NUR 218 Exam 3

A Jewish patient who adheres to a kosher diet is diagnosed with type 1 diabetes. What would be the best response of the nurse when the patient refuses to take insulin, stating, "Insulin contains pork and I do not eat pork"? a. "There is only a tiny amount of pork by-product in insulin." b. "All of the insulin used today is made synthetically." c. "I will notify your physician to change the insulin order." d. "You really do not have the option of not taking insulin."

"All of the insulin used today is made synthetically." All insulin manufactured today is biosynthetic. It is no longer derived from pork or cattle pancreas. There is no need to contact the physician to change the order. Patients always have the right to refuse medication. In this case, educating the patient about the source of the insulin should allay any fears of the insulin coming from pigs.

Which of the following documentation statements indicates a normal assessment of the perianal area? a. "Anus moist, color darker than adjacent tissues. No lesions or discharge. Opening tightly closed." b. "Anal area dark pink, moist, with 0.5-cm shiny blue skin sac at 5 o'clock." c. "Anus with flabby skin sac at 7 o'clock." d. "Small round opening in the anal area."

"Anus moist, color darker than adjacent tissues. No lesions or discharge. Opening tightly closed." Normal findings during inspection of the perianal area include anus moist and hairless, with coarse folded skin that is more pigmented than the perianal skin; anal opening that is tightly closed; and no lesions present. A shiny blue skin sac is a thrombosed hemorrhoid. A flabby skin sac is a hemorrhoid. A small round opening in the anal area is a fistula.

When a patient reports having dyspareunia, which question is it most appropriate for the nurse to ask? a. "Have you talked with your partner about this discomfort?" b. "Have you had these spasms since you became sexually active?" c. "Does the bleeding continue longer than five days?" d. "Do your breasts swell up large enough for you to need a larger bra?"

"Have you talked with your partner about this discomfort?" Dyspareunia is painful intercourse, and the sexual partner should be made aware of this to foster understanding and adjustment of sexual practices. Spasms, bleeding, and breast swelling are not associated with this condition.

What snack choice would be the best suggestion by the nurse for a patient on a renal diet? a. Peanut butter b. Bananas c. Diet cola d. Carrot sticks

Carrot sticks Carrot sticks are the best snack food to suggest for a patient on a renal diet. Renal diets restrict potassium, sodium, protein, and phosphorus intake, making peanut butter, bananas, and diet cola poor choices.

The nurse instructs a patient with a vitamin A deficiency on food sources that could prevent symptoms. Which of the following food combinations would be appropriate? a. Corn and potatoes b. Carrots and spinach c. Iron-fortified bread or cereals d. Raisins and papaya

Carrots and spinach Carrots and spinach are good sources of vitamin A. Corn and potatoes are good sources of starch and fiber. Raisins and papaya are excellent sources of calcium. Fortified bread and cereals are good sources of iron and fiber.

Ascites is defined as: a. a bowel obstruction. b. a proximal loop of the large intestine. c. an abnormal enlargement of the spleen. d. an abnormal accumulation of serous fluid within the peritoneal cavity.

an abnormal accumulation of serous fluid within the peritoneal cavity. Ascites is free fluid in the peritoneal cavity. A bowel obstruction may result in abdominal distention. The proximal loop of the large intestine is the ascending colon. Splenomegaly is the term to describe an enlarged spleen

Orchitis is (are): a. a meatus opening on the dorsal side of the glans or shaft. b. hard, subcutaneous plaques associated with painful bending of the erect penis. c. a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes. d. an acute inflammation of the testes.

an acute inflammation of the testes. Orchitis is an acute inflammation of the testes. Epispadias is a meatus opening on the dorsal side of the glans or shaft. Peyronie disease is a result of hard, nontender, subcutaneous plaques on the penis that cause a painful bending of the penis during an erection. A hydrocele is a circumscribed collection of serous fluid in the tunica vaginalis surrounding the testes.

A comprehensive nutritional assessment always includes: a. anthropometric measures. b. a direct observation of feeding and eating processes. c. a work history. d. a comprehensive metabolic panel.

anthropometric measures. Anthropometric measures evaluate growth, development, and body composition. Examples include height, weight, waist circumference, derived weight measures (e.g., body mass index, waist-to-hip ratio), and triceps skinfold thickness.

The group of axillary lymph nodes that drains the other three groups of nodes is the: a. anterior nodes. b. central nodes. c. lateral nodes. d. posterior nodes.

central nodes. The central axillary nodes receive lymph from the other three groups of nodes (i.e., anterior [pectoral], posterior [subscapular], and lateral).

Pyloric stenosis is a(n): a. abnormal enlargement of the pyloric sphincter. b. inflammation of the pyloric sphincter. c. congenital narrowing of the pyloric sphincter. d. abnormal opening in the pyloric sphincter.

congenital narrowing of the pyloric sphincter. Pyloric stenosis is a congenital defect causing a narrowing of the pyloric sphincter.

The first sign of puberty in boys is: a. enlargement of the testes. b. the appearance of pubic hair. c. an increase in penis size. d. pubic hair growth extending up the abdomen.

enlargement of the testes. The first sign of puberty in boys is enlargement of the testes. Following the enlargement of the testes, pubic hair appears, then penis size increases. Pubic hair growth extending up the abdomen occurs after puberty.

The knee joint is the articulation of which three bones? a. femur, fibula, and patella. b. femur, radius, and olecranon process c. fibula, tibia, and patella. d. femur, tibia, and patella.

femur, tibia, and patella. The knee joint is the articulation of the femur, the tibia, and the patella. The fibula is not involved in articulation of the knee joint. The radius and ulna are bones in the lower part of the upper extremity; the olecranon process is located on the proximal end of the ulna.

A patient is taking iron supplements. The patient should expect the stools to be: a. clay colored b. nontarry and black. c. tarry and black. d. frothy.

nontarry and black. Iron medication supplements cause stools to be nontarry and black. Clay-colored stools are caused by the absence of bile pigment. Melena is the term to describe tarry, black stools; this indicates the presence of blood in the stool. Frothy stools have excessive fat from a malabsorption of fat; the term to describe fatty stools is steatorrhea.

The relative proportion of glandular, fibrous, and adipose breast tissue depends on: a. environmental factors. b. genetics. c. sex. d. nutritional state.

nutritional state. The relative proportion of glandular, fibrous, and fatty tissue varies depending on age, cycle, pregnancy, lactation, and general nutritional state.

Dysmenorrhea is: a. painful intercourse. b. pain with defecation. c. pain with urination. d. pain associated with menstruation.

pain associated with menstruation. Dysmenorrhea is the abdominal cramping and pain associated with menstruation. Dyspareunia is the term to describe painful intercourse. Dyschezia is pain with bowel movements. Dysuria describes pain or burning with urination.

The functions of the musculoskeletal system include: a. protection and storage. b. movement and elimination. c. storage and control. d. propulsion and preservation.

protection and storage. The functions of the musculoskeletal system are as follows: provide support to stand erect; allow movement; encase and protect the inner vital organs; produce the red blood cells in the bone marrow; and act as a reservoir for storage of essential minerals, such as calcium and phosphorus in the bones.

The abdomen normally moves with breathing until the age of __ years. a. 4 b. 7 c. 14 d. 75

7 Abdominal breathing in children continues until the age of 7 years.

For optimum health, infants and children up to 2 years of age should receive whole milk. What component of whole milk is essential for neurologic development? a. Lactose b. Pasteurized protein c. Fortified vitamin D d. Fat

Fat Infants and children younger than 2 years of age should not drink skim or low-fat milk or be placed on low-fat diets. Fat (calories and essential fatty acids) is required for proper growth and central nervous system development.

When a 52-year-old man asks the nurse if some sexual positions are considered perverted, the nurse replies by saying many people enjoy different positions for sex and that each couple has the right to use any position for sex that they enjoy. In consideration of the PLISSIT model for counseling patients with sexual problems, of what is the nurse's response an example? a. Limited information b. Specific suggestion c. Permission giving d. Intensive therapy

Limited information The nurse's response is providing limited information to dispel this patient's misconception. The other steps listed occur, but they are different components of the PLISSIT model.

Select the most appropriate goal for a patient experiencing diarrhea related to antibiotic use: a. The patient will return to previous elimination pattern. b. The patient will increase intake of grains, rice, and cereals. c. The patient will discontinue antibiotic use and contact the health care provider. d. The patient will increase fluid intake.

The patient will increase fluid intake.

The nurse informs a group of men at the senior citizens' center about what age-related sexual change? a. Increased testosterone levels b. More frequent erections c. Weaker erections d. Sperm production increases

Weaker erections Weaker erections in older men occur due to physiologic changes associated with aging. As men age, their testosterone level decreases, they need more time to achieve erection and ejaculation, and sperm production decreases.

patient is being discharged from the hospital with a new ileostomy. The patient expresses concern about caring for the ostomy. Before hospital discharge, it is most important for the nurse to coordinate with which member of the health care team? a. Home care nurse b. Wound ostomy continence nurse c. Registered dietitian d. Primary care provider

Wound ostomy continence nurse The wound ostomy continence nurse (WOCN) is the most important person to contact to schedule teaching sessions and follow-up care. This nurse specialist is certified in the treatment of patients who have a bowel or bladder diversion. Although team input is important, the contribution of the WOCN is paramount to help the patient achieve competence and comfort with self-care before discharge.

The extrapyramidal system is located in the: a. hypothalamus. b. cerebellum. c. basal ganglia. d. medulla.

basal ganglia. The basal ganglia are large bands of gray matter buried deep within the two cerebral hemispheres that form the subcortical associated motor system (the extrapyramidal system).

Dietary guidelines suggest that overall fat consumption should be: a. less than 300 mg per day. b. between 10% and 20% of the total calorie intake. c. between 20% and 35% of the total calorie intake. d. mostly trans-fatty acid or saturated fat.

between 20% and 35% of the total calorie intake. Total fat intake should be between 20% and 35% of calories, mostly from polyunsaturated or monounsaturated fats. Consumption of cholesterol should be less than 300 mg per day. Intake of saturated fat should be limited. Trans-fatty acid consumption should be as low as possible.

