Patho Exam II

8. A neighbor is complaining to a friend (who happens to be a nurse) about several changes in their body. Which of the following complaints raises a "red flag" because it could be a sign of epithelial cell bladder cancer?

"I Noticed My Urine is Pinkish Red, but I'm Not Having Any Pain When I Pee."

17. An adult client has been diagnosed with polycystic kidney disease. Which of the client's following statements demonstrates an accurate understanding of this diagnosis?

"I Suppose I Should Be Tested To See if My Children Might Inherit This."

2. A 51 year old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which of the man's following statements demonstrates a sound understanding of his new diagnosis?

"If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis."

12. Which of the following individuals is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of granuloma on chest x-ray?

A 30-Year-Old African American Man Who Has Been Diagnosed With Sarcoidosis

19. A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants' following statements demonstrates an accurate understanding of the risk factors for bladder cancer?

"More Than Ever, I Guess It Would Be Worthwhile for Me to Quit Smoking."

17. A client asks: "Why am i taking a water pill when it's my heart that is having the problem?". What explanation would be appropriate in the education of the patient?

"Since Your Heart is Not Pumping Efficiently, The Kidneys Are Holding on to Sodium and Water."

4. Which of the following clients are at risk for developing primary varicose veins?

A 47-Year-Old Waitress Who Works 12-Hour Shifts Three or Four Times/Week A Morbidly Obese Male Who Works Behind the Counter of a Convenience Store 10 Hours/Day, 5 Days/Week

4. A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:

A : Tubular Necrosis

7. Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease?

A Patient with a Recent Diagnosis of Type 2 Diabetes who Does Not Monitor His Blood Sugars or Control His Diet

4. Which of the following clients is at risk for developing a preventable disorder related to prolonged immobility?

A Postsurgical Client Who is Refusing to Get Out of Bed and Walk and Will Not Wear Those "Uncomfortable Elastic Stockings"

15. A client is admitted with dilated cardiomyopathy with left ventricular dysfunction. What clinical manifestation would the nurse find in the patient?

A: Dyspnea, Orthopnea, Extreme Fatigue

13. A heart failure client has an endocardiogram performed revealing an ejection factor of 40%. The nurse recognizes this is a low reading and explains to the patient that:

A: This Means Your Heart Is Not Pumping As Much Blood Out of the Heart With Each Beat

10. The most common cause of left-sided heart failure is:

Acute Myocardial Infarction

3. A child is recovering from a bout with group A β-hemolytic Streptococcus infection. They return to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:

Acute Post-Infectious Glomerulonephritis

8. A father experienced the onset of chest pain and dies suddenly. There is a high possibility the patient developed an acute heart attack and experienced:

Acute Ventricular Arrhytemia

9. What is a non-modifiable risk factor for the development of hypertension?

African American Race

1. A client has been given the diagnosis of diffuse glomerulonephritis. They ask the nurse what diffuse means. The nurse responds:

All Glomeruli and All parts of the Glomeruli are Involved.

12. Which of the following patients should most likely be assessed for orthostatic hypotension?

An 80-Year-Old Elderly Client Who Has Experienced Two Falls Since Admission

18. Glomerulonephritis is usually caused by:

Antigen-Antibody Complexes

20. Following several weeks of fatigue and subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of the heart valve would have what consequences?

Backflow of Blood from Left Ventricle to Left Atrium

14. If a CKD client is developing uremic encephalopathy, the earliest manifestations may include:

Decreased alertness Diminished awareness

19. The client is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth of the area. He has clinical manifestations of:

Deep Vein Thrombosis

15. A client is beginning to recover from acute tubular necrosis. The nurse would likely be assessing which of the following manifestations of the recovery phase of ATN?

Diuresis

13. A mother rushes her toddler into the emergency department stating, " My baby cant breath." Initial assessment reveals the child is struggling to breath in the upright position. He has both inspiratory and expiratory stridor and is using his chest muscles to breathe. The nurse suspects the child has which of the following acute respiratory infections?

Epiglottitis

14. Blue Bloaters is an acronym for patients with emphysema.

False - Chronic Bronchitis

19. Shortness of breath when lying down is apnea.

False - Orthopnea

8. The pathogenic capacity of the tubercle bacillus is related to:

Formation of the Ghon Focus Lesion

6. Which of the following lab results strongly suggests immunologic response in a client with possible rheumatic heart disease?

Group A (Beta-Hemolytic) Streptococcal Antibodies

12. While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which of the following high-risk factors with the development of this cancer?

