Patho Exam 2
3. A child with asthma is walking outside and develops a bronchospasm. The school nurse knows this bronchospasm has what effects on bronchioles with airflow? Select all that apply.
A) Narrowing of bronchioles B) Impairs airflow
16. An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis?
A) Obstruction of the intestinal lumen
9. The physician thinks a teenager is having clinical manifestations of irritable bowel syndrome. Which of the following complaints would support this diagnosis? Select all that apply.
A) Pain is relieved by defecation. D) Pain is described as "cramping" in the lower abdomen.
13. While lecturing on COPD, the instructor mentions emphysema. The instructor asks the students, "If the client is a smoker, explain the physiology behind cellular changes occurring in the lung which allow destruction of the alveoli." Which students have an accurate response? Select all that apply.
A) "Antiprotease production and release is not adequate to neutralize the excess protease production." C) "There is 1-antitrypsin deficiency, so this enzyme can't protect the lung from damage."
16. A nurse runs into an old high school friend after 20 years. She notes her friend continues to smoke after all these years. The friend asks, "Do you think I sound hoarse?" Upon further assessment, the nurse/friend notes her friend has several warning signs of cancer. Which manifestations would lead to this conclusion? Select all that apply.
A) "I seem to have some difficulty swallowing food... this is new for me." C) "Can you feel how large my lymph nodes are on my neck and armpits (axillae)?"
14. A client with a history of chronic obstructive pulmonary disease (COPD) is undergoing pulmonary function testing. Which of the following instructions should the technician provide in order to determine the client's forced vital capacity (FVC)?
A) "I'll ask you to breathe in as deep as you can, and then blow out as much of that air as possible."
14. A 51-year-old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which of the man's following statements demonstrates a sound understanding of his new diagnosis?
A) "If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis."
22. A young, male child is born with severe respiratory failure. Over the course of months, the parents note his body looks swollen. They ask, "Is our baby's kidneys not working right? Why is he so swollen?" The nurse bases his or her reply on which of the following physiological principles?
A) "The right side of his heart (cor pulmonale) is not pumping effectively. Blood is backlogging in his body, which is why he is so swollen."
18. 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."
18. Which of the following individuals is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of a granuloma on chest x-ray?
A) A 30-year-old African American man who has been diagnosed with sarcoidosis
22. 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
7. From the following clients, who are at high risk for developing heart failure as a result of diastolic dysfunction? Select all that apply.
A) A 48-year-old client with uncontrolled hypertension D) A 70-year-old with enlarged left ventricle due to myocardial hypertrophy
6. The nurse would anticipate that which of the following clients would be considered a good candidate for coronary artery bypass grafting (CABG)?
A) A 56-year-old with a history of MI experiencing new-onset chest pain and ST elevation
20. Which of the following clients should the nurse observe most closely for the signs and symptoms of paralytic ileus?
A) A client who is first day postoperative following gallbladder surgery
20. Which of the following clients are likely experiencing a shift to the right in the dissociation curve? Select all that apply.
A) A client with respiratory influenza with a temperature of 102.6°F B) A COPD client with pneumonia with blood gas pH level of 7.31 C) A renal failure client with admitting hemoglobin level of 8.0 mg/dL
23. When educating the parents of a cyanotic infant diagnosed with of tetralogy of Fallot, the nurse will include which of the following statements related to the physiological abnormalities? The infant has: Select all that apply.
A) A hole in the ventricular septal B) A small, narrow pulmonary outflow channel C) A large, thick, right ventricular wall
24. Which of the following clients is at risk for developing acute respiratory failure?
A) A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has pneumonia with low O2 saturation
1. Which of the following clients are more than likely experiencing impairment of the mucociliary blank with cilia dysfunction? Select all that apply.
A) A smoker who smokes 2 packs of cigarettes/day and currently hospitalized with pneumonia D) A mountain skier who spends all day outside teaching ski lessons E) A nursing home client diagnosed with H1N1 influenza with fever of 102°F
24. Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis?
A) A woman who has six to eight alcoholic beverages each evening
11. The shortness of breath and cyanosis that occur in clients experiencing acute heart failure syndrome are primarily caused by: Select all that apply.
A) Accumulation of fluid in the alveoli and airways B) Lung stiffness E) Impaired gas exchange
22. When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize the pathogenesis begins with an inflammatory process whereby:
A) Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.
8. The most common causes of left-sided heart failure include:
A) Acute myocardial infarction
13. Which of the following is a nonmodifiable risk factor for the development of primary hypertension?
A) African American race
5. Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination?
A) An 81-year-old resident of a long-term care facility
12. A toddler seems to have a little "cold" and runny nose. At bedtime, he appears to be OK. A few hours later, parents awaken hearing a "tight" coughing sound. They recognize the child is not breathing well, so they rush to the emergency department. On arrival, the nurses suspect bronchial asthma based on which of the following assessment data? Select all that apply.
A) Audible wheezing C) Respiratory rate—44 with prolonged exhalation E) Sitting upright, leaning forward, and using accessory muscles to breathe
10. While assessing a client diagnosed with inflammatory bowel diseases, the nurse should assess for systemic manifestations that may include: Select all that apply.
A) Autoimmune anemia D) Lactose intolerance
19. Soon after delivery, the mother grabs the nurses arm and states, "Something's wrong...I can't get my breath." Which of the following assessments lead the nurse to suspect the client has had an amniotic emboli travel to the lungs? Select all that apply.
