Patho Chapters 1,2,3,6,29,30,31,51,52,25,27,40,41

The nurse is discussing the diagnostic workup with a client suspected of having metastatic thyroid cancer. How should the nurse explain the purpose of a scan involving a combination of positron emission tomography (PET) and computed tomography (CT)?

"A PET scan focuses on tissue functioning while the CT is best for looking at tissue structure."

A student asks the instructor about the origins of different tissues and their cellular origins during the process of development. Which of the instructor's following statements best describes the process of cell differentiation?

"A fertilized ovum undergoes a series of divisions, yielding many different cell types."

A 31 year-old man who has worked for several years installing fiberglass insulation has developed itchy, irritating lesions on his wrists and forearms over the last several months. He has applied moisturizing creams repeatedly and has taken antihistamines but has experienced no significant improvement. He is understandably concerned about the potential effect this could have on his livelihood and has asked his care provider when treatment will resolve the problem. What is the care provider's most appropriate response?

"A steroid cream will likely help, but often the skin problem lasts long after contact with the product that irritates the skin."

Which student statement demonstrates a sound understanding of the cellular processes of hypertrophy and hyperplasia?

"I know that cells like neurons have little capacity for hyperplastic growth."

An 18 year-old female of Southeast Asian ancestry is distraught over the recent appearance of white patches on her forearms and upper arms which have been subsequently confirmed as vitiligo. Which of the following statements by the woman express an accurate understanding of her condition?

"I suppose this shouldn't come as too much of surprise, since this tends to run in my family."

The daughter of a client with metastatic cancer is confused as to why the client is receiving radiation therapy and asks the nurse, "Why are we still treating the cancer? The plan was only for comfort care." What is the nurse's best response?

"In this case, the radiation is being used to help alleviate the bone pain your family member is experiencing."

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

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

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

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

As part of their orientation to a cardiac care unit, a group of recent nursing graduates is receiving a refresher in cardiac physiology from the unit educator. Which of the following teaching points best captures a component of cardiac function?

"The diastolic phase is characterized by relaxation of ventricles and their filling with blood."

Which of the following teaching points would be most appropriate for a group of older adults who are concerned about their cardiac health?

"The plaque that builds up in your heart vessels obstructs the normal flow of blood and can even break loose and lodge itself in a vessel."

The nurse is teaching a group of new mothers about postpartum nutrition, when one of the clients states that she was told to avoid eating fish too often due to the risk of mercury poisoning. Which of the nurse's following responses most accurately addresses the clients concerns?

"There are some modest risks, but they are only associated with some long-living fish."

When educating a college student who lives in a crowded apartment and was recently diagnosed with tuberculosis, the school nurse will emphasize which treatment plan?

"To destroy this bacterium, you must strictly adhere to a long-term drug regimen of several medications."

As part of a public health initiative, a nurse is teaching a group of older adults about ways to promote and maintain their health. Which teaching points about the common cold is most accurate for the nurse to share with this group of senior citizens?

"Use caution when choosing over-the-counter drugs for your cold; most people do best with rest and anti-fever medications."

Which teaching points is most appropriate for an adolescent who has sought care for the treatment of their severe acne located on the face and back?

"You might need antibiotic pills in addition to a cream for your face."

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."

Of the following situations, which one would be an example of a maladaptive cellular change?

44 year old male with a 60 pack/year smoking history who was diagnosed with a histological grade 3 lung cancer.

A client has sustained superficial or first-degree burns to both legs and the left arm. According to the rule of nines, what percentage of total body surface area should the nurse record as affected by this burn? Correct!

45%

The nurse is caring for a group of clients and deciding who should receive prophylaxis for venous thromboembolism (VTE). Which clients should the nurse identify at high risk for VTE? Select all that apply.

A 25-year-old on oral contraceptives who smokes A 45-year-old with a fractured patella A 65-year-old who had a stroke and is now immobile.

Which of the following individuals is most likely to be experiencing vasodilation?

A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin-angiotensin-aldosterone system

Which of the following clients of an oncologist is likely to have the poorest prognosis?

A 69 year-old man who has been diagnosed with stage IV malignant melanoma.

In which of the following situations would blood be most likely to be rapidly relocated from central circulation to the lower extremities?

A client is helped out of bed and stands up

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

A nasogastric (NG) tube attached to suction

Which of the following changes in an 86 year-old male's skin would necessitate further examination and possible medical treatment?

A new mole-like growth on his forearm.

Which phenomena is most likely occurring during a child's alveolar stage of lung development?

A single-capillary network exists and the lungs are capable of respiration.

The nurse is caring for a client with angina. If wanting to reduce the Frank-Starling effect on myocardial oxygen consumption, what type of medication would the nurse expect to be prescribed?

A venous vasodilator

Which of the following hormones are derivatives of cholesterol

Aldosterone and testosterone

Upon admission to the ICU, a client with a history of cor pulmonale will likely be exhibiting which clinical manifestations of right-sided heart failure? Select all that apply.

Altered level of consciousness. +4 pitting edema in lower extremities. Jugular vein distension.

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

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

The nurse is caring for the client who is incontinent of urine and showing evidence of skin breakdown in the perineal area. Which product should the nurse apply to the client's perineum to prevent skin breakdown?

An occlusive

A client has experienced first degree burns due to sun exposure and states, "The itchiness is so bad, but I don't want to scratch because it hurts." What should the nurse recommend? Select all that apply.

An oral antihistamine An emollient lotion

The geriatric nurse is teaching a group of older adults about the value of including foods containing antioxidants in their diet. Which of the following statements best captures the rationale underlying the nurse's advice?

Antioxidants inhibit the actions of reactive oxygen species.

The medical-surgical nurse is providing care for a client with a diagnosis of amyotrophic lateral sclerosis (ALS). The nurse recognizes which of the following mechanisms are suspected to play a role in the cellular death associated with ALS?

