Patho Test 1 Ch. 13, 17, 19-21, 24, 46

An older adult client is unable to stay awake past 7:30 pm and gets up every morning at 4:30 am. Which disorder does the nurse see that the sleep pattern may indicate?

Advanced sleep phase syndrome

A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms?

Allergic reaction

A 6-year-old child is having a stem cell transplant using umbilical cord blood. What benefit does the nurse understand that this type of transplant will have for the child?

This type of transplant creates less risk of graft versus host disease

The nurse teaches a client about a new diagnosis of astrocytoma. Which statement indicates an accurate understanding?

Treatment is hard since glial cells support neurons and blood vessels in the brain.

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below:

140/90

The nurse assesses a client during perineal care and finds a foul odor coming from the vaginal area. What is the best statement for the nurse to make?

"Do you have any other symptoms?"

A nurse discusses sleep-promoting strategies with a client who reports insomnia. Which strategy would the nurse suggest?

"Get out of the bed. Do something else for a while, and then return to bed."

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

"I should have my LDL monitored."

In teaching a client about genital warts, which statement is correct for the nurse to say?

"The incubation period is 6 weeks to 3 months."

Which statement about natural killer (NK) cells is the best explanation of their function when reviewing laboratory work for a 10-year-old child?

"The primary job of natural killer (NK) cells is to hunt down and destroy foreign cells in the body."

A client awakes after being in a coma several days following a traumatic head injury. The client is able to give the family a detailed account of what was said at the bedside while theclient was in a coma. The family asks the nurse, "How is this possible?" Which response is most accurate?

"The thalamus can interpret highly emotional auditory experiences and remember them."

A mother brings her child to the pediatric clinic because of irritability, loss of appetite, low-grade fever, pallor, and leg pain. Blood tests reveal anemia, thrombocytopenia, and an elevated leukocyte count with atypical lymphocytes. A diagnosis of acute lymphocytic leukemia (ALL) is confirmed with bone marrow studies. The child undergoes aggressive, high-dose chemotherapy with plans for a possible stem cell transplant. Which question is most appropriate for the nurse to ask the mother?

"When your child was born, did you save the umbilical cord blood in a blood bank?"

A client has been diagnosed with a cataract and wants to know what percentage of individuals get cataracts. The client is 78 years old. What percentage of clients over the age of 75 have cataracts?

70%

The nurse evaluating a client's blood work determines that a client has an increased risk for infection based on which lab result?

Absolute neutrophil count of 800/μL (0.80 x 109/L)

One of the stages of sleep is the rapid eye movement, or REM, stage. What is it that the brain cannot do during REM sleep?

Acquire new sensory information

The parasympathetic nervous system is part of which system?

Autonomic nervous system

A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice.

Azithromycin

A 26-year-old client who has recently traveled by airplane complains of pain in his right ear. The nurse suspects which condition?

Barotrauma

A young child has been diagnosed with amblyopia. The parents ask the nurse when treatment should be considered. At what age should treatment of children with the potential for development of amblyopia be instituted?

Before 6 years

A nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups?

Black and South Asian people

Select the option that best describes the production of T lymphocytes.

Bone marrow → thymus → lymph nodes

The nurse caring for a client in the early stage of multiple myeloma would anticipate the client to report which symptom?

Bone pain

A nurse educator is explaining basic neuroanatomy to a class of prospective nursing students. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?

CSF cushions the brain and provides a near-water medium for diffusion of nutrients.

The nurse is assessing a client's risk for sensorineural hearing loss. Which condition or situation places the client at greatest risk?

Chronic noise exposure

Which receptor type requires bright light for generation of nerve impulses?

Cones

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply.

Consume a diet rich in fruits, vegetables, and low-fat dairy products. Reduce dietary sodium intake. Stop smoking. Limit alcohol consumption.

The nurse is caring for a client who has a low level of T lymphocytes. The nurse plans care for a client with:

Decreased immune response

A nurse is caring for a newborn that has developed a low platelet count. What could be the cause?