A) BP 90/65; pulse 130, irregular; respiratory rate 35, shallow. E) Productive cough with blood-streaked sputum.
8. Which of the following diagnostic methods are utilized when gastric cancer is suspected? Select all that apply.
A) Barium swallow study B) Endoscopic exam with biopsy D) Papanicolaou smear of gastric secretions
3. A client has entered hypovolemic shock after massive blood loss in a car accident. Many of the client's peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon?
A) Blood pressure is no longer able to overcome vessel wall tension.
21. A 6-hour-old newborn develops a critical respiratory problem and is rushed to the ICU. The ICU nurses suspect the infant has respiratory distress syndrome (RDS) based on which findings? Select all that apply.
A) Bluish discoloration of the skin and mucous membranes (central cyanosis) B) Substernal retractions with each breathe E) Expiratory grunting
7. A client is diagnosed with Zollinger-Ellison syndrome. Which of the following clinical manifestations confirm this diagnosis? Select all that apply.
A) Burning, gnawing pain when the stomach is empty B) Pain located near the midline close to the xiphoid process
17. 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
18. An elderly client is complaining about chronic constipation. When evaluating the client's medication regimen, the nurse will note that which of the following medications may contribute to his constipation? Select all that apply.
A) Calcium channel blockers for his hypertension B) Antacids for his heartburn C) Diuretics for his heart failure
23. 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
5. Bronchial circulation differs from the pulmonary circulation by providing blood for the:
A) Conducting airways
22. A client arrives in the emergency department suffering a traumatic brain injury as a result of a car accident. While assessing this client, the nurse notices the client has an irregular breathing pattern consisting of prolonged inspiratory gasps interrupted by expiratory efforts. The underlying physiological principle for these signs would include:
A) Damage has occurred at the connection between the pneumotaxic and apneustic centers.
19. 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 D) Takes cyclosporine daily since a kidney transplant
2. A client has had severe heart burn associated with persistent gastroesophageal reflux for many years. Which of the following statements made by the client leads the nurse to suspect the client is having a complication related to his reflux? The client is having:
A) Difficulty in swallowing with feelings that food is "stuck" in the throat
10. A client who is quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the following actions performed by the client's caregiver is likely to promote defecation?
A) Digital stimulation of the client's rectum
20. A client is admitted with dilated cardiomyopathy with left ventricular dysfunction. The nurse should assess for which of the following clinical manifestations? Select all that apply.
A) Dyspnea B) Orthopnea C) Extreme fatigue with activity
6. At the cellular level, cardiac muscle cells respond to an increase in ventricular volume to the point of overload by: Select all that apply.
A) Elongating the cardiac muscle cells D) Decreasing the ventricular wall thickness
10. Clients with chronic autoimmune hepatitis may display which of the following clinical manifestations upon physical exam? Select all that apply.
A) Enlarged liver B) Jaundice
15. An elderly client is admitted with the diagnosis of severe aortic regurgitation. Which of the following client reports support this diagnosis? Select all that apply.
A) Exertional dyspnea B) Orthopnea D) Paroxysmal nocturnal dyspnea E) Palpitations
20. The physiological rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes:
A) Facilitating the absorption of osmotically active particles
25. A person newly diagnosed with Kawasaki disease in the acute phase will likely have which of the following clinical manifestations? Select all that apply.
A) Fever C) Edematous hands and feet D) Bilateral conjunctivitis
1. The "cold viruses" are rapidly spread from person to person. The greatest source of spread is:
A) Fingers
8. Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
A) Fixed coronary obstruction
11. A 16-year-old girl has been admitted to the emergency department after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this client faces a severe risk of acute fulminant hepatitis, with elevated ammonia levels that can result in: Select all that apply.
A) Flapping tremor (asterixis) B) Confusion C) Convulsions
11. While planning care for a client with irritable bowel syndrome, knowing the client has an increased amount of secretions with impaired GI absorption, the priority nursing diagnosis would be:
A) Fluid volume deficit
5. A client has visited the health care provider following several days of nausea/vomiting and abdominal pain. The provider thinks the client may have Helicobacter pylori (H. pylori) infection. As part of the education provided, the client should be informed that which of the following complications can occur if this infection is not eradicated? Select all that apply.
A) GI bleeding due to peptic ulcer formation D) Gastric cancer due to metaplasia changes in the cells
25. In the ICU setting, clients who develop shock need thorough head-to-toe assessments. Which of the following clinical manifestations would alert the health care provider that the client may be developing ischemia associated with gastrointestinal redistribution of blood flow?
A) Gastric bleeding
13. Following a dust storm in Arizona, several clients have presented to the clinic complaining of productive cough, fever, and night sweats. The health care provider suspects a fungal infection related to breathing dust. One particular client is critical. They suspect the infection has progressed outside the lung when they observe the client has: Select all that apply.
A) Generalized lymph node enlargement D) An enlarged liver via palpation E) Copious bleeding at the site where the lab technician drew some blood
18. An ultrasound (US) of a client with intermittent pain reveals gallbladder sludge. Which of the following client history items are likely factors in the US result? Select all that apply.
A) Had lap band surgery 2 years ago and lost 100 pounds B) Recent pregnancy with a 6-month-old child at home C) Current prescription for a medicine to lower cholesterol
13. A client is admitted with late manifestations of cirrhosis. Which of the following clinical manifestations confirm this diagnosis? Select all that apply.
