PATHO FINAL 1st set 162 question

A patient misses two dialysis sessions numerous electrolyte imbalances resulted. The patient will likely demonstrate (Select all that apply.)

lethargy because of metabolic acidosis and increased BUN., skeletal muscle weakness and possible cardiac dysrhythmias because of hyperkalemia., deep rapid breathing because of compensatory mechanism for metabolic acidosis.

A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.)

liver., spleen., kidneys.

A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102 F. This information is most consistent with

meningitis.

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a headache.

migraine

A loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation.

A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is

myeloma.

A major cause of treatment failure in tuberculosis is

noncompliance.

A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing shock.

obstructive

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of

octreotide acetate.

A bone disorder that results from insufficient vitamin D is referred to as.

osteomalacia

A malignant bone-forming tumor is referred to as a(n)

osteosarcoma.

A patient with flail chest will demonstrate

outward chest movement on expiration

A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician?

pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing

paroxysmal nocturnal dyspnea.

A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for

pneumothorax.

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is

positive antinuclear antibodies.

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of

primary prevention.

A 52-year-old female had a surgical procedure in which the breast, lymphatics, and underlying muscle were removed. The procedure performed was a .

radical mastectomy

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

secondary prevention.

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of shock.

septic

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is .

serum potassium

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is .

stable angina

A patient receiving chemotherapy may be at greater risk for development of

stomatitis.

A clinical finding consistent with a diagnosis of rheumatoid arthritis would be

systemic manifestations of inflammation.

A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with

telangiectasia.

A clinical finding consistent with a hypoglycemic reaction is

tremors.

A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely to be

uric acid crystals.

"Tell me again the name of that chemical that makes crystals when my gout flares up," asks the client. The nurse's best response is

uric acid.

A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing

vitamin K deficiency bleeding.

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of

vitamin K deficiency.

A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of years.

4 and 7

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating

"His renal tubules are recovering, so he is making more urine, but he is not able to concentrate urine well, because he is not fully recovered."

"Please explain the pathophysiology of osteoarthritis to me," says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best response is

"No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone."

A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is a.

"Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."

A patient injured severely in a motor vehicle accident is hospitalized with acute kidney injury as well as multiple broken bones and lacerations. When family members ask what is meant by the term 'prerenal,' the nurse responds

"Your husband's kidneys injury did not start in the kidney itself, but rather in the blood flow to the kidney."

A patient who reported a very painful sore throat 3 weeks ago is now diagnosed with acute post-streptococcal glomerulonephritis. When asked, "Why is my urine the color of coffee?", the nurse responds

"Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored."

A level of on the Glasgow Coma Scale indicates likely fatal damage.

3

A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis is

ALL (acute lymphoid leukemia)

A commonly ingested substance associated with prolongation of the bleeding time is

aspirin.

A patient is diagnosed with stage IIA Hodgkin disease. This patient's clinical stage was most likely determined by (Select all that apply.)

Patient history CT scan Physical examination

A common component of renal calculi is

Calcium

A biliary cause of acute pancreatitis is suggested by an elevation in which serum laboratory results?

Alkaline phosphatase

______edema occurs when ischemic tissue swells because of cellular energy failure.

Cytotoxic

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient's blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time?

Begin antihypertensive drug therapy.

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine.

A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of

bacterial pneumonia.

A patient who should be routinely evaluated for peptic ulcer disease is one who is

being treated with high-dose oral glucocorticoids.

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.

FALSE

A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.)

Fatigue, Weight loss, Abdominal discomfort, Sweats

A patient who reports an intestinal fistula also reports feeling "weak and dizzy" when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician?

Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.

A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of

Graves disease.

A patient with chronic gastritis would likely be tested for

Helicobacter pylori.

A male patient involved in a motor vehicle accident is brought to the emergency department with acute flank pain. What additional signs of bleeding may the patient exhibit? (Select all that apply.)

Hematuria, Melena, Hematemesis, Hemoptysis

A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient? (Select all that apply.)

Hypotension, Urticaria, Angioedema, Wheezing

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type hypersensitivity reaction.

III

A patient with forward effects of heart failure may present with which symptoms? (Select all that apply.)

Impaired memory, Mental fatigue, Confusion

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?

Iron deficiency

A patient is diagnosed with aplastic anemia. The nurse expects to find what patient symptoms upon assessment? (Select all that apply.)

Lethargy, Heart palpitations , Transient murmurs

A patient being treated for hepatic encephalopathy could be expected to receive a(n) diet.

Low-protein and high-fiber

______ is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord.

Meningocele

_____ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes.

Nystagmus

A compound, transverse fracture is best described as a bone that is

broken and protruding through the skin.

A newborn patient is diagnosed with hemolytic disease. The nurse may expect to find what signs and symptoms? (Select all that apply.)

Petechial hemorrhages, Hepatomegaly, splenomegaly, Kernicterus

A deficiency of von Willebrand factor impairs

Platelet adhesion to injured tissue

A patient has heart failure with a normal ejection fraction. Which findings are most likely found in this patient? (Select all that apply.)

Pulmonary congestion, Edema, Ejection fraction greater than 50%

A patient experiencing shock may exhibit which signs and symptoms? (Select all that apply.)

Pulse of more than 100 beats/minute, Fast and deep respirations

A patient is diagnosed with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient's cancer? (Select all that apply.)

Radiation, Bone marrow transplant, Chemotherapy, Monoclonal antibody therapy

A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?

Rapid, deep breathing, lethargy, abdominal pain

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

Septic

A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm?

Ventricular escape rhythm

A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing

acute cardiogenic pulmonary edema.

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of

amyotrophic lateral sclerosis.

A breast lump that is painless, hard, and unmoving is most likely

carcinoma.

A cause of thrombocytopenia includes

chemotherapy.

A patient has ureteral colic. The manifestation that requires immediate notification of the physician is

chills and fever.

A fracture in which bone breaks into two or more fragments is referred to as

comminuted.

A patient presenting with a urethral stricture may experience (Select all that apply.)

decreased urinary stream., urethral discharge., infection., urine retention.

A major modifiable risk factor for nephrolithiasis is

dehydration.

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for

delayed healing.

A common characteristic of viral pneumonia is a.

dry cough.

A 32-year-old female complaining of severe pain with menstruation and inability to participate in her routine household activities is likely experiencing

dysmenorrhea.

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)

elderly woman without a previous history of MI.

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is

elevated total iron-binding capacity.

A disease that is native to a particular region is called

endemic.

A patient diagnosed with a micropenis must be evaluated for

endocrine disorders.

A patient who has difficulty walking without assistance is incontinent of urine when help doesn't get to her quickly enough. The term for this type of incontinence is

functional.

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is

gastroesophageal varices.

A patient is diagnosed with hairy cell leukemia. The patient's laboratory results would most likely indicate a decrease in (Select all that apply.)

granulocytes., platelets., red blood cells.

A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with .

hemophilia

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of

hypertensive crisis.

A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is

hypoglycemia.

A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is

hypokalemia.

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is

hyponatremia.

A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of

hypoparathyroidism.

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to

hypotension.

A major risk factor for the development of active pulmonary tuberculosis (TB) disease is

immunosuppression.

A patient has a positive Chvostek sign. The nurse interprets this as a sign of

increased neuromuscular excitability.

A change occurring in a pregnant woman that is indicative of a potential disorder is

increased urinary protein.

A known cause of hypokalemia is

insulin overdose.

A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of this disease. This stage of illness is called the stage.

latent