2022 Patho Exam 2

Typical symptoms seen in the latent period of HIV infection include which of the following

No signs or symptoms

The nurse is assessing a client who has experienced a seizure. The client describes having a feeling or warning that the seizure would occur. Which term does the nurse use when documenting about this perceived warning?

prodrome

The nurse is preparing a client for a surgical procedure to create an endolymphatic shunt. The nurse understands that this procedure aims to relieve which symptom?

vertigo

The nurse understands that movement of otoliths may result in:

vertigo and nystagmus.

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 pregnant client is in labor and the obstetrician suspects that the fetus has developed an infection in utero. If an infection was present, which labs test would be elevated in the fetus at birth?

IgM

The nurse is reviewing the functions of immunoglobulins and determines which immunoglobulin is associated with its correct action?

IgM, the first antibody to be produced by a developing fetus.

A nurse caring for a client with a head injury is concerned that respirations are 30 breaths per minute. Which physiologic factor will affect cerebral blood flow?

Decreased carbon dioxide level

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?

Elevated atrial natriuretic hormone

A client is diagnosed with metabolic syndrome. Frequent concomitants of this syndrome include which of the following? Select all that apply.

Elevated fasting plasma glucose (FPG) Coronary artery disease Hypertriglyceridemia Body mass index (BMI) greater than 30

Keratitis can be caused by different infectious agents. What is the treatment goal with herpes simplex virus keratitis?

Eliminating viral replication within the cornea

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

Excess ACTH production by a pituitary tumor

The nurse is suctioning a client with a C3 spinal cord injury when the client's heart rate drops from 86 bpm to 42 bpm. What intervention does the nurse understand should be provided prior to suctioning to prevent this vasovagal response from occurring?

Hyperoxygenate prior to suctioning.

Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?

Hypothalamus

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?

Hypothalamus

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory immunoglobulin (Ig) that is found in the colostrum?

IgA

Which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces?

IgA

A client experiences an allergic reaction. Select the immunoglobulin that would bind to mast cells and release histamine.

IgE

The nurse is providing care for a client whose abrupt-onset hypersensitivity reaction was stimulated by an antigen challenge. The nurse should understand that this reaction is:

IgE-mediated.

Infants are born with a passive immunity that occurs when immunoglobulin antibodies cross the placenta from the maternal circulation prior to birth. Which immunoglobulin is capable of crossing the placenta?

IgG

The nurse is aware that the only class of immunoglobulins to cross the placenta is:

IgG

An individual experiencing spinal cord damage (SCD) is at high risk for developing deep vein thrombosis (DVT) and pulmonary emboli (PE) due to which pathophysiologic cause? Select all that apply.

Impaired mobility Impaired vasomotor tone Hypercoagulation of blood Stasis of blood flow

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the client's temperature is 102°F (38.9°C). Which other clinical manifestations may lead to the diagnosis of encephalitis?

Impaired neck flexion resulting from muscle spasm

The nurse is conducting a community education class on amblyopia. The nurse determines that the participants understand the concepts when they identify which time period as the time when amblyopia is generally diagnosed?

Infancy

The nurse is teaching a new mother about caring for her baby and reducing the risk for infection. On what principle does the nurse base the knowledge of passive immunity?

Infants are protected at birth from infection by maternal IgG.

The immune suppressive and anti-inflammatory effects of cortisol cause:

Inhibition of prostaglandin synthesis

A client comes to the emergency room concerned about infection after being cut on the hand by a piece of glass; the skin surrounding the wound is red, warm and painful. After assisting with suture insertion, the nurse develops discharge instructions to include which information on the body's natural defenses? Select all that apply.

Innate immunity is the body's first line of defense. The epithelial layers of the skin provide innate immunity. Redness, heat, pain and swelling are part of the normal inflammatory process.

Which metabolic abnormality can lead to the development of type 2 diabetes?

Insulin resistance

The nurse is admitting a client documented to have papilledema. The nurse recognizes that papilledema is most commonly caused by which condition?

Intracranial pressure

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

The nurse is conducting a Weber test on a client diagnosed with a conductive hearing loss. The nurse anticipates that the client will report that the sound has what qualities?

Is louder on the side with the hearing loss

Why is it important for a client with a diagnosis of papilledema to follow up with a health care provider?

It is associated with visual loss.

Which items would be included in implicit memory? Select all that apply.

It is largely unconscious It includes somatic memories. It includes emotional memories. It includes motor memories.

During an eye assessment the nurse notes inflammation of the client's cornea. The nurse should document this as which condition?

Keratitis

The nurse assessing a client with meningitis should assess which postures for signs of meningeal irritation? Select all that apply.

Kernig sign Brudzinski sign

Although there are over 40 neurotransmitters, those that are the most familiar and important for psychiatric disorders are all of the following except:

Renin

A client's family reports to the nurse that the client—who had previously been outgoing and easygoing—has become angry and withdrawn. Which intervention by the nurse would be most appropriate?

Report the change to the health care provider

The student nurse is reviewing a client chart in preparation for a clinical experience. The student sees the term nummular to describe the client's lesion. What would describe a nummular lesion?

Round, coin-like

Hearing impairment, blindness, and adverse neurodevelopment in newborns can be prevented by immunization against which childhood disease?

Rubella

A nurse is evaluating client histories for potential substance abuse. Which factors in a client's history may indicate an increased risk for substance abuse? Select all that apply.

Schizophrenia Major depression

While working in the newborn nursery, a nurse is assessing a new admission. The nurse notes the infant has an increased distance between his eyes, a very small jaw, and a split uvula. Thinking this infant might have DiGeorge syndrome, the nurse should be assessing this infant for which electrolyte imbalance?

Tetany due to hypocalcemia

A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which pathophysiologic condition has contributed to this client's diagnosis?:

Weakness in the muscular wall of an artery

The nurse is performing a health history for a 72-year-old client. When reviewing the client's medications, the client states, "I take a baby aspirin every day, but I'm worried. I heard that aspirin can cause hearing problems!" What is an appropriate response by the nurse?

"A baby aspirin is a low dose that is considered to be safe."

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?

"A single hormone can act on not only one process or organ but often on several different locations or processes."

When a client who has been newly diagnosed with HIV asks, "What are the chances that I can be cured?," what is the nurse's most therapeutic response?

"Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:

"Because the skull sutures are not fused there may be no brain damage."

The nurse is caring for a client who has been diagnosed with presbycusis. The nurse understands that with this disorder, the client experiences which of the following?

