patho final

Which of the following statements best captures an aspect of the role of hormones in the body?

Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems

During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle?

The follicle will die, which results in a fall of FSH

After receiving change-of-shift report on the following four patients, which patient should the nurse see first?

A 70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and has an elevated temperature of 103.2

Which of the following data would a clinician consider as most indicative of acute renal failure?

B) increased nitrogenous waste levels; decreased glomerular filtration rate (GFR)

Damage to which of the following areas of a nephron would most likely result in impaired secretion and reabsorption? A) Distal tubule B) Loop of Henle C) Proximal tubule D) Collecting tubule

C) Proximal tubule

A patient is admitted to the hospital in adrenal crisis 1 month after a diagnosis of Addison disease. The nurse knows which of the following clinical manifestations would support this diagnosis?

Change in the level of consciousness and profound hypotension

Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary hormone (HPA) system?

The pituitary gland communicates with the adrenal cortex through the release of ACTH

A client with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which of the following statements most accurately underlies the dominant regulation process of hormone levels in the body?

With input from various sensors, hormone production and release are adjusted based on existing hormone levels

a 17-year-old male experienced third-degree full-thickness burns 2 days ago to his lower limbs after a fire at his workplace. which of the following complications should his care team foresee and regularly assess for? select all that apply A) Systemic infection B) Fluid volume deficit C) Respiratory dysfunction D) Hypermetabolic response E) Constipation and bowel obstruction

systemic infection, fluid volume deficit, respiratory dysfunction, hypermetabolic response, constipation and bowel obstruction A) Sepsis, B) hemodynamic instability, C)respiratory dysfunction, D) hypermetabolism, and E) bowel obstructions are all demonstrated consequences of thermal injury. Sepsis, hemodynamic instability, respiratory dysfunction, hypermetabolism, and bowel obstructions are all demonstrated consequences of thermal injury.

Following an automobile accident where the patient had a traumatic amputation of his lower leg and lost greater than 40% of his blood volume, he is currently not producing any urine output. The nurse bases this phenomena on which of the following humoral substances responsible for causing severe vasoconstriction of the renal vessels? A) Aquaproin-2 channels B) Angiotensin II and ADH C) Renin and potassium ions D) Albumin and norepinephrine

B) Angiotensin II and ADH

Which of the following changes in an 86-year old male's skin would necessitate further examination and possible medical treatment? A) A decrease in general sebaceous gland activity B) Appearance of new skin tags on his chest C) A new mole-like growth on his forearm D) Appearance of a keratosis on the man's trunk

C) A new mole-like growth on his forearm Appearance of a new mole or a change in the size or shape of an existing mole can be indicative of malignant melanoma. Decreased sebaceous gland secretions, skin tags, and keratoses are normal age-related changes.

The physician is considering prescribing an anti-tumor necrosis factor (TNF) like infliximab for a rheumatoid arthritis patient. which of the following statements is accurate about the advantages of using a TNF inhibitor? A) "Since TNF inhibitors have few side effects, these drugs will fit well into your regimen." B) "Your disease-modifying antirheumatic drug (DMARD) methotrexate has more cardiovascular side effects than TNF inhibitors." C) "TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions." D) "Not only do TNF inhibitors control your disease better but they also will interrupt the inflammatory cascade at several levels."

"TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions" Second-line antirheumatic drugs include anti-TNF drugs such as etanercept, infliximab, and adalimumab. These drugs are biologic response-modifying agents or TNF inhibitors that block TNF-a, one of the key proinflammatory cytokines in RA. Anti-TNF-a agents have shown significant efficacy although they do have some potential adverse side effects. Evidence indicates that CV side effects are not different for TNF inhibitors than for DMARDs. The TNF inhibitor agents also have been shown to inhibit radiologic disease progression and improve functional outcomes.

Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis? A) "Are you using tampons during your period or do you normally use pads?" B) "What does your daily hygiene routine usually consist of?" C) "How many sexual partners have you had?" D) "Have you ever had a therapeutic abortion in the past?"

"how many sexual partners have you had?" Having multiple sex partners is a factor that has been identified in the development of PID. The use of tampons, inadequate hygiene, and a history of TA are less likely to predispose to PID.

While being tackled, a 20-year-old football player puts out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment? A. "This strain will likely resolve itself with sufficient rest." B. "You've suffered a severe sprain, and you might need a cast." C. "Your wrist contusion will have to be observed for bleeding under the skin surface." D. "It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."

"it looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."

A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of Web sites. which of the following statements that he has read is most plausible? A) "Testicular cancer is a leading cause of death among males who should be in the prime of their life." B) "Men with cryptorchidism--the term for an undescended testicle--are known to have a higher risk of developing testicular cancer." C) "For most men with testicular cancer, bloody urine is their first sign that something is wrong." D) "Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed."

"men with cryptorchidism-the term for an undescended testicle-are known to have a higher risk of developing testicular cancer" Cryptorchidism is an identified risk factor for the development of testicular cancer. The diagnosis is no longer a leading cause of death. Hematuria is not a common symptom, and orchiectomy is still the standard treatment modality.

A 60-year-old women who is 11 years menopausal has presented to the emergency department stating, "i haven't had my period in years, but lately i've been bleeding again, and quite heavily in the last few days." the care team needs to rule out endometrial cancer. How should they best explain the most accurate plan for confirming or ruling out the diagnosis? A) "We're going to book a CT scan for you as soon as possible so that we can see what is inside your uterus." B) "We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus." C) "We are going to order blood work that will measure your hormone levels." D) "We can do a Pap smear right now, and we will get the results as soon as we can."

"we're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus"

A 60-year-old man has been diagnosed with renal calculi after repeated episodes of excruciating flank pain in recent weeks. The man states that, "i don't know how this could happen to me, since i'm so careful about eating a healthy diet." what is the most appropriate response to the mans statement? A) "Your diet may have played a part in this, but in fact, genetics are likely primarily to blame." B) "What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved." C) "You likely don't need to change your diet, but now that you have stones in one kidney, you're at very high risk of growing them in the other kidney." D) "Your diet might be normally healthy, but high intake of normally beneficial minerals like calcium and magnesium can lead to stones."

"what you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved." Classic ureteral colic is manifested by acute, intermittent, and excruciating pain in the flank and upper outer quadrant of the abdomen on the affected side. The pain may radiate to the lower abdominal quadrant, bladder area, perineum, or scrotum in the man.

