Exam 4
The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? A. Have you ever given your child any honey or honey-containing products? B. Is there any family history of neuromuscular diseases? C. Has your baby ever been directly exposed to any chemical cleaning products? D. Is there any mold in your home that you know of?
Answer: A. Have you ever given your child any honey or honey-containing products?
Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options. Hiatus Pylorus Duodenum Jejunum Ileum Cecum
Answer: 1 Hiatus 2 Pylorus 3 Duodenum 4 Jejunum 5 Ileum 6 Cecum
While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply. A. Secretion of mucus to lubricate and protect the inner surface of the alimentary canal B. Smooth muscle cells that facilitate movement of contents of the GI tract C. Holding the organs in place and storage of fats D. Barrier to prevent the entry of pathogenic organisms E. A cushioning to protect against injury from sports or car accidents
Answer: A & D A. Secretion of mucus to lubricate and protect the inner surface of the alimentary canal D. Barrier to prevent the entry of pathogenic organisms
A campus-based peer counseling group is conducting an information blitz on sexually transmitted diseases. Which of the following statements about genital warts requires correction? A) "Genital warts can take up to a month after exposure to first become visible." B) "There is no existing treatment that can eradicate the virus once it's contracted." C) "Condoms do not necessarily prevent the transmission of the virus that causes genital warts." D) "There are a number of subtypes of the virus that cause genital warts, but current vaccines protect against most common causes of them."
Answer: A) "Genital warts can take up to a month after exposure to first become visible."
A 20-year-old male has presented to a health clinic with multiple genital lesions that are filled with a viscous, creamy exudate and has subsequently been diagnosed with molluscum contagiosum. What is his care provider most likely to tell him about the plan for treating the diagnosis? A) "This kind of infection often subsides on its own and doesn't grow more serious over time." B) "These lesions usually respond well to oral antiviral medications." C) "Treatment of this problem is usually successful, but if untreated, it can lead to sterility." D) "The bacteria that cause this disease are often latent for several years at a time, and you would be contagious for the entire period."
Answer: A) "This kind of infection often subsides on its own and doesn't grow more serious over time."
Which of the following endocrine functions are responsible for increased resorption of bone that results in a reduction of the number and function of osteoclasts? Select all that apply. A) Calcitonin secretion B) Decrease in estrogen levels C) Stimulation of excess thyroid hormone D) Release of catecholamines E) Increase movement of calcium and phosphate from bone into the extracellular fluid
Answer: A) Calcitonin secretion B) Decrease in estrogen levels
The parents of an active 9-year-old are leaving the emergency department (ED) following cast placement for their son's lower extremity as a result of a fall in soccer. The nurse should emphasize that assessment of the cast is important and that they should bring their son back to the ED if they note which of the following signs and symptoms? Select all that apply. A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg. C) Swelling in the lower leg has remained the same since they left the ED 12 hours ago. D) Pulses are palpable below the level of the cast. E) Bruising noted in the lower foot and toes.
Answer: A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg.
When a 4-year-old boy stands erect with his medial malleoli touching, the distance between his knees is 2 inches. What is the child's most likely diagnosis and treatment? A) Genu varum, which can be treated by bracing B) Flatfoot, which will require orthopedic shoes C) Genu valgum necessitating a series of surgeries D) Femoral torsion, which will spontaneously resolve before puberty
Answer: A) Genu varum, which can be treated by bracing
A 60-year-old man has long managed his type 1 diabetes effectively with a combination of vigilant blood sugar monitoring, subcutaneous insulin administration, and conscientious eating habits. This morning, however, his wife has noted that he appears pale and clammy and appears to be in a stupor, though he is responsive. She suspects that he has made an error in his insulin administration and that he is experiencing a hypoglycemic episode. Which of the following actions should be the wife's first choice? A. Administration of 15 to 20 g of glucose in a concentrated carbohydrate source B. Administration of subcutaneous glucagon C. IV infusion of 50% dextrose and water solution D. Careful monitoring for level of consciousness and resolution of hypoglycemia
Answer: A. Administration of 15 to 20 g of glucose in a concentrated carbohydrate source
Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system? A. Second messengers act as the intracellular signal that responds to the presence of a hormone. B. Endocrine-producing cells must release both a hormone and a second messenger in order to exert a distant effect. C. Second messengers act to supplement hormone effects on cell receptors when the desired hormonal effect must be either increased. D. Second messengers provide an alternative pathway for endocrine effects on a cell that bypass the normal receptor pathways.