Difficulty hearing high-pitched frequencies

A nurse is caring for a client with high-level paraplegia with known vasovagal response associated with severe bradycardia. Which preventive measure should not be included in the treatment plan for this client?

Discouraging use of stimulants such as caffeine

Which hormone is produced by the anterior pituitary gland

Growth hormone (GH)

The school nurse is preparing a lecture on the human immunodeficiency virus (HIV) for high school students. The nurse includes which information about the transmission of HIV? Select all that apply.

HIV is transmitted through sexual contact. HIV is transmitted through blood-to-blood contact. HIV is transmitted from the mother to the unborn baby.

Which visual deficit is a clinician justified in attributing to the normal aging process?

Presbyopia

A nurse is caring for a child who has had a history of recurrent severe infections that have been resistant to treatment with antibiotics. Which disorder should be suspected in this child?

Primary immunodeficiency disorder (PID)

Which process that contributes to immunity takes place in a child's thymus gland?

Production of mature, immunocompetent T lymphocytes

A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?

Prolactin

What is the priority intervention for a nurse caring for a client with wasting syndrome from AIDS?

Promote nutritional intake.

The nurse is planning care for a client with a diagnosis of primary immunodeficiency. What is the priority intervention to incorporate into the plan?

Protecting the client from infection

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dL (4.72 mmol/L)

A client is having difficulty with sleeping and has also been experiencing marital difficulties over the past couple of months. The client tells the nurse at the physician's office that all this started after he had a car accident earlier that year. What would be the most important question for the nurse to ask?

"Did you sustain any injuries in the accident?"

The educator of a geriatric unit is orienting new staff and is teaching strategies on communicating with older adults with impaired hearing. Which teaching point is most appropriate?

"Ensure that the hearing aid is in place, turned on, and properly functioning."

Which statement from a group of young adults demonstrates the need for further teaching related to HIV and prevention of the spread of HIV?

"Having oral sex is one way I can prevent passing on HIV to my partner."

Which of these clients' statements would be most suggestive of retinal detachment?

"I feel like there's a shadow that's blocking my vision."

The employee health nurse is working with a nursing student who has just sustained a needlestick injury and has received a dose of hepatitis B immune globulin. The nurse is counseling the student about vaccination against hepatitis B. Which statement by the student indicates understanding?

"I need to start the hepatitis B vaccination series as soon as possible."

An older adult client has been diagnosed with macular degeneration. Which statement by the client best demonstrates an accurate understanding of the new diagnosis?

"I suppose that this may be one of the things that happens when you get older."

The family of a male client documented to be in a vegetative state excitedly reports to the nurse that the client has just opened his eyes for the first time. The best response by the nurse is:

"I will come and assess the client.

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?

"If there is a hearing problem, it can be addressed right away before your baby starts to adapt to it."

The nurse is administering a childhood vaccine to a pediatric client. The mother asks the nurse why the child needs so many vaccinations. How should the nurse respond?

"Immunization is an important means of inhibiting the spread of infection by decreasing your child's susceptibility to the infection."

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 being treated for diabetes type 2 with insulin presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high). Which response by the client may account for this abnormal laboratory result?

"My meter broke so I have not been checking my blood glucose levels for a while."

While conducting client education at a public health clinic, a nurse teaches about sexually transmitted disease prevention. Included in the education is a segment on HIV/AIDS. Which statement from a client would indicate that more teaching is needed?

"Natural or lambskin condoms are as protective as latex condoms."

What would be the best response to the mother of two teens who have been diagnosed with scabies?

"One of your children probably had direct contact with an infected person."

The adult child of a client with end-stage Alzheimer disease asks the nurse if Alzheimer disease can be passed on to him or her. What is the nurse's most accurate response?

"Research supports a possible genetic link with an early onset

A pregnant client who has HIV asks the nurse if her baby will have the disease. The best response would be:

"The baby will test positive for the HIV antibody test result, although the child may not necessarily be infected with the virus."

A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse?

"The prognosis of the child depends on an improvement in behavior and catch-up growth."

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?

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

The spouse of a client who has been in a long-term care facility for a few months due to a brain injury that caused a vegetative state asks the nurse why the client is still being fed through the gastrostomy tube. What is the nurse's best response?

"To avoid aspiration into the lungs."

A 24-year-old pregnant client presents to the clinic for her second prenatal visit. The results of her ELISA test are positive. Which statement by the nurse projects the best way to counsel this client?

"We will need to wait for the Western Blot results to confirm the diagnosis of HIV."

A client reports occasional ringing in the ears that worsens toward the end of the day. The most important question for the nurse to ask would be:

"What prescription medication and over-the-counter medication do you take?"

The nurse is caring for a client who has just learned that he is HIV positive. The client asks the nurse how long he has been able to infect others. Select the best response by the nurse.

"You can infect others before the HIV antibody is detectable in your blood."

A client asks "Why do I have albinism?" What is the nurse's best answer?

"You inherited this disorder."

The spouse of a client diagnosed with Alzheimer disease asks the nurse why the client often neglects to take a shower. The spouse states that the client was always diligent with hygiene in the past; however, over the past few months that has not been the case. What is the nurse's best response?

"You should remind the client to shower."

Shortly after being diagnosed with HIV, a client has begun highly active antiretroviral therapy (HAART). The client asks, "My doctor tells me that my viral load is going down. What does that mean?" The nurse's best response is:

"Your HAART medications are working to slow the progression of the disease."

A client reports being struck in the eye by flying debris falling off a building being demolished. Following fluorescein staining and use of biomicroscope, it is determined the eye has an injury to the Bowman membrane and stromal layer. Which explanation should the nurse provide to the client regarding the extent of this injury?

"Your eye will heal slower with scar formation that impairs the transmission of light to some extent.

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated loss of which physiologic function?

Acetylcholine receptors

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

0 to 15 mm Hg

What is the length of time from infection with HIV to seroconversion?

1 to 3 months

According to the Glasgow Coma Scale, opening one's eyes to only painful stimuli would receive which score?

2

Which manifestation indicates a client is at risk for developing diabetes mellitus?

2 hour oral GTT 175 mg/dL (9.7 mmol/L)

The molecules that are recognized as foreign on allografts are called:

Alloantigens

Which hearing test would be prescribed to help differentiate conductive from sensorineural hearing loss?

A Weber (tuning fork) test

The nurse is reviewing assessment data and determines which client is at highest risk for developing type 2 diabetes?