Following a workup that included endocrine studies (FSH/LH, prolactin, testosterone, DHEAS levels), a 22-year-old college student complaining of abnormal bleeding has been diagnosed with dysmenorrhea due to alterations in her hormone levels. The nurse should anticipate that she will likely be prescribed: Select all that apply. A) oral contraceptives. B) estrogen only. C) prostaglandin synthetase inhibitors. D) anxiolytic medications. E) androgens.

A) oral contraceptives C) prostaglandin synthetase inhibitors The treatment of dysfunctional bleeding of a nonhormonal nature is usually treated with oral contraceptives or cyclic progesterone therapy. Prostaglandin synthetase inhibitors are prescribed for dysmenorrhea. Anxiolytic drugs treat mood changes of PMS.

Which of the following clinical findings among older adults is most unlikely to warrant further investigation and possible treatment?

A 78-year-old female's GFR has been steadily declining over several years

The mother of a 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which of the following phenomena would be the physicians most likely suspect as contributing factor to the boy's short stature? A) Genetic short stature B) Lack of IGF receptors in epiphyseal long bones C) A shortage of hypothalamic GHRH production D) Excess insulin production resulting in chronically low blood glucose levels

A shortage of hypothalamic GHRH production Inadequate levels of hypothalamic GHRH will result in adequate production but inadequate release of GH by the pituitary. Genetic short stature is less likely given the disparity between his height and his twin's, and a shortage of IGF receptors is not a noted pathology. While poorly controlled diabetes can contribute to short stature, excess insulin production is not a likely factor.

A 28-year-old male who is 6'11" tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem? A) "My pituitary gland produced a much higher than normal amount of growth hormone when I was a child." B) "A tumor in my brain threw off my hormone levels after I was finished adolescence." C) "My liver is malfunctioning and produces too many of the hormones that ultimately cause growth." D) "The high sugar levels that go along with my diabetes made my pituitary gland overproduce the hormones that cause you to grow."

A tumor in my brain threw off my hormone levels after i was finished adolescence Acromegaly is associated with adult onset and nearly always involves an adenoma. Increased GH as a child and liver dysfunction are not noted contributors to acromegaly. High levels of GH can cause overproduction of insulin and eventual diabetes, but diabetes does not itself lead to acromegaly.

A campus-based peer counseling group is conducting an informational blitz on sexually transmitted diseases. Which of the following statements about genital warts requires correction? A) "Genital warts can take up to a month after exposure to first become visible." B) "There is no existing treatment that can eradicate the virus once it's contracted." C) "Condoms do not necessarily prevent the transmission of the virus that causes genital warts." D) "There are a number of subtypes of the virus that cause genital warts, but current vaccines protect against most common causes of them."

A) "genital warts can take up to a month after exposure to first become visible" Genital warts can take between 6 weeks to 8 months to incubate after exposure. The virus cannot be eliminated, and condoms do not provide proven protection. Vaccine protects against 4 HPV types.

The osteoporosis patient asks the nurse to explain what a bisphosphonate medication does. the nurse will respond, A) "This medication helps prevent bone resorption, which will help prevent fractures." B) "These drugs increase your phosphorus levels and thereby help with your calcium levels as well." C) "This medication stimulates your parathyroid gland to increase osteoclastic activity." D) "This medication plays an important role in bone remodeling."

A) "this medication helps prevent bone resorption, which will help prevent fractures." Bisphosphonates are effective inhibitors of bone resorption and the most effective agents for the prevention and treatment of osteoporosis. The bisphosphonates bind to hydroxyapatite and prevent bone resorption by inhibiting osteoclast activity. They are effective in reducing the risk of hip, vertebral, and nonvertebral fractures.

Which of the following newborn infants demonstrates the highest risk of presenting with developmental dysplasia of the hip (DDH)? A) A girl who was born with toeing-in and who was in a breech presentation B) A twin girl who required resuscitation after delivery C) A boy who was born by caesarian section to a 44-year-old first-time mother D) A boy with Down syndrome who was exposed to cocaine in utero

A) A girl who was born with toeing-in and who was in a breech position Female sex, a history of breech presentation, and congenital skeletal abnormalities are all correlated with DDH. Respiratory emergencies, delivery by caesarian section, advanced age of the mother, Down syndrome, and drug exposure are not noted risk factors for DDH.

Which of the following endocrine functions are responsible for increased resorption of bone that results in a reduction of the number and function of osteoclasts? select all that apply A) Calcitonin secretion B) Decrease in estrogen levels C) Stimulation of excess thyroid hormone D) Release of catecholamines E) Increase movement of calcium and phosphate from bone into the extracellular fluid

A) Calcitonin secretion B) decrease in estrogen levels Parathyroid hormone increases the number of resorptive function of the osteoclasts. Calcitonin is thought to reduce the number and resorptive function of the osteoclasts. Estrogen also reduces the number and function of the osteoclasts. Thus, the decrease in estrogen levels that occurs at menopause results in increased resorption of bone. Release of catecholamines has no influence over osteoclast function. Increased movement of calcium and phosphate from bone into extracellular fluid is regulated by parathyroid hormone.

An 80-year-old female with a diagnosis of osteoporosis receives daily supplements of calcitonin in the form of a nasal spray that she instills each morning. Which of the following phenomenon would her care providers expect to result from her supplementation? A) Decreased serum calcium levels B) Increased bone resorption C) Acceleration of osteoclast action D) An increase in bone formation

A) Decreased serum calcium levels Calcitonin lowers both the rate of bone resorption and serum calcium levels. It does not accelerate osteoclast action, and it is not noted to increase bone formation.

A 16-month-old boy has a normal weight for his age but a height far below the normal range. his list of symptoms includes a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed, and he has difficulty standing. what is the child's most likely diagnosis? A) Rickets B) Rachitic rosary C) Paget disease D) Developmental dysplasia of the hip

A) Rickets All of these are symptoms of rickets that are noticed between 6 months and 3 years of age. The rachitic rosary refers to prominent rib cartilage, which is also a symptom of rickets. Paget disease is a progressive skeletal disorder characterized by increasing structural changes of the long bones, spine, pelvis, and cranium; it usually begins during mid-adulthood. DDH is developmental dysplasia of the hip.

