Patho Cumulative
The nurse is evaluating client risk for the development of overactive bladder/urge incontinence and determines that which client is at highest risk for this condition?
A client with diabetes mellitus
A client has developed signs and symptoms of systemic lupus erythematosus (SLE). The nurse reviews the client's medication record for which medications that are associated with drug-induced lupus? Select all that apply.
Hydralazine Isoniazid Procainamide
Which person is most at risk for hip fractures?
66-year-old white female with history of alcohol use disorder
Which symptom indicates the next stage of a fever after a prodrome?
A chill
A new client presents with elevated BUN, systemic edema, a BP of 145/93 mm Hg, recurrent infections, and a GFR of 51 mL/min/1.73 m2. Which treatment should the nurse anticipate?
Dialysis
Hemophilia A is a hereditary blood disorder caused by inadequate activity or absence of which blood component?
Factor VIII
A nurse caring for a child with type 1 neurofibromatosis notes that the child has pigmented nodules of the iris. Which of the following is the nurse reporting?
Lisch nodules
What information should be included in the teaching plan of care for the parents of a child diagnosed with Tay-Sachs disease?
The disorder involves accumulation of abnormal lipids.
A postmenopausal client questions the nurse about the diagnosis of osteoporosis. Which statement describes the pathology of osteoporosis?
The process of bone renewal after menopause is slowed in relation to the occurrence of bone breakdown.
A nurse in a genetic clinic reads that a client's karyotype includes a broken "p." The nurse interprets this to mean which of the following?
The short arm of the X chromosome is broken.
A client was started on 5000 units of heparin twice daily. For which immune response-associated health problem should the nurse monitor this client?
Thrombocytopenia
The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:
a loss of over half the client's normal kidney function.
The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure?
Client with prostatic hyperplasia
A client has developed dystrophic calcification as a result of macroscopic deposition of calcium salts. The tissue that would be most affected would be:
injured tissue.
Which symptoms commonly occur with Osgood-Schlatter disease? Select all that apply.
Knee pain Edema of the knee Tenderness in the knee and tibia
The nurse is assessing a prepubertal male with fragile X syndrome. Assessment findings would include:
Large testes
Which description sums up the basic pathophysiology of heart failure that the nurse would include when educating a client?
Low cardiac output due to reduced pumping ability
A client is experiencing fatigue and laboratory results reveal: Hct 40% (0.40); Hgb 8 g/dL (80 g/L); WBC 8000 (8 x 109/L); and platelets 175,000/ µL (175 ×109/L). The nurse would interpret these results as indicative of which diagnosis?
Low hemoglobin/anemia
Intracellular buildup of substances that can be either normal or toxic occurs in which area of the cell?
Lysosome
The physician decides that the best course of action for a 60-year-old client who has been diagnosed with sick sinus syndrome (SSS) is to start medications to decrease the tachyarrhythmias. Prior to starting, what does the physician explain to the client will be needed?
Permanent pacemaker
The client with ulcerative colitis should be assessed by the health care provider for which clinical manifestations associated with this disease? Select all that apply.
Persistent diarrhea Stool containing blood (hematochezia)
The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?
increased nitrites
Two health care workers are comparing the etiology and incidence of multifactorial inheritance disorders and single-gene disorders. Which statement best captures the relationship between the two types of genetic disorders?
"A couple with a child with a multifactorial disorder have a higher risk of having another with the same disorder."
An adult with flat feet is complaining about pain. Which statements will best help this client? Select all that apply.
"Be fitted for good shoes with arch supports." "Surgery may be needed if symptoms do not decrease." "Losing weight may ease the pain."
The nursing instructor who is teaching about incontinence in older adults recognizes a need for further instruction when a student makes which statement?
"Frequency is not a major problem for the elderly."
The mother of a child with Turner syndrome asks the nurse what the physician meant when the disease was explained as monosomy of the X chromosome. The nurse explains the syndrome as having which of the following characteristics?
"There is one X chromosome."
A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?
"With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."
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 geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes?
A 78-year-old woman's GFR has been steadily declining over several years.
What is the definition of a congenital deformity?
Abnormalities present at birth
Reflex activity involves which neurons?
Afferent neurons, Interneurons, and Efferent neurons
A client sustained a puncture injury to the chest resulting in development of a tension pneumothorax. What is the pathogenesis behind a tension pneumothorax?
Air is permitted to enter but not leave the pleural space, causing lung collapse.
Which term is used to describe the process when a child receives two members of a gene pair, one inherited from the mother and the other from the father?
Alleles
Place the events in the renin-angiotensin-aldosterone system in the correct order.
Angiotensinogen (AGT) in plasma Renin release Angiotensin-converting enzyme Angiotensin-II production Aldosterone release
The nurse is providing care for a client with a diagnosis of amyotrophic lateral sclerosis (ALS). The nurse recognizes that which mechanism is suspected to play a role in the cellular death associated with ALS?
