Patho Quiz Study Questions

A nurse holds an exercise class for older adults and knows which of the following statements listed below by a class member requires clarification?

"Exercise can help to keep down the salt levels that cause high blood pressure."

A nurse is changing the wound dressing on the coccyx-region pressure ulcer of an immobilized patient. The existing dressing is saturated with both watery, clear discharge and foul, gray-colored liquid. Which of the following entries in the patient's chart best captures this? A. "Large amounts of suppurative and serous exudates noted" B. "Purulent discharge and fibrinous exudates noted on existing dressing" C. "Abscess activity noted to coccyx wound" D. "Plasma proteins and membranous exudates present on existing dressing"

A. "Large amounts of suppurative and serous exudates noted"

A nurse educator is performing client education with a 51-year-old man who has been recently diagnosed with chronic kidney disease. Which of the following statements by the client would the nurse most likely want to correct or clarify? A. "My kidney problems increase my chance of developing high blood pressure or diabetes." B. "My heart rate might go up because of my kidney disease, and my blood might be a lot thinner than it should be." C. "I'll have a risk of either bleeding too easily or possibly clotting too quickly, though dialysis can help minimize these effects." D. "I'll be prone to anemia, since I'm not producing as much of the hormone that causes my bones to produce red blood cells."

A. "My kidney problems increase my chance of developing high blood pressure or diabetes."

A nurse is collecting a urine specimen prior to measuring the albumin level in a client's urine. A colleague questions the rationale for the test, stating, "I thought albumin was related to liver function, not kidney function." How can the nurse best respond to this statement? A. "Urine albumin levels are useful for diagnosing diabetic kidney disease." B. "A urine dipstick test will tell us exactly how much albumin is being spilled by the client's kidneys." C. "Urine should normally be free of any proteins, and albumin is one of the more common proteins to be excreted in chronic renal failure." D. "A urine test for albumin allows us to estimate the client's GFR quite accurately."

A. "Urine albumin levels are useful for diagnosing diabetic kidney disease."

A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate? A. "Your prognosis will depend on whether we can surgically resect your tumor." B. "The major risk that you face is metastases to your lungs, liver, or bones." C. "Our treatment plan will depend on whether your tumor is malignant or benign." D. "This is likely a result of a combination of heredity and lifestyle."

A. "Your prognosis will depend on whether we can surgically resect your tumor."

Which of the following individuals is most likely to be diagnosed with a central vestibular disorder? A. A woman who has ongoing difficulty in balancing herself when walking B. A woman who suffered a loss of consciousness after being struck on the head during a soccer game C. A man who states that he feels car sick whenever he rides in the back seat of a vehicle D. A man who got up quickly from his bed and sustained an injury after he "blacked out"

A. A woman who has ongoing difficulty in balancing herself when walking

Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture? A. An 8-year-old boy who fell out of a tree and on to his arm B. A 20-year-old football player who had an opposing player fall laterally on his leg C. An 81-year-old woman with a history of osteoporosis who stumbled and fell on her hip D. A 32-year-old woman who fell awkwardly on her arm while skiing

A. An 8-year-old boy who fell out of a tree and on to his arm

A pediatric nurse is assessing a newborn diagnosed with persistent patency of the ductus arteriosus. Which of the following findings are associated with this heart defect? Select all that apply. A. BP 84/30 classified as a wide pulse pressure B. Shortness of breath with activity such as kicking C. Bulging jugular neck veins D. Stridor with inspiratory wheezes E. Murmur heard at the second intercostal space, during both systole and diastole

A. BP 84/30 classified as a wide pulse pressure E. Murmur heard at the second intercostal space, during both systole and diastole

A brain tumor causing clinical manifestations of headache, nausea, projectile vomiting, and mental changes is likely located in which parts of the brain? Select all that apply. A. Extra-axially B. Temporal lobe C. Brain stem D. Frontal lobe E. Intra-axially

A. Extra-axially D. Frontal lobe E. Intra-axially

Which of the following nursing interventions would be a priority when caring for a newborn who is receiving phototherapy for high bilirubin levels? Select all that apply. A. Frequent monitoring of temperature B. Keeping diapers dry and clean C. Maintaining oral intake to prevent dehydration D. Applying sunscreen to prevent ultraviolet radiation E. Putting lotion on his skin frequently to prevent drying/cracking of skin

