Patho Midterm
A 6-hour-old newborn develops a critical respiratory problem and is rushed to the ICU. The ICU nurses suspect the infant has respiratory distress syndrome (RDS) based on which findings? Select all that apply.
Expiratory grunting Substernal retractions with each breath Bluish discoloration of the skin and mucous membranes (central cyanosis)
A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which physiologic phenomenon will occur as a consequence of hypoxemia?
Increased heart rate
Which statement explains how nonsteroidal anti-inflammatory drugs (NSAIDs) control pain?
NSAIDs block the enzyme that synthesizes prostaglandins.
Migraine headaches affect millions of people worldwide. What are first-line agents for the treatment of migraine headaches?
Naproxen sodium and metoclopramide
Which peripheral nerve injury will likely result in cellular death with little chance of regeneration?
Nerve fibers destroyed close to the neuronal cell body
During embryonic development, which structure develops into the central nervous system (CNS)?
Neural tube
Which of the following types of pain is characterized by severe, brief, often repetitive pain?
Neuralgia
A neurologic nurse is explaining the structure and function of motor units to a client who has a spinal cord injury. The nurse should describe which components of a motor unit? Select all that apply.
Neuromuscular junction Skeletal muscle Lower motor neuron
Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissues?
Nitric Oxide
A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?
Nociceptive afferents are conducting the sensation of pain along the cranial and spinal nerve pathways of the ANS.
The nurse is studying sensory systems. She understands that signal transduction of an impulse to the thalamus for processing is accomplished by:
Second-order neurons
Which lobe of the brain performs functions of perception, long-term memory, and recognition of auditory stimuli?
Temporal Lobe
The nurse working in the neurologic intensive care unit is performing a neurologic assessment of somatosensory function for a client who was involved in a motor vehicle accident with suspected spinal cord injury. What should the nurse be sure to include in this assessment?
Testing the integrity of spinal segmental nerves
A nurse educator is explaining the divisions of the nervous system to a class of prospective nursing students. Which characterization of the organization of the nervous system is most accurate?
The ANS is represented in both the CNS and PNS.
During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that a client has a sustained damage to her vagus nerve (CN X). Which assessment finding is most likely to lead the physician to this conclusion?
The client has difficulty swallowing and has had recent constipation and hypoactive bowel sounds.
An older adult client has a temperature of 101°F (38.3°C). The client becomes confused and disoriented. The nurse's priority assessment would be to check:
pulse oximetry.
A client who has developed a fever is now reporting a headache. The nurse would recognize this manifestation as a result from the:
vasodilatation of cerebral vessels.
Pain is an expected assessment finding in clients who have which lung disease?
Pleuritis
What description is characteristic of the pathology of interstitial lung disease?
Airways become stiff and resist expansion, leading to hypoxemia.
Which symptom indicates the next stage of a fever after a prodrome?
Chill
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:
"All glomeruli and all parts of the glomeruli are involved."
The nurse is performing a health history for a male client who is having a series of diagnostic tests to determine the presence of squamous cell carcinoma. What question would be most beneficial for the nurse to ask that would correlate with this suspicion?
"Do you have a history of smoking, and if so, how much?"
Diagnostic testing has resulted in a diagnosis of small cell lung cancer (SCLC) in an older adult client. When exploring the etiology of the client's disease, what assessment question is most relevant?
"Have you ever been a smoker?"
The nurse is teaching a client about various methods of pain control. Which information will the nurse include when teaching the client about applying heat for pain control?
"Heat promotes more blood flow to the area to improve oxygen supply."
An older adult client who was recently diagnosed with emphysema asks the nurse what caused the disease. Which statement is the best response?
"One of the causes of emphysema is a history of cigarette smoking that causes damage to the lungs. Have you ever smoked?"
A client has visited the health care provider reporting intermittent passing of blood-tinged urine over the last several weeks. Cytology confirms a diagnosis of invasive bladder cancer. Which statement by the provider is most accurate about treatment options?
"It is likely that you will need surgery, possibly a procedure called a cystectomy."
Upon admission to the ICU, a client with a history of cor pulmonale will likely be exhibiting which clinical manifestations of right-sided heart failure? Select all that apply.
+4 pitting edema in lower extremities Jugular vein distension Altered level of consciousness
What percentage of the body's oxygen does the brain consume?
20%
The nurse witnesses a client go into cardiac arrest. If the nurse delays intervention, when will the death of brain cells begin?
