Chapter 1- prepu practice

The nurse evaluates a client for manifestations of a disease. Which assessment data is a sign of a disorder? Select all that apply.

Dilated pupils Skin rash tachycardia

What do morbidity and mortality statistics refer to?

Functional effects and death-producing characteristics of a disease

A nurse plans to conduct a research study on a group of clients who had laparoscopic gastric bypass. Which term describes this type of study?

cohort A cohort study focuses on a group of people born around the same time or who share a common characteristic such as gastric bypass

A nurse is evaluating findings from the Nurses' Health Study, a study that has followed a group of nurses since 1976 to study the relationship between oral contraceptive use and breast cancer. The nurse evaluates the findings using criteria for which type of study?

cohort also known as a longitudinal study, follows a group of people over a period of time to observe specific health outcomes. Because the Nurses' Health Study followed the same group of nurses since 1976, it is an example of a cohort, or longitudinal, study.

A client is taking a synthetic thyroid hormone for the treatment of hypothyroidism. The client develops signs and symptoms of hyperthyroidism. The nurse refers to this adverse extension of disease development as:

complications are possible adverse extensions of a disease or outcomes from treatment.

Why are some diseases termed syndromes?

They are a compilation of signs and symptoms characteristic of a specific disease state.

Which actions will a nurse teach as secondary prevention of disease? Select all that apply.

Colonoscopy at age 50 and every 10 years Annual Pap test for women

A client has been admitted to the intensive care unit with a myocardial infarction. After the client recovers from the acute course of the event and ready for discharge, the nurse provides information about the beta adrenergic blocker, atenolol, that the client will take to prevent complications after the MI. What type of prevention is the nurse providing?

tertiary prevention

A client has died and the nurse is responsible for filling out the death certificate. In performing this task, the nurse is required to record the client's age, sex, and cause of death, among other factors. What is the purpose of reporting these statistics?

these statistics are useful in terms of anticipating health care needs, planning public-education programs, directing health research efforts, and allocating health care dollars. Mortality statistics are very useful in predicting the needs of clients with similar symptoms, as well as planning future therapeutic interventions.

When considering the clinical course, a disease that is characterized by remissions and exacerbations is considered to be:

chronic

When the nurse questions the blood glucose level obtained via a glucometer, a serum blood level is ordered. This protocol is directed toward ensuring which measure of standardization?

validity

Facility policies on wound dressing selection refer the nurse to a dressing algorithm. The nurse anticipates that the algorithm will include:

a step-by-step decision-making tree for dressing selection.

The nurse is educating a client who will be having a series of diagnostic tests. The clients asks the nurse, "What is the importance of me having all of these tests? I told the physician I know what is wrong with me!" What is the best response by the nurse?

"The physician wants to validate what he believes the client problem is." The diagnostic tests are ordered to validate what is thought to be the problem. They are also performed to determine other possible health problems that were not obtained from the history and PE, but may be present given the signs and symptoms identified.

A nurse documenting a client's health history places hypertension under which category?

Acquired

A physician is providing care for a number of clients on a medical unit of a large, university hospital. The physician is discussing with a colleague the differentiation between diseases that are caused by abnormal molecules and molecules that cause disease. Which client most clearly demonstrates the consequences of molecules that cause disease?

A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive.

A member of the health care team is researching the etiology and pathogenesis of a number of clients who are under her care in a hospital context. Which client situation best characterizes pathogenesis rather than etiology?

A client who has increasing serum ammonia levels due to liver cirrhosis

An infant has a difficult time passing through the birth canal and the physician uses forceps to deliver the child. In the process, the facial nerve was damaged, resulting in a facial droop. Which condition does the nurse recognize this to be?

Acquired defect

Following assessment of a newly admitted client, which assessment results indicate the client has pathophysiology? Select all that apply.

Bruit is heard over the carotid artery. Crepitus often occurs with knee flexion.

Which client conditions would be considered a congenital defect? Select all that apply.

Cleft lip and palate Club foot Hypospadias

A client used a prescription medication prescribed by her physician during the first trimester of pregnancy before realizing she was pregnant, which caused a facial deformity in her infant. Which term best descirbes how to categorize this infant's condition?