Apoptosis
Acute pyelonephritis is a result of:
Bacterial infection
A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will most likely be prescribed to help determine the cause of these new symptoms?
Blood work for hemoglobin, red blood cells, and hematocrit
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 nurse notes that a client with neurofibromatosis has eight flat, cutaneous, light brown spots (2 cm in diameter each) over the trunk area. The nurse documents these as being:
Cafe au lait spots
With the exception of the first two steps, what element is required in all steps of the clotting process?
Calcium
Which statement is true?
Cell division involves the duplication of chromosomes.
A client's ECG reveals that he is suffering from a myocardial infarction. Prompt interventions are chosen to minimize further myocardial harm. What damage is the care team trying to prevent?
Cellular hypoxia
A severe type of headache that occurs more frequently in men than women and is described as having unrelenting, unilateral pain located most frequently in the orbit is called:
Cluster headache
A nurse mentoring a new graduate nurse informs the graduate that urinary obstructions are usually classified according to which parameters? Select all that apply.
Congenital or acquired Partial or complete Acute or chronic Upper or lower
What intervention is appropriate for a client with sarcoidosis?
Corticosteroids
Select the laboratory blood test that would be a used to suggest a diagnosis of muscular dystrophy (MD).
Creatine kinase
A 57-year-old man is diagnosed with thrombocytopenia. The nurse knows that thrombocytopenia refers to a decrease in the number of circulating platelets. The nurse also knows that thrombocytopenia can result from what?
Decreased platelet production
An adult client recently had a cerebrovascular accident that resulted in dysphagia. What is the nurse's priority action to prevent the aspiration of gastric contents?
Elevate the head of the bed.
An adult client with good overall health has reported headaches and dizziness in recent weeks. The nurse's assessment reveals blood pressure of 158/99 mm Hg, which is unprecedented for the client. On observation, the client's skin appears reddened, though he denies feeling warm. The nurse should anticipate what further diagnostic finding?
Elevated RBC, hemoglobin, and hematocrit.
Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on:
Eradicating Helicobacter pylori (H. pylori)
Following assessment, an adult client experiences dull bone pain unrelated to movement, restrictions in movement, and edema over the involved bone area. Which diagnosis is closely related to these findings?
Ewing sarcoma
A teenager has been diagnosed with failure to thrive possibly due to malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?
Fatty, yellow-gray, foul-smelling stools
Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease?
Fine-needle aspiration biopsy
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:
Fistula formation
A client with a neurogenic bladder has a lesion at the level of sacral reflexes/peripheral nerves that innervate the bladder. The nurse anticipates the client will experience which type of bladder dysfunction?
Flaccid bladder dysfunction
A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring?
HDL
A nurse recognizes that no two clients have the same susceptibility to disease and that this is partly due to:
Haplotype
The nurse is preparing a client with a possible stroke for radiology. Which diagnostic procedure would be beneficial for this client?
Helical computed tomography angiography
The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which complete blood count (CBC) result is characteristic of this type of anemia?
Hemoglobin 7.8 g/dL (78 g/L)
A nurse is assessing a client who displays pale skin and nail beds. Which laboratory data should the nurse evaluate?
Hemoglobin level
Metastatic calcification takes place in normal tissues as the result of increased serum calcium levels (hypercalcemia). Anything that increases the serum calcium level can lead to calcification in inappropriate places such as the lung, renal tubules, and blood vessels. What are the major causes of hypercalcemia?
Hyperparathyroidism and immobilization
Mendelian inheritance characteristics are most closely associated with which one of the following?
Marfan syndrome
Which factor contributes to an infant developing macrosomia (large body size)?
Maternal diabetes
Which characteristic of genetic disorders involves a single-gene trait?
Mendelian patterns of inheritance
A nurse sees that a client's disorder has a polygenic inheritance pattern. The nurse understands this involves which physiologic concept?
Multiple genes at different loci
A client arrives at the doctor's office reporting severe indigestion that has been intermittent; however, the pain is now constant and feels like a vise. The nurse does an ECG and recognizes that the situation is possibly emergent due to ST-segment elevation, which could indicate:
Myocardial infarction
While measuring the height of a 12-year-old girl, the primary care provider noted a deviation of the girl's spine. This was quantified as being a right curve scoliosis of approximately 10 degrees deviation. Which treatment option is most appropriate?
Observation and no active treatment.
A client sustains a musculoskeletal injury of the wrist. Which manifestation would the nurse expect to accompany the strain?
Pain and stiffness
The nurse teaching a client with a deficiency of glucose-6-phosphate-dehydrogenase (G6PD) should instruct the client to avoid taking which medications?
Primaquine
A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this client?
Radiation, chemotherapy, and biotherapy
A nurse is completing an abdominal assessment on a client suspected to have appendicitis. When the nurse applies and then releases pressure in the client's right lower quadrant, the client experiences tenderness. The nurse is documenting the presence of:
Rebound tenderness
What of these would be tested by a complete blood count (CBC)?