A 45-year-old obese female with a sedentary lifestyle

What is the most common cause of progressive dementia?

Alzheimer disease

Which client has the highest risk of contracting an opportunistic infection?

A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL

Which client is at the greatest risk for developing an intracellular pathogen infection?

A client with AIDS who has a decreased CD4+ TH1 count

Select the category of hormones that include norepinephrine and epinephrine.

Amines and amino acids

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.

Anticonvulsive medications are used in the treatment of bipolar depression. What other drug is used to treat bipolar disorder?

Lithium

A child with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. The child has a brief loss of contact with the environment and then is ready to resume normal activity. What type of seizure did this client most likely experience?

Absence seizure

When pupillary dilation partially compensates for the reduced size of the retinal image by increasing the light entering the pupil, this is a component of which eye adjustment?

Accommodation

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Action of releasing hormones from hypothalamus

The nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics

A 42-year-old client reports increasing difficulty reading the labels on packages. He states that he has to continually hold it further and further away from his face in order to see the type clearly. Which eye disorder is this client most likely experiencing?

An age-related change in accommodation.

Some members of the population are so sensitive to certain antigens that they react within minutes by developing itching, hives, and skin erythema, followed shortly thereafter by bronchospasm and respiratory distress. What is this near-immediate reaction commonly known as?

Anaphylactic reaction

Hormones can be synthesized by both vesicle-mediated pathways and non-vesicle-mediated pathways. What hormones are synthesized by non-vesicle-mediated pathways?

Androgens and estrogens

The students are reviewing the anatomy of the eye and where the eye structures are located. Where is the anterior chamber located?

Anterior segment of the globe

The cells that mediate humoral immunity do so because they are capable of producing:

Antibodies

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Antidiuretic hormone (ADH) and oxytocin

Substances foreign to the host that can stimulate an immune response are known as:

Antigens

The nurse is evaluating an client who is a baby boomer. Which assessments regarding mentation will the nurse need to perform knowing this generation has a high rate of alcohol and drug use? Select all that apply.

Any recent falls Declining vision and hearing Ask about sleep problems

The nurse caring for a client with an epidural hematoma recognizes the bleeding is associated with which physiological finding?

Arterial tear

A client has been admitted to the hospital for the treatment of HIV infection, which has recently progressed to overt AIDS. Which nursing action should the nurse prioritize when providing care for this client?

Astute infection control and respiratory assessments

When hormones act locally rather than being secreted into the bloodstream, their actions are termed:

Autocrine and paracrine

Select the statement that best describes autoimmune disease.

Autoimmune diseases represent a disruption in self-tolerance that results in damage to body tissues by the immune system.

A client presents with copious amounts of yellow-green drainage, conjunctival redness, and chemosis to the right eye. A culture of the eye drainage reveals S. pneumoniae. The client most likely developed:

Bacterial conjunctivitis

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

Barotrauma

The early management recommendations for an asymptomatic person confirmed to have HIV antibodies would consist of which intervention?

Baseline screening for viral load and CD4+ counts

A diagnosis of acquired immunodeficiency syndrome (AIDS) is identified when the CD4+ T cell count reaches which level?

Below 200 cells/μL

A client reveals that, when in bed, changes in head position cause brief periods of vertigo, usually lasting less than 1 minute. Which condition is the client most likely experiencing?

Benign paroxysmal positional vertigo

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:

Benign paroxysmal positional vertigo

Acne vulgaris is typically an infection in the adolescent population. What topical agent used in the treatment of acne is both an antibacterial and a comedolytic?

Benzoyl peroxide

Which statement about acquired immunodeficiency syndrome (AIDS) is true?

Both B-cell and T-cell function are affected.

Which cardinal assessment finding would lead the nurse to suspect a client has developed Parkinson disease?

Bradykinesia

A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:

Brain death

A client with acromegaly comes to the clinic and informs the nurse that she is having a productive cough and a low grade fever. This is the client's fourth visit in 1 year for the same problem. What condition does the nurse understand results from this client's enlarged cartilaginous structures?

Bronchitis

Physical changes associated with lipodystrophy related to HIV infection include which manifestations? Select all that apply.

Buffalo hump Breast enlargement Increased abdominal girth

At which level of the cervical spine would a complete cord injury result in the client retaining the ability to flex and extend the fingers?

C8

Which of these is an AIDS-defining condition?

CD4+ count less than 200 cells/μL

Which complication of acromegaly can be life threatening?

Cardiac structures increase in size

When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which functions in the brain? Select all that apply.

Causes ischemia to build up lactic acid due to anaerobic metabolism Allows cells to increase volume to the point of rupture, damaging neighboring cells

A client presents to the urgent care and tells the health care provider he came home from vacation 4 days ago and does not feel well. Upon assessment, the provider notes the client's right upper thigh area is red, warm, and painful, and the lymph nodes are palpable. The client states he had been swimming in a lake all week. The health care provider recognizes these manifestations as:

Cellulitis

A hospitalized client with diabetes mellitus has sudden onset of slurred speech; lack of coordination; and cool, clammy skin. What will the nurse do first?

Check blood glucose.

The nursing instructor is teaching a class on diabetes and discusses complications of the disease. The instructor further states that diabetic retinopathy is one of the leading causes of blindness. What does the instructor tell the students are major risk factors for developing diabetic retinopathy? Select all that apply.

Chronic hyperglycemia Hypertension Smoking

A client's emergency room report includes the presence of a contrecoup injury. The nurse plans care for a client with which of the following?

Closed head injury opposite the area of impact

What is the term for a subset of cytokines that stimulate the production of large numbers of platelets, erythrocytes, lymphocytes, neutrophils, and monocytes, eosinophils, basophils, and dendritic cells?

Colony-stimulating factors (CSFs)

A client has had recurrent infections with the encapsulated bacteria, Streptococcus pneumoniae. This is characteristic of which type of deficiency?

Complement deficiencies

A client had an arm cast fitted after suffering a right humeral fracture in a hockey game. The client reported a loss of sensation in the right hand, but sensation returned upon removal of the cast. Which was the most likely cause of the client's loss of sensation?

Compression lesion of the musculocutaneous nerve

A client tells the nurse that he is experiencing floaters in the eye. What is the appropriate nursing intervention?

Contact the physician

Which responses of the adaptive immune system provides protection against virus-infected cells?

Distinct antigenic properties allow T cells to isolate specific organisms.

A client is diagnosed with a mild case of an autoimmune disorder and is beginning a treatment regimen. What is the mainstay of treatment with an autoimmune disorder?