Hematuria is a term used for: a. bloody discharge. b. blood in the urine. c. bleeding after intercourse. d. urine in the blood.

blood in the urine.

The nurse determines that which question is the most appropriate way to begin a sexual assessment of an older adult? a. "How has your sexual function changed as you have become older?" b. "Do you find it embarrassing to talk about sexual activity?" c. "Do you ever feel pressured or unsatisfied during sexual activity?" d. "Would it be okay if I asked you some questions about your sexual health?"

"How has your sexual function changed as you have become older?" An open-ended question provides the patient with the opportunity to respond with more data than a closed-ended question. The remaining three choices are all closed-ended questions that do not foster conversation.

A patient who had a hysterectomy 3 days ago says to the nurse, "I no longer feel like a real woman." Which response by the nurse would be most appropriate? a. "Don't worry about that. The feeling will probably go away." b. "You should talk to your doctor about how you feel." c. "I don't blame you. I would feel like half a woman also." d. "I hear your concern. Tell me more about your feelings."

"I hear your concern. Tell me more about your feelings." Providing an opportunity for communication with an open-ended response encourages the patient to discuss concerns. Telling the patient not to worry is dismissing those concerns and will hamper discussion. Agreeing with the patient also is nontherapeutic and does not foster dialogue. Telling the patient to talk with the doctor stops the chance of conversation and reduces the nurse's role in helping the patient to express feelings.

patient is scheduled for a colonoscopy. After preprocedure teaching by the nurse, the patient demonstrates understanding when he makes which statement? a. "I can have coffee the morning of the procedure." b. "I should drink a red sports drink the day before to stay hydrated." c. "I should drink clear liquids for 2 days before the procedure." d. "I will be able to drive home immediately after the procedure."

"I should drink clear liquids for 2 days before the procedure." The patient will be on a clear liquid diet for 1 to 3 days before the procedure. The patient should not eat or drink anything immediately before the procedure. Drinks with red or purple dye are contraindicated because they could interfere with the exam findings. Patients are given medications during the procedure that alter the sensorium and therefore need to have someone else drive them home.

A female patient has had frequent urinary tract infections. Which statement by the patient indicates that the nurse's teaching on prevention has been effective? a. "I will limit my fluid intake to 40 ounces per day." b. "I will use bubble bath when bathing." c. "I will wait to wear my tight jeans until after my urine is clear." d. "I will wipe from the front to back after voiding."

"I will wipe from the front to back after voiding." Wiping the female perineal area from front to back after voiding is crucial in the prevention of microorganisms, which lead to infection, being transferred from the rectum or vagina to the urethral meatus. Limiting fluid intake, using bubble bath, and wearing tight-fitting clothing all may contribute to the promotion of urinary tract infections, rather than their prevention.

A patient recovering from major abdominal surgery is to be progressed from a clear liquid diet to the next diet level. Which statement by the nurse would be most appropriate in this circumstance? a. "You will progress from a clear liquid diet to a mechanical soft diet." b. "If you can tolerate the clear liquid diet, your next meal will be a full liquid." c. "You will receive a regular diet tray with anything you want at the next meal." d. "It is important that you eat a pureed diet after you are able to tolerate the clear liquids."

"If you can tolerate the clear liquid diet, your next meal will be a full liquid." A full liquid diet is used as a transition diet to avoid overdistending the abdomen after abdominal surgery. A mechanical soft diet incorporates modified food consistency such as ground meat or soft cooked foods. It also is used for people who have difficulty chewing effectively. The regular diet has no restrictions, which could cause damage to the abdomen if the wrong food were selected. A pureed diet is given to persons who cannot tolerate the texture of some foods, which have to be blended so the patient can chew them. There is no indication that this patient has difficulty chewing food.

A hospitalized patient comments to the nurse, "Well, I guess my sex life is over." Which response would the nurse determine to be the most appropriate initial response? a. "I am sorry to hear that." b. "Tell me why you say that." c. "Oh, you have a lot of good years left." d. "Have you asked your doctor about that?"

"Tell me why you say that." Encouraging the patient to share information or feelings is an appropriate therapeutic communication technique. Sympathy and using a cliché may not encourage communication. Asking about interaction may be helpful, but it is not the most appropriate initial nursing response.

Which statement by a patient indicates an accurate understanding of contraceptive methods? a. "Hormonal injections are an effective defense against sexually transmitted infections." b. "Abstinence is never an effective method of contraception when used as a periodic or continuous strategy." c. "Withdrawal of the penis before ejaculation is an ineffective method of birth control that does not reduce the potential spread of sexually transmitted infections." d. "Oral contraceptives protect against pregnancy by stimulating ovulation, thinning cervical mucus, and allowing a fertilized egg to move through the uterus to the fallopian tube."

"Withdrawal of the penis before ejaculation is an ineffective method of birth control that does not reduce the potential spread of sexually transmitted infections." Withdrawal is not effective as a method of contraception and does not reduce the spread of sexually transmitted diseases. The remaining statements are false.

When a patient is beginning a regimen of an antidepressant medication, which information should the nurse include in the medication teaching as it pertains to sexuality? a. "Your partner will be pleased because your sexual functioning is going to improve." b. "You may find that your desire for sex will decrease while on this medication." c. "Your skin will probably become supersensitive to touch, so you may need to change your activity during sex." d. "You will be unable to have an erection while taking your antidepressants."

"You may find that your desire for sex will decrease while on this medication." Reduced sexual desire can be a side effect of antidepressant use. Skin sensitivity and erectile dysfunction are not side effects. Improved sexual function is not a specific effect of antidepressant administration.

The number of lobes within the breast ranges from: a. 10 to 20. b. 15 to 20. c. 20 to 25. d. 20 to 40.

15 to 20. The glandular breast tissue contains 15 to 20 lobes radiating from the nipple.

Average urine pH is a. 4 b. 6 c. 7 d. 9

6 Urine normally is slightly acidic, with an average pH of 6. Urine with a pH of 4 is very acidic. A pH of 7 is neutral, and a pH of 9 is very alkaline.

When the nurse teaches sexually transmitted disease (STD) prevention, which unimmunized individual would be identified as being at the highest risk for contracting the human papilloma virus (HPV)? a. A prepubescent 11-year-old child b. A sexually active 21-year-old college student c. A 42-year-old celibate divorced person with hypertension d. A 28-year-old monogamous married truck driver who has type 2 diabetes

A sexually active 21-year-old college student HPV is transmitted by sexual intimacy. According to the CDC, men and women can lower their risk of getting HPV by being in a monogamous, faithful relationship. Of the individuals mentioned, the 21-year-old who is sexually active is the most likely candidate to get the disease, regardless of gender.

Prior to discharge, the nurse teaches the patient the proper techniques for applying an ostomy pouch. When evaluating the teaching, the nurse observes the patient apply a new ostomy pouch without cleansing the skin underneath. What action(s) should the nurse implement following this patient's return demonstration? (Select all that apply.) a. Repeat the demonstration to show the patient how to clean the ostomy site. b. Document that the patient performed the initial return demonstration accurately and safely. c. Offer positive reinforcement regarding the need to cleanse the site to prevent skin breakdown below the appliance. d. Discharge the patient with written instructions and illustrations that demonstrate the correct procedure. e. Notify the health care provider that a repeat demonstration of the ostomy appliance procedure is needed.

A, C, D The initial return demonstration was not performed accurately, and since it is the nurse's responsibility to complete the needed teaching, the health care provider does not need to be notified. Discomfort and damage to the skin can result from not washing the site; therefore, the nurse should repeat the demonstration, emphasizing the importance of cleansing. Positive reinforcement and the provision of written instructions are valuable teaching strategies.

Which of the following ethnic groups has the lowest incidence of osteoporosis? a. African Americans b. Hispanic c. Asians d. American Indians

African Americans African American adults have a decreased risk of fractures compared with white adults, and Hispanic women have a decreased risk of fractures compared with white women. The difference in fracture rates may be traced to childhood, where African American and Hispanic children have shown significantly higher bone strength than white children show. There is greater bone density at specific bone sites in African American and Hispanic children.

Which statement is the best resource for the nurse to use when determining appropriate nursing care for a transsexual patient? a. Gender identity is altered by acute psychosis. b. Sexual attraction is to individuals of both genders. c. Gonadal gender, internal organs, and external genitals are contradictory. d. Anatomy associated with sexual identity is not consistent with gender identity.

Anatomy associated with sexual identity is not consistent with gender identity. A transsexual's sex organs do not match gender identity. Being a transsexual is not a psychosis. Transsexuals usually are attracted to persons of the gender opposite their own gender identity. Gonadal gender and internal and external organs are not in contradiction.

Sexual health history questions would be most relevant for the nurse to include when admitting a patient who is taking what type of medication? a. Hypnotics (sleeping pills) b. Antihistimines (cold medications) c. Antihypertensives (blood pressure medication) d. Antiinflammatories (such as aspirin or ibuprofen)

Antihypertensives (blood pressure medication) Many antihypertensive medications have erectile dysfunction as a side effect. Anti-inflammatory, hypnotic, and antihistamine medications do not have erectile dysfunction as a side effect.

A patient is scheduled for an upper GI series. Which information is most important to obtain from him before the procedure? a. Allergy to lasix b. Last bowel movement c. Time the enema was administered d. Any difficulty swallowing

Any difficulty swallowing The patient will need to drink barium for this x-ray; therefore, swallowing ability should be assessed prior to the start of the procedure.

While performing an abdominal assessment on an unconscious patient, the nurse notes presence of an ostomy. The fecal output is liquid in consistency, with a pungent odor, and the stoma is located in the upper right quadrant of the abdomen. What type of ostomy does the patient have? a. Descending colostomy b. Ureterostomy c. Ileostomy d. Ascending colostomy

Ascending colostomy An ascending colostomy meets the description of fecal output of liquid consistency and with a pungent odor, as well as location of the stoma in the upper right quadrant of the abdomen. Descending colostomies produce increasingly formed stool. An ileostomy will produce liquid stool but with less odor because enzyme activity is not present. Ureterostomies drain urine, not stool.

