patho exam 4

What is a pathologic fracture? A) A fracture in which the overlying skin is broken B) A fracture that occurs in a weakened area of bone secondary to a disease involving the bone C) A fracture in which the bone is shattered into multiple pieces D) A fracture associated with an autoantibody

A fracture that occurs in a weakened area of bone secondary to a disease involving the bone

Which of the following should be appropriate to treat a patient with cerebral edema? A. Hypertonic Solutions B. Hypotonic solutions C. isotonic solutions D. loop diuretics

A. Hypertonic Solutions, fluid from interstitial space goes back to vascular space

which of the following statements regarding gout is incorrect? A) It is a disturbance of purine metabolism. B) It is associated with an autoantibody directed against antigens in joint cartilage. C) Uric acid may precipitate in tissues, forming gouty tophi. D) The frequency of attacks can be reduced by drugs that lower blood uric acid.

It is associated with an autoantibody directed against antigens in joint cartilage.

which of the following diagnoses is most likely in a patient who experiences progressive weakness and loss of muscle mass in the upper extremities? a. amyotrophic lateral sclerosis b. Guillain-barre syndrome c. Parkinson's disease d. hydrocephalus

a. amyotrophic lateral sclerosis

which of the following would be appropriate treatment for mild scoliosis? a. bracing b. routine exercise c. smoking cessation d. calcium supplement

a. bracing

___ 38. What is an excessive lateral curvature of the spine? A) Scoliosis B) Kyphosis C) Lordiosis D) Anklosing spondylitis

a. scoliosis

The most important determinant for prescribing therapy for acute stroke is: a. thrombotic verses embolic cause b. ischemic/thrombic verses hemorrhagic cause c. location of ischemia d. age of the patient

b. ischemic/thrombic verses hemorrhagic cause

common early manifestations of fracture include which of the following: a. muscle flaccidity b. swelling at fracture site c. elevated white blood cells d. loss of sensation in affected extremity

b. swelling at fracture site

Which of the following is the most common of type of skin cancer? A) Nevi B) Malignant melanoma C) Basal cell carcinoma D) Squamous cell carcinoma

basal cell carcinoma

J.R. is a 33-year-old lawyer who has sustained a leg fracture as a result of colliding with a tree while skiing. His fracture has been diagnosed as "compound, transverse fracture of the tibia and fibia." The type of fracture J.R. sustained is best described as a bone A) Broken in two or more pieces. B) Cracked but not completely separated. C) Broken along the long axis. D) Broken and protruding through skin.

broken and protruding through skin

One of the effects of aging on the skin is the presence of lentigos. If these areas were present, what would the nurse note? A) Red to purple ecchymosis on the abdomen. B) Longitudinal ridges in nailbeds. C) Brown spots indicating hyperpigmentation D) Red to purple ecchymoses on exposed skin

brown spots indicating hyperpigmentation

which one of the following types of dementia is caused by an infectious agent? a. pick's disease b. Huntington's disease c. Creutzfeldt-jacob disease (mad cow) d. wernicke-korsakoff's sydrome

c. Creutzfeldt-Jacob disease. Mad cow

a 44 yo women presents to her primary care physician with antisocial behavior, restlessness, and dyskinesia. the nurse would assess her for a family history of which of the following? a. seizures b. pick's disease c. Huntington's disease d. Parkinson's disease

c. Huntington's disease

A patient presents to the emergency room after a motor vehicle accident with obvious deformity and lack of function to the right lower leg. A x-ray of the extremity reveals that the tibia is broken into two pieces and the fibula is broken into three pieces. The patient has more than likely suffered a: A) Comminuted fracture. B) Greenstick fracture. C) Impacted fracture. D) Spiral fracture.

comminuted fracture

Which of the following foods should you instruct the patient prone to gout to avoid? A) Spinach. B) Crawfish. C) Chocolate. D) Potato chips.

crawfish. (spinach too but crawfish is best answer)

spinal shock describes: a. respiratory paralysis associated with spinal cord injury b. the hypotensive state associated with the trauma of the injury c. a hypovolemic shock caused by blood loss associated with injury d. a transient loss of somatic and autonomic reflexes below the level of injury

d. a transient loss of somatic and autonomic reflexes below the level of injury

to reduce risk for meningitis, the nurse's best advice to an older patient is: a. stay mentally active and engaged b.drink at least 3000 mls of fluid per day c. exercise 15 to 30 minutes most days of the week d. get pnuemoccocal pneumonia and influenza vaccinations

d. get pneumococcal pneumonia and influenza vaccinations

the most fatal stroke is: a. mini stroke b. ischemic/thrombic stroke c. transient stroke d. hemorrhagic stroke

d. hemorrhagic stroke

Presbycusis refers to: A) Hearing loss that occurs as the result of an ototoxic drug. B) Decreased hearing that accompanies the aging process. C) Hearing loss to injury to the tympanic membrane. D) Idiopathic hearing loss.