4-6 minutes
Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the following?
Airway inflammation
Which is the most common cause of atelectasis?
Airway obstruction
Which client most likely faces the highest risk of developing secondary pulmonary hypertension?
A client with COPD and a 35 pack-year smoking history.
Which client may be experiencing the effects of neuropathic pain?
A man with pain secondary to his poorly controlled diabetes
What description is characteristic of the pathology of chronic bronchitis?
Airways are obstructed by mucus, causing hypoxemia.
Sweating is mediated by which neurotransmitter?
Acetylcholine
What are the main neurotransmitters of the autonomic nervous system (ANS)? Select all that apply.
Acetylcholine Epinephrine Norepinephrine
A client is diagnosed with early pneumococcal pneumonia. What does the nurse recognize occurs during the first stage of pneumococcal pneumonia?
Alveoli become filled with protein-rich edema fluid containing numerous organisms and increase in red blood cells.
Many pharmaceutical agents may cause pulmonary damage. The nurse knows that which cardiac medication has been associated with toxic effects in the lungs?
Amiodarone
A 60-year-old male is being treated for significant denervation and muscle fiber atrophy. His movements are still smooth and he has no cognitive defects. Which likely diagnosis is associated with these clinical manifestations?
Amyotrophic lateral sclerosis, a mixed UMN/LMN disorder
Which long-term care resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)?
An 81-year-old male who has a productive cough and recurrent respiratory infections.
A young female relays to her health care provider, "I've had double-vision a few different times, and I get tired more easily than I ever have." The client's muscle strength is diminished, and inspection of her eyelids reveals the presence of ptosis. Which diagnostic testing should the nurse anticipate being prescribed?
Anticholinesterase testing
A medical student is working with a 61-year-old male client in the hospital who has presented with a new onset of atrial fibrillation. Which course of treatment will the student most likely expect the attending physician to initiate?
Anticoagulants and beta-blockers to control rate
A client has sudden severe dyspnea, fear, asymmetrical chest movement and decreased lung sounds on the right side. Which intervention is most appropriate?
Assist to high-Fowler's position and prepare for chest tube insertion.
A client has a heart rate of 40 beats/min and syncope. Which muscarinic blocking medication will the nurse prepare to administer to increase the heart rate?
Atropine
Atelectasis is the term used to designate an incomplete expansion of a portion of the lung. Depending on the size of the collapsed area and the type of atelectasis occurring, the nurse may see a shift of the mediastinum and trachea. Which way does the mediastinum and trachea shift in compression atelectasis?
Away from the affected lung
Neurotransmitters are small molecules that exert their actions through specific proteins, called receptors, embedded in the postsynaptic membrane. Where are neurotransmitters synthesized?
Axon Terminal
With bronchiectasis, persistent airway obstruction and chronic infection results in which physiologic response?
Bronchial dilation
An infant born 10 weeks premature was placed on mechanical ventilation. Eight weeks later a nursing assessment reveals a barrel chest, tachycardia, rapid and shallow breathing, hypoxemia, hypercapnia, and poor weight gain. Based on this assessment, which diagnosis is most likely?
Bronchopulmonary dysplasia
The critical care nurse is caring for a client with decreased cardiac output. For which consequence of low cardiac output does the nurse monitor the client?
Buildup of urea and electrolytes in the blood
Neurotoxins such as the botulism organism can produce paralysis by what mechanism?
By blocking release of acetylcholine
At which level of the cervical spine would a complete cord injury result in the client retaining the ability to flex and extend the fingers?
C8
Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma?
Chemical mediators are released from pre-sensitized mast cells
A client is diagnosed with pulmonary embolism. Which symptom would most likely be present?
Chest pain and dyspnea
Which brain structure makes continuous adjustments that result in smoothness of movement, particularly during delicate maneuvers?
Cerebellum
A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which factor most likely had the greatest impact on development of the lung cancer?
Cigarette smoke
A client had an arm cast fitted after suffering a right humeral fracture in a hockey game. The client reported a loss of sensation in the right hand, but sensation returned upon removal of the cast. Which was the most likely cause of the client's loss of sensation?
Compression lesion of the musculocutaneous nerve
Several months ago, a 20 year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?
Conus Medullaris Syndrome
A 3-year-old boy has been diagnosed with croup (acute laryngotracheobronchitis). The nurse anticipates the plan of care to include:
Cool, humidified air to relieve airway spasms
Which medication is used to treat acute attacks of multiple sclerosis (MS)?