Answer: A. Second messengers act as the intracellular signal that responds to the presence of a hormone.
Which of the following statements best captures an aspect of the role of hormones in the body? A. Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems. B. Hormones directly initiate many of the processes that contribute to homeostasis. C. Control of body processes is ensured by the fact that a single hormone can only exert one effect on one specific system or tissue. D. Each hormone that exists in the body is produced by only one specific endocrine gland.
Answer: A. Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems.
A 3-year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes? A. The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin. B. It's not known exactly why your daughter has completely stopped making insulin, and treatment will consist of your rigidly controlling her diet. C. This tendency to produce insufficient amounts of insulin is likely something that she inherited. D. Environmental and lifestyle factors are known to play a part in the fact that her pancreas secretes and withholds insulin at the wrong times.
Answer: A. The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin.
A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistulae (EA/TEF). Which of the following explanations should the care team provide to the infant's parents? A. We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally. B. This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time. C. The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration. D. The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs.
Answer: A. We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally.
A female patient presented to her primary care physician with classic signs and symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the health care providers explain her Cushing syndrome signs and symptoms to this patient? A. Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms. B. We are going to have to run some more tests. We think you might have a problem with your pituitary gland. C. There is no connection between the Cushing syndrome and the vaginal carcinoma. You have two very distinct problems occurring at the same time. D. We need to check your thyroid. Your Cushing syndrome may be caused by hypofunction of this gland.
Answer: A. Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms.
When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by A. decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials. B. increasing the peristaltic motion of the GI tract, thereby causing explosive diarrhea. C. increasing the amount of secretions being entered into each segment of the intestinal tract. D. signaling the vagus nerve to slow down motility and increase absorption of water from the large intestine.
Answer: A. decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials.
Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of A. milliseconds. B. less than 10 minutes. C. 24 to 36 hours. D. 4 to 7 days.
Answer: A. milliseconds.
A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications? A) "Do you get cold sores very often?" B) "Do you have pain when you urinate or have difficulty starting the stream?" C) "Have you noticed excessive swelling in your scrotum the last few days?" D) "Have you been experiencing flank pain and bloody urine?"
Answer: B) "Do you have pain when you urinate or have difficulty starting the stream?"
A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate to include which of the following accurate statements? A) "After your caesarean section, it will be safest if you don't breast-feed your child." B) "If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with." C) "A vaginal delivery will be safe as long as you are consistent with taking your valacyclovir." D) "We'll have to book you a caesarian delivery in order to ensure your baby isn't exposed to the virus."
Answer: B) "If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."
A female toddler has been diagnosed with toeing-in (metatarsus adductus). What teaching should the pediatrician provide to the parents of the child about her diagnosis? A) "She will likely walk later than most children, but it will resolve itself with time." B) "We'll likely need to start putting the first of a series of casts on her legs quite soon." C) "The best time to perform the surgery that's needed will be at age 3 or 4." D) "While there's no effective treatment for her toeing-in, most children learn to accommodate the problem and walk independently."
Answer: B) "We'll likely need to start putting the first of a series of casts on her legs quite soon."
Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture? A) A 20-year-old football player who had an opposing player fall laterally on his leg B) An 8-year-old boy who fell out of a tree and on to his arm C) An 81-year-old woman with a history of osteoporosis who stumbled and fell on her hip D) A 32-year-old woman who fell awkwardly on her arm while skiing
Answer: B) An 8-year-old boy who fell out of a tree and on to his arm
The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture? A) A 77-year-old male who runs marathons and maintains a BMI of 25. B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom. C) A 64-year-old male with uncontrolled diabetes and chronic kidney disease on dialysis. D) A 73-year-old nursing home patient with long-term continence issues but able to walk the hallways for exercise.
Answer: B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom.
During pathophysiology class, a nursing student asks the faculty what purpose do the osteoprogenitor cells serve. From the following list, identify the purpose of these cells. Select all that apply. A) Formation of red blood cells B) Growth and remodeling of bone C) Anchorage point for blood vessels D) Repair of bone E) Supply nerves to the bone matrix
Answer: B) Growth and remodeling of bone D) Repair of bone
While reviewing the role of the parathyroid hormone in the balance of calcium and phosphate levels, the nursing faculty will emphasize that the kidney responds to parathyroid stimulation by A) increasing reabsorption of sodium in the distal tubules. B) reducing the reabsorption of phosphate. C) stimulating production of red blood cells. D) decreasing the reabsorption of calcium.
