Pathophysiology

During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, "What is that?" How should the nursing student reply?

"A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles."

As part of his diagnostic workup, a 77-year-old male is having his ferritin level analyzed. Which explanation by the health care provider regarding the significance and rationale for this test is most accurate?

"Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills."

Your 4-year-old patient is getting ready to start her first round of chemotherapy for treatment of neuroblastoma. What statement by the parents would indicate that they understood the pre-treatment education?

"She may not be able to get pregnant when she's older"

A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client's husband is confused as to why a disease of coagulation can result in bleeding. Which statement by the nurse best characterizes DIC?

"So much clotting takes place that there are no available clotting components left, and bleeding ensues."

A 70-year-old woman with a diagnosis of benign paroxysmal positional vertigo (BPPV) is receiving teaching from her physician about her diagnosis. The client is eager to avoid future episodes of vertigo and has asked the physician what she can do to prevent future episodes. How can the physician best respond?

"There are some exercises that I'll teach you to help reorient your inner ear and prevent vertigo."

The end result of meiosis is

4 non-identical cells

Which of the following patients are at greatest risk for the development of a deep vein thrombosis (DVT)?

A 42-year-old on estrogen replacement therapy who had surgery for colon cancer 2 days ago

Which situation can best be characterized as an example of passive immunity?

A 6-week-old infant receives antibodies from his mother's breast milk.

Which individual best exemplifies the processes of innate immunity?

A child who experienced heat and swelling of his skinned knuckles

A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?

A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins

Parminder is a 58-year-old woman who was hospitalized for an acute myocardial infarction. During her hospital stay, she develops pneumonia and is put on a ventilator. This is an example of

A nosocomial infection

When counseling a male client with suspected HIV, the nurse informs him that if the enzyme-linked immunosorbent assay (ELISA) comes back positive, then:

A second test known as the Western blot assay will be ordered to confirm positive HIV status.

Characteristics of Marfan syndrome include

A single-gene disorder Results in dangerous cardiovascular disorders Involves alteration in connective tissue Leads to skeletal and joint deformities

Eustress refers to

A stress response that promotes a positive outcome

A 26-year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced?

A tonic-clonic seizure

Zika virus is transmitted through

A vector

Tumor suppression genes cause cancer when they are

Absent from the cell

Which phenomenon would be least likely to result in activation of the complement system?

Activation of toll-like receptors (TLRs) on complement proteins.

Which of the following would increase the risk for having a fetus with Trisomy 21?

Advanced maternal age

Which of the following is a negative symptom of schizophrenia?

Affective flattening

In sickle cell disease, vaso-occlusive crisis is the result of

Aggregation of abnormally shaped red blood cells in the peripheral vasculature

Patients with Parkinson's disease exhibit

Akinesia

A 45-year-old woman with a diagnosis of shingles is experiencing an acute onset of severe neuropathic pain. Which stage of Selye's characterization of stress response is the woman most likely currently experiencing?

Alarm

A nurse working nights is constantly complaining of being tired and calls in often with complaints of being sick. What is a possible explanation for this?

Alterations in her sleep-wake cycle have decreased her immune function

Oxidative stress refers to

An excess of free radicals in the body

A pediatric health care worker is presenting education to a group of new parents on measures to prevent acute otitis media (AOM). Which topics will the provider include in this education? Select all that apply.

Avoid feeding infants while lying down and propping the bottle. Provide routine vaccinations against pneumococci and influenza. Eliminate all household smoking.

Which agent is considered risk level A in a bioterrorism event?

Bacillus anthracis

A child has been diagnosed with an autoimmune disease that predominantly affects epithelial tissue. Histologic examination should include which body parts as potential sites of involvement?

Bladder Blood vessels Epidermis

The pancytopenia associated with aplastic anemia may present with a variety of signs and symptoms including

Bleeding

Which condition is characterized by an abundance of immature B cells?

Chronic lymphocytic leukemia

A client with multiple sclerosis (MS) is frustrated by tremors associated with the disease. How should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS:

Communication being sent through neurons is slowed

The release of what substance causes leukocyte marginalization?

Cytokines

UV radiation causes damage to cells by

Damaging the DNA

Conditions that predispose the individual with sickle cell anemia to sickling include which of the following?

Decrease in oxygen saturation

Injury to the cervical spinal cord may be life-threatening because of

Diaphragmatic impairment

Your client with end-stage renal disease is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2 g/dL [82 g/L]). Twenty minutes into the first transfusion, the nurse observes the client has a flushed face, hives over upper body trunk, and is reporting pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56. What is the nurse's priority action?

Discontinue the transfusion and begin an infusion of normal saline.

A 50-year-old woman has experienced devastating consequences in her family and work life as a result of her longstanding alcohol addiction. Her levels and pathways of which neurotransmitter are likely to differ from an individual's without addiction?

