Last Patho Exam

A new mother brings her infant to the clinic reporting that the child is not sleeping or eating much. Upon assessment, the health care provider notes that the infant's ear canal is reddened with a bulging tympanic membrane. Which other data collected would lead to the diagnosis of acute otitis media (AOM)? Select all that apply.

A) "Yes, he has been pulling at his ear."C) "He's been very irritable and fussy the past couple of days."

Which of the following clients are at risk for developing and acute episode of angle-closure glaucoma? Select all that apply.

A) A 60-year-old female emotionally devastated after divorcing her husband of 35years B) A soldier ordered to stay in a pitch-black cave to observe enemy militants for an extended period of time E) A surgical client who has received many doses of IV atropine to keep heart rate above 50

As part of the community health department, a nurse is educating a group of diabeticclients about prevention of blindness. Which of the following topics should be coveredduring this class? Select all that apply.

A) Importance of yearly eye examsC) Tight control of blood glucose levelsD) Keep BP below 130.85 (Am. Heart Assoc. Guidelines)

When educating a group of teenagers about sexually transmitted infections, the school nurse also mentions that cervical cancer has been associated with which of the following viral infections? A. Chlamydia trachomatis B. Herpes simplex C. Human papilloma D. Varicella zoster

C. Human papilloma

Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? A. Human papillomavirus infection (HPV) B. Lymphgranuloma venereum (LGV) C. Herpes simplex virus type 2 infection (HSV-2) D. Candidiasis

B. Lymphgranuloma venereum (LGV)

The nurse is collecting data from a patient with diabetes mellitus. The patient'smedical history reveals multiple episodes of hyperglycemia requiring medical management. Thepatient tells the nurse, "I just got new glasses, but I still do not see very well." Which conditiondoes the nurse suspect?

Background retinopathy

The laboratory result of a specimen from a 20-year-old female patient shows human papillomavirus (HPV). What would the nurse suspect the patient's diagnosis to be? a. Syphilis b. Gonorrhea c. Genital warts d. Genital herpes

C Genital warts are caused by human papillomavirus (HPV). Syphilis is caused by T. pallidum. Gonorrhea is caused by N. gonorrhoeae. Genital herpes are caused by herpes simplex virus.

What is the first indication of macular degeneration?

The loss of central vision

Which of the following is often the first sign of ototoxicity from drugs or chemicals?

Tinnitus

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? a)decongestant nasal spary such as phenylephrine b(oral corticosteroid, such as prednisone c)intranasal steroid such as fluticasone propionate d)antihistamine nasal spray such as olopatadine

a) decongestant nasal spary such as phenylephrine

Which hearing test would be prescribed to help differentiate conductive from sensorineural hearing loss? a)A Weber (tuning fork) test b)An audioscopic nerve impulse examination c)An auditory brain stem-evoked response (ABR) d)A simple whisper test by the examiner

a)A Weber (tuning fork) test

A male diagnosed with gonorrhea will likely complain of which of the following clinical manifestations? Select all that apply. a)Creamy, yellow discharge b)Pain in the urethra with urination c)Difficulty starting a stream of urine d)"Fish"-smelling discharge from the penis e)Diffuse pelvic pain

a)Creamy, yellow discharge b)Pain in the urethra with urination

A 22-year-old woman with multiple sexual partners seeks care after several weeks of experiencing painful and frequent urination and vaginal discharge. Although the results of a culture of cervical secretions are not yet available,the nurse explains to the patient that she will be treated as if she has gonorrhea and chlamydia to prevent a. obstruction of the fallopian tubes. b. endocarditis and aortic aneurysms. c. disseminated gonococcal infection. d. polyarthritis and generalized adenopathy.

a. Upward extension of gonorrhea or chlamydia commonly causes PID, which can cause adhesions and fibrous scarring, leading to tubal pregnancies and infertility.