Red blood cells and platelets
A nurse is teaching a client with a new diagnosis of diabetes mellitus about blood glucose testing. Which statement is correct?
Schedule HgbA1C levels every 3 months
The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?
Septic shock
A child struggling to breathe is brought to the emergency department with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. What is the most likely diagnosis?
Severe asthma attack
A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume?
Sinus bradycardia
A client is seen in the emergency department complaining of chest discomfort, productive cough, and a fever of over 101°F (38.3°C) for 3 days. The nurse performs an electrocardiogram and observes a rate of 110 beats per minute (bpm) with a normal P wave and a PR interval of 0.12 second preceding each QRS complex. What does the nurse determine the rhythm to be?
Sinus tachycardia
Which complication of spinal cord injury is the most preventable in a paraplegic client?
Skin breakdown
The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?
Smoking cessation program
An immunocompromised host is open to pneumonia from all types of organisms. There is, however, a correlation between specific types of immunologic deficits and specific invading organisms. What organism is most likely to cause pneumonia in an immunocompromised host with neutropenia and impaired granulocyte function?
Staphylococcus aureus
What is the primary cause of heart failure in infants and children?
Structural heart defects
A social worker is counseling the family of an 85-year-old woman who has just been diagnosed with non-small cell lung cancer. What concerns should she convey to the family regarding the unintended effects of treating the disease?
Surgical treatment may have the consequence of weakening the client.
A client receiving continuous ambulatory peritoneal dialysis (CAPD) treatments has excessive weight gain in the past 24 hours and tells the nurse excessive amounts of fluids were consumed while out with family. What change in the client's dialysis order will the nurse anticipate once relaying these findings to the health care provider?
Switching the client from 2.5% to a 4.25% dextrose dialysate
Which client is at the greatest risk of developing rheumatic heart disease?
Teenager with untreated strep throat
A client has presented to a clinic for the treatment of severe dermatitis after contact with poison ivy on a camping trip. The client has been prescribed prednisone, a corticosteroid, for the treatment of his skin condition. The client's care provider has emphasized that dosages of the drug will be gradually tapered off rather than stopped upon resolution of the symptoms. Which rationale is the most accurate for this dosing protocol?
The client's hypothalamic-pituitary-adrenal (HPA) system will require recovery time before normal function is restored.
A busy 45-year-old female executive has been diagnosed with diverticulitis. Her primary treatment is an increase in the fiber content of her diet. What effect will the fiber have on the diverticula?
The fiber increases bulk, promotes regular defecation, and increases colonic contents and colon diameter, thereby decreasing intraluminal pressure.
When parents give birth to a child with a defect, they focus on getting answers to which two priority issues?
The immediate and future care of the affected child, and the possibility of future children in the family having a similar defect
The nurse is assessing a client with reports of knee joint pain. Which findings does the nurse document as supporting osteoarthritis? Select all that apply.
The joint is firm upon palpation Crepitus is felt with joint movement The client's body mass index is 35
A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?
The nurse is likely asymptomatic.
A client arrives in the clinic with a cough, fever, and chest discomfort and is diagnosed with community-acquired pneumonia. What education does the nurse anticipate providing prior to discharging the client from the clinic?
The use of antibiotics
A normally healthy client is diagnosed with polycythemia vera. The nurse should prioritize assessments aimed at the early identification of which complication associated with this diagnosis?
Thromboembolism
The most common cause of an ischemic stroke is which of the following?
Thrombosis
Which of the following describes how atrophied cells survive?
Through decreased oxygen consumption
A client 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:
Valvular regurgitation
A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect?
Vasodilating effects reducing preload and afterload
The practitioner examines his client's foot and observes the great toe to be black and dry. The practitioner explains to the client that the dead tissue is caused by:
dry gangrene.
Which pregnant couple should the nurse refer to genetic counseling regarding the risk of an additional chromosome 21?
father, aged 35 and mother, aged 46 and primipara, both reasonably "healthy"
A client tells the nurse she is very concerned because the health care provider informed her that her fractured arm is healing with malunion. The nurse recognizes this as:
healing with deformity, angulation, or rotation that is visible on x-ray films.
The nurse is providing dietary instruction for a client with chronic kidney disease (CKD) who is on hemodialysis. Which food would the nurse encourage the client to restrict?
lean meats
A yellow-brown pigment that accumulates in neurons and may be a sign of cellular stress is:
lipofuscin
When discussing upcoming chromosome studies, a client asks, "What kind of sample are they going to take to do these tests?" The nurse replies, "The most common cells used for this purpose are:
lymphocytes from a venous blood specimen.
A client undergoing chemotherapy has a critically low platelet count. To stimulate platelet cell production, the nurse expects to administer:
oprelvekin, which is a thrombopoietin