Apoptosis

A frustrated 26-year-old female has sought a referral to a dermatologist in an effort to resolve her sweating and body odor which persist despite good hygiene. Which facts would underlie the explanation that her healthcare provider provides about her problem? Correct!

Aprocrine sweat glands produce a substance that is more oily than sweat from other sources.

In the early morning, a black woman brings her 5-year-old son to the emergency room. The boy is wheezing, short of breath, and has a dry cough. The mother states that he has always been very healthy. He went to bed with only a slight cold and a runny nose but woke her with his coughing shortly after 4 a.m. His symptoms worsened so dramatically that she brought him to the hospital. The care team would most likely suspect that he has:

Asthma

The nurse is caring for a group of clients in their 80s. How can the nurse best prevent skin tear injuries while caring for these clients?

Avoid manipulation that causes traction on the skin.

A female older adult client has presented with a new onset of shortness of breath, and the client's physician has ordered measurement of her brain natriuretic peptide (BNP) levels along with other diagnostic tests. What is the most accurate rationale for the physician's choice of bloodwork?

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the client's dyspnea from a respiratory pathology.

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.

The emergency department is awaiting the arrival of a spinal cord injured patient. Knowing the innervation of the diaphragm, a patient with which type of injury may be in need of immediate mechanical ventilation? Injury to the:

C4 area.

A patient in the emergency department is experiencing a massive stroke with extremely low blood flow to the brain exhibited by a BP <60 mm Hg. The nurse suddenly notes there is a sharp rise in the BP to 250 mm Hg. This high BP lasts about 5 minutes and then the BP drops sharply again. The pathophysiologic principle behind this is likely due to the:

CNS ischemic response

The public health nurse is designing a course about risk factors for various chronic illnesses. For risk factors about which chronic illness will the nurse consult the Framingham study?

Cardiovascular disease

An epidemiologist is conducting a program of research aimed at identifying factors associated with incidence and prevalence of congenital cardiac defects in infants. The researcher has recruited a large number of mothers whose infants were born with cardiac defects as well as mothers whose infants were born with healthy hearts. The researcher is comparing the nutritional habits of all the mothers while their babies were in utero. Which of the following types of studies is the epidemiologist most likely conducting?

Case-control study

The nurse is caring for a client in intensive care receiving mechanical ventilation and intravenous insulin infusion. The nurse notes sudden onset hypotension, tachycardia, and jugular vein distension. What should the nurse do first?

Check the tidal volume setting on the ventilator

A nurse practitioner is working in a crowded neighborhood where the population is primarily immigrants from China. The nurse has designed a research study to follow children from kindergarten to the age of 25. She is going to be looking at their diet, successful progression in school, health practices, and development of disease, to name a few items. This type of research is known as:

Cohort study

The nurse is caring for a 22-year-old client with a circumferential burn to the left thigh. What assessment should the nurse perform as a priority specific to this type of burn?

Color, warmth, circulation, sensation, and movement of the left lower leg and foot

The nurse is caring for a 22-year-old client with a circumferential burn to the left thigh. What assessment should the nurse perform as a priority specific to this type of burn? Correct Answer

Color, warmth, circulation, sensation, and movement of the left lower leg and foot Swelling or pain in the perineum and genital region and the client's ability to void

A patient is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering:

Corticosteroid

A nurse is teaching clients about the benefits of smoking cessation. What should the nurse include as the most accurate reason for the development of a chronic "smoker's cough"?

Damage to cilia in the respiratory tract make it necessary to cough to clear the airway.

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

A client experienced third-degree, full-thickness burns 2 days ago to the lower limbs after a fire at his workplace. Which systemic complications should the nurse regularly assessed for? Select all that apply.

Decreased peristalsis of bowel Sepsis Hypermetabolic response Respiratory dysfunction

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.

When explaining to a patient why they only had minimal muscle damage following 99% occlusion of the left anterior descending artery, the nurse will explain this is primarily due to:

Development of collateral circulation that build channels between some of the smaller arteries usually when the flow is decreased gradually.

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

Diuretic, ACE inhibitor, and beta blocker

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

Dry and warm skin

The nurse working in the ICU knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which of the following clinical manifestations?

Dyspnea and crackles in bilateral lung bases.

A patient has been diagnosed with a neurodegenerative disease called multiple sclerosis (MS). The physician explains to the patient that this disease may be caused by dysregulated apoptosis. Later that day, the patient asks the nurse what this means. The nurse should reply:

Dysregulated apoptosis has caused an excessive rate of programmed cell death along the neuro-pathways.

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

Echocardiogram, blood cultures, temperature

A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method.

Endoplasmic reticulum stress in the gastrointestinal system

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

Estrogen will continue to pass freely through the cellular membranes.

When trying to discern the extent of a burn, the nurse will note that second-degree full-thickness burns are characterized by:

Extensive pain along with waxy white areas with blister formation.

A patient with malignant melanoma has been prescribed alpha interferon, a biologic response modifier. Since this drug prolongs the cell cycle, increasing the percentage of cells in the G0 phase, and stimulates NK cells and T-lymphocyte killer cells, the nurse can anticipate that they may experience which of the following common side effects?

Fever, chills, and fatigue.

After falling off his bicycle, an 8-year-old boy has a large abrasion on his posterior thigh that has removed the epidermis in the region but left the dermis largely intact. Which of the following changes in integumentary system would be expected in the area of his wound?

Fewer Merkel and Langerhans cells in the region

A researcher is interested in the natural history of a disease being studied. What should the nurse focus on to best understand the condition's natural history?

Focusing on clients who did not receive treatment for the condition

The client tells the nurse, "I have tried all types of antihistamines and they don't really help with my chronic itch." Which medication would be most appropriate for the nurse to suggest the client discuss with the health care provider as an option for treating pruritus?

