Patho Preview Quiz 13, 7, Quiz Eleven, Structure and Function of GI, Path Exam 2, Patho Ch 46 Skin Disorders, Unit 7 patho, GI Quiz, Exam 3, Chapter 29, Patho Exam 5, Final Review Ch 18, Exam 4 patho chapter 13, Quiz #7 & 8: Chs 29, 30, 32, 33, Patho...

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A 31-year-old man who has worked for several years installing fiberglass insulation has developed itchy, irritating lesions on his wrists and forearms over the last several months. He has applied moisturizing creams repeatedly and has taken antihistamines but has experienced no significant improvement. He is understandably concerned about the potential effect this could have on his livelihood and has asked his health care provider when treatment will resolve the problem. What is the health care provider's most appropriate response?

"A steroid cream will likely help, but often the skin problem lasts long after contact with the product that irritates the skin."

The nurse assesses a client's skin and finds an elevated palpable mass with a circumscribed border. How will the nurse chart this finding?

"Client has a papule."

A college student is lamenting the fact that she has developed a cold on the weekend prior to exam week. Which of the following statements shows that the student has an accurate understanding of her upper respiratory infection?

"I suppose I should have been washing my hands more in the past few days."

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the patient's following statements indicates a need for further health-promotion teaching?

"I'm resolving to eat organic foods from now on and to drink a lot more water

Which of the following would be a nurse's best description of a pustule?

"It is a pus-filled vesicle."

Which of the following is the nurse's best description of a "wheal"?

"It is an elevated mass with irregular borders."

A diabetic client presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high)? Which response by the patient may account for this abnormal lab result?

"My meter broke so I have not been checking my blood glucose levels for a while."

What would be the best response to the mother of two teens who have been diagnosed with scabies?

"One of your children probably had direct contact with an infected person."

What should a nurse tell a client who is concerned about melasma?

"Stay out of the sun."

What should the nurse teach the client about the diagnosis of "primary skin disorder"?

"This disorder is caused by a virus, bacteria, or fungus that invades the skin."

A patient takes 650 mg of aspirin every 4 hours daily for complaints of joint pain. Which of the following statements should be included in the patient's teaching plan?

"This medication can damage gastric mucosa." Aspirin and nonsteroidal anti-inflammatory drugs can damage the gastric mucosa. Partial thromboplastin is not affected, nor is hemoglobin or hematocrit. The medication should help to decrease inflammation in the joints.

A client with new-onset herpes zoster (shingles) asks the nurse, "Why is this rash just on my face?" Which response by the nurse is most accurate?

"This virus was reactivated and travels from the gangila to the skin of the corresponding single spinal nerve like your face."

A 51 year-old male professional is in the habit of consuming 6 to 8 rum and cokes each evening after work. He assures the nurse practitioner who is performing his regular physical exam that his drinking is under control and does not have negative implications for his work or family life. How could the nurse best respond to the client's statement?

"When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts."

A teenager with bullous pemphigoid on the thighs asks, "What causes this blistering?" The best response by the nurse would be:

"Your body has developed antibodies against basement membrane proteins."

A nurse is performing patient health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?

. "I'm trying to think of ways that I can cut down the amount of salt that I usually eat."

What are the two main types of waxing products?

...

A client is being seen in the primary care physician's office for a follow up appointment for a second-degree burn. The burn is healing. In approximately what time frame do second-degree burns maintain their softness and elasticity but may have loss of sensation with scar formation?

1 month

A client has sustained superficial or first-degree burns to both legs and the left arm. According to the rule of nines, what percentage of total body surface area should the nurse record as affected by this burn?

45%

4. One of the best products for extremely dry skin on the elbows would be to apply which type of dressing? A) An occlusive with petroleum material mixed in the cream B) A humectant lotion that contains a á-hydroxy acid C) A lotion that has a corticosteroid in it D) A cream that has a lidocaine product mixed with it

A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, & mucous membranes. The child is mildly febrile but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect? A. Varicella B. Lichen planus C. Rosacea D. Impetigo

A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile, but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect? A) V aricella B) Lichen planus C) Rosacea D) Impetigo.

A child has been experiencing hypoglycemic episodes. "How does the body know when to secrete insulin and when to stop secreting it?" The best response by the nurse, explaining the physiologic background, would be: A) "The body knows that if the blood glucose level falls, it will inhibit insulin secretion and release glycogen to release glucose from the liver." B) "It's just a big guessing game; first we give sugar like orange juice, and then we withhold the carbohydrates if the blood glucose level is too high." C) "Your pituitary gland in the brain is the 'master gland,' and it controls and regulates all the hormones." D) "Once the child starts getting confused, the brain will send a message to the pancreas to stop producing insulin."

A client asks, "Why do I keep getting these cold sores on my lips? Am I kissing people too much?" The nurse will base her response by saying: A) "These sores usually develop when you are not sleeping well or are emotionally upset." B) "Have you been forgetting to wash your hands after going to the restroom?" C) "Have you been going outside with a wet head?" D) "Maybe you should stay away from crowds for the next few weeks."

A client is experiencing stress as a nurse prepares to insert a peripheral intravenous catheter into his forearm. The client's locus ceruleus (LC) is consequently producing which of the following hormones? A) Norepinephrine (NE) B) Corticotropin-releasing factor (CRF) C) Antidiuretic hormone (ADH) D) Adrenocorticotropic hormone (ACTH)

A client is extremely anxious about his impending surgery. Which of the following measures should the nurse implement to create an atmosphere for effective use of relaxation techniques? A) A quiet, dim environment B) A soothing, warm foot soak C) Gentle muscle stroking D) Repetitive questioning

A dermatologist is explaining to a client the advantages of using a lotion that can draw out water to the skin surface. The nurse knows the technical term for this lotion is a/an: A) Occlusive B) Humectant C) Emollient D) Xerosis

A teenager with bullous pemphigoid on the thighs asks, "What causes this blistering?" The best response by the nurse would be:" A) Your body has developed antibodies against basement membrane proteins." B) "You have been eating too much candy with large amounts of triglycerides." C) "The contraction of your arrector pili muscles causes this." D) "The lymph vessels are inflamed and responsible for this enlargement."

An 84-year-old client's blood cultures have come back positive, despite the fact that his oral temperature has remained within normal range. Which of the following phenomena underlies the alterations in fever response that occur in the elderly? A) Disturbance in the functioning of the thermoregulatory center B) Increased heat loss by evaporation C) The presence of comorbidities that is associated with lowered core temperature D) Persistent closure of arteriovenous shunts

An older adult client has just sheared the skin on her elbow while attempting to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the client's inflammation? A) Outpouring of exudate into interstitial spaces B) Chemotaxis C) Accumulation of leukocytes along the epithelium D) Phagocytosis of cellular debris

Dry, itchy plaques on her elbows & knees prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the patient with psoriasis, a disorder that results from: A. increased epidermal cell turnover. B. an IgE-mediated immune reaction. C. hormonal influences on sebaceous gland activity. D. human papillomaviruses (HPV).

Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the client with psoriasis, a disorder that results from: A) Increased epidermal cell turnover B) An IgE-mediated immune reaction C) Hormonal influences on sebaceous gland activity D) Human papillomaviruses (HPV)

Dysplastic nevi are precursors of malignant melanoma that are: A) Larger than other nevi B) Oval epidermal nests C) Dermal cords of cells D) Brown, rounded papules

Dysplastic nevi are precursors of malignant melanoma that are: A. larger than other nevi. B. oval epidermal nests. C. dermal cords of cells. D. brown rounded papules.

Manifestations of superficial dermatophytosis of the skin include: A. scaling. B. erythema. C. vesicles. D. infiltration.

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by: A) Scaling papules B) Granular scabbing C) Raised red borders D) Nodular ulcerations

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by: A. scaling papules. B. granular scabbing. C. raised red borders. D. nodular ulcerations.

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by: A) Scaling papules B)Granular scabbing C) Raised red borders D) Nodular ulcerations

The main cause of decubitus ulcers (bedsores) is ______ that impairs the flow of blood & lymph. A. external pressure B. shearing forces C. tissue edema D. thrombosis

The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense: A) Muscle position B) Visceral fullness C) Temperature D) Painful touch

Two people experience the same stressor, yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with: A) A sense of purpose in life B) Circadian rhythm disruption C) Age-related renal dysfunction D) Excessive weight gain

What neoplasm of the skin is associated with the poorest prognosis? A. Malignant melanoma B. Basal cell carcinoma C. Intraepidermal squamous cell carcinoma D. Invasive squamous cell carcinoma

What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli? A) Pattern B) Specificity C) Gate control D) Neuromatrix

When a person is stung on the index finger by a bee, the thalamus interprets the pain as: A) Somewhere on the hand B) A spot on the index finger C) Attributable to a bee stung D) Similar to a previous bee sting

When asking pathophysiology students, "Why do sebaceous glands secrete sebum?" the student with the correct answer would be: A) To lubricate skin and hair B) To supply energy in the form of fibrous protein C) To increase water amounts released via perspiration D) To supply a nutritional source for vitamin D

When talking to a group of teenagers about ways to protect against skin damage from ultraviolet radiation, the nurse should discuss which of the following tissues/cells? A) Melanocytes B) Langerhans C) Subcutaneous fat D) Protein granule

Which of the following actions could result in pressure ulcer formation? A) Pulling a stroke client up in bed B) Turning a client from side to side every 2 hours C) Allowing a client to side up in a chair at mealtime D) Applying powder to buttocks area when diaphoresis has become a problem

Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands? A) Apocrine secretions contain oils. B) Apocrine secretions help maintain skin pH. C) Apocrine glands are more numerous and widely distributed than eccrine glands. D) Apocrine glands are primarily thermoregulatory.

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics? A) Acne vulgaris B) Urticaria C) Atopic dermatitis D) Verrucae

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics? A)Acne vulgaris B)Urticaria C)Atopic dermatitis D)Verrucae

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics? A. Acne vulgaris B. Urticaria C. Atopic dermatitis D. Verrucae

Which of the following emergency department clients is most likely demonstrating clinical manifestations of acute stress? A client with: A) An acute heightened sense of alertness to surroundings and personnel B) Inattention to details of the accident with memory issues C) Negative feedback overactivity resulting in mental instability D) Muscle impairment and fatigue

Which of the following manifestations would be considered a result of stress-induced cortisol hormone secretion? A) Increased blood glucose level to 180 with excess hunger and thirst B) Increased hematopoiesis resulting in hemoglobin levels in the 20s with blood clots in legs C) Increased thyroid-stimulating hormone secretions resulting in signs of hyperthyroidism D) Depressed CNS function exhibited by drowsiness and change in level of consciousness

While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist 18. diagnoses this as: A) Bullae B) Wheal C) Nodule D) V esicle

With eyes closed, an object is placed in a student's hand. The instructor asks the student to identify the object. When he does so correctly, this is primarily the responsibility of: A) Meissner corpuscles D) Conical projections C) Prickle cell lesions D) Krause end bulbs

A school student with a rash goes to the school nurse for evaluation. The nurse suspects the student has contact dermatitis. The primary cell responsible for this delayed-type hypersensitivity reaction is: A. Merkel cells B. Reticular dermis C. Langerhans cells D. Dermal dendrocytes

A As antigen-presenting cells, the Langerhans cells are involved in delayed-type hypersensitivity reactions such as contact dermatitis and other cell-mediated immune responses in the skin; their dendritic processes extend through keratinocytes, forming a network to bind and process antigen. Merkel cells provide sensory information to the skin. In the dermis, the reticular dermis is a complex meshwork of three-dimensional collagen bundles that contain dermal dendrocytes, which have phagocytic properties.

While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist diagnoses this as: A. Bullae B. Wheal C. Nodule D. Vesicle

A Bullae are large (1.0 cm or larger in diameter) fluid-filled blisters, whereas vesicles are small (<1.0 cm in diameter). Nodules are solid marble-like lesions (>0.5 cm) that are deeper and firmer than a papule. A wheal is a somewhat irregular, relatively transient area of localized skin edema, such as a mosquito bite.

Dysplastic nevi are precursors of malignant melanoma that are: A. Larger than other nevi B. Oval epidermal nests C. Dermal cords of cells D. Brown, rounded papules

A Dysplastic nevi, a precursor of malignant melanoma, are larger than other nevi (often >5 mm in diameter), have a flat, slightly raised plaque and pebbly surface, or a target-like lesion with a darker, raised center and irregular border. Nevocellular nevi are tan to deep brown, uniformly pigmented, small papules with well-defined and rounded borders that grow in nests or clusters along the dermal-epidermal junction. Eventually, most junctional nevi grow into the surrounding dermis as nests or cords of cells.

Which of the following actions could result in pressure ulcer formation? A. Pulling a stroke client up in bed B. Turning a client from side to side every 2 hours C. Allowing a client to side up in a chair at mealtime D. Applying powder to buttocks area when diaphoresis has become a problem

A Factors contributing to the development of pressure ulcers include external pressure that compresses blood vessels and friction and shearing forces that tear and injure blood vessels. Shearing forces are caused by the sliding of one tissue layer over another with stretching and angulation of blood vessels, causing injury and thrombosis. Shear occurs when the skeleton moves, but the skin remains fixed to an external surface, such as occurs with transfer from a stretcher to a bed or pulling a person up in bed. Whether a person is sitting or lying down, the weight of the body is borne by tissues covering the bony prominences. Moisture contributes to pressure ulcer formation by weakening the cell wall of individual skin cells and by changing the protective pH of the skin.

A dermatologist is explaining to a client the advantages of using a lotion that can draw out water to the skin surface. The nurse knows the technical term for this lotion is a/an: A. Occlusive B. Humectant C. Emollient D. Xerosis

A Humectants are the additives in lotions, such as α-hydroxy acids and urea, that draw out water from the deeper skin layers and hold it on the skin surface. Emollients are fatty acid-containing lotions that replenish the oils on the skin surface but usually do not leave a residue on the skin. They have a short duration of action and need to be applied frequently. Urea is a nitrogenous substance that has been quite effective in reducing xerosis when combined with lotions. It is a humectant at lower concentrations (10%), but in higher concentrations (20%-30%), it is mildly keratolytic. Occlusives are thick creams that contain petroleum or some other moisture-proof material. They prevent water loss from the skin.

When talking to a group of teenagers about ways to protect against skin damage from ultraviolet radiation, the nurse should discuss which of the following tissues/cells? A. Melanocytes B. Langerhans C. Subcutaneous fat D. Protein granule

A In addition to the keratinocytes, the epidermis has melanin pigment-producing melanocytes that protect against ultraviolet radiation and Langerhans cells that link the epidermis to the immune system. Subcutaneous tissue contains fat and binds the dermis to underlying body tissues. The third keratinocyte layer, the stratum granulosum, is composed of flat cells containing protein granules called keratohyalin granules.

With eyes closed, an object is placed in a student's hand. The instructor asks the student to identify the object. When he does so correctly, this is primarily the responsibility of: A. Meissner corpuscles B. Conical projections C. Prickle cell lesions D. Krause end bulbs

A Meissner corpuscles are encapsulated mechanoreceptors specialized for tactile discrimination. They are concentrated on the fingertips and palms of the hands, where they account for about half of the tactile receptors. The skin is also supplied by Krause end bulbs, nerve endings contained in a cylindrical or oval capsule. They are found most frequently in the oral cavity, conjunctiva, and genitalia. Although their function is uncertain, they are thought to act as mechanoreceptors and heat detectors. The stratum spinosum is two to four layers thick, consisting of cells commonly referred to as prickle cells because they develop a spiny appearance as their cell borders interact. The papillary dermis lies adjacent to the epidermis and is densely covered with conical projections called dermal papillae.

One of the best products for extremely dry skin on the elbows would be to apply which type of dressing? A. An occlusive with petroleum material mixed in the cream B. A humectant lotion that contains a α-hydroxy acid C. A lotion that has a corticosteroid in it D. A cream that has a lidocaine product mixed with it

A Occlusives are thick creams that contain petroleum or some other moisture-proof material. They prevent water loss from the skin. They are the most effective agents for relieving skin dryness. Humectants are the additives in lotions, such as a-hydroxy acids and urea, that draw out water from the deeper skin layers and hold it on the skin surface. However, the water that is drawn to the skin is transepidermal water, not atmospheric water; thus, continued evaporation from the skin can actually exacerbate dryness. α-Hydroxy acids are derived from fruits, hence the abundance of fruit additives in over-the-counter shampoos and lotions. Lotion or cream additives include corticosteroids or mild anesthetics, such as camphor, menthol, lidocaine, or benzocaine. These agents work by suppressing itching while moisturizing the skin.

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by: A. Scaling papules B. Granular scabbing C. Raised red borders D. Nodular ulcerations

A Papulosquamous dermatoses are a group of skin disorders characterized by scaling papules and plaques. Nodular ulcerative type is a frequently occurring type of basal cell carcinoma. Squamous cell carcinoma is a red-scaling, keratotic, slightly elevated lesion that later grows outward, with large ulcerations and crusts with raised, erythematous borders. Varicella (chickenpox) is caused by the varicella-zoster virus; characteristic skin lesion occurs in three stages: macule, vesicle, and granular scab.

Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the client with psoriasis, a disorder that results from: A. Increased epidermal cell turnover B. An IgE-mediated immune reaction C. Hormonal influences on sebaceous gland activity D. Human papillomaviruses (HPV)

A Psoriasis is characterized by increased epidermal cell turnover with marked epidermal thickening, a process called hyperkeratosis. Hives are caused by an IgE-mediated immune reaction, and HPV causes warts. Dysfunction of the sebaceous glands results in acne.

When asking pathophysiology students, "Why do sebaceous glands secrete sebum?" the student with the correct answer would be: A. To lubricate skin and hair B. To supply energy in the form of fibrous protein C. To increase water amounts released via perspiration D. To supply a nutritional source for vitamin D

A Sebaceous glands secrete sebum, an oily mixture consisting of lipids, including triglycerides, cholesterol, and wax, that lubricates hair and skin. Keratinocytes of the epidermis produce a fibrous protein called keratin, which is essential to the protective function of skin. Sweat glands produce watery secretions. The dermis supports the epidermis and serves as its primary source of nutrition.

A teenager with bullous pemphigoid on the thighs asks, "What causes this blistering?" The best response by the nurse would be: A. "Your body has developed antibodies against basement membrane proteins." B. "You have been eating too much candy with large amounts of triglycerides." C. "The contraction of your arrector pili muscles causes this." D. "The lymph vessels are inflamed and responsible for this enlargement."

A The basement membrane zone is often involved in skin disorders that cause bullae or blister formation. One of these disorders, bullous pemphigoid, is a blistering disease caused by antibodies against basement membrane proteins. The thighs and flexor tendons are most commonly affected. The disease is self-limited but chronic, and the person's general health is unaffected. The sympathetic nervous system controls the arrector pili (pilomotor) muscles that cause elevation of hairs on the skin. Contraction of these muscles tends to cause the skin to dimple, producing "goose bumps." The basal cells of the epidermis project into the papillary dermis, forming rete ridges. Lymph vessels and nerve tissue also are found in this layer.

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics? A. Acne vulgaris B. Urticaria C. Atopic dermatitis D. Verrucae

A The etiology of acne vulgaris is bacterial, and some clients may require treatment with systemic antibiotics. Urticaria (hives) and atopic dermatitis result from allergic and hypersensitivity processes. Verrucae, or warts, are of viral origin and thus unresponsive to antibiotic therapy.

Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands? A. Apocrine secretions contain oils. B. Apocrine secretions help maintain skin pH. C. Apocrine glands are more numerous and widely distributed than eccrine glands. D. Apocrine glands are primarily thermoregulatory.

A The major difference between apocrine glands and the eccrine glands is that apocrine glands secrete an oily substance. Apocrine glands are less widely distributed than eccrine glands, and they do not contribute as significantly to thermoregulation. Neither is a major contributor to skin pH.

A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile, but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect? A. Varicella B. Lichen planus C. Rosacea D. Impetigo.

A Varicella (chickenpox) begins with a macular stage that is characterized by the development of macules over the trunk, spreading to the limbs, buccal mucosa, scalp, axillae, upper respiratory tract, and conjunctiva. Mild to extreme pruritus accompanies the lesions, and clients are often mildly febrile. Impetigo manifests vesicles or pustules that are primarily on the face. Rosacea and lichen planus are chronic skin disorders of older persons.

A nurse is caring for four clients. Select the client most at risk for the development of a pressure ulcer.

A 72-year-old undernourished female who recently underwent thigh surgery

A client is admitted to the hospital with first- and second-degree burns. Which assessment findings are associated with first-degree burns? Select all that apply. A. Painful B. Wet C. Red or pink D. Full-thickness burn

A and C

A skin care consultant informs the client that he needs to bath and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that

A basal cell is mitotically active and pushes older dead cells to the skin's surface.

A 30-year-old woman who just found out that she is pregnant seeks treatment for her severe acne. Which treatment for her skin condition is most appropriate?

A benzoyl peroxide agent

Which of the following clients likely faces the greatest risk of a gastrointestinal bleed?

A client who takes aspirin with each meal to control symptoms of osteoarthritis

Which term is correctly linked with its definition?

A corn is a keratinous thickening of skin.

Which of the following clients is at greatest risk for developing balanitis xerotica obliterans?

A male who has an uncircumcised penis

Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"?

A middle aged overweight adult with a sting plasma level of 122 with follow up OGTT of 189 mg/DL

Which of the following clients would experience in accelerated rate of cell diffusion in the stratum germinativum layer?

A motorcycle accident client with large abrasions on the lower limbs

Which of the following individuals is experiencing the effects of a primary endocrine disorder?

A patient who has low calcium levels because of the loss of his parathyroid gland

A man's primary care physician has characterized his skin lesion as being a temporary eruption but has cautioned him against repeated rubbing or scratching to avoid lichenization. What is the most likely categorization of the man's skin lesion?

A rash

A superficial fungal infection

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the care provider give the patient? A) "There is a chance that these will clear up on their own without any treatment." B) "It's important to start treatment soon, so I will prescribe you pills today." C) "Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease." D) "I'd like to give you an HPV vaccination if that's okay with you."

A) "There is a chance that these will clear up on their own without any treatment."

Which of the following patients should the nurse observe most closely for the signs and symptoms of paralytic ileus? A) A patient who is postoperative day 1 following gall bladder surgery B) A patient whose acute diarrhea has necessitated the use of antidiarrheal medications C) An obese patient who refuses to ambulate because he complains of shortness of breath D) A patient with a longstanding diagnosis of irritable bowel syndrome

A) A patient who is postoperative day 1 following gall bladder surgery

Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis? A) A woman who has six to eight alcoholic beverages each evening B) A man who has become profoundly ill during a tropical vacation C) A woman who takes two Tylenol tablets five to six times a day D) An obese man who has a high-fat diet and has a sedentary lifestyle

A) A woman who has six to eight alcoholic beverages each evening

Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis? A) A woman who has six to eight drinks each evening B) A man who has become profoundly ill during a tropical vacation C) A woman who takes two Tylenol tablets five to six times a day D) An obese man who has a high-fat diet and has a sedentary lifestyle

A) A woman who has six to eight drinks each evening

When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize the pathogenesis begins with an inflammatory process whereby: A) Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue. B) The pancreas is irreversibly damaged and will not recover to normal functioning (chronic). C) The pancreas will hypertrophy (enlarge) to the point of causing bowel obstruction. D) Stones will develop in the common bile duct, resulting in acute jaundice.

A) Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.

Which of the following sexually transmitted infections (STIs) is associated with an increased risk of infertility in women due to asymptomatic infection? A) Chlamydial infection B) Herpes simplex virus C) Gonorrhea D) Syphilis

A) Chlamydial infection

Clients with chronic autoimmune hepatitis may display which of the following clinical manifestations upon physical exam? Select all that apply. A) Enlarged liver B) Jaundice C) Bacterial meningitis D) Nuchal rigidity E) Edematous joints

A) Enlarged liver B) Jaundice

Which of the following factors is most strongly associated with the pathogenesis of gallstones? A) Excess serum ammonia and urea levels B) Portal hypertension C) Abnormalities or stasis of bile D) High cholesterol diet

A) Excess serum ammonia and urea levels

A 16-year-old girl has been admitted to the emergency department after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this client faces a severe risk of acute fulminant hepatitis, with elevated ammonia levels that can result in: Select all that apply. A) Flapping tremor (asterixis) B) Confusion C) Convulsions D) Elevated creatinine levels E) Photosensitivity

A) Flapping tremor (asterixis) B) Confusion C) Convulsions

An ultrasound (US) of a client with intermittent pain reveals gallbladder sludge. Which of the following client history items are likely factors in the US result? Select all that apply. A) Had lap band surgery 2 years ago and lost 100 pounds B) Recent pregnancy with a 6-month-old child at home C) Current prescription for a medicine to lower cholesterol D) A runner training for a marathon E) Works in surgery with long periods of standing in one place

A) Had lap band surgery 2 years ago and lost 100 pounds B) Recent pregnancy with a 6-month-old child at home C) Current prescription for a medicine to lower cholesterol

A client is admitted with late manifestations of cirrhosis. Which of the following clinical manifestations confirm this diagnosis? Select all that apply. A) Hepatomegaly felt on deep palpation B) Diffuse liver fibrosis with large, palpable lumps C) GI bleeding related to esophageal varices D) Acute renal failure with electrolyte imbalances E) Splenomegaly with bleeding tendencies

A) Hepatomegaly felt on deep palpation C) GI bleeding related to esophageal varices E) Splenomegaly with bleeding tendencies

A 60-year-old male patient has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this patient's pharmacologic treatment? A) Inhibiting gastric acid production B) Promoting hypertrophy of the gastric mucosa C) Increasing the rate of gastric emptying D) Increasing muscle tone of the cardiac sphincter

A) Inhibiting gastric acid production

A client with hepatitis B asks the nurse, "How did I get this hepatitis?" The nurse responds that the mode of transmission is predominantly by: Select all that apply. A) Intravenous drug use B) Fecal-oral route C) Unprotected sexual intercourse D) Sharing oral secretions by kissing E) Inhalation of airborne droplets

A) Intravenous drug use C) Unprotected sexual intercourse

Following a lengthy series of diagnostic tests, a patient's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this patient most likely to require? A) Joint replacement surgery B) Intravenous antibiotics C) Injections of corticosteroids into the synovial space D) Transfusion of packed red blood cells

A) Joint replacement surgery

An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis? A) Obstruction of the intestinal lumen B) Elimination of normal intestinal flora C) Sloughing of the intestinal mucosa D) Increased osmolality of intestinal contents

A) Obstruction of the intestinal lumen

Which of the following disorders of the skeletal system occurs exclusively in older adults? A) Polymyalgia rheumatica B) Psoriatic arthritis C) Reiter syndrome D) Ankylosing spondylitis

A) Polymyalgia rheumatica

A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience? A) Prehepatic B) Intrahepatic C) Posthepatic D) Infectious

A) Prehepatic

A patient's longstanding diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this patient most likely experience? A) Prehepatic B) Intrahepatic C) Posthepatic D) Infectious

A) Prehepatic

Which of the following meals is most likely to exacerbate an individual's celiac disease? A) Spaghetti with meatballs and garlic bread B) Stir-fried chicken and vegetables with rice C) Oatmeal with milk, brown sugar, and walnuts D) Barbecued steak and a baked potato with sour cream

A) Spaghetti with meatballs and garlic bread

Which of the following factors accounts for the poor prognosis that typically accompanies a diagnosis of primary hepatocellular cancer? A) Surgical options do not exist because removal of all or part of the liver is a threat to health. B) Liver cancer typically metastasizes at a much earlier stage than other cancers. C) Liver tumors are poorly differentiated due to the low density of hepatic tissue. D) The nonspecific symptomatology of liver cancer means that diagnosis often happens at a late stage.