Which continent has the lowest prevalence rate of prostate cancer? a. North America b. Australia c. Northwestern Europe d. Asia

Asia Prostate cancer is more common in North America and northwestern Europe and is less common in Central and South America, Africa, and Asia.

In using the PLISSIT model, what is the first action initiated by the nurse? a. Present basic information about sexual functioning. b. Ask permission to begin the sexual assessment. c. Inquire about any medications the patient is taking. d. Ask the patient about sexual activity and practices.

Ask permission to begin the sexual assessment. Before initiating discussion via the PLISSIT model, the nurse should first seek permission to have the conversation with the patient. All of the other listed steps occur, but only after permission is obtained.

While performing a physical assessment on a female patient, the nurse finds several bruises on the patient's inner thighs that are in various stages of healing and suspects that the patient may be a victim of sexual abuse. What should be the nurse's first action? a. Refer the patient to a sexual counselor. b. Tell the patient about the safe house for women. c. Ask the patient to describe how she got the bruises. d. Report the abuse immediately to the proper authorities.

Ask the patient to describe how she got the bruises. The nurse's first action is to gather more data that can confirm or negate the suspicion of sexual abuse. The other actions also could be appropriate after additional information is obtained.

Which nursing instruction is correct when a urine specimen is collected for culture and sensitivity testing from a patient without a urinary catheter? a. Tell the patient to void and pour the urine into a labeled specimen container. b. Ask the patient to void first into the toilet, stop midstream, and finish voiding into the sterile specimen container. c. Instruct the patient to discard the first void and collect the next void for the specimen. d. Have the patient keep all voided urine for 24 hours in a chilled, opaque collection container.

Ask the patient to void first into the toilet, stop midstream, and finish voiding into the sterile specimen container. Urine specimens for culture and sensitivity testing must be collected in sterile containers using the clean-catch, midstream method whenever possible. All voided urine specimens should be collected directly into the specimen container, not transferred from another potentially contaminated vessel. Discarding the entire first void and saving urine in a chilled, opaque container are both procedures for conducting a 24-hour urine collection.

The nurse is assessing a patient with an indwelling catheter and finds that the catheter is not draining and the patient's bladder is distended. What action should the nurse take next? a. Notify the primary care provider (PCP). b. Assess the tubing for kinks and ensure downward flow. c. Change the catheter as soon as possible. d. Aspirate the stagnant urine in the catheter for culture.

Assess the tubing for kinks and ensure downward flow. The next action by the nurse should be to check the patency of the catheter tubing. At this point there is no need to aspirate any urine or call the PCP. The catheter should not be changed unless absolutely necessary, owing to the possibility of causing an infection.

What term is used to describe involuntary muscle movements? a. Ataxia b. Flaccid c. Athetosis d. Vestibular function

Athetosis Athetosis is slow, writhing, continuous, and involuntary movements of the extremities. Ataxia is an impaired ability to coordinate movement, often characterized by a staggering gait and postural imbalance. Flaccid is weak, soft, and flabby; lacking normal muscle tone. Vestibular function is the sense of balance.

Vaginal lubrication during intercourse is produced by: a. Skene glands. b. Bartholin glands. c. sebaceous glands. d. adrenal glands.

Bartholin glands. The vestibular (Bartholin) glands secrete a clear lubricating mucus during intercourse. Paraurethral (Skene) glands are tiny, multiple glands that surround the urethral meatus. Sebaceous glands are microscopic glands in the skin that secrete an oily/waxy matter, called sebum, to lubricate the skin and hair. The adrenal glands are endocrine glands responsible for releasing hormones in conjunction with stress through the synthesis of corticosteroids and catecholamines.

A female Muslim patient is admitted to the hospital and informs the nurse that it is the month of Ramadan. Which action by the nurse is most appropriate in caring for this patient? a. Provide a vegetarian diet for the patient on Friday throughout her hospitalization. b. Ask the dietitian to visit the patient to ensure that fruit and cheese are not combined. c. Check on the potential effect fasting until sundown will have on the patient's condition. d. Document that milk and milk products cannot be prepared with meat or meat products.

Check on the potential effect fasting until sundown will have on the patient's condition. Persons of the Islamic faith fast until sundown during the month of Ramadan. Fruit is not restricted in the patient's culture or religion. No meat on Fridays is commonly followed in the Catholic faith. Kosher diets restrict the preparation of meat and milk products together.

A patient with an indwelling catheter reports a need to void. What is the priority intervention for the nurse to perform? a. Check to see if the catheter is patent. b. Reassure the patient that it is not possible to void while catheterized. c. Catheterize the patient again with a larger-gauge catheter. d. Notify the primary care provider (PCP).

Check to see if the catheter is patent. Checking the position and patency of the catheter first will determine whether the problem is mechanical or physiologic in nature. At times, the end of the catheter may become lodged up against the side of the bladder preventing the flow of urine into the tubing. Telling the patient that is impossible to void while catheterized is erroneous. Catheterizing the patient with a larger-gauge catheter is unnecessary at this point, as is contacting the PCP.

An 18-year-old patient tells the nurse that cocaine is used regularly to try to boost sexual performance. What statement does the nurse identify as true about the effects of cocaine on sexual performance? a. Cocaine has no effect on sexuality. b. Even a small amount of cocaine can cause impotence. c. Cocaine can reduce sex hormone levels and sperm production. d. Chronic cocaine use results in sexual dysfunction and loss of desire in both men and women.

Chronic cocaine use results in sexual dysfunction and loss of desire in both men and women. The repeated use of cocaine decreases sexual function and desire in both genders. Cocaine does have an impact on sexuality due to reduced desire and function. Cocaine does not reduce sex hormone levels or sperm production and a small amount does not result in impotence.

What self-care measure is most important for the nurse to include in the teaching plan for a patient who will be discharged with a urostomy? a. Change the appliance before going to bed. b. Cut the wafer 1 inch larger than the stoma. c. Cleanse the peristomal skin with mild soap and water. d. Use firm pressure to attach the wafer to the skin.

Cleanse the peristomal skin with mild soap and water. The peristomal area can be washed by the patient using warm water and mild soap as needed and routinely at bath time. The collection device typically has a face plate to ensure a good fit and prevent leakage of urine. These appliances are changed less frequently than before bed each night, and neither a widely cut wafer or firm pressure is needed for their application.

When teaching the patient mechanical barriers for birth control, the nurse would include which method? a. Diaphragm b. Transdermal patch c. Hormone injection d. Oral contraceptives

Diaphragm The diaphragm is the only mechanical barrier listed for birth control. Oral contraceptives are absorbed through the gastrointestinal tract, hormones in injections, and transdermal patches are absorbed systemically.

. Which discharge instruction should the nurse provide to the patient following a colonoscopy? a. Some discomfort and bleeding is normal postprocedure. b. Return to the emergency room if you experience mild abdominal cramping. c. Do not drive or operate heavy machinery for 12 hours postprocedure. d. Return to your normal bowel pattern immediately postprocedure.

Do not drive or operate heavy machinery for 12 hours postprocedure. Since sedation is given for the procedure, the patient should not drive or operate heavy machinery.

he teaching plan for a patient with diarrhea should include which intervention? a. Drinking at least eight glasses of fluid each day b. Eating foods low in sodium and potassium c. Limiting the amount of soluble fiber in the diet d. Eliminating whole-wheat and whole-grain breads and cereal

Drinking at least eight glasses of fluid each day Diarrhea is associated with high risk for dehydration, so the patient should increase the fluid intake. The patient may need increased sodium and potassium intake owing to loss of these electrolytes in the frequent stools. Fiber will add bulk and help to form the stools so should be increased. Whole-grain products contain fiber.

A patient tells the examiner that passing stools is painful. What term would the examiner use to document painful bowel movements? a. Dyschezia b. Occult c. Flatulence d. Encopresis

Dyschezia Dyschezia is the painful passage of stool secondary to a local condition (e.g., hemorrhoids, fissure) or constipation. Occult is a term used to describe blood in the stools that is not visible. Flatulence is the passage of gas from the anus. Encopresis is persistent passing of stools into clothing in a child older than age 4 years, at which age continence would be expected.

What nursing intervention would be most beneficial to implement in an effort to prevent aspiration by a patient receiving tube feedings? a. Check the pH of stomach contents before starting each feeding. b. Hold prescribed medications until after each feeding. c. Elevate the head of the patient's bed at least 45 degrees. d. Slow the delivery of the tube feeding to 15 mL/hour.

Elevate the head of the patient's bed at least 45 degrees. If the head of the bed head is elevated 45 degrees during feedings, the risk of vomiting, or regurgitating the tube feeding formula and aspirating it into the lungs, is reduced. Checking the pH of stomach contents does not reduce the incidence of aspiration. Slowing the delivery of tube feedings may decrease the incidence of diarrhea, but not aspiration. Holding prescribed medication pertains to the compatibility of medications with the tube feeding, rather than the risk of aspiration.

A patient has suspected iron-deficiency anemia. The nurse monitors the patient and reports which of the following findings supporting this diagnosis? a. Elevated transferrin level b. Elevated oxygenation saturation c. Urine tests positive for protein d. Increased hemoglobin level

Elevated transferrin level Transferrin is a blood protein that binds with iron and is important to its transport. A decreased oxygenation and hemoglobin would be most likely due to the lack of oxygen-carrying capacity of the red blood cells. Positive protein in the urine (proteinuria) is an indication of chronic kidney disease.

Which organism is responsible for the majority of urinary tract infections in female patients? a. Escherichia coli b. Nesseria gonorrhea c. Candida albicans d. Haemophilus influenza

Escherichia coli Urinary tract infections (UTIs) are the result of bacteria in the urine. Infection occurs when bacteria from the digestive tract, usually Escherichia coli, invade the urethra and multiply.