A client has been diagnosed with bilateral cataracts associated with having difficulty seeing clearly. Reviewing the medication history, which drug may be responsible for the development of this condition?

corticosteroids

Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? a)Human papillomavirus (HPV) infection b)Herpes simplex virus type 2 (HSV-2) infection c)Candidiasis d)Lymphogranuloma venereum (LGV)

d)Lymphogranuloma venereum (LGV)

The nurse is reinforcing teaching provided to a patient with primary open-angleglaucoma (POAG) about symptoms to report. Which patient statement regarding symptomsindicates a correct understanding of the teaching?

"Headache and seeing halos around lights"

During accommodation, pupillary dilation partially compensates for the reduced size of theretinal image by:

Increasing light entering the pupil

Diabetic and hypertensive retinopathy are both characterized by the appearance of:

Intraretinal hemorrhages

The nurse is admitting a client documented to have papilledema. The nurse recognizes that papilledema is most commonly caused by which condition? a)Intracranial pressure b)Type 2 diabetes c)Viral infection d)Systemic lupus erythematosus

a) Intracranial pressure

A client presents with a rash on the palms of his hands, mucous membranes, and stomach. He is reporting a sore throat and nausea. Which conditions is the nurse concerned about? a)Syphilis b)Chlamydia c)Bacterial vaginitis d)Gonorrhea

a) Syphilis

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit: a)No symptoms of infection b)Copious amounts of frothy discharge from the penis c)Numerous pustules on the penal shaft d)Redness and pain at the urethral meatus

a)No symptoms of infection

There is no known cure for genital herpes, and methods of treatment are often symptomatic. Pharmacologic management of genital herpes includes which drugs?

Acyclovir

Which of the following is an example of conduction deafness?

Adhesions reducing the movement of the ossicles

A client presents to the ENT clinic with some vague signs/symptoms. Which complaints would lead the health care provider to suspect the client has otosclerosis? Select all that apply.

A) Inability to hear whispering. C) When chewing food, sounds are much intensified. E) The person's own voice sounds unusually loud.

A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing:

Acute angle-closure glaucoma

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.

A client presents with signs and symptoms of candidiasis and is concerned about why this occurs after taking antibiotics. The most appropriate information for the nurse to provide would be:

Antibiotics suppress the normal protective vaginal flora allowing overgrowth of C. albicans.

A client develops fever, headache, and burning/itching in the periorbital area. After a few days, a vesicular rash appears around the eyelid margins. The health care provider will likely prescribe:

Antiviral medication for herpes zoster ophthalmicus

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

Chronic hyperglycemiaHypertension Smoking

A patient tells the nurse that he has hearing loss due to otosclerosis. The nurse realizes that the patient has which of the following?

Conductive hearing loss

The nurse is educating a patient diagnosed with Meniere's disease on lifestyle modifications to reduce the frequency and/or intensity of exacerbations. Which should the nurse include?

Decrease dietary intake of sodium

A 22 yr old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A. Candida albicans B. Chlamydia trachomatis C. Trichomonas vaginalis D. Human papillomavirus (HPV)

D. Human papillomavirus (HPV)

An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms? A. Human papillomavirus symptoms B. Chlamydia C. Gonorrhea D. Tertiary syphilis

D. Tertiary syphilis

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.

Dementia Blindness Ataxia

One of the causes of conductive hearing loss is:

Excess middle ear fluid

How does otosclerosis cause hearing loss?

Fixation of the stapes to the oval window

Which of the following is a sign of a detached retina?

No pain, development of a dark area in the visual field

The nurse is conducting hearing tests in a neighborhood clinic. The nurse isconcerned about the number of young adult patients who exhibit signs of sensorineural hearingloss. For which reason does the nurse suspect this type of hearing loss in this population?

Prolonged exposure to loud noise

The nurse understands that an antimicrobial drug is most likely to be prescribed for which condition? a)Otosclerosis b)Barotrauma c)Otitis media with effusion d)Acute otitis media

d) Acute otitis media

The nurse is assisting with the care of a patient being prepared for emergencyintervention for a detached retina. If the nurse asks the patient about the ability to maintain areclining position for 16 hours, which procedure is planned for this patient?