A) Surgical options do not exist because removal of all or part of the liver is a threat to health.

Infected men may harbor ___________ but they are always asymptomatic. A) Trichomonas vaginalis B) Chlamydia trachomatis C) Neisseria gonorrhoeae. D) Treponema pallidum

A) Trichomonas vaginalis

Which of the following signs and symptoms is most suggestive of acute cholecystitis? A) Upper right quadrant or epigastric pain B) Fever and sudden abdominal distention C) Appearance of undigested fat in feces D) Nausea resulting in greenish vomitus

A) Upper right quadrant or epigastric pain

A client has been diagnosed with cholestasis and is experiencing pruritus. The nurse caring for this client should be educating the client about reduced bile flow that will interfere with intestinal absorption of which of the following vitamins? Select all that apply. A) Vitamin A B) Vitamin B C) Vitamin C D) Vitamin D E) Vitamin K

A) Vitamin A D) Vitamin D E) Vitamin K

A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The assessment data related to this lab value includes: Select all that apply. A) Yellowish discoloration of the skin B) Colicky, intermittent pain associated with formula feeding C) Xanthomas D) Yellowing of the sclera of the eye E) Dark-colored urine

A) Yellowish discoloration of the skin D) Yellowing of the sclera of the eye E) Dark-colored urine

Premature osteoporosis is being seen increasingly in female athletes because of an increased prevalence of: A) amenorrhea. B) high protein intake. C) abnormal body fat. D) osteoarthritis.

A) amenorrhea.

The most commonly occurring early symptoms of systemic lupus erythematosus (SLE) include: A) arthralgia. B) tendon rupture. C) facial hair growth. D) pyelonephritis.

A) arthralgia.

Inflammatory bowel diseases are accompanied by systemic manifestations that include: A) autoimmune anemia. B) rheumatoid arthritis. C) thrombocytopenia. D) lactose intolerance.

A) autoimmune anemia.

The mechanisms of liver damage in viral hepatitis include: A) direct cellular injury. B) fatty liver changes. C) disrupted bile flow. D) bile duct inflammation.

A) direct cellular injury.

Systemic sclerosis (scleroderma) is an autoimmune disease of connective tissue characterized by: A) fibrosis. B) thin fragile skin. C) collagen deficiency. D) avascular necrosis.

A) fibrosis.

Disorders that affect cortical bone typically result in: A) fractures of long bones. B) impaired collagen synthesis. C) infection. D) vertebral fractures.

A) fractures of long bones.

Crohn's type of inflammatory bowel disease is characterized by: A) granulomatous lesions. B) ulcerative erosions. C) fibrotic smooth muscle. D) necrotic crypt abscesses.

A) granulomatous lesions.

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

A) human papillomavirus (HPV).

The patient has a fractured tibia. After the cast is applied he is at high risk for compartment syndrome caused by: A) inflammation. B) joint immobility. C) muscle atrophy. D) extremity elevation.

A) inflammation.

Abnormally high accumulation of bilirubin in the blood causes: A) jaundice. B) cholestasis. C) xanthomas. D) biliary cirrhosis.

A) jaundice.

Alcoholic liver disease manifests in three stages. The intermediate stage, alcoholic hepatitis, is characterized by liver cell: A) necrosis. B) nodules. C) atrophy. D) hypertrophy.

A) necrosis.

Symptomatic tertiary syphilis is characterized by: A) necrotic gummas. B) chancre papules. C) condylomata lata. D) maculopapular rash.

A) necrotic gummas.

A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of: A) pannus tissue. B) tophi deposits. C) subluxations. D) autoantibodies.

A) pannus tissue.

Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative diplococcus, and is characterized by: A) purulent exudates. B) painful small vesicles. C) cauliflower-shaped lesions. D) persistent perianal itching.

A) purulent exudates.

A hallmark of irritable bowel syndrome is abdominal pain: A) relieved by defecation. B) most severe at night. C) with blood in the stool. D) after and between meals.

A) relieved by defecation.

Despite differences in onset, involvement, and symptomatology, all of the spondyloarthropathies involve: A) sacroiliitis. B) calcinosis. C) excessive bone turnover. D) autoimmune etiology.

A) sacroiliitis.

The distinguishing characteristic of chronic osteomyelitis is the presence of: A) sequestrum bone. B) abscess formation. C) severe bone pain. D) external drainage.

A) sequestrum bone.

A major complication of persistent gastroesophageal reflux is: A) strictures. B) heartburn. C) chest pain. D) hoarseness.

A) strictures.

A college baseball player has seen his season cut short by a rotator cuff injury. Rotator cuff injuries are frequent because of: A) the inherent instability of the shoulder. B) the absence of ligaments at the glenohumeral joint. C) the vulnerability of the shoulder menisci. D) the large mass of the humeralAzszead.

A) the inherent instability of the shoulder.

22. A woman has just delivered a child with a hemangioma on his right cheek area. The mother clutches the nurse and asks, "What is that thing on his face?" The nurse will respond with which of the following facts? Select all that apply. A) "This is usually called a strawberry 'birth mark' and pretty common in newborns." B) "These hemangiomas may grow larger early on followed by a period where the growth is reversed." C) "Most of these hemangiomas will remain with the infant for the rest of his life. However, they are not cancerous." D) "If this birth mark develops ulceration, we will need to keep a close eye on it to prevent any infections." E) "We will keep a close watch on your infant's vision since they can develop malformation of the eye that could develop into glaucoma."

A) "This is usually called a strawberry 'birth mark' and pretty common in newborns." B) "These hemangiomas may grow larger early on followed by a period where the growth is reversed." D) "If this birth mark develops ulceration, we will need to keep a close eye on it to prevent any infections."

8. A teenager with bullous pemphigoid on the thighs asks, "What causes this blistering?" The best response by the nurse would be: A) "Your body has developed antibodies against basement membrane proteins." B) "You have been eating too much candy with large amounts of triglycerides." C) "The contraction of your arrector pili muscles causes this." D) "The lymph vessels are inflamed and responsible for this enlargement."

A) "Your body has developed antibodies against basement membrane proteins."

17. Which of the following patients should the nurse observe most closely for the signs and symptoms of paralytic ileus?

A) A patient who is postoperative day 1 following gall bladder surgery

5. Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics? A) Acne vulgaris B) Urticaria C) Atopic dermatitis D) Verrucae

A) Acne vulgaris

1. A client is exhibiting manifestations of superficial dermatophytosis of the skin with skin scaling and nail disintegration. Based on these findings, the nurse can anticipate that the client will be prescribed: Select all that apply. A) An antifungal like ketoconazole B) An antibiotic like tetracycline C) Topical corticosteroid D) An antihistamine like Benadryl

A) An antifungal like ketoconazole C) Topical corticosteroid

24. One of the best products for extremely dry skin on the elbows would be to apply which type of dressing? A) An occlusive with petroleum material mixed in the cream B) A humectant lotion that contains a -hydroxy acid C) A lotion that has a corticosteroid in it D) A cream that has a lidocaine product mixed with it

A) An occlusive with petroleum material mixed in the cream

10. Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands? A) Apocrine secretions contain oils. B) Apocrine secretions help maintain skin pH. C) Apocrine glands are more numerous and widely distributed than eccrine glands. D) Apocrine glands are primarily thermoregulatory.

A) Apocrine secretions contain oils.

Patients with Crohn's disease may experience which of the following potential complications? A) Fistula formation B) Excessive weight gain C) Difficulty swallowing D) Chronic constipation

A) Fistula formation

15. A child has been admitted to the burn unit after pulling a pan of hot water off the stove. Given the fact that there is primarily second- and third-degree burns, the health care worker should prioritize care to focus on which of the following? Select all that apply. A) Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B) Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality. C) Maintain sterile field when doing dressing changes and debridement. D) Withhold foods/nutrition since the GI tract may have slowed down in response to stress. E) Minimize pain medication administration to not compromise the child's respiratory effort.

A) Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B) Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality. C) Maintain sterile field when doing dressing changes and debridement.

10. Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the client with psoriasis, a disorder that results from: A) Increased epidermal cell turnover B) An IgE-mediated immune reaction C) Hormonal influences on sebaceous gland activity D) Human papillomaviruses (HPV)

A) Increased epidermal cell turnover

12. A 60-year-old male patient has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this patient's pharmacologic treatment?

A) Inhibiting gastric acid production

19. Dysplastic nevi are precursors of malignant melanoma that are: A) Larger than other nevi B) Oval epidermal nests C) Dermal cords of cells D) Brown, rounded papules

A) Larger than other nevi

20. A client has just received the diagnosis of malignant melanoma, stage 3B. He asks the nurse what this means. The nurse should respond relaying which of the following information? Select all that apply. A) Malignant melanoma is a very rapid growing, aggressive cancer. B) This cancer usually extends wide and deep but rarely metastasize. C) This cancer is mainly contained to the head and neck area. D) Your cancer has grown into the deep tissues and quite likely into lymph nodes (stage 3B).

A) Malignant melanoma is a very rapid growing, aggressive cancer. D) Your cancer has grown into the deep tissues and quite likely into lymph nodes (stage 3B).

9. With eyes closed, an object is placed in a student's hand. The instructor asks the student to identify the object. When he does so correctly, this is primarily the responsibility of: A) Meissner corpuscles B) Conical projections C) Prickle cell lesions D) Krause end bulbs

A) Meissner corpuscles

15. An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis?

A) Obstruction of the intestinal lumen

25. A dermatologist is explaining to a client the advantages of using a lotion that can draw out water to the skin surface. The nurse knows the technical term for this lotion is a/an: A) Occlusive B) Humectant C) Emollient D) Xerosis

A) Occlusive

1. Which of the following would be considered functions of the skin? Select all that apply. A) Protection against physical injury B) Protection from an invasion of microbes C) Regulation of acid-base balance D) Regulation of metabolism E) Synthesis of vitamin D

A) Protection against physical injury B) Protection from an invasion of microbes E) Synthesis of vitamin D

16. Which of the following actions could result in pressure ulcer formation? A) Pulling a stroke client up in bed B) Turning a client from side to side every 2 hours C) Allowing a client to side up in a chair at mealtime D) Applying powder to buttocks area when diaphoresis has become a problem

A) Pulling a stroke client up in bed

9. Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by: A) Scaling papules B) Granular scabbing C) Raised red borders D) Nodular ulcerations

A) Scaling papules

18. Which of the following meals is most likely to exacerbate an individual's celiac disease?

A) Spaghetti with meatballs and garlic bread

A patient has been diagnosed with an incompetent pyloric sphincter. This patient will experience abnormal communication between which of the following components of the gastrointestinal tract? A) Stomach and duodenum B) Esophagus and stomach C) Rectum and anus D) Small intestine and colon

A) Stomach and duodenum

24. Which of the following changes are normal in the elderly population? Select all that apply. A) The dermis and epidermis thin as one ages. B) An increase in the amount of subcutaneous tissue. C) A thickening of blood vessels. D) Increased amount of padding on the buttocks. E) Skin may become dry, rough, and scaly.

A) The dermis and epidermis thin as one ages. C) A thickening of blood vessels. E) Skin may become dry, rough, and scaly.

13. When asking pathophysiology students, "Why do sebaceous glands secrete sebum?" the student with the correct answer would be: A) To lubricate skin and hair B) To supply energy in the form of fibrous protein C) To increase water amounts released via perspiration D) To supply a nutritional source for vitamin D

A) To lubricate skin and hair

23. A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile, but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect? A) Varicella B) Lichen planus C) Rosacea D) Impetigo.

A) Varicella

7. Atopic dermatitis can be described as: Select all that apply. A) Vesicle formation B) Oozing C) Round, erythematous papules that enlarge and coalesce D) Raised wheals with associated itching

A) Vesicle formation B) Oozing

5. Inflammatory bowel diseases are accompanied by systemic manifestations that include:

A) autoimmune anemia.

6. Crohn's type of inflammatory bowel disease is characterized by:

A) granulomatous lesions.

4. A hallmark of irritable bowel syndrome is abdominal pain:

A) relieved by defecation.

1. A major complication of persistent gastroesophageal reflux is:

A) strictures.

A child has been admitted to the burn unit after pulling a pan of hot water off the stove. Given the fact that there is primarily second- and third-degree burns, the health care worker should prioritize care to focus on which of the following? Select all that apply. A)Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B)Maintain sterile field when doing dressing changes and debridement. C)Minimize pain medication administration to not compromise the child's respiratory effort. D)Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality. E)Withhold foods/nutrition since the GI tract may have slowed down in response to stress.

A)Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B)Maintain sterile field when doing dressing changes and debridement. D)Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality.

A thermal burn described as involving the entire epidermis and dermis is classified as: A)Full-thickness second degree B)Full third degree C)Deep first degree D)Partial second degree

A)Full-thickness second degree

When talking to a group of teenagers about ways to protect against skin damage from ultraviolet radiation, the nurse should discuss which of the following tissues/cells? A)Melanocytes B)Langerhans C)Protein granule D)Subcutaneous fat

A)Melanocytes

A)Occlusive

A 14-year-old presents to the dermatologist clinic with a severe case of acne. The nurse explains that this acne is a result of inflamed A)Sebaceous glands B)Dermal papillae C)Apocrine glands D)Follicular bulbs

A)Sebaceous glands

When asked to name the parts of the pilosebaceous unit of the skin, which student has the correct answer? A)Sebaceous glands B)Eccrine secretions C)Connective tissues E)Keratinized plates

A)Sebaceous glands

While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is: A)Sebum, secreted by the sebaceous gland B)A nerve ending C)An eccrine sweat gland D)A Langerhans cell, which produces antigen-presenting cells

A)Sebum, secreted by the sebaceous gland

A client is exhibiting manifestations of superficial dermatophytosis of the skin with skin scaling and nail disintegration. Based on these findings, the nurse can anticipate that the client will be prescribed: Select all that apply. A)Topical corticosteroid B)An antihistamine like Benadryl C)An antibiotic like tetracycline D)An antifungal like ketoconazole

A)Topical corticosteroid D)An antifungal like ketoconazole

A client with poor arterial circulation in the lower limbs has developed areas of inflammation and "weeping" clear serous exudate. Since chronic inflammation lasts for a long time, it has been associated with which of the following changes in physiological response? Select all that apply. A) Formation and development of new blood vessels B) The death of one or more cells in the body within a localized area C) Release of a number of potent inflammatory mediators, altering adhesive properties D) Regulation and modulation of the immune response through synthesis and release of inflammatory mediators E) Release of scavenger cells capable of engulfing bacteria through phagocytosis

A, B

Atopic dermatitis can be described as: Select all that apply. A) Vesicle formation B) Oozing C) Round, erythematous papules that enlarge and coalesce D) Raised wheals with associated itching

A, B

Atopic dermatitis can be described as: Select all that apply. A. Vesicle formation B. Oozing C. Round, erythematous papules that enlarge and coalesce D. Raised wheals with associated itching

A, B The lesions of atopic dermatitis are usually characterized by vesicle formation, oozing, and crusting with excoriations. The lesions of erythema multiforme are round, erythematous papules that enlarge and coalesce, changing to concentric zones of color appearing as "target" or "iris" lesions. Urticaria, or hives, is a common skin disorder characterized by the development of edematous wheals accompanied by intense itching.

A child has been admitted to the burn unit after pulling a pan of hot water off the stove. Given the fact that there is primarily second- and third-degree burns, the health care worker should prioritize care to focus on which of the following? Select all that apply. A) Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B) Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality. C) Maintain sterile field when doing dressing changes and debridement. D) Withhold foods/nutrition since the GI tract may have slowed down in response to stress. E) Minimize pain medication administration to not compromise the child's respiratory effort.

A, B, C

Following an automobile accident that resulted in a traumatic amputation of the right lower leg, the client complains of feeling tingling, heaviness, and shooting pain in the amputated limb. The health care providers treat phantom limb pain by which of the following interventions? Select all that apply. A) TENS of the large myelinated afferents innervating the area B) Hypnosis C) Relaxation techniques D) Warm, moist compresses E) Use of mirrors to visualize the limb is no longer there

A, B, C

The nurse notes the client has developed a systemic response of inflammation based on assessment findings. Which of the following clinical manifestations support this diagnosis? Select all that apply. A) Temperature of 100.9°F, lethargy B) Pulse rate 130 beats/minute (high) C) Generalized achiness D) Low urine output E) Pounding, throbbing headache

A, B, C

Which of the following interventions would be considered a nonpharmacologic method of pain control? Select all that apply. A) Distraction by knitting B) Guided imagery C) Biofeedback D) OTC acetaminophen

A, B, C

A child has been admitted to the burn unit after pulling a pan of hot water off the stove. Given the fact that there is primarily second- and third-degree burns, the health care worker should prioritize care to focus on which of the following? Select all that apply. A. Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B. Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality. C. Maintain sterile field when doing dressing changes and debridement. D. Withhold foods/nutrition since the GI tract may have slowed down in response to stress. E. Minimize pain medication administration to not compromise the child's respiratory effort.

A, B, C Fluid is lost from the vascular, interstitial, and cellular compartments. Because of a loss of vascular volume, major burn victims often present in the emergency department in a form of hypovolemic shock. Manifestations of inhalation injury include hoarseness, drooling and inability to handle secretions, hacking cough, and labored, shallow breathing. Immunologically, the skin is the body's first line of defense. When the skin is no longer intact, the body is open to bacterial infection. The stress of burn injury increases metabolic and nutritional requirements; therefore, nutrition should not be withheld. Pain medication should be titrated to the child's need.

Which are common manifestations of rosacea? Select all that apply. A. Heat sensitivity B. Swelling of the eyelid C. Burning eyes D. Erythema E. Telangiectasia

A, B, C, D, and E (all)

A woman has just delivered a child with a hemangioma on his right cheek area. The mother clutches the nurse and asks, "What is that thing on his face?" The nurse will respond with which of the following facts? Select all that apply. A) "This is usually called a strawberry 'birth mark' and pretty common in newborns." B) "These hemangiomas may grow larger early on followed by a period where the growth is reversed." C) "Most of these hemangiomas will remain with the infant for the rest of his life. However, they are not cancerous." D) "If this birth mark develops ulceration, we will need to keep a close eye on it to prevent any infections." E) "We will keep a close watch on your infant's vision since they can develop malformation of the eye that could develop into glaucoma."

A, B, D

A woman has just delivered a child with a hemangioma on his right cheek area. The mother clutches the nurse and asks, "What is that thing on his face?" The nurse will respond with which of the following facts? Select all that apply. A. "This is usually called a strawberry 'birth mark' and pretty common in newborns." B. "These hemangiomas may grow larger early on followed by a period where the growth is reversed." C. "Most of these hemangiomas will remain with the infant for the rest of his life. However, they are not cancerous." D. "If this birth mark develops ulceration, we will need to keep a close eye on it to prevent any infections." E. "We will keep a close watch on your infant's vision since they can develop malformation of the eye that could develop into glaucoma."

A, B, D Hemangiomas of infancy (formerly called strawberry hemangiomas) are small, red lesions that are noticed shortly after birth. Hemangiomas of infancy are generally benign vascular tumors produced by proliferation of endothelial cells. They are seen in approximately 10% of children in the first year of life. Hemangiomas of infancy typically undergo an early period of proliferation during which they enlarge, followed by a period of slow involution during which the growth is reversed until complete resolution. A small percentage of hemangiomas develop complications. Ulceration, the most frequent complication, can be painful and carries the risk of infection, hemorrhage, and scarring. Port-wine stains usually are confined to the skin but may be associated with vascular malformations of the eye, resulting primarily in glaucoma.

When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with: Select all that apply. A) Substernal chest pain B) Neck pain C) Umbilicus pain D) Deep, right-sided abdominal pain E) Pain that radiates to the left arm

A, B, E

Which of the following would be considered functions of the skin? Select all that apply. A. Protection against physical injury B. Protection from an invasion of microbes C. Regulation of acid-base balance D. Regulation of metabolism E. Synthesis of vitamin D

A, B, E Besides providing a covering for the entire body surface, the skin performs many other functions, including protection against physical injury, sunlight, and microorganisms; prevention of loss of fluids from the internal environment; regulation of body temperature; continual reception of sensations from the environment, such as touch, temperature, and pain; and synthesis of vitamin D through the action of sunlight on the skin. Acid-base regulation occurs primarily in the lungs and kidneys. Metabolic rate is regulated by many hormones, not the skin.

The skin covers the body, and it is exposed to a number of potentially damaging agents in the external environment. What effects do ultraviolet rays of sunlight have on the skin? Select all that apply. A. Accelerating the effect of aging on the skin B. Causing potential for directly damaging the skin C. Predisposing to the development of skin cancer D. Interrupting blood flow causing pressure ulcers

A, B, and C

A client is exhibiting manifestations of superficial dermatophytosis of the skin with skin scaling and nail disintegration. Based on these findings, the nurse can anticipate that the client will be prescribed: Select all that apply. A) An antifungal like ketoconazole B) An antibiotic like tetracycline C) Topical corticosteroid D) An antihistamine like Benadryl

A, C

A client is exhibiting manifestations of superficial dermatophytosis of the skin with skin scaling and nail disintegration. Based on these findings, the nurse can anticipate that the client will be prescribed: Select all that apply. A. An antifungal like ketoconazole B. An antibiotic like tetracycline C. Topical corticosteroid D. An antihistamine like Benadryl

A, C The fungi that cause superficial mycoses are called dermatophytes and require keratin for growth. Therefore, these fungi do not infect deeper body tissues or mucosal surfaces. The dermatophytes emit an enzyme that enables them to digest keratin, which results in superficial skin scaling, nail disintegration, or hair breakage, depending on the location of the infection. The principal agents are the azoles (ketoconazole, miconazole, clotrimazole, etc.) and the allylamines (naftifine and terbinafine). Both act by inhibiting the synthesis of ergosterol, which is an essential part of fungal cell membranes. Topical corticosteroids may be used in conjunction with topical antifungal agents to relieve itching and erythema secondary to inflammation. Antibiotics are not effective for fungal infections, and antihistamines are usually reserved for itching, which is not characteristic of this disease.

Although stress exposure initiates integrated responses by multiple systems, the functional results are first manifested as: Select all that apply. A) Enhanced respiratory rate/depth B) Cravings for high-carbohydrate foods C) Increased alertness and focus D) Increased glucose utilization E) Increased GI peristalsis

A, C, D

Which assessment findings of a client with an elevated temperature would be considered a "normal" finding? Select all that apply. A) Flushed skin B) White, cheesy patches on oral mucous membranes C) Pain when moving joints to sit up in bed D) Unusual fatigue and drowsiness E) Complaining of "spots before the eyes"

A, C, D

Which of the following clients have a pathophysiologic process capable of causing fever by inducing the production of pyrogens? Select all that apply. A) A farmer who cut his arm while sharpening his tools coming to clinic because of acute inflammation signs like fever and redness B) A middle-aged obese client complaining of "knees hurting and swelling by the end of the day" C) An older adult recuperating following a myocardial infarction D) A newly diagnosed Hodgkin lymphoma client E) A 30-year-old end-stage renal failure client receiving hemodialysis three times per week

A, C, D

Which of the following lab results confirm the client has developed an acute-phase inflammatory response? Select all that apply. A) Erythrocyte sedimentation rate (ESR) 175 mm/h (high). B) Red blood cell count (RBC) 3.11 cells/μL (low). C) Leukocytes (WBC) 18.7 cells/μL (high). D) C-reactive protein (CRP) 10.0 mg/L (high). E) Fibrinogen level 1.5 g/L (normal).

A, C, D

While explaining the somatosensory cortex to a group of nursing students, the instructor asks, "What is involved in the final processing of somatosensory information?" The correct response includes: Select all that apply. A) Full localization B) Autonomic nervous system C) Discrimination of intensity D) Interpretation of somatosensory stimuli E) Pacinian corpuscle receptors

A, C, D

Which of the following changes are normal in the elderly population? Select all that apply. A) The dermis and epidermis thin as one ages. B) An increase in the amount of subcutaneous tissue. C) A thickening of blood vessels. D) Increased amount of padding on the buttocks. E) Skin may become dry, rough, and scaly.

A, C, E

Which of the following changes are normal in the elderly population? Select all that apply. A. The dermis and epidermis thin as one ages. B. An increase in the amount of subcutaneous tissue. C. A thickening of blood vessels. D. Increased amount of padding on the buttocks. E. Skin may become dry, rough, and scaly.

A, C, E Normal skin changes associated with aging are seen on areas of the body that have not been exposed to the sun. They include thinning of the dermis and the epidermis, diminution in subcutaneous tissue, and a decrease and thickening of blood vessels. These result in less padding and thinner skin, with color and elasticity changes. Although the reason is poorly understood, the skin in most elderly persons older than 70 years of age becomes dry, rough, scaly, and itchy.

A client has just received the diagnosis of malignant melanoma, stage 3B. He asks the nurse what this means. The nurse should respond relaying which of the following information? Select all that apply. A) Malignant melanoma is a very rapid growing, aggressive cancer. B) This cancer usually extends wide and deep but rarely metastasize. C) This cancer is mainly contained to the head and neck area. D) Your cancer has grown into the deep tissues and quite likely into lymph nodes (stage 3B).