Gabapentin

The nurse is preparing laboratory requisitions for a group of clients based on the health care provider's (HCP) orders. For which order should the nurse request clarification from the HCP?

Glucose load suppression testing for a client suspected of having type 1 diabetes

Nurse Smith is caring for a client with gastroesophageal reflux disease (GERD) who is questioning taking the acid-reducing medication because it is "just a little heartburn." What is the nurse's best response?

Having uncontrolled GERD can increase your risk for esophageal cancer.

A 26-year-old man who survived childhood acute lymphocytic leukemia (ALL), one of the most common childhood cancers, now complains of weakness, fatigue, and shortness of breath. His treatment for ALL likely included anthracyclines. What is the most likely cause of his symptoms?

Heart failure resulting from childhood chemotherapy

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.

An elderly patient has arrived at the physician's office complaining of a rash. Upon further investigation, the patient states the rash feels like a burning pain but also has some tingling. It is extreme sensitive to touch and it's "like crazy." The nurse notes that the rash is made up of vesicles and located on the right thoracic region. The nurse suspects the patient has: Correct!

Herpes zoster

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

High afterload because of backpressure against the left ventricle.

A client has suffered a head injury during a motorcycle accident resulting in impaired swallowing and aspiration pneumonia. Which statement most accurately captures an aspect of his condition?

His vocal folds of the larynx are not performing their normal function.

A community health care worker is explaining to a group of factory workers the importance of wearing gloves when working with strong chemicals such as turpentine and paint thinner. Which characteristics of cell membranes underlies the nurse's teaching?

Impermeability of cell membranes to all but lipid-soluble substances.

The nurse is caring for a client who is incontinent and at risk for pressure ulcer formation. What should the nurse include in the plan of care to reduce the risk for pressure ulcer formation? Select all that apply. Correct!

Inspect bed sheets for cleanliness each time client is turned Establish a toileting routine during waking hours Record client's intake and address nutritional deficits.

The nurse is caring for a client who is incontinent and at risk for pressure ulcer formation. What should the nurse include in the plan of care to reduce the risk for pressure ulcer formation? Select all that apply.

Inspect bed sheets for cleanliness each time client is turned Plan to turn the client when the client reports discomfort. Record client's intake and address nutritional deficits.

The nurse is creating a care plan for a premature infant with respiratory distress syndrome. Which aspects of care should the nurse include in the plan? Select all that apply.

Keeping infant in incubator Delivery of oxygen under positive pressure Monitoring blood glucose Administration of synthetic surfactant

A client has been told she has elevated levels of low-density lipoproteins (LDL). The client says, "I have always followed a low-cholesterol diet, so how could it be elevated?" How should the nurse respond?

LDL needs to be taken up into the intracellular space and this process does not work well in some people, causing LDL elevations in the blood.

Clinical investigation of a 40-year-old female client with diverse dermatological signs and symptoms has focused on the woman's basement membrane. Which of the following skin functions would a clinician most likely attribute to a region of the integument other than the basement membrane?

Lack of sensory nerve impulse conduction

While working in an allergy clinic, the nurse notices that many patients come in with all types of skin reactions. The nurse working in this area knows that which cells play a role in the development of allergic skin condition?

Langerhans cells

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

Large numbers of alveolar macrophages in septal connective tissue

The nurse is changing an occlusive dressing on a stage III pressure ulcer and notes the formation of new eschar in the wound bed. For what change in the wound care plan should the nurse advocate?

Leaving the wound open to air Switching to using wet-to-dry dressings

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

Legionella pneumonia

A client has recently been diagnosed with large cell carcinoma, and the nurse is preparing the client for diagnostic testing to identify distal metastases. Which sites should the nurse explain to the client as the primary focus for the investigation? Select all that apply.

Liver Brain Bone

Which clinical manifestations should the nurse expect to find during physical assessment of a client diagnosed with bronchiectasis? Select all that apply:

Low hemoglobin levels Production of purulent sputum Recurrent chest infections

The nurse is caring for a client who develops sudden onset dyspnea. Which assessment should the nurse prioritize to best identify if the cause may be a pulmonary embolism?

Lower limb appearance

Which of the following components of immune function is absent in the dermis?

Lymph nodes

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

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

Which of the following situations would be classified as a complication of a disease or outcome from the treatment regime? Select all that apply.

Massive pulmonary emboli following diagnosis of new onset atrial fibrillation. Development of pulmonary fibrosis following treatment with Bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma.

A client whose only diagnosis is essential hypertension is fasting for a fasting blood glucose and lipid profile test to be performed in the morning. The client's regular medications are currently on hold. What is the nurse's priority action?

Measure client's blood pressure and heart rate periodically.

The nurse is caring for a client whose potassium level is 5.9 mEq/L (mmol/L). What treatment should the nurse be prepared to administer?

Medication to promote the movement of potassium into the intracellular space.

A 51-year-old woman who was born congenitally blind and deaf is able to distinguish individuals by light touch of the individual's face. Which of the following components of the woman's skin innervation likely contributes the most to this ability?

Meissner corpuscles

The nurse is planning care for a client who is receiving antimetabolite chemotherapy. What should the nurse include in the plan of care? Select all that apply

Monitor bowel movements closely. Daily weights Falls prevention protocol

Which of the following best describes the half-life of a highly protein bound drug such as thyroxine (99% protein bound)? The half-life would be:

Much longer to reduce the concentration of the hormone by one half.

A 3-year-old boy has developed croup following a winter cold. His care provider would recognize that which of the following microorganisms and treatments are most likely to be related and effective, respectively?

Parainfluenza virus, treated with a mist tent and oxygen therapy.

During a discussion on cellular components and their function, a student asked the instructor the purpose of messenger RNA (mRNA). Of the following, which is the most accurate answer?

Performs an active role of protein synthesis, where mRNA molecules direct the assembly of proteins on ribosomes to the cytoplasm.