A. Frequent monitoring of temperature C. Maintaining oral intake to prevent dehydration

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action A. Frontal lobe B. Cerebellum C. Basal ganglia D. Thalamus

A. Frontal lobe

A 20-year-old college student has presented to his campus medical clinic because of his unshakable despondency in recent months. He has been diagnosed with depression based on his signs, symptoms, and history. The nurse knows that which of the following treatments will likely be prescribed for this student? A. Medication that inhibits the reuptake of serotonin in his presynaptic space B. Antipsychotics such as olanzapine C. Cholinesterase inhibitors that potentiate the action of available acetylcholine D. Benzodiazepines such as clonazepam that modulate his GABA receptors. E. Drugs that inhibit the accumulation of cyclic adenosine monophosphate (cAMP)

A. Medication that inhibits the reuptake of serotonin in his presynaptic space

A 30-year-old male's blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man's most likely diagnosis? A. Multiple myeloma B. Acute lymphocytic leukemia C. Acute myelogenous leukemia D. Hodgkin lymphoma

A. Multiple myeloma

A patient presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus(MRSA) cellulitis. The patient's physician has ordered a complete blood count and white cell differential. Which of the following blood components would the physician most likely anticipate to be elevated? A. Neutrophils B. Eosinophils C. Platelets D. Basophils

A. Neutrophils

A patient who has been on a high-protein diet comes to the emergency department with respiratory symptoms. Upon analysis of arterial blood gases (ABGs), the patient is diagnosed with hypercapnia. The nurse will note the ABG results that confirm this diagnosis include: Select all that apply. A. Serum HCO3of -33 mEq/L (normal 22 to 28). B. PO2 of 97%. C. PCO2 of 58 mm Hg (normal 38 to 42). D. pH 7.31 (normal 7.35 to 7.45). E. Serum K+ (potassium)of 3.6 mmol/L (normal 3.5 to 5.0).

A. Serum HCO3of -33 mEq/L (normal 22 to 28). C. PCO2 of 58 mm Hg (normal 38 to 42). D. pH 7.31 (normal 7.35 to 7.45).

A 2-year-old girl has had repeated ear and upper respiratory infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the child's recurrent infections? A. The child's immune system is unable to synthesize adequate immunoglobulin on its own. B. The child lacks the antigen-presenting cells integral to normal B-cell antibody production. C. The child had a congenital absence of IgG antibodies that her body is only slowly beginning to produce independently. D. The child was born with IgA and IgM antibodies, suggesting intrauterine infection.

A. The child's immune system is unable to synthesize adequate immunoglobulin on its own.

A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates. Which of the following factors would the physician be most likely to rule out as a contributor? A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA) B. The fact that the infant is being breast-fed C. Hypoxia D. Hepatic immaturity of the infant

A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)

Following an injury where a child hit his head from a fall, the CT scan reveals a contusion that the doctor classifies as a moderate brain injury. Which of the following manifestations will the nurse more than likely assess on this child that support this diagnosis? Select all that apply. A. Weakness or slight paralysis affecting one side of the body B. Aphasia at times C. Periods of unconsciousness D. Nuchal rigidity E. Coma with total paralysis

A. Weakness or slight paralysis affecting one side of the body B. Aphasia at times C. Periods of unconsciousness

A patient arrives at the ED complaining of numbness in the left lower leg. Upon assessment, the nurse finds the lower left leg to be cold to touch, pedal and posterior tibial pulses nonpalpable, and a sharp line of paralysis/paresthesia. The nurse's next action is based on the fact that A. acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow. B. the immediate infusion of tissue plasminogen activator (tPA) will not correct the problem and should only be used for CVAs. C. administration of an aspirin and sublingual nitroglycerin will vasodilate the artery to restore perfusion. D. submersion in a whirlpool with warm water will improve the venous blood flow and restore pulses.

A. acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow.

Which of the following clients' signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult A. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days. B. has experienced a sudden loss of balance and slurred speech. C. states that his left arm and leg are numb, and gait is consequently unsteady. D. has vomited and complained of a severe headache.

A. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days.