Answer: B) reducing the reabsorption of phosphate.
A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem? A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins C. Cerebellar lesions; surgical and immunosuppressive treatment D. Excess acetylcholinesterase production; treatment with thymectomy
Answer: B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins
A 28-year-old male who is 6 S11 c tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem? A. My pituitary gland produced a much higher than normal amount of growth hormone when I was a child. B. A tumor in my brain threw off my hormone levels after I was finished adolescence. C. My liver is malfunctioning and produces too many of the hormones that ultimately cause growth. D. The high sugar levels that go along with my diabetes made my pituitary gland overproduce the hormones that cause you to grow.
Answer: B. A tumor in my brain threw off my hormone levels after I was finished adolescence.
Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the emergency department with malaise, nausea, and yellow eyes. Serology has confirmed a diagnosis of hepatitis A (HAV), to the shock of the client. What teaching is most appropriate for this client? A. You can expect these symptoms to disappear after about 2 months, but you'll be a carrier of the disease indefinitely. B. A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time. C. You likely came in contact with blood or body fluids at some point, and you'll have to ensure no one is subsequently exposed to your own blood or body fluids. D. You likely got this by way of what we call the 'fecal oral' route; you will have chronic hepatitis now, but the symptoms can be controlled with medication.
Answer: B. A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time.
A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment? A. Delirium B. Coma C. Brain death D. Vegetative state
Answer: B. Coma
A 9-year-old boy has been brought to the emergency department by his father who is concerned by his son's recent fever, stiff neck, pain, and nausea. Examination reveals a petechial rash. Which of the following assessment questions by the emergency room physician is most appropriate? A. Is your son currently taking any medications? B. Has your son had any sinus or ear infections in the last little while? C. Does your son have a history of cancer? D. Was your son born with any problems that affect his bone marrow or blood?
Answer: B. Has your son had any sinus or ear infections in the last little while?
A 40-year-old man who uses heroin intravenously was diagnosed with hepatitis C (HCV) 1 year ago and is now considered to have chronic viral hepatitis. Which of the following statements by the client to his care provider would warrant correction? A. I know the medications to treat this aren't fantastic, but at least there are some options for controlling the virus. B. It's at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms. C. Even though I'm sick, at least I won't feel sick most of the time. D. I'm not looking forward to all the side effects of the drug treatments for my HCV, but I hope I don't end up needing a liver transplant.
Answer: B. It's at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms.
The nurse knows which of the following phenomena listed below is an accurate statement about axonal transport? A. Anterograde and retrograde axonal transport allow for the communication of nerve impulses between the neuron and the central nervous system (CNS). B. Materials can be transported to the nerve terminal by either a fast or slow component. C. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens. D. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.
Answer: B. Materials can be transported to the nerve terminal by either a fast or slow component.
Which of the following statements best captures an aspect of the function of the hypothalamic¡Vpituitary¡Vadrenal (HPA) system? A. Adrenocorticotropic hormone (ACTH) released by the hypothalamus controls to release of cortisol. B. The pituitary gland communicates with the adrenal cortex through the release of ACTH. C. The adrenal cortex receives corticotrophin-releasing hormone (CRH) and in turn releases cortisol. D. The pituitary gland causes a release of CRH from the hypothalamus, which promotes hormone release from the adrenal cortex.
Answer: B. The pituitary gland communicates with the adrenal cortex through the release of ACTH.
Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? A. Your daughter has lost all her cognitive functions as well as all her basic reflexes. B. Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change. C. If you or the care team notices any spontaneous eye opening, then we will change our treatment plan. D. Your daughter's condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.
Answer: B. Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.
A middle-aged male walks into the emergency department complaining of chest pain radiating to the neck, shortness of breath, and nausea. His heart rate is 120 and BP is 94/60. The ED physician recognizes the patient is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to A. the patient not having a very high pain tolerance. B. hypoxia exerting a direct effect on the chemoreceptor trigger zone. C. the patient not having digested his meal completely. D. fear of having to make major lifestyle changes.
Answer: B. hypoxia exerting a direct effect on the chemoreceptor trigger zone.
When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is: A. positively charged. B. inhibitory. C. overstimulated. D. dormant.