A) Hepatomegaly felt on deep palpation C) GI bleeding related to esophageal varices E) Splenomegaly with bleeding tendencies
2. 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
18. Electrical burns over a large surface area of a client's body have resulted in hypovolemic shock after the loss of large amounts of blood and plasma. Following physical assessment, which findings lead the nurse to believe the client's body is compensating for this fluid loss? Select all that apply.
A) Increased heart rate D) The client complaining of extreme thirst E) Deep, rapid respirations
25. A 2-year-old child is admitted to pediatric unit with bronchiolitis. The nurse calls the physician fearing the child is going into respiratory failure based on which of the following assessment findings? Select all that apply.
A) Increased respiratory rate to 44 breaths/minute B) Substernal retractions becoming more pronounced C) New-onset expiratory grunting
16. An 86-year-old male client is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure?
A) Increased vascular stiffness
6. A 60-year-old male client has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment?
A) Inhibiting gastric acid production
9. A client with hepatitis B asks the nurse, "How did I get this hepatitis?" The nurse responds that the mode of transmission is predominantly by: Select all that apply.
A) Intravenous drug use C) Unprotected sexual intercourse
14. An elderly female client who reports increasing fatigue has been diagnosed with aortic stenosis, a disease that her primary care provider believes may have been long-standing. Which of the following compensatory mechanisms has most likely maintained the woman's ejection fraction until recently?
A) Left ventricular hypertrophy
10. The client with emphysema should be educated about changes in lung tissue that may include which of the following changes? Select all that apply.
A) Loss of elastic recoil B) Difficulty exhaling due to inability to recoil C) Increased lung compliance
13. Which of the following diagnostic/assessment findings would been seen in a client with worsening mitral valve stenosis? Select all that apply.
A) Low-pitched diastolic murmur that is increasing in duration B) Sharp elevation in left atrial pressure C) Decreased cardiac output
20. Most respiratory disorders in infants produce a decrease in:
A) Lung compliance
3. One of the principal mechanisms by which the heart compensates for increased workload is:
A) Myocardial hypertrophy
6. When a client with a history of asthma takes a walk outside on a windy day with high pollen counts, she may experience an asthma attack, resulting in an increase in respiration rate and wheezing. The body's response is likely related to which pathophysiological principle?
A) Parasympathetic nervous system stimulation resulting in airway constriction
10. 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
12. The ulcerative colitis client should be assessed by the health care provider for which of the following clinical manifestations? Select all that apply.
A) Persistent diarrhea C) Stool containing blood (hematochezia)
9. Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?
A) Pet dander
4. A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience?
A) Prehepatic
3. A client asks the nurse to explain the digestive tract layers because the client is experiencing upper GI problems. When talking about the mucosa layer, the nurse will emphasize that the roles/functions of this layer consist of: Select all that apply.
A) Production of mucus to protect and lubricate the inner lining B) Beginning of the digestive process by secreting enzymes to break food down
7. A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the clinic with the following complaints: auscultation of breath sounds reveal absent/diminished breath sounds in the right lower lobe. Which other manifestations lead the health care provider to suspect the client may have developed atelectasis? Select all that apply.
A) Respiratory rate—32; pulse rate—122 beats/minute. B) "Having a hard time catching my breath." D) Using accessory muscles to help him breathe.
9. Assessment of an elderly female client reveals the presence of bilateral pitting edema of the client's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the client's lungs reveals clear air entry to bases, and the client's oxygen saturation level is 93%, and vital signs are within reference ranges. What is this client's most likely health problem?
A) Right-sided heart failure
25. When caring for a cancer client experiencing chemotherapy-induced nausea and vomiting, which of the following drugs work to delay this nausea and vomiting by acting on the CNS to block the activation of the NK-1 receptors? Select all that apply.
A) Serotonin (5-hydroxytryamine) antagonists B) Neurokinin-1 receptor antagonists
16. Which of the following would be considered a clinical manifestation of acute pericarditis? Select all that apply.
A) Sharp, abrupt onset of chest pain that radiates to the neck B) Pericardial friction rub E) Abnormal ECG results
19. Which of the following signs/symptoms would lead the nurse to suspect the post-op client has developed a mechanical bowel obstruction? Select all that apply.
A) Sluggish to absent bowel sounds B) Increase in abdominal distention C) Nausea and vomiting E) Continuous abdominal pain
15. A client with an 80-pack-year history of tobacco smoking has presented to the clinic complaining of "bronchitis" cough for the past 5 months, weight loss, and shortness of breath. Today, this client "got scared" when he coughed up blood in his sputum. The health care provider is concerned this client may have which of the following possible diagnoses?
A) Small cell lung cancer due to smoking history
21. 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?
A) Smooth muscle relaxation of vessels
23. Which of the following meals is most likely to exacerbate an individual's celiac disease?
A) Spaghetti with meatballs and garlic bread
1. The plaques in a client's coronary arteries are plentiful, and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which of the following diagnoses?
A) Stable angina
5. Motility along the length of the GI tract, controlling the function of each segment of the GI tract and integrating signals for absorption of nutrients primarily, is innervated by which portion of the enteric nervous system?
A) Submucosal plexus
24. A 6-month-old infant has been hospitalized with acute bronchiolitis. Which of the following treatments should be prioritized in the infant's care?
A) Supplementary oxygen therapy
14. A client with newly diagnosed squamous cell carcinoma of the lung asks, "So how do we treat this cancer?" Which response from the health care provider is most accurate? Select all that apply.
