Practice Questions patho exam 2
A client who experiences constant cloudiness of vision, sees floaters, and has an opaque lens is diagnosed with a cataract. The most appropriate treatment would be: a) Surgical lens replacement to correct vision b) Patching the affected eye until vision returns c) Daily application of Pilocarpine eye drops d) Wearing bifocal lenses to strengthen vision
A
It is often necessary to assess a client's pain. What factors would the nurse assess when assessing pain? (Select all that apply.) a) Nature and severity of pain b) Location and radiation of pain c) Spinal tract involvement and radiation of pain d) Severity and spinal reflex involvement of pain e) Spinal reflex involvement and nature of pain
AB
The nurse on the pediatric unit is implementing distraction strategies for a child who is experiencing pain. The best strategies for the nurse to implement would be: Select all that apply. a) Music b) Television c) Bubbles d) Silence e) Acetaminophen f) Games
ABCF
Which of the following is an effective treatment for phantom limb pain? Select all that apply. a) Transcutaneous electrical nerve stimulation (TENS) b) NSAIDs c) Bisphosphonates d) Hypnosis e) Nerve block
ADE
Which type of receptor is mediated through vision in dim light? a) Chemoreceptors b) Photoreceptors c) Mechanoreceptors d) Osmoreceptors
B
A nurse is teaching a patient with a history of migraines about methods to control attacks. Which of the following instructions should the patient implement when an attack starts? Select all that apply. a) Eating a high-protein snack b) Taking aspirin or an NSAID with caffeine c) Using intranasal medications if nauseated d) Resting in a darkened quiet room e) Taking a beta adrenergic blocker
BCD
Pulmonary function studies are an essential tool in the diagnosis of pulmonary disorders. A spirometer is used in these studies and through direct measurement provides valuable information on which of the following? Select all that apply. a) Residual volume b) Tidal volume c) Expiratory reserve volume d) Inspiratory reserve volume
BCD
Which are the earliest manifestations that a client is developing hypoxemia? Select all that apply. a) Confusion b) Tachycardia c) Personality changes d) Diaphoresis e) Cyanosis Submit your answer
BD
A 2-year-old child who has had otitis media (OM) for 4 months and been treated with several courses of antibiotics now appears to have some hearing loss. The nurse anticipates that the most appropriate treatment for the child would be: a) Retreating with a stronger antibiotic b) The child will need a hearing aid c) Tympanostomy tube insertion d) Monitoring for complications of OM
C
People with emphysema often have a difficult time with air trapping, which is air left in the lungs following expiration, often due to the destruction of the alveoli. Pulmonary rehabilitation educates people who suffer from this disease to use which of the following to help air leave the lungs more effectively? a) Pulmonary and scalene muscles b) Shoulder and diaphragmatic muscles c) Intercostal and abdominal muscles d) Abdominal and pelvic muscles
C
The nurse determines that the client has clubbing of the fingertips. Which is the best intervention? a) Assess peripheral capillary refill. b) Call the health care provider. c) Check the patient's O2 saturation level. d) Monitor the client's heart rate.
C
The nurse documents the presence of nystagmus when assessing a client. This can be interpreted as: a) Voluntary eye movements that preserve eye fixation on stable objects in the visual field b) Fixed eye movements that preserve eye fixation on unstable objects in the visual field c) Involuntary eye movements that preserve eye fixation on stable objects in the visual field d) Unilateral eye movement that preserve eye fixation on unstable objects in the visual field
C
The nurse is caring for a client who is now 2 days post near-drowning. The focused assessment would involve which of the following areas of the lung involved in gas exchange? a) Bronchus b) Bronchioles c) Alveoli d) Trachea
C
The nurse is teaching a teenaged client strategies to avoid recurrent ear infections. The nurse understands that further teaching is required when the client states which of the following? a) "I will use the eardrops as prescribed for me." b) "I will take my allergy medication as it has been prescribed." c) "I will dry the inside of my ears thoroughly with cotton-tipped applicators after swimming." d) "I'll wear ear plugs each time I swim."
C
What is ocular muscle imbalance resulting in "lazy eye" called? a) Myopia b) Presbyopia c) Amblyopia d) Hyperopia
C
A 6-month-old infant has been hospitalized with acute bronchiolitis. Which of the following treatments should be prioritized in the infant's care? a) Tracheotomy b) Intravenous antibiotics c) Transfusion of fresh frozen plasma d) Supplementary oxygen therapy
D
A child has developed respiratory stridor and is displaying a crowing sound. The parents ask the nurse what is causing this sound. The best response would be: a) Nasal obstruction and inhalation occurring through the mouth rather than the nares b) Pulling in of the soft tissue surrounding the cartilaginous and bony thorax c) The collapse of intrathoracic airways because of air trapping d) Increased turbulence of air moving through the obstructed airways
D
A child is brought to the emergency department struggling to breathe with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which of the following is the most likely diagnosis? a) Cystic fibrosis b) Chronic obstructive pulmonary disease c) Pulmonary embolism d) Severe asthma attack
D
A patient's history and physical document the presence of the homonymous hemianopia. The nurse interprets this as which of the following? a) Loss of different half fields in the two eyes b) Equal loss of central vision in each eye c) Bilateral loss of peripheral vision d) Loss of the same side of the visual field in each eye
D
The parents of a 6-month-old child who was born with a blocked tear duct are concerned because their child has been waking up the past few mornings with inflammation in the left eye and yellow, dried secretions preventing eye opening in spite of massaging the tear duct. The nurse would anticipate which of the following? a) The tear duct needs to be probed immediately. b) The tear duct will open spontaneously. c) The parents have not been massaging the tear duct. d) The child has developed dacryocystitis.