A female client with suspected glomerular disease has been referred to a nephrologist. The nurse knows that which of the following clinical manifestations may be present with the diagnosis of acute nephritic syndrome? Select all that apply. A) Sudden onset of hematuria B) Proteinuria C) Flank pain D) Excess urine output E) Edema

A) Sudden onset of hematuria B) Proteinuria E) Edema In its most dramatic form, the acute nephritic syndrome is characterized by sudden onset of hematuria, variable degrees of proteinuria, diminished GFR, oliguria, and signs of impaired renal function. Inflammatory processes damage the capillary wall. This damage to the capillary wall allows RBCs to escape into the urine and produce a decrease in GFR. Extracellular fluid accumulation, hypertension, and edema develop because of the decreased GFR. Flank pain is usually associated with kidney stones. Oliguria occurs rather than excess urine output.

The infant of a family that has recently immigrated to the United States from South Asia has been diagnosed with rickets. Bone density scanning would yield which of the following characteristics of the infants bones? A) The child's bones are far softer than those of healthy children. B) The infant has bones that are brittle and susceptible to breakage. C) The child's bones lack bone matrix and prevent weight bearing. D) The child's bones are oversized due to insufficient osteoclasts.

A) The child's bones are far softer than those of healthy children. Rickets is characterized by soft bones that are undermineralized. Bone matrix is not lacking, and the bones tend not to be brittle. Osteoclast deficiency does not underlie rickets.

A 74-year-old female has been diagnosed with osteoporosis after her bone density scan indicated osteopenia. which of the following factors would her care team be most likely to rule out as contributors to her health problem? A) The woman is an African American and was exposed to asbestos in her work. B) She has been a heavy drinker for her whole adult life and has diabetes mellitus. C) The client takes corticosteroids for treatment of her long-standing osteoarthritis. D) The woman has an estrogen deficiency and has never undergone hormone therapy.

A) The women is an African American and was exposed to asbestos in her work African American race is not a risk factor for the development of osteoporosis, and African Americans tend to have higher bone density than Whites and Hispanics. Asbestos exposure is not a noted risk factor for osteoporosis, while alcohol use, diabetes, steroids, and estrogen deficiency are all risk factors.

Which of the following clients of an oncologist is likely to have the poorest prognosis? A) a 69-year old man who has been diagnosed with stage 4 malignant melanoma B) a 70-year old whose skin cancer has been identified as nodular ulcerative basal cell carcinoma C) a 51-year old women whose biopsy revealed intraepidermal squamous cells carcinoma D) a 59-year old women who has invasive squamous cell carcinoma

A) a 69-year old man who has been diagnosed with stage 4 malignant melanoma Late detection of malignant melanoma is associated with particularly poor outcomes. Basal cells carcinomas often have strong treatment success rates. While invasive SCC has worse outcomes than intraepidermal SCC, these are both exceeded in mortality by late-stage malignant melanoma.

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? select all that apply.

A) a bodily process can be the result of the combined effect of several different hormones from different sources. B) A single hormone can act not only on one process or organ but often on several different locations or processes. C) Its common for production of hormones to be far removed from the tissue where they they ultimately exert their effect D) sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions

While teaching a class on female cancers, the instructor emphasizes to the nursing students that many patients with ovarian cancer may display A) abdominal pain, bloating, feeling full quickly after ingesting food. B) pain after intercourse, bleeding irregularities, perineal tenderness. C) colicky low abdominal pain, adnexal mass present without palpation. D) lower abdominal pain localized to one side, referred shoulder pain.

A) abdominal pain, bloating, feeling full quickly after ingesting food Symptoms that are believed to have a strong correlation to ovarian cancer include abdominal pain, increased abdominal size or bloating, and difficulty in eating or feeling full quickly after ingesting food. Pain and bleeding after intercourse are usually associated with an inflammatory process. Colicky low abdominal pain and adnexal mass are associated with cancer of the fallopian tube. Localized abdominal pain to one side with referred shoulder pain is common in ectopic pregnancy.

A nurse on a medical unit is providing care for a 37-year-old female patient who has a diagnosis of Graves disease. Which of the following treatments would the nurse most likely anticipate providing the client?

A) beta-adrenergic-blocking medications to reduce sympathetic nervous stimulation

While speaking to a senior citizen club about osteoarthritis (OA), which of the following facts are accurate to share? select all that apply A) By the time you are in your 70s, about 85% of adults will have some form of OA B) Men usually get OA in their hands, whereas women get OA primarily in their hips C) Obesity in women has been correlated to having OA in the knees D) Heredity does not play a significant role in the development of OA

A) by the time you are in your 70s, about 85% of all adults will have some form of OA C) obesity in women has been correlated to having OA in the knees Eighty-five percent of people with OA are in their 70s. Men are affected more commonly at a younger age. Heredity influences the occurrence of hand OA in the DIP joint. Hand OA is more likely to affect white women, whereas knee OA is more common in black women. Obesity is a particular risk factor for OA of the knee in women.

A 22-year-old women has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the women expect over the course of recovery? select all that apply A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity D) Presence of infectious microorganisms in the synovial capsule E) Rapid restoration of the cartilage cells in the meniscus

A) decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity Meniscal injuries have consequences for the lubricating and shock absorption capacities of the meniscus and would involve decreased range of motion. An infectious process is unlikely due to the internal nature of meniscal injuries, and healing is typically very slow.

to treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. what is the most likely rationale for this treatment? A) It removes water from the filtrate and returns it to the vascular compartment. B) It lessens the amount of fluid entering the glomerulus. C) It leads to the production of dilute urine. D) It causes tubular cells to lose their water permeability.

A) it removes water from the filtrate and returns it to the vascular compartment ADH maintains extracellular volume by returning water to the vascular compartment. This leads to the production of concentrated urine by removing water from the tubular filtrate. In exerting its effect, ADH produces a marked increase in water permeability in tubular cells.

Prior to performing a laparoscopy, a patient exhibiting which of the following clinical manifestations would be treated with oral antibiotic therapy for suspected pelvic inflammatory disease (PID)? select all that apply A) Lower abdominal pain. B) Tenderness when cervix is touched during bimanual exam. C) Feeling of fullness and bloating in abdomen. D) Purulent cervical drainage noted on tissue after voiding. E) Elevated white cell count.

A) lower abdominal pain B) tenderness when cervix is touched during bimanual exam D) purulent cervical drainage noted on tissue after voiding E) elevated white cell count The symptoms of PID include lower abdominal pain, which may start just after a menstrual period; dyspareunia; back pain; purulent cervical discharge; adnexal tenderness; and cervical motion tenderness on bimanual examination with no other apparent cause. Fever, increased erythrocyte sedimentation rate, and elevated WBC are commonly seen.