A) Surgery to remove tumor B) Radiation therapy C) Chemotherapy
9. A client is admitted to hospital to rule out Legionnaire disease following a canoe trip where he was sprayed in the face with a lot of "creek" water. Which of the following manifestations are characteristic of Legionnaire pneumonia? Select all that apply.
A) Temperature of 103.5°, pulse 80 B) "Talking but not making a lot of sense" (confusion) E) Chest x-ray that reveals areas of consolidation suggestive of pneumonia
11. A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis and has subsequently developed latent tuberculosis infection. Which of the following is true of this nurse?
A) The nurse is likely asymptomatic.
2. An elderly client who has been restricted to bed by numerous comorbidities for several weeks has been diagnosed with a large pleural effusion. Which of the following treatment modalities is most likely to resolve the client's most recent health problem?
A) Thoracentesis
7. The client chews an apple and starts the swallowing process. As the food bolus enters the back of the mouth and swallowing is initiated, the nurse knows that the client's motor impulses are being carried out by which of the following cranial nerves? Select all that apply.
A) Trigeminal (V) B) Vagus (X) C) Hypoglossal (XII) D) Abducent (VI)
20. Which of the following signs and symptoms is most suggestive of acute cholecystitis?
A) Upper right quadrant or epigastric pain
11. A college student goes to the campus health office complaining of diarrhea, lower right abdominal pain, and weight loss. Suspecting Crohn disease, the nurse will assess for which complication associated with this diagnosis?
A) Urine that has the look and smell of feces
10. An IV drug abuser has been diagnosed with infective endocarditis. He is in the emergency department reporting increasing shortness of breath, rapid breathing, chest pain that worsens with breathing, and coughing up blood. The health care provider recognizes this may be caused by:
A) Vegetative emboli traveling in the blood stream to the lungs
15. In addition to mucus, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous-type fluid are secreted to act as a:
A) Vehicle for absorption
15. Preload represents the volume work of the heart and is largely determined by:
A) Venous blood return
5. A client has been diagnosed with cholestasis and is experiencing pruritus. The nurse caring for this client should be educating the client about reduced bile flow that will interfere with intestinal absorption of which of the following vitamins? Select all that apply.
A) Vitamin A D) Vitamin D E) Vitamin K
10. While teaching a client with new-onset right-sided heart failure, the nurse should educate the client to monitor for fluid accumulation by:
A) Weighing every day at the same time with same type of clothing
8. Which of the following clients at the clinic should be encouraged to receive the pneumococcal polysaccharide vaccine (PPSV23)? A client: Select all that apply.
A) Who is 65 years old with chronic asthma B) With a smoking history
3. A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The assessment data related to this lab value includes: Select all that apply.
A) Yellowish discoloration of the skin D) Yellowing of the sclera of the eye E) Dark-colored urine
10. When explaining a new diagnosis of complete heart block to a client/family, the nurse should include which of the following statements?
B) "One consequence of this type of block is a very slow heart rate that limits circulation to the brain."
4. A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which of the following explanations is most appropriate to share?
B) "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."
12. While administering a tuberculin (TB) skin test, a client who is HIV positive asks, "I heard from my friends, this test may not work on me since I have HIV." The health care provider's best response would be:
B) "Sometimes immunocompromised clients will have negative results if you are unable to mount a normal immune reaction."
13. A heart failure client has an echocardiogram performed revealing an ejection fraction (EF) of 40%. The nurse knows this EF is below normal and explains to the client:
B) "This means your heart is not pumping as much blood out of the heart with each beat."
20. An elderly client newly diagnosed with systolic hypertension asks her health care provider why this happens. The most accurate response would be:
B) "With age, your arteries lose their elasticity and are replaced with collagen, which makes your arteries stiffer."
1. Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, midclavicular line. The client asks, "What does that mean?" The nurse will base her answer on which of the following physiologic principles?
B) "You have a heart valve that is diseased."
24. A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is:
B) "You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked."
1. 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?
B) "You more than likely have small, dense type of 'bad cholesterol' (LDL)."
14. A client with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveal the following findings: heart rate 80 beats/minute; end-diastolic volume 120 mL; and end-systolic volume 60 mL. What is this client's ejection fraction?
B) 50%
13. Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis?
B) A 79-year-old hospitalized client who is being treated with broad-spectrum antibiotics
4. Which of the following individuals is suffering the effects of acute coronary syndrome (ACS)?
B) A client who occasionally experiences persistent and severe chest pain when at rest
6. Which of the following clients would be considered at high risk for developing pneumonia (both community and hospital setting)? Select all that apply.
B) A young adult in motorcycle accident with head injury requiring tracheostomy and mechanical ventilation D) A HIV-positive client with a WBC count of 2000 who has been camping near a commercial farm raising chickens for food E) A school-aged child with severe asthma controlled by steroids admitted for an exacerbation
4. A distinguishing feature of viral influenza is:
B) Abrupt-onset, profound malaise
4. A client has been told he has abdominal adhesions due to an old appendix infection. Knowing the structures of the abdominal cavity, the nurse will explain which of the following structures can form bands of fibrous scar tissue to wall off the infection, preventing it from spreading to other parts of the body?
B) Omentum
15. 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?
B) Activation of the renin-angiotensin-aldosterone mechanism
23. Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which of the following complications?
B) Acute tubular necrosis
7. On the 3rd day following an acute myocardial infarction, the client is being discharged home. The nurse is explaining how the heart tissue heals following an MI. "Since today is your 3rd day after your heart attack, the tissue is:
B) Acutely inflamed."