A 15-year-old female gymnast is hospitalized with the diagnosis of bulimia nervosa. Which data would the nurse anticipate finding in the patient's admission history and physical assessment? a. Excessive intake of food, self-induced vomiting, and use of laxatives b. Refusal to eat, body image disturbance, constipation, and amenorrhea c. Excessive exercise, refusal to eat, poor muscle tone, and social isolation d. Hair loss, BMI of 27, occasional use of diuretics, calorie intake 2200/day

Excessive intake of food, self-induced vomiting, and use of laxatives Bulimia involves the obsession with binging (the intake of excessive amounts of food), with consumption of as much as 2000 to 3000 calories at one time, followed by purging (vomiting). In an effort not to gain weight from the excessive amount of food eaten, the affected person may use self-induced vomiting or excessive exercise. It also may involve the abuse of laxatives or diuretics. A refusal to eat, excessive exercise, body image disturbance, poor muscle tone, hair loss, amenorrhea, social isolation are relevant to anorexia nervosa. Intake of 2200 calories/day and BMI of 27 are indications of excessive dietary intake and borderline obesity in a 15-year-old female.

A patient is scheduled for an intravenous pyelogram (IVP). Which piece of data would be most important to know before the procedure is carried out? a. Urinalysis showing negative results on testing for sugar and acetone b. History of allergies c. History of a recent thyroid scan d. Frequency of urination

History of allergies Contraindications tor IVP include an allergy to iodine, which is similar in nature to the contrast material injected during the intravenous pyelogram. Knowing this information would be critical to providing safe patient care. Frequency of urination may be an indication to perform an IVP; however, this is not critical to know before performing an IVP. The results of a urinalysis and history of a recent thyroid scan would not affect a scheduled IVP.

The nurse is assigned the care of a patient for whom a cleansing enema has been ordered. What information is most important for the nurse to know before administration of the enema? a. The proper way to position the patient b. Signs and symptoms of intolerance to the procedure c. Vital signs before the procedure d. History of surgery of the anus or rectum

History of surgery of the anus or rectum The most important item in preadministration assessment data is a history of surgery to the anus or rectum, which may contraindicate enema administration. The nurse needs to know the proper patient position for an enema and must observe for signs of intolerance to the procedure, but these are done during the procedure. Vital signs are not routinely obtained before an enema.

Which nursing intervention is included for a patient experiencing diarrhea? a. Limiting fluid intake to 1000 mL/day b. Administering a cathartic suppository c. Increasing fiber in the diet d. Limiting exercise

Increasing fiber in the diet Fiber is encouraged in patients with diarrhea to add bulk to the stools. Fluid intake and exercise should be encouraged. Cathartics would not be used because they are strong laxatives used to soften the stool and evacuate the bowels. LO: 40.6

The nurse is placing an indwelling catheter in a female patient. She inserts the catheter into the vagina. What is the next action for the nurse to implement? a. Collect a urine specimen and notify the PCP. b. Leave the catheter in place and insert a new catheter into the urethra. c. Remove the catheter from the vagina and place it into the urethra. d. Ask another nurse to attempt the catheterization of the patient.

Leave the catheter in place and insert a new catheter into the urethra. By leaving the first catheter in place in the vagina, the nurse can more accurately identify the urethra for insertion of the new catheter. This prevents misplacing the new catheter into the vagina during the second catheterization attempt. The catheter that was placed in the vagina is no longer sterile, so it should not be reused and should be discarded after the new catheter is properly placed. It is impossible to get a urine sample from the catheter placed in the vagina. Only after experiencing difficulty with proper placement of the new catheter may the nurse wish to ask for assistance from another nurse.

An indwelling catheter is ordered for a postoperative patient who is unable to void. What is the primary concern of the nurse performing the procedure? a. Teaching deep-breathing techniques b. Maintaining strict aseptic technique c. Medicating the patient for pain before the procedure d. Positioning the patient for comfort during the procedure

Maintaining strict aseptic technique It is most important to maintain strict aseptic technique while inserting an indwelling catheter to try to prevent a urinary tract infection. It is not necessary to medicate patients before urinary catheterization. Although comfortable positioning and deep breathing may help to relax the patient, this is not the primary concern.

When teaching female reproduction to a group of high school students, the nurse uses what term to indicate the cessation of a woman's menstrual activity? a. Menarche b. Menopause c. Premenstrual syndrome d. Menstrual dysfunction

Menopause The definition of menopause is the cessation of a female's menstrual activity. Menarche is the onset of menstruation. Premenstrual syndrome is a set of specific symptoms that occur before the monthly menstrual cycle. Menstrual dysfunction refers to altered patterns of menstruation associated with various disorders.

The nurse is inserting an indwelling catheter into a male patient. While initially passing the catheter through the urethra, resistance is met. What action should the nurse take next? a. Notify the primary care provider to place a coudé catheter. b. Straighten the penis and attempt to progress the catheter again. c. Remove the catheter and insert one with a smaller lumen. d. Inflate the balloon and wait for urine passage.

Notify the primary care provider to place a coudé catheter. Coudé catheters are a special type of double-lumen, indwelling catheters that are slightly stiff and bent at the end, allowing the catheter to pass more easily through a partially constricted urethra. They are used mostly in men experiencing prostate enlargement or BPH. Coudé catheters may need to be placed using a metal wire introducer. Placement using an introducer typically is performed by a physician or the patient's urologist, to avoid damaging urethral tissue

What symptom is most likely to be exhibited by the patient who complains of voiding small amounts of urine in relation to his fluid intake? a. Nocturia b. Polyuria c. Anuria d. Oliguria

Oliguria Oliguria is reduced urine volume. Nocturia is excessive urination at night. Polyuria is an excessive amount of urine excreted each day, and anuria is excretion of 50 to 100 mL or less of urine each day.

__ is acute inflammation of the testes. a. Genital herpes b. Priapism c. Orchitis d. Paraphimosis

Orchitis Orchitis is an acute inflammation of the testes. Genital herpes is a sexually transmitted infection caused by the herpes simplex virus; the vesicles erupt on the glans or foreskin. Priapism is a prolonged painful erection of the penis. Paraphimosis occurs when the foreskin is retracted and fixed.

The nursing instructor is teaching information about constipation in the elderly. Which statement from the student indicates a need for further instruction on this topic? a. Patients receiving tube feedings often experience constipation. b. Poor fluid intake and inability to eat a high-fiber diet often cause constipation. c. Patients with impaired mobility may experience constipation. d. Medications commonly taken by elders often contribute to constipation.

Patients receiving tube feedings often experience constipation. Patients on tube feedings often experience diarrhea, not constipation.

To best determine the patient's competency in changing an ostomy appliance, what should the nurse ask the patient to do? a. Verbalize the procedure. b. Identify the supplies needed. c. Perform the procedure. d. List the steps in the procedure

Perform the procedure Repeat performance is the best way to ensure competency.

The nurse is caring for a 35-year-old married male, father of one, who has been admitted for a vasectomy. Though he is seeking this procedure of his own free will, the nurse's personal moral standards indicate this is wrong. What would be the most appropriate action by the nurse when caring for this patient? a. Have the hospital chaplain speak with this patient. b. Remind the patient that he has time to still change his mind. c. Provide the patient with appropriate care, realizing the decision is personal. d. Tell the patient about all the males in the infertility clinic who would be envious of his situation.

Provide the patient with appropriate care, realizing the decision is personal. Therapeutic communication indicates that the nurse must not be judgmental when interacting with the patient. Communicating with the chaplain may be helpful in some cases but should not be used by the nurse to avoid patient interaction. Reminding the patient that there is time to change his decision interjects the nurse's personal beliefs and biases. It is judgmental and belittling to note that others would be envious.

A 75-year-old male patient reports decreased frequency of sexual intercourse, although he does not express dissatisfaction or difficulty. He seems a little embarrassed by the discussion but is engaged and asks some questions. Which nursing diagnosis does the nurse determine is most appropriate for this patient? a. Sexual Dysfunction b. Disturbed Body Image c. Sedentary Lifestyle d. Readiness for Enhanced Knowledge

Readiness for Enhanced Knowledge Because the patient is able to discuss the topic of reduced sexual frequency without noting difficulty or dysfunction, manages any embarrassment, is engaged in the conversation, and is able to ask questions, the most appropriate nursing diagnosis is Readiness for Enhanced Knowledge. These collective behaviors do not describe Sexual Dysfunction or Disturbed Body Image, and "sedentary lifestyle" is not a NANDA-I nursing diagnosis.

A young adult female is considering becoming pregnant and is not taking any multivitamins. Which instruction would best help reduce the potential for development of neural tube defects in the fetus? a. Discuss taking selenium supplements with meals. b. Stress the importance of prenatal exercise. c. Recommend folic acid dietary supplements. d. Inquire about the patient's diet and birth control method.

Recommend folic acid dietary supplements. Folic acid is necessary to prevent the formation of neural tube defects such as spina bifida. Selenium is unrelated to the prevention of neural tube defects. Exercise, diet, and birth control methods do not specifically relate to neural tube defect prevention.

A dietary practice to restrict meat on certain days such as Ash Wednesday and Fridays during Lent is an example of what type of nutritional influence? a. Ethnic b. Economic c. Religious d. Cultural

Religious Meat restrictions on certain holy days is a religious influence on dietary practices for many denominations of Catholics.

A 40-year-old patient complains of 4 days of frequent loose stools with abdominal cramping. What is the priority nursing diagnosis for this patient? a. Altered Skin Integrity b. Risk for Imbalanced Fluid Volume c. Acute Pain d. Self-Care Deficit: Toileting

Risk for Imbalanced Fluid Volume Diarrhea can cause dehydration with loss of fluids and electrolytes. There is no statement of problems with the skin, although this patient may be at risk for skin breakdown if the diarrhea continues. In addition, no self-care deficit is stated for this patient. Although the patient has experienced cramping and the pain needs to be addressed, the main consideration would be correction of any fluid and electrolyte problems, followed by determination of the cause of the diarrhea.

he nurse knows that the teaching for a patient who was recently diagnosed with constipation has been effective if the patient's meal request specifies which food choice? a. Hot dog on a bun b. Grilled chicken c. Tuna sandwich on white bread d. Spinach salad with dressing

Spinach salad with dressing Green leafy vegetables are high in fiber. None of the other options are high in fiber but could be modified by using whole-grain products.