Dopamine

The nurse is educating a group of clients about why routine screening for open-angle glaucoma is important. What information should the nurse should include? Select all that apply

Early intervention can prevent vision loss. Open-angle glaucoma is an asymptomatic condition. Increasing intraocular pressure damages the optic nerve.

The nurse assesses clients for the cardinal signs of inflammation. Which of the following signs does this include?

Edema Warmth Redness

Neurons that carry impulses away from the CNS are called

Efferent neurons

A patient is diagnosed with tendonitis in the left elbow. What would you expect to be the clinical manifestations of this condition given what you know about acute inflammation?

Elbow pain, swelling, limited range of motion

A 16-year-old has enlarged lymph nodes and a sore throat. His girlfriend was recently diagnosed with mononucleosis. While educating this teenager, you emphasize that infectious mononucleosis is caused by what pathogen, and usually transmitted via:

Epstein Barr virus; saliva

A nurse has been asked to do a community presentation on factors that increase the risk for development of cancer. Which factors should be included?

Family History Human papillomavirus Excess alcohol intake Autoimmune disease

Which of the following tissues has no capacity for replacing damaged cells?

Fixed cells

Your patient tells you that she is trying to get pregnant. Part of your patient education plan includes telling her that she can decrease the risk of her fetus developing spina bifida if she starts taking prenatal vitamins. Which supplement in prenatal vitamins helps to decrease the risk of this condition?

Folic acid

For a person to be considered a "carrier" of a genetic trait, they must be

Heterozygous for an autosomal recessive gene mutation

A client arrives at the emergency department with symptoms of stroke. What evidence should the nurse gather to determine if the client is a candidate for thrombolytic therapy? Select all that apply.

History of stroke Blood pressure Time of symptom onset

A client reports a bumpy raised scar around an old wound that is identified as a keloid. This occurs due to an increase in the number of cells in a tissue or organ. Which term best describes this condition?

Hyperplasia

Solutions that have a greater osmolality than the intracellular fluid are called

Hypertonic

The increase in organ size and function in response to increased workload is called

Hypertrophy

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

Hypocalcemia

Which condition in associated with hyperphosphatemia?

Hypocalcemia

A nurse is discussing the role of hypoxia in red blood cell production. Which statement by the patient reflects an accurate understanding of this information?

Hypoxia stimulates the release of erythropoietin by the kidneys

The parent of a child with allergies has been told the child will have a blood test done for immunoglobulin measurement. The nurse should tell the parent that which immunoglobulin will be tested?

IgE

Which of the following reflect the non-specific "fight or flight" response?

Increase in cognition and alertness

Hemolytic anemia may result in

Jaundice

Deficient production of clotting factors would occur if which of the following organs were injured.

Liver

Danyal is a 64-year-old patient with a history of hypertension and diabetes. They present with headache, weakness, flushed skin, and Kussmaul breathing. Their arterial blood gases include pH 7.24, PCO2 40, and HCO3 15. You determine that the patient is experiencing

Metabolic acidosis

Sharon has a history of heartburn and has had a biopsy of the cells in her esophagus. The results show the normal cells of the esophagus have been replaced by columnar cells. Which of the following describes this finding?

Metaplasia

Stan Brown is admitted with complaints of back pain. His x-ray shows multiple areas of reduced bone density with punched out lesions and vertebral fractures. His blood work shows an elevation in his serum calcium. Which of the following is most consistent with these findings

Multiple myeloma

A 30-year-old woman has presented to her family doctor reporting three distressing episodes over the last several months in which she got extremely dizzy, had loud ringing in her ears and felt like her ears were full of fluid. She states that her hearing diminishes and she feels nauseous during these episodes. What diagnosis is the physician most likely to first suspect?

Ménière disease

Steven has developed a myocardial infarction during which the heart was deprived of oxygen. Although Steven survived the myocardial infarction, cardiac cells suffered irreversible damage and death. This type of cell death is called

Necrosis

The leukocyte that migrates to the site of acute infection most quickly is the

Neutrophil

The manifestations of amyotrophic lateral sclerosis include

Normal intellectual and sensory function until death

Characteristics of the offspring of 2 parents who are heterozygous, autosomal, recessive for a given disorder include the fact that

Offspring of an affected individual have a 25% chance of inheriting the disease

Which of the following HIV-positive individuals would appropriately be given the diagnosis of AIDS?

One with a CD4 count of 250 cells/ul and Pneumocystis pneumonia

Leukemia is best characterized by

Overproduction of immature blood cells in the bone marrow

A nurse is caring for a patient who reports severe bleeding. The Nurse Practitioner prescribes a diagnostic test that would measure the time it takes the blood to clot and examine the extrinsic pathway of the coagulation cascade. Which test does the nurse expect to perform?

PT

Non-Hodgkin lymphoma is characterized by

Painless lymph node enlargement

Factors that affect the virulence of a pathogen include all of the following except

Patient age

Which of the following exposures represents the greatest risk for acquiring HIV?

Perinatal transmission from an HIV-infected mother to her fetus

Histological presentation of macrocytic, normochromic anemia is found with

Pernicious anemia

Nociceptive pain results from

Physical trauma

A patient with aplastic anemia has undergone an allogenic bone marrow transplant. Which of the following clearly suggest the existence of graft versus host disease (GVHD)?

Presence of a pruritic rash that has begun to slough off the surface skin layer

An article reporting on the total number of deaths from a particular disease is an example of

Prevalence

Mild symptoms of infection initially present during which part of the disease course?

Prodromal Stage

You are assessing your patient's foot ulcer and note that the wound bed is moist and beefy red. In which phase of wound healing is this patient's ulcer?

Proliferation

Examples of secondary prevention for cancers include which of the following

Prostate-specific antigen testing Clinical breast exam Pap smears

The nurse suspects a spinal cord injury client is developing autonomic dysreflexia. Which assessment findings would confirm the development of this complication? Select all that apply.

Pulse rate 49 Complains of a pounding headache BP 180/90

The patient has been diagnosed with post-traumatic stress disorder (PTSD) after being involved with a severe car accident that resulted in the death of a family member. This disorder includes an "intrusion" state that is experienced as

Repeated relived memories as nightmares

Your elderly patient is lethargic and confused after surgery. Vital signs are T 98.8F, oral; HR 92, regular; BP 130/88, right arm, laying; RR 8. Their arterial blood gases include pH 7.56, PCO2 22, and HCO3 15. You call the surgeon to report that your patient has

Respiratory alkalosis

Sleep apnea

Results from airway obstruction in sleep

A college junior calls his mother, a nurse, reporting "not being able to see." When questioned further, he describes the following: "A gray curtain just went down my right visual field. I don't know what to do." The nurse should recognize this symptom as which condition and have the teenager go to the emergency department immediately?

Retinal detachment

In the context of an explanation of how human growth occurs, a student is explaining to a colleague the necessity and roles of different types of RNA in protein synthesis. Which type of RNA is a result of the process of transcription?

Ribosomal RNA

Your patient fell while jogging 2 months ago, resulting in a large, wide, and deep injury to her leg that is being treated with daily wound dressings. This type of wound will likely heal by

Secondary intention

Your patient has 3+ pitting edema of the feet and has an increase in her abdominal girth. Based on this assessment, which of the following labs would be an indicator of the etiology of these conditions?

Serum albumin

What form of oral rehydration--bottled water or salty soup--is best suited for a patient with signs of clinical dehydration after 3 days of fever and vomiting?

Soup because it will provide some sodium to help hold the fluid in his blood vessels and interstitial space as well as fluids.

At the end of which phase of mitosis is cellular division completed?

Telophase

The family member of a client with bipolar disorder reports the client is in a manic phase. What instructions should the health care provider give the family member to watch for, because it can lead to harm?

The client may self-medicate with alcohol or recreational drugs.

A breast cancer patient has just learned that her tumor is T3, N2, M0. The patient asks for an explanation of this - which of the following is the most accurate?

The tumor is large and at least 2 lymph nodes have tested positive for cancer

The patient's lung biopsy has confirmed the presence of a benign tumor. Which of the following is characteristic of a benign neoplasm?

The tumor is likely slow growing and is likely encapsulated

A couple is seeking genetic counseling because they want to have a child but are concerned about having the genetic disorder, Tay-Sachs. They both test positive for the trait but have no symptoms themselves. What does the nurse recognize is the outcome of this process?

They are both carriers of the disease and can pass the disease along to their offspring if the woman gets pregnant

A nurse conducting a genetics class says that one type of RNA delivers the appropriate amino acids to the ribosome. Which type of RNA is the nurse referring to

Transfer

Protein synthesis occurs during

Translation

Jane has a severe allergy to bee stings. The last time she was stung she developed wheezing, became short of breath and developed severe urticaria. This is an example of

Type I hypersensitivity

Apoptosis is a physiologic process in which a cell

Undergoes programmed cell death

Localized erythema and warmth are caused by which part of the inflammatory process

Vasodilation

Your patient has a potassium level of 5.4 mEq/L. What signs/symptoms might you expect to see?

Ventricular arrhythmia

You are assessing a newly admitted patient. Which of the following are examples of signs of the patient's disease?

White blood cells 20,000 cells/μL Decreased skin turgor Elevated heart rate

Individuals affected by which genetic disorder are almost all male?

X-linked recessive disorders