A, D

A client has just received the diagnosis of malignant melanoma, stage 3B. He asks the nurse what this means. The nurse should respond relaying which of the following information? Select all that apply. A. Malignant melanoma is a very rapid growing, aggressive cancer. B. This cancer usually extends wide and deep but rarely metastasize. C. This cancer is mainly contained to the head and neck area. D. Your cancer has grown into the deep tissues and quite likely into lymph nodes (stage 3B).

A, D Although melanoma represents a small subset of skin cancers, it is the most deadly. It is a rapidly progressing, metastatic form of cancer. Malignant melanomas differ in size and shape. Usually, they are slightly raised and black or brown. Borders are irregular and surfaces are uneven. Most appear to arise from preexisting nevi or new mole-like growths. There may be surrounding erythema, inflammation, and tenderness. Because most melanomas initially metastasize to regional lymph nodes, additional information may be obtained through lymph node biopsy. Consistent with other cancerous tumors, melanoma is commonly staged using the TNM (tumor, lymph node, and metastasis) staging system. Basal cell cancer usually extends wide and deep but rarely metastasizes and are most frequently seen on the head and neck, most often occurring on skin that has hair.

Atopic dermatitis can be described as: Select all that apply. A) Vesicle formation B)Oozing C)Round, erythematous papules that enlarge and coalesce D) Raised wheals with associated itching

A,B

A child has been admitted to the burn unit after pulling a pan of hot water off the stove. Given the fact that there is primarily second- and third-degree burns, the health care worker should prioritize care to focus on which of the following? Select all that apply. A) Focus on replacing fluids that have been lost from the vascular, interstitial, and cellular compartments. B) Assess for indications that the child's airway has been compromised by assessing breath sounds and voice quality. C) Maintain sterile field when doing dressing changes and debridement. D) Withhold foods/nutrition since the GI tract may have slowed down in response to stress. E) Minimize pain medication administration to not compromise the child's respiratory effort.

A,B,C

A,B,D

Which of the following would be considered functions of the skin? Select all that apply. A) Protection against physical injury B) Protection from an invasion of microbes C) Regulation of acid-base balance D) Regulation of metabolism E) Synthesis of vitamin D

A,B,E

A client is exhibiting manifestations of superficial dermatophytosis of the skin with skin scaling and nail disintegration. Based on these findings, the nurse can anticipate that the client will be prescribed: Select all that apply. A) An antifungal like ketoconazole B) An antibiotic like tetracycline C) Topical corticosteroid D) An antihistamine like Benadryl

A,C

A,C,E

A,D

A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the client's following statements demonstrates an accurate understanding of this diagnosis? Select one: A. "I suppose I should try to eat a bit more fiber in my diet." B. "From now on, I'm going to stick to an organic diet and start taking more supplements." C. "I think this might have happened because I've used enemas and laxatives too much." D. "I've always struggled with heartburn and indigestion, and I guess I shouldn't have ignored those warning signs."

A. "I suppose I should try to eat a bit more fiber in my diet."

A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be: Select one: A. "This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes." B. "If you put all your children on a low-carbohydrate diet, maybe they won't get diabetes." C. "We don't know what causes diabetes, so we will just have to wait and see." D. "Probably not since genetically your other children have a different cellular makeup, they just might not become diabetic."

A. "This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."

What will the nurse teach a mother whose child has been diagnosed with impetigo? A. "Treat the area with topical mupirocin and discourage scratching of the area." B. "Wash the area with antifungal soap." C. "Treat the area with topical corticosteroid cream." D. "Administer daily antifungal oral agents."

A. "Treat the area with topical mupirocin and discourage scratching of the area."

When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize the pathogenesis begins with an inflammatory process whereby: Select one: A. Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue. B. The pancreas is irreversibly damaged and will not recover to normal functioning (chronic). C. The pancreas will hypertrophy (enlarge) to the point of causing bowel obstruction. D. Stones will develop in the common bile duct, resulting in acute jaundice.

A. Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.

A decrease in the serum level of which of the following substances is suggestive of liver injury? Select one: A. Albumin B. Alanine aminotransferase (ALT) C. Alkaline phosphatase D. γ-Glutamyltransferase (GGT)

A. Albumin

Which of the following residents of a long-term facility is exhibiting clinical manifestations of hypothyroidism? Select one: A. An 80-year-old woman who has uncharacteristically lost her appetite and often complains of feeling cold B. A 90-year-old woman with a history of atrial fibrillation whose arrhythmia has recently become more severe C. An 88-year-old man with a history of Alzheimer disease who has become increasingly agitated and is wandering around the facility more frequently D. A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis

A. An 80-year-old woman who has uncharacteristically lost her appetite and often complains of feeling cold

Dry, itchy plaques on the elbows and knees have prompted a 23-year-old client to seek care. The health care provider has diagnosed the client with psoriasis, based on which histologic characterization? A. Increased epidermal cell turnover with marked epidermal thickening B. An IgE-mediated immune reaction C. Human papillomaviruses (HPV) swabbing D. Hormonal influences on sebaceous gland activity

A. Increased epidermal cell turnover with marked epidermal thickening

Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes? A client who: Select one: A. Is morbidly obese defined as greater than 100 pounds over ideal weight B. Was diagnosed with placenta previa early in her pregnancy C. Is gravida five (in her fifth pregnancy) D. Has BP of 130/85 mm Hg and pulse rate of 90 beats/minute

A. Is morbidly obese defined as greater than 100 pounds over ideal weight

Which of these is a characteristic of impetigo? A. Most common superficial bacterial infection B. Ringworm infection C. Heals with scars D. High fever, lymphadenopathy, abscesses

A. Most common superficial bacterial infection

The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as: Select one: A. Phagocytes B. Channels C. Filters D. Cytotoxic cells

A. Phagocytes

A liver failure client asks, "How does the liver process ammonia in healthy individuals?" The health care provider explains that ammonia is toxic to tissues, especially neurons, so this ammonia is removed from the blood by the liver, which: Select one: A. Processes it into urea, releasing it into the circulation B. Processes ammonia into nitrogen and hydrogen ions for excretion C. Combines it with oxygen to create ammonium oxide D. Converts it into bilirubin, which is then excreted intestinally

A. Processes it into urea, releasing it into the circulationA. Processes it into urea, releasing it into the circulation

Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary? Select one: A. Production of insulin-like growth factors (IGFs) by the liver B. Positive feedback of the hypothalamic-pituitary-thyroid feedback system C. Development of cartilage and bone D. Increase in overall metabolic rate and cardiovascular function

A. Production of insulin-like growth factors (IGFs) by the liver

One of the first signs that indicates an infant may have congenital hypothyroidism is: Select one: A. Prolonged period of physiologic jaundice B. Full, bounding fontanels C. Palpable mass in the neck region D. No passage of meconium within the first 72 hours after birth Feedback

A. Prolonged period of physiologic jaundice

A yeastlike Candida albicans fungal infection can be differentiated from a tinea fungal infection by the presence of which diagnostic assessment finding? A. Satellite lesions B. Circular patches C. Fungal spores D. Raised borders

A. Satellite lesions

Following the analysis of a recent barium enema and colonoscopy with biopsy, a client has been diagnosed with colorectal cancer. Which of the following treatment modalities will be the mainstay of this client's treatment? Select one: A. Surgery B. Radiation therapy C. Pharmacologic therapies D. Chemotherapy

A. Surgery

A client has sustained serious first degree, second degree, and third degree burns in a fire. Which best describes this full-thickness burn and the burned area that involves subcutaneous tissue, muscle, and bone? A. Third-degree burn B. First- and second-degree burns C. Second-degree burn D. Second- and third-degree burns

A. Third-degree burn

A 20-year-old female tells the nurse she is concerned about getting a good suntan before going on a vacation. The best response by the nurse would be: A. Use a self-tanning product that produces the appearance of a tan without sun exposure. B. Use natural sunlight without sunscreen to acquire a tan. C. Attend a tanning salon several times per week to tan evenly prior to travel. D. Use tanning pills with canthaxanthin, which is found in carrots, to help tan.

A. Use a self-tanning product that produces the appearance of a tan without sun exposure.

Explain the first stage of the hair-growth cycle.

ANAGEN PHASE- the growth stage during which new hair is produced. New keratinized cells are manufactured in the hair follicle. cells at the junction between the arrector pili muscle and the follicle grown downward and stimulate cell mitosis in the matrix. New cells form hair and root sheaths while the older part of the hair is pushed upward. Once hair has reached its full length it can remain there for weeks or years, depending on its location. The length of the anagen phase determines length of hair.

Which of the following factors is most strongly associated with the pathogenesis of gallstones?

Abnormalities or stasis of bile

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics?

Acne vulgaris

Paracrine action involves which of the following characteristics?

Act locally on cells other than those that produce the hormone

Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion?

Actinic keratosis

Which skin disorder seen in older adults is considered a premalignant lesion?

Actinic keratosis

While on tour, a 32 year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8°C (101.8°F), blood pressure 89/48 mmHg and heart rate 116 beats per minute. Blood work indicates that his serum levels of C-reactive protein, amylase and lipase are all elevated. Which of the following diagnoses would the care team suspect first?

Acute pancreatitis

Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which of the following complications?

Acute tubular necrosis

A client pulled from a burning house is transported to the emergency department of a local hospital and found to have severe burns. The nurse is aware that the client is at risk for:

Airway problems Infection Hemodynamic instability Pain Emotional stress

A decrease in the serum level of which of the following substances is suggestive of liver injury?

Albumin

Which of the following statements about the structure of the skin is correct?

All five layers of the epidermis lack a blood supply.

Which enzyme is found in the mouth and is the first to initiate the breakdown of starches?

Amylase Digestion of starch begins in the mouth with the action of amylase. Fat emulsification is influenced by bile. Protein digestion begins in the stomach with the action of pepsin and is further broken down by trypsin.

What lab study should you anticipate being ordered for a patient who is suspected to have pancreatitis?

Amylase and Lipase

When assessing the client with acute pancreatitis, which of these diagnostic tests, consistent with the disease, does the nurse anticipate will be altered?

Amylase and lipase

Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination?

An 81-year-old resident of a long-term care facility

A client is seen in the primary care office with eczema. What is the best description to include in the electronic medical record about the skin assessment?

An acute, red, itchy, vesicular crusted lesion

Which of the following individuals displays a precursor to acromegaly?

An adult with an excess of growth hormone due to an adenoma

One of the best products for extremely dry skin on the elbows would be to apply which type of dressing?

An occlusive with petroleum material mixed in the cream

A postsurgical patient's complaints of calf pain combined with the emergence of swelling and redness in the area have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this patient?

Anticoagulation therapy and elevation of the leg

Which of the following functions is performed by saliva?

Antimicrobial protection Saliva performs three roles: lubrication, antimicrobial protection, and initiation of starch digestion. Saliva does not promote the growth of intestinal flora, buffer gastric secretions, or catalyze the actions of brush border enzymes.

Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands?

Apocrine secretions contain oil

Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands?

Apocrine secretions contain oils.

A nurse is caring for a client with a stage II pressure ulcer with little exudate. Which treatment option is most appropriate for the nurse to implement for this client?

Application of semipermeable or occlusive dressing

Which of the following structures would likely be present in a hair follicle in a man's groin but not in a follicle on his face?

Aprocrine gland

Which statement concerning blood flow to the skin is true?

Arteriovenous anastomoses in the skin regulate temperature.

Acute gastritis refers to a transient inflammation of the gastric mucosa which can be caused by

Aspirin

Prolonged immobility is implicated in the development of which of the following disorders?

Atelectasis and pulmonary embolism

Coronary artery bypass grafting (CABG) is a relevant treatment modality for which of the following disorders of cardiac function?

Atherosclerosis with history of MI

The release of insulin from the pancreatic beta cells can inhibit its further release from the same cells. This is an example of which type of hormone action?

Autocrine

A 44-year-old man has been brought to the emergency department by emergency medical services with severe electrical burns resulting from a workplace accident. The most immediate threat to this patient's survival at this time is: A. infection. B. hemodynamic instability. C. acute pain. D. decreased protein synthesis & impaired healing.

A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is: A) Infection B) Hemodynamic instability C) Acute pain D) Decreased protein synthesis and impaired healing

A 79-year-old client has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize in the prevention of pressure ulcers? A) Prophylactic antibiotics B) Repositioning the client on a scheduled basis C) Applying protective dressings to vulnerable areas D) Parenteral nutrition

A 79-year-old patient has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize int eh prevention of pressure ulcers? A. Prophylactic antibiotics B Repositioning the patient on a scheduled basis C. Applying protective dressings to vulnerable areas D. Parenteral nutrition

A client asks why his temperature is always below 98.6°F. The nurse responds: A) Some people maintain a core body temperature of 41°C and that is normal for them. B) Normal core temperature varies between individuals within the range of 97.0°F to 99.5°F. C) A person's highest point of core temperature is usually first thing in the morning. D) The best way to bring your body temperature up to normal is to live in a warmer climate.

A client complains to the health care provider that he keeps getting hard skin on the sides of the great and little toes19. when he wears certain pairs of shoes. This is probably caused by ill-fitting shoes putting pressure on certain areas of the foot and would be called a: A) Blister B) Corn C) Callus D) Hematoma

A client cuts herself with a sharp knife while cooking dinner. The client describes how the wound started bleeding and had a red appearance almost immediately. The nurse knows that in the vascular stage of acute inflammation, the vessels: A) Bleed profusely until the body can compensate and start to send fibrinogen to the wound B) Vasodilate causing the area to become congested causing the red color and warmth C) Constrict as a result of "fight/flight" hormone release resulting in pale-colored skin D) Swell to the point of compromising circulation causing the limb to become cool to touch

A client presents to the emergency department following a major traffic accident. Though outwardly there are no apparent physical injuries found, the client is experiencing chest pain and heightened alertness, which the health care worker attributes to the first stage of general adaptation syndrome (GAS). The health care worker concludes the client is experiencing manifestations related to the release of: A) Aldosterone, which interferes with sodium absorption B) Epinephrine C) Too little cortisol D) Thyroid-stimulating hormone

A college student has just learned that her latest Pap smear revealed atypical cells, a fact that has resulted in stress and an accompanying release of angiotensin II. How would the effects of this hormone be objectively demonstrated? A) Increased respiratory rate B) Increased blood pressure C) Decreased oxygen saturation D) Decreased blood sugar

A febrile, 3-week-old infant has been brought to the emergency department by his parents and is currently undergoing a diagnostic workup to determine the cause of his fever. Which of the following statements best conveys the rationale for this careful examination? A) The immature hypothalamus is unable to perform normal thermoregulation. B) Infants are susceptible to serious infections because of their decreased immune function. C) Commonly used antipyretics often have no effect on the core temperature of infants. D) Fever in neonates is often evidence of a congenital disorder rather than an infection.

A nurse working at nights is constantly complaining of being tired and sick. It seems like she catches every illness that is on the unit. One possible reason for this may relate to: A) She does not contain the "hardiness" gene in her system. B) Alterations in sleep-wake cycle have decreased her immune function. C) She is stressing too much about being tired and sleepy. D) Maybe she should get tested for sleep apnea.

A student is participating in an extended fast as part of a charitable fundraising effort. Which of the following is an example of the physiologic reserve that will facilitate the student's adaptation to the stress of this sudden change in diet? A) The student has experience in demonstrating perseverance from previous participation in competitive sports. B) The student's adipose tissue contains large and accessible stores of energy. C) The student is young, is a male, and has no preexisting medical conditions. D) The student is utilizing guided imagery to achieve a sense of "mind over matter."

A teenager has just been told by the dermatologist that he is high risk for developing skin cancer since he has natural red hair and fair skin. The physiology behind this statement may be due to the: A) Oversecretion of eumelanin, a brown-black pigment that causes tans B) Enhanced photoreactivity of pheomalanin, as compared to eumelanin C) Lack of pheomelanin pigmentation, which protects against skin cancer formation D) Increased susceptibility to photosensitivity due to oversecretion of melanin

A teenager reports ugly warts that have invaded her hands. She wants them gone before prom season. The nurse will likely be explaining which of the following treatment measures to this teenager? A) How to apply steroid creams and Band-Aids B) Applying a keratolytic agent like salicylic acid C) Taking a pair of tweezers and pulling the wart off D) How to safely use cryotherapy at home

A teenager reports ugly warts that have invaded her hands. She wants them gone before prom season. The nurse will likely be explaining which of the following treatment measures to this teenager? A) How to apply steroid creams and Band-Aids B)Applying a keratolytic agent like salicylic acid C)Taking a pair of tweezers and pulling the wart off D)How to safely use cryotherapy at home

A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron? The neurons: A) Between the woman's finger and her spinal cord B) Between the thalamus and the cortex C) Between the CNS and the thalamus D) Of the efferent pathway that causes muscle contraction

A yeast-like Candida albicans fungal infection can be differentiated from a tinera fungal infection by the presence of: A. circular patches. B. satellite lesions. C. fungal spores. D. raised borders.

Allostasis is characterized by: A) Organ-specific physiologic responses B) Interactive physiologic changes in numerous systems C) Systems that detect psychological function D) Future expectations as a catalyst for change

An elderly client is dressed only in a hospital gown and complains of a draft in her room. Consequently, she has requested a warm blanket while she sits in her wheelchair. Which of the following mechanisms of heat loss is most likely the primary cause of her request? A) Evaporation and conduction B) Radiation and convection C) Conduction and convection D) Convection and evaporation

As a nurse working in the newborn nursery and intensive care unit, when an infant has been diagnosed with failure to thrive, which of the following statements about hormones' effect on the body will the nurse explain to the family? A) The catecholamine norepinephrine is primarily responsible for the failure to thrive. B) CRF increases somatostatin levels, which inhibits secretion of growth hormone. C) ACTH release from the pituitary causes babies to not gain weight. D) Antidiuretic hormone is involved in the stress response and can increase water retention.

Due to the increasing dryness of her skin in recent years, a 70-year-old woman has needed to reduce the number of baths that she takes. Which of the following factors has resulted in this age-related change in skin function? A) Slower keratinization B) Changes in sebaceous secretions C) Dehydration of epidermal cells D) Increased production of bile salts

Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to the release of endogenous pyrogens that: A) Stabilize thermal control in the brain B) Produce leukocytosis and shivering C) Block viral replication in cells D) Inhibit prostaglandin release

Nociceptors are sensory receptors that are activated by: A) Cortisol B) Noxious stimuli C) Pressure and touch D) Sudden movements

Stretch-sensitive receptors in the skin (Ruffini end organs, Pacinian corpuscles, and Merkel cells) help signal postural information and are processed through the: A) Third-order neurons B) Dorsal column-medial lemniscus pathway C) Anterolateral pathway D) Posterior column of the spinal cord

The client recently returned from a year of military battle duty and has posttraumatic stress disorder (PTSD). This disorder includes an "intrusion" state that is experienced as: A) Excessive anxiety and safety concerns B) Repeated relived memories as nightmares C) Loss of concentration and increased vigilance D) Emotional numbing and feelings of depression

Warts develop when _____ are invaded by human papillomavirus (HPV). A. melanocytes B. keratinocytes C. sebaceous glands D. subcutaneous cells

When asked to name the parts of the pilosebaceous unit of the skin, which student has the correct answer? A)Eccrine secretions B)Sebaceous glands C)Keratinized plates D) Connective tissues

When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin? A) Laminim B) Tyrosinase C) Bradykinin D) Pheomalanin

Which of the following clients is most likely to be susceptible to developing a neurogenic fever? A client who has: A) Stage II Alzheimer disease B) Sustained a head injury in a bicycle crash C) Become delirious after the administration of a benzodiazepine D) Begun taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression

Which of the following clients may be experiencing the effects of neuropathic pain? A) A girl whose playground accident resulted in an arm fracture B) A man with pain secondary to his poorly controlled diabetes C) An elderly woman with a stage III pressure ulcer D) A man whose pain is caused by gastric cancer

Which of the following clients would be predisposed to developing a yeast-like Candida albicans fungal infection? A) A diabetic male child with circular patches on the arms B) An immunosuppressed cancer client with maculopapular satellite lesions C) A high school football player with fungal spores cultured on the feet D) A dance instructor with a rash on the hands described as raised borders

Which of the following clients would experience an accelerated rate of cell division in the stratum germinativum layer? A) A stroke client who is incontinent of stool and bladder B) A motorcycle accident client with large abrasions on the lower limbs C) A young athlete who experienced a torn cartilage in the knee D) A pregnant client who has developed dark purple stretch marks on the abdomen

Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer? A) Opioids should be avoided in order to prevent liver and kidney insult. B) Dosing and timing should aim for a steady serum level of the prescribed drug. C) Doses of analgesia should be given only when the client's pain becomes severe. D) Drugs from numerous classifications should be used to maximize pain control.

Which of the following skin disorders seen in elderly persons is considered a premalignant lesion? A. Cherry angiomas B. Actinic keratosis C. Solar lentigines D. Telangiectases

Which of the following statements about temperature regulation and skin is accurate? A) Since the skin is avascular, it is the subcutaneous layer that primarily is responsible for temperature control. B) Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation. C) It is primarily the arteries that bring blood from the heart that keeps the body temperature within a normal range. D) The lymphatic system of the skin is primarily responsible for heating and cooling the skin.

Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion? A) Cherry angiomas B) Actinic keratosis C) Solar lentigines D) Telangiectases

While playing outside in the snow, a young child complained of painful fingertips since he would not keep his gloves on. In the emergency department, the nurse knows this painful sensation is a result of which transmission of proprioceptive somatosensory information? A) Reflexive networks B) Type C dorsal root ganglion neurons C) Anterolateral pathway D) Myelinated type B trigeminal sensory neurons

While sponging a client who has a high temperature, the nurse observes the client begins to shiver. At this point, the priority nursing intervention would be to: A) Administer an extra dose of aspirin B) Stop sponging the client and retake a set of vital signs C) Increase the room temperature by turning off the air conditioner and continue sponging the client with warmer water D) Place a heated electric blanket on the client's bed

Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion? A. Cherry angiomas B. Actinic keratosis C. Solar lentigines D. Telangiectases

B Actinic keratoses are the most common premalignant skin lesions that develop on sun-exposed areas. Solar lentigines are tan to brown, benign spots on sun-exposed areas. They are commonly referred to as liver spots. Senile angiomas (cherry angiomas) are smooth, cherry-red or purple, dome-shaped papules, usually found on the trunk. Telangiectases are single dilated blood vessels, capillaries, or terminal arteries that appear on areas exposed to sun or harsh weather, such as the cheeks and the nose.

A 79-year-old client has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize in the prevention of pressure ulcers? A. Prophylactic antibiotics B. Repositioning the client on a scheduled basis C. Applying protective dressings to vulnerable areas D. Parenteral nutrition

B Although adequate nutrition is important in both the prevention and treatment of pressure ulcers, the most important intervention is to prevent pressure and ischemia. This can be accomplished by frequently repositioning the client. Prophylactic antibiotics are not commonly used, and dressings are not normally required unless skin breakdown is evident.

A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is: A. Infection B. Hemodynamic instability C. Acute pain D. Decreased protein synthesis and impaired healing

B Although infection and the potential for sepsis are highly significant risks for clients with burns, the most immediate threat is hemodynamic instability. Pain control is essential, but inadequate pain control does not pose a direct threat to survival. The healing process is a later priority.

When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin? A. Laminim B. Tyrosinase C. Bradykinin D. Pheomalanin

B Although there are more than 10 different types of albinism, the most common type is recessively inherited oculocutaneous albinism, in which there is a normal number of melanocytes, but they lack tyrosinase, the enzyme needed for synthesis of melanin. The lamina lucida consists of fine anchoring filaments and a cell adhesion glycoprotein, called laminin, which plays a role in the organization of the macromolecules in the basement membrane zone and promotes attachment of cells to the extracellular matrix. Many chemicals have been found to produce the itch sensation, including histamine, serotonin, and cytokines. Substances such as bradykinin and bile salts act locally to stimulate the itch sensation. Localized concentrations of eumelanin are also responsible for the formation of freckles and moles. Pheomelanin, a reddish yellow pigment, is particularly concentrated in the lips, nipples, glans penis, and vagina.

A client complains to the health care provider that he keeps getting hard skin on the sides of the great and little toes when he wears certain pairs of shoes. This is probably caused by ill-fitting shoes putting pressure on certain areas of the foot and would be called a: A. Blister B. Corn C. Callus D. Hematoma

B Corns (helomas) are small, well-circumscribed, conical, keratinous thickenings of the skin. They usually appear on the toes from rubbing or ill-fitting shoes. The corn may be either hard (heloma durum) with a central hard, horny core or soft (heloma molle), as commonly seen between the toes. Blisters are circumscribed elevations of the skin caused by fluid under or within the epidermis. A callus is a hyperkeratotic plaque of skin that develops because of chronic pressure or friction. Hematomas are a mass of blood caused by a break in a blood vessel under the skin.

Which of the following clients would be predisposed to developing a yeast-like Candida albicans fungal infection? A. A diabetic male child with circular patches on the arms B. An immunosuppressed cancer client with maculopapular satellite lesions C. A high school football player with fungal spores cultured on the feet D. A dance instructor with a rash on the hands described as raised borders

B In addition to microscopic analysis of skin scrapings for tinea fungal spores, a candidal infection often can be differentiated from a tinea infection by the presence of maculopapular satellite lesions found outside the clearly demarcated borders. Some persons are predisposed to candidal infections by conditions such as diabetes mellitus, antibiotic therapy, pregnancy, oral contraceptive use, poor nutrition, and immunosuppressive diseases. The most common types of tinea lesions are oval or circular patches with raised red borders consisting of vesicles, papules, or pustules on exposed skin surfaces.

When asked to name the parts of the pilosebaceous unit of the skin, which student has the correct answer? A. Eccrine secretions B. Sebaceous glands C. Keratinized plates D. Connective tissues

B Most hair follicles are associated with sebaceous glands, and these structures combine to form the pilosebaceous unit. The nails are hardened keratinized plates. Eccrine sweat glands transport sweat to the outer skin surface to regulate body temperature. The subcutaneous tissue layer consists primarily of fat and connective tissues that lend support to the vascular and neural structures supplying the outer layers of the skin.