decreased hearing that accompanies the aging process

The most serious consequence of osteoporosis is: A) Bad skin B) Falls C) Hip fracture D) Loss of height

hip fracture

A 58 year old, obese man presents to the clinic with joint pain that worsens with activity and relieved by rest. Physical exam reveals joint stiffness and crepitis. These findings are consistent with which of the following diseases? A) Osteoarthritis. B) Gouty arthritis. C) Reactive arthritis. D) Rheumatoid arthritis.

osteoarthritis

__________ results in the failure of cartilage cells to maintain the balance between degradation and synthesis of the supporting matrix. A) Gout B) Rheumatoid Arthritis C) Osteoarthritis D) None of the above

osteoarthritis

The active bone-forming cells that produce the collagenous bone matrix and secrete the enzyme alkaline phosphatase are called: A) Osteocytes B) Osteoblasts C) Trabeculae D) Osteoclasts

osteoblasts

After a period of prolonged bed rest, the healthcare provider tells the patient that she has developed brittle bones. The nurse should explain to the patient that the prolonged be rest has resulted in: A) Atrophy B) Fractures C) Contractures D) Osteoporosis

osteoporosis

All of the following conditions predispose to osteoporosis or increase the risk of osteoporosis EXCEPT: A) Overweight B) Low intake of calcium in the diet C) Vitamin D deficiency D) White race E) Female gender

overweight

What is the major problem associated with herpes zoster? A) Pain B) Very contagious C) Secondary pneumonia D) No effective treatment

pain

___ 30. To determine if a patient is experiencing compartment syndrome, which of the following is a priority area for nursing assessment? A) Edema at the fracture site. B) Deformity at the fracture site. C) Presence of drainage on the cast. D) Pain at fracture site above what would be expected.

pain at fracture site above what would be expected

Which disorder is characterized by the inelasticity and thickening of the lens with aging? A) Myopia. B) Hyperopia. C) Presbyopia. D) Astigmatism.

presbyopia

Which of the following would be an expected skin finding associated with aging? A) the presence of a scaly scalp, or cradle cap. B) the presence of a macular rash, or rubella. C) the presence of dry skin and poor skin tugor. D) the presence of nevi.

presence of dry skin and poor skin turgor

Astigmatism is: A) The bending of light at angulated surfaces. B) The nonuniform curvature of the cornea, lens, or retina. C) A disorder of accommodation in which the lens cannot bring near objects in focus. D) A disorder of accommodation in which the lens cannot bring far objects in focus.

the nonuniform curvature of the cornea, lens or retina

While assessing a child, the nurse notes a circular area of erythema with hair loss on the scalp. The likely diagnosis for this condition is: A) Tinea coropis. B) Tinea unguium. C) Tinea capitis. D) Tinea pedis.

tine capitis

A deposit of uric acid in the soft tissues of a gouty subject is called: A) Calculus B) Synovium C) Tophus D) Arthritis

tophus

Alan is a 48-year-old man who is concerned about a skin lesion on his back. The lesion is determined to be a nevus (mole). Which of the following findings indicates a need for further evaluation? A) Skin-colored nevus, lacking dark pigmentation. B) Variations in color within the nevus. C) Very dark coloration. D) Size greater than 2 mm diameter.

variations in color within the nevus

A patient with Meniere's disease would probably complain of which of the following? A) Fatigue. B) Vertigo and nausea. C) Pain when the ear is touched. D) Tenderness over the mastoid area.

vertigo and nausea

Rickets is characterized by soft, weak bones resulting from: A) Hypercalcemia. B) Estrogen deficiency. osteoporosis C) Phosphate excess. osteoporosis D) Vitamin D deficiency.

vitamin d deficiency

Which of the following persons is at the highest risk for developing pathological fractures? A) A highly active 2 year old female B) 20 year old male that routinely participates in contact sports C) 40 year old female with moderate scoliosis D) 68 year old postmenopausal female with bone cancer

68 year old postmenopausal female with bone cancer

Which of the following persons is at highest risk for osteoporosis? A) 72 year old Caucasian female with a body mass index (BMI) of 19. B) 70 year old African American female with a BMI of 28. C) 40 year old Hispanic male that has been quadriplegic for 6 years. D) 68 year old Caucasian male that has been wheelchair bound for 5 years.