Answer: B. inhibitory
While assessing a critically ill patient in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the patient became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is: A. metabolic acidosis that occurs spontaneously following any dysrhythmias. B. interruption of the blood/oxygen supply to the brain. C. massive cerebrovascular accident (CVA) resulting from increased perfusion. D. a blood clot coming from the heart and occluding the carotid arteries.
Answer: B. interruption of the blood/oxygen supply to the brain.
A 68-year-old African American man who has smoked for at least 50 years reports that lately he feels as though food is getting stuck in his throat. At first, this was a problem just with dry food, but now his morning oatmeal is getting stuck. On questioning, he reports drinking at least three alcoholic beverages nearly every day. His problem is most likely A. achalasia. B. squamous cell carcinoma of the esophagus. C. dysphagia secondary to scleroderma. D. gastrointestinal reflux disease.
Answer: B. squamous cell carcinoma of the esophagus.
Bone is connective tissue, in which the intercellular matrix has been impregnated with inorganic calcium salts, that has great tensile and compressible strength but is light enough to be moved by coordinate muscle contractions. One third of the dry weight of bone is composed of which of the following? A) Bone cells, inorganic salts, and blood vessels B) Hydroxyapatite, calcium carbonate, and calcium fluoride C) Bone cells, blood vessels, and nerves D) Organic matter and inorganic salts
Answer: C) Bone cells, blood vessels, and nerves
Which of the following is an aspect of the bone growth and development that occurs during the first two decades of life? A) Most bone abnormalities can be traced to anomalies in the embryonic stage of development. B) The physiological effects of in utero positioning normally remain into late adolescence. C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells. D) Bone length increases through childhood, while bone diameter remains static.
Answer: C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells.
Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace and that the man will regain full function after healing and rehabilitation. Which of the following cells is most responsible for restoring the integrity of the man's broken bone? A) Osteocyte B) Osteoclast C) Osteoblast D) Osteoma
Answer: C) Osteoblast
The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which of the following phenomena would the physician most likely suspect as contributing factor to the boy's short stature? A. Genetic short stature B. Lack of IGF receptors in epiphyseal long bones C. A shortage of hypothalamic GHRH production D. Excess insulin production resulting in chronically low blood glucose levels
Answer: C. A shortage of hypothalamic GHRH production
Which of the following hormones are derivatives of cholesterol? A. Epinephrine and norepinephrine B. Insulin and glucagon C. Aldosterone and testosterone D. Eicosanoids and retinoids
Answer: C. Aldosterone and testosterone
A 30-year-old male who manages his type 1 diabetes with glyburide presents at the emergency room complaining of headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half-marathon. Which of the following is likely to be the cause of his complaints? A. Diabetic ketoacidosis B. Hyperosmolar hyperglycemic state C. Hypoglycemia D. Somogyi effect
Answer: C. Hypoglycemia
A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood brain barrier and been transferred from the vascular space into the client's interstitial space. Which of the following diagnoses best captures this pathophysiology? A. Focal hypoxia B. Cytotoxic edema C. Hydrocephalus D. Vasogenic edema
Answer: D. Vasogenic edema
A nurse practitioner is providing care for a male client with a long-standing hiatal hernia. Which of the following statements most accurately captures an aspect of the pathophysiology of hiatal hernias? A. Paraesophageal hiatal hernias are common and are normally not treated if the client is asymptomatic. B. The root causes of hiatal hernias are normally treatable with medication. C. If esophageal acid clearance is impaired, esophagitis can result. D. An incompetent pyloric sphincter and high-fat diet are commonly implicated in the development of hiatal hernias.
Answer: C. If esophageal acid clearance is impaired, esophagitis can result.
The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle? A. It holds organs in place. B. It attaches the jejunum and ileum to the abdominal wall. C. It has lots of mobility and moves around in the peritoneal cavity with peristaltic movements. D. It is mainly there to prevent any noxious substance from inner into the gut.
Answer: C. It has lots of mobility and moves around in the peritoneal cavity with peristaltic movements.