Which of the following clients would experience an accelerated rate of cell division in the stratum germinativum layer? A. A stroke client who is incontinent of stool and bladder B. A motorcycle accident client with large abrasions on the lower limbs C. A young athlete who experienced a torn cartilage in the knee D. A pregnant client who has developed dark purple stretch marks on the abdomen

B The deepest layer, the stratum germinativum, consists of a single layer of basal cells that are attached to the basal lamina in the basement membrane zone. The basal cells are the only epidermal cells that are mitotically active. It normally takes 3 to 4 weeks for the epidermis to replicate itself. The rate of cell division in the stratum germinativum is greatly accelerated when the outer layers of the epidermis are stripped away as occurs in abrasions and burns. The outer epidermis, which is avascular, is composed of four to five layers of stratified squamous epithelial cells, predominantly keratinocytes, which are formed in the deepest layer of the epidermis and migrate to the skin surface to replace cells that are lost during normal skin shedding. These are most affected by incontinence. Stretch marks are similar to stratum granulosum cells that have a dark staining granule of keratohyalin.

Due to the increasing dryness of her skin in recent years, a 70-year-old woman has needed to reduce the number of baths that she takes. Which of the following factors has resulted in this age-related change in skin function? A. Slower keratinization B. Changes in sebaceous secretions C. Dehydration of epidermal cells D. Increased production of bile salts

B The effects of aging on skin dryness include a change in the composition of sebaceous gland secretions and a decrease in the secretion of moisture from the sweat glands. Changes in the composition of keratinocytes and the process of keratinization do not account for the drier skin that accompanies aging. Deposition of bile salts on the skin surface causes pruritus and dry skin, but this is a pathologic process rather than an age-related change.

Which of the following statements about temperature regulation and skin is accurate? A. Since the skin is avascular, it is the subcutaneous layer that primarily is responsible for temperature control. B. Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation. C. It is primarily the arteries that bring blood from the heart that keeps the body temperature within a normal range. D. The lymphatic system of the skin is primarily responsible for heating and cooling the skin.

B The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. These anastomoses are important for temperature regulation. The lymphatic system of the skin, which aids in combating certain skin infections, also is limited to the dermis.

A teenager has just been told by the dermatologist that he is high risk for developing skin cancer since he has natural red hair and fair skin. The physiology behind this statement may be due to the: A. Oversecretion of eumelanin, a brown-black pigment that causes tans B. Enhanced photoreactivity of pheomalanin, as compared to eumelanin C. Lack of pheomelanin pigmentation, which protects against skin cancer formation D. Increased susceptibility to photosensitivity due to oversecretion of melanin

B There are two major forms of melanin: eumelanin and pheomelanin. Exposure to the sun's ultraviolet rays increases the production of eumelanin, a brownish black pigment, which causes tanning to occur. An enhanced photoreactivity of the red melanin, pheomelanin, compared to the black melanin, eumelanin, is commonly invoked to explain why fair-skinned individuals are more susceptible to skin cancers. The primary function of such melanin is to protect the skin by absorbing and scattering harmful ultraviolet rays, which are implicated in skin cancers. Localized concentrations of eumelanin are responsible for the formation of freckles and moles. This does not mean that they will develop skin cancer. Pheomelanin, a reddish yellow pigment, provides color to the body when it is concentrated, primarily in the lips, nipples, glans penis, and vaginal areas. Photosensitivity refers to abnormal sensitivity (not reactivity) of the skin to ultraviolet light, usually following exposure to certain oral or topical drugs or to other sensitizing chemicals and resulting in accelerated burning and blistering of the skin. Both types of melanin are found in hair, particularly red hair. It has been suggested that the reason fair-haired individuals are more susceptible to skin cancers may be due to the enhanced photoreactivity of pheomelanin, as compared to eumelanin.

A teenager reports ugly warts that have invaded her hands. She wants them gone before prom season. The nurse will likely be explaining which of the following treatment measures to this teenager? A. How to apply steroid creams and Band-Aids B. Applying a keratolytic agent like salicylic acid C. Taking a pair of tweezers and pulling the wart off D. How to safely use cryotherapy at home

B Verrucae, or warts, are common, benign papillomas caused by DNA-containing human papillomavirus (HPV) that invade the superficial skin keratinocytes. Removal is usually done by applying a keratolytic agent, such as salicylic acid, which works by dissolving intercellular cement and producing desquamation of the horny layer of skin without affecting normal epidermal cells. Steroid creams will not help with removal of a wart. Pulling the wart off is not recommended. Cryotherapy may be needed, but this is performed in a doctor's office.

The nurse caring for a client with a malignant melanoma should prepare the client for which prescribed treatment measures? Select all that apply. A. Cosmetic surgery to remove the mole without leaving a scar B. Biologic chemotherapy with interferon alfa-2B C. Surgical excision with lymph node biopsy D. Immediate radiation therapy to shrink the tumors

B and C

Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis? A) "Have you recently begun a new sexual relationship?" B) "Have you been on antibiotics recently?" C) "Have you noticed any new growths on your vagina in recent months?" D) "Do you use condoms during sexual activity?"

B) "Have you been on antibiotics recently?"

Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis? A) A 55-year-old man who takes proton pump inhibitors for the treatment of peptic ulcers B) A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics C) A premature neonate who has developed hyperbilirubinemia and is receiving phototherapy D) A 30-year-old patient who has a history of Crohn disease and has been admitted to a hospital to treat a recent flare-up

B) A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics

Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which of the following complications? A) Cerebral hemorrhage B) Acute tubular necrosis C) Bilateral pneumothorax D) Complete heart block

B) Acute tubular necrosis

A decrease in the serum level of which of the following substances is suggestive of liver injury? A) γ-Glutamyltransferase (GGT) B) Albumin C) Alanine aminotransferase (ALT) D) Alkaline phosphatase

B) Albumin

Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer? A) Heartburn after an individual consumes high-fat meals B) Dysphagia in an individual with no history of neurologic disease C) A new onset of gastroesophageal reflux in a previously healthy individual D) Recurrent episodes of gastritis that do not respond to changes in diet

B) Dysphagia in an individual with no history of neurologic disease

As with other ulcerative sexually transmitted infections (STIs), genital herpes (herpes simplex virus type 2, HSV-2) increases the risk of: A) cervical cancer. B) HIV transmission. C) localized necrosis. D) urinary tract infection.

B) HIV transmission.

An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this patient's decline in health? A) A mismatch between bone resorption and remodeling B) Immunologically mediated joint inflammation C) Excessive collagen production and deposition D) Cytokine release following mechanical joint injury

B) Immunologically mediated joint inflammation

A 55-year-old male patient has reported joint pain in his feet. Which of the following blood work results should prompt further testing to rule out primary gout? A) Increased C-reactive protein (CRP) B) Increased serum uric acid C) Increased polymorphonuclear leukocytes D) Increased serum cortisol

B) Increased serum uric acid

Which of the following signs and symptoms should prompt a 29-year-old woman's primary care provider to assess for systemic lupus erythematosus (SLE)? A) Chronic nausea and vomiting that is unresponsive to antiemetics B) Joint pain and increased creatinine and blood urea nitrogen C) A history of thromboembolic events and varicose veins D) Dysmenorrhea and recent spontaneous abortion

B) Joint pain and increased creatinine and blood urea nitrogen

Which of the following processes occurs in the pathophysiology of infection by herpes simplex virus (HSV)? A) Replication of the squamous epithelium B) Periods of latency in the nervous system C) Inhibition of cell-mediated immunity D) Production of exotoxins

B) Periods of latency in the nervous system

A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which of the following manifestations related to the necrosis of liver cells? A) Tremors of the hands B) Rapid onset of jaundice C) Long muscle group atrophy D) Development of multiple skin nodules

B) Rapid onset of jaundice

Both prehepatic and posthepatic causes of portal hypertension include the formation of: A) Fibrous nodules B) Venous thrombosis C) Collateral circulation D) Portosystemic shunts

B) Venous thrombosis

For many patients, the first indication that they have osteoporosis is: A) bone pain that is not alleviated by rest. B) a bone fracture. C) craving high-calcium foods. D) decreased range of motion in the hip and knee joints.

B) a bone fracture.

Acute pancreatitis involves activated pancreatic enzymes that escape into surrounding tissues to cause _______. A) fatty deposits B) autodigestion C) bowel obstruction D) abscess formation

B) autodigestion

Human papillomavirus (HPV) infection is directly associated with: A) testicular cancer. B) cervical dysplasia. C) genital herpes lesions. D) urinary tract infections.

B) cervical dysplasia.

In contrast to structural scoliosis, postural scoliosis: A) compresses vertebrae. B) corrects with bending. C) is apparent at birth. D) becomes painful.

B) corrects with bending.

A serious complication of chlamydial infections in women is: A) uterine cancer. B) fallopian tube damage. C) amenorrhea. D) nongonococcal urethritis.

B) fallopian tube damage.

The vaginal discharge characteristic of trichomoniasis is described as: A) thick cheesy. B) frothy green. cC) fishy smelling. D) mucopurulent.

B) frothy green.

In men, urethral pain and a creamy yellow, bloody discharge from the penis is characteristic of the sexually transmitted infection: A) candidiasis. B) gonorrhea. C) chancroid. D) trichomoniasis.

B) gonorrhea.

In order to initiate the cellular events essential to bone healing, there must be ________ formation at the fracture site. A) callous B) hematoma C) ossification D) fibrin meshwork

B) hematoma

Rheumatoid arthritis is a systemic inflammatory disease with joint manifestations described as: A) dysplasia. B) polyarticular. C) asymmetrical. D) osteophytes.

B) polyarticular.

As a protective measure to keep abdominal inflammation and infection localized, the peritoneum: A) constricts bowel contents. B) secretes fibrous exudate. C) increases intestinal motility. D) abdominal vasoconstriction.

B) secretes fibrous exudate.

The Helicobacter pylori protobacteria cause peptic ulceration by producing: A) acids B) toxins C) ischemia D) bleeding

B) toxins

The most likely vaginal infection to be spread through sexual contact is: A) candidiasis. B) trichomoniasis. C) vulvovaginitis. D) bacterial vaginosis.

B) trichomoniasis.

Both prehepatic and posthepatic causes of portal hypertension include the formation of: A) fibrous nodules. B) venous thrombosis. C) collateral circulation. D) portosystemic shunts.

B) venous thrombosis.

A pathologic stress fracture occurs in bones subjected to: A) sudden direct force. B) weakening by disease. C) repeated excessive use. D) massive muscle contraction.

B) weakening by disease.

13. Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis?

B) A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics

2. Which of the following clients would experience an accelerated rate of cell division in the stratum germinativum layer? A) A stroke client who is incontinent of stool and bladder B) A motorcycle accident client with large abrasions on the lower limbs C) A young athlete who experienced a torn cartilage in the knee D) A pregnant client who has developed dark purple stretch marks on the abdomen

B) A motorcycle accident client with large abrasions on the lower limbs

25. Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion? A) Cherry angiomas B) Actinic keratosis C) Solar lentigines D) Telangiectases

B) Actinic keratosis

3. Which of the following clients would be predisposed to developing a yeast-like Candida albicans fungal infection? A) A diabetic male child with circular patches on the arms B) An immunosuppressed cancer client with maculopapular satellite lesions C) A high school football player with fungal spores cultured on the feet D) A dance instructor with a rash on the hands described as raised borders

B) An immunosuppressed cancer client with maculopapular satellite lesions

4. A teenager reports ugly warts that have invaded her hands. She wants them gone before prom season. The nurse will likely be explaining which of the following treatment measures to this teenager? A) How to apply steroid creams and Band-Aids B) Applying a keratolytic agent like salicylic acid C) Taking a pair of tweezers and pulling the wart off D) How to safely use cryotherapy at home

B) Applying a keratolytic agent like salicylic acid

7. Which of the following statements about temperature regulation and skin is accurate? A) Since the skin is avascular, it is the subcutaneous layer that primarily is responsible for temperature control. B) Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation. C) It is primarily the arteries that bring blood from the heart that keeps the body temperature within a normal range. D) The lymphatic system of the skin is primarily responsible for heating and cooling the skin.

B) Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation.

23. Due to the increasing dryness of her skin in recent years, a 70-year-old woman has needed to reduce the number of baths that she takes. Which of the following factors has resulted in this age-related change in skin function? A) Slower keratinization B) Changes in sebaceous secretions C) Dehydration of epidermal cells D) Increased production of bile salts

B) Changes in sebaceous secretions

19. A client complains to the health care provider that he keeps getting hard skin on the sides of the great and little toes when he wears certain pairs of shoes. This is probably caused by ill-fitting shoes putting pressure on certain areas of the foot and would be called a: A) Blister B) Corn C) Callus D) Hematoma

B) Corn

11. Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer?

B) Dysphagia in an individual with no history of neurologic disease

5. A teenager has just been told by the dermatologist that he is high risk for developing skin cancer since he has natural red hair and fair skin. The physiology behind this statement may be due to the: A) Oversecretion of eumelanin, a brown-black pigment that causes tans B) Enhanced photoreactivity of pheomalanin, as compared to eumelanin C) Lack of pheomelanin pigmentation, which protects against skin cancer formation D) Increased susceptibility to photosensitivity due to oversecretion of melanin

B) Enhanced photoreactivity of pheomalanin, as compared to eumelanin

6. A teenager with rosacea should be educated that in addition to the "blush appearance" on the face, she should also assess for which of the following additional complications? Select all that apply. A) Inflamed and tender axillary lymph nodes B) Eye problems C) Edema of the eyelids D) Large abscesses on the upper arms and neck

B) Eye problems C) Edema of the eyelids

14. A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is: A) Infection B) Hemodynamic instability C) Acute pain D) Decreased protein synthesis and impaired healing

B) Hemodynamic instability

18. A 79-year-old client has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize in the prevention of pressure ulcers? A) Prophylactic antibiotics B) Repositioning the client on a scheduled basis C) Applying protective dressings to vulnerable areas D) Parenteral nutrition

B) Repositioning the client on a scheduled basis

22. Following a camping trip, a client returns with multiple "bug bites" and skin rashes. The nurse should encourage which of the following interventions to decrease pruritus to prevent further spread of the rashes? Select all that apply. A) Obtain a prescription for opioids, so the client can sleep uninterrupted. B) Rub areas with the hand rather than using long fingernails. C) Take lots of very warm, soothing oatmeal baths. D) Use topical corticosteroid creams. E) Take antihistamines like Benadryl, especially at bedtime.

B) Rub areas with the hand rather than using long fingernails. D) Use topical corticosteroid creams. E) Take antihistamines like Benadryl, especially at bedtime.

11. When asked to name the parts of the pilosebaceous unit of the skin, which student has the correct answer? A) Eccrine secretions B) Sebaceous glands C) Keratinized plates D) Connective tissues

B) Sebaceous glands

When asking pathophysiology students, "Why do sebaceous glands secrete sebum?" the student with the correct answer would be: A)To supply a nutritional source for vitamin D B) To lubricate skin and hair C)To supply energy in the form of fibrous protein D)To increase water amounts released via perspiration

B) To lubricate skin and hair

20. When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin? A) Laminim B) Tyrosinase C) Bradykinin D) Pheomalanin

B) Tyrosinase

10. As a protective measure to keep abdominal inflammation and infection localized, the peritoneum:

B) secretes fibrous exudate.

3. The Helicobacter pylori protobacteria cause peptic ulceration by producing:

B) toxins

The patient chews an apple and starts the three phases of swallowing. As food enters the patient's esophagus, stretching and _____ nerve impulses initiate _______ that are controlled by the swallowing center. A) phrenic; gag reflexes B) vagus; peristaltic waves C) hypoglossal; contractions D) trigeminal; tactile receptors

B) vagus; peristaltic waves

A teenager with bullous pemphigoid on the thighs asks, "What causes this blistering?" The best response by the nurse would be: A)"The lymph vessels are inflamed and responsible for this enlargement." B)"Your body has developed antibodies against basement membrane proteins." C)"You have been eating too much candy with large amounts of triglycerides." D)"The contraction of your arrector pili muscles causes this."

B)"Your body has developed antibodies against basement membrane proteins."

A skin care consultant informs the client that he needs to bath and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that A)Cells of the stratum spinosum will turn into prickle cells if not removed by bathing. B)A basal cell is mitotically active and pushes older dead cells to the skin's surface. C)All layers of epidermis undergo rapid mitosis. D)Keratinocytes will turn to fibrous protein tissue if not removed by bathing.

B)A basal cell is mitotically active and pushes older dead cells to the skin's surface.

Which of the following clients would experience an accelerated rate of cell division in the stratum germinativum layer? A)A young athlete who experienced a torn cartilage in the knee B)A motorcycle accident client with large abrasions on the lower limbs C)A stroke client who is incontinent of stool and bladder D)A pregnant client who has developed dark purple stretch marks on the abdomen

B)A motorcycle accident client with large abrasions on the lower limbs

Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands? A)Apocrine glands are primarily thermoregulatory. B)Apocrine secretions contain oils. C)Apocrine glands are more numerous and widely distributed than eccrine glands. D)Apocrine secretions help maintain skin pH.

B)Apocrine secretions contain oils.

The nurse caring for a client with a malignant melanoma should prepare the client for which of the following treatments? Select all that apply. A)Cosmetic surgery to remove the mole without leaving a scar B)Biologic therapy with interferon alfa-2B C)Immediate radiation therapy to shrink the tumors D)Surgical excision with lymph node biopsy

B)Biologic therapy with interferon alfa-2B D)Surgical excision with lymph node biopsy

While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist diagnoses this as: A)Vesicle B)Bullae C)Nodule D)Wheal

B)Bullae

A teenager with rosacea should be educated that in addition to the "blush appearance" on the face, she should also assess for which of the following additional complications? Select all that apply. A)Inflamed and tender axillary lymph nodes B)Eye problems C)Edema of the eyelids D)Large abscesses on the upper arms and neck

B)Eye problems C)Edema of the eyelids

A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is: A)Acute pain B)Hemodynamic instability C)Infection D)Decreased protein synthesis and impaired healing

B)Hemodynamic instability

Which of the following would be considered functions of the skin? Select all that apply. A)Regulation of acid-base balance B)Protection against physical injury C)Protection from an invasion of microbes D)Regulation of metabolism E) Synthesis of vitamin D

B)Protection against physical injury C)Protection from an invasion of microbes E) Synthesis of vitamin D

Which of the following actions could result in pressure ulcer formation? A)Applying powder to buttocks area when diaphoresis has become a problem B)Pulling a stroke client up in bed C)Turning a client from side to side every 2 hours D)Allowing a client to side up in a chair at mealtime

B)Pulling a stroke client up in bed

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by: A)Granular scabbing B)Scaling papules C)Raised red borders D)Nodular ulcerations

B)Scaling papules

Following a camping trip, a client returns with multiple "bug bites" and skin rashes. The nurse should encourage which of the following interventions to decrease pruritus to prevent further spread of the rashes? Select all that apply. A)Obtain a prescription for opioids, so the client can sleep uninterrupted. B)Take antihistamines like Benadryl, especially at bedtime. C)Take lots of very warm, soothing oatmeal baths. D)Rub areas with the hand rather than using long fingernails. E)Use topical corticosteroid creams.

B)Take antihistamines like Benadryl, especially at bedtime. D)Rub areas with the hand rather than using long fingernails. E)Use topical corticosteroid creams.

Which of the following skin disorders is likely to result from the localized lack of melanin production by melanocytes? A)Bullae B)Vitiligo C)Melasma D)Rash

B)Vitiligo

A client who has had a spinal injury now has sensory changes on the distal forearm and fourth and fifth fingers. The nurse can predict that this client has experienced an injury to the: Select all that apply. A) Cervical (C) 7 B) Cervical (C) 8 C) Thoracic (T) 1 dorsal root D) Thoracic (T) 2 dorsal root

B, C

A teenager with rosacea should be educated that in addition to the "blush appearance" on the face, she should also assess for which of the following additional complications? Select all that apply. A) Inflamed and tender axillary lymph nodes B) Eye problems C) Edema of the eyelids D) Large abscesses on the upper arms and neck

B, C

A teenager with rosacea should be educated that in addition to the "blush appearance" on the face, she should also assess for which of the following additional complications? Select all that apply. A. Inflamed and tender axillary lymph nodes B. Eye problems C. Edema of the eyelids D. Large abscesses on the upper arms and neck

B, C Rosacea is a chronic skin disorder of middle-aged and older persons. The blush eventually becomes a permanent, dark-red erythema on the nose and cheeks that sometimes extends to the forehead and chin. Ocular problems occur in at least 50% of persons with rosacea. Prominent symptoms include eyes that are itchy, burning, or dry; a gritty or foreign body sensation; and erythema and swelling of the eyelid. Acne conglobata occurs later in life as a severe, chronic form of acne. Comedones, papules, pustules, nodules, abscesses, cysts, and scars occur on the back, buttocks, and chest. Lesions occur to a lesser extent on the abdomen, shoulders, neck, face, upper arms, and thighs. The comedones or cysts have multiple openings, large abscesses, and interconnecting sinuses.

A client with chronic low back pain presents to the clinic. In addition to a detailed pain assessment, which of the following questions would be appropriate to ask? Select all that apply. A) "Do you have trouble making water?" B) "Can you financially afford your medicine?" C) "What kind of stressors are you experiencing?" D) "Do you consider yourself a good driver?" E) "Are you having trouble sleeping?"

B, C, E

A client with trigeminal neuralgia usually complains of excruciating pain. Which of the following activities may trigger an acute pain attack? Select all that may apply. A) Brushing the teeth with lukewarm water B) Working in the office that has an air duct located directly overhead C) One's significant other lightly stroking their face D) Applying lipstick E) Walking outside on a windy day

B, C, E

A client is being seen in the dermatology clinic for a follow-up appointment for a second-degree full-thickness burn. What are characteristics of second-degree burns? Select all that apply. A. No edema B. Mottled, pink red C. Blistered D. Painful

B, C, and D

Which of the following clients will be more able to adapt to a stressor based on an individual's ability to adapt? Select all that apply. A) A Muslim male experiencing abnormal GI bleeding B) An infant with decreased water intake due to diarrhea C) A child living in a crowded apartment with his financially poor, immediate family D) A male client producing increased corticotropin-releasing factor (CRF) E) A client with known CAD, expressing problems affording all his prescribed medication

B, D, E

Following a camping trip, a client returns with multiple "bug bites" and skin rashes. The nurse should encourage which of the following interventions to decrease pruritus to prevent further spread of the rashes? Select all that apply. A. Obtain a prescription for opioids, so the client can sleep uninterrupted. B. Rub areas with the hand rather than using long fingernails. C. Take lots of very warm, soothing oatmeal baths. D. Use topical corticosteroid creams. E. Take antihistamines like Benadryl, especially at bedtime.

B, D, E Pruritus, or the unpleasant sensation of itch, is a symptom common to many skin disorders leading to the desire to scratch. Measures such as using the entire hand to rub over large areas and keeping the fingernails trimmed often can relieve itch and prevent skin damage. Self-limited or seasonal cases of pruritus may respond to treatment measures such as moisturizing lotions, bath oils, and the use of humidifiers. Because vasodilation tends to increase itching, cold applications may provide relief. Cool showers before bed, light sleepwear, and cool home temperatures also may be helpful. Mild cutaneous disorders, such as bug bites, are mediated by histamine; therefore, topical antihistamines tend to be the treatment of choice. Topical corticosteroids are effective as antipruritics, particularly when used for urticaria (hives) or insect bites. Opioids are for pain control and not itching. Very warm baths would increase the itching rather than decrease it.

B,C

Which of the following factors is most strongly associated with the pathogenesis of gallstones? Select one: A. Excess serum ammonia and urea levels B. Abnormalities or stasis of bile C. Portal hypertension D. High-cholesterol diet

B. Abnormalities or stasis of bile

A teenager reports ugly warts that have invaded her hands. She wants them gone before prom season. The nurse will likely be explaining which of the following treatment measures to this teenager?

B. Applying a keratolytic agent like salicylic acid

While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist diagnoses this as:

B. Bullae

A client comes to the OB/GYN clinic complaining of difficulty in emptying the bladder and frequency and urgency of urination. After examination, the health care provider will likely diagnose:

B. Cystocele

Which factor is most protective against squamous cell carcinomas? A. Lack of family history B. Dark skin color C. Under 50 years of age D. Male gender

B. Dark skin color

A client tells his health care provider that his body is changing. It used to be normal for his blood glucose to be higher during the latter part of the morning. However, now his fasting blood glucose level is elevated in the early AM (07:00). The health care provider recognizes the client may be experiencing: Select one: A. Somogyi effect B. Dawn phenomenon C. Possible stress-related hypoglycemia D. Hyperglycemic hyperosmolar state (HHS)

B. Dawn phenomenon

A teenager who has a history of achalasia will likely complain of which of the following clinical manifestations? Select one: A. Excessive heartburn following a high-fat meal of French fries B. Feeling like there is food stuck in the back of the throat C. Vomiting large amounts of bright red emesis D. Projectile vomiting across the room unrelated to meals

B. Feeling like there is food stuck in the back of the throat

While trying to explain the physiology behind type 2 diabetes to a group of nursing students, the instructor will mention which of the following accurate information? Select one: A. The destruction of beta cells and absolute lack of insulin in people with type 2 diabetes means that they are particularly prone to the development of diabetic complication. B. In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance. C. Because of the loss of insulin response, all people with type 2 diabetes require exogenous insulin replacement to control blood glucose levels. D. They have increased predisposition to other autoimmune disorders such as Graves disease, rheumatoid arthritis, and Addison disease.