D
The pulmonary rehabilitation specialist is educating medical students on a respiratory disease process that causes a severe compromise in exhalation due to air trapping. Air trapping is caused by the loss of elastic recoil, especially in the alveoli, which occurs after overstretching in which of the following diseases? a) Asthma b) Chronic obstructive pulmonary disease (COPD) c) Chronic bronchitis d) Emphysema
D
Ventilation is driven by which alteration in arterial blood? a) Increased pH b) Increased HCO3 c) Decreased PO2 d) Increased PCO2
D
The nurse is performing her morning assessment on a 69 year old patient on a medical-surgical unit. Upon assessing her pupils the nurse notices that they are equal and responsive to light but not to accommodation.The nurse is aware that with aging the lens becomes thicker and its capsule less elastic so she believes this to be the case. When accommodation is diminished in an older person as a result of aging this is referred to as what? a) presbyopia b) farsightedness c) myopia d) hyperopia
a
To diagnoses a vestibular disorder, which test would be used that assesses the eye movements in response to vestibular, visual, and positional stimulation? a) Romberg test b) Electronystagmography c) Audiogram d) Caloric stimulation
B
A 26-year-old client who has recently traveled by airplane complains of pain in his right ear. The nurse suspects which condition? a) Barotrauma b) Otitis externa c) Otitis media d) Cerumen accumulation
A
A 32-year-old man reports burning, itching, photophobia, and severe pain in his right eye after swimming in a hotel pool for several days. Which symptom would distinguish that the eye condition was corneal rather than a conjunctival disease? a) Severe pain b) Burning c) Photophobia d) Itching
A
Which of the following is a risk factor for the development of acute otitis media in a child? a) Inappropriate ear hygiene techniques b) Upper respiratory infection c) Foreign object in the ear d) Repeated exposure to loud noises
B
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma? a) Cold weather b) Pet dander c) Stress d) Respiratory tract infections
B
Which of the following signs and symptoms is most indicative of Ménière disease? a) Otalgia and recurrent otitis media b) Rotary vertigo and tinnitus c) Progressive hearing loss and frequent falls d) Nausea and vomiting
B
Which of the following vision deficits is a clinician justified in attributing to the normal aging process? a) Strabismus b) Presbyopia c) Conjunctivitis d) Angle-closure glaucoma
B
A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that which of the following is the most likely cause of this infection? a) Autoimmune disease b) Community-acquired infection c) Nosocomial hospital-acquired infection d) Opportunistic infection
C
A client is experiencing acute pain. The nurse would anticipate the client to manifest: a) Hypotension b) Bradypnea c) Tachycardia d) Hyperthermia
C
A client who is being treated for chronic low back pain is using a TENS unit for relief of pain. The nurse is aware that the use of this device is considered what type of pain relief? a) A physical agent b) Distraction c) Stimulus-induced analgesia d) Biofeedback
C
A client with a history of migraine headaches tells the physician that he or she usually experiences an aura before the onset of the headache. The client is most likely experiencing: a) Lethargy b) Dysphasia c) Visual disturbances d) Dizziness
C
A client with primary lung disease has developed right heart failure. The health care provider would document this as: a) Adult respiratory distress syndrome b) Cor pulmonale c) Primary hypertension d) Cardiac tamponade
C
An elderly woman comes to the clinic complaining of seeing flashing lights and small spots. She tells the nurse that this has been going on for over 24 hours but now it is as if she sees a dark curtain whenever she opens her eyes. She asks the nurse if this means she is going to be blind.What diagnosis should the nurse suspect ? a) cataracts b) glaucoma c) conjunctivitis d) retinal detachment
D
A client is experiencing a cluster headache. The client would most likely manifest: a) Sensitivity to light b) Nausea with vomiting c) Symptoms aggravated by physical activity d) Severe pain behind the eye
D
A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing: a) Primary open-angle glaucoma b) Acute-onset wide-angle glaucoma c) Subacute angle-closure glaucoma d) Acute angle-closure glaucoma
D
A client was admitted 3 days ago and is developing signs and symptoms of pneumonia. Select the correct documentation of the diagnosis. a) Community-acquired pneumonia b) Antibiotic-resistant pneumonia c) Typical pneumonia d) Nosocomial pneumonia
D
A patient has shingles. What is the best time frame for the initiation of oral and intravenous antiviral drugs after the appearance of a rash to reduce the incidence of ocular complication? a) 4 days b) 6 days c) 5 days d) 3 days
D
During an eye assessment the nurse notes inflammation of the client's cornea. The nurse should document this as which of the following? a) Arcus senilis b) Uveitis c) Conjunctivitis d) Keratitis
D
Which of these clients' statements would be most suggestive of retinal detachment? a) "I came in today because of this bleeding in the white part of my eye." b) "All of a sudden I got the most intense pain behind my left eye." c) "This morning I woke up with the worst headache of my life." d) "I feel like there's a shadow that's blocking my vision."