A physician is attempting a differential diagnosis of a 30-year-old female who is suspected of having systemic lupus erythematosus (SLE). which of the following aspects of the physicians assessment and the client's history would be considered potentially indicative of SLE? select all that apply A) The client has a "butterfly rash" on her nose and cheeks. B) She complains of intermittent joint pain. C) The woman states that she has numerous environmental allergies. D) The client has been hospitalized twice in the past for pleural effusions. E) Blood work indicates low red cells, white cells, and platelets.

A) the client has a "butterfly rash" on her nose and cheeks B) she complains of intermittent joint pain D) the client has been hospitalized twice in the past for pleural effusions E) blood work indicates low red cells, white cells, and platelets A butterfly rash, joint pain, pleural effusion, and low levels of blood cellular components are all associated with SLE. Environmental allergies are not noted to be risk factors or associated symptoms of the disease.

which of the following substances is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms? A) Water B) Sodium C) Phosphate D) Calcium

A) water Water is passively reabsorbed across tubular epithelial membranes, while ions like sodium, phosphate, and calcium necessitate active transport.

Following a meal, a women's blood glucose level has increased. in addition, her pancreas has increased the amount of insulin produced and released. Which of the following phenomena has occured?

Adjustment according to the level of the substance a hormone regulates

A 44-year-old women who has a long-standing diagnosis if SLE has been able to control her symptoms with lifestyle modifications for several years, but has presented to her care provider due to recent exacerbation. which of the following pharmacological treatment options is her care provider most likely to rule out first? A) Nonsteroidal anti-inflammatory drugs B) Corticosteroids C) Anti-platelet aggregator D) Immunosuppressive drugs

Anti-platelet aggregators While NSAIDs, corticosteroids, and immunosuppressives are all noted treatment options for SLE, antiplatelet aggregators are unlikely to address the etiology or signs and symptoms of the disease. A new drug that has shown positive effects in decreasing inflammatory exacerbations for people with SLE is Belimumab, which is a monoclonal antibody that inhibits B-lymphocyte stimulator.

A new patient arrives at the clinic. the physician is suspecting that the patient may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and a history of pleural effusions. the nurse should anticipate which of the following diagnostic test will be a priority to facilitate with the diagnosis? A) Anti-DNA antibody test B) Routine hemoglobin C) C-reactive protein D) B-cell lymphocytes

Anti-DNA antibody test Ninety-five percent of people with untreated SLE have high ANA levels. However, ANA is not specific for SLE. The anti-DNA antibody test is more specific for the diagnosis of SLE. Hemoglobin may be low if the patient has severe anemia, but it is not specific for SLE. C-reactive protein will show an inflammatory response but again not specific for SLE.

A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. upon inspection, the nurse notices some pustules and vesicles. while taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications? A) "Do you get cold sores very often?" B) "Do you have pain when you urinate or have difficulty starting the stream?" C) "Have you noticed excessive swelling in your scrotum the last few days?" D) "Have you been experiencing flank pain and bloody urine?"

B) "Do you have pain when you urinate or have difficulty starting the stream?" The initial symptoms of primary genital herpes infections include tingling, itching, and pain in the genital area, followed by eruption of small pustules and vesicles. In men, the infection can cause urethritis and lesions of the penis and scrotum. Urethritis is characterized by pain with urination and difficulty starting the stream. Cold sores are not related to genital herpes. Swelling of the scrotum is common in epididymitis, while flank pain and bloody urine are associated primarily with kidney stone formation.

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. to prevent transmission of the virus to her baby, the physician will educate to include which of the following accurate statements? A) "After your caesarean section, it will be safest if you don't breast-feed your child." B) "If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with." C) "A vaginal delivery will be safe as long as you are consistent with taking your valacyclovir." D) "We'll have to book you a caesarian delivery in order to ensure your baby isn't exposed to the virus."

B) "if there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with" Vaginal delivery is safe in the absence of lesions at the onset of labor. HSV does not preclude breast-feeding, and antivirals would not be commonly used in pregnancy, nor would they guarantee a risk-free vaginal delivery.

A 70-year-old women's family physician has recommended a vitamin D supplement. the women states that she tries hard to take as few pills as possible and questions her physician on the rationale and necessity of the hormone. How can the physician most accurately reply to the clients concerns? A) "Vitamin D can prevent osteoporosis by increasing the density of your bones." B) "Vitamin D is important in order for your body to absorb the calcium that you consume in your diet." C) "When your liver is unable to produce enough on its own, it's important to take vitamin D supplements to promote bone strength." D) "Vitamin D slows down the rate that your body breaks down your bones."

B) "vitamin D is important in order for your body to absorb the calcium that you consume in your diet" Vitamin D facilitates intestinal absorption of calcium. It does not directly increase bone density, and the liver does not independently produce vitamin D. Vitamin D does not decrease the rate of bone resorption.

A nurse is teaching a wellness group among a group of older adult women. one of the women has asked for advice about preventing osteoporosis, which affects many of her friends. what is the nurses best response to the women's query? A) "Osteoporosis has been shown to have a strong genetic basis, so there is little you can do to prevent it." B) "Weight-bearing exercise is helpful, as are calcium supplements." C) "If possible, scaling back your hormone replacement therapy will reduce your osteoporosis risk." D) "There are drugs called glucocorticoids that both prevent osteoporosis and treat it if you do develop it."

B) "weight-bearing exercise is helpful, as are calcium supplements" Exercise and calcium supplementation have been shown to reduce the incidence of osteoporosis. Use of steroids is a risk factor, and estrogen deficiency would contribute to, rather than preventing, osteoporosis. There is a genetic component to the disease, but this does not preclude prevention efforts.

While educating a mother about the benefits of giving her child the human papilloma virus (HPV) vaccine, gardisil, which of the following statements will the nurse need to clarify for the parent? select all that apply. the vaccine is A) best administered before the child becomes sexually active. B) 100% effective against development of cervical cancer for her life span. C) effective against the two most common strains of genital warts. D) only recommended for females between the ages of 9 and 26. E) recommended prior to exposure to HPV, and if the child has genital warts, they are already exposed.

B) 100% effective against development of cervical cancer for her life span D) only recommended for females between the ages of 9 and 26 The HPV vaccine has decreased the risk of cervical cancer by 97%. Gardisil is one type of HPV vaccine to prevent infection with the HPV subtypes 16, 18, 9, and 11. This vaccine has been approved for girls and boys between 9 and 26 years of age (prior to becoming sexually active) to prevent HPV 6 and 11 genital warts. The vaccine targets the two strains of HPV (16 and 18) responsible for 70% of the cervical cancer. There is no treatment that is 100% effective against cervical cancer.

A nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which of the following individuals are at risk of developing urinary obstruction? A) A 43-year-old male with an acid-base imbalance secondary to malnutrition B) A 29-year-old female, pregnant for the first time C) A 69-year-old female with anemia secondary to insufficient erythropoietin production D) A 70-year-old male with benign prostatic hyperplasia (BPH) E) A 58-year-old male with renal calculi F) A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

B) A 29-year-old female, pregnant for the first time D) A 70-year-old male with benign prostatic hyperplasia (BPH) E) A 58-year-old male with renal calculi F) A 28-year-old male with neurogenic bladder secondary to spinal cord injury Pregnancy, BPH, renal calculi, and neurogenic bladder are all identified contributors to urinary obstructions. Acid-base imbalances and impaired erythropoietin production are health problems with renal involvement but are less likely to contribute to urinary obstruction.

The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture? A) A 77-year-old male who runs marathons and maintains a BMI of 25. B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom. C) A 64-year-old male with uncontrolled diabetes and chronic kidney disease on dialysis. D) A 73-year-old nursing home patient with long-term continence issues but able to walk the hallways for exercise.

B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom Hip fracture is a major public health problem in the Western world. The incidence of hip fractures increases with age. The incidence is also higher in white women compared with nonwhite women. Risk factors for hip fracture include low BMI, tall body structure, use of benzodiazepines, lack of exercise, previous injury to lower body extremity, vision problems, and confusion.

at which of the following locations in the nephron would a health care professional first expect blood to be largely free of plasma proteins? A) Proximal convoluted tubule B) Bowman space C) Loop of Henle D) Afferent arteriole

B) Bowman space Active filtration occurs when the whole blood enters via the afferent arteriole in to the glomerular capillaries, and the blood is then filtered into the Bowman space, removing plasma proteins. The filtrate that enters the proximal convoluted tubule and the loop of Henle is already free of plasma proteins.

A nurse in an acute medical unit of a hospital has admitted a 62-year-old female from the emergency department who has been diagnosed with acute pyelonephritis. Which of the following statements most accurately conveys an aspect of the knowledge base that the nurse needs to perform adequate care and teaching? A) Most cases of acute pyelonephritis are attributable to poorly controlled hypertension. B) Flank pain, dysuria, and N/V are likely assessment findings. C) The infection in the kidney is most likely a manifestation of a systemic infection. D) Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis.

B) Flank pain, dysuria, and N/V are likely assessment findings Manifestations of acute pyelonephritis include pain, frequency, urgency, dysuria, nausea, and vomiting. Chronic rather than acute pyelonephritis is often caused by hypertension, while most cases are caused by ascending bacteria, not systemic infections. Scarring is more commonly a result of chronic pyelonephritis.

Which of the following lab results would be associated with abnormalities in kidney function? Select all that apply. A) An absence of protein in a urine sample B) Increased creatinine levels C) Urine gravity of 1.038 and normal serum creatinine levels D) Decreased blood urea nitrogen (BUN) level E) Detectable levels of glucose in a urine sample F) Elevated cystatin-C level.

B) Increased creatinine levels E) Detectable levels of glucose in a urine sample F) Elevated cystatin-C level.

Due to her progressing osteoarthritis (OA), an 80 year-old woman is no longer able to perform her activities of daily living without assistance. Which of the following phenomena most likely underlies the woman's situation? A) Inappropriate T-cell-mediated immune responses have resulted in articular cartilage degeneration. B) Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself. C) Excessive collagen deposits have accumulated in the woman's synovial joints. D) Bone overgrowth in synovial joints has resulted in fusing of adjacent bones that normally articulate.

B) Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself The joint changes associated with osteoarthritis, which include a progressive loss of articular cartilage and synovitis, result from the inflammation caused when cartilage attempts to repair itself, creating osteophytes or spurs. These changes are accompanied by joint pain, stiffness, limitation of motion, and in some cases by joint instability and deformity. Immune etiology is more associated with rheumatoid arthritis, and collagen deposits are characteristic of scleroderma. Bones do not tend to fuse in the pathogenesis of OA.

While an infant is in the supine position with both knees flexed, the clinician applies gentle downward pressure to both knees, and the knee and thigh are abducted as an upward and medial pressure is applied to the proximal thigh. This examination technique, used to screen for a reducible dislocation, is called A) Galeazzi test. B) Ortolani maneuver. C) clubfoot test. D) Trendelenburg test.

B) Ortolani maneuver The Ortolani maneuver is a described test for a reducible dislocation. The Galeazzi test is a measurement of the length of the femurs that is done by comparing the height at the knees while they are flexed at 90 degrees. Trendelenburg test is used for an older child.

While reviewing the role of the parathyroid hormone in the balance of calcium and phosphate levels, the nursing faculty will emphasize that the kidney responds to parathyroid stimulation by A) increasing reabsorption of sodium in the distal tubules. B) reducing the reabsorption of phosphate. C) stimulating production of red blood cells. D) decreasing the reabsorption of calcium.

B) Reducing the reabsorption of phosphate In the kidney, PTH stimulates tubular reabsorption of calcium while reducing the reabsorption of phosphate. The latter effect ensures that increased release of phosphate from bone during mobilization of calcium does not produce an elevation in serum phosphate levels.

Which of the following sexually active women most likely faces the highest risk of developing an ectopic pregnancy? A) A 14-year-old who experienced menarche 2 years prior. B) A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed. C) A 27-year-old who stopped using medroxyprogesterone contraceptive injection (Depo-Provera) several months ago D) A 22-year-old who has a history of anorexia nervosa and who has a body mass index (BMI) of 12.0 (normal weight = 18.5 to 24.9).

B) a 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed Previous tubal ligation is an identified risk factor for ectopic pregnancy. Young age, use of injectable contraception, and low BMI are not specifically associated with ectopic pregnancy.