Pneumatic retinopexy

Which may contribute to otitis media? (Select all that apply.)

a. Exposure to cigarette smoke b. Allergies c. Upper respiratory infections

Which of the following are causes of cataracts? (Select all that apply.)

a. Long-term use of corticosteroids c. Congenital from exposure to maternal rubella d. Diabetes mellitus f. Smoking

When is syphilis highly contagious? a)When gummas lesions are observable b)During its primary stage c)After the characteristic rash disappears d)Years 3 to 5 of its latent stage

b) During its primary stage

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? a) Amenorrhea b) Fallopian tube damage c) Vaginal adhesions d) Uterine cancer

b) Fallopian tube damage

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has: a)Candidiasis b)Trichomoniasis c)Bacterial vaginosis d)Chlamydial infection

b) Trichomoniasis

The most prevalent vaginal infection to be spread through sexual contact is: a)Candidiasis b)Trichomoniasis c)Vulvovaginitis d)Bacterial vaginosis

b) Trichomoniasis

A client states that she experiences motion sickness during travel by air. In addition to nausea, what signs and symptoms characterize this complaint? Select all that apply. a)Hearing loss b)Feeling lightheaded c)Rapid heart rate d)Diaphoresis e)Sudden onset of vertigo

b)Feeling lightheaded c)Rapid heart rate d)Diaphoresis

Causes of eyelid weakness include neurologic causes. There can be damage to the cranial nerves (CN) that innervate the eyelids, or there can be damage to the central nuclei of the cranial nerves. Where are the central nuclei of cranial nerve III (oculomotor nerve) and CN VII (facial nerve)? a)Medulla oblongata and pineal body b)Midbrain and caudal pons c)Faux cerebellum and amygdala d)Hypothalamus and pyramid

b)Midbrain and caudal pons

A client who is being treated in the critical care unit is experiencing a slowing of blood flow to the central retinal artery, ultimately resulting in edema of the client's optic papilla. Which assessment would most likely address the etiology of this health problem? a)Culture and sensitivity testing of the client's eye exudate b)Monitoring of the client's intracranial pressure c)Monitoring of the client's mean arterial pressure d)Palpation for cervical lymphedema

b)Monitoring of the client's intracranial pressure

A 46 year-old male has presented to the emergency department because of the eye pain, severe headache and blurred vision that has followed an eye exam at an optometrist's office earlier in the day. The client tells the triage nurse that he received eye drops during the exam "to keep my pupils wide open." What differential diagnosis will the care team first suspect?

Angle-closure glaucoma

As the eyes rotate upward, the upper eyelid reflexively retracts. Which cranial nerve is primarily responsible for this response?

Cranial nerve III.

Which of the following events is associated with the primary stage of syphilis? A. Development of gummas B. Palmar rash C. Development of central nervous system lesions D. Genital chancres

D. Genital chancres

Why is otitis media found more frequently in children 6 to 36 months?

Eustachian tubes in children are shorter and straighter.

Why does vertigo occur with Ménière's syndrome?

Excessive endolymph impairs the function of hair cells in the labyrinth.

The nurse is collecting data from a patient with a detached retina. Which findings doesthe nurse expect in this patient? (Select all that apply.)

Flashing lights Loss of peripheral vision Loss of acuity in the affected eye

The nurse is providing care for a patient with a sensorineural hearing loss. Whichprescribed medications does the nurse question before administering medications to this patient?(Select all that apply.)

Gentamicin Furosemide Indomethacin

A patient has been diagnosed with hemianopia. The patient asks the nurse what this is describing concerning the eye?

Loss of half of the visual field in one eye

A client has been diagnosed with open-angle glaucoma during routine eye exam. The client has been prescribed a topical b-adrenergic antagonist. Client teaching about how this drug works should include which of the following statements? b-adrenergic antagonists:

Lower intraocular pressure by decreasing aqueous humor production

A young teenager is brought to the clinic for an eye exam. She has been complaining that she is having difficulty in school as she cannot see the blackboard as clearly as she used to. She tells the nurse that it is blurry. What should the nurse suspect is wrong with this child?

Myopia

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

Which of the following signs and symptoms is most indicative of Ménière disease?

Rotary vertigo and tinnitus

An infection that damages the auditory nerve can cause what type of hearing loss?