B. In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance.

A client has been diagnosed with nevus with architectural disorder with cytologic atypia (former known as dysplastic nevus). Because of the large size of the nevi, the nurse will educate this client on which priority topic? A. Transmitted by physical contact B. Increased risk for melanoma C. Easily becomes infected with pustules D. Frequent bleeding if touches fabric

B. Increased risk for melanoma

A 60-year-old male client has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment? Select one: A. Promoting hypertrophy of the gastric mucosa B. Inhibiting gastric acid production C. Increasing muscle tone of the cardiac sphincter D. Increasing the rate of gastric emptying

B. Inhibiting gastric acid production

The iatrogenic form of Cushing syndrome is caused by: Select one: A. Benign or malignant adrenal tumor B. Long-term cortisone therapy C. Pituitary tumor secreting ACTH D. Ectopic ACTH-secreting lung tumor

B. Long-term cortisone therapy

The nurse is assessing an Asian client who presents with pigmented birthmarks on the buttocks and sacral area. The nurse would document this assessment as: A. Rosacea B. Mongolian spots C. Hemangiomas D. Nevi

B. Mongolian spots

The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which of the following signs/symptoms? Select one: A. Complaints of muscle fatigue B. Ophthalmopathy C. Facial myxedema with puffy eyelids D. Pulse rate of 64 beats/minute

B. Ophthalmopathy

A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience? Select one: A. Posthepatic B. Prehepatic C. Intrahepatic D. Infectious

B. Prehepatic

A hospital client with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin? Select one: A. Promotion of gluconeogenesis B. Promotion of glucose uptake by target cells C. Initiation of glycogenolysis D. Promotion of fat breakdown

B. Promotion of glucose uptake by target cells

Which nursing intervention involves the greatest risk of skin shearing? A. Rolling the client from a supine to side-lying position B. Pulling the client up in bed C. Helping the client ambulate after surgery D. Inserting a peripheral intravenous catheter

B. Pulling the client up in bed

An adult client has a large number of nevi on her neck and back. How should the nurse best interpret this assessment finding? A. Each nevi must be biopsied before any conclusions can be drawn B. The nevi are likely benign, unless they are undergoing changes C. The client's risk of skin cancer is proportionate to the number of nevi D. The appearance of large number of nevi is an expected, age-related change

B. The nevi are likely benign, unless they are undergoing changes

Both prehepatic and posthepatic causes of portal hypertension include the formation of: Select one: A. Collateral circulation B. Venous thrombosis C. Fibrous nodules D. Portosystemic shunts

B. Venous thrombosis

Following a camping trip, a client returns with multiple "bug bites" and skin rashes. The nurse should encourage which of the following interventions to decrease pruritus to prevent further spread of the rashes? Select all that apply. A) Obtain a prescription for opioids, so the client can sleep uninterrupted. B) Rub areas with the hand rather than using long fingernails. C) Take lots of very warm, soothing oatmeal baths. D) Use topical corticosteroid creams. E) Take antihistamines like Benadryl, especially at bedtime.

B<D<E

A client is being seen in the dermatology clinic for an infectious skin disorder. What does the nurse know are causes of infectious skin disorders? Select all that apply.

Bacteria Fungi Viruses

Acne vulgaris is typically an infection in the adolescent population. What topical agent used in the treatment of acne is both an antibacterial and a comedolytic?

Benzoyl peroxide

A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous 17. small blisters on the shaft of his penis. On examination, the clinician notes that the lesions are between 2 and 4 mm in diameter and are filled with serous fluid. The clinician would document the presence of: A) Pustules B) Macules C) V esicles D) Papules

A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize? A) "Weight loss and exercise are very important components of your treatment." B) "Stopping all of your current medications, even temporarily, should provide some relief." C) "It would be helpful for you to take control of your diet, sleep schedule, and stress levels." D) "Your headaches are likely a result of a nerve disorder and, unfortunately, cannot be treated successfully."

A 70-year-old client admitted to a hospital for a prostatectomy is surprised to learn that his physician has prescribed insulin on a sliding scale, despite the fact that the client successfully manages his type 2 diabetes using diet and oral antihyperglycemics when at home. Which of the following facts may underlie the physician's action? A) The stress of illness stimulates the hypothalamus to release corticotropin-releasing factor (CRF). B) Stress-induced release of vasopressin increases serum blood glucose. C) Stress and illness can increase glycogenolysis and insulin resistance. D) Increased levels of epinephrine and norepinephrine cause alterations in glucose metabolism.

A client arrived in the emergency department following 2 days of general malaise. The temperature is 103.8°F. The nurse administers the prescribed aspirin, an antipyretic. Which of the following statements relates to the rationale for this action? A) Temperatures in excess of 37.5°C (99.5° F) can result in seizure activity. B) Lower temperatures inhibit the protein synthesis of bacteria. C) These medications protect vulnerable organs, such as the brain, from extreme temperature elevation. D) Most common antipyretics have been shown to have little effect on core temperature.

A client presents to the clinic with a swollen, painful "hang nail" on the index finger. There is a large pustule over the site that needs to be lanced. The health care worker knows that which mediator of inflammation causes this increase in capillary permeability and pain? A) Serotonin B) Histamine C) Bradykinin D) Nitric oxide

A client with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which of the following assessment components should the nurse prioritize when assessing the client's pain? A) The appearance of grimacing, guarding, or wincing B) The presence of changes in vital signs that correspond to pain C) The client's subjective report of the character and severity of pain D) The results of a detailed neurologic assessment

A diabetic client has injured his foot while walking barefoot on the lawn. On admission, which of the following assessment findings would be considered a localized cardinal sign of acute inflammation? A) Temperature of 101°F B) Fatigue with listlessness C) Redness and edema at the injured site D) Urine output of less than 500 mL/24 hours (low)

A female client experienced a random assault several months earlier, and her recent vigilance around her own safety is described as "obsessive" by her friends and family. Which of the following aspects of posttraumatic stress disorder (PTSD) characterizes the client's behavior? A) Avoidance B) Intrusion C) Hyperarousal D) Flashbacks

A man's winter vacation to a tropical destination has been accompanied by repeated sunburns. What process accounts for the damaging effects of the sun's radiation? A. Initiation of a autoimmune response B. Compensatory increases in melanin production. C. Damage to epidermal cell DNA & free radical production. D. Hyperkeratinization & the formation of microscopic, subcutaneous lesions.

A postsurgical client who is recovering in the postanesthetic recovery unit states that she is "freezing cold." Which of the following measures is likely to be initiated in the client's hypothalamus in an effort to reduce heat loss? A) Opening of arteriovenous (AV) shunts B) Reduced exhalation of warmed air C) Contraction of pilomotor muscles D) Decreased urine production

A school student with a rash goes to the school nurse for evaluation. The nurse suspects the student has contact dermatitis. The primary cell responsible for this delayed-type hypersensitivity reaction is: A) Merkel cells B) Reticular dermis C) Langerhans cells D) Dermal dendrocytes

A skin care consultant informs the client that he needs to bath and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that A) All layers of epidermis undergo rapid mitosis. B) Cells of the stratum spinosum will turn into prickle cells if not removed by bathing. C) A basal cell is mitotically active and pushes older dead cells to the skin's surface. D)Keratinocytes will turn to fibrous protein tissue if not removed by bathing.

According to Walter B. Cannon, homeostasis is a stable internal environment achieved through a system of: A) Interdependent system-wide adaptive responses B) Variable internal and external conditioning factors C) Coordinated physiologic processes that oppose change D) Compatibility between cells and the internal environment

Allergic & hypersensitivity dermatoses are characterized by: A. target lesions. B. dark erythema. C. epidermal edema. D. silver-white scale.

An occupational therapist is preparing to begin a relaxation program on an oncology unit of a hospital. Which of the following variables will assist in the success of the program? A) Verbal rapport between the therapist, staff, and clients B) The therapist's own ability to demonstrate relaxation techniques C) A quiet, calm, and therapeutic environment D) Appropriate use of pharmacologic agents for clients prior to attending the program

An otherwise healthy client has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This client is likely to be diagnosed with which of the following health problems? A) Visceral pain B) Hypoalgesia C) Allodynia D) Primary hyperalgesia

During a lecture on inflammation, the physiology instructor discusses the major cellular components involved in the inflammation response. The instructor asks, "Which of the following cells arrives early in great numbers?" The student with the correct response is: A) Basophils B) Lymphocytes C) Neutrophils D) Monocytes

Following a school shooting, many of the children want to talk about the traumatic event. The school nurse knows this is very therapeutic and would be called: A) Nonadaptive functioning B) Fatalism C) Debriefing D) Guided imagery

Hepatitis __________ is the most common cause of chronic hepatitis, cirrhosis, and hepatocellular cancer in the world.

In third-world countries, many children experience uncontrolled itching and scratching, which may develop into: A) Blisters B) V esicles C) Lichenification D) Ulcers

Onychomycosis initially causes the toenail to appear ____ as a fungus digest the nail keratin. A. black B. cracked C. opaque D. eroded

The clinic health care worker notices that a client has a fungal infection on her nails that looks like the fungus is digesting the nail keratin. The nail appears opaque and white in color. The client states she has had this for years. The health care worker suspects the client has: A) Candidiasis B) Cellulitis C) Onychomycosis D) Tinea corporis

What process accounts for the damaging effects of the sun's radiation? A) Initiation of an autoimmune response B) Compensatory increases in melanin production C) Damage to epidermal cell DNA and free radical production D) Hyperkeratinization and the formation of microscopic, subcutaneous lesions

Which of the following actions involves the greatest risk of skin shearing? A) Inserting a peripheral intravenous catheter B) Rolling the client from a supine to side-lying position C) Pulling the client up in bed D) Helping the client ambulate after surgery

Which of the following actions involves the greatest risk of skin shearing? A. Inserting a peripheral intravenous catheter B. Rolling the patient from a supine to side-lying position C. Pulling the patient up in bed D. Helping the patient ambulate after surgery

Which of the following clinical manifestations would lead the health care provider to diagnose the sunburn as severe? A) Skin is red and warm to touch. B) Some peeling and itching occur several days after the initial burn. C) There is blistering of the skin and associated fever and chills. D) There is a pruritic rash over the sunburned skin area.

Which of the following skin disorders is likely to result from the localized lack of melanin production by melanocytes? A) Rash B) Bullae C) Vitiligo D) Melasma

Which of the following skin disorders is likely to result from the localized lack of melanin production by melanocytes? A. Rash B. Bullae C. Vitiligo D. Melasma

C In cases of vitiligo, depigmented areas may contain no melanocytes, greatly altered or decreased amounts of melanocytes, or, in some cases, melanocytes that no longer produce melanin. Melasma results from increased pigmentation, and neither bullae nor rashes are consequences of alteration in melanocyte function.

The clinic health care worker notices that a client has a fungal infection on her nails that looks like the fungus is digesting the nail keratin. The nail appears opaque and white in color. The client states she has had this for years. The health care worker suspects the client has: A. Candidiasis B. Cellulitis C. Onychomycosis D. Tinea corporis

C Onychomycosis often begins at the tip of the nail, where the fungus digests the nail keratin. Initially, the nail appears opaque, white, or silvery. The nail then turns yellow or brown and remains unchanged for years. Gradually, the nail thickens and cracks as the infection spreads. Candidiasis (moniliasis) is a fungal infection caused by C. albicans. This yeast-like fungus is a normal inhabitant of the gastrointestinal tract, mouth, and vagina. Cellulitis is a deeper infection affecting the dermis and subcutaneous tissues. The lesion consists of an expanding red, swollen, tender plaque with an indefinite border, covering a variety of widths. Cellulitis is frequently accompanied by fever, erythema, heat, edema, and pain. Tinea corporis (ringworm of the body) are oval or circular patches on exposed skin surfaces and the trunk, back, or buttocks.

In third-world countries, many children experience uncontrolled itching and scratching, which may develop into: A. Blisters B. Vesicles C. Lichenification D. Ulcers

C Repeated rubbing and scratching can lead to lichenification (thickened and roughened skin characterized by prominent skin markings caused by repeated scratching or rubbing) or excoriation (lesion caused by breakage of the epidermis, producing a raw linear area). Blisters are circumscribed elevations of the skin caused by fluid under or within the epidermis. Pustules are circumscribed pus-filled elevations of the skin. Vesicles are small (<1.0 cm in diameter). An ulcer is a skin defect in which there has been loss of the epidermis and papillary layer of the dermis.

Which of the following actions involves the greatest risk of skin shearing? A. Inserting a peripheral intravenous catheter B. Rolling the client from a supine to side-lying position C. Pulling the client up in bed D. Helping the client ambulate after surgery

C Shear occurs when the skeleton moves, but the skin remains fixed to an external surface, such as occurs with transfer from a stretcher to a bed or pulling a person up in bed. Rolling a client, starting an IV catheter, or assisting with mobilization does not pose a risk of skin shearing.

Which of the following clinical manifestations would lead the health care provider to diagnose the sunburn as severe? A. Skin is red and warm to touch. B. Some peeling and itching occur several days after the initial burn. C. There is blistering of the skin and associated fever and chills. D. There is a pruritic rash over the sunburned skin area.

C Sunburn ranges from mild to severe. Mild sunburn consists of various degrees of skin redness. The burn continues to develop for 24 to 72 hours, occasionally followed by peeling skin in 3 to 8 days. Some peeling and itching may continue for several weeks. Inflammation, blistering, weakness, chills, fever, malaise, and pain often accompany severe forms of sunburn.

A skin care consultant informs the client that he needs to bathe and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that A. All layers of epidermis undergo rapid mitosis. B. Cells of the stratum spinosum will turn into prickle cells if not removed by bathing. C. A basal cell is mitotically active and pushes older dead cells to the skin's surface. D. Keratinocytes will turn to fibrous protein tissue if not removed by bathing.

C The basal cells are the only epidermal cells that are mitotically active. All cells of the epidermis arise from this layer. As new cells form in the basal layer, the older cells change shape and are pushed upward toward the skin surface. The second layer, the stratum spinosum, is two to four layers thick. The cells of this layer are commonly referred to as prickle cells because they develop a spiny appearance as their cell borders interact. The keratinocytes are the predominant cell type of the epidermis. They produce a fibrous protein called keratin, which is essential to the protective function of skin and may be involved in the immune system and wound healing.

What process accounts for the damaging effects of the sun's radiation? A. Initiation of an autoimmune response B. Compensatory increases in melanin production C. Damage to epidermal cell DNA and free radical production D. Hyperkeratinization and the formation of microscopic, subcutaneous lesions

C Ultraviolet B (UVB) radiation is primarily responsible for sunburns, and it acts mainly on the cells in the basal layer of the epidermis, producing direct damage to the DNA and other nuclear proteins. It also provokes free radical production and induces a significant reduction in skin antioxidants, impairing the ability of the skin to protect itself against the free radicals that are generated. UV radiation does not provoke an autoimmune response or hyperkeratinization, although there is an inflammatory response. Increased melanin production is a protective mechanism and does not participate in the deleterious effects of UV radiation.

A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous small blisters on the shaft of his penis. On examination, the clinician notes that the lesions are between 2 and 4 mm in diameter and are filled with serous fluid. The clinician would document the presence of: A. Pustules B. Macules C. Vesicles D. Papules

C Vesicles are less than 1 cm in diameter and filled with serous fluid, such as the lesions typical of herpes simplex. Macules are small variations in skin color that are nonpalpable, while pustules are filled with pus. Papules are small, solid masses.

C) Abnormalities or stasis of bile

The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which of the flowing lab values? A) Albumin 2.0 g/dL (low) B) Amylase 150 unites/L (high) C) Bilirubin 15 mg/dL (high) D) Serum calcium level 7 mg/dL (low)

C) Bilirubin 15 mg/dL (high)

Individuals with liver disease often experience the effects of excess serum ammonia as a result of impairment of the liver's ability to process ammonia. How does the liver process ammonia in healthy individuals? A) By converting it into bilirubin which is then excreted intestinally B) By processing ammonia into nitrogen and hydrogen ions for excretion C) By processing it into urea and releasing it into the circulation D) By combining it with oxygen to create ammonium oxide

C) By processing it into urea and releasing it into the circulation

Which of the following measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life? A) Weight-control and daily use of low-dose corticosteroids B) Genetic testing and range of motion exercises C) Calcium supplementation and regular physical activity D) Increased fluid intake and use of vitamin D supplements

C) Calcium supplementation and regular physical activity

Which of the following phenomena is thought to underlie the decreased reported incidence of some STIs? A) Increased knowledge of the correct use of condoms B) Increased public funding for health promotion activities C) Decreased reporting of cases of certain STIs D) Decreased numbers of sexual partners among young adults

C) Decreased reporting of cases of certain STIs

Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male patient? A) Presence of purulent, whitish discharge from the penis B) Emergence of hard, painless nodules on the shaft of the penis C) Itching, pain, and the emergence of pustules on the penis D) Production of cloudy, foul-smelling urine

C) Itching, pain, and the emergence of pustules on the penis

Which of the following statements is true of colorectal cancer? A) Aspirin and NSAIDs are implicated in the etiology. B) It is one of the few cancers that is known to sometimes have an infectious etiology. C) Most cases are quite advanced before symptoms become apparent. D) Survival rates for colorectal cancer are less than 20%, but are increasing.

C) Most cases are quite advanced before symptoms become apparent.

A major factor in the development of hepatic encephalopathy is: A) Hypersplenism B) High sodium level C) Neurotoxin accumulation D) Steroid hormone deficiency

C) Neurotoxin accumulation

A client presents to the emergency department vomiting large amounts of bright red blood. The client has a history of alcohol abuse, and the physician suspects esophageal varices. The drug that is used to reduce splanchnic and hepatic blood flow and portal pressures is: A) Propranolol, a β-adrenergic blocking agent B) Lisinopril, an ACE inhibitor C) Ocetrotide, a long-acting synthetic analog of somatostatin D) Famotidine, a histamine-2 blocker to decrease stomach acid

C) Ocetrotide, a long-acting synthetic analog of somatostatin

The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as: A) Filters B) Channels C) Phagocytes D) Cytotoxic cells

C) Phagocytes

A patient with a diagnosis of small cell lung carcinoma has developed bone metastases, a finding that has prompted a series of new interventions. What are the primary goals of the treatment regimen for this patient's bone cancer? A) Prevention of brain metastasis and early identification of osteonecrosis B) Promotion of bone remodeling at tumor sites through calcium and vitamin D supplements C) Prevention of pathologic fractures and maximization of function D) Pain management and prevention of osteomyelitis

C) Prevention of pathologic fractures and maximization of function

A liver failure client asks, "How does the liver process ammonia in healthy individuals?" The health care provider explains that ammonia is toxic to tissues, especially neurons, so this ammonia is removed from the blood by the liver, which: A) Converts it into bilirubin, which is then excreted intestinally B) Processes ammonia into nitrogen and hydrogen ions for excretion C) Processes it into urea, releasing it into the circulation D) Combines it with oxygen to create ammonium oxide

C) Processes it into urea, releasing it into the circulation

The patient has right upper quadrant pain caused by acute choledocholithiasis. If the common bile duct becomes obstructed, manifestations will also include: A) ascites. B) vomiting. C) bilirubinuria. D) hemorrhage.

C) bilirubinuria.

Osteoarthritis is a degenerative form of joint disease that is often evidenced by: A) spongy joints. B) cartilage hypertrophy. C) crepitus and grinding. D) systemic inflammation.

C) crepitus and grinding.

Factors that may adversely affect bone healing include______ of the bone. A) immobilization B) weight bearing C) delayed union D) tight alignment

C) delayed union

Factors that contribute to the formation of gallstones, or acute cholelithiasis, include: A) chronic pancreatitis. B) rapid elimination of bile. C) gallbladder inflammation. D) excessive alcohol intake.

C) gallbladder inflammation.

A major factor in the development of hepatic encephalopathy is: A) hypersplenism. B) high sodium level. C) neurotoxin accumulation. D) steroid hormone deficiency.

C) neurotoxin accumulation.

The clinical course of osteoarthritis (OA) culminates in: A) osteonecrosis and loss of synovial fluid. B) formation of tophi in the synovial space. C) osteophyte formation and erosion of cartilage. D) separation of the epiphyseal plate.

C) osteophyte formation and erosion of cartilage.

Kupffer cells function as ______ to remove harmful substances or cells from the portal blood as it moves through the venous sinusoids. A) filters B) channels C) phagocytes D) cytotoxic cells

C) phagocytes

The late manifestations of cirrhosis are related to liver failure and: A) hepatomegaly. B) diffuse liver fibrosis. C) portal hypertension. D) hepatorenal syndrome.

C) portal hypertension.

3. A skin care consultant informs the client that he needs to bath and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that A) All layers of epidermis undergo rapid mitosis. B) Cells of the stratum spinosum will turn into prickle cells if not removed by bathing. C) A basal cell is mitotically active and pushes older dead cells to the skin's surface. D) Keratinocytes will turn to fibrous protein tissue if not removed by bathing.

C) A basal cell is mitotically active and pushes older dead cells to the skin's surface.

Liver failure can cause ascites by which of the following mechanism? A) Portal hypertension B) Decreased plasma proteins C) All of the above D) Increased circulating aldosterone

C) All of the above

11. What process accounts for the damaging effects of the sun's radiation? A) Initiation of an autoimmune response B) Compensatory increases in melanin production C) Damage to epidermal cell DNA and free radical production D) Hyperkeratinization and the formation of microscopic, subcutaneous lesions

C) Damage to epidermal cell DNA and free radical production

Which of the following is a factor in the development of diverticulitis? A) Alcohol consumption B) Recent abdominal surgery C) Diet low in fiber D) H. pylori infection

C) Diet low in fiber

Which of the following aspects of gastrointestinal function is performed by the brush border enzymes of the villus structures? A) Fat metabolism B) Vitamin A synthesis C) Digestion of carbohydrates D) Maintenance of fluid and electrolyte balance

C) Digestion of carbohydrates

6. A school student with a rash goes to the school nurse for evaluation. The nurse suspects the student has contact dermatitis. The primary cell responsible for this delayed-type hypersensitivity reaction is: A) Merkel cells B) Reticular dermis C) Langerhans cells D) Dermal dendrocytes

C) Langerhans cells

A school student with a rash goes to the school nurse for evaluation. The nurse suspects the student has contact dermatitis. The primary cell responsible for this delayed-type hypersensitivity reaction is: A)Reticular dermis B)Dermal dendrocytes C) Langerhans cells D)Merkel cells

C) Langerhans cells

16. In third-world countries, many children experience uncontrolled itching and scratching, which may develop into: A) Blisters B) Vesicles C) Lichenification D) Ulcers

C) Lichenification

19. Which of the following statements is true of colorectal cancer?

C) Most cases are quite advanced before symptoms become apparent.

2. The clinic health care worker notices that a client has a fungal infection on her nails that looks like the fungus is digesting the nail keratin. The nail appears opaque and white in color. The client states she has had this for years. The health care worker suspects the client has: A) Candidiasis B) Cellulitis C) Onychomycosis D) Tinea corporis

C) Onychomycosis

17. Which of the following actions involves the greatest risk of skin shearing? A) Inserting a peripheral intravenous catheter B) Rolling the client from a supine to side-lying position C) Pulling the client up in bed D) Helping the client ambulate after surgery

C) Pulling the client up in bed

A 79-year-old client has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize in the prevention of pressure ulcers? A)Parenteral nutrition B)Applying protective dressings to vulnerable areas C) Repositioning the client on a scheduled basis D)Prophylactic antibiotics

C) Repositioning the client on a scheduled basis

21. The nurse caring for a client with a malignant melanoma should prepare the client for which of the following treatments? Select all that apply. A) Cosmetic surgery to remove the mole without leaving a scar B) Immediate radiation therapy to shrink the tumors C) Surgical excision with lymph node biopsy D) Biologic therapy with interferon alfa-2B

C) Surgical excision with lymph node biopsy D) Biologic therapy with interferon alfa-2B

12. Which of the following clinical manifestations would lead the health care provider to diagnose the sunburn as severe? A) Skin is red and warm to touch. B) Some peeling and itching occur several days after the initial burn. C) There is blistering of the skin and associated fever and chills. D) There is a pruritic rash over the sunburned skin area.

C) There is blistering of the skin and associated fever and chills.

17. A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous small blisters on the shaft of his penis. On examination, the clinician notes that the lesions are between 2 and 4 mm in diameter and are filled with serous fluid. The clinician would document the presence of: A) Pustules B) Macules C) Vesicles D) Papules

C) Vesicles

21. Which of the following skin disorders is likely to result from the localized lack of melanin production by melanocytes? A) Rash B) Bullae C) Vitiligo D) Melasma

C) Vitiligo

Which of the following clients would be predisposed to developing a yeast-like Candida albicans fungal infection? A)A diabetic male child with circular patches on the arms B)A high school football player with fungal spores cultured on the feet C)An immunosuppressed cancer client with maculopapular satellite lesions D)A dance instructor with a rash on the hands described as raised borders

C)An immunosuppressed cancer client with maculopapular satellite lesions

In third-world countries, many children experience uncontrolled itching and scratching, which may develop into: A)Ulcers B)Vesicles C)Lichenification D)Blisters

C)Lichenification

Which of the following actions involves the greatest risk of skin shearing? A)Rolling the client from a supine to side-lying position B)Helping the client ambulate after surgery C)Pulling the client up in bed D)Inserting a peripheral intravenous catheter

C)Pulling the client up in bed

When asked to name the parts of the pilosebaceous unit of the skin, which student has the correct answer? A)Keratinized plates B)Eccrine secretions C)Sebaceous glands D)Connective tissues

C)Sebaceous glands

The nurse caring for a client with a malignant melanoma should prepare the client for which of the following treatments? Select all that apply. A) Cosmetic surgery to remove the mole without leaving a scar B) Immediate radiation therapy to shrink the tumors C) Surgical excision with lymph node biopsy D) Biologic therapy with interferon alfa-2B

C, D

The nurse caring for a client with a malignant melanoma should prepare the client for which of the following treatments? Select all that apply. A. Cosmetic surgery to remove the mole without leaving a scar B. Immediate radiation therapy to shrink the tumors C. Surgical excision with lymph node biopsy D. Biologic therapy with interferon alfa-2B

C, D Treatment of melanoma is usually surgical excision, the extent of which is determined by the thickness of the lesion, invasion into the deeper skin layers, and spread to the regional lymph nodes. Current capability allows for mapping lymph flow to a regional lymph node that receives lymphatic drainage from tumor sites on the skin. This lymph node, which is called the sentinel lymph node, is then sampled for biopsy. If tumor cells have spread from the primary tumor to the regional lymph nodes, the sentinel node will be the first node in which tumor cells appear. Therefore, sentinel node biopsy can be used to test for the presence of melanoma cells and determine if radical lymph node dissection is necessary. Interferon alfa-2b is a biologic therapy available for adjuvant treatment of melanoma.

While talking about their migraine headaches, two women have found that they have some common triggers for their migraines, which may include: Select all that apply. A) Nonpharmacologic treatments like yoga B) Piercings of their nose and cheeks C) At the time of their menstrual cycle D) When drinking white wine E) Consuming chocolate

C, E

The nurse caring for a client with a malignant melanoma should prepare the client for which of the following treatments? Select all that apply. A) Cosmetic surgery to remove the mole without leaving a scar B) Immediate radiation therapy to shrink the tumors C) Surgical excision with lymph node biopsy D) Biologic therapy with interferon alfa-2B

C,D

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the client's statements suggests that he understands his new diagnosis? Select one: A. "I guess I'm an example of why you should always use condoms." B. "I'm still trying to deal with the fact that this will forever change my life." C. "I don't know why I didn't bother to get vaccinated against this." D. "I'm embarrassed that I'll be a carrier of hepatitis from now on."