A child with rhinosinusitis should be monitored for complications. Which of the following assessment findings would alert the nurse that a complication is developing?

Periorbital edema

As a consequence of long-standing lung disease, a client is in a chronic state of hypoxia. Which phenomena would the client's care team be most justified in anticipating? Select all that apply:

Personality changes Increased erythropoietin production Hyperventilation

While studying the skin in a science class, a student asks why all people have a pinkish color to their lips/mucous membranes. The instructor would respond by citing which of the following responses?

Pheomelanin is the yellow to red pigment particularly concentrated in the lips and nipples in humans.

A 13 year-old girl has presented to a clinic with her mother explaining that she had an oval-shaped red patch on her chest a week ago, but that more of the lesions are now appearing on her back. On examination, the lesions on her back are in a "Christmas tree" pattern. What is the girl's most likely diagnosis?

Pityriasis rosea

The nurse is caring for a client with pneumonia and a severe case of psoriasis that is being treated with methotrexate. During the morning assessments, which lab values would alert the nurse that the client is experiencing a side effect to this medication? Select all that apply.

Platelet count 37 x 103/microL White blood cell count 1.2 x 103/microL Alanine Aminotransferase (ALT) 28 units/L.

An 11 year-old boy with skin lesions on his trunk characteristic of ringworm has been brought to the health care provider. Which aspect of the clinician's assessment relates most directly to the suspected diagnosis?

Potential contact with the fungus from pets or other children

A nurse is taking a manual measure of a client's blood pressure. The nurse knows that which factors related to blood flow underlies the ability to hear blood pressure by auscultation (listening)?

Pressure pulsation that exceeds the velocity of blood flow is audible and coincides with systolic BP.

As part of a community class, student nurses are developing a class to teach expectant parents the importance of having their child properly secured in a child safety seat. During the class, the students are going to have a safety officer examine the car seats that the parents have installed in their vehicle. This is an example of which type of prevention?

Primary prevention

A client has many residual health problems related to compromised circulation following recovery from septic shock. The nurse knows which complications listed below is a result of being diagnosed with septic shock and therefore should be assessed frequently? Select all that apply.

Profound dyspnea due to acute respiratory distress syndrome.

An adult diagnosed of type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which physiological processes are actions of insulin? Select all that apply.

Promoting glucose uptake by target cells. Inhibiting protein breakdown Facilitating triglyceride synthesis by the liver

The initial medical management for a symptomatic patient with obstructive hypertrophic cardiomyopathy (HCM) would be administering a medication to block the effects of catecholamines. The nurse will anticipate administering which of the following medications?

Propranolol, a β-Adrenergic blocker.

The nurse is caring for a client with peripheral edema. When elevating the client's legs to the level of the heart, what will the nurse expect to occur? Sel

Reduction in the venous hydrostatic pressures of the legs

A community health nurse is preparing an awareness campaign about the risks factors for developing hypersensitivity pneumonitis. Which risk factors should the nurse include? Select all that apply.

Repairing air conditioners Caring for pigeons Stacking hay bales inside a barn

The mother of a 7 year-old boy who has recently been diagnosed with childhood asthma has come to the education center to learn more about her son's condition. Which of the following teaching points is most justifiable?

Research has shown that viruses may actually be a factor in many children's asthma."

A client experienced third-degree, full-thickness burns 2 days ago to the lower limbs after a fire at his workplace. Which systemic complications should the nurse regularly assessed for? Select all that apply. Correct!

Respiratory dysfunction Sepsis Decreased peristalsis of bowel Hypermetabolic response

The nurse caring for a lung cancer patient with metastasis to the brain suspects the patient has developed a paraneoplastic syndrome known as Syndrome of Inappropriate AntiDiuretic Hormone (SIADH) secretion. Which laboratory result in this patient who has gained three pounds in a day would alert the nurse to the possibility of SIADH?

Serum sodium of 115 mmol/L.

The nurse caring for a child with respiratory problems is concerned he may be developing respiratory failure. Upon assessment, which findings correlate to impending respiratory failure? Select all that apply.

Severe accessory muscle retractions. Nasal flaring Grunting on expiration.

A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. Upon assessment of the lungs, what clinical manifestations should the nurse expect?

Short, shallow breaths

A nurse is providing care for a client with a diagnosis of Crohn's disease. The nurse recognizes the fact that the disease involves the inflammation and irritation of the intestinal lining. Which of the following types of tissue is most likely involved in the client's pathology?

Simple columnar epithelium

Which statement best captures an aspect of the role of hormones in the body?

Some chemical substances can function as hormones or be integrated with central/peripheral nervous systems.

A new myocardial infarction patient requiring angioplasty and stent placement has arrived to their first cardiac rehabilitation appointment. In this first session, a review of the pathogenesis of coronary artery disease is addressed. Which statement by the patient verifies to the nurse that he/she has understood the nurse's teachings about coronary artery disease?

Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which lead to my clogged artery."

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

Stimulation test

The nurse is caring for a client with small cell lung cancer (SCLC) and known mediastinal lymph node involvement. What new assessment finding should the nurse prioritize as evidence the client requires emergent intervention?

Swelling of the neck and face

The nurse is changing an occlusive dressing on a stage III pressure ulcer and notes the formation of new eschar in the wound bed. For what change in the wound care plan should the nurse advocate?

Switching to using wet-to-dry dressings.

An elderly client is showing the nurse some changes in their skin that they found while taking a shower. Which of the lesions would give the nurse concern that it might be a pre-cancerous lesion? Select all that apply.

Tan-to-brown lesions commonly called 'liver spots" located on forearm and hands. Several dry, brown, scaly lesions that is ~ 1 cm in diameter and a few of the lesions are showing some ulceration.