D
While educating a smoking cessation class, a client asks the nurse, "If I can still get lung cancer, what should I be looking for?" Which response by the nurse is best? a) "If you start losing weight without trying and coughing up thick, yellow sputum, you should seek medical attention." b) "When you can no longer get up or have the energy to go to work [fatigue], you should make an appointment with your physician." c) "If you wake up with dried blood on your pillow, call your doctor right away." d) "The earliest symptoms relate to a chronic cough and shortness of breath."
D
An infant who was born prematurely and developed respiratory distress syndrome was placed on mechanical ventilation for several weeks. What condition should the nurse monitor the infant for related to the long-term ventilatory support? a) Bronchopulmonary dysplasia b) Bacterial tracheitis c) Spasmodic croup d) Blastomycosis
A
Complex regional pain syndrome is characterized by: a) Disproportionate pain with mobility b) Repetitious dermatome pain attacks c) Trigeminal neuralgia with facial tics d) Severe limb pain after amputation
A
A client has been diagnosed with sensorineural hearing loss. Which should the care team assess to determine a plausible cause? a) The patency of the client's eustachian tubes b) The client's recent medication use c) The presence of cerumen in the ear canal d) The client's immunization status
B
The nurse is caring for a client who has returned from surgery after having a colon resection. What is the best method for the nurse to use when administering an opioid for pain in order to optimize pain control? a) Administer the opioid if the client is becoming restless. b) Administer the opioid preemptively and before pain becomes extreme. c) If the client is asleep, wait until she awakens to administer an opioid, because sleeping clients are not in pain. d) Administer the opioid each time the client asks for it. Submit your answer
B
The nurse is caring for a client who has been diagnosed with Meniere disease. The nurse expects which of the following medications will be prescribed to manage the symptoms? a) Pantoprazole (Protonix) b) Chlorpropamide (Diabenase) c) Clopidogrel (Plavix) d) Promethazine (Phenergan)
D
The nurse learns that different types of headaches respond to different therapies. Which headache is most responsive to non-medication centered therapy? a) Cluster b) Sinus c) Migrain d) Tension
D
In contrast to acute pain, persistent chronic pain indicates which of the following? a) Imposes physiologic stresses b) Causes musculoskeletal spasms c) Is generally of short duration d) Serves as a warning system
A
A 69-year-old patient comes to the clinic for a routine checkup. Upon examination the nurse practitioner informs the patient that she has cataracts. The patient then tells the nurse that she already knew that and her physician told her that she could use bifocals and that would take care of the problem. What would be the best response by the nurse practitioner? a) "Surgery is the only effective treatment for cataracts." b) "Strong bifocal lenses can often cure cataracts." c) "You are wrong and should not listen to your doctor." d) "The doctor was correct and you are doing everything you can to help with this condition."
A
A client asks the nurse if it is possible to contract influenza by being exposed to wound secretions. On what knowledge should the nurse base her response to the client? a) Influenza transmission occurs by inhalation of droplet nuclei. b) Influenza is transmitted by exposure to urine, blood, and body secretions. c) Influenza may be contracted by touching a surface that an infected person has touched. d) Influenza transmission occurs through contact with the skin of an infected person.
A
A client had a tuberculin skin test (TST) performed as part of her immigration process and is surprised that the results are positive. How should the nurse best interpret this result? a) The client was exposed to the tubercle bacillus at an indefinite point in the past. b) The client has a genetic susceptibility to infection by M. Tuberculosis. c) The client will likely develop symptoms of primary tuberculosis within the next several months unless treated prophylactically. d) The client has had contact with a person who has active or latent tuberculosis in the past 12 to 18 months.
A
A client has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems? a) Perform transillumination and ask the client if bending forward exacerbates the headache. b) Compare the client's oral, tympanic, and axillary temperatures and order a white blood cell count. c) Take a sputum sample for culture and sensitivity. d) Palpate the client's lymph nodes and inspect the ears with an otoscope.
A
A client is being taught how to use a TENS unit .The nurse determines that teaching was effective when the client states: a) "I should take my medication and apply the TENS unit to the painful area as soon as I feel the pain." b) "Anytime that the setting on my TENS unit needs to be changed I will have to return it to the company and wait for them to deliver a new one." c) "The TENS unit is the easiest and most cost-effective way to manage my pain at home." d) "I will need to return to the doctor's office to have this TENS unit surgically implanted under my skin for the best pain relief."