72 year old caucasian female with a body mass index of 19

The pathophysiology underlying gouty arthritis may be attributed to: A) Increased immune complexes within the joint cavity. B) The presence of fibrous adhesions within bony cartilage. C) An alteration in purine metabolism resulting in hyperuricemia. D) Excessive bone remodeling secondary to increased levels of phosphorus.

An alteration in purine metabolism resulting in hyperuricemia. (gout does not excrete uric acid)

Which of the following statements does NOT apply to myasthenia gravis? A) Abnormal fatigability of voluntary muscles B) Associated with degeneration of motor nerve cells supplying the affected muscles C) Associated with autoantibodies against acetylcholine receptors at the myoneural junction of the muscle fibers D) Symptoms of the disease are relieved by drugs that prolong the action of acetylcholine

Associated with degeneration of motor nerve cells supplying the affected muscles

Which of the following best describes herpes simplex virus (HSV) type 1? A) HSV type 1 occurs only once to an individual. B) HSV type 1 can be triggered by fever, infection, or menses. C) Antivirals can be given for protection. D) HSV type 2 can be transmitted sexually to cause type 1.

HSV type 1 can be triggered by fever, infection or menses.

Which of the following statements about scoliosis are CORRECT? A) Scoliosis can be identified by examination of the spine when the teen is either standing upright or while bending forward. B) Usually a curvature progresses after the teenager stops growing. C) Thoracic curvature reduces the size of the thorax, interfering with lung function. D) Scoliosis never requires surgical treatment. E) All of the above.

Scoliosis can be identified by examination of the spine when the teen is either standing upright or while bending forward. Thoracic curvature reduces the size of the thorax, interfering with lung function.

Atopic eczema is associated with: A) A type I hypersensitivity reaction. B) Decreased collagen production. C) A bacterial infection. D) Moist skin.

a type I hypersensitivity reaction

Epidural bleeding is: A. characterized by a lucid interval immediately after injury. b. located between the arachnoid and the dura mater c. associated with widespread vascular disruption d. usually due to venous leakage

a. Characterized by a lucid interval immediately after injury. b. sub c. CVA D. sub

In what way do subdural hematomas differ from epidural hematomas? a. subdural hematoms exhibit a classic picture of momentary loss of consciousness, lucid interval, and rapid deterioration b. subdural hematoma should be suspected if the individual has a fracture that crosses meningeal artery. c. subdural hematoma result from arterial damage, thus bleeding forcefully and occurring rapidly d. subdural hematoma may develop weeks to months following a head injury.

a. epidural c. not artery damage d. subdural hematomas may develop weeks to months following a head injury.

acceleration-deceleration movements of the head often result in polar injuries in which: A) Focal injuries occur in two places at opposite poles. Car wreck whiplash bruising two parts opposite of brain B) Bleeding form venules fills the subdural space. C) Injury is localized to the site of initial impact. D) Widespread neuronal damage is incurred.

a. focal injuries occur in two places at opposite poles. car wreck whiplash bruising two parts opposite of brain.

The following are risk factors for arthritis except: A) overweight/obesity B) joint injuries C) infection in joints D) certain occupations E) All of the above are risk factors.

all of the above are risk factors

which of the following pathophysiological mechanisms explains the cause of Huntington's disease? a. Autoimmune disease that causes damage to peripheral nerve myelin. b. An autosomal dominant disorder that causes a mutation on chromosome 4. c. Inheritance of a gene coding for apolipoprotein E, which cause neuronal cell death. d. Degenerative changes of the upper and lower motor neurons of the cerebral cortex, brain stem, and spinal cord.

an autosomal dominant disorder that cause a mutation on chromosome 4

Which of the following patients is at highest risk for macular degeneration? A) An older adult patient. B) A young adult with multiple allergies. C) A youth hit in the eye with a baseball. D) A biochemist exposed to a various toxins.

an older adult patient

A 12 year old patient comes into the emergency room with a strained wrist from a fall while skating. The appropriate intervention during the first 24 hours is to: A) Keep the wrist in a dependent position to decrease stress on the ligaments. B) Apply ice packs to promote vasoconstriction. RICE C) Apply heat packs to promote vasodilatation. D) Apply traction to prevent muscle spasms.