Sensorineural

The nurse is assessing a steel mill worker who suffers from hearing loss related to exposure to loud, occupational noise. The nurse understands that this type of hearing loss is classified as which of the following?

Sensorineural hearing loss

A young child is flying on a plane for the first time. As the plane begins its decent for landing, his ears begin to hurt. The flight attendant sees that he is in pain and tells him to swallow until the pain goes away. Which structure is the child using to equalize the pressure and relieve the pain?

Swallowing pulls air through the eustachian tubes, allowing the air pressure to equalize in the inner ear.

During a routine 2-month checkup at the pediatric clinic, a mother expresses concern thather son looks "cross-eyed." She asks if she need to put patches over his good eye.Assessment reveals full eye movement, and the child uses each eye independently. Thehealth care provider explains that the best treatment for the infant's eye problem is:

To prepare for some surgery to correct this problem early on to correct the eyemuscle disorder.

An older client is complaining of having difficulty seeing. The nurse suspects that the client has cataracts. What are the common manifestations of a cataract? Select all that apply. a)Increasingly blurred vision b)Constriction of the pupil in dim light improves vision c)Hyperopia d)Visual distortion

a)Increasingly blurred vision d)Visual distortion

The nurse is teaching a client about the treatment of open-angle glaucoma. The mostappropriate information for the nurse to give the client would be: a)administration of topical beta-adrenergic antagonists to lower the pressure. b)to monitor vision for signs of closed-angle vision. c)oral diuretics should be administered immediately. d)laser peripheral iridotomy is performed immediately.

a)administration of topical beta-adrenergic antagonists to lower the pressure.

Which manifestations are characteristic of the late or tertiary stage of syphilis (select all that apply)? a. Heart failure b. Tabes dorsalis c. Saccular aneurysms d. Mental deterioration e. Generalized cutaneous rash f. Destructive skin, bone, and soft tissue lesions

a, b, c, d, f. In the tertiary (or late) stage of syphilis there can be gummas (chronic destructive lesions), cardiovascular problems (heart failure, aneurysms, valve insufficiency), and neurosyphilis manifestations (mental deterioration, tabes dorsalis, and speech disturbances). Generalized cutaneous rash occurs in the secondary stage of syphilis, a few weeks after the chancre appears.

Select all the conditions that may cause conductive hearing loss. (Select all that apply.)

a. Buildup of cerumen b. Foreign bodies c. Otosclerosis of external auditory canal f. Otitis media with effusion

Corneal transplants come from cadavers. Why do corneal transplants have such a low rejection rate? Select all that apply. a)The cornea is very vascular. b)Antigen-presenting cells are not present in great numbers. c)The cornea secretes immunosuppressive factors. d)The cornea has no lymphatics. e)Corneal cells secrete substances that protect against keratitis.

b)Antigen-presenting cells are not present in great numbers. c)The cornea secretes immunosuppressive factors. d)The cornea has no lymphatics.

A female patient with a purulent vaginal discharge is seen at an outpatient clinic. The nurse suspects a diagnosis of gonorrhea. How would this STI be treated? a. Oral acyclovir (Zovirax) b. Benzathine penicillin G given IM c. Ceftriaxone (Rocephin) IM or oral cefixime (Suprax) d. Would need a second confirmatory test result before treatment

c. An established diagnosis of gonorrhea is treated with cefixime (Suprax) orally or with a single dose of IM ceftriaxone (Rocephin)

After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts? a)6 months to 8 months b)6 weeks to 8 weeks c)6 days to 8 days d)6 weeks to 8 months

d) 6 weeks to 8 months

A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which sexually transmitted infection? a)Gonorrhea b)Genital herpes c)Chlamydia d)Syphilis

d)Syphilis

A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women? a)Herpes simplex b)Chancroid c)Genital warts d)Trichomoniasis

d)Trichomoniasis

The home health patient complains of tearing and a feeling of dryness in the right eye.The nurse assesses that the eyelid is turned inward and the sclera is red. The nurse documents the presence of a(n)_________________.

entropion

What are the symptoms of Ménière disease? Select all that apply.