16. A client with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are consistent with decreased cardiac output. Which of the following determinants of cardiac output is hypertension most likely to affect directly?
B) Afterload
16. Respiratory movement of air that does not participate in alveolar gas exchange is known as alveolar dead space. Dead space increases when alveolar/alveoli:
B) Air supply exceeds blood flow.
6. A decrease in the serum level of which of the following substances is suggestive of liver injury?
B) Albumin
8. In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum:
B) Between contractions
19. Which of the following statements about calcium channel-blocking (CCB) drugs is accurate?
B) CCB drugs work on β-adrenergic receptors to close the channels, so vasodilation occurs.
6. Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is:
B) Calf pain
16. A 25-year-old cystic fibrosis client presents to the clinic in obvious respiratory distress. Following physical exam, the health care provider suspects bronchiectasis based on which of the following findings? Select all that apply.
B) Copious amounts of foul-smelling purulent sputum D) Blood-tinged sputum E) Wheezing throughout the lung fields
2. Above the glottis that opens and closes for speech, the epiglottis performs which physiologic functions during swallowing?
B) Cover the larynx
12. 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?
B) Crackles in bilateral lung bases caused by left-sided heart failure
20. Following a hypertensive crisis, a client's family asks, "Why are the client's eyes so bloodshot?" The nurse responds that high arterial pressure:
B) Damages more fragile blood vessels like those in the eyes to the point of rupture
23. For which of the following types of shock might intravenous antibiotic therapy be indicated?
B) Distributive shock
3. Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer?
B) Dysphagia in an individual with no history of neurologic disease
3. Clients with ischemic coronary vessel disease and acute coronary syndrome (ACS) are classified as low or high risk for acute myocardial infarction based on characteristics that include significant:
B) ECG changes
5. In the days following a tooth cleaning and root canal, a client has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this client's most likely diagnosis?
B) Endocarditis
1. A teenager who has a history of achalasia will likely complain of which of the following clinical manifestations?
B) Feeling like there is food stuck in the back of the throat
15. When evaluating the pulmonary function test results for a COPD client, which one correlates to the mismatch of ventilation and perfusion associated with this diagnosis?
B) Forced expiratory volume (FEV) is decreased.
17. The stomach is the source of two hormones produced by the gastrointestinal tract: gastrin and ghrelin. Ghrelin is a peptide hormone produced in the mucosal layer that has an important role in regulation of:
B) Growth hormone
7. A family brings their elderly father to emergency department. He has been exposed to pneumococcal pneumonia at his retirement home. Today, they noted a change in his mental status. They thought he might need some oxygen. Which of the other assessment findings would correlate with this diagnosis? Select all that apply.
B) Increase in chest pain with deep inspiration D) Loss of appetite for past few days E) Purulent sputum with bloody patches
2. Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a:
B) Large lipid core
20. A client has arrived in the emergency department in cardiogenic shock. Which of the following assessment findings confirm this diagnosis? Select all that apply.
B) Less than 5 mL dark, concentrated urine in the past hour C) BP reading of 80/65 D) Difficult to arouse with changes in level of consciousness
3. Pleuritic chest pain associated with respiratory movements is usually described as:
B) Localized
5. A motor vehicle accident has resulted in critical injury for the driver of the car. The driver has hit the steering wheel with his chest and fractured his sternum and some ribs. Which of the following manifestations would lead the staff to suspect the driver has developed a tension pneumothorax? Select all that apply.
B) Mediastinal shift of the trachea toward one side E) Subcutaneous emphysema palpated in the upper chest/neck region
23. COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population?
B) PO2 level of 50 mm Hg
17. A teenaged cystic fibrosis client presents to the clinic. The health care provider (HCP) knows that cystic fibrosis (CF) causes severe chronic respiratory disease in children. In addition, the HCP should also focus his or her assessment on which of the other body systems affected by CF?
B) Pancreatic
7. 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:
B) Percutaneous transluminal angioplasty and stent placement
4. A client with a history of emphysema from long-term cigarette smoking has loss of many alveoli. When comparing the type I alveolar cell physiologic function with the primary role of type II alveoli, the nurse would be aware that the type II alveoli are responsible for:
B) Production of surfactant
12. A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which of the following manifestations related to the necrosis of liver cells?
B) Rapid onset of jaundice
21. As a protective measure to keep abdominal inflammation and infection localized, the peritoneum:
B) Secretes fibrous exudate
24. When educating residents of a senior citizen living facility, the nurse should review which of the following information about colorectal cancer? Select all that apply.
B) Seek out medication attention for any blood in the stool. C) Most cases are quite advanced before symptoms become apparent.
22. A family member comes rushing out of a client's room telling the nurse that the loved one can't breathe. The nurse has just left the room after hanging IV penicillin. Which of the following clinical manifestations lead the nurse to suspect the client is experiencing anaphylactic shock? Select all that apply.
B) Severe bronchospasm C) Wheezing sound on inspiration D) Hives over entire body E) Swelling around the lips and eyes
11. Clients who have been bed-ridden for a long time likely will experience:
B) Shallow, quiet breathing, which impairs the spreading of surfactant
19. Which of the following characteristics of the lungs of infants and small children creates an increased risk of respiratory disorders?
B) Smaller airways create a susceptibility to changes in airway resistance and airflow.