A patient is asked to stand with feet together, eyes open, and hands by the sides. Then the patient is asked to close his eyes while the nurse observes for a full minute. What assessment is the nurse performing? A. Segmental reflex B. Posture C. Proprioception D. Crossed-extensor reflex
Answer: C. Proprioception
A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD), in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur? A. Decreased absorption of ingested foods and fluids B. Impaired control of the gastric emptying rate C. Protrusion of the stomach or regurgitation of stomach contents into the esophagus D. Inappropriate release of gastric enzymes
Answer: C. Protrusion of the stomach or regurgitation of stomach contents into the esophagus
A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell? A. Special somatic afferent fibers B. General somatic afferents C. Special visceral afferent cells D. General visceral afferent neurons
Answer: C. Special visceral afferent cells
When explaining the role of liver Kupffer cells to a group of nursing students, which of the following statements about the function of these cells is most accurate? A. The primary function of Kupffer cells is to secrete bile. B. These cells are the functional unit of the liver and are responsible for all liver secretions. C. The cells are capable of removing and phagocytizing old and defective blood cells. D. The role of the Kupffer cells is to provide at least 50% of cardiac output each minute to each lobular of the liver.
Answer: C. The cells are capable of removing and phagocytizing old and defective blood cells.
A 51-year-old male has been diagnosed with alcohol-induced liver disease. He admits to the nurse providing his care that, I know what the lungs do, and I know what the heart does, but honestly I have no idea what the liver does in the body. Which of the following statements would best underlie the explanation that the nurse provides? A. The liver is responsible for the absorption of most dietary nutrients as well as the production of growth hormones. B. The liver contributes to the metabolism of ingested food and provides the fluids that the GI tract requires. C. The liver metabolizes most components of food and also cleans the blood of bacteria and drugs. D. The liver maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals, and vitamins.
Answer: C. The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.
The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents? A. Your son's muscular dystrophy is a result of faulty connections between muscles and the nerves that normally control them. B. He'll require intensive physical therapy as he grows up, and there's a good chance that he will outgrow this problem as he develops. C. Your son will be prone to heart problems and decreased lung function because of this. D. His muscles will weaken and will visibly decrease in size relative to his body size throughout his childhood.
Answer: C. Your son will be prone to heart problems and decreased lung function because of this.
The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state that A. it takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells. B. there is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane. C. the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable. D. the neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.
Answer: C. the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which of his statements is most accurate? A) "If you've been exposed to the herpes virus in the past, then there's no significant risk of reinfection." B) "The worst case scenario is that you'll develop cold sores, since this is the type of herpes virus that I've got." C) "If you've had cold sores when you were younger, it means that you've got antibodies against this type of herpes virus." D) "Even when I'm not having a recurrence, I could still pass the virus on to you."
Answer: D) "Even when I'm not having a recurrence, I could still pass the virus on to you."
An adult male has a new diagnosis of Guillain-Barré syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)? A. The destruction of myelin causes fewer Schwann cells to be produced in the client's PNS. B. The axonal transport system is compromised by the lack of myelin surrounding nerve cells. C. Unless remyelination occurs, the axon will eventually die. D. A deficit of myelin predisposes the client to infection by potential pathogens.
Answer: C. Unless remyelination occurs, the axon will eventually die.
While being tackled, a 20-year-old football player puts out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment? A) "This strain will likely resolve itself with sufficient rest." B) "You've suffered a severe sprain, and you might need a cast." C) "Your wrist contusion will have to be observed for bleeding under the skin surface." D) "It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."
Answer: D) "It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."
Following genetic testing and a thorough history from the child's mother and father, a 5-month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father? A) "His skeleton is prone to breakage, and we'll begin hormone therapy to treat this." B) "His hips are extremely susceptible to dislocation, so rough play is out of the question." C) "You'll need to commit to calcium supplementation for the duration of his development." D) "You'll need to be very careful to avoid causing fractures to his fragile bones."
Answer: D) "You'll need to be very careful to avoid causing fractures to his fragile bones."
During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action? A. Cerebellum B. Thalamus C. Basal ganglia D. Frontal lobe
Answer: D. Frontal lobe
Which of the following statements best describes an aspect of the normal process of glucose metabolism? A. Blood glucose levels are primarily a result of the timing, quantity, and character of food intake. B. Ingested glucose that is not needed for cellular metabolism circulates in the blood until it is taken up to meet cellular needs. C. Blood glucose levels are kept in a steady state by selective excretion and reuptake by the kidneys. D. Glucose that exceeds metabolic needs is converted and stored by the liver.
Answer: D. Glucose that exceeds metabolic needs is converted and stored by the liver.