Which of the following enzymes listed below are responsible for cancer cells ability to prevent aging of the cells and contributes to cellular immortality that is so characteristic of this disease process?

Telomerase

An occupational therapist conducts a group therapy program called MindWorks with older adults who have diagnoses of dementia and Alzheimer's disease. The goal of the group is to slow the cognitive decline of clients by engaging them in regular, organized mental activity such as reading maps and solving puzzles. How would the program most likely be characterized?

Tertiary prevention

Which of the following characteristics could apply to healthy somatic cells rather than cancerous cells?

The cells are unable to proliferate except by mitotic division.

The nurse is caring for a client preparing for a bone marrow transplant who has undergone chemotherapy and radiotherapy to destroy the existing bone marrow. The client asks how the donation can replace all the different types of blood cells. What is the nurse's best response?

The cells we are injecting are hematopoietic stem cells and can transform into different cells.

A 68 year old male client with aortic stenosis secondary to calcification of the aortic valve is receiving care. Which of the following statements best captures an aspect of this client's condition?

The client has possibly undergone damage as a result of calcification following cellular injury

During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle?

The follicle will die which results in a fall of FSH.

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

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

Which of the following statements best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function?

The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.

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

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

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

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

A 47-year-old male collapsed while unloading a truck of heavy sacks of feed for his cattle. When he arrived in the Emergency Department, blood gasses reveal a slightly acidic blood sample. The nurse caring for this patient is not surprised with this result based on which of the following pathophysiological rationales?

The skeletal muscles are producing large amounts of lactic acid and release it into the bloodstream during heavy work/exercise.

Which of the following statements best conveys an aspect of the process of keratinization?

The stratum germinativum continuously produces new keratinocytes to replace losses.

The nurse is teaching a group of colleagues about the cell division cycle as background to caring for oncology clients. Which of the following statements is true of the cell cycle?

The two broad phases of the cell cycle are mitosis and synthesis.

Which aspects of the woman's history and assessment could be potential contributors to her diagnosis of psoriasis? Select all that apply.

The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension. Skin trauma of any kind often precedes an outbreak. She takes Plaquenil for rheumatoid arthritis.

The nurse is caring for a client with a stage III decubitus ulcer being treated with an occlusive dressing. A family member says to the nurse, "It seems like that bandage is hardly ever changed and it looks wet underneath. I thought wounds should not be wet and bandages should be changed every day." What points related to occlusive dressings should the nurse include in the response? Select all that apply.

The wound fluid contains growth factors that aid in healing.

The nurse is caring for a client with a stage III decubitus ulcer being treated with an occlusive dressing. A family member says to the nurse, "It seems like that bandage is hardly ever changed and it looks wet underneath. I thought wounds should not be wet and bandages should be changed every day." What points related to occlusive dressings should the nurse include in the response? Select all that apply.

The wound fluid contains growth factors that aid in healing. These dressings can help reduce the pain in the wound. Being occlusive, it keeps bacteria out, reducing infections

A client with a newborn infant is also the caregiver for her 75-year-old mother, who lives with them and who has diabetes. The client requests pneumonia vaccinations for her entire household. Which vaccine is most likely to be effective for the baby?

There is no effective vaccine for newborn infants.

The nurse is caring for a client with small cell lung cancer who has developed a syndrome associated with hyperglycemia, hypokalemia, and sodium and water retention. The client asks the nurse why this occurring. How should the nurse respond?

This is the result of tumor cells releasing the adrenal hormones, such as cortisol, in excessive amounts.

The public health nurse is hosting a well-baby clinic. A client with a 1-month old infant asks, "Why are there pimples on my child's forehead? Should I be washing the area more often?" What is the nurse's best response?

This type of acne is related to being exposed to the maternal hormones in utero and should begin clearing up soon.

Which of the following situations is most likely to result in an increased binding affinity of hemoglobin for oxygen?

Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen.

A client with chronic obstructive pulmonary disease (COPD) has chronically elevated carbon dioxide levels. How does the nurse best ensure safe delivery of supplemental oxygen to this client?

Titrating the oxygen delivery to maintain a saturation level of 88%

Following a winter power outage, a client who had been using a home gasoline generator began to experience dizziness and headaches and was diagnosed with carbon monoxide poisoning. What is the goal of hyperbaric oxygen treatment for carbon monoxide poisoning?

To increase the amount of oxygen carried in the dissolved state

During a myocardial infarction (MI), a client with a 97% occlusion of their left descending artery develops ventricular arrhythmias due to the amount of ischemia occurring in the myocardium. While providing education about MI's, which statement is most accurate to share with this client?

Treatment needs to be sought immediately so that the buildup of lactic acid is limited and cellular changes can be reversed

A 22 year-old male who has been backpacking around Southeast Asia for several months has responded well to treatment for scabies that he acquired while on his trip. What follow-up measures should be taken?

Treatment of individuals that he has been in close contact with.

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

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

Upon entering the room of a 74-year-old client receiving brachytherapy for cervical cancer, you find the radiation implant and the position-holding device in the client's bed. What is the nurses first best action?

Use tongs to place the implant in the radiation container.

A 60-year-old male hospital patient with a diagnosis of chronic obstructive pulmonary disease (COPD) is undergoing lung function tests to gauge the progression of his disease. Which of the following aspects of the lung volumes will the respiratory therapist be most justified in using to guide interpretation of the test results?

Vital capacity will equal the patient's combined inspiratory reserve, expiratory reserve, and tidal volume.

A young patient has just been diagnosed with xeroderma pigmentosum. When teaching this family about this disease, the nurse should emphasize which teaching points? Select all that apply.

Wear long sleeves, long pants, gloves, a hat, sunglasses with side shields, and sunscreen while outdoors. The best time to allow the child to play outside is in the evening hours after the sun goes down.

The nurse is caring for a client with pneumonia and a severe case of psoriasis that is being treated with methotrexate. During the morning assessments, which lab values would alert the nurse that the client is experiencing a side effect to this medication? Select all that apply.