During pathophysiology class, a nursing student asks the faculty what purpose do the osteoprogenitor cells serve. From the following list, identify the purpose of these cells. Select all that apply. A) Formation of red blood cells B) Growth and remodeling of bone C) Anchorage point for blood vessels D) Repair of bone E) Supply nerves to the bone matrix

B) growth and remodeling of bone D) repair of bone The endosteum is the membrane that lines the spaces of spongy bone, the marrow cavities, and the haversian canals of compact bone. It is composed mainly of osteoprogenitor cells that contribute to the growth and remodeling of bone and are necessary for bone repair. The osteons consist of concentric lamellae of the bone matrix, surrounding a central canal, called the Haversian canal that contains blood vessels and supply nerves to the bone matrix. The periosteum acts as an anchorage point for blood vessels to enter and leave the bone. RBC formation occurs in the shaft of long bones.

When explaining to a class of nursing students the effects of disregulation of the RANKL/RANK/OPG pathway, the instructor emphasizes that this plays a prominent role in the pathogenesis of. select all that apply. A)osteomalacia B) neoplasia of the bone C)osteoporosis D) genu varum E) bone necrosis

B) neoplasia of the bone C) osteoporosis It is now believed that dysregulation of the RANKL/RANK/OPG pathway plays a prominent role in the pathogenesis of bone diseases such as neoplasia and bone lesions as well as osteoporosis. Avascular necrosis is known as bone necrosis (death) due to interruption to the blood supply of the bone.

A 24-year-old college student has presented to the campus medical clinic with complaints of frequent, burning urination and has, subsequent to urinalysis, been diagnosed with an acute lower urinary tract infection (UTI) caused by E. coli. What teaching will the clinician most likely provide to the student? A) "This should likely resolve itself if you drink a lot of water and especially cranberry or blueberry juice." B) "Unfortunately, the bacteria causing your infection is no longer responsive to antibiotics, but there are alternative treatments that we can use." C) "Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe." D) "This likely shows that you have some sort of obstruction in your urinary system, so when that is treated your UTI will likely resolve as well."

C) "Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe." Feedback: Microbial resistance to TMP-SMX antibiotics is now common in the United States; however, other specific antibiotic options do exist. Cranberry and blueberry juice are more appropriate as preventative rather than curative measures (reduces bacterial adherence to the epithelial lining of the urinary tract), and the majority of uncomplicated UTIs in young women are not the result of urinary obstructions.

A public health nurse is conducting a health promotion teaching session at a seniors drop-in center. Which of the following teaching points about hip fractures in older adults is most justified? A) "Current treatment options for hip fractures in older adults mean that surgery is no longer a common necessity." B) "Because of their generally higher body mass, men are particularly susceptible to breaking a hip in a fall." C) "Most hip fractures are actually a break at the very top of the thigh bone." D) "Because bone density is largely determined by your genes, there's little you can do to prevent hip fractures other than avoiding falls."

C) "most hip fractures are actually a break at the very top of the thigh bone" Fractures to the femoral head are the most common etiology of hip fractures in the older adult. Surgery is commonly required, and incidence is higher in women than in men. There are numerous risk factors for hip fracture beyond genetic factors, many of which are modifiable.

A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. the boy's heart rate is 122 beats/minute, and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen, and the testes are firm to touch and tender, with extensive cremaster muscle contraction noted. what is the boy's most likely diagnosis? A) Epididymitis B) Hydrocele C) Testicular torsion D) Varicocele

C) Testicular torsion The combination of the boy's age, signs, and symptoms is indicative of testicular torsion. Epididymitis normally lacks cremaster muscle involvement, and hydrocele is marked by massive distention of the scrotum. Varicocele is often asymptomatic or marked by heaviness in the scrotum.

a physician who is providing care for a 71-year-old male client with a recent diagnosis of renal failure and an acid-base imbalance is explaining some of the underlying etiology of the mans diagnosis to him and his family. which of the following phenomena would most accurately underlie the teaching that the physician provides? A) The kidneys are integral to the reabsorption of hydrogen ions and maintenance of a low pH. B) Blood buffer systems and respiratory control can compensate for inadequate renal control of pH. C) The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body. D) pH is kept at an optimal level through the renal secretion of bicarbonate ions in blood filtrate.

C) The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body. The kidneys have the primary responsibility for maintaining body pH by eliminating excess hydrogen ions from the body, a function that blood buffer systems and respiratory control are incapable of. Hydrogen ions must be eliminated, not retained, and bicarbonate must be produced as part of buffer action, not secreted.

A 23-year-old women has been referred to a fertility clinic after 1 year of attempting to become pregnant. Her diagnostic workup has resulted in a diagnosis of polycystic ovary syndrome (PCOS). What will the first line of treatment most likely consist of? A) Estrogen-progesterone hormone therapy and the administration of clomiphene B) Surgical resection of the ovaries using laparoscopy C) Lifestyle modifications to include weight loss by lowering calories and fat consumption D) Temporary use of oral contractive agents

C) lifestyle modifications to include weight loss by lowering calories and fat consumption Lifestyle modifications are the treatment of choice for PCOS. Hormone therapy, surgery, and use of oral contraceptives are less likely to be a primary treatment option.

A 15-year-old female has presented to her family physician complaining of frequent discomfort around the time of her period. She has subsequently been diagnosed with primary dysmenorrhea. which of the following treatments is most likely to be effective? A) Investigation and resolution of her hypothalamic-pituitary-ovarian disorder B) Hormone therapy aimed at resolving her estrogen deprivation C) Pain control with prostaglandin synthetase inhibitors D) Dilation and curettage

C) pain control with prostaglandin synthetase inhibitors Because she has been diagnosed with primary rather than secondary dysmenorrhea, treatment of a specific underlying condition is not indicated. Treatment will likely focus on adequate pain control. D&C is not a relevant intervention.

During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which diagnosis? A) Genital herpes B) Gonorrhea C) Condylomata acuminata D) Candidiasis

Condylomata acuminata HPV is an identified precursor to condylomata acuminata, or genital warts. Herpes, gonorrhea, and candidiasis are not likely to result directly from HPV.

Which of the following individuals is at the highest risk of developing a urinary tract infection (UTI)? A) A 60-year-old man with a history of cardiovascular disease who is recovering in hospital from a coronarNyUarRteSryIbNyGpTasBs.grCaOftM B) A 66-year-old man undergoing dialysis for the treatment of chronic renal failure secondary to hypertension C) A 38-year-old man with high urine output due to antidiuretic hormone insufficiency D) A 30-year-old woman with poorly controlled diabetes mellitus

D) A 30-year-old woman with poorly controlled diabetes mellitus Feedback:Young women as well as persons with diabetes are at high risk of UTIs. Neither postsurgical recovery nor renal failure is necessarily a direct risk for UTI development, and high urine output would prevent decrease rather than increase in UTI risk.

