) decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials. B) increasing the peristaltic motion of the GI tract, thereby causing explosive diarrhea. C) increasing the amount of secretions being entered into each segment of the intestinal tract. D) signaling the vagus nerve to slow down motility and increase absorption of water from the large intestine.

decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials.

Reflex activity involves which neurons?

efferent, afferent, interneuron

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced:

generalized seizure.

A middle-aged male walks into the emergency department complaining of chest pain radiating to the neck, shortness of breath, and nausea. His heart rate is 120 and BP is 94/60. The ED physician recognizes the patient is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to A) the patient not having a very high pain tolerance. B) hypoxia exerting a direct effect on the chemoreceptor trigger zone. C) the patient not having digested his meal completely. D) fear of having to make major lifestyle changes.

hypoxia exerting a direct effect on the chemoreceptor trigger zone.

A client has developed global ischemia of the brain. The nurse determines this is:

inadequate to meet the metabolic needs of the entire brain.

The most common cause of C. botulinum in infants is:

ingestion of honey products containing C. botulinum spores.

When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is A) positively charged. B) inhibitory. C) overstimulated. D) dormant.

inhibitory

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

interruption of the blood/oxygen supply to the brain.

A 41-year-old woman diagnosed with multiple sclerosis (MS) is sharing her story with members of an MS support group made up of people recently diagnosed. Which aspects of her health problem should the woman warn others to expect at some point in the progression of the disease? Select all that apply.

loss of mental acuity, debilitating fatigue, progressive loss of visual acuity

A nurse caring for a client in myasthenic crisis identifies a priority concern as:

maintenance of airway and respiration.

Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of A) milliseconds. B) less than 10 minutes. C) 24 to 36 hours. D) 4 to 7 days.

milliseconds

The bacteria that line the gut of a human help maintain normal gut health and provide essential nutrients. This type of relationship is:

mutualistic.

Growth hormone (GH) secretion is inhibited by A) hypoglycemia. B) starvation. C) heavy exercise. D) obesity.

obesity.

Global or diffuse brain injury is manifested by changes in the level of consciousness.

true

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 A) increasing reabsorption of sodium in the distal tubules. B) reducing the reabsorption of phosphate. C) stimulating production of red blood cells. D) decreasing the reabsorption of calcium.

reducing the reabsorption of phosphate.

The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that:

resistance should be provided with the knee in a flexed position.

Death caused by muscular dystrophy in early adulthood is usually due to:

respiratory and cardiac muscle involvement.

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet.

A nurse is caring for a client experiencing muscle fasiculations. Fasiculations appear as:

spontaneous contractions of muscle fibers presenting as twitching.

A 68-year-old African American man who has smoked for at least 50 years reports that lately he feels as though food is getting stuck in his throat. At first, this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least three alcoholic beverages nearly every day. His problem is most likely A) achalasia. B) squamous cell carcinoma of the esophagus. C) dysphagia secondary to scleroderma. D) gastrointestinal reflux disease.

squamous cell carcinoma of the esophagus.

A client has started on interferon beta for treatment of multiple sclerosis. What should the clinician include in the teaching? Select all that apply.

subcutaneous injection, alters immune response

1. The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state that A) it takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells. B) there is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane. C) the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable. D) the neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.

the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.

The most common cause of ischemic stroke is:

thrombosis.

The nurse has just completed an assessment on a client admitted with Guillain-Barré syndrome. The nurse determines that a priority of care will be:

ventilatory assessment and support.

Many different proteins, enzymes, and hormones are involved in maintaining hemostasis. Which protein is required for platelet adhesion?

von Willebrand factor

Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:

who had his forearm partially crushed by gears during an industrial accident.

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CHAPTER 18 - DISORDERS OF BLOOD FLOW AND BLOOD PRESSURE, Da 5th one, Patho Chapter 34 Quiz Questions, Unit 8 Patho, Patho ch 15, Patho Chap 19, Ch. 34- Learning: Disorders Affecting Motor Function, Adaptive Quizzing-Exam 4, PrepU CH. 14, Patho Exam #...

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Chapter 2

Scoliosis

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