__ is an emergency requiring surgery. a. A scrotal hernia b. Epididymitis c. Testicular torsion d. Cryptorchidism

Testicular torsion Testicular torsion is a sudden twisting of the spermatic cord; blood supply is cut off, and the testis can become gangrenous in a few hours. Emergency surgery is required. A scrotal hernia is usually due to indirect inguinal hernia; the scrotal sac herniates through the internal inguinal ring and passes into the scrotum. Epididymitis is an acute infection of the epididymis. Cryptorchidism is a developmental defect in which the testes have not descended.

For which reason are patients unlikely to introduce the topic of sex with health care providers? a. Most patients have few, if any, questions or problems relating to this topic. b. They are too embarrassed to discuss the topic of sex with a health care provider. c. Female patients prefer to discuss problems with female health care providers. d. They assume that health care professionals know little about sexual functioning.

They are too embarrassed to discuss the topic of sex with a health care provider. Embarrassment to discuss a personal subject can cause the patient to avoid introduction of the topic. Gender is not a consideration in this question, and it cannot be generalized that patients have few questions or problems on any topics. Health care professionals generally are considered to be knowledgeable in subject matters associated with health and illness.

A patient tells the nurse that he needs to increase his intake of potassium because he has been taking large doses of diuretics. To minimize complications from hypokalemia, the nurse should instruct the patient to include which of the following foods as a part of his diet? a. Cheese and crackers b. Peanut butter and jelly sandwich c. Tomatoes and spinach d. Apples and grapes

Tomatoes and spinach Tomatoes and spinach are good sources of potassium. Cheese and crackers are sources of calcium and fiber. Peanut butter is a good source of protein; jelly is mostly sugar and does not provide necessary nutrients. Apples and grapes are fruit and are sources of fiber.

Which action should the nurse take when caring for a patient receiving a continuous enteral feeding through a percutaneous endoscopic gastrostomy (PEG) tube if the feeding tube becomes occluded? a. Use 15 mL of cranberry juice in a 30-mL syringe to clear the tubing. b. Ask to have the PEG tube replaced to prevent rupture of the gastrostomy. c. Flush the PEG tube with 60 mL of cold tap water, using gravity. d. Try using cola if a 20- to 30-mL warm-water flush is ineffective.

Try using cola if a 20- to 30-mL warm-water flush is ineffective. Using cola, which is a carbonated beverage, to try to flush the tube if flushing with warm water does not work would be the best option. Using cranberry juice in a small, 30-mL syringe is not recommended and may cause excessive force on the tube, resulting in rupture. Replacing the tube would increase the patient's discomfort and should be a last-resort action. Cold tap water and gravity should not be used, because this measure is unlikely to be effective owing to the lack of even, gentle force needed to clear the occlusion, and because cold water may cause abdominal cramping if it reaches the stomach.

A patient is experiencing acute renal failure. What is the most common cause of this critical illness? a. Hypovolemia b. Cardiogenic shock c. Nephrotoxic substances d. Urethral obstruction

Urethral obstruction Inadequate flow or complete obstruction by anything (such as stones or tumors) that blocks both ureters and the bladder, or obstructs the urethra, can lead to an anuric state, resulting in acute or chronic renal failure.

A patient is admitted to the hospital with pernicious anemia and a surgical history of having had a gastrectomy six months ago. On assessment, the nurse questions the patient about compliance with taking which of the following medications that supports the development of red blood cells? a. Vitamin K b. Vitamin B12 c. Calcium supplement d. Magnesium supplement

Vitamin B12 Patients who have had a gastrectomy lack the intrinsic factor and this results in deficiency of vitamin B12 and requires replacement (IM) for life due to the inability of the body to absorb this very important vitamin. Vitamin K, calcium, and magnesium are not relevant to this condition.

A nurse is caring for a patient with a diagnosis of pellegra resulting from a niacin deficiency who complains of fatigue, loss of appetite, headache, weight loss, scaly sores, and neurological deterioration. The nurse performs a dietary assessment for which of the following vitamins? a. Vitamin B3 b. Vitamin B2 c. Vitamin C d. Vitamin B12

Vitamin B3 Pellegra is the result of a niacin (vitamin B3) deficiency with the manifestations of fatigue, anorexia, headache, weight loss, dry, patchy skin, and changes in mental status. Vitamin C (ascorbic acid) is important as an antioxidant, and promotes healing and iron absorption. Deficiency of vitamin C results in impaired wound healing, decreased collagen formation, and a strong immune system and is found in citrus fruits, orange and yellow fruits, and sweet and white potatoes. Vitamin B12 (cyancobalamin) deficiency contributes to pernicious or megoblastic anemia. Vitamin B2 (riboflavin) deficiencies are involved in changes in the skin and vision such as cheilosis, dermatitis, and vision problems.

A patient with a history of diarrhea is seen in the clinic. Which nursing intervention is most essential to include in this patient's plan of care? a. Weighing the patient daily b. Encouraging a diet high in fiber c. Decreasing the patient's fluid intake d. Instructing the patient to increase protein in the diet

Weighing the patient daily The patient with diarrhea is susceptible to dehydration. Checking the patient's weight daily will monitor fluid status.

Obesity in adults is defined as: a. excess body fat placed predominately within the hips and thighs. b. excessive body fat leading to body weight 5% above ideal. c. a body mass index of 30 or greater. d. overnourished.

a body mass index of 30 or greater. Obesity in adults is defined as a body mass index of 30 or greater. Overweight in adults is defined as a body mass index of 25 or greater. Obese persons with most of their fat in the hips and thighs have gynoid obesity; android (upper body) obesity places a person at higher risk for obesity-related diseases and early mortality. Obesity is greater than 120% of the ideal body weight. Overnutrition is caused by the consumption of nutrients, especially calories, sodium, and fat, in excess of body needs.

Pyrosis is: a. an inflammation of the peritoneum. b. a burning sensation in the upper abdomen. c. a congenital narrowing of the pyloric sphincter. d. an abnormally sunken abdominal wall.

a burning sensation in the upper abdomen. Pyrosis (heartburn) is a burning sensation in the esophagus and stomach from reflux of gastric acid. Peritonitis is an inflammation of the peritoneum. Pyloric stenosis is a congenital narrowing of the pyloric sphincter. A scaphoid abdomen abnormally caves in or is sunken.

An anorectal fistula is usually caused by: a. a tear in the superficial mucosa. b. a chronically inflamed gastrointestinal tract. c. trauma from passing hard stools. d. daily use of laxatives.

a chronically inflamed gastrointestinal tract. An anorectal fistula is caused by a chronically inflamed gastrointestinal tract. Fissures are tears that occur in the superficial mucosa and often result from trauma (e.g., passing a large, hard stool) or from irritant diarrheal stools. Long-term use of laxatives may lead to dependence.

The etiology of a pilonidal cyst is: a. a chronically inflamed gastrointestinal tract. b. a tear in the superficial mucosa. c. a congenital disorder. d. trauma or irritant diarrheal stools.

a congenital disorder. A pilonidal cyst is a congenital disorder that is first diagnosed between the ages of 15 and 30 years. An anorectal fistula is caused by a chronically inflamed gastrointestinal tract. Fissures are tears that occur in the superficial mucosa and often result from trauma (e.g., passing a large, hard stool) or from irritant diarrheal stools.

A deep recess formed by the peritoneum between the rectum and the cervix is called: a. the Chadwick sign. b. a cystocele. c. a rectocele. d. a rectouterine pouch.

a rectouterine pouch. he rectouterine pouch (or cul-de-sac of Douglas) is the deep recess between the rectum and the cervix. The cervical mucosa during the second month of pregnancy is blue, which is termed the Chadwick sign. The cervix may also turn blue in any condition causing hypoxia or venous congestion. A cystocele is an abnormality of the pelvic musculature in which the bladder prolapses into the vagina. A rectocele is an abnormality of the pelvic musculature in which the rectum prolapses into the vagina.

The corona is: a. a shoulder where the glans joins the shaft. b. a hood or flap of skin over the glans. c. a corpus spongiosum cone of erectile tissue. d. folds of thin skin on the scrotal wall.

a shoulder where the glans joins the shaft. The corona is a shoulder where the glans joins the shaft. Over the glans, the skin folds in and back on itself forming a hood or flap called the foreskin or prepuce. The penis is composed of three cylindrical columns of erectile tissue: two corpora cavernosa on the dorsal side and the corpus spongiosum ventrally. The scrotal wall consists of thin skin lying in folds, or rugae, and the underlying cremaster muscle.

A retention cyst in the epididymis filled with milky fluid containing sperm is called: a. a varicocele. b. a spermatocele. c. Peyronie disease. d. a prepuce.

a spermatocele. A spermatocele is a retention cyst in the epididymis filled with milky fluid containing sperm. A varicocele is a dilated, tortuous varicose vein in the spermatic cord. Peyronie disease is a result of hard, nontender, subcutaneous plaques on the penis that cause a painful bending of the penis during an erection. Over the glans, the skin folds in and back on itself forming a hood or flap called the foreskin or prepuce.

A normal common breast variation is: a. enlarged axillary lymph nodes. b. a supernumerary breast. c. a supernumerary nipple. d. fixation of the breast.

a supernumerary nipple. A supernumerary nipple is a normal and common variation. An extra nipple on the thorax or abdomen is a congenital finding. It is usually 5 to 6 cm below the breast near the midline and has no glandular tissue. Enlarged axillary lymph nodes indicate a local infection of the breast, arm, or hand or breast cancer metastases. A supernumerary breast is rare; additional glandular tissue is present. Fixation of the breast indicates invasive cancer that fixes the breast to the underlying pectoral muscles.

When emptying a patient's catheter drainage bag, the nurse notes that the urine appears to be discolored. The nurse understands that what factors may change the color of urine? (Select all that apply.) a. Taking the urinary tract analgesic phenazopyridine (Pyridium) b. A diet that includes a large amount of beets or blackberries c. An enlarged prostate or kidney stones d. High concentrations of bilirubin secondary to liver disease e. Increased carbohydrate intake

a, b, c, d Urine may appear orange when a patient is taking phenazopyridine. Urine can appear red or pink with a diet including beets or blackberries and if blood is present in the urine, which may be secondary to an enlarged prostate or kidney stones. Urine often has a brownish appearance when liver disease such as hepatitis or cirrhosis is present.