A
A client on an acute medicine unit with a diagnosis of small bowel obstruction is reporting intense, diffuse abdominal pain. Which physiologic phenomenon is most likely contributing to the client's pain? a) Nociceptive afferents are conducting along the cranial and spinal nerve pathways of the ANS. b) The client is experiencing neuropathic pain. c) First order neurons are inappropriately signaling pain to the dorsal root ganglion.
A
A client who has no previous history of respiratory disease describes a sensation of shortness of breath and the feeling of not being able to pass enough air during exercise that has just developed over the past month. The client would be documented as having which of these? a) Dyspnea b) Hyperventilation c) Eupnea d) Orthopnea
A
A client with hearing loss is being seen in the clinic. Select the hearing test that would be used to help differentiate conductive from sensorineural hearing loss. a) A Weber/tuning fork test b) An audioscopic nerve impulse examination c) A simple whisper test by the examiner d) An auditory brain stem-evoked response (ABR)
A
A distinguishing feature of viral influenza is: a) Abrupt-onset, profound malaise b) Profuse watery nasal discharge c) Direct contact transmission d) Constant pounding headache
A
A female client with rheumatoid arthritis has taken high doses of aspirin for several years to control inflammatory pain. Which of the following statements leads the health care provider to suspect the client has developed ototoxicity? a) "I've been getting dizzy and light-headed. I seem to have a constant ringing in my ear." b) "When my grandchildren whisper, I can't hear a word they are saying." c) "I can't go to the movies anymore. It's so noisy, I miss half the words." d) "I almost got hit by a garbage truck. I didn't hear its backup beeper."
A
A nurse assesses a patient with a cerebral infarct for sensation. Which of the following results indicates that second-order neurons are intact? a) Patellar reflex +2 b) Dysphagia c) Flaccid hemiparesis d) Alert and oriented x3
A
A nursing student is studying the respiratory airways in the lungs, in particular the alveoli. A fellow student asks which of the following cells is most instrumental in the destruction of foreign substances that may enter the alveoli with inspired air. The most accurate response would be alveolar which of the following? a) Macrophages b) Brush cells c) Pneumocytes d) Killer T cells
A
A patient diagnosed with asthma is scheduled for a pulmonary function test. During the test, the technician instructs the patient to forcefully exhale air for 1 second to evaluate: a) Forced expiratory volume b) Maximum voluntary ventilation c) Forced vital capacity d) Inspiratory capacity
A
A severe type of headache that occurs more frequently in men than women and is described as having unrelenting, unilateral pain located most frequently in the orbit is called what? a) Cluster headache b) Tension headache c) Chronic daily headache d) Migraine headache
A
A young patient is brought to the clinic with symptoms of a runny nose, small amount of drainage from both eyes, fever, and malaise. The mother states to the nurse, "I knew she was going to be sick. That swimming pool she played in 2 days ago was filthy." What disease should the nurse suspect this child is experiencing? a) Viral conjunctivitis b) Abrasion of the cornea c) Keratitis d) Myopia
A
A young teenager is brought to the clinic for an eye exam. She has been complaining that she is having difficulty in school as she cannot see the blackboard as clearly as she used to. She tells the nurse that it is blurry. What should the nurse suspect is wrong with this child? a) Myopia b) Hyperopia c) Presbyopia d) Immature cataracts
A
An adult client has presented to the emergency department reporting symptoms of vertigo. Further assessment reveals that the client is ataxic and has facial weakness. The care team should consider which possible cause of this client's health problem? a) Brain stem ischemia b) Acute otitis media c) Auditory tumour d) Cerumen impaction
A
An elderly client is experiencing pain and is concerned about how the pain will be managed. The nurse is aware that the first line of therapy for managing pain in the elderly would be: a) Acetaminophen b) Albuterol c) Allopurinol d) Amiodarone
A
Conductive hearing loss can occur for a variety of reasons, including foreign bodies in the ear canal, damage to the ear drum, or disease. What disease is associated with conductive hearing loss? a) Paget disease b) Alzheimer disease c) Huntington disease d) Parkinson disease
A
During the admission interview the client, who is admitted with bacterial pneumonia, reveals a 20 pack per year smoking history. The nurse relates the possible cause of this pneumonia to the decreased defense of the pulmonary system caused by cigarette smoking. Smoking affects the pulmonary defense system by which of these? a) Damage or destruction of cilia b) Vasodilation of blood vessels c) Buildup of nicotine on the cilia d) Increased development of atherosclerosis
A
Dyspnea is defined as an uncomfortable sensation or difficulty in breathing that is subjectively defined by the client. Which of the following disease states is not characterized by dyspnea? a) Multiple sclerosis b) Myasthenia gravis c) Emphysema d) Pneumonia
A
Select the statement that best describes Meniere disease. a) Meniere disease is a disorder of the inner ear due to distention of the endolymphatic compartment of the inner ear, causing a triad of hearing loss, vertigo, and tinnitus. b) Meniere disease is a disorder of the middle ear due to constriction of the endolymphatic compartment of the inner ear, causing hearing loss. c) Meniere disease is a disorder of the inner ear due to distention of the endolymphatic compartment of the inner ear: the client will be asymptomatic. d) Meniere disease is a bacterial infection of the outer inner ear due to distention of the endolymphatic compartment.