Heavy Smoking

1. Which of the following manifestations typically accompanies an asthmatic attack?

Hyperinflation of the Lungs

11. Football fans are shocked to learn of the sudden death of a star player who apparently has suffered from an enlarged heart. What is the most likely cause of death?

Hypertrophic Cardiomyopathy

20. The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this client's diagnosis?

Hypophosphatemia

15. A child with asthma is walking outside and develops a bronchospasm. The school nurse knows this bronchospasm has what effect on bronchioles with airflow?

Impairs Airflow Narrowing of Bronchioles

10. A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the client integrate into his lifestyle to reduce the risk of recurrence?

Increase Fluid Intake and Dietary Changes

7. A 2 year old child is admitted to a pediatric unit with bronchitis. The nurse calls the physician fearing the child is going into respiratory failure based on which of the following assessment findings?

Increased Respiratory Rate to 44 Breaths/Minute Substernal Retractions Becoming More Pronounced New-Onset Expiratory Grunting

2. The most recent assessment of a client with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk?

Microalbuminuria

1. One of the principal mechanisms by which the heart compensates for increased workload is:

Myocardial Hypertrophy

6. A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows this can:

Obstruct the renal tubules with myoglobin and damage tubular cells

9. COPD clients live with persistence elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in the client population?

PCO2 level of 50 mm Hg

18. A teenaged cystic firbrosis client rpesents to the clinic. The health care provider knows that cystic fibrosis causes severe chronic respiratory disease in children. In addition, the health care provider should also focus his or her assessment on which of the other body system affected by CF?

Pancreatic

10. Following surgery, a client had a chest x-ray that reports some opacities in the lung base likely due to atelectasis. Which of the following pathophysiologic processes will result from this condition?

Perfusion Without Ventilation

3. While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which of the following physiologic processes?

Peripheral Vascular Resistance

11. Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?

Pet Dander

16. A client with a history of emphysema from long term cigarette smoking has loss of many alveoli. When comparing type ii alveolar cells physiologic function with the primary role of type two alveoli, the nurse would be aware that the type two alveolar cells are responsible for:

Production of Surfactant

9. Which of the following assessment findings would lead the nurse to suspect the client has nephrotic syndrome?

Proteinuria and Generalized Edema

5. As a result of hypoxemia and polycythemia, person with chronic obstructive bronchitis are prone to:

Pulmonary Hypertension

5. Many factors contribute to the incontinence that is common among the elderly. A major factor is increased:

Use of Multiple Medications

16. If the parasympathetic neurotransmitter releases acetyl-codeine, the nurse should expect:

Slowing of Heart Rate To Below 60 BPM

14. When lecturing to a group of students about the pathophysiological principles behind heart failure, the instructor explains that cardiac output is:

The Amount of Blood Pumped Out of the Heart With Each Beat

13. In anatomy class, the instructor asks, "Explain how urine is expelled from the bladder during voiding." The student with the most accurate response would be:

The Detrusor Muscles Contract Down on the Urine and the Ureteral Orifices are Forced Shut. The External Sphincter Relaxes as Urine Moves Out of the Bladder

2. Upon admission assessment, the nurse hears a murmur located in the fifth intercostal space, midclavicular line. What does this mean?

The Heart Valve is Diseased

6. A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happens.The nurse responds:

This means your lungs collapsed and expelled its air when you lose negative pressure

5. The most important complication of atherosclerosis that may cause occlusion of small heart vessels is:

Thrombosis

3. A man sustained a puncture injury to his chest that causes a tension pneumothorax to form. This is a life threatening condition because :

Trapped, Inspired Air Collapses the Lung.

20. The respiratory drive in patients with chronic obstructive pulmonary disease can be diminished when administering oxygen.

True

Difficulty breathing is dyspnea.

True

18. Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by:

Vegetative Valve Destruction

7. A male client with a history of angina has presented to the emergency department with uncharacteristic chest pain, and his EKG reveals T-Wave elevation. What does this abnormalities suggest about the cardiac cycle?

Ventricular Re-polarization

16. A female client asks, "Why do I leak urine every time I cough or sneeze?" The health care worker's response is based on which physiologic principle?

When Intravesical Pressure Exceeds Maximal Urethral Closure Pressure

11. A female teenager has experienced three uncomplicated urinary tract infections in the last 3 months. Knowing the anatomical location of the urethra, the nurse should educate this teenager about:

Wiping From Front to Back To Prevent E. Coli Contamination of the Urethra