Corticosteroids
Which classification of medications used to self-treat the common cold should be avoided by those with a history of hypertension?
Decongestants
The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?
Dietary protein
Which dermatologic problem most often accompanies chronic kidney disease (CKD)?
Dry skin and pruritus
Which of the meninges provides the major protection for the brain and spinal cord?
Dura Matter
Sometimes recurrent fevers occur but do not follow a strictly periodic pattern. Causes of these recurrent fevers include genetic disorders such as familial Mediterranean fever. What are the characteristics of familial Mediterranean fever?
Early age of onset (<20 years) and high fever
A nurse is teaching parents of a child who is being discharged after treatment for a streptococcal infection. For what symptoms should the nurse teach the parents to observe, because they are related to the risk for poststreptococcal glomerulonephritis? Select all that apply.
Edema Decreased urine output
Which intervention(s) is important for the nurse caring for a child admitted with bronchiolitis, using the latest evidence in the research literature? Select all that apply.
Elevate the head to facilitate respiratory movements. Administer supplemental oxygen when the oxygen saturation consistently falls below 90%.
A client who was hospitalized with bacterial pneumonia has now developed an infection in the pleural cavity. Which terminology correctly identifies this pathophysiologic finding?
Empyema
A middle-aged woman is admitted with acute pyelonephritis. Which assessment finding correlates with this diagnosis?
Flank pain, dysuria, and nausea/vomiting
The nurse is caring for a client with a disease causing excess antidiuretic hormone (ADH). When performing the assessment, the nurse should focus on which manifestation of excess ADH?
Fluid volume excess
Knowing that she is a carrier for Duchenne muscular dystrophy (DMD), a pregnant woman underwent prenatal genetic testing that diagnosed her child with DMD. As her child develops, the woman should watch for which early signs that the disease is progressing?
Frequent falls and increased muscle size
A client is hospitalized and being treated for an acute kidney injury. Which information is most useful to the nurse while evaluating for improvement in kidney function?
GFR
The nurse measures a blood glucose level of 40 mg/dL (2.22 mmol/L) for a client with type 1 diabetes. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client?
Glucose is not stored in the brain and is a major fuel source for brain function.
A nurse is assessing a 2-week-old infant with pulmonary edema. Which symptom indicates the infant is experiencing respiratory distress?
Grunting during expiration
Which interventions are appropriate for a client with acute pain following abdominal surgery? Select all that apply.
Guided Imagery Cold Therapy Ibuprofen Hydrocodone
A client has sustained damage to cranial nerve VIII. The nurse recognizes that the client may experience difficulty with:
Hearing
Common results of acute respiratory failure are hypoxemia and:
Hypercapnia
The nurse is suctioning a client with a C3 spinal cord injury when the client's heart rate drops from 86 bpm to 42 bpm. What intervention does the nurse understand should be provided prior to suctioning to prevent this vasovagal response from occurring?
Hyperoxygenate prior to suctioning.
The health care provider is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which assessment finding is congruent with the client's diagnosis?
Hypotonia
The nurse is caring for a client diagnosed with pneumonia. The client's arterial blood gas results identify decreased level oxygen and other laboratory work reveals an increase in lactic levels. How will the nurse interpret these findings?
Hypoxemia
A client presents with sudden onset of hematuria, variable proteinuria, decreased GFR, oliguria, and signs of impaired renal function. Upon taking a history the nurse learns that the client had strep throat 3 weeks ago. Upon renal biopsy the diagnosis of acute glomerulonephritis is confirmed. What mechanism of damage is the most plausible?
Injury resulting from circulating antigen-antibody complexes that become trapped in the glomerular membrane.
There are two types of stimuli that affect the raising or lowering of body temperature. What are these stimuli?
Innocuous and noxious
Which structure within the myocardium contains gap junctions that allow impulses to travel rapidly so the heart can contract as a single unit?
Intercalated discs
The health care provider is performing a spinal tap on a client with suspected infection. The provider would perform the procedure at:
L3 or L4
Feelings of dread, high anxiety, or exquisite pleasure can be elicited by stimulation of areas in which structure?
Limbic System
The region of the brain involved in emotional experience and control of emotional behavior is the:
Limbic System
Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?
Proteinuria and generalized edema
A nurse educator is explaining the importance of maintaining GFR for the maintenance of homeostasis. Which of these plays an essential role in maintaining a constant GFR?