Decreased thrombopoietin (TPO) A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem?

A parent brings a 15-year-old adolescent into the clinic, stating "I cannot wake him up in the morning. He has been late for school several times and I do not know what to do any longer." Which sleep syndrome is the nurse aware is common in adolescents?

Delayed sleep phase syndrome (DSPS)

Which of the meninges provides the major protection for the brain and spinal cord?

Dura mater

To diagnose a vestibular disorder, which test would be used that assesses the eye movements in response to vestibular, visual, and positional stimulation?

Electronystagmography

Which leukocyte is correctly matched with its function within the body?

Eosinophil—allergic reaction

Which catecholamine is formed in the adrenal gland?

Epinephrine

A nurse is caring for a client undergoing a multiple sleep latency test (MSLT). What is the purpose of this test?

Evaluate daytime sleepiness.

Which assessment findings would support a diagnosis of obstructive sleep apnea? Select all that apply.

Experiencing sexual dysfunctions Feels a need to sleep during the day Reports difficulty concentrating Morning headaches

Vision is a special sensory function that incorporates the visual receptor functions of which parts of the eye? Select all that apply.

Eyeball Optic nerve Retina

The nurse is conducting a vision assessment on a 2-year-old child. The nurse should assess for which visual ability in this child?

Fixation on an object

The nurse's plan of care for a client with multiple myeloma should include interventions to prevent:

Fractures

Which event is associated with the primary stage of syphilis?

Genital chancres

Adult strabismus is almost always of the paralytic variety. What is a cause of adult strabismus?

Graves disease

A 50-year-old man is having routine blood work done as part of his yearly physical. The doctor informs him that his good cholesterol is low. To which form of cholesterol is the doctor referring?

HDL

A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a client suspected of having a lymphoma. The nurse interprets the report as indicating:

Hodgkin lymphoma

The pathologist notes that the client has Reed-Sternberg cells. He knows that these cells are a diagnostic hallmark for which disorder?

Hodgkin lymphoma

A client tells the nurse of being able to see everything in the distance very clearly. The client has difficulty seeing clearly close up. The nurse has to document in the electronic medical record what condition for this client?

Hyperopia

A client states that she has been experiencing insomnia for several weeks and that the situation is getting worse. The client states that she will likely require prescription medications to help her sleep. Which principle will guide the primary care provider's plan of care?

Hypnotic medications should only be used on a short-term basis.

A client arrives in the clinic after having a tongue piercing performed and is unable to control the movement of the tongue. The nurse is aware that which nerve may have been damaged from the piercing?

Hypoglossal

The nurse is caring for a pediatric client who will be having bone marrow aspiration from the posterior iliac crest. The parent asks why the sternum is not used to obtain the sample as this is the site used for another relative. How does the nurse respond?

In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs.

A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem?

Increased blood viscosity

The nurse is discussing a 6-year-old pediatric client's sleep characteristics with the child's mother. The mother states that her child sometimes awakens her with fits of crying and appears to be very frightened. The mother asks the nurse what she should do when this happens. What is the most appropriate direction from the nurse?

Instruct the mother to help the child settle without trying to awaken the child.

Which type of macrophages are found in the liver?

Kupffer cells

A client's bone marrow study report reveals the findings of blast cells in the bone marrow. What does the nurse interpret this as indicating?

Leukemia

The region of the brain involved in emotional experience and control of emotional behavior is the:

Limbic system

The nurse is conducting education for a client who is scheduled to undergo diagnostic testing for non-Hodgkin lymphoma (NHL). The nurse includes information on:

Lymph node biopsy

When collecting a client's history the client states that he is receiving treatment to maintain remission from leukemia. What does the nurse document that the client is receiving?

Maintenance therapy

When conditions occur that impair retinal blood flow, such as hyperviscosity of the blood or a sickle cell crisis, what can occur in the eye?

Neovascularization

A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the client's central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely to be affected by this disease process?

