Cellular Regulation
During which stage of pregnancy would a teratogen cause neural tube defects? 1 Fetal period 2 Presomite period 3 Embryonic period 4 Preimplantation period
3 Neural tube defects may occur due to the exposure to a teratogen during the embryonic period (3 to 8 weeks). Exposure to a teratogen during the fetal period (9 to 38 weeks) may cause learning deficits and behavioral abnormalities. Exposure to teratogens during the presomite and preimplantation period (1 to 2 weeks) may cause a spontaneous abortion.
A nurse notices a firm, edematous, irregularly shaped skin lesion on a client who reports an insect bite. Which skin lesion is this? 1 Wheal 2 Plaque 3 Vesicle 4 Pustule
1 A wheal is a firm, edematous, irregularly shaped skin lesion, formed as an inflammatory response to an allergen or insect bite. A plaque is a circumscribed, elevated, superficial lesion, like psoriasis. A vesicle is a circumscribed, superficial collection of serous fluid. A pustule is an elevated, superficial lesion filled with purulent fluid.
After assessing a client with an involuntary loss of urine, the nurse suspects overflow incontinence. Which symptom supports the nurse's suspicion? 1 Constant dribbling of urine 2 Abrupt and strong urge to void 3 Loss of urine with physical exertion 4 Large amount of urine loss with each occurrence
1 Overflow incontinence is characterized by an involuntary loss of urine due to overdistention of the bladder when the bladder's capacity reaches the maximum. This condition is characterized by bladder distention up to the level of the umbilicus and constant urine dribbling. An abrupt and strong urge to void is a clinical manifestation of urge incontinence. Stress incontinence is characterized by loss of urine with physical exertion. Urge incontinence is characterized by the loss of large amounts of urine with each occurrence.
The nurse is providing care to an infant diagnosed with Down syndrome. Which parental statement related to the infant's growth indicates the need for further education? 1 "My baby will have growth deficiencies during infancy." 2 "My child will have accelerated growth during adolescence." 3 "My child will most likely be overweight by 3 years of age." 4 "My baby will have reduced growth in both height and weight."
2 Children diagnosed with Down syndrome will often have growth deficiencies. These deficiencies are most pronounced during adolescence and infancy. Because weight gain is more rapid than growth in stature, many children with Down syndrome are overweight by 3 years of age. Overall reduced growth is noted for both height and weight.
The nurse is teaching self-management techniques to a client newly diagnosed with polycystic kidney disease. Which statement of the client indicates a need for further teaching? 1 "I should monitor my bowel movements." 2 "I should weigh myself once a week." 3 "I should record my blood pressure daily." 4 "I should notify my healthcare provider if I have fever.
2 Polycystic kidney disease is characterized by a sudden weight gain due to enlarged kidneys. Therefore the client should weigh himself or herself every day at the same time of day and with the same amount of clothing on. Bowel movements should be monitored to prevent constipation. The client should regularly record his or her blood pressure to prevent hypertension. The client should notify the healthcare provider if he or she has fever.
Which infection is identified by evaluating the vaginal specimen of an adolescent client who sustained a sexual assault? 1 Syphilis 2 Chlamydia 3 Hepatitis B 4 Trichomoniasis
4 Trichomoniasis is detected by evaluating the specimen of a vaginal swab. Nucleic acid amplified testing (NAATs) is used to check for chlamydial and gonorrheal infections. Serum evaluation will reveal syphilis and hepatitis infections.
What issues are associated with the difficulty in identification of teratogens? Select all that apply. 1 Teratogenic effects may be delayed. 2 Prolonged drug exposure may be required. 3 Animal test results may not be applicable to humans. 4 Behavioral effects can be easily documented and evaluated. 5 Controlled experiments on humans can reveal the effect of teratogens
1, 2, 3 Teratogenic effects may be delayed; some drugs may take years to show their effects. To identify a teratogenic effect, the subject should be exposed to drugs for a prolonged time. Some drugs may not be toxic to animals but may have adverse effects in humans. The easy documentation and evaluation of behavioral effects may help to easily identify teratogens. Controlled experiments cannot be done in humans; this makes the identification of teratogens difficult.
What is the effect of parathyroid hormone on bones? Select all that apply. 1 Increased bone breakdown 2 Increased serum calcium levels 3 Increased sodium and phosphorus excretion 4 Increased absorption of calcium and phosphorus 5 Increased net release of calcium and phosphorus
1, 2, 5 Parathyroid hormone increases bone breakdown, which increases serum calcium levels. Parathyroid hormone increases net release of calcium and phosphorus from bone into the extracellular fluid. It increases sodium and phosphorus excretion by the kidneys, not in the bone and increases absorption of calcium and phosphorus in the gastrointestinal tract by using activated vitamin D. However, this increased absorption of calcium and phosphorus is not related to the bone.