Macula densa
Select the tactile receptors that are sensitive to the movement of very light objects over the surface of the skin.
Meisser Corpusles
Which statement is true of migraine headaches?
Migraines may have a hormonal etiology in some clients.
Diagnosing the primary cause is one of several methods used to treat fever. What are some other methods? Select all that apply.
Modification of external environment to increase heat transfer from the internal to the external environment Support of hypermetabolic state that accompanies fever Protection of vulnerable body organs and systems
Sick sinus syndrome is suspected in the case of a child who is postoperative following cardiac surgery. Which nursing action is most appropriate?
Monitor the child's ECG for bradycardia.
A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which process will accompany the actions of the neurotransmitter in a chemical synapse?
More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.
A nurse is caring for a client with fever of unknown origin (FUO). The nurse anticipates that the client may have which underlying condition? Select all that apply.
Non-hodgkin lymphoma Abscessed infection
A two-day postoperative client's temperature was 98.5°F (36.9°C) at 3:00 pm. At 6:00 pm, the unlicensed assistant (UAP) notifies the nurse that the client's temperature is 102°F (38.9°C). Which action should the nurse take?
Notify the physician
The nurse is explaining the role of endothelial cells in synthesizing vasoactive substances, one of which nitric oxide. What affect does nitric oxide have on renal blood flow?
Opens the renal vessels to increase blood flow
Which chemical does blood-brain and CSF-brain barrier control with easy entrance?
Oxygen
When a peripheral nerve is irritated enough, it becomes hypersensitive to the noxious stimuli, which results in increased painfulness or hyperalgesia. Health care professionals recognize both primary and secondary forms of hyperalgesia. What is primary hyperalgesia?
Pain sensitivity that occurs directly in damaged tissues
A teenaged client with cystic fibrosis presents to the clinic. The health care provider (HCP) knows that cystic fibrosis (CF) causes severe chronic respiratory disease in children. In addition, the HCP should also focus his or her assessment on which of the other body systems affected by CF?
Pancreatic
Which factor is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?
Pet dander
A child is brought to the emergency department with a respiratory infection. The child is struggling to breathe and is very anxious. The health care providers suspect epiglottitis. Which intervention would be a priority?
Place the child upright in bed and begin preparing for a tracheostomy placement.
A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain, and increased respiratory rate. What is a classic sign of pulmonary infarction?
Pleuritic pain
Guillain-Barré syndrome is characterized by which form of neuron damage?
Polyneuropathy
An older adult client with high blood pressure is prescribed a thiazide diuretic. What should the nurse expect to happen to this client's potassium and calcium levels?
Potassium level will drop, but calcium level may rise.
A client recently had surgery for a hip fracture. Which nursing intervention would be most effective for preventing pulmonary emboli in this client?
Prevention of the development of a deep vein thrombosis
The management of cor pulmonale is directed at the underlying lung disease and heart failure. Why is low-flow oxygen therapy a part of the management of cor pulmonale?
Reduces pulmonary hypertension and polycythemia associated with chronic lung disease
A client is experiencing chest pain that radiates to the left arm and neck. The nurse would interpret this pain as:
Referred
Potassium outflow from the cell is characteristic of which phase of the action potential?
Repolarization
Which symptom is unique to amyotrophic lateral sclerosis (ALS) and is not observed in multiple sclerosis (MS)?
Respiratory muscle impairment
A client arrives in the ED after an automobile accident. Which clinical manifestations lead the nurse to suspect a pneumothorax? Select all that apply.
Respiratory rate 34. Asymmetrical chest movements, especially on inspiration Diminished breath sounds over painful chest area
Which skin receptors communicate the sensation of heavy and continuous touch and pressure?
Ruffini end-organs
A child struggling to breathe is brought to the emergency department with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. What is the most likely diagnosis?
Severe asthma attack
A 7-year-old child had an emergency appendectomy during the night. When trying to assess the child's pain, the nurse should:
Show the child a scale with faces of actual children and have the child point to the picture that best describes how he or she is feeling.
A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the bag other than the phone. The nurse knows that which term best describes one's ability to sense the shape and size of an object in the absence of visualization?
Stereognosis
The health care provider is assessing a client to differentiate a herniated disk from other causes of acute back pain. The most important test for the provider to perform would be:
Straight-Leg test
A client is experiencing anorexia, myalgia, arthralgia, headache, and fatigue. The nurse should assess for:
Temperature
The nurse asks the client to hold her left wrist in complete flexion for approximately 1 minute. The client states she feels tingling and numbness when she does this, pointing to the medial nerve. What does the nurse anticipate the client will be prepared for after this assessment?