To prevent constipation in an inactive patient, which early interventions should the nurse implement? (Select all that apply.) a. Stool softener administration b. Enema administration c. Increasing the fiber in the diet d. Increasing physical activity e. Increasing fluid intake

a, c, d, e Administering stool softeners, increasing the fiber and fluids in the diet, and increasing physical activity are all early interventions to prevent constipation. Although used to treat constipation, an enema would not be an early intervention for prevention

The nurse is caring for an elderly patient who has residual weakness on the right side as the result of a cerebrovascular accident (stroke). The nurse is correct in reporting dysphagia when the patient exhibits which symptoms? (Select all that apply.) a. Incomplete lip closure b. Presence of a normal gag reflex c. A change in voice quality after eating d. Difficulty speaking, with a slow, weak voice e. Abnormal movements of the mouth, tongue, and lips

a, c, e Persons with residual weakness of the throat and mouth after a stroke have poor muscle tone in the mouth and throat, lack of tongue action, and loss of the ability to chew and swallow effectively. Normal gag reflex is not an adverse symptom. Difficulty speaking is dysphasia.

When administering a cleansing enema, which techniques should the nurse use? (Select all that apply.) a. Assist the patient to a left side-lying (Sims) position. b. Perform hand hygiene and apply sterile gloves. c. Add room-temperature solution to enema bag. d. Lubricate 2 to 4 cm (1 to 2 inches) of tip of rectal tube with lubricating jelly. e. Raise container, release clamps, and allow solution to flow to fill tubing. f. Hang solution bag 45 to 60 cm (18 to 21 inches) above anus and instill rapidly. g. Clamp tubing after solution is instilled

a, e, g The patient should be assisted to the left side-lying (Sims) position. The container release clamps must be released and the solution allowed to flow for fill the tubing. After the solution is instilled, the tubing should be clamped. Gloves for this procedure do not need to be sterile. Solution should be warmed to slightly warmer than body temperature (or 100° to 105° F) to prevent cramping. The tip of the rectal tube should be lubricated 6 to 8 cm (3 to 4 inches). If the enema bag is hung too high and the solution is instilled too rapidly, cramping may occur.

The __ reflex is an example of a __ reflex. a. plantar; deep tendon b. abdominal; superficial c. quadriceps; pathologic d. corneal light; visceral

abdominal; superficial Superficial reflexes test the sensory receptor in the skin; the motor response is a localized muscle contraction. Superficial reflexes include abdominal, cremasteric, and plantar (or Babinski) reflexes. Deep tendon reflexes test the reflex arc at the spinal level and include the biceps, triceps, brachioradialis, quadriceps, and Achilles. The quadriceps reflex is a deep tendon reflex and is normal. The corneal light reflex assesses the parallel alignment of the eye (cranial nerves III, IV, and VI).

During assessment of extraocular movements, two back-and-forth oscillations of the eyes in the extreme lateral gaze occurs. This response indicates: a. that the patient needs to be referred for a more complete eye examination. b. a disease of the vestibular system, further evaluation is needed. c. an expected movement of the eyes during this procedure. d. this assessment should be repeated in 15 minutes to allow the eyes to rest.

an expected movement of the eyes during this procedure. Nystagmus is a back-and-forth oscillation of the eyes. End-point nystagmus, a few beats of horizontal nystagmus at extreme lateral gaze, occurs normally.

Pruritus is the presence of: a. an itching or burning sensation b. a longitudinal tear in the superficial mucosa at the anal margin. c. blood in the stool. d. excessive fat in the stool.

an itching or burning sensation. Pruritus is an itching or burning sensation. A fissure is a painful longitudinal tear in the superficial mucosa at the anal margin. Melena, hematochezia, and occult describe blood in the stool. Steatorrhea is excessive fat in the stool.

Obese persons with more fat in the upper body, especially the abdomen, have: a. gastronomic obesity. b. gynoid obesity. c. anthropometric obesity. d. android obesity.

android obesity. Obese persons with most of their fat in the abdomen have android (upper body) obesity. A waist-to-hip ratio of 1.0 or greater in men or 0.8 or greater in women is indicative of android obesity, which places a person at higher risk for obesity-related diseases and early mortality.

When testing for muscle strength, the examiner should: a. observe muscles for the degree of contraction when the individual lifts a heavy object. b. apply an opposing force when the individual puts a joint in flexion or extension. c. measure the degree of force that it takes to overcome joint flexion or extension. d. estimate the degree of flexion and extension in each joint.

apply an opposing force when the individual puts a joint in flexion or extension. The person should flex or extend muscle groups for each joint while the examiner applies an opposing force. Range of motion can be described by estimating (or measuring) the degree of flexion and extension of a joint.

Moles on the abdomen: a. are common. b. are uncommon. c. require a biopsy. d. are no cause for concern.

are common. Pigmented nevi (moles) are common on the abdomen. Nevi are circumscribed brown macular or papular areas. Nevi should be observed for unusual color or change in shape; biopsy or removal is indicated if nevi change, which indicates a possible malignancy.

On palpation the prostate gland is enlarged, nontender, firm, and smooth with a palpable central groove. This assessment finding indicates: a. benign prostatic hypertrophy. b. prostatitis. c. prostate carcinoma. d. a normal prostate gland.

benign prostatic hypertrophy. In benign prostatic hypertrophy, the prostate gland is enlarged, nontender, firm, and smooth with a palpable central groove. In prostatitis, the prostate gland is swollen and exquisitely tender. In prostatic carcinoma, the prostate gland is stone-hard and irregular with fixed nodules. A normal prostate gland does not protrude more than 1 cm into the rectum; is heart-shaped, with a palpable central groove; is smooth; is elastic, rubbery, and slightly movable; and is nontender to palpation.

The symptoms occurring with lactose intolerance include: a. bloating and flatulence. b. gray stools. c. hematemesis. d. anorexia.

bloating and flatulence. Lactose intolerance produces abdominal pain, bloating, and flatulence when milk products are consumed. Gray stools may occur with hepatitis. Hematemesis occurs with stomach or duodenal ulcers and esophageal varices. Anorexia is a loss of appetite and occurs with gastrointestinal disease, as a side effect of some medications, with pregnancy, or with psychological disorders.

The first sign of puberty in girls is: a. the first menstrual cycle (menarche). b. axillary hair development. c. rapid increase in height. d. breast and pubic hair development.

breast and pubic hair development. The first signs of puberty are breast and pubic hair development, beginning between 8½ and 13 years of age. These signs usually occur together, but it is not abnormal if they do not develop together. This development takes about 3 years to complete. Menarche occurs during the latter half of the sequence of breast and pubic hair development, just after the peak of growth velocity. Coarse curly hairs develop in the pubic area first and then in the axillae.

The __ coordinates movement, maintains equilibrium, and helps maintain posture. a. extrapyramidal system b. cerebellum c. upper and lower motor neurons d. basal ganglia

cerebellum The cerebellum controls motor coordination of voluntary movements, equilibrium (i.e., posture balance of the body), and muscle tone. The extrapyramidal system maintains muscle tone and controls body movements, especially gross automatic movements such as walking. The upper motor neurons are located within the central nervous system; influence or modify the lower motor neurons; and include the corticospinal, corticobulbar, and extrapyramidal tracts. The lower motor neurons are located mostly in the peripheral nervous system and extend from the spinal cord to the muscles; examples include the cranial nerves and spinal nerves. The basal ganglia control automatic associated movements of the body.

The divisions of the spinal vertebrae include: a. cervical, thoracic, scaphoid, sacral, and clavicular b. scapular, clavicular, lumbar, scaphoid, and fasciculi. c. cervical, thoracic, lumbar, sacral, and coccygeal. d. cervical, lumbar, iliac, synovial, and capsular.

cervical, thoracic, lumbar, sacral, and coccygeal. Humans have 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3 to 4 coccygeal vertebrae.

The most common sexually transmitted infection in the United States is: a. gonorrhea. b. syphilis. c. chlamydia. d. trichomoniasis.

chlamydia. Chlamydia is the most common sexually transmitted infection in the United States.

A patient reports consuming approximately 2000 calories per day. For a healthy diet, the patient should: a. eat at least 4 cups of fruits and 4½ cups of vegetables per day. b. consume less than 100 mg per day of cholesterol. c. consume 6 ounces of whole-grain products per day. d. keep fat intake to 5% of total calories.

consume 6 ounces of whole-grain products per day. On a 2000-calorie-per-day diet, a person should consume three servings (6-ounce equivalents) or more of whole grain products per day and three servings of other enriched grain products. On a 2000-calorie-per-day diet, a person should consume 2 cups of fruit and 2½ cups of vegetables per day. On a 2000- calorie-per-day diet, a person should consume less than 300 mg per day of cholesterol. On a 2000-calorie-per-day-diet, a person should keep total fat intake to 20% to 35% of total calories.

What should be included in teaching for a patient who will be discharged with a prescription for a laxative? a. Calling the health care provider if nausea, vomiting, or abdominal pain occurs b. Continuing use of laxatives to encourage bowel evacuation c. dding regular exercise, sufficient fluids, and regular defecation habits to his or her routine d. Knowing the difference between laxatives and cathartics

dding regular exercise, sufficient fluids, and regular defecation habits to his or her routine The patient who is discharged on laxatives should still be instructed on the nonpharmacological methods to decrease constipation and promote normal bowel patterns. Laxatives are contraindicated in patients with nausea, vomiting, or undiagnosed abdominal pain. Ongoing use of laxatives is associated with harmful side effects, such as an increase in constipation and impaction, predisposition to colorectal cancer, dependency, and electrolyte imbalance and should not be encouraged. Knowing the difference between laxatives and cathartics will not help the patient in this case.

An expected postmenopausal breast change is: a. increased glandular tissue. b. decreased fibrous connective tissue. c. increased fatty tissue. d. decreased breast size.

decreased breast size. Expected breast changes after menopause include a decrease in breast size. Expected breast changes after menopause include breast glandular tissue atrophy. Expected breast changes after menopause include increased fibrous connective tissue. Expected breast changes after menopause include fat tissue atrophy.