A
The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections? a) Rapid onset of profound malaise b) Slow onset of fever and chills c) Rapid onset of productive cough d) Slow onset of upper respiratory symptoms
A
The health care provider suspects a newly admitted client may have a hemothorax. The client most likely experienced: a) Fractured or dislocated ribs b) Renal failure c) Pneumonia d) Congestive heart failure
A
The nurse instructs the certified nursing assistant (CNA) to be sure to turn the client every 2 hours in order to avoid pressure on the skin and avoid a pressure ulcer. What type of stimuli is the nurse encouraging the CNA to avoid? a) Mechanical stimuli b) Chemical stimuli c) Thermal stimuli d) Pain stimuli
A
The nurse is caring for a postoperative patient who is ordered to have oxygen saturation monitored. The method used to monitor the saturation of oxygen in the blood is: a) pulse oximetry. b) cardiac output. c) pulmonary function tests. d) assessment of respiratory rate every shift.
A
The nurse is describing to a new mother the health screening actions that will be performed on her infant. The client states, "I'm sure my baby's exhausted. I'd prefer to do this in a few weeks." What rationale for early hearing testing should the nurse describe? a) "If there is a hearing problem, it can be addressed right away before your baby starts to adapt to it." b) "We do these tests to ensure that all fluids from birth have been cleared from your baby's auditory canal." c) "We prioritize these tests in order to determine if any hearing damage occurred during the birth process." d) "It's actually a very easy test, so it's best to just get it out of the way now."
A
The nurse is discussing measures that a client may take to prevent barotrauma related to airplane travel. Which of the following measures will the nurse recommend during changes in air pressure? a) Swallowing b) Forcefully coughing c) Mouth breathing d) Cupping the ears with one's hands
A
The nurse is explaining to the parent of a 5-year-old that the child has otitis media with effusion (OME), noted by otoscopic exam, following an upper respiratory infection. Unlike acute otitis media (AOM), OME does not require treatment with antibiotics because it is usually which of the following? a) Asymptomatic and often self-limiting b) Asymptomatic and requires the administration of antivirals c) Very symptomatic and requires immediate intervention d) Symptomatic and the tympanic membrane is blue
A
The nurse is preparing a pediatric client for insertion of a tympanostomy tube. The nurse will teach which of the following to the parents post-procedure? a) The ears must be kept out of water. b) The child should not ride in an airplane for at least six weeks. c) No special precautions are needed. d) The child should not be exposed to loud noises.
A
The nurse is teaching a client about the treatment of open-angle glaucoma. The most appropriate information for the nurse to give the client would be: a) Administration of topical beta-adrenergic antagonists to lower the pressure. b) Oral diuretics should be administered immediately. c) To monitor vision for signs of closed-angle vision. d) Laser peripheral iridotomy is performed immediately.
A
What can the nurse assume about a child's behavior when faced with the need to repeat a painful procedure? a) A child will resist any intervention that involves contact with their body. b) Children act to avoid pain based on their memory of past painful events. c) A child will benefit from a matter-of-fact approach on the part of the nurse. d) Pain causes similar responses in people regardless of their age.
A
Which of the following nursing interventions is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo implement? a) Fall precautions b) Adminster ordered antibiotic c) Weber test d) Skin assessment
A
onopioids, such as acetaminophen (Tylenol), are the first line of therapy for managing mild to moderate pain in the elderly because they are safe. a) True b) False
A
A beta-adrenergic blocker has been prescribed for a client diagnosed with migraines. The most important information for the nurse to teach the client would be: a) "Take the medication only when feeling a migraine start." b) "Take the medication daily as you have been directed." c) "Stop this medication immediately if you have dizziness after taking it." d) "This medication will prevent you from having any more migraines."
B
A client asks if pain threshold and pain tolerance are the same. The best response by the health care provider would be: a) "Pain tolerance is the minimum intensity of pain a client will endure." b) "Pain threshold is the point at which a stimulus is perceived as painful." c) "Pain tolerance is not affected by psychological, familial, cultural, and environmental factors." d) "Pain threshold is not varied for person to person."
B
A client has developed chronic hypoxia and has developed pulmonary hypertension (HTN). The nurse recognizes that the most likely cause of pulmonary hypertension would be: a) Decreased vascular resistance in the pulmonary vessels b) Constriction of the pulmonary vessels in response to hypoxemia c) Hardening of the pulmonary vessels due to increased fat deposits d) Constant dilation of the pulmonary vessels in response to hypoxia
B
A client states that she is often "nauseous and sweaty" when she rides in the back seat of a car. The nurse should understand that the client's symptoms result from: a) confused signals from the thalamus due to environmental mismatching. b) repeated rhythmic stimulation of the vestibular system. c) the presence of mineral deposits in the vestibular system. d) overstimulation of the vestibular system due to motion.