Corticosteroids and immunosuppressants

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

Cortisol, a glucocorticoid

Once T helper cells are activated, they secrete which substance that activates and influences nearly all of the other cells of the immune system?

Cytokines

A client's exposure to an antibiotic-resistant microorganism while in the hospital has initiated an immune response. Which process is responsible for the mediated and regulated actions that occur in this situation?

Cytokines released at cell-to-cell interfaces bind to specific receptors on the cells that they target

Which of the types of T cells is responsible for destroying pathogens by punching holes in their cell membrane and by secreting cytokines/lymphokines?

Cytotoxic T cells

Which factor is most protective against squamous cell carcinomas?

Dark skin color

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 hyperthyroidism. When evaluating the laboratory test results, which alteration does the nurse anticipate will be present?

Decrease in TSH

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis (MS) is the result of which pathophysiologic event?

Decreased oligodendrocytes

Regarding the pathophysiology of Parkinson disease, which statement is true?

Degeneration of the nigrostriatal dopamine neurons occurs.

which statement best describes the pathophysiology of Parkinson disease?

Degeneration of the nigrostriatal dopamine system

Depression has various subclassifications distinguished by symptom patterns. Which is that key clinical manifestation of depression with psychotic features?

Delusions or hallucinations

An older adult client with Parkinson disease has been diagnosed with neurocognitive disorder. Which assessment finding would the nurse correlate with this new diagnosis?

Dementia and slowness of movement and thought

The nurse is evaluating a client for possible signs of depression. What are clinical manifestations of major depressive disorder? Select all that apply.

Depressed mood Anhedonia Decreased concentration

Which metabolic abnormalities can cause type 2 diabetes? Select all that apply.

Deranged secretion of insulin Insulin resistance Increased glucose production by the liver

A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?

Dopamine nigrostriatal system

When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which diagnostic test?

Dual-energy x-ray absorptiometry (DXA)

Parents of a 7-year-old girl are concerned about their daughter because she has begun to develop secondary sexual characteristics. What etiologic factor is most likely to underlie the child's condition?

Early activation of the hypothalamic-pituitary-gonadal axis

A client who sustained a complete C6 spinal cord injury 6 months ago has been admitted to the hospital for pneumonia. The nurse observes the client with diaphoresis above the level of C6 and the blood pressure is 260/140 mm Hg. What is the first intervention the nurse should provide?

Elevate the head of the bed.

An adult client with a possible growth hormone (GH)-secreting tumor is undergoing testing. If a glucose load is given, which response by the body would confirm the client has a GH-secreting tumor?

Elevated GH level after a glucose load

Schizophrenia is a complex disease that strikes men and women equally. What is a common sign or symptom of schizophrenia in its early stages?

Enhancement of senses

A 15-year-old child with type 1 diabetes asks nurse about the potential to "lose sight." Which response would be the most appropriate?

Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels

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

A client with rosacea should be educated that in addition to the "blush appearance" on the face, she should also assess for which additional complications? Select all that apply.

Eye problems Edema of the eyelids

The nurse assessing for the doll's head response (doll's eye response) in an unconscious client documents which eye movement as an abnormal response?

Eyes turn right when head is turned right

The underlying causative problem in Parkinsonism is:

Failure of dopamine release

A 70-year-old female client has had her mobility and independence significantly reduced by rheumatoid arthritis. Which process likely contributed to the development of her health problem?

Failure of normal self-tolerance

Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease?

Fine-needle aspiration biopsy

A client comes in with a mild sunburn. Which term best describes the sunburn?

First-degree burn

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

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

Flaccid paralysis

Vitreous humor occupies the posterior portion of the eyeball. It is an amorphous biologic gel. When liquefaction of the gel occurs, as in aging, what can be seen during head movement?

Floaters

A client with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the client appears confused—he is oriented to person and place but not time. What type of seizure did this client most likely experience?

Focal seizure with impairment to consciousness

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

A lactation nurse visits a new mother after delivery of her first child and encourages the mother to breast-feed her infant, even for a short time. Which statement made by the nurse correctly explains the importance of breast-feeding?

For several months, colostrum will provide the infant with passive immunity to diseases to which the mother has immunity.

Knowing that she is a carrier for Duchenne muscular dystrophy (DMD), a pregnant woman underwent prenatal genetic testing that diagnosed her child with DMD. As her child develops, the woman should watch for which early signs that the disease is progressing?

Frequent falls and increased muscle size

A nurse is conducting a home safety assessment for an older adult client. Which items present potential safety hazards due to common vision changes in the older adult? Select all that apply.

Glare from sunlight coming through the windows Abrupt changes in lighting Polished wood floors

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:

Glycosylated hemoglobin, hemoglobin A1C (HbA1C)

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Graves disease

A nurse caring for a client who has undergone an antithyroid peroxidase (anti-TPO) antibody test with elevated results should be prepared to educate the client about which disease process?

Hashimoto thyroiditis

The nurse is assisting with a client who is undergoing caloric testing. The nurse expects which action will be needed to complete the test?

Have ice water available.

A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?

Helping the client make meaningful changes to his diet and activity level.

The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education?

Hemoglobin A1C level is 8.7%.

An older adult client presents with noted burning pain along the thoracic region with a tingling sensation and extreme sensitivity of the skin to touch, but there is no rash present at this time. Which skin problem will the health care provider interpret for this client?

Herpes zoster

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

Which statement best explains the function of hormone receptors?

Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.

When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?

Hormone stimulation

While trying to explain the physiology behind type 2 diabetes to a group of nursing students, the instructor will mention which accurate information?

In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance

A nurse assessing an older adult client for signs and symptoms of depression would assess for which manifestations? Select all that apply.

Inability to make decisions Fatigue Feelings of worthlessness

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?

Increase in appetite

A nurse is teaching a group of seniors about the decline of the immune system due to aging. Which topic should be included in the teaching plan regarding the immune response of older adults? Select all that apply.

Increase in susceptibility to infections Higher incidence of cancer Weakened response to vaccinations

The nurse reading a client's lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted?

Large number of polymorphonuclear neutrophils

Which lab values correlate to the fact that the client has developed a lytic drug reaction and is having an antibody response that lyses the drug-coated cell? Select all that apply.

Low hemoglobin of 9.1 Low platelet level of 10,000/mm3

A client has common variable immunodeficiency (CVID), a form of humoral primary immunodeficiency. Which alteration in serum levels would the nurse expect to see?