apply ice packs to promote vasoconstriction. RICE

Glaucoma is characterized by an increase in intraocular pressure because of increased: A) Aqueous humor in the anterior chamber of the eye. B) Vitreous humor in the posterior chamber of the eye. C) Fluid near the opening of the retina. D) Waste products and toxins.

aqueous humor in the anterior chamber of the eye

during an assessment, a 10 year old patient describes her seizures as losing consciousness for short periods. her friends tell her that she looks like she is daydreaming except that her eyes blink. what kind of seizure is she describing? a. simple focal seizure b. absence seizure c. myoclonic seizure d. tonic-clonic seizure

b. absence seizure

what is the classic sign and symptom for hydrocephalus in infants? a. projectile vomiting b. bulging fontanels c. neck rigidity d. headache

b. bulging fontanels

prevention of osteoporosis focuses on: a. increasing phosphorus intake b. increasing weight-bearing exercise c. limiting soy intake d. limiting vitamin d intake

b. increasing weight bearing exercise (all others increase)

A 40 year old women presents to the clinic complaining of morning stiffness, fatigue, and loss of energy. Physical exam reveals hard, swollen joints, limited range of motion, deformity of the interphalangeal joints, fever, and systemic inflammatory responses. Laboratory results indicate an elevated sedimentation rate. The healthcare provider should suspect which of the following diseases? A) Gout. B) Osteoarthritis. C) Rheumatoid arthritis. D) Systemic lupus erythematosus.

c. rheumatoid arthritis

RICE would be the appropriate treatment protocol for which of the following diseases? a. Paget's disease b. osteoarthritis c. sprains d. gout

c. sprains

Rupture of a cerebral aneurysm should be suspected if the patient reports: a. transient episodes of numbness b. transient episodes of vertigo c. sudden, severe headache d. tinnitus

c. sudden severe headache

The virus that causes herpes zoster is the same one that causes: A) Chickenpox in children. B) Measles in children. C) Mumps in children. D) Polio in children.

chickenpox in children

osteoporosis is most likely to affect which group of people: a. adolescents b. young men and women c. middle aged women d. older women

d. older women

a dementia of Alzheimer disease is associated with structural changes in the brain, including: a. degeneration of the basal ganglia b. hypertrophy of the frontal lobe neurons c. significant aluminum deposits in the brain d. deposition of amyloid plaques in the brain

deposition of amyloid plaques in the brain

Which of the following lab data would be most significant in the patient with Paget's disease? A) Elevated white blood cell count. B) Elevated erythrocyte sedimentation rate. C) Elevated serum alkaline phosphatase. Liver panel CMP when bone is degrading (bone tumor) D) Positive tissue biopsy for Staphylococcus.

elevated serum alkaline phosphatase. liver panel CMP when bone is degrading (bone tumor)

Tertiary activities for osteoporosis include which of the following: A) Education, diet B) Exercise, fall prevention C) Medication, education D) Bone density screening, medication

exercise, fall prevention

A life-threatening complication of a fracture is: A) compartment syndrome- limb threatening complication B) fat embolism C) nonunion D) infection

fat embolism

An adult patient presents to the Emergency Department after having a rock hit his eye while weeding along a ditch near a busy highway. The event occurred several hours earlier. The nurse assesses the eye and finds redness and weeping, but the patient denies any pain. Which of the following early symptoms would help confirm retinal detachment? A) Pain. B) Floaters. C) Halo vision. D) Subconjunctival hemorrhage.

floaters

A patient presents to the clinic with pain and burning sensation of the skin that begins on the right lower back and ends on the right lower abdomen. Physical exam reveals a silvery rash in that area. The nurse should suspect: A) Herpes simplex. B) Herpes zoster. C) Psoriasis. D) Uticaria.

herpes zoster

Which of the following conditions is NOT a characteristic manifestation of rheumatoid arthritis? A) Autoantibodies directed against gamma globulin B) High levels of uric acid in the blood C) Chronic inflammation of synovium D) Involvement of the small joints of the hands and feet

high levels of uric acid in the blood

Which of the following laboratory values would you expect for the patient with gout due to under excretion? A) Normal serum uric acid and elevated urine uric acid. B) Low serum uric acid and low urine uric acid. C) High serum uric acid and normal urine uric acid. D) High serum uric acid and low urine uric acid.

high serum uric acid and low urine uric acid

A 2-year-old child has been sick with a cold and has developed a honey-colored lesions on her chin within the past 3 days. The nurse determines that this clinical picture is consistent with which of the following? A) Scabies. B) Impetigo. C) Herpes simplex. D) Contact dermatitis.