B
A patient is diagnosed with pulmonary embolism. Which of the following symptoms would most likely be present? a) Left arm pain and diaphoresis b) Chest pain and dyspnea c) Cough and crackles d) Shallow respirations and wheezing
B
A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the backpack. Which component of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items? a) A slow-conducting pathway that projects into the intralaminar nuclei of the thalamus b) The primary dorsal root ganglion neuron, dorsal column neuron, and the thalamic neuron c) The opposite anterolateral pathway that travels to the reticular activating system d) A bilateral, multisynaptic, slow-conducting tract
B
Amblyopia, or lazy eye, occurs at a time when visual deprivation or abnormal binocular interactions occur in visual infancy. Whether amblyopia is reversible depends on what? a) The child has to be able to wear contact lenses. b) Maturity of the visual system at time of onset c) The child has to be older than 5 years. d) The child has to have bilateral congenital cataracts.
B
Clients who have been bed-ridden for a long time likely will experience: a) A sharp increase in surfactant levels that will require frequent suctioning b) Shallow, quiet breathing, which impairs the spreading of surfactant c) An inability to produce sufficient amounts of surfactant and may require recombinant forms d) Increase in their depth of breathing, which increases lung volumes causing more surfactant to spread out over the alveolar surfaces
B
Cortical blindness is the bilateral loss of the primary visual cortex. What is retained in cortical blindness? a) Phytosis b) Pupillary reflexes c) Red spots seen behind the eyelids d) Myopia
B
The nurse is assessing a patient's risk for sensorineural hearing loss. Which of the following places the patient at greatest risk? a) Nystagmus b) Chronic noise exposure c) Otitis media d) Impacted earwax
B
The nurse is caring for a client who is hearing impaired. The nurse understands that effective communication with the client includes which of the following? a) Shouting in a loud voice b) Facing the client so that the client can visualize the lips c) Performing hand gestures d) Using exaggerated lip movements
B
The nurse is caring for a client who reports, "My ears are constantly ringing!" The nurse will evaluate the client further for the use of which of the following medications? a) Acetaminophen (Tylenol) b) Acetylsalicylic acid (aspirin) c) Potassium chloride d) Vitamin C
B
The nurse is working at a first aid station in an amusement park. A 45-year-old client arrives reporting severe dizziness after a ride on the roller coaster. The nurse understands that a common cause of this sensation is which of the following? a) Otosclerosis b) Benign paroxysmal positional vertigo c) Barotrauma d) Acute otitis media
B
The nurse understands that vestibular rehabilitation includes which of the following? a) Visual focusing techniques b) Exercises in balance retraining c) Stress reduction d) Herbal remedies
B
A client 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? a) "Unfortunately there aren't any proven treatments for your condition." b) "We usually don't actively treat BPPV unless it starts to affect your hearing." c) "There are some exercises that I'll teach you to help reorient your inner ear and prevent vertigo." d) "Although they involve some risks, there are some options for ear surgery that can prevent future vertigo." Submit your answer
C
A nurse caring for a client with renal failure and associated malignant hypertension is concerned that the client may suffer partial or total visual loss due to papilledema noted on examination. The nurse realizes that papilledema is: a) an early indication of retinopathy and decreased intracranial pressure. b) indicative of the potential of hypertensive crisis. c) a late sign and often indicates severe increase intracranial pressure. d) an early sign for the development of glaucoma.
C
A nurse who is testing a patient's response to passive movement of the fingers with the patient's eyes closed, notes that the patient cannot accurately identify on which side the movement occurred or in what position the finger was placed. Which of the following is an appropriate interpretation of this result? a) Intact thermal sensations b) Normal reflex function c) Abnormal discrimination pathway function d) That the sense of proprioception is intact
C
A patient has been diagnosed with bacterial conjunctivitis. This type of infection is usually characterized by large amounts of what color drainage? a) Pink-red b) Serous c) Yellow-green d) Blue-yellow
C
A patient is having difficulty with balance. The nurse understands that the area of the ear that impacts balance is which one of the following? a) Tympanic membrane b) Malleus c) Vestibular apparatus d) Cochlea
C
A young child is brought to the ER with CPR in progress. The parent found the child lying on the kitchen floor without respirations, although a heartbeat was initially detected. The triage nurse anticipates the most likely cause of the situation is an obstruction of the conducting airways which caused an interruption in a) diffusion. b) exhalation. c) ventilation. d) inhalation.