16. Gastrin production, a task that is performed by the stomach, results in which of the following effects?
B) Stimulation of HCl secretions by parietal cells
11. Which of the following medications helps treat the inflammatory reaction of asthma clients diagnosed with late-phase asthma response?
B) Systemic corticosteroids
1. When lecturing to a group of students about the pathophysiological principles behind heart failure, the instructor explains that cardiac output represents:
B) The amount of blood the heart pumps each minute
8. A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happened. The nurse states, "For unknown reasons, you lose intrapleural negative pressure.
B) This means your lungs collapsed and expelled its air when you lose negative pressure."
4. The most important complication of atherosclerosis that may cause occlusion of small heart vessels is:
B) Thrombosis
4. A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because:
B) Trapped, inspired air collapses the lung.
19. In an ICU setting, one assessment that would lead the nurse to suspect shock has resulted in decrease blood flow to vital organs is:
B) Urine output less than 20 mL/hour
4. Which of the following statements about vascular compliance is accurate?
B) Veins can act as a reservoir for storing large quantities of blood.
14. Both prehepatic and posthepatic causes of portal hypertension include the formation of:
B) Venous thrombosis
23. A client's complex and worsening pressure ulcer has necessitated the use of numerous antibiotics over the last several months. Which of the following consequences may result from this client's medication regimen?
B) Vitamin K deficiency
18. Which of the following assessment findings would be suggestive of cardiac tamponade?
C) A 20 mm Hg drop in systolic blood pressure during respiration
1. The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as:
C) Phagocytes
2. A college student is lamenting the fact that she has developed a cold on the weekend prior to exam week. Which of the following statements shows that the student has an accurate understanding of her upper respiratory infection?
C) "I suppose I should have been washing my hands more in the past few days."
14. 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?
C) "I'm resolving to eat organic foods from now on and to drink a lot more water."
16. 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?
C) "You may not sense any problems, but it really increases your risk of heart disease and stroke."
7. A client who is in a room at 1 atmosphere (760 mm Hg) is receiving supplemental oxygen therapy that is being delivered at a concentration of 50%. What is the consequent PO2?
C) 380 mm Hg.
23. A client has had a myocardial infarction (MI) that damaged the right atrium, which has interfered with the SA node. The compensatory mechanism, the AV node, becomes the pacemaker of the heart and beats how many times/minute?
C) 45 to 50 beats/minute
8. When discussing the AV node's role in the electrical conduction of the heart with a client newly diagnosed with an AV block, which of the following statements are accurate? Select all that apply.
C) A block at the AV bundle of His interferes with the normal delay of the impulse, thereby interfering with complete ejection of blood from the atria prior to ventricular contraction. D) When there is an AV block, impulses from the atria and ventricles beat independently of each other so, the heart rhythm is usually chaotic and not regular.
14. A client with a diagnosis of heart failure has returned from a visit with his primary care provider with a prescription for a change in his daily medication regimen. Which of the following drugs is likely to improve the client's cardiac function by increasing the force and strength of ventricular contractions?
C) A cardiac glycoside
20. Which of the following clients is at risk for developing a preventable disorder related to prolonged immobility?
C) A postsurgical client who is refusing to get out of bed and walk and will not wear those "uncomfortable elastic stocking"
9. Because of its location, the presence of an abdominal aortic aneurysm may first be manifested as:
C) A pulsating mass
19. Which of the following factors is most strongly associated with the pathogenesis of gallstones?
C) Abnormalities or stasis of bile
7. Heart muscle differs from skeletal muscle tissue by being able to generate:
C) Action potentials
5. A father experienced the onset of chest pain and dies suddenly. The family asks, "What caused him to die so suddenly?" The health care provider's reply that is most appropriate would be, "There's a high probability that your loved one developed an acute heart attack and experienced:
C) Acute ventricular arrhythmia."
21. Which of the following clients should most likely be assessed for orthostatic hypotension?
C) An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom
12. A child's history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child?
C) Antibiotics and anti-inflammatory drugs
2. A client is diagnosed with an abdominal aortic aneurysm that the physician just wants to "watch" for now. When teaching the client about signs/symptoms to watch for, the nurse will base the teaching on which of the following physiological principles?
C) As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.
2. A client who has had his gallbladder (GB) removed asks the nurse, "Why do I feel sick every time I go through a drive-in fast-food restaurant and order burgers and fries?" The nurse bases the response knowing that:
C) Bile from the GB is needed to breakdown lipids.
21. The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which of the flowing lab values?
C) Bilirubin 15 mg/dL (high)
25. The parasympathetic nervous system causes a slowing of the heart rate by increasing:
C) Cardioinhibitory center
18. A large increase in heart rate can cause:
C) Decreased stroke volume
8. A client has just been admitted to the postsurgical unit following a below-the-knee amputation. Which of the following measures should her care team prioritize to prevent atelectasis during the client's immediate recovery?
C) Deep-breathing exercises and early mobilization
21. Implantation of a pacemaker is most likely to benefit a client with which of the following cardiomyopathies?
C) Dilated cardiomyopathy (DCM)
22. A mother rushes her toddler into the emergency department stating, "My baby can't breathe." Initial assessment reveals the child is struggling to breathe in an upright position. He has both inspiratory and expiratory stridor and is using his chest muscles to breath. The nurse suspects the child has which of the following acute respiratory infections?
C) Epiglottitis
19. While explaining digestion and absorption of nutrients to a client, the nurse mentions that the brush border enzymes would facilitate absorption of which of the following foods?