Congenital condition

Which action will a nurse teach as tertiary prevention of disease? Select all that apply.

Daily foot inspection by clients with diabetes mellitus Taking antihypertensives for clients post-myocardial infarction

A nurse is calculating the incidence of pressure ulcers on the unit. The nurse should take which action?

Divide the number of new cases by the number of clients on the unit. Incidence reflects the number of new cases arising in a population at risk during a specified time and is determined by dividing the number of new cases by the population at risk.

Which question is an example of an epidemiologic study?

Does smoking cause heart disease? Epidemiologic studies look for patterns of people affected with a particular disorder such as age, race, or lifestyle habits. Epidemiologists are concerned with whether something happens versus how it happens or the best treatment for a particular disease.

Signs and symptoms describe the structural and functional changes that accompany a disease. Symptoms are what the client describes to the caregiver. Signs are what the caregiver observes. Which is considered a sign?

Elevated white cell count and fever of 101.5°F (38.6°C)

Despite using the same screening tools as previous years (which have been confirmed as highly valid, reliable, sensitive, and specific), the public health nurse notes an increase in the number of people in the population testing positive for type 2 diabetes this year. What action should the nurse take?

Investigate the population for factors that would cause an increase in the prevalence of diabetes.

A disease agent can affect more than one organ of the body, and more than one disease agent can affect the same organ of the body. Which term best describes this aspect of disease etiology?

Multifactorial in origin

When attempting to reach a health diagnosis, the health care provider commonly applies four primary steps. Place the steps for reaching a diagnosis in order. Use all the options.

Obtain clinical history. Conduct a physical examination. Perform diagnostic testing. Determine the most likely cause of the client's presentation.

A client has been diagnosed with a heart attack and has been placed on beta-blockers to reduce the workload on the heart, as well as a statin drug and a low-fat diet to lower cholesterol. Which level(s) of prevention of disease would these therapies be classified?

Primary and tertiary

Which assessment data would a nurse identify as a complication of a disease or disorder?

Pulmonary emboli following deep vein thrombosis (DVT)

The nurse notes that a colleague neglects to wipe away the first drop of blood from the sample during point-of-care blood glucose testing; this in contradiction of the unit policy. What action should the nurse take first?

Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results.

There are three fundamental types of prevention used in health care: primary, secondary, and tertiary. Which statement accurately describes secondary prevention?

Secondary prevention detects disease early, and most is done in clinical settings.

A client with risk factors associated with human immunodeficiency virus (HIV) has a positive enzyme-linked immunosorbent assay (ELISA) test followed by a negative Western blot test.

The lab must have contaminated the specimen. A laboratory test such as the ELISA test for HIV is known to give some false positive results. Therefore, a positive ELISA test is followed with a Western blot test. If the Western blot shows negative, the specificity of the test indicates a true negative result. The client does not have HIV.

During an assessment, a client tells the nurse that he has suffered from asthma since childhood. He is not experiencing any symptoms at this time but takes an inhaled steroidal medication daily. The nurse should document the asthma as being which type of condition?

chronic

A particular disease has a debilitating effect on the ability of sufferers to perform their activities of daily living and is a significant cause of decreased quality of life. However, few people die as a result of the disease's direct effects. There are hundreds of thousands of Canadians living with the disease but relatively few new cases in recent years. This disease has:

high morbidity, low mortality, high prevalence, and low incidence.

The nurse is caring for a client in the burn unit who has sustained partial and full thickness burns over 16 percent of the body. What type of etiologic factor does the nurse recognize these burns are?

physical forces

The nurse is conducting a staff educational program on screening tests. The nurse determines that the participants understand the information when they identify the proportion of true positive test results in a given population as being:

positive predictive value

The nurse is performing an assessment on a newly admitted client with asthma and hears wheezes in the upper lobes of the lungs. When the nurse documents this finding, the nurse recognize this to be:

sign

A client has tested positive for the tuberculosis antibody but is not exhibiting signs of the disease. This client is considered to be in which stage of the disease process?

subclinical

When the nurse is assisting with the diagnostic process for a client with an illness, what is a priority when compiling all of the data to have an accurate diagnosis? Select all that apply.

• Diagnostic tests • A careful history • Detailed physical examination