The client will be prepared for further diagnostic tests such as an electromyogram (EMG).
A client with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which assessment components should the nurse prioritize when assessing the client's pain?
The client's subjective report of the character and severity of pain
A client has been recovering from a stroke for several weeks and has been reluctant to participate in physical therapy. As a result, the client has experienced disuse atrophy. The nurse should recognize that the client is experiencing the consequences of which physiologic process?
The diameter of the client's muscle cells has decreased
Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which drug action is most likely to result in diminished sensation of pain for the player?
The drug inhibits the enzyme needed for prostaglandin synthesis.
A client suffering from chronic hypertension is beginning to show the symptoms of glomerular disease. This client's kidney damage is due to what phenomenon?
The higher volume of blood reaching the kidneys overworks them, and they begin to atrophy
A client has been diagnosed with pneumococcal infection. The nurse shares with the client which statement about the spread of the disease?
The spread of this bacteria, especially the antibiotic-resistant strain, is largely by healthy, colonized individuals.
What do deep tendon reflexes assess?
The stretch reflex at different spinal cord segments
A client reports chronic pain. Assessment indicates it is located at the T6 dermatome. How will this information assist the nurse to develop an effective plan of care?
Treatment can be tailored to the specific location.
An older adult client admitted to the hospital with tuberculosis becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. What is the most likely diagnosis?
Tuberculous empyema due to primary progressive tuberculosis
Which of these project from the motor strip in the cerebral cortex to the ventral horn and are fully contained within the CNS?
Upper motor nuerons
The nursing instructor informs the students during a lecture that the control of the emptying functions of the bladder involves which portion of the nervous system? Select all that apply.
Voluntary somatic nervous system Involuntary autonomic nervous system
Which process is most likely to occur as a result of a spinal reflex?
Withdrawal of a hand from a hot stove element
Which type of reflex is stimulated by a nociceptive stimulus?
Withdrawal reflex
An older adult client is scheduled for cataract surgery and asks the nurse if driving a motor vehicle will be permitted once the cataracts are removed. What is the nurse's best response?
You will need to score above a certain level on a visual acuity test to be approved to drive
A client involved in a car accident is admitted with a chest tube following pneumothorax. He also has an elevated blood alcohol level. When the nurse enters his room, she notes the client is dyspneic, short of breath, and holding his chest tube in his hand. When the nurse pulls the linens back, she finds a "sucking" chest wound. After calling a "code blue," the next priority intervention would be to:
apply a Vaseline gauze (airtight) dressing over the insertion site.
Which risk factor presents the greatest risk for injury in an older adult client who is experiencing a dysfunction in temperature regulator function?
delayed initiation of appropriate treatment
A nurse notes that a client with a fever has begun to shiver. The nurse should assess for which finding?
increased temperature
Place the components of the rapid-transmitting discriminative (dorsal column-medial lemniscal) pathway in the correct chronological order. Use all the options.
peripheral sensory axon dorsal root ganglion body dorsal column thalamus primary sensory cortex
A child is being treated in the emergency department for respiratory syncytial virus (RSV) bronchiolitis. Which treatment(s) does the nurse include in the plan of care? Select all that apply.
providing supplemental oxygen based on oxygen saturation level providing a quiet, comforting environment
While walking down the street, a cat jumps out of an alley into the pathway of an adult. They note that the man's heart is "racing." This physiologic response is primarily due to:
secretions of sympathetic neurotransmitters produced in the adrenal medulla.
A nurse is caring for a client experiencing muscle fasciculations. Fasciculations appear as:
spontaneous contractions of muscle fibers presenting as twitching.
Which manifestation(s) will the nurse anticipate with mild hypoxemia? Select all that apply.
tachycardia diaphoresis tachypnea
With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiologic principle behind this respiratory distress is related to:
the stiffening of the lung, making it more difficult to inflate.
A 30-year-old female has suffered a third-degree burn to her hand after spilling hot oil in a kitchen accident. Which teaching point by a member of her care team is most appropriate?
"Opioids aren't without side effects, but we will take action to manage these side effects so you can continue getting these drugs."
What happens during the depolarization phase of nerve cells?