C
Adverse effects of emboli on pulmonary circulation and airways include which of the following? a) Lower lobe consolidation b) Excess surfactant c) Local vasoconstriction d) Area bronchodilation
C
Children feel pain just as much as adults do. What is the major principle in pain management in the pediatric population? a) Base treatment of pain on gender and age group. b) Always use nonpharmacologic pain management before using pharmacologic pain management. c) Treat on individual basis and match analgesic agent with cause and level of pain. d) Treat pediatric pain the way the parents want it treate
C
One of the neurotransmitters between the nociceptive neurons and the dorsal horn neurons is a major excitatory neurotransmitter. What is this neurotransmitter? a) Norepinephrine b) Substance P c) Glutamate d) Dopamine
C
The students are reviewing the anatomy of the eye and where the eye structures are located. Where is the anterior chamber located? a) Posterior segment of the globe b) Choroid c) Anterior segment of the globe d) Retina
C
Which of the following best describes the pressure that drives breathing? a) Pressure inside the airways and alveoli of the lungs b) Difference between the intra-alveolar and intrapleural pressures c) Pressure in the pleural cavity d) Pressure in the thoracic cavity
C
Which of the following characteristics of the lungs of infants and small children creates an increased risk of respiratory disorders? a) There are fewer chemoreceptors in the young medulla. b) The pneumotaxic center in the pons in underdeveloped until 8 years of age. c) Smaller airways create a susceptibility to changes in airway resistance and airflow. d) Type II alveoli in children may overproduce surfactant. Submit your answer
C
Which of the following patients is exhibiting headache symptoms that indicate a need for further evaluation? a) College student with unilateral headache after eating a chocolate bar b) Older adult with a headache after missing the evening meal c) Pregnant mother with drowsiness and unrelenting headache d) Parent with general head pain after a night caring for an ill child
C
Which of the following statements is true of migraine headaches? a) The majority of patients have a migraine with aura. b) Surgical treatments for migraines are indicated if pharmacologic treatments are unsuccessful. c) Migraines may have a hormonal etiology in some patients. d) Opioid analgesics achieve adequate pain control in most patients.
C
While administering influenza vaccines for the general public, the nurse will advise which clients to avoid taking the flu shot? Select all that apply. a) Client who has pain at the injection site b) Client who recently got over a cold with running nose and cough but not fever c) Client with allergy to eggs d) Client who is HIV positive e) Client with Guillain-Barre syndrome
CE
A client who is being treated in the critical care unit is experiencing a slowing of blood flow to the central retinal artery, ultimately resulting in edema of the client's optic papilla. Which assessment would most likely address the etiology of this health problem? a) Monitoring of the client's mean arterial pressure b) Culture and sensitivity testing of the client's eye exudate c) Palpation for cervical lymphedema d) Monitoring of the client's intracranial pressure
D
A client who is being treated in the critical care unit is experiencing a slowing of blood flow to the central retinal artery, ultimately resulting in edema of the client's optic papilla. Which assessment would most likely address the etiology of this health problem? a) Palpation for cervical lymphedema b) Monitoring of the client's mean arterial pressure c) Culture and sensitivity testing of the client's eye exudate d) Monitoring of the client's intracranial pressure Submit your answer
D
A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happened. The nurse states, "For unknown reasons, you lose intrapleural negative pressure. a) You must have coughed too forcibly and your air sacs burst." b) You must have a genetic anomaly causing weakened alveolar sacs to rupture." c) You must have experienced a forced expiration against a closed glottis to cause the lung to deflate." d) This means your lungs collapsed and expelled its air when you lose negative pressure."
D
A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which of the following most likely had the greatest impact on development of the lung cancer? a) Radiation b) Air pollution c) Asbestos d) Cigarette smoke
D
A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis and has subsequently developed latent tuberculosis infection. Which of the following is true of this nurse? a) The nurse is now immune to more severe tuberculosis infection. b) The nurse can spread tuberculosis to others. c) The nurse has active tuberculosis infection. d) The nurse is likely asymptomatic.
D
A parent calls 911 and states her child is having trouble breathing. The child is rushed to the emergency department. Upon assessment, the child appears pale, toxic, and lethargic and assumes a distinctive position—sitting up with the mouth open and the chin thrust forward. The parent states that the child just developed a sore throat and fever today. The health care provider determines that the child is experiencing: a) Pneumonitis b) Tracheobronchitis c) Bronchitis d) Epiglottitis
D
A patient with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior-posterior chest diameter. Which of the following terms should the nurse use to document this finding? a) Blue bloater b) Pneumothorax c) Pink puffer d) Barrel chest
D
A social worker is counselling the family of an 85-year-old woman who has just been diagnosed with non-small cell lung cancer. What concerns should she convey to the family regarding the unintended effects of treating the disease? a) The elderly cannot metabolize chemotherapeutic agents, resulting in a buildup of medication. b) The elderly cannot tolerate radiation, and therefore it is not used. c) The client will react to the therapy exactly the same as a younger client. d) Surgical treatment may have the consequence of weakening the client.
D
Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes: a) loss of consciousness. b) permanent hearing loss. c) light-headedness. d) an illusion of motion.
D
An individual has sensitivity to perfumes and experiences shortness of breath when exposed to them. This occurs because: a) toxins can compete with oxygen for hemoglobin-binding sites. b) certain chemicals in artificial scents disrupt gas diffusion c) a type III hypersensitivity reaction is caused. d) stimulation of irritant receptors causes bronchoconstriction.