White blood cell count 1.2 x 103/microL Platelet count 37 x 103/microL

A nurse working in a long-term care facility has attended an educational conference on pressure ulcer care in older adult population. Which protocol in the facility would the nurse advocate changing for the client who develops a stage I ulcer?

Wound dressings are applied promptly to all identified or potential pressure ulcers.

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

acute lung injury

The nurse is caring for a group of clients. Which clients should the nurse identify as experiencing a shift to the right on the oxygen dissociation curve? Select all that apply. A client with:

anemia fever pulmonary edema

A 44 year-old man has been diagnosed with chronic urticaria, the exact cause of which cannot be determined. What is the pharmacological treatment that is most likely to be of most use to the man?

antihistamines

A nurse is considering setting up a screening program for a specific health condition in a population. What characteristic of the condition would need to be true for the nurse to justify screening a population? The condition should:

be asymptomatic at an early stage

The nurse is caring for a group of clients. Which client should the nurse prioritize as being most at risk for developing hypoglycemia? The client:

being treated for type 1 diabetes who has been having nausea and vomiting for 4 hours

When trying to explain the advantages of using an emollient over other products to a patient suffering from dry skin, the nurse will emphasize that emollients:

can replenish the oils on the skin surface because they contain fatty acids.

The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication?

decrease airway inflammation

Which of the following clinical findings would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease (COPD)?

decreased tidal volume

A 3 year old child with right-sided heart failure has been admitted for worsening of their condition. Which of the following assessments would be considered one of the earliest signs of systemic venous congestion in this toddler?

enlargement of the liver

A nurse is teaching a client with a recent diagnosis of diabetes about the roles that glucose and insulin play in the disease pathology and the fact that glucose must enter the body cell in order to provide energy for the client. The nurse knows that which of the following processes allows glucose to enter body cells?

facilitated diffusion

The nurse is caring for a group of infants with bronchiolitis. Which infant should the nurse prioritize as requiring immediate intervention? The infant who:

has diminishing wheezing and cyanosis

An elderly patient has arrived at the physician's office complaining of a rash. Upon further investigation, the patient states the rash feels like a burning pain but also has some tingling. It is extreme sensitive to touch and it's "like crazy." The nurse notes that the rash is made up of vesicles and located on the right thoracic region. The nurse suspects the patient has:

herpes zoster

The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?

left ventricle

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

milliseconds

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

pH 7.31 (Normal 7.35-7.45) PCO2 58 mm Hg (Normal 35-45) Serum HCO3 33 mEq/L (Normal 22-28)

The nurse is hearing diminished breath sounds and a "grating" sound during respirations. This is consistent with excess collection of fluid in the pleural cavity. The medical term for this is:

pleural effusion

Reviewing pathology for an exam on pulmonary vasculature, the nursing student states that blood enters the right side of the heart via vena cava's, then to the right atrium, right ventricle, and then which vessel carries the deoxygenated blood into the pulmonary system?

pulmonary artery

A child comes in to show his parents (who are nurses) a blister on his foot from "breaking in" a new pair of shoes. The child wants to "pop the blister" to get all the fluid out of it so it won't hurt so much when he puts on shoes and socks. The parents know that breaking the skin of the blister will put him at risk for which of the following?

secondary infection

A patient in the intensive care unit has a blood pressure of 87/39 and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilatation and a decrease in systemic vascular resistance. What is this client's most likely diagnosis?

septic shock

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

they are inactive in the bound state.

A client with rheumatoid arthritis is being started on immunosuppressive therapy. It would be most important for the nurse to inform the health care provider about the client's history of:

tuberculosis

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

A boy has arrived home after experiencing his first outdoor camping trip with his Boy Scout troop. Upon arrival at home, he is very uncomfortable and scratches a rash. It appears that he has poison ivy and that it has spread to many areas on his body. The nurse in the clinic will likely prescribe which of the following treatments for this child? Select all that apply.

• Prescription for corticosteroids • Cool showers, especially right before bedtime • Over-the-counter antihistamines

A nurse practitioner student is trying to distinguish the various rashes they will be seeing in their pediatric rotation. Their nurse preceptor is assisting by describing the rash associated with rubeola. Which of the following characteristics would apply to rubeola? Select all that apply.

• Rash is macular and blotchy. • The rash usually begins on the face and then spreads to the legs/arms.

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

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

A client who has a diagnosis of lung cancer is scheduled to begin radiation treatment. The nurse knows that which of the following statements listed below about potential risks of radiation is most accurate?

"Some clients experience longer-term irritation of skin adjacent to the treatment site."

As part of a first aid class, a health care instructor is teaching a group of industrial workers about how electrical injuries can cause cell damage. Which of the statements made by one of the workers indicate that further teaching is necessary?

"The greater the skin resistance, the greater the amount of deep and systemic damage a victim is likely to incur."

The family member of a client with terminal metastatic cancer who is experiencing cachexia-related weight loss asks the nurse why the client is losing weight despite taking in a large amount of calories per day. What is the nurse's best response?

"This weight loss is related to the cancer itself and occurs despite an intake of adequate calories."

A 60 year-old man has presented to a clinic and is requesting screening for tumor markers after reading about them in a magazine. What can the clinician most accurately tell the man about the clinical use of tumor markers?

"Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not a very useful screening tool."

An oncology nurse who has worked for many years providing care for children with cancer has taken a job on an adult oncology unit of a hospital. What differences might the nurse anticipate in this new job?

There will be a greater number of cancers that are epithelial in origin.

Which of the following patients of primary care physician would not require extra screening for cancer?

A 38 year-old female with Down syndrome and congenital scoliosis

The nurse is caring for a client with arterial insufficiency of the left leg with gangrenous wounds on the second and third toes. What characteristics of the wounds should the nurse evaluate as expected? Select all that apply.