A rapid change in polarity to one that is positive on the inside, and the membrane becomes open to sodium ions.
The nurse is assessing a client said to be in sinus rhythm. What does the nurse expect to find when evaluating the electrocardiogram? Select all that apply.
A "P" before every QRS wave Constant R to R intervals A rate between 60 and 100 beats per minute
Which individual is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of a granuloma on chest x-ray?
A 30-year-old male who has been diagnosed with sarcoidosis
The nurse is assessing several clients in an outpatient clinic. Which client is most likely to have chronic histoplasmosis?
A 52-year old male with chronic obstructive lung disease who smokes
The nurse is caring for four clients. Select the client at risk for the development of a pulmonary embolism.
A 62-year-old male who is postoperative for repair of a fractured femur
A client tells the nurse that he is concerned he may be developing chronic bronchitis and asks how the diagnosis is made. The most appropriate information for the nurse to provide would be:
A diagnosis of chronic bronchitis requires a history of a chronic productive cough that has persisted for at least 3 consecutive months in at least 2 consecutive years.
Which client who presented to a walk-in medical clinic is most likely to be diagnosed with rhinosinusitis rather than a common cold?
A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F (38.2°C)
The nurse is planning care for a client with damage to the vestibular area of the vestibulocochlear nerve. What should the nurse include in the plan of care? Select all that apply.
Administering medications for motion sickness Asking client to call for assistance prior to ambulation Teaching the client to change positions slowly
Which disorder is a manifestation of a serious condition that causes new-onset back pain in persons age 50 years or older?
Aortic Aneurysm
Which cardiac drug classification decreases sympathetic outflow to the heart and is the is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)?
Beta-adrenergic blockers
A practitioner is preparing to do a lumbar puncture on a client with suspected meningitis. Which area on the spine does the practitioner choose to obtain a cerebrospinal fluid (CSF) sample?
Between L3 and L4
The nurse is taking the history of a client scheduled for surgery with general anesthesia. What is the first response by the nurse to the client's statement that an uncle died after receiving general anesthesia?
Ensure the anesthesiologist is made aware of the information.
Which acute respiratory infection in children poses the greatest threat of severe hypoxia caused by inflammatory edema?
Epiglottitis
Which respiratory infection in children is associated with the poorest outcomes?
Epiglottitis
Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.
Escherichia coli
A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?
HIV positive and homeless
A health care provider is evaluating a client's cerebrovascular accident. The provider knows that this disorder frequently affects which part of the brain?
Hindbrain
A hiker presents to the emergency department with reports of flu-like symptoms—thirst, nausea, and inability to urinate. Upon assessment, it is determined that the client has a rectal temperature of 102.2°F (39°C) and is tachycardic. These symptoms support a diagnosis of:
Heat exhaustion
Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?
Hematuria
Which signs and symptoms would you expect to see in a client diagnosed with acute nephritic syndrome?
Hematuria and proteinuria
A 60-year-old male office worker presents to a clinic complaining of new-onset of lower back pain that has been worsening over the last 6 weeks. The nurse knows that which component of his physical assessment and history is most indicative of a serious pathologic process (like aortic aneurysm or cancer)?
His onset of pain has been gradual and he has no prior history of lower back problems.
Humoral control of blood flow involves the effect of vasodilator and vasoconstrictor substances in the blood. Select the factor that has a powerful vasodilator effect on arterioles and increases capillary permeability.
Histamine
What diagnostic test does the nurse explain to the client will assist with the diagnosis of disseminated histoplasmosis?
Histoplasma urine antigen assay
A client has been diagnosed with an advanced tumor that has invaded the mediastinum. The client would most likely manifest:
Hoarseness and difficulty swallowing
A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction?
I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
The nurse is assessing a client diagnosed with myasthenia gravis (MG). The nurse would expect the assessment to include:
Inability to move eyes in multiple positions
A family brings their elderly father to the emergency department after exposure to pneumococcal pneumonia at his retirement home. They note he has a change in his mental status. Which other assessment findings would correlate with this diagnosis? Select all that apply.
Increase in chest pain with deep inspiration Loss of appetite for past few days Purulent sputum with bloody patches
The pathophysiology instructor will emphasize that the cells of the proximal tubule have a fine, villous structure that increases surface area, allowing for which physiologic function to occur with fluids? Select all that apply.
Increase in reabsorption Supports active transport processes
The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?
Increased Nitrites
Albuminuria is an important indicator of nephron damage. The nurse recognizes that which statements regarding albuminuria are correct? Select all that apply.