A middle-aged woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady; her speech is slurred; and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which of the following health problems most likely underlies her present state? A. Cerebellar damage caused by a cerebrovascular accident B. Multiple sclerosis C. Guillain-Barré syndrome D. Myasthenia crisis

A.Cerebellar damage caused by a cerebrovascular accident

The nurse knows which of the following statements listed below relative to a client with malignant melanoma treated with alpha interferon (IFN-a) is accurate? Alpha interferon (IFN-a) A. plays an important role in the modulation of the inflammatory response. B. controls the migration of leukocytes to their primary site. C. will kill certain microorganisms that may help spread the cancer. D. helps keep all the blood levels at a higher level.

A.plays an important role in the modulation of the inflammatory response.

A family physician is performing patient teaching about the influenza virus with each patient who has come to the clinic to receive that year's vaccine. Which of the following statements by the patient best reflects an accurate understanding of the flu virus? A. "I know my vaccination is especially important since there aren't any drugs that can treat the flu once I get sick with it." B. "I could come down with viral or bacterial pneumonia as a result of a bad flu bug." C. "Like all vaccines, it is ideal if everyone in a population gets immunized against the flu." D. "The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated and actually ineffective."

B. "I could come down with viral or bacterial pneumonia as a result of a bad flu bug."

A 42-year-old male has been diagnosed with renal failure secondary to diabetes mellitus and is scheduled to begin dialysis soon. Which of the following statements by the client reflects an accurate understanding of the process of hemodialysis? A. "It's stressful knowing that committing to dialysis means I can't qualify for a kidney transplant." B. "I won't be able to go about my normal routine during treatment." C. "I know I'll have to go to a hospital or dialysis center for treatment." D. "Changing my schedule to accommodate 3 or 4 hours of hemodialysis each day will be difficult."

B. "I won't be able to go about my normal routine during treatment."

A family physician is providing care for a 61-year-old obese male who has a history of diabetes and hypertension. Blood work has indicated that the man has a GFR of 51 mL/minute with elevated serum creatinine levels. Which of the following statements will the physician most likely provide the client in light of these results? A. "You're in kidney failure, and I'll be starting dialysis treatment immediately." B. "Your chronic kidney disease has likely been caused by your diabetes and high blood pressure." C. "You likely have chronic kidney disease, and there may be urine in your blood until it is controlled." D. "We will regularly monitor your kidney function, but most likely your kidneys will be able to compensate on their own and intervention is not required."

B. "Your chronic kidney disease has likely been caused by your diabetes and high blood pressure."

A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a "coup" injury. How will the nurse explain this to the family so they can understand? A. "When the bat hit his head, his neck jerked backward causing injury to the spine." B. "Your son has a contusion of the brain at the site where the bat hit his head." C. "It's like squeezing an orange so tight that the juice runs out of the top." D. "Your son has a huge laceration inside his brain where the bat hit his skull."

B. "Your son has a contusion of the brain at the site where the bat hit his head."

Which of the following clients would be considered to have a significant risk of developing the prerenal form of acute renal failure? Select all that apply. A. A 68-year-old male with a diagnosis of benign prostatic hyperplasia (BPH) B. A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure C. A 41-year-old female who is admitted for intravenous antibiotic treatment of pyelonephritis D. A 20-year-old male who is admitted for treatment of an overdose of a nephrotoxic drug E. A 22-year-old male who has lost large amounts of blood following a workplace injury F. An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

B. A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure E. A 22-year-old male who has lost large amounts of blood following a workplace injury F. An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

Which of the following clients' diagnostic blood work is most suggestive of chronic kidney disease (CKD)? A. A client with low potassium levels; low calcitriol levels; and increased PTH levels B. A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels C. A client with low bone density; low levels of calcium; and low levels of phosphate D. A client with high pH; low levels of calcium; and low levels of phosphate

B. A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels

Which of the following individuals would most likely experience global ischemia to his or her brain? A. A woman who has been admitted to the emergency department with a suspected intracranial bleed B. A man who has entered cardiogenic shock following a severe myocardial infarction C. A male client who has just had an ischemic stroke confirmed by CT of his head D. A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater

B. A man who has entered cardiogenic shock following a severe myocardial infarction

When assessing a patient diagnosed with brain stem ischemia complaining of vertigo, the nurse will likely observe which of the following clinical manifestations? Select all that apply. A. Deafness B. Inability to coordinate voluntary muscular movements C. