Pharm exam 3 Prep U study

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

A hypermetabolic state

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

A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of:

An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve

The most common cause of C. botulinum in infants is:

ingestion of honey products containing C. botulinum spores.

A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

"I will have to take my medication for the rest of my life."

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

"Insulin is destroyed by the stomach contents and has to be administered by injection."

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

Which intracranial pressure (ICP) would the nurse consider a normal reading?

0 to 15 mm Hg

A client is diagnosed with infectious mononucleosis. When was this client most likely infected with the Epstein-Barr virus (EBV)?

4-8 weeks earlier

A client with small cell carcinoma lung cancer may secrete an excess of which hormone, causing an ectopic form of Cushing syndrome due to a nonpituitary tumor?

ACTH

A male client has smoked cigarettes for decades and currently drinks around 10 beers a day. His diet is high in fat and low in fiber. This morning he has arrived at the emergency department with weakness on his left side and an inability to speak. What is most likely causing his symptoms?

An ischemic stroke involving the middle cerebral artery

A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding antiepileptic medications?

Antiepileptic medications should never be discontinued abruptly.

A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:

Arms

A 14-year-old girl has been thrown from the back of a pick-up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column?

Cannot breathe on own, needs ventilator assistance

Which intracranial volume is most capable of compensating for increasing intracranial pressure?

Cerebrospinal fluid

A client's laboratory report shows the presence of the Philadelphia chromosome. Which diagnosis should the nurse suspect the client has developed?

Chronic myelogenous leukemia (CML)

An 80-year-old client with a history of heavy alcohol use is being seen by his provider for drowsiness, confusion, and headache. His family states that he fell and hit his head "several weeks ago." Which type of hematoma does the provider suspect?

Chronic subdural

Which medication is used to treat acute attacks of multiple sclerosis (MS)?

Corticosteroids

Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?

Excess ACTH production by a pituitary tumor

Loss of coordinated movement and balance is likely due to damage to which physical structure?

Extrapyramidal structures

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?

Eye health and visual acuity

The nurse is caring for a client with myasthenia gravis on the acute care unit. Which order from the physician for the treatment of pneumonia should the nurse question for administration in this client?

Gentamicin

Which neuron connects sensory and motor neurons?

Interneurons

A Vietnam War vet tells the nurse that he was exposed to Agent Orange during the war and he is concerned about his risk for cancer. The nurse responds that one cancer associated with Agent Orange exposure is:

Multiple myeloma

Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category?

Myasthenia gravis

Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding?

Paralysis

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

The nurse is performing an assessment for a client suspected of having symptoms that correlate with carpal tunnel disorder. The client states he feels a tingling sensation that radiates into the palm of the hand when the nurse lightly percusses over the median nerve. How would the nurse document this finding?

Positive Tinel sign

The transmission of impulses at the neuromuscular junction is mediated by which action?

Release of neurotransmitter acetylcholine from autonomic nerve endings

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

Chronic lymphocytic leukemia (CLL) commonly causes hypogammaglobulinemia. This makes clients with CLL more susceptible to infection. What is the most common infectious organism that attacks clients with CLL?

Staphylococcus aureus

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?

Stupor

A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the Philadelphia chromosome. This client is likely to experience:

a prolonged chronic phase of leukemia.

Graves disease

hyperthyroidism: Abnormal TSH

Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?

reading

The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that

resistance should be provided with the knee in a flexed position.

Death caused by muscular dystrophy in early adulthood is usually due to:

respiratory and cardiac muscle involvement.

A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to:

scan his bladder to make sure it is empty

A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

"With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."

Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphagia, muscle weakness and spasticity, and dysphonia?

ALS is caused by both an upper motor neuron and lower motor neuron disturbance.

The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?

Accelerated

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

Bone marrow → thymus → lymph nodes

Select the laboratory blood test that would be a used to suggest a diagnosis of muscular dystrophy (MD).

Creatine kinase

A client with type 2 diabetes experiences unexplained elevations of fasting blood glucose in the early morning hours. Which conditions can account for this effect?

Dawn phenomenon

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

Ischemic stroke

The nurse observes that the upper extremities of a client with a brain injury are abducted while the lower extremities are internally rotated. The nurse communicates which terminology during hand-off reporting?

Decorticate posturing

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 client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?

Dopamine

An emergency room nurse receives a report that a client's Glasgow Coma Scale (GCS) is 3. The nurse prepares to care for a client with which of the following?

Flaccid motor response

A sudden, traumatic, complete transection of the spinal cord results in what type of injury below the site?

Flaccid paralysis

Which topic should the nurse include in the discharge teaching plan for a client with Felty syndrome?

Handwashing

A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food?

Home-grown and canned vegetables

Guillain-Barré syndrome is characterized by which form of neuron damage?

Polyneuropathy

The diagnosis of type 1 diabetes would be confirmed by which principle?

Insulin is not available for use by the body.

Following a head injury, a client is diagnosed with intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. What additional clinical manifestations correlate with this diagnosis?

Ipsilateral pupil dilation

A nurse educator is explaining to a group of students the differences between leukemias and lymphomas. With respect to classification of these diseases, which explanation is most accurate?

Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures.

The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:

Lumbar puncture

Which of the following diseases is associated with fewer acetylcholine receptors, resulting in a lower-amplitude endplate potential, muscle weakness, and fatigability?

Myasthenia gravis

Myelinated neurons found in the central nervous system are covered by which type of cells?

Oligodendrocytes

A client admitted to the hospital with elevated blood glucose is diagnosed with type 2 diabetes mellitus. What characteristics commonly differentiate type 2 diabetes mellitus from type 1 diabetes mellitus? Select all that apply.

Onset after age 35 and obesity

The entire hematopoietic system, including the precursor erythroids, myelocytes, lymphocytes, and megakaryocytes are derived from a small population of cells. These cells are known as:

Pluripotent stem cells

A client is admitted with a suspected diagnosis of Hodgkin lymphoma (HL). Which diagnostic test would the nurse look for to confirm the diagnosis?

Presence of Reed-Sternberg cells

A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?

Psychological manifestation due to involvement of white matter of cerebral cortex

A client with a diagnosis of myasthenia gravis underwent a mastectomy. The surgery was a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which priority measure should the care team initiate immediately?

Respiratory support and protection of the client's airway

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client?

Respiratory ventilation assessment and prevention of aspiration pneumonia

Which complication of spinal cord injury is the most preventable in a paraplegic client?

Skin breakdown

A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma?

Slow Growing

An older adult has had a recent decrease in coordination, with gait being described as wide-based, unsteady, and lacking in fluidity, although the client's muscle tone appears normal. This client requires further assessment for which condition that is involved with coordination of movement?

Slow to start walking and has difficulty when asked to "stop" suddenly

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

Somogyi effect

A nurse at a long-term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the client's TIAs?

TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.

The nurse is explaining to a client's family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be:

The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will I get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?

The brain relies on blood glucose as its main energy source.

A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.

The client is achieving normal glycemic control.

A client has been recovering from a stroke for several weeks and has been reluctant to participate in physical therapy. As a result, the client has experienced disuse atrophy. The nurse should recognize that the client is experiencing the consequences of which physiologic process?

The diameter of the client's muscle cells has decreased

A client is to have a serum thyroxine and thyroid stimulating laboratory test performed to assess the baseline status of the hypothalamic-pituitary target cell hormones. When educating the client about the laboratory tests, when would the nurse inform him the test should be obtained?

before 8am

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source?

brain

The family of a multiple sclerosis client asks, "What psychological manifestations may we expect to see in our mother?" The health care provider informs them to expect which of the following? Select all that apply.

depression, inattentiveness, forgetfulness

A child with Down syndrome has been experiencing unexplained nosebleeds for the past several months. His blood tests identify blast cells in the peripheral smear. In addition to nosebleeds, this child may manifest which signs/symptoms? Select all that apply.

infections due to neutropenia Fatigue due to RBC deficiency Bleeding due to thrombocytopenia