Nerve conduction

During embryonic development, which structure develops into the central nervous system (CNS)?

Neural tube

The physician reviews a client's lab results and notes that the neutrophil count is 900/μL (0.90 x 109/L). This is known as:

Neutropenia Neutropenia refers specifically to an abnormally low number of neutrophils and is commonly defined as a circulating neutrophil count of less than 1000/μL (1.0 x 109/L).

The basis for assessing the function of any peripheral nerve lies in which principle?

Peripheral nerves contain processes of more than one of the four afferent and three efferent cell columns.

Progenitor cells, or parent cells, for the production of myeloid and lymphoid cells are derived from:

Pluripotent stem cells

Presbycusis is degenerative hearing loss associated with aging. What is the first symptom of this disorder?

Reduction in ability to understand speech

A client presents with gonorrhea. Which of the following is a primary nursing action?

Reporting the case to the Centers for Disease Control and Prevention

The nurse is assessing a steel mill worker who suffers from hearing loss related to exposure to loud, occupational noise. The nurse understands that this type of hearing loss is classified as which of the following?

Sensorineural hearing loss

A 26-year-old client has an absolute neutrophil count of less than 500 cells/mm3 (0.50 x 109/L) Which interpretation of this lab value is accurate?

Severe neutropenia

Which parasomnia occurs primarily in children in the non-REM stage and may result in emotional experiences that are frightening?

Sleep terrors

The nurse is teaching a client about how a vaccine can help create immunity to a virus. What information does the nurse provide?

The vaccine causes B lymphocytes to create antibodies against the virus.

A nurse working in a clinic performs screening tests for hearing loss. Which result indicates the client has hearing loss?

The client heard bone conduction longer than air conduction in the Rinne test.

The nurse is preparing to auscultate a client's blood pressure. Which information obtained from the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading?

The client just smoked a cigarette.

An adult male client's erythrocyte sedimentation rate (ESR) is 24 mm/hour. What conclusion can the nurse most plausibly draw from this information?

The client may have an infection that has not yet been diagnosed.

Which client will the nurse determine is a candidate for continuous antiviral suppressive therapy for genital herpes?

The client with more than six outbreaks this year

Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant?

Umbilical cord blood and bone marrow

Which condition or situation is a risk factor for the development of acute otitis media in a child?

Upper respiratory infection

The nurse is providing a client with education on taking the medication clozapine. The nurse includes the importance of:

Weekly blood work

A high school teenager comes to the emergency room with symptoms that include the abrupt onset of severe pharyngitis and a high fever. The teenager reports that in the previous 4 days he has "just not felt well." The nurse anticipates orders to include which of the following?

White blood cell count

The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider?

White blood cells (WBCs) 18,500/µL (18.50 x 109/L)

A client develops fever, headache, and burning/itching in the periorbital area. After a few days, a vesicular rash appears around the eyelid margins. The health care provider will likely prescribe:

antiviral medication for herpes zoster ophthalmicus.

A client seeks medical care when he wrecks his car because of poor eyesight. At the time of admission, his blood glucose level was 390 mg/dL. The client is diagnosed with diabetes (type 2). The ophthalmologist must perform an urgent intravitreal injection. The nurse explains this to the client by stating the doctor will:

put a needle with syringe into your eyeball and inject some medication to decrease active bleeding.

While walking down the street, a cat jumps out of an alley into the pathway of an adult. They note that the man's heart is "racing." This physiologic response is primarily due to:

secretions of sympathetic neurotransmitters produced in the adrenal medulla.

The nurse is examining a pediatric client who reports ear pain. As the nurse inserts the otoscope, the child begins to cough and gag. The nurse understands that this behavior is most likely related to:

stimulation of the vagus nerve.

A client is undergoing overnight testing at a sleep clinic. The client's diagnostic testing includes an electro-oculogram (EOG) and electromyelogram (EMG). Evaluation of the findings from these diagnostic tests will allow the care team to determine:

the quantity of the client's REM sleep.