Low serum IgG levels

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

Lumbar puncture

Adaptive immune responses, also called acquired or specific immunity, are composed primarily of which type of cells?

Lymphocytes

A nurse is teaching a client and family about best practice to minimize the cycling of bipolar disorder. Which instruction should be included in this teaching plan?

Maintain a steady pattern of sleep and activity.

A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information?

Maintain healthy blood pressure and blood sugar levels.

A client who experienced a myocardial infarction 2 weeks ago reports awakening early, loss of appetite, difficulty sitting still or concentrating, and loss of interest in personal hobbies. What mental health disorder do these manifestations represent?

Major depression

What is the task of the prefrontal area of the brain?

Manage information

Which maternal factor contributes to an infant having macrosomia, hypoglycemia, and hyperbilirubinemia?

Maternal diabetes

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 which factor?

Maturity of the visual system at time of onset.

The nurse is assessing a client who has been diagnosed with esotropia. The nurse would expect the assessment findings to include:

Medial deviation

What role do the basal ganglia play in cognition?

Monitor sensory information coming into the brain and apply it to information stored in the memory

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?

Monitoring of the client's intracranial pressure

Which statement correctly identifies the role of the C3b subcomponent of the complement system?

Opsonizes microbes to facilitate phagocytosis

While on an ocean cruise, a person develops malaise and nausea/vomiting. The nurse notes the client's blood pressure is 88/52 mm Hg; pulse is 110 bpm; and skin is moist with perspiration. Which diagnosis is associated with these clinical manifestations?

Motion sickness

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Multiple sclerosis (MS)

The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?

Muscle atrophy

Which disease is thought to be caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction?

Myasthenia gravis

While caring for a pediatric client admitted with a viral infection, the nurse knows that which type of cell will be the child's primary defense against the virus?

Natural killer (NK) cells

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Negative feedback loop

Thought and memory pass across synapses in the brain. What are the neural circuits transmitted by new or reactivated pathways called?

Neuronal networks

A teenager with an infected wound asks, "How does my body fight off the germs in my scraped arm?" Which response by the nurse correctly identifies the cells that play a central role to the innate immune response to an infectious microorganism?

Neutrophils

A male infant is diagnosed with a primary humoral immunodeficiency caused by a defect in early B-cell development, creating a severe decrease in production, maturation, and survival of mature B lymphocytes. Which clinical manifestation does the nurse anticipate assessing after the birth?

No symptoms; infants are usually asymptomatic at birth.

A 37-year-old male with HIV who has recently become symptomatic has begun highly active antiretroviral therapy (HAART). Among the numerous medications that he now regularly takes are several that inhibit the change of HIV RNA to DNA in a CD4+ cell. Which class of medications addresses this component of the HIV replication cycle?

Non-nucleoside reverse transcriptase inhibitors

Which major neurotransmitters are most important for psychiatric disorders? Select all that apply

Norepinephrine Gamma-aminobutyric acid Serotonin Dopamine

The nurse is caring for a client who reports intermittent periods of mild, high-pitched tinnitus that lasts for several minutes. The nurse recognizes this may occur under which circumstance?

Normal hearing

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?

Paget disease

A client is being seen in the dermatology clinic for a follow-up appointment for a second-degree full-thickness burn. What are characteristics of second-degree burns? Select all that apply.

Painful Blistered Mottled, pink red

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

Paralysis

A client who has experienced a spinal cord injury still has use of the arms but has impaired motor and sensory function of the trunk, legs, and pelvic organs. Which term best describes how this injury is classified?

Paraplegia

What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?

Parkinson disease

A newborn is found to have transient hypothyroidism following a cesarean birth. Which nursing intervention could have induced the transient hypothyroidism as the staff prepared the mother for the surgical procedure?

Performing a skin scrub with povidone-iodine solution on delivery site

A client has been assessed and has been found to be experiencing the effects of the leakage of serous fluid into the subretinal space. Which is a potential therapy?

Periocular corticosteroid injections

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 conducting the Rinne test. What is included in this test?

Placing a vibrating tuning fork on the client's mastoid bone and in front of the ear in an alternating fashion

The nurse is evaluating a client's hearing using the Weber test. Which explanation about this test should be included during this examination?

Placing a vibrating tuning fork on the forehead or vortex of the head

Select the most common symptoms of diabetes. Select all that apply.

Polydipsia Polyuria Polyphagia

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

Polyneuropathy

Multiple sclerosis is characterized by what type of neuron damage?

Polyneuropathy

A child has a congenital condition in which the thymus gland is absent. Which information should the nurse include as the priority when providing caregiver education?

Practice strict infection control practices.

Which physical findings would lead the nurse to suspect a client is experiencing carpal tunnel syndrome?

Precision grip weakness

What disease has primary lesions that have a silvery scale over thick red plaques?

Psoriasis vulgaris

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

Cortical blindness is the bilateral loss of the primary visual cortex. What is retained in cortical blindness?

Pupillary reflexes

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

Reading

The nurse is treating a client with a history of chronic alcohol abuse. The client's spouse tells the nurse that the client 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:

Receptive aphasia

Following assessment of a client with papulosquamous dermatoses manifesting as psoriasis, the nurse will most likely document which finding?

Red, thickened plaques with overlying silvery-white scale

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

Many people have experienced some kind of traumatic event in their lives. While response to trauma varies with individuals, what is a generalized response in those who have experienced severe trauma in childhood?

Response later in adulthood that manifests itself in medical and mental issues

An older adult client comes to the clinic complaining of seeing flashing lights and small spots. The client tells the nurse that this has been going on for over 24 hours but now it is as if there is a dark curtain whenever the client opens the eyes. The client asks the nurse if this means that blindness is imminent. What diagnosis should the nurse suspect?

Retinal detachment

The results of recent research suggest that a key role in the origin of some diseases is played by inflammation. For which disease is it thought that inflammation has a role in its beginnings

Rheumatoid arthritis

Which diagnostic test results indicate a client has a vestibular disturbance?

Romberg test response shows increased swaying with arm drift to one side.

A client expresses concern about feeling fullness in the ear. Which additional manifestation leads the health care provider to suspect Menière disease?

Rotary vertigo and tinnitus

The nurse is caring for an older adult client with a suspected diagnosis of presbycusis. Select the most likely manifestation.

Sensorineural hearing loss caused by natural aging

The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers?

Sensory neuropathy

A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which lab results to determine if an allergy is present?