Older adults have: a. decreased salivation leading to dry mouth. b. increased gastric acid secretion. c. increased liver size. d. decreased incidence of gallstones.

decreased salivation leading to dry mouth. Aging results in decreased salivation leading to dry mouth. Aging results in decreased gastric acid secretion. Aging results in decreased liver size. Aging results in increased incidence of gallstone formation.

Long-term use of laxatives frequently leads to: a. hemorrhoids. b. a chronically inflamed gastrointestinal tract. c. dependence. d. fistula formation.

dependence. Long-term use of laxatives may lead to dependence. Hemorrhoids result from increased portal venous pressure, as occurs with straining at stool, chronic constipation, pregnancy, obesity, chronic liver disease, or a low-fiber diet. An anorectal fistula may be caused by a chronically inflamed gastrointestinal tract.

An area of the body that is supplied mainly from one spinal segment through a particular spinal nerve is identified as a: a. dermatome. b. dermal segmentation. c. hemisphere. d. crossed representation.

dermatome. A dermatome is a circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve. Dermal segmentation is the cutaneous distribution of the various spinal nerves. Each half of the cerebrum is a hemisphere. Crossed representation is a feature of the nerve tracts; the left cerebral cortex receives sensory information from and controls motor function to the right side of body, whereas the right cerebral cortex likewise interacts with the left side of the body.

A known risk factor for breast cancer is: a. early menarche or late menopause. b. low breast tissue density. c. breastfeeding an infant for more than 6 months. d. low-fat, low-cholesterol diet.

early menarche or late menopause. A risk factor for breast cancer is early menarche (before age 12 years) or late menopause (after age 55 years). A risk factor for breast cancer is high breast tissue density. A risk factor for breast cancer is never breastfeeding a child. A risk factor for breast cancer is a high-fat diet.

Bundles of muscle fibers that compose skeletal muscle are identified as: a. fasciculi. b. fasciculations. c. ligaments. d. tendons.

fasciculi. Each skeletal muscle is composed of bundles of muscle fibers, or fasciculi. Fasciculation is localized uncoordinated, uncontrollable twitching of a single muscle group innervated by a single motor nerve fiber or filament. Ligaments are fibrous bands running directly from one bone to another. Tendons are strong fibrous cords that attach skeletal muscles to bones.

The term rugae refers to: a. a corpus spongiosum cone of erectile tissue. b. folds of thin skin of the scrotal wall. c. a muscle that controls the size of the scrotum. d. an acute inflammation of the testes.

folds of thin skin of the scrotal wall. The scrotum wall consists of thin skin lying in folds, or rugae, and the underlying cremaster muscle. The penis is composed of three cylindrical columns of erectile tissue: two corpora cavernosa on the dorsal side and the corpus spongiosum ventrally. The cremaster muscle controls the size of the scrotum. Orchitis is an acute inflammation of the testes.

Soft, pointed, fleshy papules that occur on the genitalia caused by human papillomavirus (HPV) are known as: a. chancres. b. genital warts. c. urethritis. d. varicoceles.

genital warts. Condylomata acuminata (genital warts) are soft, pointed, fleshy papules that occur on the genitalia and are caused by HPV. Syphilitic chancres are small, solitary, silvery papules that erode to a red, round or oval, superficial ulcer with a yellowish serous discharge. Urethritis is an infection of the urethra; the meatus edges are reddened, everted, and swollen. A varicocele is a dilated, tortuous varicose vein in the spermatic cord.

The patient is ordered an ultrasound to determine the size, shape, and location of the kidneys. The nurse knows that prior to the test the patient will a. be required to have a bowel cleansing enema. b. be checked for any allergies to shellfish. c. be required to drink a large amount of fluids before the test. d. have no pretest requirements.

have no pretest requirements. An ultrasound scan may be performed to assess the size, shape, and location of the kidneys. Ultrasound studies may be safely conducted in patients who have allergies to contrast media, because no radiation or contrast dyes are used. No patient preparation such as fasting or sedation is required.

The production of red blood cells in the bone marrow is called: a. hematopoiesis. b. hemolysis. c. hemoptysis. d. hemianopsia.

hematopoiesis. Hematopoiesis is the production of red blood cells in the bone marrow (spongelike material in the cavities of bones). Hemolysis is the breakdown of red blood cells. Hemoptysis is coughing up blood from the respiratory system. Hemianopsia is blindness in half of the normal visual field.

An elderly patient is admitted with a diagnosis of osteoporosis and bone scan results that reveal a reduction in bone mass. The nurse encourages the patient to eat foods that are a. high in iron. b. low in vitamin E. c. low in sodium. d. high in calcium.

high in calcium. Osteoporosis and diminished bone mass are the result of poor absorption of calcium. Dietary sources include milk and milk products, salmon with bones, spinach, kale, fortified whole wheat bread, tofu, and orange juice. Iron, vitamin A, and sodium are important nutrients but not linked to the identified problem. Calcium is the most abundant mineral in the body and responsible for bone strength. Sodium and vitamin E are not specific to bone.

The presence of primitive reflexes in a newborn infant is indicative of: a. immaturity of the nervous system. b. prematurity of the infant. c. mental retardation. d. spinal cord alterations.

immaturity of the nervous system. The nervous system is not completely developed at birth, and motor activity in the newborn is under the control of the spinal cord and medulla. The neurons are not yet myelinated. Movements are directed primarily by primitive reflexes. As the cerebral cortex develops during the first year, it inhibits these reflexes, and they disappear at predictable times. Persistence of the primitive reflexes is an indication of central nervous system dysfunction.

The penis: a. is composed of two corpora cavernosa and one corpus spongiosum. b. is a loose protective sac that is a continuation of the abdominal wall. c. and scrotum are the internal structures of the male genitals. d. size is controlled by the cremaster muscle.

is composed of two corpora cavernosa and one corpus spongiosum. The penis is composed of three cylindrical columns of erectile tissue: two corpora cavernosa on the dorsal side and the corpus spongiosum ventrally. The scrotum is a loose protective sac that is a continuation of the abdominal wall. The penis and scrotum are the external structures of the male genitals; the internal structures are the testis, epididymis, and vas deferens. The cremaster muscle controls the size of the scrotum.

Nursing interventions for the patient who suffers from stress incontinence include a. kegel exercises. b. surgical interventions. c. bowel retraining. d. intermittent catheterization.

kegel exercises. Kegel exercises also are known as pelvic floor exercises. They improve muscle tone in the pelvic floor, which helps to prevent stress incontinence.

The organ in the right upper quadrant of the abdomen is the: a. spleen b. liver c. cecum d. sigmoid colon

liver The liver is in the right upper quadrant of the abdomen. The spleen is in the left upper quadrant. The cecum is in the right lower quadrant. The sigmoid colon is in the left lower quadrant.

Gynecomastia occurs with: a. Addison disease. b. hypothyroidism. c. calcium channel blockers. d. liver cirrhosis.

liver cirrhosis. Gynecomastia occurs in liver cirrhosis because the liver is unable to metabolize estrogens. Gynecomastia may occur in Cushing syndrome, not Addison disease. Gynecomastia may occur in hyperthyroidism. Gynecomastia may occur as an adverse effect of certain medications (e.g., metronidazole, isoniazid, digoxin, angiotensin-converting enzyme inhibitors, diazepam, and tricyclic antidepressants).

Energy requirements for an aging adult decrease as a result of: a. loss of energy. b. eating habits. c. loss of lean body mass. d. decreasing body fat.

loss of lean body mass. An older adult has a decrease in energy requirements as a result of loss of lean body mass, the most metabolically active tissue. An older adult has a decrease in energy requirements as a result of an increase in fat mass.

Toilet training (for bowel movements) in children: a. should start after 4 years of age. b. may begin when the nerves in the rectal area are fully myelinated. c. can be successful as early as 12 months of age. d. should begin after the gastrocolic reflex disappears.

may begin when the nerves in the rectal area are fully myelinated. Voluntary control of the external anal sphincter cannot occur until the nerves supplying the area have become fully myelinated, usually around 1½ to 2 years of age. Toilet training usually starts after age 2 years. The wave of peristalsis that occurs after eating is the gastrocolic reflex. This reflex is present at birth and does not disappear.

Cessation of menses is known as: a. menarche. b. menopause. c. salpingitis. d. adnexa.

menopause. Menopause is the cessation of menses. Menarche is the age of the first period. Salpingitis is inflammation of the fallopian tube. The adnexa of uterus (or uterine appendages) refers to the structures most closely related structurally and functionally to the uterus; these structures include the ovaries, fallopian tubes, and ligaments.

Heberden and Bouchard nodes are hard and nontender and are associated with: a. osteoarthritis. b. rheumatoid arthritis. c. Dupuytren contracture. d. metacarpophalangeal bursitis.

osteoarthritis. Osteoarthritis is characterized by hard, nontender nodules, 2 to 3 mm or more in size. These osteophytes (bony overgrowths) of the distal interphalangeal joints are called Heberden nodes, and osteophytes of the proximal interphalangeal joints are called Bouchard nodes. Swan neck, boutonnière deformity, and ulnar deviation are conditions associated with rheumatoid arthritis. Dupuytren contracture occurs with diabetes, epilepsy, and alcoholic liver disease. Chronic hyperplasia of the palmar fascia causes flexion contractures of the digits. Bursitis is an inflammation of the bursa.

An older woman is having an annual mammogram. Before the mammogram, the nurse does a breast examination. Expected normal findings would include: a. palpable, firm, stringy lactiferous ducts b. increased glandularity. c. yellow colostrum expressed from the nipple. d. a unilateral venous pattern.

palpable, firm, stringy lactiferous ducts The lactiferous ducts of an older woman (eighth to ninth decades) are more palpable and feel firm and stringy because of fibrosis and calcification. The glandular breast tissue in an older woman atrophies. Yellow colostrum may be expressed from the nipple of a pregnant woman after the first trimester. A venous pattern is prominent over the skin surface of pregnant women.