A clear demarcation between the healthy and affected tissue A clear demarcation between the healthy and affected tissue Diminished pulse strength Atrophy to the affected toes Darkened appearance of affected tissue

A member of the health care team is researching the etiology and pathogenesis of a number of clients who are under his care in a hospital context. Which of the following aspects of clients' situations best characterizes pathogenesis rather than etiology?

A client who has increasing serum ammonia levels due to liver cirrhosis

The nurse is planning care for a group of clients. Which clients should the nurse prioritize as "at risk" for hypercalcemia and advocate for monitoring calcium levels? Select all that apply.

A client with prolonged immobility A client with hypophosphatemia A client who has breast cancer with bone metastasis

Laboratory testing is ordered for a male patient during a clinic visit for routine follow-up assessment of hypertension. When interpreting lab values, the nurse knows:

A normal value represents the test results that fall within the bell curve.

A client is experiencing muscle atrophy following two weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the client's muscle cells?

A reduction of skeletal muscle use secondary to the traction treatment.

A 41 year old female with a family history has had a baseline mammogram. She states that she performs monthly self breast exams but really has a hard time evaluating her lumps since she has numerous cysts. At her annual mammogram, the technician views a suspicious area and refers her to the radiologist. She asks the nurse in the office, "How can a lump appear so quickly?" The nurses response is based on which of the following principles?

A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.

The nurse is caring for an 8-year-old client who has cystic fibrosis. What aspect of client care should be the nurse prioritize?

Airway clearance

As part of a screening program for prostate cancer, men at a senior citizen's center are having their blood levels of prostate-specific antigen (PSA) measured. Which of the following statements would best characterize high positive predictive value but low negative predictive value for this screening test?

All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

A home health nurse is making a visit to a family with an 8 month old infant with severe motor deterioration. The physician has diagnosed the infant with Tay-Sachs disease. The parents are asking the nurse why this happened. The nurse will base her answer knowing the root cause of Tay-Sachs is:

An enzyme defect causing abnormal lipid accumulation in the brain.

The nurse is caring for a client with an infection and fever. The client reports feeling chilled and having "goose bumps." The nurse will anticipate what change in the client's assessment findings as a result of this physiologic reaction?

An increase in body temperature

The nurse is caring for a 45-year-old client undergoing radiotherapy of the mediastinal nodes due to lymphoma. Which interventions should the nurse prioritize? Select all that apply.

Assessing for fatigue Avoiding invasive procedures Performing respiratory assessment

During a crime scene investigation, the coroner confirms that rigor mortis has set in. This helps to confirm an approximate time of death. The forensic nurse can explain this process (rigor mortis) to a group of students based on the fact that:

At death, the body is unable to complete the actin/myosin cycle and release the coupling between the myosin and actin, creating a state of muscular contraction.

Blood-borne cancerous cells have recent spread from a woman's primary pancreas tumor to her bones. Which components of the woman's immune system are likely to be directly involved in the attempt to eradicate the potential metastasis? Select all that apply.

B lymphocyte cells Macrophages Natural killer (NK) cells T lymphocytes

A nurse is triaging clients at a disaster site. Local facilities have different specialized units. To what facility should the nurse send a client who has sustained an electrical injury to his left thigh?

Burn unit

The nurse is questioning the validity of oxygen saturation readings from the new oximeters on the unit. Which action should the nurse take to best determine if the results from the oximeter are valid?

Compare clients' results to measurements taken using arterial blood gas analyses.

The client receiving external beam radiation for a brain tumor is concerned about damage to the healthy brain tissue. What teaching points should the nurse include? Select all that apply.

Computerized precision is used to develop a mapping of the treatment area You will have a mold placed over your head to prevent you from moving during treatment. The machine is programmed to deliver higher amounts of radiation to the cancerous cells.

The nurse is administering a calcium channel blocker to a client with a cardiac dysrhythmia. For what side effect should the nurse assess?

Constipation

A nurse is the emergency department admits a male client who has experienced severe frostbite to his hands and toes after becoming lost on a ski hill. The nurse recognizes that which of the following phenomena has contributed to his tissue damage?

Decreased blood flow has induced hypoxia.

Parents bring their 18-month-old child to the emergency room exhibiting behavior changes and vomiting. They are concerned the child ingested something in the older home they are renovating. Laboratory findings indicate low hemoglobin and elevated creatinine. Which diagnostic test should the nurse advocate for first? Correct!

Erythrocyte protoporphyrin level

A 2 year old boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which of the following assessment findings is most congruent with the client's diagnosis?

Hemoglobin 9.9 g/dL

A particular disease has a debilitating effect on the ability of sufferers to perform their activities of daily living and is a significant cause of decreased quality of life. However, few people die as a result of the disease's direct effects. There are hundreds of thousands of Americans living with the disease but relatively few new cases in recent years. Which of the following statements best conveys an accurate epidemiological characterization of the disease?

High morbidity; low mortality; high prevalence, low incidence

The laboratory technologists are a discussing the a new blood test that helps establish a differential diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a respiratory/pulmonary etiology. A positive result is purported to indicate a cardiac etiology. The marketers of the test report that 99.8% of patients who have confirmed cardiac etiologies test positive in the test. However, 1.3 percent of patients who do not have cardiac etiologies for their shortness of breath also test positive. Which of the following statements best characterizes this blood test?

High sensitivity, low specificity

The nurse is teaching new nursing assistants on the unit about the phenomenon of muscle hypertrophy. Which of the following clients on the unit is most likely to experience muscle hypertrophy? A client with:

Hypertension, obesity and decreased activity tolerance.

A client is receiving external beam radiation therapy for prostate cancer. What aspects of care should the nurse prioritize? Select all that apply.