Serum IgE

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

Skin breakdown

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which abnormality in the client's gait?

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

The nurse is assessing a client's skin and notices a few papules. What is the best description to include in the assessment about papules?

Small, raised superficial lesions

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function

Stimulation tests

A nurse comes upon a automobile accident where smoke and flames are coming from the car's engine. What would be the nurse's priority in this situation?

Stop the fire or remove the person from the vehicle.

What term is used to describe a level of consciousness during which a client responds only to vigorous and repeated stimuli and has minimal or no spontaneous movement?

Stupor

Which statement does the nurse know is true concerning substance use disorder in adolescence?

Substance use disorder in teenagers can change the development of the brain.

Which characteristics of a cherry angioma should be considered suspicious?

Sudden collection of several papules

A client with cirrhosis has just received a liver transplant. Tissue rejection can be best prevented by what means

Suppression of CD8+ cytotoxic T cells

A nurse has just learned that her child has a life-threatening complement disorder known as hereditary angioneurotic edema (HAE). Due to deficiency in C1-INH, the nurse needs to be prepared for which possible life-threatening clinical manifestation?

Swelling of the airway

A nurse caring for a client with a spinal cord injury knows that control of sweat gland activity and temperature regulation is managed by the direct action of which body system?

Sympathetic nervous system

Which statement explains how T lymphocytes and B lymphocytes differ?

T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.

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 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.

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?

The child has developed dacryocystitis.

The nurse is caring for a client with myasthenia gravis. Which symptoms displayed by the client would indicate to the nurse that the client may be experiencing myasthenia crisis?

The client has a sudden onset of severe weakness.

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.A client expresses concern about feeling fullness in the ear.

The nurse is providing discharge instructions on the antiseizure medication valproic acid to a woman of childbearing age. Which teachings should the nurse include in the client's education packet? Select all that apply.

The client should also take a folic acid supplement daily. The medication may predispose her to osteoporosis. The medication should be taken consistently. The medication may interact with oral contraceptives.

The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?

The client should be strongly urged not to smoke.

The nurse asks the client to hold her left wrist in complete flexion for approximately 1 minute. The client states she feels tingling and numbness when she does this, pointing to the medial nerve. What does the nurse anticipate the client will be prepared for after this assessment?

The client will be prepared for further diagnostic tests such as an electromyogram (EMG).

Which client would the nurse be most concerned about?

The client with herpes zoster affecting the trigeminal nerve

After surviving an ischemic stroke, a client has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings and exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which brain structure?

The components of the client's limbic system

A nurse is providing education to a client newly diagnosed with Guillain-Barré syndrome. Which statement reflects accurate information about the course of the disease?

The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.

The nurse is caring for a client with decreased serum protein levels secondary to liver failure. When administering medications that are highly protein bound, the nurse anticipates the resulting drug level will respond in which of these ways?

The drug level will be elevated as lack of protein allows more free drug to circulate.

A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?

The hypothalamic-pituitary-target cell system

A child is born with dwarfism to normal-sized parents. The nurse is explaining how growth hormone (GH) plays a central role in the increase in stature that characterizes childhood and adolescence. What is the first step in the growth hormone chain of events?

The hypothalamus secretes GH-releasing hormone.

An infant has been born to a client who is HIV positive. What is the infant's most likely prognosis for developing AIDS?

The infant can be HIV antibody positive by ELISA for up to 18 months of age without being actively infected with HIV.

A newborn has been lethargic and is not nursing well. Testing of cord blood done at birth reveals the presence of IgM. How should the nurse interpret this finding?

The presence of IgM suggests the newborn has an infection.

In an attempt to best explain the innate immune system to a class of first-year nursing students, the instructor should describe what characteristic?

The response of the innate immune system is rapid, usually within minutes to hours, and prevents the establishment of infection and deeper tissue penetration of microorganisms

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?

The thyroid gland is responsible for increasing the metabolic rate.

The nurse is teaching a client about a sulfonylurea medication. Which teaching points should be included in the discussion? Select all that apply.

These medications cause insulin to be released from the pancreas. Hypoglycemia may result from this type of medication.

A groups of students are reviewing information about common warts (verrucae). Which statements by one of the students indicate the need for further review of the information? Select all that apply.

They are precancerous. No matter the age, they tend to regress.

Which statement describes how water-soluble peptides, such as parathyroid hormone or glucagon, exert their effect on cells?

They bind to receptors.

The nurse is presenting information about various causes of dementia to a group of clients in a senior facility. What will the nurse include as the major cause of Wernicke-Korsakoff syndrome?

This form of progressive dementia commonly results from chronic alcoholism.

The nurse observes nystagmus in a client sitting quietly without head movement. The nurse interprets this finding in which way?

This is a pathological finding.

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

Thrombolysis

The most common cause of an ischemic stroke is which of the following?

Thrombosis

The health care provider is assessing a client for carpal tunnel syndrome. The health care provider performs light percussion over the median nerve at the wrist. This assessment is known as:

Tinel sign

The nurse is a conducting discharge teaching to a client prescribed an ototoxic medication. Which signs and/or symptoms will the nurse ask the client to report? Select all that apply.

Tinnitus Hearing loss Dizziness Light-headedness

A 60-year-old client with a medical history of diabetes and hypertension is instructed to make an appointment with an ophthalmologist. The client states no vision issues or problems. Which response is best to explain the purpose of a checkup by an ophthalmologist?

To rule out the presence of open-angle glaucoma, which often has no signs or symptoms

A 4-year-old male child has several small pustules with honey-colored crusted drainage on his face but in no other location. The child is diagnosed with impetigo. The most appropriate treatment would be:

Topical mupirocin and limiting exposure, as it is transmitted easily

A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing:

Transient ischemic attack (TIA)

A client comes to the clinic and informs the nurse that he believes he is suffering from Parkinson disease. What objective data assessed by the nurse would correlate with the client's concern? Select all that apply.

Tremor Rigidity Bradykinesia

The nurse is teaching a client who has tinnitus about suggested dietary modifications. What information is most important for the nurse to include?

Try cutting down on foods high in monosodium glutamate."

A client has an appointment concerning the possible diagnosis of malignant melanoma. Which statement is correct concerning malignant melanoma?

Tumor thickness is a very important factor.

It is important to differentiate between the kinds of hearing loss so they can be appropriately treated. What is used to test between conductive and sensorineural hearing loss?