• Severe ringing in the ear(s) • Feeling of fullness in the ear(s) • Episodes of disabling vertigo

Otitis media (OM), which can occur is any age group, is the most common diagnosis made by health care providers who care for children. Which bacterial pathogen causes the largest proportion of cases that result in sensorineural hearing loss?

Streptococcus pneumoniae

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? a)Syncope b)Motion sickness c)Light-headedness d)Dizziness

b)Motion sickness

What are the common clinical manifestations of acute angle-closure glaucoma? Select all that apply. a)Pinpoint pupil b)Ocular pain c)Blurred vision d)Sudden, continuous increase in intraocular pressure

b)Ocular pain c)Blurred vision Symptoms of acute angle-closure glaucoma are related to sudden, intermittent increases in intraocular pressure. Attacks of increased intraocular pressure are manifested by ocular pain and blurred or iridescent vision caused by corneal edema. The pupil may be enlarged and fixed.

A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in. a)Latent b)Secondary c)Primary d)Tertiary

b)Secondary

A mother brings her toddler to the clinic and tells the nurse that she thinks something is wrong with the baby's eyes. Upon further assessment the nurse notices that the child has upper deviation in movement in only one eye. What diagnosis should the nurse suspect for this child? a)Amblyopia b)Strabismus c)Cataract d)Glaucoma

b)Strabismus

For a woman, what is the most serious long-term outcome of an infection resulting from exposure to the N. gonorrhoeae bacteria? a)Dysuria b)Bartholin gland abscesses c)Sterility d)Postcoital bleeding

c) Sterility

A client has been diagnosed with candidiasis. Which symptom was present to diagnose this condition? a)Pustules b)Urinary retention c)Thick, white secretions d)Severely painful lesions

c) Thick, white secretions

A client is distraught because she has suddenly lost vision in the right half of both of her eyes. The care team's subsequent diagnostic testing will address the likelihood of: a)microvascular effects of diabetes. b)macular degeneration. c)an optic nerve lesion. d)multiple sclerosis.

c) an optic nerve lesion.

In assessing a client, the nurse notes a grayish discharge from the vaginal area accompanied by a foul odor. What is the nurse's best action? a)Applying an antifungal cream b)Encouraging better hygiene c)Asking about other symptoms d)Flushing the area with an antibiotic wash

c)Asking about other symptoms

An acute episode of angle-closure glaucoma is preceded by which symptom? a)Vitreous humor fluid loss b)Corneal surface trauma c)Prolonged pupil dilation d)Central visual field loss

c)Prolonged pupil dilation

A client has been diagnosed with sensorineural hearing loss. What should the care team assess to determine a plausible cause? a)The client's immunization status b)The presence of cerumen in the ear canal c)The client's recent medication use d)The patency of the client's Eustachian tubes

c)The client's recent medication use

A 55-year-old client has been diagnosed with acute angle-closure glaucoma. The client's ophthalmologist is recommending immediate and aggressive drug treatment because the: a)pressure will cause a clouding of the lens that will rapidly lead to blindness. b)increase in intraocular pressure may change the shape of the lens. c)increase in intraocular pressure will cause degradation of the optic nerve. d)decrease in intraocular pressure will inhibit blood perfusion in the eye.

c)increase in intraocular pressure will cause degradation of the optic nerve.

During the physical assessment of a female patient with HPV infection, what should the nurse expect to find? a. Purulent vaginal discharge b. A painless, indurated lesion on the vulva c. Painful perineal vesicles and ulcerations d. Multiple coalescing gray warts in the perineal area

d. HPV is responsible for causing genital warts, which manifest as discrete single or multiple white to gray warts that may coalesce to form large cauliflower-like masses on the vulva, vagina, cervix, and perianal area. Purulent vaginal discharge is associated with gonorrhea or chlamydia. Painful perineal vesicles and ulcerations arecharacteristic of genital herpes and a chancre of syphilis is a painless indurated lesion on the vulva, vagina, lips, or mouth.

The physiologic reasoning behind giving acyclovir, an antiviral medication, to a client diagnosed with genital herpes would include the fact that these drugs:

interfere with viral DNA replication, which can decrease the frequency of recurrences