Inspection of urine output Energy conservation techniques Strategies for coping with sexual dysfunction

While attending an international nursing conference, many discussions and break-out sessions focused on the World Health Organizations (WHO) views on health. Of the following comments made by nurses during a discussion session, which statements would be considered a good representation of the WHO definition? Select all that apply.

Interests in keeping the elderly population engaged in such activities as book reviews and word games during social time. Increase in the number of chair aerobics classes provided in the skilled care facilities. Interventions geared toward keeping the elderly population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes. Providing handwashing teaching sessions to a group of young children.

The nurse notes a client's PaCO2 on an arterial blood gas is 55 mm Hg (7.32 kPa). The client asks if this means he or she has carbon dioxide poisoning. How should the nurse explain how carbon dioxide became present in the client's blood?

It is a normal end-product of aerobic cellular respiration but you are not eliminating it efficiently.

A multidisciplinary healthcare team operates a program aimed at the prevention, identification and treatment of diabetes on a large Indian reservation. Which of the following aspects of the program would be most likely to be classified as secondary prevention?

Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked

A community health nurse is teaching a group of recent graduates about the large variety of factors that influence an individual's health or lack thereof. The nurse is referring to the Healthy People 2020 report from the U.S. Department of Health and Human Services as a teaching example. Of the following aspects discussed which would be considered a determinate of health that is outside the focus of this report?

The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with their treatment regime.

The neuroscience nursing unit has developed a set of step-by-step directions of what should occur if a nursing assessment reveals the patient may be exhibiting clinical manifestations of a cerebrovascular accident (CVA). Which of the following statements about clinical practice guidelines are accurate? Select all that apply.

The development of evidence-based practice guidelines require a research review from different studies to develop the most accurate diagnostic method to implement. When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot test it for further feedback. A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method.

A nurse is investigating the epidemiologic factors influencing breast cancer for women in a population. What information should the nurse include? Select all that apply.

The geographic location of women diagnosed with breast cancer The age of women at the time of diagnosis

The clinical educator of a hospital medical unit has the mandate of establishing evidence-based practice guidelines for the nursing care on the unit. Which of the following statements most accurately captures a guiding principle of the nurse's task?

The guidelines will combine individual expertise with external systematic evidence.

As of Nov. 1, 2012, there were a total of 10 confirmed cases of hantavirus infection in people who were recent visitors (mid-June to end of August, 2012) to Yosemite National Park. Three visitors with confirmed cases died. Health officials believe that 9 out of the 10 cases of hantavirus were exposed while staying in Curry Village in the Signature Tent Cabins. This is an example of:

The incidence of people who are at risk for developing hantavirus while staying in Yosemite National Park.

Nurse Jones works in the neonatal care unit is caring for a premature infant requiring ventilator support. What teaching point about this treatment should the nurse share with the parents?

There is an increased risk that your child may require asthma medications when older.

A 77 year old man is a hospital inpatient admitted for exacerbation of his chronic obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time. Which of the following aspects of the patient's current state of health would be best characterized as a symptom rather than a sign?

The patient notes that he has increased work of breathing when lying supine.

A male international business traveler has returned from a trip to Indonesia. While there, he hired a prostitute for companionship and engaged in unprotected sex on more than one occasion. Unbeknownst to him, this prostitute harbored the hepatitis C virus. Upon return to the U.S., he exhibited no symptoms and returned to his usual activities. During this period of no outward symptoms, the disease would be classified as being in:

The preclinical stage of diseases

Professor William is teaching a group of students about the role of mitochondria within the cell. Which of the following statements is true of mitochondria

They are the site of adenosine triphosphate (ATP) production.

The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. What is the primary significance of these structures?

They regulate body temperature.

The homecare nurse is making a home visit to a 51 year old female client with a longstanding diagnosis of multiple sclerosis. The nurse knows that the muscle wasting and weakness associated with the disease process is ultimately manifested as a failure of what normal process in muscle tissue?

Thick myosin and thin actin filaments sliding over each other

A caregiver is working with a client who is having poorly controlled pain due to shingles. The associate pain travels to the client's nervous system via:

afferent neurons

Which of the following structures would likely be present in a hair follicle in a man's groin but not in a follicle on his face?

aprocrine gland

The nurse is administering an insulin secretagogue and the client asks, "Is this an insulin pill?" What response should the nurse offer the client? This medication:

causes your body to release more insulin from your pancreas.

The nurse is providing care for a client with a diagnosis of cirrhosis, and she notes that the client's sclerae are jaundiced. The nurse recalls that jaundice is a pigment that can accumulate in which part of the cell?

cytoplasm

A 40-year-old male client has a congenital syndrome that affects the function of the Langerhans cells of his epidermis. The man's care provider would expect which of the following manifestations of his condition?

increased susceptibility to infection

Which of the following statements most accurately conveys an aspect of cell injury due to impaired calcium homeostasis?

injured cells tend to accumulate calcium.

The health caregiver is explaining the rationale for administering a hypotonic intravenous solution (lower concentration of solutes in its surroundings) to a client. Which of the following mechanisms of membrane transport most likely underlies this action?

osmosis

The nurse is explaining the workings of selective serotonin reuptake inhibitors to a client with a diagnosis of depression. Within the teaching, the nurse mentions that in the nervous system, the transmission of information by neurotransmitters is:

synaptic signaling

Ms Smith is a clinical nurse specialist who is interested in developing a research study focused on clients living with the sequelae of ischemic stroke. Which clients should the nurse include? Select all that apply.

unilateral weakness dysphagia (difficulty swallowing) vision changes

An 81-year-old woman has noted a gradual decrease in the moisture of her skin over many years. Which phenomena associated with the aging process are known to contribute to her xerosis? Select all that apply.

• Decreased moisture secretions from sweat glands • Flattening of the dermal rete ridges • Changing composition of sebaceous gland secretions • Decrease in skin capillaries