C. "I don't know why I didn't bother to get vaccinated against this."

A diabetic client presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high)? Which response by the patient may account for this abnormal lab result? Select one: A. "I've been doing great. I haven't needed much insulin coverage before meals." B. "I've had more periods of hypoglycemia than usual over the past few months." C. "My meter broke so I have not been checking my blood glucose levels for a while." D. "To tell you the truth, my blood glucose levels have been pretty normal for me."

C. "My meter broke so I have not been checking my blood glucose levels for a while."

What should the nurse teach the client about the diagnosis of "primary skin disorder"? A. "This disorder occurs primarily in children." B. "This disorder occurs after another primary systemic diagnosis." C. "This disorder is caused by a virus, bacteria, or fungus that invades the skin." D. "This disorder occurs from side effects of primary medications."

C. "This disorder is caused by a virus, bacteria, or fungus that invades the skin."

A client presents with a skin infection in which the health care provider uses a potassium hydroxide (KOH) preparation and the Wood (UV) light to determine the cause. Which type of infection does this client most likely have? A. Atopic dermatitis B. Varicella zoster infection C. A superficial fungal infection D. Impetigo

C. A superficial fungal infection

The client has a stage III pressure ulcer. Which is the best description of a stage III pressure ulcer? A. Full thickness skin loss and necrosis with extensive destruction or damage to the underlying subcutaneous tissues that may extend to involve muscle, bone, and supporting structures. B. Defined area of persistent redness in lightly pigmented skin or an area of persistent redness with blue or purple hues in darker skin C. Full-thickness skin loss involving damage and necrosis of subcutaneous tissue that may extend down to but not through underlying fascia D. Partial-thickness loss of skin involving the epidermis or dermis, or both

C. Full-thickness skin loss involving damage and necrosis of subcutaneous tissue that may extend down to but not through underlying fascia

Which of the following assessment findings of a male client constitutes a criterion for a diagnosis of metabolic syndrome? The client: Select one: A. Has a resting heart rate between 85 and 95 beats/minute B. States that he does less than 30 minutes of strenuous physical activity each week C. Has blood pressure that is consistently in the range of 150/92 mm Hg D. Has a fasting triglyceride level of 100 mg/dL

C. Has blood pressure that is consistently in the range of 150/92 mm Hg

An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis? Select one: A. Elimination of normal intestinal flora B. Sloughing of the intestinal mucosa C. Obstruction of the intestinal lumen D. Increased osmolality of intestinal contents

C. Obstruction of the intestinal lumen

Which action could result in pressure ulcer formation? A. Turning a client from side to side every 2 hours B. Applying powder to buttocks area when diaphoresis has become a problem C. Pulling a stroke client up in bed D. Allowing a client to slide up in a chair at mealtime

C. Pulling a stroke client up in bed

Primary adrenal insufficiency is manifested by: Select one: A. Hypopigmentation over neck and BP greater than 150/90 B. Potassium level of 2.8 mEq/L and weight gain of 3 pounds overnight C. Serum sodium level of 120 mmol/L (low) and blood glucose level of 48 mg/dL (low) D. Truncal obesity and 3+ pitting edema in lower legs

C. Serum sodium level of 120 mmol/L (low) and blood glucose level of 48 mg/dL (low)

Which of the following meals is most likely to exacerbate an individual's celiac disease? Select one: A. Stir-fried chicken and vegetables with rice B. Oatmeal with milk, brown sugar, and walnuts C. Spaghetti with meatballs and garlic bread D. Barbecued steak and a baked potato with sour cream

C. Spaghetti with meatballs and garlic bread

A client who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive? Select one: A. Stopping the drug suddenly may "shock" the HPA axis into overactivity. B. Sudden changes in glucocorticoid dosing may reverse the therapeutic effects of the drug. C. Stopping the drug suddenly may cause acute adrenal insufficiency. D. Sudden cessation of a glucocorticoid can result in adrenal gland necrosis.

C. Stopping the drug suddenly may cause acute adrenal insufficiency.

Explain the second stage of the hair growth cycle.

CATAGEN PHASE- the transition stage of hair growth. Mitosis ceases, the hair grows upward and detaches itself from the dermal papilla. The follicle degenerates and collapses as epidermal tissue retracts upward. Hair loses its inner root sheath and becomes dryer, and is now referred to as a club hair. The shortest part of the hair cycle.

Which of the following measures should a public health nurse recommend to middle-aged women to reduce chances of developing osteoporosis later in life?

Calcium supplementation and regular physical activity

Which of the following measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life?

Calcium supplementation and regular physical activity

A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increase risks associated with exercise, the health care provider should encourage the client to:

Carry a snack with carbs to prevent profound hypoglycemia

Causing potential for directly damaging the skin Accelerating the effect of aging on the skin Predisposing to the development of skin cancer

Common risk factors associated with erectile dysfunction due to generalized female arterial insufficiency include

Cigarette smoking

A 17-year-old male has developed phimosis to the point that he is having difficulty voiding. The nurse should prepare this teenager for:

Circumcision

_____________ represents the end stage of chronic liver disease in which much of the functional liver tissue has been replaced by fibrous tissue.

Cirrhosis

A nurse is conducting a healthy living workshop for a group of women in their 20s. Which of the following screening recommendations should the nurse provide to the participants?

Clinical breast examination every 3 years until age 40

List four of the safety precautions that must be followed for waxing.

Complete client consultation form, Wear gloves, hair should be 1/4" long, do not remove vellus hair, always test temperature, have client keep eyes closed, do not apply over warts moles abrasions or irritated skin, never wax over curves, if sensitive use hard wax, give post wax precautions

An adult man has been brought to the emergency department with severe electrical burns. Which assessment finding leads the providers to suspect the brain has been damaged with this burn?

Confusion, memory loss, and lethargy

The nurse is recommending to a patient ways to relieve the itching sensation of his uncontrollable pruritis. Which of the following should the nurse recommend?

Cool shower

A client complains to the healthcare provider that he keeps getting hard skin on the sides of the great and little toes when he wheres certain pairs of shoes. This is probably caused by L fitting shoes putting pressure on certain areas of the flight and would be called:

Corn

The nurse is caring for a patient with pruritis. The nurse anticipates orders for which of the following interventions?

Corticosteroids

Lentigines are skin lesions common in older adults. A type of lentigo is tan to brown in color with benign spots. Lentigines are removed because they are considered precursors to skin cancer. How are lentigines removed?

Cryotherapy

Which of the following means inflammation of the bladder?

Cystitis

A 14-year-old presents to the dermatologist clinic with a severe case of acne. The nurse explains that this acne is a result of inflamed A) Follicular bulbs B) Dermal papillae C) Apocrine glands D) Sebaceous glands

A client has an abscess in the mouth with a profuse amount of thick creamy white exudate. The nurse knows that this wound with necrotic cells is classified as: A) Serous B) Fibrinous C) Suppurative D) Membranous

A client has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this client's health? A) The development of bacterial cellulitis on compromised skin surfaces B) Fluid and electrolyte imbalances resulting from the loss skin integrity C) A cascading autoimmune response that may result in shock D) The presence of diffuse lesions and skin sloughing on the client's mucous membranes

A client has sought care because of recent malaise and high fever. Upon assessment, the client states that his current fever began 2 days earlier, although he states that for the last 2 weeks he is in a cycle of high fever for a couple of days followed by a day or two of normal temperature. Which of the following fever patterns is this client experiencing? A) Recurrent fever B) Remittent fever C) Sustained fever D) Intermittent fever

A client is experiencing significant stress while awaiting the results of her recent lymph node biopsy. Among the hormonal contributors to this response is a release of aldosterone, resulting in which of the following physiologic effects? A) Decreased release of insulin B) Increased cardiac contractility C) Potentiating effects of epinephrine D) Increased sodium absorption

A client's primary care provider has recommended biofeedback in an effort to address her chronic stress and reduce the potential for complications. What will be the goal of this intervention? A) Using exercise to control the client's endocrine function B) Helping the client to accommodate continued nervous stimulation C) Relieving tension by using tactile stimulation D) Teaching the client to consciously control her own body functioning

A group of teenagers spent an entire day on the beach without using sunscreen. The first night, their skin was reddened and painful to touch. The second day, they awoke to find large fluid-filled blisters over several body areas. The nurse recognizes the development of blisters as which type of inflammatory response? A) Cellular response B) Immediate transient response C) Continuous response D) Delayed response

A hospital client has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the client reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the client's concern? A) "You might become addicted, but there are excellent resources available in the hospital to deal with that development." B) "You should likely prioritize the control of your pain over any fears of addiction that you have." C) "If you start needing higher doses to control your pain, then we'll address those concerns." D) "There's only a minute chance that you will become addicted to these painkillers."

A nursing student's current clinical placement has been a source of stress due to high client acuity combined with interpersonal conflict with some of the unit staff. At the same time, the student has been fighting a cold for more than 2 weeks and has been unable to regain a normal feeling of health. How might these two phenomena be related? A) Epinephrine and norepinephrine inhibit the release and action of lymphocytes. B) Stress and illness lack a statistical correlation, though they are often thought to coexist. C) The effects of stress on the cerebellum initiate a decrease in immunity. D) Endocrine-immune interactions may suppress the student's immune response.

A patient has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of the sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this patient's health? A. The development of bacterial cellulitis on compromised skin surfaces. B. Fluid & electrolyte imbalances resulting from the loss of skin integrity. C. A cascading autoimmune response that may result in shock. D. The presence of diffuse lesions & skin sloughing on the patient's mucous membranes.

A thermal bone described as involving the entire epidermis & dermis is classified as: A. full third-degree. B. deep first-degree. C. partial second-degree. D. full-thickness second-degree.

A thermal burn described as involving the entire epidermis and dermis is classified as: A) Full third degree B) Deep first degree C) Partial second degree D) Full-thickness second degree

Complex regional pain syndrome is characterized by: A) Repetitious dermatome pain attacks B) Trigeminal neuralgia with facial tics C) Severe limb pain after amputation D) Disproportionate pain with mobility

During lecture on wound care, the instructor mentions the final stage of the cellular response of acute inflammation. Of the following statements, which describes what physiologically occurs in the final stage? A) Leukocytes accumulate and begin migration to the site of injury. B) Chemokines direct the trafficking of leukocytes. C) Mediators are transformed into inactive metabolites. D) Neutrophils, monocytes, and macrophages engulf and degrade the bacteria/cellular debris.

In contrast to acute inflammation, chronic inflammation is characterized by which of the following phenomena? A) Profuse fibrinous exudation B) A "shift to the left" of granulocytes C) Metabolic and respiratory alkalosis D) Lymphocytosis and activated macrophages

In science class, a group of sixth graders are "freaked out" when they learn that nails grow continuously and are the end product of which of the following components? A) Hypertrophy of arrector pili muscle B) Anagen follicles C) Telogen phase D) Dead cells pushed outward from the nail matrix

Opioid receptors are highly concentrated in which region of the CNS and produce pain relief through the release of endogenous opioids? A) The enkephalins B) Primary afferent neurons C) Thalamus D) Periaqueductal gray (PAG) region

Pain assessment is likely to be most challenging when providing care for which of the following older adult clients? A) A 90-year-old client who takes multiple medications for cardiac and respiratory conditions B) A 77-year-old man who has sustained burns on the lower part of his body C) An 82-year-old woman who has been diagnosed with diabetes and an anxiety disorder D) An 87-year-old man with vascular dementia and other health problems like heart failure

The transition of a melanoma from radial growth to vertical growth is associated with: A. failure of the integrity of the basement membrane. B. involvement of the nonkeratinizing cells. C. spontaneous resolution. D. an increased risk of metastasis.

Which manifestation of stress reflects the nonspecific "fight-or-flight" response? A) Decreased pupillary light response B) Increased gastrointestinal motility C) Decreased short-term memory D) Increased cardiopulmonary rates

Which of the following characteristics differentiates a migraine with aura from a migraine without aura? A) Gastrointestinal involvement in the hours leading up to the headache B) A decrease in mood and affect prior to the headache C) Lack of response to nonpharmacologic treatments D) Visual symptoms that precede the headache

Which of the following individuals most likely has the highest risk of experiencing chronic inflammation? A client who: A) Has recently been diagnosed with type 2 diabetes B) Is a carrier of an antibiotic-resistant organism C) Is taking oral antibiotics for an upper respiratory infection D) Is morbidly obese and who has a sedentary lifestyle

While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is: A) A Langerhans cell, which produces antigen-presenting cells B) An eccrine sweat gland C) A nerve ending D) Sebum, secreted by the sebaceous gland

In science class, a group of sixth graders are "freaked out" when they learn that nails grow continuously and are the end product of which of the following components? A. Hypertrophy of arrector pili muscle B. Anagen follicles C. Telogen phase D. Dead cells pushed outward from the nail matrix

D Like hair, nails are the end product of dead matrix cells that are pushed outward from the nail matrix. Unlike hair, nails grow continuously rather than cyclically. The arrector pili muscle, located under the sebaceous gland, provides a thermoregulatory function by contracting to cause goose bumps. Anagen hair has long inner roots and outer root sheaths, is deeply rooted in the dermis, is difficult to detach, and does not come out with regular brushing. Telogen hair has short, white, club-shaped roots. With formation of new anagen hair below the root, the developing follicle will eventually replace the telogen hair, leading to the shedding of approximately 50 to 100 hairs a day.

While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is: A. A Langerhans cell, which produces antigen-presenting cells B. An eccrine sweat gland C. A nerve ending D. Sebum, secreted by the sebaceous gland

D Sebum lubricates the hair and skin, prevents undue evaporation of moisture from the stratum corneum during cold weather, and helps to conserve body heat. Langerhans cells are dendritic cells that reside principally in the stratum spinosum of the epidermis and play a major role in the functioning of the skin's immune system. Their major function is to phagocytose and process foreign antigens. Most hair follicles are associated with sebaceous glands, and these structures combine to form the pilosebaceous unit. Langerhans cells are not paired with hair follicles, and apocrine, not eccrine, glands are often associated with a hair follicle. Nerve endings are widely distributed throughout the skin, but these are not paired with hair follicles.

A thermal burn described as involving the entire epidermis and dermis is classified as: A. Full third degree B. Deep first degree C. Partial second degree D. Full-thickness second degree

D Second-degree full-thickness burns involve the entire epidermis and dermis. First-degree burns (superficial partial-thickness burns) involve only the outer layers of the epidermis. Second-degree partial-thickness burns involve the epidermis and various degrees of the dermis. Third-degree full-thickness burns extend into the subcutaneous tissue and may involve muscle and bone.

A client has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this client's health? A. The development of bacterial cellulitis on compromised skin surfaces B. Fluid and electrolyte imbalances resulting from the loss skin integrity C. A cascading autoimmune response that may result in shock D. The presence of diffuse lesions and skin sloughing on the client's mucous membranes

D TEN is manifested by large areas of denuded skin resulting from separation at the basement membrane. This sloughing and necrosis can be fatal if it occurs in the airway and on the other mucous membranes. Infection and fluid and electrolyte imbalances may occur, but the most immediate threat results from the immediate consequences of skin sloughing. A cascading autoimmune response does not occur in TEN.

A 14-year-old presents to the dermatologist clinic with a severe case of acne. The nurse explains that this acne is a result of inflamed A. Follicular bulbs B. Dermal papillae C. Apocrine glands D. Sebaceous glands

D The sebaceous glands are the structures that become inflamed in acne. Growth of the hair is centered in the bulb (i.e., the base) of the hair follicle, which is just one part of the hair structure. Apocrine sweat glands are located deep in the dermal layer and open through a hair follicle. Dermal papillae minimize separation of the dermis and the epidermis and contain capillary venules that nourish the epidermal layers of the skin.

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the client's statements suggests that he understands his new diagnosis? A) "I guess I'm an example of why you should always use condoms." B) "I'm embarrassed that I'll be a carrier of hepatitis from now on." C) "I'm still trying to deal with the fact that this will forever change my life." D) "I don't know why I didn't bother to get vaccinated against this."

D) "I don't know why I didn't bother to get vaccinated against this."

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the patient's statements suggests that he understands his new diagnosis? A) "I guess I'm an example of why you should always use condoms." B) "I'm embarrassed that I'll be a carrier of hepatitis from now on." C) "I'm still trying to deal with the fact that this will forever change my life." D) "I don't know why I didn't bother to get vaccinated against this."

D) "I don't know why I didn't bother to get vaccinated against this."

A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the patient's following statements demonstrates an accurate understanding of this diagnosis? A) "From now on, I'm going to stick to an organic diet and start taking more supplements." B) "I think this might have happened because I've used enemas and laxatives too much." C) "I've always struggled with heartburn and indigestion, and I guess I shouldn't have ignored those warning signs." D) "I suppose I should try to eat more fiber and become a bit more active."

D) "I suppose I should try to eat more fiber and become a bit more active."

The nurse who is providing care for a client with pancreatic cancer should prioritize which of the following assessments? A) Assessment for ascites and close monitoring of fluid balance B) Respiratory assessment and monitoring of arterial blood gases C) Vigilant monitoring of blood glucose levels D) Assessment for deep vein thrombosis

D) Assessment for deep vein thrombosis

The nurse who is providing care for a patient with pancreatic cancer should prioritize which of the following assessments? Assessment for ascites and close monitoring of fluid balance B) Respiratory assessment and monitoring of arterial blood gases C) Vigilant monitoring of blood glucose levels D) Assessment for deep vein thrombosis

D) Assessment for deep vein thrombosis

A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is: A) chancroid. B) candidiasis. C) Trichomonas vaginalis. D) Chlamydia.

D) Chlamydia.

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

D) Genital chancres

Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type? A) Larger volume of diarrhea B) Electrolyte imbalances C) Absence of blood in the stool D) Infection of intestinal cells

D) Infection of intestinal cells

Which of the following STIs is most likely to respond to treatment with the antibiotics tetracycline or doxycycline? A) Human papillomavirus (HPV) infection B) Herpes simplex virus type 2 (HSV-2) infection C) Candidiasis D) Lymphogranuloma venereum (LGV)

D) Lymphogranuloma venereum (LGV)

A client presents to the emergency department with some vague symptoms. After history and physical exam, the physician is suspecting the client may have viral hepatitis. Which of the following clinical manifestations leads the nurse to suspect the client is in the prodromal period of viral hepatitis? A) Slight jaundice in the sclera of the eyes B) Liver tenderness on palpation C) Onset of severe itching with skin breakdown D) Muscle aches and pain along with fatigue

D) Muscle aches and pain along with fatigue

Which of the following neoplasms of the skeletal system is likely to require the most timely and aggressive treatment? A) Exostosis B) Osteochondroma C) Endochondroma D) Osteosarcoma

D) Osteosarcoma

A patient's clavicular fracture has healed in the weeks following a bicycle accident. Which of the following events takes place in the remodelling stage of bone healing? A) Formation of granulation tissue B) Development of fibrocartilage that resembles the appearance of the original bone C) Deposition of mineral salts into the callus D) Reduction in the size of the callus

D) Reduction in the size of the callus

Following the analysis of a recent barium enema and colonoscopy with biopsy, a patient has been diagnosed with colorectal cancer. Which of the following treatment modalities will be the mainstay of this patient's treatment? A) Chemotherapy B) Radiation therapy C) Pharmacologic therapies D) Surgery

D) Surgery

Hepatocellular cancer usually has a poor prognosis due in part to which of the following factors? A) Surgical options do not exist because removal of all or part of the liver is a threat to health. B) Liver cancer typically metastasizes at a much earlier stage than other cancers. C) Liver tumors are poorly differentiated due to the low density of hepatic tissue. D) The nonspecific symptomatology of liver cancer leads to a diagnosis at a late stage.

D) The nonspecific symptomatology of liver cancer leads to a diagnosis at a late stage.

Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with: A) diarrhea. B) food allergies. C) gastric reflux. D) alcohol intake.

D) alcohol intake.

HLA-B27 antigen may be linked to other genes that determine the pathologic autoimmune phenomenon in: A) gout syndrome. B) rheumatoid arthritis. C) osteoarthritis syndrome. D) ankylosing spondylitis.

D) ankylosing spondylitis.

Osteonecrosis is most often caused by: A) stress fractures. B) bacterial infection. C) synovial inflammation. D) bone marrow ischemia.

D) bone marrow ischemia.

Metastatic bone disease is most closely associated with: A) cervical cancer and ovarian cancer. B) acute myelogenous leukemia (AML) and malignant melanoma. C) non-Hodgkin lymphoma and bladder cancer. D) breast cancer and prostate cancer.

D) breast cancer and prostate cancer.

Characteristics of a patient that is at high risk for falling and fracturing a hip include: A) obesity and short stature. B) excessive sugar intake. C) hearing impairment. D) chronic osteoporosis.

D) chronic osteoporosis.

In contrast to osteoporosis, osteomalacia causes _______ without the loss of bone matrix. A) stress fractures B) calcium excretion C) bone cortex thinning D) defective mineralization

D) defective mineralization

While in its dormant state, herpes simplex virus resides and replicates in the: A) local lymph nodes. B) subcutaneous tissue. C) mucous membrane. D) dorsal root ganglia.

D) dorsal root ganglia.

Diverticulitis, a complication of diverticulosis, is manifested by acute: A) rectal bleeding. B) abdominal distention. C) large-volume diarrhea. D) lower left quadrant pain.

D) lower left quadrant pain.

Shortly after a closed fracture has occurred, early manifestations include localized: A) tetany. B) deformity. C) necrosis. D) numbness.

D) numbness.

The condition that contributes to the pathology of all metabolic bone diseases is: A) impaired vitamin D synthesis. B) osteosarcoma. C) infection. D) osteopenia.

D) osteopenia.

A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the patient notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the patient's medication administration record. The nurse should conclude that this patient likely has a history of: A) scleroderma. B) osteoarthritis. C) rheumatoid arthritis. D) osteoporosis.

D) osteoporosis.

Major causes of mechanical bowel obstruction include: A) chemical irritation. B) ruptured appendix. C) abdominal distention. D) postoperative adhesions.

D) postoperative adhesions.

Unlike the Crohn type of inflammatory bowel disease, the ulcerative colitis type is characterized by: A) skip lesions. B) steatorrhea. C) gastric ulcers. D) pseudopolyps.

D) pseudopolyps.

A 26-year-old woman has sought care for increasing pain at the back of her ankle and the bottom of her foot over the past 2 weeks. The patient states that she is generally in good health, although she completed a course of antibiotics for a chlamydial infection 6 weeks earlier. This patient's recent history suggests the possibility of: A) systemic sclerosis. B) ankylosing spondylitis. C) osteoarthritis. D) reactive arthritis.

D) reactive arthritis.

A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours. Vomiting results from stimulation of what site in the neurologic system? A) Myenteric plexus B) Intramural plexus C) Vagus nerve D) Chemoreceptor trigger zone

D) Chemoreceptor trigger zone

15. In science class, a group of sixth graders are "freaked out" when they learn that nails grow continuously and are the end product of which of the following components? A) Hypertrophy of arrector pili muscle B) Anagen follicles C) Telogen phase D) Dead cells pushed outward from the nail matrix

D) Dead cells pushed outward from the nail matrix

Which finding in a patient with liver failure is an indication that the patient is at an increased risk of bleeding? A) Increased Platelets B) Decreased Albumin C) Elevated Ammonia D) Elevated Prothrombin time

D) Elevated Prothrombin time

13. A thermal burn described as involving the entire epidermis and dermis is classified as: A) Full third degree B) Deep first degree C) Partial second degree D) Full-thickness second degree

D) Full-thickness second degree

14. A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the patient's following statements demonstrates an accurate understanding of this diagnosis?

D) I suppose I should try to eat more fiber and become a bit more active.

A patient has been diagnosed with cholecystitis (gall bladder inflammation) that has impaired the normal release of bile. Which of the following gastrointestinal consequences is this patient likely to experience? A) Incomplete digestion of starches B) Impaired glucose metabolism C) Inadequate gastric acid production D) Impaired digestion of fats

D) Impaired digestion of fats

16. Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type?

D) Infection of intestinal cells

4. When talking to a group of teenagers about ways to protect against skin damage from ultraviolet radiation, the nurse should discuss which of the following tissues/cells? A) Melanocytes B) Langerhans C) Subcutaneous fat D) Protein granule

D) Protein granule

14. A 14-year-old presents to the dermatologist clinic with a severe case of acne. The nurse explains that this acne is a result of inflamed A) Follicular bulbs B) Dermal papillae C) Apocrine glands D) Sebaceous glands

D) Sebaceous glands

12. While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is: A) A Langerhans cell, which produces antigen-presenting cells B) An eccrine sweat gland C) A nerve ending D) Sebum, secreted by the sebaceous gland

D) Sebum, secreted by the sebaceous gland

20. Following the analysis of a recent barium enema and colonoscopy with biopsy, a patient has been diagnosed with colorectal cancer. Which of the following treatment modalities will be the mainstay of this patient's treatment?

D) Surgery

8. A client has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this client's health? A) The development of bacterial cellulitis on compromised skin surfaces B) Fluid and electrolyte imbalances resulting from the loss skin integrity C) A cascading autoimmune response that may result in shock D) The presence of diffuse lesions and skin sloughing on the client's mucous membranes

D) The presence of diffuse lesions and skin sloughing on the client's mucous membranes

18. While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist diagnoses this as: A) Bullae B) Wheal C) Nodule D) Vesicle

D) Vesicle

2. Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with:

D) alcohol intake.

8. Diverticulitis, a complication of diverticulosis, is manifested by acute:

D) lower left quadrant pain.

9. Major causes of mechanical bowel obstruction include:

D) postoperative adhesions.

7. Unlike the Crohn type of inflammatory bowel disease, the ulcerative colitis type is characterized by:

D) pseudopolyps.

Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion? A)Solar lentigines B)Telangiectases C)Cherry angiomas D)Actinic keratosis

D)Actinic keratosis

Which of the following statements about temperature regulation and skin is accurate? A)It is primarily the arteries that bring blood from the heart that keeps the body temperature within a normal range. B)Since the skin is avascular, it is the subcutaneous layer that primarily is responsible for temperature control. C)The lymphatic system of the skin is primarily responsible for heating and cooling the skin. D)Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation.