Which type of immunity will clients acquire through immunizations with live or killed vaccines? 1 Natural active immunity 2 Artificial active immunity 3 Natural passive immunity 4 Artificial passive immunity
2 Artificial active immunity is acquired through immunization with live or killed vaccines. Natural active immunity is acquired when there is natural contact with antigens through a clinical infection. Natural passive immunity is acquired through the transfer of colostrums from mother to child. Artificial passive immunity is acquired by injecting serum from an immune human
While reviewing a client's laboratory reports, the nurse finds a neutrophil count of 12,000/mm3. Which condition may be present in this client? 1 Influenza 2 Pneumonia 3 Immunosuppression 4 Autoimmune disorder
2 The normal adult leukocyte count is 5,000 to 10,000/mm3. A count of 12,000/mm3 indicates an increased neutrophil level, which indicates the presence of an acute bacterial infection that could result in pneumonia or inflammation. Viral influenza may occur when the neutrophil count is low. Immunosuppression and autoimmune disorders may result from a decreased leukocyte count.
client with osteoporosis is prescribed raloxifene. What should the nurse monitor in the client? 1 Check serum creatinine 2 Monitor urinary calcium 3 Monitor liver function tests 4 Observe for anxiety and drowsiness
3 Raloxifene increases the risk for hepatic disease. Therefore the liver function test is monitored in a client who is prescribed this drug. Serum creatinine is checked in a client who is prescribed zoledronic acid. Urinary calcium is monitored in a client who is prescribed calcium supplements. Anxiety and drowsiness is observed in a client who is prescribed risedronate.
A registered nurse is teaching a nursing student how to assess for edema. Which statement made by the student indicates the need for further education? 1 "Edema results in the separation of skin from pigmented and vascular tissue." 2 "Pitting edema leaves an indentation on the site of application of pressure." 3 "Trauma or impaired venous return should be suspected in clients with edema." 4 "If the pressure on an edematous site leaves an indentation of 2 mm, a score of 2+ is given
4 The depth of indentation left after applying pressure to an edematous site determines the degree of edema. A 1+ score is given if the depth of indentation is 2 mm. A 2+ is the score given if the depth of edema indentation is 4 mm. An accumulation of edematous fluid will result in the separation of skin and underlying vasculature. Edema is classified as pitting if the application of pressure on the edematous site will leave an indentation for some time. Edema results from a direct trauma to the tissue or by impaired venous return.
A client that has a diagnosis of bone cancer is being prepared for the first radiation treatment. As the nurse begins the treatment, the client starts crying, stating, "I'm so discouraged." What is the nurse's best response? 1 Tell the client, "It's difficult to deal with your diagnosis and treatment." 2 Complete the preparation and tell the client, "We can talk about this later." 3 Explain the therapy and reinforce that it will only cause a little discomfort. 4 Allow the client to be alone for a few minutes so the client can regain composure.
1 The correct response focuses on the client's feelings of despair and provides the opportunity to talk about them. Leaving the client alone abandons the client and leaves the client with no support. Avoiding a pressing problem misses an opportunity for discussion of feelings. Explaining the therapy and saying it will only cause a little discomfort focuses on the nurse's interpretation of the problem, not the client's.
A client with tuberculosis is prescribed isoniazid. What statements should the nurse tell the client? Select all that apply. 1 "Take the drug on an empty stomach." 2 "Report any changes in vision to your primary healthcare physician." 3 "Take daily multiple vitamins that contain B-complex." 4 "Wear protective clothing when going outdoors during the day." 5 "Report darkening of the urine or a yellowish skin discoloration."
1, 3 , 5 Isoniazid should be taken on an empty stomach because food prevents absorption of the drug. Multiple vitamins that contain the vitamin B-complex should be taken along with isoniazid because the drug depletes vitamin B. A client on isoniazid should report darkening of the urine and yellowish skin discoloration because these conditions are signs of liver toxicity. A client on ethambutol should be taught to report changes in vision. A client on pyrazinamide is instructed to wear protective clothing if he or she will be exposed to sunlight.
A child with impaired congenital brain development was brought in for treatment. Which nursing interventions should the nurse perform to help in planning the client's treatment? Select all that apply. 1 Enquire about the family history 2 Refer to the physician for treatment 3 Enquire about the surroundings of the child 4 Enquire about the behavioral aspects of the child 5 Enquire if the mother was on any medication during her pregnancy
1, 5 Improper brain development in utero is a congenital anomaly that could be caused by genetic factors and drugs. Therefore, the nurse should enquire about the family history and of any treatment history of the mother during her pregnancy. Consulting the doctor without knowing the cause of the condition would not help in providing proper treatment. Enquiring about the child's surroundings would not help in providing proper treatment. The study of the child's behavior may not help to determine the cause of the brain injury.
A nurse is caring for a client with hyperthyroidism. Which laboratory test will be most beneficial in monitoring the effectiveness of drug therapy? 1 Free thyroxine (FT4) Correct 2 Thyroxine (T4), total Incorrect 3 Free triiodothyronine (FT3) 4 Triiodothyronine (T3), total
2 The thyroxine (T4) total study is the best method of monitoring thyroid therapy. A free thyroxine (FT4) study measures the active component of total T4; this test is an indicator of thyroid function. Free triiodothyronine (FT3) measures the active component of triiodothyronine (T3) total. Total T3 helps to diagnose hyperthyroidism when T4 levels are normal.
What is the possible etiology of intertrigo in clients? 1 Anemia 2 Obesity 3 Liver disease 4 Hypothyroidism
2 Intertrigo, which is infection/rash of the overlying surfaces of the skin, may be caused by obesity. Anemia, liver disease, and hypothyroidism are not associated with intertrigo. Anemia may cause pallor. Spider angiomas may be caused by liver disease. Hypothyroidism may cause carotenemia