D
An older adult tells the nurse, "My friend just developed shingles and has a lot of pain. Is there a way for me to protect myself from it?" Which of the following is an appropriate response from the nurse? a) "Use antiviral drugs as soon as you are exposed." b) "Apply a topical anesthetic agent." c) "Avoid children and people with shingles." d) "Get a Zostavax vaccination."
D
Chronic obstructive pulmonary disease (COPD) is a combination of disease processes. What disease processes have been identified as being part of COPD? a) Chronic obstructive bronchitis and asthma b) Chronic bronchitis and emphysema c) Emphysema and asthma d) Chronic obstructive bronchitis and emphysema
D
In comparison to children with acute otitis media (AOM), those with otitis media with effusion (OME) have: a) Earache and fever b) Sensorineural hearing loss c) Systemic infection d) Excess middle ear fluid
D
Select the most appropriate pain assessment tool for a health care provider to use when caring for children between the ages of 3 to 7 years old. a) Behavioral distress scale b) Word graph scale c) Numeric pain scale d) Faces pain scale
D
Sites of referred pain are determined by which of the following? a) Location of the noxious stimuli b) Intensity-coding receptors c) Stimulation that activates C fibers d) Visceral embryonic development
D
The health care provider is reviewing the results of a client's caloric test. The results were as follows: the client's eyes exhibited a jerk nystagmus lasting 2 to 3 minutes, with the slow component toward the irrigated ear followed by rapid movement away from the ear. This would be interpreted as: a) A nonfunctioning brain stem that requires immediate surgical intervention b) A brainstem that has been altered by medication c) A nonfunctioning brain stem d) A functioning brain stem
D
The nurse caring for a client with bilateral rib fractures explains to the client that the pain causes him to take more shallow respirations which will contribute to feeling SOB due to a a) Increased total lung capacity. b) Increased vital capacity. c) Decreased residual volume. d) Decreased tidal volume.
D
The nurse is caring for an elderly client with a suspected diagnosis of presbycusis. Select the most likely manifestation that the nurse would note. a) Feeling a continuous drainage coming from both ears b) Buzzing or ringing in the ears c) Feeling of continuous pressure in both ears d) Inability to understand words during a conversation
D
The nurse is conducting a community education class on amblyopia. The nurse determines that the participants are understanding the concepts when they identify which of the following as the time when amblyopia is generally diagnosed? a) After an eye injury b) Young adulthood c) Adolescence d) Infancy
D
The nurse is performing an eye assessment on a client who presents with a redness in the right eye. The nurse determines that the redness is related to bacterial conjunctivitis versus acute glaucoma based on which of the following additional symptoms? a) Cloudy, painful corneas b) Blurred or iridescent vision c) Mydriasis and headaches d) Tearing, itching, and burning
D
The nursing student who is studying pathophysiology correctly identifies the condition that characteristically has an increase in the aqueous humor which fills the anterior and posterior chambers of the eye as which disease? a) retinopathy b) amblyopia c) cataract d) glaucoma
D
The spouse of a client with a history of chronic alcohol abuse tells the nurse that her spouse has no difficulty speaking and responds when spoken to but is having difficulty understanding what is being said. The spouse asks if the nurse believes the client needs a hearing aid. The nurse explains to the spouse that the client probably does not require a hearing aid but may be suffering from which of the following? a) Global aphasia b) Expressive aphasia c) Moderate hearing loss d) Receptive aphasia
D
When a client reports that he feels like he is spinning but the room is stable, the nurse should document the finding as which of the following? a) Fainting b) Objective vertigo c) Blacking out d) Subjective vertigto
D
Which cranial nerve is designated as the vestibulocochlear nerve? a) Cranial nerve III b) Cranial nerve IV c) Cranial nerve VI d) Cranial nerve VIII
D
Which of the following acute respiratory infections in children poses the greatest threat of severe hypoxia caused by inflammatory edema? a) Asthma b) Bronchiolitis c) Croup d) Epiglottitis
D
Which of the following clients may be experiencing the effects of neuropathic pain? a) A man whose pain is caused by gastric cancer b) A girl whose playground accident resulted in an arm fracture c) An elderly woman with a stage III pressure ulcer d) A man with pain secondary to his poorly controlled diabetes
D
Which of the following will conduct injurious stimuli to alert the body of potential damage? a) Odorant b) Proprioceptors c) Thermoreceptors d) Nociceptors
D
With which of the following activities would a patient experiencing astereognosis need help? a) Recognizing faces b) Maintaining bladder continence c) Chewing and swallowing food d) Identifying an object by touch
D
he nurse is working with a client who has been diagnosed with recurring migraine headaches. Which advice by the nurse is most appropriate? a) "It's likely in your best interests to move to a rural setting and explore getting a lower stress job." b) "Migraines are poorly understood and are generally considered unavoidable, so always have your medication with you." c) "Migraine headaches usually respond poorly to medication, so I can help you explore nonpharmacologic options." d) "Many people find that maintaining regular eating and sleeping habits is beneficial."
D