Increased excretion of albumin indicates CKD. Urine dipstick can detect albuminuria. Albumin-to-creatinine ratio can confirm albuminuria.
The nurse is caring for a client with heart failure and left atrial enlargement. Which physiologic consequence does the nurse anticipate when atrial natriuretic peptide (ANP) is released due to atrial stretch?
Inhibition of aldosterone
Which is the primary component of white matter?
Myelinated fibers
A client reports a sudden intense headache. Which factor would indicate the presence of a possible subarachnoid hemorrhage?
Intractable pain
Respiratory sinus dysrhythmia is considered a more optimal rhythm than a rhythm where all RR intervals are equal. In respiratory sinus dysrhythmia, what is the variation in cardiac cycles related to?
Intrathoracic pressure changes that occur with respiration
The nurse is preparing to educate a client with HIV-related histoplasmosis about the lifelong medication he will be taking. What medication will the nurse discuss with the client?
Itraconazole
A client in shock is experiencing a decrease in the glomerular filtration rate (GFR). What is the physiologic reason for the kidney to decrease GFR at this time?
Maintain urine-concentrating ability of the kidneys
Older adults are very susceptible to pneumonia in all its varieties. The symptoms that older adults exhibit can be very different than those of other age groups who have pneumonia. What signs and symptoms are older adults with pneumonia less likely to experience than people with pneumonia in other age groups?
Marked elevation in temperature
Select the tactile receptors that are sensitive to the movement of very light objects over the surface of the skin.
Meissner corpuscles
Myelinated neurons found in the central nervous system are covered by which type of cells?
Oligonendrocytes
Which disease can result in symptoms that can occur when a brain tumor causes damage to the nigrostriatal pathway?
Parkinson disease
Place the four successive stages of fever in correct order.
Prodromal Chill Flush Defervescence
A client experiencing a sinus arrest would demonstrate which symptom or finding?
Prolonged periods of asystole demonstrated on an electrocardiogram
Muscle spindles and Golgi tendon organs are two types of sensory receptors that provide information to the central nervous system (CNS). This information is relayed to the thalamus and sensory cortex and is experienced as:
Proprioception
An emergency nurse working in a military hospital admits a new military recruit who collapsed during a heavy training exercise in the desert. The skin is moist, the pulse is 120 beats/minute, and the respirations are 28/minute. What interventions will the nurse implement? Select all that apply.
Provide fluid resuscitation. Remove client's heavy clothing. Keep the environment cool.
A client has sustained an acute spinal cord injury in a fall from a tree stand during a hunting trip. The client will require surgical intervention for the unstable spinal cord. What does the nurse recognize is the goal of early surgical intervention for this client?
Provide internal skeletal stabilization.
As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to which complication?
Pulmonary hypertension
A client is diagnosed with gouty arthritis. To prevent the buildup of uric acid and recurrence of gout attacks, the nurse teaches the client to avoid eating foods containing which compound?
Purine
The nurse is interpreting an electrocardiogram of a 65-year-old woman. Which should the nurse recognize as representing ventricular depolarization?
QRS Complex
Which types of cells are supporting cells of the peripheral nervous system?
Schwann Cells
Which clients are at increased risk for hyperthermia? Select all that apply.
Quadriplegic attending an outdoor summer event Client with heart disease in an non-air-conditioned vehicle Client with schizophrenia taking haloperidol
Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department and diagnosed of Guillain-Barré syndrome based on which assessment findings? Select all that apply.
Rapid deterioration of respiratory status Flaccid paralysis of the limbs BP 90/62
A client diagnosed with the common cold has been taking an over-the-counter antihistamine for the control of symptoms. What should the client be aware may occur if the drugs are used too frequently over too many days?
Rebound symptoms
Neurotransmitters exert their actions through specific proteins that are known as:
Receptors
When assessing a newborn (7 days old), which finding indicates the infant may have a bacterial infection?
Rectal temperature of 100.4°F (38°C).
Which types of cells are supporting cells of the peripheral nervous system?
Schwann cells
An athlete has become dehydrated during a long race in hot weather. Which physiologic process will occur in an attempt to protect the athlete's extracellular fluid volume?
Release of antidiuretic hormone from the posterior pituitary
A nurse reading a client's history and physical notes that the client has had a remitting fever. The nurse interprets this to mean that the client's temperature has done what?