C) Garlic toast
11. Which of the following lab results strongly suggest an immunologic response in the client with possible rheumatic heart disease?
C) Group A (β-hemolytic) streptococcal antibodies
19. Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which of the following disorders was the player's most likely cause of death?
C) Hypertrophic cardiomyopathy (HCM)
5. 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?
C) Inhibition of the renin-angiotensin-aldosterone system
12. During ventricular systole, closure of the atrioventricular (AV) valves coincides with:
C) Isovolumetric contraction
18. Increased upper airway resistance and decreased airflow into the lungs in neonates (0 to 4 weeks of age) can result from:
C) Nasal congestion
16. A major factor in the development of hepatic encephalopathy is:
C) Neurotoxin accumulation
21. 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?
C) Obstructive shock
15. A client presents to the emergency department vomiting large amounts of bright red blood. The client has a history of alcohol abuse, and the physician suspects esophageal varices. The drug that is used to reduce splanchnic and hepatic blood flow and portal pressures is:
C) Ocetrotide, a long-acting synthetic analog of somatostatin
23. A child is brought to the emergency department with a respiratory infection. The child is struggling to breath and is very anxious. The health care providers suspect epiglottitis. Which of the following interventions would be a priority?
C) Place the child upright in bed and begin preparing for a tracheostomy placement.
2. A client has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the client's end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this?
C) Preload
2. A liver failure client asks, "How does the liver process ammonia in healthy individuals?" The health care provider explains that ammonia is toxic to tissues, especially neurons, so this ammonia is removed from the blood by the liver, which:
C) Processes it into urea, releasing it into the circulation
21. As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to:
C) Pulmonary hypertension
11. 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?
C) Renal monitoring and adjustment of extracellular fluid volume
22. Following a kitchen accident with a knife, the client's cut has experienced a decrease in the amount of bleeding and has developed a clot. The nurse knows this is primarily a result of humoral control of blood flow with the release of:
C) Serotonin
24. A client has experienced a bout of coughing after aspirating some of his secretions. The client's coughing was triggered by which of the following?
C) Signals from receptors in the tracheobronchial wall
18. When explaining absorption to a client, the nurse mentions that a number of substances require a specific carrier or transport system. An example the nurse could use relates to the transport of amino acids and glucose, which requires the presence of which of the following for absorption to occur?
C) Sodium
21. The intestinal absorption of glucose and amino acids is facilitated by which of the following transport systems?
C) Sodium linked
12. When thinking in terms of airway radius with regard to resistance, the lung structure responsible for the most airway resistance to airflow would be:
C) The bronchioles near the trachea
12. When discussing digestion with a group of nursing students, the instructor asks, "Where does the digestion of our food begin?" The most accurate student response would be
C) The mouth with ptyalin and amylase breaking down starches
1. A client has been diagnosed with an incompetent pyloric sphincter. This client is experiencing a lot of abdominal pain and nausea. When this client vomits, the nurse should expect what type of secretions will be in the basin?
C) Thick, brownish, foul-smelling emesis
22. Congenital heart defects can cause a right heart-to-left heart shunting of blood that results in increased:
C) Unoxygenated blood flow
11. A male client with a history of angina has presented to the emergency department with uncharacteristic chest pain, and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle?
C) Ventricular repolarization
13. Biopsy results reveal that a client has a deficit amount of parietal (oxyntic) cells in their stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:
C) Vitamin B12
24. Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by:
D) Ventilation-perfusion mismatch
8. Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the client's statements suggests that he understands his new diagnosis?
D) "I don't know why I didn't bother to get vaccinated against this."
15. A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the client's following statements demonstrates an accurate understanding of this diagnosis?
D) "I suppose I should try to eat a bit more fiber in my diet."
13. A nurse is performing client health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?
D) "I'm trying to think of ways that I can cut down the amount of salt that I usually eat."
15. A client awaiting a heart transplant is experiencing decompensation of her left ventricle that will not respond to medications. The physicians suggest placing the client on a ventricular assist device (VAD). The client asks what this equipment will do. The health care providers respond:
D) "This device will decrease the workload of the myocardium while maintaining cardiac output and systemic arterial pressure."
8. 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?
D) "Your arteries in your hands/fingers are going into spasm, which decreases blood flow and circulating oxygen."
13. Completion of a client's pulmonary function study has yielded the following data: tidal volume, 500 mL; inspiratory reserve, 3100 mL; expiratory reserve, 1200 mL; residual volume, 1200 mL; functional residual capacity, 2400 mL. What is this client's inspiratory capacity?
D) 3600 mL.
14. Which of the following clients likely faces the greatest risk of a gastrointestinal bleed?
D) A client who takes aspirin with each meal to control symptoms of osteoarthritis
17. Which of the following individuals is most clearly in need of diagnostic testing for lung cancer?
D) A man who demonstrates wasting of the pelvic and shoulder muscles combined with signs of hypercalcemia
4. Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with:
D) Alcohol intake
25. 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?
D) Anticoagulation therapy and elevation of the leg
6. A car accident client is admitted with a chest tube following pneumothorax. He also has an elevated blood alcohol level. When the nurse enters his room, she notes the client is dyspneic, short of breath, and holding his chest tube in his hand. When the nurse pulls the linens back, she finds a "sucking" chest wound. After calling a "code blue," the next priority intervention would be to:
D) Apply a Vaseline gauze (airtight) dressing over the insertion site
25. The nurse who is providing care for a client with pancreatic cancer should prioritize which of the following assessments?