D)Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation.

In science class, a group of sixth graders are "freaked out" when they learn that nails grow continuously and are the end product of which of the following components? A)Hypertrophy of arrector pili muscle B)Telogen phase C)Anagen follicles D)Dead cells pushed outward from the nail matrix

D)Dead cells pushed outward from the nail matrix

Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the client with psoriasis, a disorder that results from: A)An IgE-mediated immune reaction B)Human papillomaviruses (HPV) C)Hormonal influences on sebaceous gland activity D)Increased epidermal cell turnover

D)Increased epidermal cell turnover

Dysplastic nevi are precursors of malignant melanoma that are: A)Oval epidermal nests B)Brown, rounded papules C)Dermal cords of cells D)Larger than other nevi

D)Larger than other nevi

A client has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this client's health? A)Fluid and electrolyte imbalances resulting from the loss skin integrity B)A cascading autoimmune response that may result in shock C)The development of bacterial cellulitis on compromised skin surfaces D)The presence of diffuse lesions and skin sloughing on the client's mucous membranes

D)The presence of diffuse lesions and skin sloughing on the client's mucous membranes

Which of the following clinical manifestations would lead the health care provider to diagnose the sunburn as severe? A)There is a pruritic rash over the sunburned skin area. B)Skin is red and warm to touch. C)Some peeling and itching occur several days after the initial burn. D)There is blistering of the skin and associated fever and chills.

D)There is blistering of the skin and associated fever and chills.

D)Varicella

A hospital client has been complaining of increasing fatigue for several hours, and his nurse has entered his room to find him unarousable. The nurse immediately checked the client's blood glucose level (and reverified with a second blood glucose meter), which is 22 mg/dL (1.2 mmol/L). The nurse should prepare to administer which of the following? Select one: A. An oral solution containing glucagon and simple sugars B. Infusion of rapid-acting insulin C. A snack that combines simple sugars, protein, and complex carbohydrates D. A 50% glucose solution intravenously

D. A 50% glucose solution intravenously

Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis? Select one: A. A 55-year-old man who takes proton pump inhibitors for the treatment of peptic ulcers B. A 30-year-old client who has a history of Crohn disease and has been admitted to a hospital to treat a recent flare-up C. A premature neonate who has developed hyperbilirubinemia and is receiving phototherapy D. A 79-year-old hospitalized client who is being treated with broad-spectrum antibiotics

D. A 79-year-old hospitalized client who is being treated with broad-spectrum antibiotics

A 30-year-old woman who just found out that she is pregnant seeks treatment for her severe acne. Which treatment for her skin condition is most appropriate? A. Isotretinoin B. Tretinoin C. Low-dose tetracycline D. A benzoyl peroxide agent

D. A benzoyl peroxide agent

Which of the following clients should the nurse observe most closely for the signs and symptoms of paralytic ileus? Select one: A. A client whose acute diarrhea has necessitated the use of antidiarrheal medications B. An obese client who refuses to ambulate because he complains of shortness of breath C. A client with a long-standing diagnosis of irritable bowel syndrome D. A client who is first day postoperative following gallbladder surgery

D. A client who is first day postoperative following gallbladder surgery

Which of the following individuals displays the precursors to acromegaly? Select one: A. A client who has recently developed primary adrenal carcinoma B. A girl who has been diagnosed with precocious puberty C. An adult who has a diagnosis of Cushing syndrome D. An adult with an excess of growth hormone due to an adenoma

D. An adult with an excess of growth hormone due to an adenoma

Which of the following clients would be predisposed to developing a yeast-like Candida albicans fungal infection?

D. An immunosuppressed cancer client with maculopapular satellite lesions

A 33-year-old client has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the client's care team prioritize? Select one: A. Assessment of the client's peripheral vascular system for thromboembolism B. Assessment of the client's level of consciousness and neurologic status C. Cardiac monitoring and assessment of peripheral perfusion D. Assessment of the client's vision and oculomotor function

D. Assessment of the client's vision and oculomotor function

Which of the following statements about screening for prostate cancer is most accurate?

D. BPH and prostatitis can confound prostate screening results.

The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which of the flowing lab values? Select one: A. Amylase 150 unites/L (high) B. Serum calcium level 7 mg/dL (low) C. Albumin 2.0 g/dL (low) D. Bilirubin 15 mg/dL (high)

D. Bilirubin 15 mg/dL (high)

Impaired and delayed healing in a person with diabetes is caused by long-term complications that include: Select one: A. Somogyi effect B. Ketoacidosis C. Fluid imbalances D. Chronic neuropathies

D. Chronic neuropathies

A diabetic client's most recent blood work indicated a decreased glomerular filtration rate and urine testing revealed + microalbuminuria. Which priority self-care measures should the client's care team prescribe for this client? Select one: A. Decreased oral sugar intake to less than 5 tsp/day B. Increased fluid intake to at least 2000 mL/day C. Use of over-the-counter herbal products for natural diuretic properties D. Diet, exercise, and prescriptions to lower blood pressure below 140/80 mm Hg

D. Diet, exercise, and prescriptions to lower blood pressure below 140/80 mm Hg

A client comes to the college campus nurse complaining of unilateral pain, swelling, and redness on his scrotal area. The nurse knows these clinical manifestations are likely caused by:

D. Epididymitis

Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type? Select one: A. Absence of blood in the stool B. Larger volume of diarrhea C. Electrolyte imbalances D. Infection of intestinal cells

D. Infection of intestinal cells

The immune suppressive and anti-inflammatory effects of cortisol cause: Select one: A. Increased cell-mediated immunity B. Increased capillary permeability C. Moderate insulin resistance D. Inhibition of prostaglandin synthesis

D. Inhibition of prostaglandin synthesis

The nurse caring for a client with diverticulitis should assess for which of the following clinical manifestations? Select one: A. Large-volume diarrhea B. Increased abdominal distention C. Frequent rectal bleeding D. Lower left quadrant pain

D. Lower left quadrant pain

When talking to a group of teenagers about ways to protect against skin damage from ultraviolet radiation, the nurse should discuss which of the following tissues/cells?

D. Melanocytes

A dermatologist is explaining to a client the advantages of using a lotion that can draw out water to the skin surface. The nurse knows the technical term for this lotion is a/an:

D. Occlusive

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis, which may develop into which of the following potential complications?

D. Pelvic adhesions

A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which of the following manifestations related to the necrosis of liver cells? Select one: A. Tremors of the hands B. Development of multiple skin nodules C. Long muscle group atrophy D. Rapid onset of jaundice

D. Rapid onset of jaundice

A client visits the OB/GYN clinic complaining of low abdominal pain, purulent cervical discharge, and painful intercourse. The health care worker (HCW) diagnoses pelvic inflammatory disease. The HCW educates the client about that fact that this disease may be associated with:

D. STI polymicrobial infection

Manifestations of superficial dermatophytosis of the skin would include which descriptor? A. Erythema B. Infiltration C. Vesicles D. Scaling

D. Scaling

Which microorganism is responsible for the development of bullous impetigo? A. Group A beta-hemolytic streptococci B. Tinea capitis C. Propionibacterium acnes D. Staphylococcus aureus

D. Staphylococcus aureus

What process accounts for the damaging effects of sun's radiation

Damage to epidermal cells DNA and free radicals production

A nurse is concerned about a patient's continual use of nonsteroidal anti-inflammatory drugs (NSAIDs). Which of the following is the nurse concerned about?

Damage to the gastric mucosa

The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes which of these altered diagnostic tests is consistent with development of edema?

Decreased albumin

What is the difference between depilation and epilation?

Depilation- a process of removing hair at or near the level of the skin. Epilation- the process of removing hair from the bottom of the follicle by breaking contact between the bulb and papilla

The photoaging effect caused by UVB exposure to sunlight causes changes primarily in which skin layer?

Dermis

Which of the following aspects of gastrointestinal function is performed by the brush border enzymes of the villus structures?

Digestion of carbohydrates Brush border enzymes aid in the digestion of carbohydrates and proteins. They do not metabolize fat or synthesize vitamin A, and they do not directly contribute to fluid and electrolyte balance

Nevi are benign tumors of the skin. There is one type of nevus that is important because of its capacity to transform to malignant melanoma. What type of nevus is this?

Dysplastic

What is the most common cause of uncomplicated urinary tract infections?

E.coli

A patient tells the nurse that he is having diarrhea. Which of the following would the nurse recommend to decrease the diarrhea?

Electrolyte drink containing sodium and glucose Water absorption from the intestines is linked to osmotically active particles, such as glucose and sodium. It follows that an important consideration in facilitating the transport of water across the intestine (and decreasing diarrhea) after temporary disruption in bowel function is to include sodium and glucose in the fluids that are consumed.

Which of the following is the correct definition of a plaque?

Elevated, coalesced papules greater than 0.5 cm

A 42-year-old female client complains of extreme xerosis and states nothing seems to work for her skin. The most appropriate treatment would be to apply:

Emollients or occlusives are the most effective treatment

A client has been diagnosed with a superficial fungal infection. Which assessment technique is most likely assisted with this diagnosis?

Examination of the area with a Wood's light

Which cause of pressure injuries (decubitus injuries or bedsores) impairs the flow of blood in the capillary beds?

External pressure

Addison disease is a temporary condition.

Hepatitis, inflammation of the liver, is of bacterial origin.

Hypothyroidism is evidenced by an increased metabolic rate, restlessness, irritability, tachycardia, diarrhea, and heat intolerance.

Jaundice results from an abnormally high accumulation of bile in the blood.

Acne and rosacea are two types of viral skin disorders.

False

Addison disease is a temporary condition.

False

All persons affected with rheumatoid arthritis have the presence of the rheumatoid factor, an autoantibody that reacts with a fragment of immunoglobulin G to form immune complexes.

False

Examples of superficial viral skin functions include tinea capitis Genia corpus and tenia pedis

False

Examples of superficial viral skin infections include: tinea capitis, tinea corporis, and tinea pedis.

False

Hypothyroidism is evidenced by an increased metabolic rate, restlessness, irritability, tachycardia, diarrhea, and heat intolerance.

False

Orchitis is an infection of the penis

False

Orchitis is an infection of the penis.

False

Rheumatic disorders have signs and symptoms that are limited to the skeletal system.

False

The dermis is the outermost later of the skin and covers the body.

False

The epidermis is well supplied by a vascular system.

False

The "cold viruses" are rapidly spread from person to person. The greatest source of spread is:

Fingers

A client comes in with a mild sunburn. Which term best describes the sunburn?

First-degree burn

The nurse notes a blister on a patient's skin. Which of the following best defines this area?

Fluid-filled papule

A nurse assesses a patient with multiple flat brown macules on the face and arms. Which of the following would best describe this lesion?

Freckles

The client has a stage III pressure ulcer. Which is the best description of a stage III pressure ulcer?

Full-thickness skin loss involving damage and necrosis of subcutaneous tissue that may extend down to but not through underlying fascia

Which process accounts for the damaging effects of the sun's radiation?

Generation of reactive oxygen species and damage to melanin

Which stratum layer of the epidermis has cells working to lose cytoplasm and DNA while synthesizing keratin?

Granulosum

Which of the following hormones is produced by the anterior pituitary gland?

Growth hormone (GH)

Which of the following processes is a component of the pathogenesis of proliferative breast lesions without atypia?

Growth of ductile or lobular epithelial cells

Select the most appropriate response that describes hair color.

Hair color is attributable to the melanin pigments that the hair contains.

What are the two main types of waxing products?

Hard and soft wax

Which type of hepatitis can be transmitted through contact with feces, saliva or contaminated food and water?

Hepatitis A

An older adult client presents with noted burning pain along the thoracic region with a tingling sensation and extreme sensitivity of the skin to touch, but there is no rash present at this time. Which skin problem will the health care provider interpret for this client?

Herpes zoster

The physician suspects a client may have developed pancreatitis, and the physician has ordered laboratory blood work. Diagnosis-confirming results would identify:

High serum amylase and lipase

Define the terms hirsutism and hypertrichosis

Hirsutism- excessive hair growth on he face, arms, and legs, especially in women. Hypertrichosis- excessive growth of hair that is characterized by the growth of terminal hair in areas of the body that normally grow only vellus hair. Like on the female face.

What are the three most important points in safe wax removal techniques?

Hold the skin taught, pull quickly, pull parallel to the skin

When educating a group of teenagers about STI's the school nurse also mentions that cervical cancer has been associated with which of the following viral infections

Human papilloma

While assessing a client who is experiencing diarrhea caused by Clostridium difficile, the nurse should anticipate hearing:

Hyperactive bowel sounds Inflammatory changes increase motility, which would lead to hyperactive bowel sounds. In many instances, it is not certain whether changes in motility occur because of inflammation or are secondary to the effects of toxins or unabsorbed materials.

the common results of respiratory failure are hypoxemia and?

Hypercapnia

A patient asks the nurse what part of the brain regulates appetite. Which is the best response by the nurse?

Hypothalamus

After skin care due to a recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer

I can't shake this feeling that I have received a death sentence

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the client's statements suggests that he understands his new diagnosis?

I don't know why i didn't bother to get vaccinated for this against this

Immunologically mediated joint inflammation

A patient has been diagnosed with choleycystitis and has impaired normal release of bile. What consequence is this patient likely to experience?

Impaired digestion of fats

When caring for the client with Laennec's cirrhosis, the nurse recognizes which of these is an expected etiology of jaundice?

Impaired uptake of billirubin

Increased epidermal cell turnover with marked epidermal thickening

The nurse is reviewing lab results of a client who has liver failure. The nurse determines that the client is at an increased risk for bleeding when the results include:

Increased prothrombin time

When caring for the client with hepatic failure, the nurse recognizes which of these problems places the client at increased risk for bleeding?

Increased prothrombin time

Increased risk for melanoma

The transition of a melanoma from radial growth to vertical growth with ulceration and invasion of the tumor into the deeper skin tissue likely results in which outcome?

Increased risk of metastasis

The immune suppressive and anti-inflammatory effects of cortisol cause:

Inhibition of prostaglandin synthesis

The most recent blood work of a patient with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What are the most likely effects of these peptides on the patient's physiology?

Inhibition of the renin-angiotensin-aldosterone system

A patient presents with pruritus of the lower extremities. Which of the following is the priority nursing assessment?

Inspection for presence of dry skin

A hormone has been synthesized in the rough endoplasmic reticulum of an endocrine cell after which it has moved into the Golgi complex, been packaged in a vesicle, and been released into circulation. What hormone is synthesized and released in this manner?

Insulin

Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes? A client who:

Is morbidly obese defined as greater than 100 pounds over ideal weight

An 81-year-old resident of an elder care facility is immobile and has been restricted to her bed for the past 6 weeks. Her physician recently discovered a decubitus ulcer on her left buttock. Which etiology is most likely?

Ischemia from prolonged pressure

A faculty member has just completed a lecture on seborrheic keratosis. Which statements by the students indicate that further teaching is required on the topic? Select all that apply.

It is a tumor of melanocytes. It is precancerous. It is caused by a virus.

Pruritus, a symptom common of many skin disorders, is a(an)

Itching sensation

Scabies infections are caused by mites that burrow under the skin. They are usually easily treated by bathing with a mite-killing agent and leaving it on for 12 hours. When scabies are resistant to the mite-killing agent, what oral drug is prescribed?

Ivermectin

Abnormally high accumulation of bilirubin in the blood causes:

Jaundice

Harmful effects on cardiac action potential are most likely to result from a deficit of which of the following electrolytes?

With aging, the skin acquires an overall thin and transparent quality while becoming dry and wrinkled. Which skin disorders are common among the older adult population?

Keratoses and solar lentigines

The ____________ cells of the liver are capable of removing and phagocytizing old and defective blood cells, bacteria, and other foreign material from the portal blood.

Kupffer

The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?

Kupffer cells

What is physiologic basis for oculocutaneous albinism?

Lack of tyrosinase

Langerhans cells

While working in an allergy clinic, the nurse notices that many patients come in with all types of skin reactions. The nurse working in this area knows that which cells play a role in the development of allergic skin condition?

Langerhans cells

A nursing instructor is teaching students about skin structure. The instructor evaluates student knowledge of the Langerhans cells based on which of the following statements?

Langerhans cells are the immunologic cells responsible for recognizing foreign antigens harmful to the body.

Cells that form a network to bind and process antigens in the epidermis are known as:

Langerhans cells.

Dysplastic nevi are precursors of malignant melanoma that are:

Larger than other nevi

What skin disease manifests with lesions on the skin and oral lesions that look like milky white lacework?

Lichen planus

A patient comes to the clinic with a "terrible itch" on the abdomen and waist that has lasted for several months and has been scratched continuously. Inspection reveals an area of thickened rough skin. The nurse documents this condition using which of the following terms?

Lichenification

In Third World countries many children experience and controlled itching and scratching, which may develop into

Lichenification

Which skin locations create particular risk factors for tumor invasion and metastasis due to squamous cell carcinoma? Select all that apply.

Lip Back of the hand Ear

The skin assessment of an African American patient reveals the presence of white areas on the skin that are flat, nonpalpable, less than 1cm in diameter, and have a circumscribed border. The nurse documents the presence of which of the following?

Macule

What neoplasm of the skin is associated with the poorest pronosis?

Malignant melanoma

A motor vehicle accident has resulted in a tension pneumothorax for the driver. What manifestation is associated with tension pneumothorax?

Mediastinal shift

A 51-year-old woman who was born congenitally blind and deaf is able to distinguish individuals by light touch of the individual's face. Which of the following components of the woman's skin innervation likely contributes the most to this ability?

Meissner corpuscles

With eyes closed, an object is placed in a student's hand. The instructor asks the student to identify the object. When he does so correctly, this is primarily the responsibility of:

Meissner corpuscles

Which are the sparsest cells in the epidermis?

Merkel cells

Which of these is a characteristic of impetigo?

Most common superficial bacterial infection

A client visited her healthcare provider and was diagnosed with acute cervitisis. A clinical manifestation that accompanies acute cervitis may include:

Mucourulent drainage

Muscle aches and pain along with fatigue

Which of the following physiologic processes results from the synthesis and release of testosterone?

Musculoskeletal growth

Which of the following signs and symptoms should prompt a 29-year-old woman's primary care provider to assess for systemic lupus erythematosus (SLE)?

NOT A history of thromboembolic events and varicose veins Renal involvement occurs in approximately one-half to two-thirds of persons with SLE, and arthralgia is a common early symptom of the disease. Although the manifestations of SLE are diffuse, these do not typically include alterations in hemostasis, gastrointestinal symptoms, dysmenorrhea, or miscarriage.

A nurse assesses a patient with a 3-cm lipoma in the subcutaneous tissue. Which of the following terms would best describe this lesion?

Nodule

Ocetrotide, a long-acting synthetic analog of somatostatin

The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which of the following signs/symptoms?

Ophthalmopathy

When assessing a client with acute cholecystitis, the nurse anticipates the client's report of pain will be consistent with which of these descriptions?

Pain in the right upper quadrant referred to the same shoulder

A client is complaining to the healthcare provider about several vague symptoms. Which of the following raises a red flag into heating the client may have developed endometrial cancer

Painless abnormal bleeding

Squam us cell cancer of the penis is characterized by which of the following clinical manifestations?

Painless lump on the inner surface of the prepuce

A person with severe lymphedema is asking the nurse where specifically are the lymph vessels located in the skin layers. What would the nurse would respond?

Papillary dermis layer

A patient is not able to absorb vitamin B12. The nurse determines that the patient is deficient in:

Parietal (oxyntic) cells, which secrete HCl and intrinsic factor Parietal (oxyntic) cells secrete HCl and intrinsic factor, which is needed for vitamin B12 absorption. Mucous neck cells secrete mainly mucus; peptic (chief) cells, which secrete large quantities of pepsinogen, which is rapidly converted to pepsin. Secretin is secreted by the S cells and inhibits gastric acid secretion.

A patient presents with lesions on his face and arms. Some are flat and some are raised. Depending on the diameter of the lesion, the nurse should document that flat lesions are either macules or

Patches

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis which may develop into which of the following potential complications

Pelvic adhesions

The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as:

Phagocytes

While studying the skin in a science class, a student asks why all people have a pinkish color to their lips/mucous membranes. The instructor would respond by citing which of the following responses?

Pheomelanin is the yellow to red pigment particularly concentrated in the lips and nipples in humans.

The nurse is assessing a patient who has a small pinpoint rash. Which of the following is the best cause of this rash?

Pinpoint petechiae

Which of the following structures controls the functions of many of target glands and cells?

Pituitary gland

A client is being seen in the dermatologist clinic for psoriasis. What term should the nurse select in the electronic health record (EHR) to describe the client's lesions associated with psoriasis?

Plaque

A client is being seen in the dermatologist clinic for psoriasis. What term should the nurse select in the electronic health record (EHR) to describe the client's lesions associated with psoriasis?

Plaques

Pain is an expected assessment finding in patients who have which of the following lung diseases?

Pleuritis

A client has a stage III pressure ulcer in the sacral area. What factors can contribute to the development of pressure ulcers? Select all that apply.

Pressure Shearing force Friction

Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary?

Production of insulin-like growth factors (IGFs) by the liver

A patient's recent history of emphysema has resulted in the functional loss of many alveoli. Which of the following physiologic functions is the primary role of type II alveoli?

Production of surfactant

One of the first signs that indicates an infant may have congenital hypothyroidism is:

Prolonged period of physiologic jaundice

Which of the following is the primary purpose of the mucosal barrier in the gastrointestinal tract?

Protection from acid secretion

What disease has primary lesions that have a silvery scale over thick red plaques?

Psoriasis vulgaris

Ulcerative Colitis is characterized by :

Psuedopolyps

Which action could result in pressure ulcer formation?

Pulling a stroke client up in bed

Which of the following actions involves the greatest risk of skin shearing?

Pulling the patient up in bed

A client is admitted to the hospital with first- and second-degree burns. Which assessment findings are associated with first-degree burns? Select all that apply.

Red or pink Painful

Which of the following physiologic processes contributes most to the long-term regulation of blood pressure?

Renal monitoring and adjustment of extracellular fluid volume

Select the layer of dermis characterized by a complex meshwork of three-dimensional collagen bundles interconnected with large elastic fibers.

Reticular dermis

Which term means inflammation of the nasal mucosa?

Rhinitis

The nurse is assessing a client who has just been admitted to the unit with a diagnosis of cholelithiasis. The nurse is aware that the client may manifest:

Right upper quadrant pain

The student nurse is reviewing a client chart in preparation for a clinical experience. The student sees the term nummular to describe the client's lesion. What would describe a nummular lesion?

Round, coin-like

Papulosquamous dermatoses such as psoriasis are a group of skin disorders characterized by

Scaling papules

Sebaceous glands excrete a mixture that lubricates the hair and skin. What is this mixture called?

Sebum

Sebum, secreted by the sebaceous gland

Upon inspection, the health care provider assesses a thermal burn as involving the entire epidermis and dermis. The provider will document this as which type of burn?

Second-degree (full-thickness)

A child comes in to show his parents (who are nurses) a blister on his foot from "breaking in" a new pair of shoes. The child wants to "pop the blister" to get all the fluid out of it so it won't hurt so much when he puts on shoes and socks. The parents know that breaking the skin of the blister will put him at risk for which of the following?

Secondary infection

The basement membrane between the epidermis and dermis provides for adhesion and serves as a:

Selective filter

A client who has been diagnosed with acute symptomatic viral hepatitis is now in the icteric period. The nurse would expect the client to manifest:

Severe pruritus and liver tenderness

A provider notes a rash on an adult's left thigh that consists of small, fluid-filled blisters following along a dermal tone. The client reports noticing the area burned and tingled. The provider likely will diagnose these signs and symptoms as being which type of infection?

Shingles

The nurse planning a sun safety community education class should include the information that the increased melanin produced by dark-colored skin decreases the risk for which of the following?

Skin cancer

In explaining a papule to a patient, a nurse defines it as being which of the following?

Small, raised solid mass with a circumscribed border

The nurse is assessing a client's skin and notices a few papules. What is the best description to include in the assessment about papules?

Small, raised superficial lesions

Pruritis, or the itch sensation, is a by-product of almost all skin disorders. However, we can itch without having a skin disorder. Itch then can be local or central in our bodies. Where is it postulated that a central "itch center" exists?

Somatosensory cortex

A 41-year-old male client is planning on having a vasectomy. Well explaining the surgery to the client, the healthcare worker will include which physiologic principle is the basis of IV us contraceptive tech meet?

Sperm can no longer pass-through the ductus deferens

Which microorganism is responsible for the development of bullous impetigo?

Staphylococcus aureus

A 30-year-old man has been diagnosed with mumps orchitis. The nurse should educate the client that which of the following complications may occur?

Sterility

A patient has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for levels of thyroid-stimulating hormone (TSH). This patient has undergone which of the following diagnostic tests?

Stimulation testing

A nurse comes upon a automobile accident where smoke and flames are coming from the car's engine. What would be the nurse's first priority in this situation?

Stop the fire or remove the person from the vehicle

A nurse comes upon a automobile accident where smoke and flames are coming from the car's engine. What would be the nurse's priority in this situation?

Stop the fire or remove the person from the vehicle.

Mitosis that results in the production of new epidermal cells occurs in which of the following layers of the epidermis?

Stratum germinativum

Which of the following carbohydrates is matched to its correct enzyme needed for digestion?

Sucrose and sucrase Sucrose is a dietary carbohydrate digested by sucrase, an enzyme. This produces the monosaccharides fructose and glucose.

In assessing a client's integumentary system, what assessment finding does the nurse report as "normal"?

Sweat glands in the axillae

Most of the skin's blood vessels are innervated by which component of the nervous system?

Sympathetic nervous system

A patient has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which of the following treatment modalities is most likely to benefit this patient?

Synthetic preparations of T3 or T4

All hormones can cross the cell membrane.

The brain is insulin independent.

The endocrine system uses chemical substances called hormones as a means of regulating and integrating body functions.

Type 2 diabetes is more common than type 1.

Explain the third stage of the hair growth cycle.

TELOGEN PHASE- the final stage of hair growth. The club hair moves up the follicle and is ready to shed. The hair is at its full size and shows above the skin's surface. The hair bulb is not active, released, and is only attached by epidermal cells.

A young adult is going on vacation to a sunny climate and plans on using a tanning booth to build up a protective tan. Which instructions should the nurse provide to the young adult?