Remained elevated but varied a few degrees
A client diagnosed with rhinosinusitis asks the nurse what type of nonpharmacologic measures can be used to reduce the nasal stuffiness that occurs with the disorder. What suggestion can the nurse give to the client? Select all that apply.
Saline nasal spray Nasal irrigation Mist humidification
A nurse is conducting a health promotion education program on heat cramps that cause painful muscle cramps. What is the likely cause of these cramps?
Salt depletion from heavy sweating
A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to:
Scan his bladder to make sure its empty
A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which abnormality in the client's gait?
Slow to start walking and has difficulty when asked to "stop" suddenly
A child is experiencing difficulty with chewing and swallowing. The nurse knows that which cells may be innervating specialized gut-related receptors that provide taste and smell?
Special visceral afferent cells
A client lost his right arm at the shoulder and often reports pain to his right arm, despite knowing that it is no longer there. Which aspect of physiology best explains this phenomenon?
Spinal nerves fire due to loss of sensory input from the lost appendage
When talking to a group of homeless women living in a shelter, the nurse should educate about risk for developing tuberculosis. The nurse should emphasize which lab/diagnostic test as considered to be the "gold" standard for diagnosing tuberculosis?
Sputum or bronchial cultures
A client is being treated for the ingestion of a neurotoxin that interferes with the depolarization phase of action potentials. What physiologic process will be disrupted?
The inflow of sodium ions
When a previously unexposed immunocompetent person is exposed to a person with tuberculosis, the pathogenesis is centered around which physiologic development?
The initiation of a cell-mediated immune response
A client presents to the physician's office with a chronic cough, shortness of breath, and wheezing that has gotten progressively worse, with recent episodes of hemoptysis. Diagnostic tests reveal a lung mass. Based on these symptoms, the nurse anticipates which of the following has occurred?
The lesion has eroded blood vessels in the lungs.
A client has started on interferon beta for treatment of multiple sclerosis. What should the nurse include in the teaching? Select all that apply.
The medication will be given by subcutaneous injection. Interferon beta alters your immune response.
A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?
The nurse is likely asymptomatic.
Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which component of his "white matter" has most likely been damaged?
The outer layer (neolayer)
A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the backpack. Which component of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items?
The primary dorsal root ganglion neuron, dorsal column neuron, and the thalamic neuron
Which statement is true during the phase where polarized cells are not transmitting?
They are more negative inside the cell as compared to the outside of the cell.
The nurse is teaching a group of nursing students about the mechanism of action of common diuretics. What best reflects the mechanism of these drugs?
They block the reabsorption of sodium and chloride in the nephron.
The nurse is administering the diuretic furosemide to a client with heart failure. The nurse recognizes that this exerts its action in which area in the kidney?
Thick ascending loop of Henle
A 33-year-old client is brought into the emergency room with a core temperature of 39°C (102.2°F). The client is red in the face, chest, and back due to significant cutaneous vasodilation. The client is likely in which stage of fever?
Third
Which nerve exits the pons and conveys the modalities of pain, temperature, touch, and proprioception to the superficial and deep regions of the face?
Trigeminal nerve
The family members of a client who has been diagnosed with autosomal dominant polycystic kidney disease (ADPKD) ask the nurse what they should do to find out if they have this disease. The nurse will respond that they should visit with their health care provider and ask about having which lab/diagnostic test to screen for the disease?
Ultrasound of the kidney
A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on which region of the brain?
Upper and lower motor nuerons
A nurse caring for a child with an airway obstruction should avoid which intervention?
Using a tongue depressor to assess the child's tonsils
Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?
Vasospasms and hypertension
In the ICU setting, a client transported from surgery following open heart bypass grafting will likely have his or her core temperature measured by:
a pulmonary artery catheter being used to measure cardiac output.
The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal kidney injury?
baseline urine output of 50 ml/hr that is now 10 mlk/hr
The physician has prescribed a thiazide diuretic for a client. The nurse anticipates that the medication will:
block the tubular reabsorption of sodium.
Drugs like diazepam, a benzodiazepine, exert their action on ion channels. These drugs do not open the GABA-operated ion channel, but they:
change the effect that GABA has when it binds to the channel at the same time as the drug
When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is:
inhibitory
A client has sought care because of recent malaise and fever. Upon assessment, the client states that for the past week there has been a cycle of high fever in the evening but normal temperature in the mornings. Which fever pattern will the nurse document?
intermittent fever