A 31-year-old male diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a women he has recently formed a relationship with. which of his statements is most true? A) "If you've been exposed to the herpes virus in the past, then there's no significant risk of reinfection." B) "The worst case scenario is that you'll develop cold sores, since this is the type of herpes virus that I've got." C) "If you've had cold sores when you were younger, it means that you've got antibodies against this type of herpes virus." D) "Even when I'm not having a recurrence, I could still pass the virus on to you."

D) "even when im not having a recurrence, i could still pass the virus on to you" HSV transmission can occur both during and between recurrences. HSV-2 is associated more with genital herpes than cold sores, and cold sores do not provide antibody protection. Prior contact with the virus does not confer immunity.

A 64-year old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. the client and his physician are discussing the effects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. which of the following statements by the client would necessitate further teaching?A) "I'm really trying to lose weight, and I've been able to lose 15 lb this year so far." B) "I've been doing muscle-strengthening exercises twice a week at the community center near my house." C) "Even though I don't like it, I've been using my walker to take some of the weight off my knees." D) "I've been avoiding painkillers because I know they can mask damage that I might be inflicting on my knees."

D) "ive been avoiding painkillers because i know they can mask damage that i might be inflicting on my knees." Analgesics are a common and appropriate treatment for OA, and it would be unnecessary and inappropriate to forego pain control in order to maximize pain signals from affected joints. Weight loss, the use of assistive devices, and muscle-strengthening exercises are appropriate treatments for OA.

Following a progressive onset of fatigue, aching, and joint stiffness over the last 2 years, a 69 year-old male has recently been diagnosed with RA. which of the following teaching points should his primary care physician include during the office visit in which this diagnosis is communicated to the client? A) "The symptoms you've been experiencing are the result of damage inside your joints, but I'll start you medications that will reverse this damage." B) "It's important that you maximize your level of activity, since decreasing your mobility will worsen the disease C) "The best treatment plan is to try all other available treatments before resorting to using medications." D) "Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms."

D) "steroids and anti-inflammatory drugs that ill prescribe will likely bring some relief to your symptoms" Current treatment guidelines for RA involve early and aggressive pharmacological treatment, including NSAIDs and corticosteroids. Damage cannot be reversed, and while therapeutic exercise plays a role in treatment, rest is also important.

a nurse is providing care for a client who has had a cast applied to her fractured arm 6 hours prior. the client is now complaining of severe pain that she describes as "even worse than when i broke my arm". what would be the nurses best course of action? A) Administration of analgesics and teaching the client about the normal course of pain after a fracture B) Teaching the client simple range of motion exercises to promote circulation and perfusion C) Taking the client's temperature due to the possibility of infection D) Assessment of motor and sensory function with the goal of identifying compartment syndrome

D) Assessment of motor and sensory function with the goal of identifying compartment syndrome Severe pain in the site of a fracture that is out of proportion to the original injury is a hallmark of compartment syndrome. Assessment of sensory and motor function would be an appropriate first action. Analgesia alone and exercises would be insufficient to diagnose or address compartment syndrome, and infection would be an unlikely etiology of sudden pain after cast application.

An 8-year old child has just been diagnosed with systemic lupus erythematosus (SLE). the parents wonder what the child's prognosis is going to be. which of the following findings would be considered a good prognostic indicator of the extent/seriousness of the disease? A) Complaints of arthralgias and arthritis in joints with movement B) Ligaments and tendons hurt during passive ROM C) Has a rash on the nose and cheeks D) Swelling in the face and eyes and rust/blood-colored urine

D) Swelling in the face and eyes and rust/blood-colored urine The clinical manifestations of SLE in children reflect the extent and severity of systemic involvement. The best prognostic indicator in children is the extent of renal involvement, which is more common and more severe in children than in adults with SLE. Edema and rusty or bloody urine are classic signs of glomerulonephritis. It is expected that people/children with SLE have arthralgias/arthritis in joints, sore ligaments and tendons, as well as integumentary signs and symptoms like a rash on the nose and cheeks (butterfly rash).

When trying to discern the extent of a burn, the nurse will note that second-degree full-thickness burns are characterized by: A) extending into the subcutaneous tissue. B) noting that blood vessels have clotted and can be seen under the burned skin. C) redness or pinkness noted, but no blister formation is present on the epidermis. D) extensive pain along with waxy white areas with blister formation.

D) extensive pain along with waxy white areas with blister formation Second-degree full-thickness burns involve the entire epidermis and dermis. These burns have extensive pain because the pain sensors remain intact. These burns appear as mottled pink, red, or waxy white areas with blister formation and edema. Answers A and B relate to third-degree full-thickness burns, whereas answer C is characteristic of first-degree burns.

A 42-year-old male has been diagnosed with renal failure secondary to diabetes mellitus and is scheduled to begin dialysis soon. Which of the following statements by the client reflects an accurate understanding of the process of hemodialysis?

D) i wont be able to go about my normal routine during treatment

which of the following statements most accurately captures the function of the ascending loop of Henle? A) Urine is concentrated by the selective absorption of free water in the ascending limb. B) Sodium and water are reabsorbed in equal amounts, reducing filtrate quantity but maintaining osmolality. C) The majority of solute and water reabsorption occurs in the ascending loop of Henle. D) Impermeability to water and absorption of solutes yields a highly dilute filtrate.

D) impermeable to water and absorption of solutes yields a highly dilute filtrate The osmolality of the filtrate reaches a low of 100 mOsm/kg of water in the ascending limb as a result of its impermeability to water.

A patient in a hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine collection test. he asks the nurse why the test is necessary since he provided a single urine sample 2 days ago. how could the nurse best respond to the patients question? A) "A single urine sample lets your care team determine if there are bacteria in your urine, but other tests of urine chemistry need a longer-term view." B) "Current lab tests aren't able to detect the small quantities of most substances contained in a single urine sample. C) "Only a longer-term test is able to show whether your kidneys are letting sugar spill out into your urine." D) "Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine."

D) often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine Twenty-four-hour urine tests are often used to quantify the amount of substances, such as proteins, that an individual's kidneys are spilling. Single urine samples are able to assess more parameters than just the presence of bacteria, and they are sufficient in quantity to detect numerous substances such as glucose.

A care aide who works in a long-term care facility recognizes the high incidence and prevalence of a stage I pressure ulcer in immobile older adults. Which of the following protocols in the facility would the care aide advocate changing? A) Residents with persistently low food intake are identified. B) Immobilized residents are turned every 2 hours during both day and night. C) Residents are frequently encouraged to increase their fluid intake. D) Wound dressings are applied promptly to all identified or potential pressure ulcers.