Tanning booths should be avoided under all circumstances.

Among the skin's protective functions is the fact that it serves as an immunologic barrier. What cells detect foreign antigens?

The Langerhans cells

Thyroid and steroid hormones, which exert their effect on target cells by way of nuclear receptors, have which of the following characteristics?

The ability to cross the cell membrane of target cells

Which client would the nurse be most concerned about?

The client with herpes zoster affecting the trigeminal nerve

What is the source of nutrition for the epidermis?

The dermis

What structures are part of the Pilosebaceous unit?

The hair follicle and its appendages, (hair root, hair bulb, hair papilla, and the attached arrector muscles and sebaceous glands.)

Why is hard was better than soft wax for sensitive areas?

The hair is gripped as the wax dries and tightens and lifts off without sticking to the skin

An adult client has a large number of nevi on her neck and back. How should the nurse best interpret this assessment finding?

The nevi are likely benign, unless they are undergoing changes

An adult client has a large number of nevi on the neck and back. How should the nurse best interpret this assessment finding?

The nevi are likely benign, unless they are undergoing changes.

A client has been admitted to the intensive care unit of the hospital after developing TEN consequence to the administration of a sulfone made anabiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this clients health

The presence of diffuse lesions in skin sloughing on the clients mucous membranes

Define electrolysis

The process of removing hair by means of electricity and is considered the only method of permanent hair removal. Preformed by inserting small needles into the hair follicles.

The ventilation- perfusion ratio refers to what?

The ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli

What are the main structures of the hair follicle?

The root, shaft, bulb, pilosabeceous unit, and papilla

Which of the following statements most accurately describes the function of the secretory glands in the gastrointestinal (GI) tract?

The secretory glands produce mucus to lubricate and protect the mucosal layer of the GI tract wall.

A client has been diagnosed with an incompetent pyloric sphincter. This client is experiencing a lot of abdominal pain and nausea. When this client vomits, the nurse should expect what type of secretions will be in the basin?

Thick, brownish, foul-smelling emesis The pylorus is located between the body of the stomach and the duodenum. At the end of the pyloric canal, the circular smooth muscle layer thickens to form the pyloric sphincter. This muscle serves as a valve that controls the rate of stomach emptying and prevents the regurgitation of intestinal contents back into the stomach. Therefore, if the pyloric sphincter is incompetent, intestinal content will flow back into the stomach.

Lichenified skin is defined as being which one of the following?

Thickened skin with exaggerated markings

A client has sustained a full-thickness burn involving subcutaneous tissue, muscle, and bone. Which term will the nurse use when documenting this type of burn?

Third-degree burn

Define threading and sugaring

Threading- works by using cotton thread that is twisted and rolled along the surface of the skin, entwining the hair in the thread and lifting it out of the follicle. Sugaring- For those who have sensitive skin. The sugaring solution is water soluble. The orignial recipe is a mixture of sugar, lemon juice, and water. It is heated to form a syrup, which is then molded into a ball and pressed onto the skin and quickly stripped away.

The pars reticularis is characterized by what?

Three-dimensional collagen bundles

What is the purpose of the basement membrane?

To interface between the dermis and epidermis

Which intervention will the nurse recommend for a client with tinea pedis?

Topical antifungal agents

A 4-year-old male child has several small pustules with honey-colored crusted drainage on his face but in no other location. The child is diagnosed with impetigo. The most appropriate treatment would be:

Topical mupirocin and limiting exposure, as it is transmitted easily

A weak urinary stream, postvoid dribbling, frequency of urination, and nocturia are classic symptoms of an enlarged prostate.

True

Cancer of the breast is the most common cancer in females

True

Cancer of the breast is the most common cancer in females.

True

Hypopituitarism is characterized by a decreased secretion of pituitary hormones.

True

Moon face, buffalo hump, obesity, amenorrhea, and increased facial hair are manifestation of Cushing syndrome.

True

Osteomalacia is a generalized bone condition in which inadequate mineralization of bone results from a calcium or phosphate deficiency, or both.

True

Primary adrenal insufficiency, or Addison disease, is caused by destruction of the adrenal gland.

True

Rickets is a metabolic bone disorder characterized by a failure or delay in calcification of the cartilaginous growth plate in children whose epiphyses have not yet fused.

True

The dermis and epidermis play a role in immune function.

True

The endocrine system uses chemical substances called hormones as a means of regulating and integrating body functions.

True

The pattern of menstrual bleeding tends to be fairly consistent in most healthy women with regard to frequency, duration, and amount of flow.

True

A client has an appointment concerning the possible diagnosis of malignant melanoma. Which statement is correct concerning malignant melanoma?

Tumor thickness is a very important factor.

Anaphylactic shock is directly associated with

Type I hypersensitivity

A patient with albinism has a genetic lack of which of the following enzymes?

Tyrosinase

When explaining why some children have albinism, the science teacher explains that which enzyme is needed for synthesis of melanin?

Tyrosinase

A young woman experiences frequent urination with a burning sensation. Her urine contains many white blood cells and bacteria. no glucose or protein in the urine. What is the cause?

UTI

Which description best summarizes the etiology of pressure injuries?

Unrelieved pressure on the skin causes decreased blood and lymph flow that leads to pressure injury development.

A 20-year-old female tells the nurse she is concerned about getting a good suntan before going on a vacation. The best response by the nurse would be:

Use a self-tanning product that produces the appearance of a tan without sun exposure.

What is photoepilation?

Uses intense light to destroy the growth cells of the hair bulb. Includes both laser hair removal and intense pulsed light to reduce hair growth

A client visiting the family medical physician is reporting her skin itching [pruritus]. Given that this is severe enough to causing excessive scratching that has broken the skin, the healthcare provider may want to educate the client to try which intervention?

Utilize topical antihistamines or corticosteroids for cutaneous disorders mediated by histamine.

A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect?

Varicella

What are six of the conditions, treatments, and medications that contraindicate hair removal?

Varicose veins, skin disorders, epilepsy, diabetes, recent chemical exfoliation, recent microderm, or injectable, laser or intense pulsed light therapy, use of Retin-A Differin, use of hydroquinone, blood thinning medications, circulatory disorders, chemotherapy and radiation, autoimmune disorders, rosacea, sunburn, pustules or papules

Vesicles

A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous small blisters on the shaft of his penis. The clinician would document the presence of:

Vesicles

When should you use a biohazard container for waste disposal?

When gauze has been in contact with blood or other bodily fluids

During a physical assessment, a nurse determines that a patient has excessively dry skin. Which of the following terms would the nurse use to document this condition?

Xerosis

diarrehea, fecal urgency, weight loss, tender red bumps on shins, pain and stiffness in elbows and knees. Discontinuous, granulomatous lesions, no blood in stool. What is the suspected diagnosis? a. crohns b. ulcerative colitis c.diverticulitits d. colon cancer

pouch like sac of mucosa that protrude through wall of the large intestine occurs in a. diverticulitis b. crohns c. celiacs d. none

For many patients, the first indication that they have osteoporosis is:

a bone fracture.

While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains:

a complex microbial system that contains hundreds of different species. The stomach and small intestine contain only a few species of bacteria, probably because the composition of luminal contents (i.e., acids, bile, pancreatic secretions) kills most ingested microorganisms, and the propulsive movements of these organs impedes their colonization. The large intestine, on the other hand, contains a large and complex microbial ecosystem. It has been estimated that each individual has 300 to 500 different species of intestinal bacteria, with anaerobic bacteria outnumbering aerobic bacteria by a large percentage.

Most of the body's hair follicles are paired with:

a sebaceous gland.

Which of the following are/is true regarding neonate respiratory distress syndrome? a. caused by inadequate production of surfactant b. caused by inadequate production of corticosteroids c. caused by inadequate supply of O2 d. none

A hallmark of irritable bowel syndrome is abdominal pain: a. relieved by defacation b. most severe at night c. with blood in stool d. after and between meals

a.relieved by defecation

A distinguishing feature of viral influenza is:

abrupt-onset, profound malaise.

The most common causes of left-sided heart failure include:

acute myocardial infarction

Acute onset bronchial asthma causes wheezing and breathlessness as a result of:

airway inflammation

What are the clinical manifestations are common indicators of diseases involving the digestive tract?

anorexia vomitting nausea

What causes glomerulonephritis?

antigen-antibody complexes

What is a predisposing factor for the development of a lower UTI?

any condition that impairs free drainage of urine introduction of a catheter into the bladder injury to bladder mucosa caused by a kidney stone

The most commonly occurring early symptoms of systemic lupus erythematosus (SLE) include:

arthralgia.

A 33-year-old client has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the client's care team prioritize?

assessment of the clients vision and oculomotor function.

Which type of hyperactive airway disease causes reversible bronchial constriction?

asthma

The release of insulin from the pancreatic beta cells can inhibit its further release from the same cells. This is an example of ________ hormone action.

autocrine

The most common cause of hypothyroidism is:

autoimmune disease.

Which of the following aspects of etiology of celiacs disease would underlie the explanation that the physician provides to a mother of a child with celiacs? a. bacterial and chemical invasion of peritoneum leads to decreased nutrient absorption b. an autoimmune that results from the production of antibodies to a component of gluten resulting in damage to the intestinal epithelium c. neurogenic or muscular inhibition of peristalisis results in inappropriate motility of ingested food d. inability to process or absorb fat content of breast milk

Which of the following individuals most likely faces the greatest risk of developing c.diff colitis? a. a 55 yo man who takes proton pump inhibitors for the treatment of peptic ulcera b. a 79 yo hospital patient who is being treated with broad spectrum antibiotics c. a premature neonate who has developed hyperbilirubinemia d. a 30 yo who has a history of crohns disease

What is/are clinical manifestations of an upper UTI?

back pain fever and chills nausea and vomitting

what could be the causes of acute bronchitis?

bacterial infections, viral infections, inhalation of chemicals or gases from the environment

The basal lamina, between the epidermis and dermis, is involved in skin disorders that cause:

blister formation.

The major adrenal cortical hormones are steroids and are synthesized from acetate and:

cholesterol.

A client calls the clinic and tells the nurse she is concerned because her husband has developed shingles. She asks the nurse if he is contagious. The best response would be that herpes zoster (shingles) is:

contagious and can be transmitted to nonimmune contacts.

Unlike hair, nails grow:

continuously.

Osteoarthritis is a degenerative form of joint disease that is often evidenced by:

crepitus and grinding.

Which is true regarding gastroesophageal reflux disease? a. symptoms occur at least twice a week and interfere with daily life b. heartburn is sever and occurs 30-60 minutes after a meal c. patient presents with chest pain can be confused with angina d. all

Which is true regarding tb? a. It is a chronic infectious disease characterized by necrosis of the lung tissue b. an immune response occurs which results in the formation of granulomas c. It is most commonly transmitted by inhalation of airborne droplets from an infected person d. all

d. all of the above

Which of the following is true regarding interstitial pneumonia? a.infiltrative cells are primarily neutrophils b. infiltrative cells are primarily lymphocytes and monocytes c. the inflammatory response involves the alveolar septa d. both b and c

d. both b and c

What can lead to acute gastritis

decreased blood flow to stomach increased acid secretion disruption of the mucosa lining in stomach

Thyroid hormone deficit ___________, which alters the function of all major organs in the body.

decreases metabolism

In contrast to osteoporosis, osteomalacia causes _______ without the loss of bone matrix.

defective mineralization

Blood work reveals BUN level of 36mg/dL. (normal is 8-25) Which of the following factors may have contributed to this finding? a. increased salt intake b. increased antidiuretic hormone secretion c. dehydration d. none

dehydration

What is the most common cause of chronic renal failure?

diabetic nephropathy hypertension

What are the clinical manifestations of COPD?

dyspnea, wheezing during auscultation, barrel shaped chest

term used to descibe inflammation of Intestinal tract?

enteritis

Allergic and hypersensitivity dermatoses are characterized by:

epidermal edema.

Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease?

excess ACTH production by a pituitary tumor

The most common cause of thyrotoxicosis is Graves disease, which has the distinguishing characteristic of ________ in addition to a diffuse goiter.

exophthalmos

The main cause of decubitus ulcers (bedsores) is _______ that impairs the flow of blood and lymph.

external pressure

The swallowing reflex is an entirely voluntary activity.

false Although swallowing is initiated as a voluntary activity, it becomes involuntary as food or fluid reaches the pharynx.

When sensors detect a change in a hormone level, the hormonal response is regulated by _________ mechanisms that will return the level to within normal range.

feedback

Which clinical presentations would one expect to observe in a patient that has bacterial pneumonia?

fever, tachypnea, crackles heard during auscultation

Systemic sclerosis (scleroderma) is an autoimmune disease of connective tissue characterized by:

fibrosis.

Disorders that affect cortical bone typically result in:

fractures of long bones.

Pressure injuries can occur quickly in older adult clients and in client who are immobile. What is a method for preventing pressure injuries?

frequent position changes

A thermal burn described as involving the entire epidermis and dermis is classified as:

full-thickness second-degree

Crohns type of inflammatory bowel disease is characterized by?

granulomatous lesion

Which of the following assessment findings of a male client constitutes a criterion for a diagnosis of metabolic syndrome? The client:

has a blood pressure that is consistently in the range 150/92 mmHg

What is the most common cause of chronic gastritis?

heliobacter pylori

hemodynamic instability.

Term used to describe a protrusion of a loop of bowel through an opening in the abdominal wall

hernia

What is a predisposing factor for the formation of uroliths?

high concentration of salts in urine uti urinary tract obstruction

Dark skin tone is genetically determined and is primarily the result of:

high production of melanin.

The common results of respiratory failure are hypoxemia and:

hypercapnia

What electrolyte abnormalities are seen in chronic renal failure?

hypernatremia hyperkalemia

What are the clinical manifestations in a patient with chronic renal failure?

hypertension weight loss edema

Release and synthesis of anterior pituitary hormones are mainly regulated by the inhibiting or releasing actions of the:

hypothalamus.

A predominant effect of a prolonged excessive growth hormone level is:

increased blood glucose levels.

Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the patient with psoriasis, a disorder that results from:

increased epidermal cell turnover.

A patient recently underwent extracorporeal shock wave lithotripsy for treatment of renal calculi. what measure should the patient integrate into his lifestyle to reduce risk of recurrence?

increased fluid intake and dietary changes

telescoping of a segment of bowel into an adjacent segment of the bowel

intussusception

A 40 year-old man who uses heroin intravenously was diagnosed with hepatitis C (HCV) one year ago and now has chronic viral hepatitis. Which of the following statements by the client to his care provider would warrant correction by the nurse?

it is at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms.

Pruritus, a symptom common of many skin disorders, is a(an):

itching sensation.

Warts develop when ______ are invaded by human papillomavirus (HPV).

keratinocytes

Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a:

large lipid core

Dysplastic nevi are precursors of malignant melanoma that are:

larger than other nevi.

Although both autocrine and paracrine hormonal actions occur without entering the blood stream, paracrine actions differ because they affect ______ cells.

local

Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with what?

local irritants such as alcohol or aspirin

The iatrogenic form of Cushing syndrome is caused by:

long-term cortisone therapy prescribed by a primary care provider.

What disorder is a non penetrating mucosal tear at the gastroesophageal junction?

mallory weis syndrome

What is true about barrots esophagus?

normal esophageal squamous mucosa is replaced by columnar epithelium

Hormones exert their action by binding to high-affinity receptors on the surface or inside of the target cell. The response of the target cell varies with the _____ and _____ of the receptors present.

numbers; affinity

The condition that contributes to the pathology of all metabolic bone diseases is:

osteopenia.

A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of:

pannus tissue.

A collection of fluid within the pleural cavity is known as ?

pleural effusion

Which term indicates a collapse of the lung?

pneumothorax

A patient with renal dysfunction caused by decreased blood flow and perfusion to the kidneys would have what type of kidney dysfunction?

prerenal dysfunction

Several hormones, including steroids and thyroid hormone, are bound to and carried by:

proteins.

Which assessment findings is most suggestive of nephrotic syndrome?

proteinuria and generalized edema

What is the best treatment regimen is likely to best address GERD?

proton pump inhibitors; avoiding large meals; eating sitting up

What are the components of COPD?

pulmonary emphysema and chronic bronchitis

Suppurative inflammation of the the kidney and renal pelvis is called?

pyelenophritis

reactive arthritis.

A 26-year-old women has sought care for increasing pain at the back of her ankle and the bottom of her foot over the past 2 weeks. The patient states that she is generally in good health, although she completed a course of antibiotics for a chlamydial infection 6 weeks earlier. This patient's recent history suggests the possibility of:

reactive arthritis.

What is cor pulmonale?

right heart failure resulting from pulmonary disease

Pruritus is the most common presenting symptom in persons with cholestasis, probably related to increased levels of bile _____________ in the blood.

salts

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by:

scaling papules.

The _______ are the skin structures that become inflammed in acne.

sebaceous glands

The pilosebaceous unit of the skin consists of:

sebaceous glands.

What is a risk factor for the development of a stress ulcer?

severe trauma sepsis cardiovascular shock

A client has a stage III pressure injury in the sacral area. What factor(s) can contribute to the development of pressure injuries? Select all that apply.

shearing force friction pressure

The nurse notes a rash on an adult's left thigh that consists of small, fluid-filled blisters following along a dermatome. The client reports the area burns and tingles. The nurse suspects the client will be diagnosed with which type of infection?

shingles

Sebaceous glands secrete sebum, which is a:

skin lubricant.

When hypofunction of an endocrine organ is suspected, a hormone ____________ test can be administered to measure and assess target gland response.

stimulation

The difference between the end-diastolic and end-systolic volumes in the:

stroke volume.

A client's primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the following instructions should the client be given?

the lab tech will give you a sugar solution and then measure your blood sugar levels at specific intervals.

A man sustained a puncture injury to his chest that caused a pneumothorax to form. why is this life threatening?

trapped, inspired air collapses the lung

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

trapped, inspired air collapses the lung.

A patient has excessive blood loss and prolonged hypotension during surgery. Post op urine output is sharply decreased and his BUN is elevated. What is the most likely cause? a.postrenal failure b. bladder outlet obstruction c. tubular necrosis d. intrarenal nephrotoxicity

tubular necrosis

One of the metabolic functions of the liver is the conversion of ammonia, which is produced by deamination of amino acids, into ______________.

urea

Which diagnosis causes an increased risk of developing intrahepatic jaundice? Select all that apply.

• Hepatitis • Cirrhosis • Liver cancer

A patient with a history of chronic renal disease has severe pruritus. Which of the following interventions should the nurse include in the teaching plan for the patient? Select all that apply.

• Keep fingernails trimmed • Moisturize the skin frequently • Take a cool shower before bed

A client asks the nurse to explain the digestive tract layers because the client is experiencing upper GI problems. When talking about the mucosa layer, the nurse will emphasize that the roles/functions of this layer consist of: Select all that apply.

• Production of mucus to protect and lubricate the inner lining • Beginning of the digestive process by secreting enzymes to break food down

Which of the following would be considered functions of the skin? Select all that apply.

• Protection from an invasion of microbes • Synthesis of vitamin D • Protection against physical injury

Which client is most likely to have a rash? Select all that apply.

• The client with an infectious disease • A baby that wears a diaper • A client who is in a hot room and has a fever

A client of Asian decent requests treatment suggestions for the darkened macules on the face. Which treatment measures for melasma should be recommended? Select all that apply.

• Try to limit amount of time in the sun • Use sunscreen regularly • Consult a healthcare provider about using a bleaching agent

Which of the following statements about temperature regulation and skin is accurate?

Arteriovenous anatomoses between an artery and vein within the skin layer are important for temperature regulation

Which of the following functions is performed by saliva? A) Antimicrobial protection B) Promotion of intestinal flora C) Buffering of gastric secretions D) Catalysis of brush border enzymes

A) Antimicrobial protection

A patient who is quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the following actions performed by the patient's caregiver is likely to promote defecation? A) Digital stimulation of the patient's rectum B) Massage of the patient's abdomen C) Seating the patient in an upright position D) Administration of large amounts of free water

A) Digital stimulation of the patient's rectum

The digestive tract is a four-layered tube. Which layer consists of connective tissue and contains nerves, blood vessels, and structures for secreting the digestive juices? A) Mucosal B) Peritoneum C) Submucosal D) Circular muscle

A) Mucosal

Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by:

C. Scaling papules

Motility along the length of the gut, control of function, and communication of each segment are innervated by the ______ neurons of the enteric nervous system. A) intramural B) vasovagal C) sympathetic D) preganglionic

A) intramural

In addition to mucus, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous type fluid are secreted to act as a: A)vehicle for absorption. B)enzyme that splits sugars. C)protection from acid content. D)parasympathetic stimulation.

A)vehicle for absorption.

Which of the following statements about temperature regulation and skin is accurate?

Arteriovenous anastomoses between an artery and a vein within the skin layer are important for temperature regulation.

Gastrin production, a task that is performed by the stomach, results in which of the following effects? A) Simulation of pancreatic enzyme secretions B) Stimulation of HCl secretions by parietal cells C) Conversion of polysaccharides to monosaccharides D) Release of insulin in response to glucose load

B) Stimulation of HCl secretions by parietal cells

A patient's complex and worsening pressure ulcer has necessitated the use of numerous antibiotics over the last several months. Which of the following consequences may result from this patient's medication regimen? A) Impaired mucus production B) Vitamin K deficiency C) Impaired protein metabolism D) Excessive release of pepsin

B) Vitamin K deficiency

In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum: A) during bile secretion. B) between contractions. C) with a mucosal surface. D) under gaseous pressure.

B) between contractions.

The stomach is the source of two hormones produced by the gastrointestinal tract: gastrin and ghrelin. Ghrelin is a peptide hormone produced in the mucosal layer that has an important role in regulation of ________ secretion. A) gastric acid fluid B) growth hormone C) biliary bicarbonate D) pancreatic enzyme

B) growth hormone

Because intestinal secretions are mainly ______ and are derived from the extracellular fluid, excessive secretion or impaired absorption can lead to extracellular _____. A) nitrogen; acidosis B) water; dehydration C) anaerobic; hypotonicity D) electrolytes; hypervolemia

B) water; dehydration

The intestinal absorption of glucose and amino acids is facilitated by a ________ transport system. A) bile-salt micelles B) fat emulsification C) sodium-dependent D) brush border enzyme

C) sodium-dependent

A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique?

C. "Sperm can no longer pass through the ductus deferens."

Which of the following physiologic changes results in menopause?

Cessation of ovarian function and decreased estrogen levels

Due to increasing dryness of her skin in the recent years egg seven-year-old woman has needed to reduce the number of baths that she takes. Which of the following factors has resulted in this age related change in skin function?

Changes in sebaceous secretions

Which of the following patients likely faces the greatest risk of a gastrointestinal bleed? A) A man whose hypertension requires him to take a diuretic, an ACE inhibitor, and a β-adrenergic blocker B) A patient who is taking a broad-spectrum antibiotic to treat a urinary tract infection C) A patient with a history of anxiety who takes benzodiazepines several times daily D) A patient who takes aspirin with each meal to control symptoms of osteoarthritis

D) A patient who takes aspirin with each meal to control symptoms of osteoarthritis

Parasympathetic stimulation results in which of the following gastrointestinal effects? A) Increase in smooth muscle tone B) Enhancement of sphincter function C) Decrease in gastrointestinal motility D) Increase in enteric nervous system activity

D) Increase in enteric nervous system activity

What body part is the largest serous membrane in the body, constitutes the outer wall of the intestine, and contains a serous fluid between its two layers? A) Mesentery B) Omentum C) Haustration D) Peritoneum

D) Peritoneum

Bile and pancreatic juices enter the ______ through the common bile duct and the pancreatic duct. A) ileum B) antrum C) jejunum D) duodenum

D) duodenum

Ovarian cancer has severe early symptoms and is most often diagnosed and it's early stages

False

The dermis is the outer most layer of the skin covers the body

False

The dermis is the outermost layer of the skin and covers the body.

False

The structure of the skin renders it susceptible to bacterial and fungal infections but resistant to viral infections.

False

The structure of the skin renders it's susceptible to bacterial and fungal infections but resistant to viral infections

False

The uterus is a thin walled muscular organ

False

The uterus is a thin-walled muscular organ.

False

Varicella in adults is of similar significance and severity as in children.

False

When sensors detect a change in a hormone level, the hormonal response is regulated by which of the following mechanisms that will return the level to within normal range.

Feedback

A diabetic client is controlled on Avandia (rosiglitazone), a thiazolidinedione medication that acts at the level of nuclear peroxisome proliferator-activated receptors (PPARs) to promote:

Glucose uptake

While discussing physiological process behind penal of action, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting blood into the sinusoids?

Nitric oxide

Certain types of sexually transmitted human papillomaviruses are risk factors for a neoplasia, which can be a precursor lesion of invasive carcinoma.

True

Malignant melanoma, Which is a malignant tumor of melanocytes is rapidly progressive and meta stick form of skin cancer

True

Malignant melanoma, which is a malignant tumor of melanocytes, is a rapidly progressive and metastatic form of skin cancer.

True

Sebaceous glands which release a lubricant for the skin and hair are located over the entire skin surface except for the palms and soles and sides of the feet

True

Sebaceous glands, which release a lubricant for the skin and hair, are located over the entire skin surface except for the palms, soles, and sides of the feet.

True

The condition of having undescended testes is also known as cryptorchidism.

True

The condition of having undescendent testes is also known as cryptorchidisn

True

The epidermis is well supplied by a vascular system.

True

A 5-year- old girl has been presented for care by her father due to reserve recent development of macules on her trunk, extremities, and mucous membranes. The child is my believe febrile but her primary symptom is extreme prior to this. What disorder of the skin should the clinician who is assessing the child first suspect?

Varicella

While trying to explain the physiology behind type 2 diabetes to a group of nursing students, the instructor will mention which of the following accurate information?

in skeletal muscle, insulin resistance promotes decreased uptake of glucose. following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearence

Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary?

production of insulin like growth factors (IGFs) by the liver

One of the first signs that indicates an infant may have congenital hypothyroidism is:

Patho Preview Quiz 13, 7, Quiz Eleven, Structure and Function of GI, Path Exam 2, Patho Ch 46 Skin Disorders, Unit 7 patho, GI Quiz, Exam 3, Chapter 29, Patho Exam 5, Final Review Ch 18, Exam 4 patho chapter 13, Quiz #7 & 8: Chs 29, 30, 32, 33, Patho...

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