Tuning fork

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:

Tympanostomy tube insertion

The type of hypersensitivity reaction that is mediated by IgG or IgM antibodies directed against target antigens on specific host cell surfaces or tissues is also known as which type of hypersensitivity reaction?

Type 2

The nurse is irrigating a client's ear in an effort to remove hardened cerumen. Which interventions are appropriate when performing this task? Select all that apply.

Use warm tap water as an irrigant. Dry the ear canal thoroughly after irrigation. Avoid the procedure in the presence of ear infection.

The nurse is assessing a client with the autoimmune disease ankylosing spondylitis for complications related to the eye. For which eye disorder should the nurse assess?

Uveitis

A young child has recently developed macules on the trunk, extremities, and mucous membranes. The child is mildly febrile, but the primary symptom is extreme pruritus. What disorder of the skin most likely is the cause of this child's condition?

Varicella

A client with a long history of cigarette smoking and poorly controlled hypertension is experiencing psychomotor deficits due to hemorrhagic brain damage. Which diagnosis is likely for the onset of progressive dementia?

Vascular dementia

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Vasospasms and hypertension

A client is having difficulty with balance. The nurse understands that the area of the ear that impacts balance is

Vestibular apparatus

A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which pathophysiologic condition has contributed to this client's diagnosis?

Weakness in the muscular wall of an artery

Dry skin is common among older adults. During which season does dry skin become worse?

Winter

A client who has just given birth to a healthy newborn says to the nurse, "I have to go back to work in 6 weeks. It seems like I should not bother to start breastfeeding for such a short time." What is the nurse's best response?

Your newborn gains some protection against infections even if you only breastfeed for the first 6 weeks."

The client tells a nurse that "many voices in his head are telling him what he should do." The nurse thinks he may be experiencing:

a hallucination.

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 late sign and often indicates severely increased intracranial pressure.

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 medication?

acetylsalicylic acid (aspirin)

Paracrine action involves which characteristic?

act locally on cells other than those that produce the hormone

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:

administration of topical beta-adrenergic antagonists to lower the pressure

Reflex activity involves which neurons?

all of the above

Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes:

an illusion of motion.

A nurse is caring for a client with a stage II pressure injury with little exudate. Which treatment option will the nurse to implement for this client?

application of semipermeable or occlusive dressing

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

arms

The spouse of a client admitted to the hospital after a motor vehicle accident reports to the nurse that the client has become very drowsy. The nurse should:

assess the client for additional signs/symptoms of increased intracranial pressure.

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:

asymptomatic and often self-limiting.

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

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

beta cells

A soccer player has been diagnosed with a brain contusion after being injured in a game. The best explanation of the injury by the nurse would be that:

bruising on the surface of the brain occurred.

The skin covers the body, and it is exposed to a number of potentially damaging agents in the external environment. What effect(s) do ultraviolet rays of sunlight have on the skin? Select all that apply.

causing potential for directly damaging the skin accelerating the effect of aging on the skin predisposing to the development of skin cancer

Severe head trauma from a coup-contrecoup injury may result in which type of brain injury?

cerebral hematoma

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.

A nurse on a neurology unit is assessing a client with a brain injury. The client is unresponsive to speech, with dilated pupils that do not react to light. The client is breathing regularly with a respiratory rate is 45 breaths/min. In response to a noxious stimulus, the client's arms and legs extend rigidly. What is the client's level of impairment?

coma

Which regimen serves as the rationale for HIV/AIDS treatment with antiretroviral therapy?

combination therapy incorporating the five classes of antiretroviral drugs

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

cones

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

ct scan

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include?

ct scan

A client, who travels frequently for work, reports intense ear pain during ascent from and descent into airports. The health care provider will recommend which category of medications to help alleviate this symptom?

decongestant nasal spray such as phenylephrine

A nurse working with an older adult for the past 2 days has assessed sudden, fluctuating confusional state and decreased consciousness. Which diagnosis would these assessment findings support?

delirium

The diagnosis of dementia is based on assessment of the presenting problem. The American Academy of Neurology practice parameters recommend screening for which disorder when assessing a client for dementia?

depression

The psychiatrist recommends electroconvulsive therapy (ECT) for an older adult client. The nurse understands that this therapy is effective for which disorder?

depression

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

Which chemical in the body is associated with the need to continue to abuse addictive substances?

dopamine

A high school student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome and ask them to watch for and report which manifestations of its presence?

headaches and poor concentration

A client has developed global ischemia of the brain. The nurse determines this is:

inadequate to meet the metabolic needs of the entire brain

A client has been admitted after developing toxic epidermal necrolysis (TEN) after the administration of a sulfonamide antibiotic. The nurse prioritizes which client need when planning care?

infection control

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

ingestion of honey products containing C. botulinum spores.

The nurse is conducting a health promotion class on the prevention of blindness and vision impairment. The nurse determines that participants understand the information when they identify which vision disorder as most likely to have an infectious etiology?

keratitis

What is a characteristic indicator that an individual is in the latent phase of a chronic viral infection such as human immunodeficiency or herpes zoster viruses?

lack of symptoms

Manifestations of Kaposi sarcoma include:

lesions of the skin and in the oral cavity, gastrointestinal tract, and lungs.

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct?

local

The nurse is caring for a client who admits to long-term substance use disorder. For which type of coexisting condition should the nurse prioritize assessing?

mental health disorders

The nurse is teaching a client about the effects of amyotrophic lateral sclerosis (ALS). Which area(s) of the nervous system will the nurse teach the client are affected by ALS? Select all that apply

motor nuclei of the brain stem lower motor neurons of the spinal cord upper motor neurons of the cerebral cortex

An older adult in an assisted care facility with documented presbyopia has lost his or her glasses. The nurse should instruct unlicensed assistive personnel that the client will need assistance with tasks that involve which part of sight?

near vision

A student nurse has been assigned to a client in the ambulatory surgery center for a cataract. What is the most common type of cataract?

nuclear

A 21-year-old client was diagnosed with HIV 4 years ago, which progressed to AIDS 1 year ago. Now, the client presents with cytomegalovirus. The nurse explains to the client that the infection is caused by a common organism that normally does not cause infection in someone with a healthy immune system. This type of infection is called what?

opportunistic infection

A client with severe hypoglycemia is unconscious. Which method of providing glucose should not be used for this client?

orange juice orally

While explaining immunity to a client, the nurse responds, "The body's internal organs are protected from pathogens because:

our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response."