D) Assessment for deep vein thrombosis
6. Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following consequences?
D) Backflow from the left ventricle to the left atrium
24. Persistent cyanosis has led an infant's care team to suspect a congenital heart defect. Which of the following assessment findings would suggest coarctation of the infant's aorta?
D) Blood pressure in the child's legs is lower than in the arms.
3. Which elevated serum marker for systemic inflammation is now considered a major risk factor for atherosclerosis and vascular disease?
D) C-reactive protein
19. Diffusion of gases in the lung is decreased, as in pulmonary edema or pneumonia, by causing an increase in alveolar:
D) Capillary membrane thickness
21. While discussing carbon dioxide transport within the body, the instructor asks, "What enzyme helps carbon dioxide with water to form bicarbonate?" Which student response is correct?
D) Carbonic anhydrase
24. A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours. While discussing vomiting with a group of nursing students, the instructor asks, "What site in the neurologic system is responsible for vomiting?" Which student response is most accurate?
D) Chemoreceptor trigger zone
9. A respiratory therapist has asked a client to breathe in as deeply as possible during a pulmonary function test. Inspiration is normally the result of which of the following phenomena?
D) Decreased intrathoracic pressure
24. 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:
D) Deep vein thrombosis
22. A teenager has been diagnosed with failure to thrive. The health care providers suspect a malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?
D) Fatty, yellow-gray, foul-smelling stools
12. While in the ICU, a client's status changes. The health care providers suspect heart failure. Which of the following diagnostic procedures would give the staff information about pulmonary capillary pressures, which will lead to the most appropriate interventions?
D) Hemodynamic monitoring
9. While assessing a client who is experiencing diarrhea caused by Clostridium difficile, the nurse should anticipate hearing:
D) Hyperactive bowel sounds
10. Which of the following manifestations typically accompanies an asthmatic attack?
D) Hyperinflation of the lungs
17. A client has just returned from his surgical procedure. During initial vital sign measurements, the nurse notes that the client's heart rate is 111 beats/minute and the BP is 100/78 (borderline low). In this early postoperative period, the nurse should be diligently monitoring the client for the development of:
D) Hypovolemic shock due to acute intravascular volume loss
5. In addition to direct invasion of the vascular wall by an infectious agent, this pathogenic mechanism is a common cause of vasculitis?
D) Immune-mediated inflammation
22. A client has been diagnosed with cholecystitis (gallbladder inflammation) that has impaired the normal release of bile. Which of the following gastrointestinal consequences is this client likely to experience?
D) Impaired digestion of fats
6. When trying to explain to a newly diagnosed irritable bowel syndrome (IBS) client how the nervous system affects gastrointestinal (GI) disorders, the nurse mentions which of the following in regard to IBS?
D) Increase in enteric nervous system activity
1. A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which of the following physiologic phenomena will occur as a consequence of hypoxemia?
D) Increased heart rate
17. Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type?
D) Infection of intestinal cells
25. The sensation of chest tightness due to an impending asthmatic attack appears to be related to which of the following physiological causes?
D) Input from lung receptors that monitor bronchial constriction.
14. The nurse caring for a client with diverticulitis should assess for which of the following clinical manifestations?
D) Lower left quadrant pain
7. A client presents to the emergency department with some vague symptoms. After history and physical exam, the physician is suspecting the client may have viral hepatitis. Which of the following clinical manifestations leads the nurse to suspect the client is in the prodromal period of viral hepatitis?
D) Muscle aches and pain along with fatigue
3. A client has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems?
D) Perform transillumination and ask the client if bending forward exacerbates the headache.
18. Following surgery, a client had a chest x-ray that reported some opacities in the lung bases likely due to atelectasis. Which of the following pathophysiologic processes will result from this condition?
D) Perfusion without ventilation
17. A client was in car accident client while not wearing a seatbelt and has sustained multiple rib fractures. During assessment, the nurse is having a hard time hearing heart sounds, and the client reports chest pain/pressure repeatedly. This client may be experiencing:
D) Pericardial effusion
25. A newly admitted critical head injury client presents to the neuro-ICU. The client is unresponsive to painful stimuli but able to breathe on his own. As the shift progresses, the nurses note a decrease in the client's respiratory effort. The client cannot maintain his O2 saturation above 70%. The nurses should anticipate assisting in beginning what type of pulmonary support?
D) Prepare for mechanical ventilation.
9. If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern?
D) Slowing of heart rate to below 60 beats/minute
25. Following the analysis of a recent barium enema and colonoscopy with biopsy, a client has been diagnosed with colorectal cancer. Which of the following treatment modalities will be the mainstay of this client's treatment?
D) Surgery
10. The pathogenic capacity of the tubercle bacillus is related to:
D) The initiation of a cell-mediated immune response
17. Hepatocellular cancer usually has a poor prognosis due in part to which of the following factors?
D) The nonspecific symptomatology of liver cancer leads to a diagnosis at a late stage.
23. With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiological principle behind this respiratory distress is related to:
D) The stiffening of the lung, making it more difficult to inflate
17. Hypoxia is said to have a negative inotropic effect on the heart, which means:
D) There will be interference in the generation of ATP, which is needed for muscle contraction.
15. Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal instead of low lung volumes, which result in:
D) Trapping of large amounts of air that cannot participate in gas exchange
17. Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes pulmonary:
D) Vasoconstriction
9. Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by:
D) Vegetative valve destruction