impetigo

A sprain involves: A) Stretching injury to a muscle or musculotendinous unit. B) Injury to the ligamentous structures that support a joint. C) Displacement and loss of articulation of bone ends within the joint capsule. D) Partial dislocation in which bone ends within a joint are still in partial contact with each other.

injury to the ligamentous structures that support a joint

Seizures are classified as general when they: A) Are recurrent. B) Are proceeded by an aura. C) Produce the same electroencephalogram (EEG) changes. D) Involve both hemispheres of the brain.

involve both hemispheres of the brain

Paget's disease: A) Is a chronic, inflammatory, rheumatic, autoimmune disease. B) Is thought to be caused by a virus that induces osteoclast proliferation. C) Is a chronic, autoimmune, connective tissue disorder involving skin and other organs. D) Is an inadequate bone mineralization as a result of a deficiency of calcium and phosphorus.

is thought to be caused by a virus that induces osteoclast proliferation

Which of the following statements related to herniated intervertebral disk is INCORRECT? A) Protrusion of the disk material may impinge on nerve roots that exit through intervertebral foramina. B) It usually results from chronic infection of the disk, which predisposes to the herniation. C) Protrusion of disk material may be detected by CT scan or myelogram. D) Part of the nucleus pulposus is extruded through a weak area or tear in the annulus fibrosus.

it usually results from chronic infection of the disk, which predisposes to the herniation

Which of the following is a malignant tumor arising from pigment-producing cells of the skin? A) Nevus B) Melanoma C) Adenocarcinoma D) Lymphosarcoma

melanoma

A concussion is a brain injury that causes: a. Momentary interruption of brain function with or without loss of consciousness. b. Small hemorrhages and some swelling of brain tissues. c. Tearing or shearing of brain structures. d. Bruising of the brain.

momentary interruption in brain function with or without loss of consciousness

Closed-angle glaucoma is caused by: A) Abnormal drainage of the aqueous humor through the trabecular meshwork that controls the flow of aqueous humor into the canal of Schlemm. B) Narrow anterior chamber angle that interferes with outflow of aqueous humor from the anterior chamber. C) Increased production of aqueous humor. D) Decreased production of aqueous humor.

narrow anterior chamber angle that interferes with outflow of aqueous humor from the anterior chamber

Compartment syndrome involves: A) Nerve and blood vessel compression caused by swelling of tissues enclosed within muscle fascia. B) Large compartment or area of localized hemorrhage. C) Presence of a loose body with a joint space. D) Bleeding into a joint space.

nerve and blood vessel compression cause by swelling of tissues enclosed with muscle fascia (Do not have to break something, can hypertrophy so fascia create compression)

Cataracts represent: A) A chronic, painful, indolent ulcer that occurs in the absence of infection. B) Opacities in the lens of the eye that interfere with light transmission. C) Scar tissue on the cornea that interferes with light transmission. D) A membrane covering over the meshwork of the eye.

opacities in the lend of the eye that interfere with light transmission

a patient presents to the ED with tonic-clonic seizures lasting three minutes and occurring one minute apart. Her family states that the seizures started approximately forty minutes ago. what is your priority nursing action? A) Role patient on their side, put the head of bed in semi-fowlers, and apply an oxygen mask at 10 L/min. B) Put a padded tongue blade in between the patient's teeth. C) Call the health care provider for a medication order. D) Restrain the patient to prevent injury.

role patient on their side, put the head of bed in semi-fowlers, and apply an oxygen mask at 10 L/min.

A chronic inflammatory disorder of middle-aged and older adults that is characterized by blushing, dark red erythema on the nose and cheek, and telangiectasia with or without acneiform components is: A) Acne. B) Tinea. C) Psoriasis. D) Rosacea.

rosacea

__________ is caused by a small parasite that burrows in the superficial layers of the skin, where it lays eggs that hatch in a few days. This causes intense itchiness. A) Lice B) "Swimmer's itch" C) Scabies D) All of the above

scabies

Autonomic dysreflexia is characterized by: a. Severe hypotension and shock. b. Severe hypertension and bradycardia. Widening pulse pressure c. Reflex emptying of the bladder and bowel. d. Muscle flaccidity of the upper and lower extremities.

severe hypertension and bradycardia. widening pulse pressure.

Complete healing of a bone fracture occurs when: A) No movement of the break is detectable. B) The callus has been completely replaced with mature bone. C) The fracture site and surrounding soft tissue are pain free. D) A cast is no longer required to stabilize the break.

the callus has completely been replaced with mature bone