An abnormal sensation of burning or tingling is best described as: a. paralysis. b. paresis. c. paresthesia. d. paraphasia.

paresthesia. Paresthesia is an abnormal sensation such as burning or tingling. Paralysis is a loss of motor function as a result of a lesion in the neurologic or muscular system or loss of sensory innervation. Paresis is a partial or incomplete paralysis. Paraphasia is a condition in which a person hears and comprehends words but is unable to speak correctly; incoherent words are substituted for intended words.

Cerebellar function is tested by: a. muscle strength assessment. b. performance of rapid alternating movements. c. the Phalen maneuver. d. superficial pain and touch assessment.

performance of rapid alternating movements. The cerebellum controls motor coordination of voluntary movements, equilibrium, and muscle tone. Cerebellar function is tested by balance tests (e.g., gait, Romberg test) and coordination and skilled movements (e.g., rapid alternating movements, finger-to-finger test, finger-to-nose test, heel-to-shin test). Muscle strength assessment examines the intactness of the motor system. The Phalen maneuver reproduces numbness and burning in a patient with carpal tunnel syndrome. Superficial pain and touch assessment examines intactness of the spinothalamic tract.

Methods to enhance abdominal wall relaxation during examination include: a. a cool environment. b. having the patient place arms above the head. c. examining painful areas first. d. positioning the patient with the knees bent.

positioning the patient with the knees bent. Position the patient supine, with the head on a pillow, knees bent or on a pillow, and arms at the side. Keep the room warm to avoid chilling and tensing of muscles. Avoid having arms above the head; this increases abdominal wall tension. Painful areas should be examined last to avoid muscle guarding.

Breast development in an adolescent girl usually: a. occurs after the beginning of menstruation. b. precedes menstruation by about 2 years. c. begins between 12 and 13 years of age. d. takes an average of 5 years.

precedes menstruation by about 2 years. Breast development usually precedes menstruation by about 2 years. Breast development usually begins between 8 and 9 years of age for African American girls and by 10 years for white girls. Full breast development from Tanner stage 2 to 5 takes an average of 3 years, although the range is 1.5 to 6 years.

When assessing for the presence of a herniated nucleus pulposus, the examiner would: a. raise each of the patient's legs straight while keeping the knee extended. b. ask the patient to bend over and touch the floor while keeping the legs straight. c. instruct the patient to do a knee bend. d. abduct and adduct the patient's legs while keeping the knee extended.

raise each of the patient's legs straight while keeping the knee extended. The straight leg-raising (Lasègue) test reproduces back and leg pain and helps confirm the presence of a herniated nucleus pulposus. The examiner raises each leg straight while keeping the knee in extension. To assess for a spinal curvature, the examiner has the person bend over and touch the toes with the knee in extension. Muscle extension can be assessed by instructing the person to rise from a squatting position without using the hands for support. To assess range of motion, the leg should be abducted and adducted with the knee extended.

Testing the deep tendon reflexes gives the examiner information regarding the intactness of the: a. corticospinal tract. b. medulla. c. reflex arc at specific levels in the spinal cord. d. upper motor and lower motor neuron synaptic junction.

reflex arc at specific levels in the spinal cord. Measurement of the deep tendon reflexes reveals the intactness of the reflex arc at specific spinal levels. The corticospinal tract is the higher motor system that permits very skilled and purposeful movements such as writing. The medulla contains all ascending and descending fiber tracts; it has vital autonomic centers for respiration, heart, and gastrointestinal function as well as nuclei for cranial nerves VIII through XII. The upper motor neurons are located within the central nervous system and influence or modify the lower motor neurons and include the corticospinal, corticobulbar, and extrapyramidal tracts. The lower motor neurons are located mostly in the peripheral nervous system and extend from the spinal cord to the muscles; examples include the cranial nerves and spinal nerves.

Crepitation is an audible sound that is produced by: a. roughened articular surfaces moving over each other. b. tendons or ligaments that slip over bones during motion. c. joints that are stretched when placed in hyperflexion or hyperextension. d. flexion and extension of an inflamed bursa.

roughened articular surfaces moving over each other. Crepitation is an audible and palpable crunching or grating that accompanies movement. It occurs when the articular surfaces in the joints are roughened. Crepitation is not the cracking noise heard when tendons or ligaments slip over bones during motion. Hyperflexion or hyperextension is assessed with range of motion. Bursitis is an inflamed bursa. Pain may occur with motion of the joint involved.

Nutritional status is best determined by: a. serum albumin. b. clinical manifestations. c. triglycerides d. 24-hour diet recall.

serum albumin. Laboratory testing is required to make an accurate diagnosis of malnutrition. Serum albumin is a common measurement of visceral protein status. Low serum albumin levels occur with protein-calorie malnutrition, altered hydration status, and decreased liver function. A serum albumin level of 2.8 to 3.5 g/dL represents moderate visceral protein depletion, and a level less than 2.8 g/dL denotes severe depletion. Clinical signs of nutritional deficiencies can be detected by a physical examination, but clinical manifestations may be a late sign of nutritional deficiencies. These signs may also be non-nutritional in origin. Triglycerides are used to screen for hyperlipidemia and the risk of coronary artery disease. A 24-hour diet recall is the easiest and most popular method for obtaining information about nutritional intake; however, this method has significant sources for error.

Clonus that may be seen when testing deep tendon reflexes is characterized by a(n): a. additional contraction of the muscle that is of greater intensity than the first contraction. b. set of rapid, rhythmic contractions of the same muscle. c. parallel response in the opposite extremity. d. contraction of the muscle that appears after the tendon is hit the second time.

set of rapid, rhythmic contractions of the same muscle. Clonus is a set of rapid, rhythmic contractions of the same muscle.

A caruncle is a(n): a. vestibular gland located on either side of the vaginal orifice. b. small, red mass protruding from the urethral meatus. c. aberrant growth of endometrial tissue. d. hard, painless nodule in the uterine wall.

small, red mass protruding from the urethral meatus. A caruncle is a small, deep red mass protruding from the urinary meatus. Bartholin glands are vestibular glands located on either side of and posterior to the vaginal orifice. Endometriosis is a disorder caused by aberrant growths of endometrial tissue scattered throughout the pelvis. Myomas (leiomyomas or uterine fibroids) is a disorder in which the uterus is irregularly enlarged, firm, mobile, and nodular with hard, painless nodules in the uterine wall.

Automatic associated movements of the body are under the control and regulation of: a. the basal ganglia b. the thalamus. c. the hypothalamus. d. Wernicke's area.

the basal ganglia The basal ganglia controls automatic associated movements of the body. The thalamus is where sensory pathways of the spinal cord, cerebellum, and brainstem form synapses on their way to the cerebral cortex. The hypothalamus is a major respiratory center with basic vital functions: temperature, appetite, sex drive, heart rate, and blood pressure control; sleep center; anterior and posterior pituitary gland regulation; and coordination of autonomic nervous system activity and stress response. Wernicke's area in the temporal lobe is associated with language comprehension.

Decreased estrogen levels during menopause cause: a. an enlargement of the uterus. b. pelvic muscles and ligaments to tighten. c. the ovaries to atrophy.

the ovaries to atrophy. Decreased estrogen levels during menopause cause atrophy of the ovaries. Decreased estrogen levels during menopause cause the uterus to shrink related to a decrease in the myometrium. Decreased estrogen levels during menopause cause the sacral ligaments to relax and the pelvic musculature to weaken, which causes the uterus to drop. Decreased estrogen levels during menopause cause the cervix to shrink and look pale with a thick, glistening epithelium.

The ejaculatory duct is: a. the passage formed by the joining of the vas deferens and the seminal vesicle. b. a muscular duct continuous with the epididymis. c. a narrow tunnel inferior to the inguinal ligament. d. a narrow tunnel superior to the inguinal ligament.

the passage formed by the joining of the vas deferens and the seminal vesicle. The ejaculatory duct is the passage formed by the junction of the duct of the seminal vesicles and the vas deferens through which semen enters the urethra. The muscular duct continuous with the epididymis is the vas deferens. The femoral canal is inferior to the inguinal ligament. The inguinal canal is superior to the inguinal ligament and is a narrow tunnel passing obliquely between layers of abdominal muscle.

The most common site of cancerous breast tumors is in the: a. upper inner quadrant. b. upper outer quadrant. c. lower inner quadrant. d. lower outer quadrant.

upper outer quadrant.

The four layers of large, flat abdominal muscles form the: a. linea alba. b. rectus abdominis. c. ventral abdominal wall. d. viscera

ventral abdominal wall. The four layers of large, flat muscles form the ventral abdominal wall. These muscles are joined at the midline by a tendinous seam, the linea alba. One set of abdominal muscles, the rectus abdominis, forms a strip extending the length of the midline. The viscera are all the internal organs inside the abdominal cavity.

Adnexa is (are): a. an absence of menstruation. b. uterine accessory organs. c. a membranous fold of tissue partly closing the vaginal orifice. d. painful intercourse.

uterine accessory organs. The adnexa of uterus (or uterine appendages) refers to the structures most closely related structurally and functionally to the uterus; these structures include the ovaries, fallopian tubes, and ligaments. Amenorrhea is the absence of menstruation. The hymen is a thin, circular or crescent-shaped fold that may cover part of the vaginal orifice or may be absent completely. Dyspareunia is the term to describe painful intercourse.

A patient's complaints include bleeding gums, splinter hemorrhages of the nails, and joint pain. These complaints are symptomatic of: a. riboflavin deficiency. b. vitamin C deficiency. c. vitamin B12 deficiency. d. iron deficiency.

vitamin C deficiency. Patients with vitamin C deficiency may have the following clinical manifestations: petechiae or ecchymoses, bleeding gums, joint pain, and splinter hemorrhages of the nails. Patients with a riboflavin deficiency may have the following clinical manifestations: nasolabial seborrhea, red conjunctivae, cheilosis, angular stomatitis, and purplish-colored tongue. Patients with a vitamin B12 deficiency may have the following clinical manifestations: pale conjunctivae, disorientation, or irritability. Patients with iron deficiencies may have the following clinical manifestations: pale conjunctivae, angular stomatitis; pale tongue; and brittle, ridged, or spoon shaped nails.