A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse? A. Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses. B. Communication between a neuron and the single neuron it is connected with will be facilitated. C. The neurotransmitter will cross gap junctions more readily. D. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.
Answer: D. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.
After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem? A. Surgical correction of the incompetent pylorus B. Antacids; avoiding positions that exacerbate reflux; a soft-textured diet C. Weight loss and administration of calcium channel blocking medications D. Proton pump inhibitors; avoiding large meals; remaining upright after meals
Answer: D. Proton pump inhibitors; avoiding large meals; remaining upright after meals
A 48-year-old woman has been diagnosed with extrahepatic cholestasis following a thorough history, ultrasound, and blood work. Which of the following symptoms most likely caused her to seek medical treatment, and what consequence to her health problem would the medical team anticipate? A. Complaints of lower flank pain with consequences of impaired fat metabolism B. Anorexia with consequences of impaired drug metabolism and blood filtration C. Skin xanthomas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors D. Pruritus with consequences of deficient levels of fat-soluble vitamins
Answer: D. Pruritus with consequences of deficient levels of fat-soluble vitamins
Growth hormone (GH) secretion is inhibited by A. hypoglycemia. B. starvation. C. heavy exercise. D. obesity.
Answer: D. obesity.
Which of the following diagnostic findings is likely to result in the most serious brain insult? A. Mean arterial pressure (MAP) that equals intracranial pressure (ICP) B. Moderate decrease in brain tissue volume secondary to a brain tumor removal C. Increased ICP accompanied by hyperventilation D. High intracellular concentration of glutamate
Answer: A. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? A. The client has decreased deep tendon reflexes. B. The client displays increased muscle tone. C. The client's muscles appear atrophied. D. The client displays weakness in the distal portions of his limbs.
Answer: B. The client displays increased muscle tone
Following a car accident of a male teenager who did not have his seatbelt on, he arrived in the emergency department with a traumatic brain injury. He has severe cerebral edema following emergent craniotomy. Throughout the night, the nurse has been monitoring and reporting changes in his assessment. Which of the following assessments correspond to a supratentorial herniation that has progressed to include midbrain involvement? Select all that apply. A. Clouding of consciousness B. Decorticate posturing with painful stimulation C. Pupils fixed at approximately 5 mm in diameter D. Respiration rate of 40 breaths/minute E. Decerebrate posturing following painful stimulation of the sternum
Answer: C, D, E
A toddler is displaying signs and symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The patient's family asks how he got this. The nurse will respond: A. This could result from playing in soil and then ingesting bacteria that are now attacking his motor neurons. B. No one really knows how this disease is formed. We just know that in time, he may grow out of it. C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait. D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.
Answer: C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
A 22-year-old woman has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the woman expect over the course of recovery? Select all that apply. A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity D) Presence of infectious microorganisms in the synovial capsule E) Rapid restoration of the cartilage cells in the meniscus
Answer: A, B, & C A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity
A nurse who works in the office of an endocrinologist is orienting a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? Select all that apply. A. A bodily process can be the result of the combined effect of several different hormones from different sources. B. A single hormone can act not only on one process or organ but often on several different locations or processes. C. It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect. D. Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions. E. The regulation in homeostasis requires that hormones be absent from the body when their effect is not needed.
Answer: A, B, C, & D A. A bodily process can be the result of the combined effect of several different hormones from different sources. B. A single hormone can act not only on one process or organ but often on several different locations or processes. C. It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect. D. Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions.
Following bone density scanning and diagnostic imaging, a 4-year-old boy has been diagnosed with Legg-Calvé-Perthes disease. Which of the following findings, signs, and symptoms would lead clinicians to this conclusion? Select all that apply. A) The boy has significant difficulty in walking. B) The boy's feet toe-in when standing upright. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic. E) There are numerous microfractures where his patellar tendon and tibia articulate.
Answer: A, C, & D A) The boy has significant difficulty in walking. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic.
A 30-year-old man with a diagnosis of type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which of the following physiological processes are actions of insulin? Select all that apply. A. Increasing the metabolic needs of body cells B. Promoting the breakdown of stored triglycerides C. Facilitating triglyceride synthesis from glucose in fat cells D. Inhibiting protein breakdown E. Promoting glucose uptake by target cells
Answer: C, D, & E C. Facilitating triglyceride synthesis from glucose in fat cells D. Inhibiting protein breakdown E. Promoting glucose uptake by target cells
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