D) wound dressings are applied promptly to all identified or potential pressure ulcers Early-stage pressure ulcers and potential pressure ulcers do not necessitate wound dressings and are better treated by turning, keeping skin dry, and removing pressure. Nutrition and hydration status are important factors, and individuals who cannot reposition themselves independently should be turned regularly.

Of the following list of medications, which would likely be prescribed to a patient with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate? A) Finasteride (Proscar), aN5Ua-RreSdIucNtaGsTe Bin.hiCbiOtoMr B) Imdur (isosorbide mononitrate), a vasodilator C) Birth control pills containing both estrogen and progestin D) Leuprolide (Lupron), a gonadotropin-releasing hormone analog

Finasteride (Proscar), a 5a-reductase inhibitor Finasteride (Proscar), a 5a-reductase inhibitor, reduces prostate size by blocking the effect of androgens on the prostate. Vasodilators, BCPs, and GnRH analogs do not decrease prostate size.

A nurse educator is orientating new nurses to a renal unit of the hospital. Which of the following teaching points should the nurse include as part of a review of normal glomerular function?

Glomerular filtrate is very similar in composition to blood plasma found elsewhere in the body

A 63-year-old woman has visited a physician because she has been intermittently passing blood-tinged urine over the last several weeks, and cytology has confirmed a diagnosis of invasive bladder cancer. Which of the following statements by the physician is most accurate? A) "There are new and highly effective chemotherapy regimens that we will investigate." B) "Fortunately, bladder cancer has a very low mortality rate, and successful treatment is nearly always possible." C) "It's likely that you'll need surgery, possibly a procedure called a cystectomy." D) "Unfortunately, there are nearly no treatment options for this type of cancer, but we will focus on addressing your symptoms."

Its likely that you'll need surgery, possibly a procedure called a cystectomy Surgical interventions are common in the treatment of bladder cancer. Effective chemotherapeutic regimens are not yet available, though there are certainly treatment options. The mortality rate of bladder cancer is high, at around 25%.

Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace and that the man will regain full function after healing and rehabilitation. which of the following cells is most responsible for restoring the integrity of the mans broken bone? A) Osteocyte B) Osteoclast C) Osteoblast D) Osteoma

Osteoblasts The osteoblasts, or bone-building cells, are responsible for the formation of the bone matrix and would participate in the healing process. Osteocytes are mature bone cells, while osteoclasts reabsorb bone cells. An osteoma is a bone tumor.

When teaching a community education class about the seven warning signs of cancer, the nurse will note that the most common sign of bladder cancer is A) inability to empty the bladder fully. B) colic spasms of the ureters. C) painless bloody urine. D) passage of large clots after voiding.

Painless bloody urine The most common sign of bladder cancer is painless hematuria. Gross hematuria is a presenting sign in the majority of people with the disease, and microscopic hematuria is present in most others. Answer choice A refers to flaccid bladder; answer choice B refers to kidney stones; answer choice D refers to clots that are usually seen after surgery such as TURP where bladder irrigation is called for to prevent the clots from blocking urine output.

A patient is showing the nurse some changes in his skin that he found while taking a shower. which of the following lesions would give the nurse concern that it might be a precancerous lesion? select all that apply A) Soft, flesh-colored papule located on the neck and "armpit." B) Wart-like, tan-brown lesion that is sharply outlined and a few centimeters in diameter. C) Several dry, brown, scaly lesions that are approximately 1 cm in diameter, and a few of the lesions are showing some ulceration D) Tan to brown lesions commonly called "liver spots" are located on the forearm and hands. E) Red-colored mark close to the skin surface located on the face.

Several dry, brown, scaly lesions that are approximately 1 cm in diameter, and a few lesions are showing some ulceration Tan to brown lesions commonly called "liver spots" are located on the forearm and hands Actinic keratoses are the most common premalignant skin lesion that develops on sun-exposed areas. The lesions are often multiple and more easily felt than seen. The lesions are described as dry, brown, and scaly approximately 1 cm in diameter. A few of the lesions may be showing some ulceration. Tan to brown lesions commonly called "liver spots" are located on the forearm and hands. Liver spots are considered risks for the development of skin cancer and should be treated. Keratoses are a horny growth or an abnormal growth of the keratinocytes. A seborrheic keratosis is a benign, sharply circumscribed, wartlike lesion that has a stuck-on appearance. Soft, flesh-colored papule located on the neck, axilla ("armpit"), and intertriginous areas are skin tags. A seborrheic keratosis is a wartlike, tan brown or black lesion that is sharply outlined and a few centimeters in diameter. Strawberry nevus, or hemangioma, is named for its color. This red tinge to your skin comes from a collection of blood vessels close to your skin's surface. While the hemangioma can be anywhere, the most common locations are the face, scalp, back, or chest. It is very common and noncancerous.

A middle-aged women has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. if the tumor has returned, the nurse would expect which of the following results?

The growth hormone level will not be suppressed following glucose load

An 82-year-old resident of a long-term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. which of the following actions by the care team is most appropriate? A) Uroflowmetry to determine the rate of the client's urine flow B) Ultrasound bladder scanning to determine the residual volume of urine after voiding C) Renal ultrasound aimed at identifying acute or chronic kidney disease D) Urinalysis focusing on the presence of or absence of microorganisms, blood, or white cells in the man's urine

Ultrasound bladder scanning to determine the residual volume of urine after voiding Ultrasound bladder scanning yields a fast and noninvasive indication of whether or not an individual is adequately emptying his or her bladder with each void. Uroflowmetry would be less indicative of whether the man is retaining, and renal ultrasound would address deficits in urine production rather than bladder emptying. Urinalysis would be useful in the diagnosis of infections and/or renal issues more than deficiencies in bladder emptying.

Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto thyroiditis. In light of this diagnosis, which of the following assessment results would constitute an unexpected finding? A) The presence of myxedema in the woman's face and extremities B) Recent weight gain despite a loss of appetite and chronic fatigue C) Coarse, dry skin and hair with decreased sweat production D) Increased white cell count and audible crackles on chest auscultation

increased white cell count and audible crackles on chest auscultation An increased white cell count and the presence of adventitious fluid in the lungs are not classic findings associated with hypothyroidism. Myxedema, weight gain, lethargy, and dry skin and nails are commonly associated with low levels of thyroid hormones.