A client comes to the emergency department complaining of dizziness, rapid breathing, sweating, palpitations, and a feeling of dying. The client has normal laboratory values and has had a cardiac workup. The symptoms persist for 30 minutes and then subside. Which condition is the client exhibiting?

panic disorder

Which structural change can contribute to mixed sensorimotor deficit?

polyneuropathies involving demyelination of peripheral nerves

The nurse is performing her morning assessment on a 69-year-old client 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:

presbyopia.

A client has a stage III pressure injury in the sacral area. What factor(s) can contribute to the development of pressure injuries? Select all that apply.

pressure shearing force friction

A client with laryngeal dystonia has gotten to the point that people on the telephone cannot understand her. She has heard about getting Botox injections into her vocal cords. The nurse will teach about the actions of Botox. What is the most accurate description? This drug:

produces paralysis of the larynx muscles by blocking acetylcholine release.

At the present time there is only one diagnosis in the DSM-5 that has a causative factor. Which diagnosis has a causative factor?

ptsd

Which action could result in pressure injury formation?

pulling a client up in bed

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

respiratory and cardiac muscle involvement

The nurse is assessing for acute graft versus host disease (GVHD). Which body system should the nurse monitor for signs and symptoms?

skin

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:

sperm production.

An older adult client is diagnosed with depression. Which medication category will the nurse anticipate will be prescribed for this client?

ssri

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

surgical lens replacement to correct vision.

Sensory input from the external environment is received by what area of the brain?

thalamus

The nurse will administer medication as diagnostic tool. Which medication will produce acute temporary hearing improvement in the client with Meniere disease? Select all that apply.

urea glycerin

In major athletic competition, athletes are required to submit to liquid chromatography testing looking for:

use of performance-enhancing agents to increase the chances of winning.

Which immunoglobulin (Ig) is the most abundant of circulating antibodies?

IgG

A member of the military is preparing for a mission that requires scotopic vision. How long does the client have to be in total or near total darkness to increase rod sensitivity to the optimum level?

4 hours

A first episode of depression that occurs after what age can be a precursor to dementia?

65

A nurse is caring for four clients. Which client is at highest risk for the development of a pressure injury?

72-year-old client who is undernourished and recently underwent thigh surgery

What is the term used to identify a person's inability to experience pleasure in things that use to result in pleasure?

Anhedonia

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

What is ocular muscle imbalance resulting in "lazy eye" called?

Amblyopia

A child has experienced a bee-sting while at the park. The health care provider is walking by and notices the child has swelling around the eyes, lips, and face in general. What priority assessment should the nurse make at this time?

Assess and establish an open airway.

A 72-year-old client admitted with congestive heart failure tells the nurse that lately he has been having difficulty hearing in the left ear. Which intervention should the nurse implement

Assess for build up of cerumen

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

Cerebrospinal fluid

The nurse is working in a nurse-managed wellness center located in a senior community center. Which client does the nurse evaluate as having the highest risk for depression?

Client who was recently widowed

An adult client is admitted to the emergency department reporting a headache, stiff neck and lethargy. Based on the intake interview, the nurse suspects that the client had a seizure the day before. The client's vital signs are within reference range with the exception of a heart rate of 102 bpm and oral temperature of 38.6°C (101.5°F). Which diagnosis is most likely?

Encephalitis

A client has been diagnosed with a superficial fungal infection. Which assessment technique is most likely assisted with this diagnosis?

Examination of the area with a Wood's light

A parent of a child with otitis media with effusion (OME) asks, "How is this different from typical acute otitis media (AOM)?" Which response by the nurse correctly identifies the main difference?

Excess middle ear fluid

The spinal cord contains the basic factors necessary to coordinate function when a movement is planned. It is the lowest level of function. What is the highest level of function in planning movement?

Frontal cortex

A client with end-stage kidney disease is receiving a kidney donated by a family member. When caring for this client, what does the nurse know is the major target involved in organ transplant rejection?

Human leukocyte antigens (HLAs)

A client with memory loss is concerned about the possibility that it may be inherited. Which disorder will the nurse teach the client is considered an inherited cause of dementia?

Huntington disease

A client with common variable immunodeficiency (CVID) is admitted to the hospital for treatment. Which type of treatment will the nurse be administering to the client?

IV immunoglobulin

The process by which microbes are coated to allow for more efficient recognition by phagocytes is known as

Opsonization

The entrance of a microbe into an individual's vascular space has initiated opsonization. Which statement explains this process?

Opsonization coats a microbe to activate phagocytosis recognition.

Although no definite genetic links for specific psychiatric disorders have been identified, which disorder is thought to be heritable?

Schizophrenia

A roofer who is in his early 50s and smokes two packs of cigarettes a day reported to his doctor that he was "having trouble seeing." He was diagnosed with a cataract in his left eye. Which causes are most plausible for this client? Select all that apply.

Ultraviolet light exposure Smoking

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 which region of the brain?

Upper and lower motor neurons

A client seeks treatment in the clinic for exposure to poison ivy with a rash over the right arm and hand. The nurse is aware that what toxin is found in the oils on poison ivy that is responsible for eliciting an allergic reaction?

Urushiol

A 20-year-old female tells the nurse she is concerned about getting a good suntan before going on a vacation. The best response by the nurse would be:

Use a self-tanning product that produces the appearance of a tan without sun exposure.

A young client 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?

Viral conjunctivitis

Which form of progressive dementia is often a result of chronic alcoholism?

Wernicke-Korsakoff syndrome

A client with a diagnosis of bipolar disorder has chosen to discontinue her medication. She is now not eating or sleeping, very irritable, has racing thoughts, and is easily distracted. The nurse should understand that the client is now experiencing:

a manic episode.

The family of an older adult reports increasing inability to perform basic activities of daily living. After evaluation, the client is diagnosed with Alzheimer disease. What intervention will be implemented to slow cognitive decline?

cholinesterase inhibitors

Of the pathways available to recognize microbes and activate the complement system, which one requires the presence of an antibody?

classical

A client is concerned about memory loss and the possibility of having Alzheimer disease (AD). Which diagnostic assessment will the nurse teach the client is most important in diagnosing AD?

collecting a detailed clinical history

A client's chart documents the finding of cholesteatoma. The nurse interprets this to mean that the client has:

cystlike mass in the middle ear.

The nurse is caring for a client with a hormonal disorder that is widely affecting many body systems. The nurse recognizes that which form of hormone signalling pathway is most likely involved in the client's disorder?

endocrine

Overstimulation of glutamate receptors is the cause of which type of brain injury?

excitotoxic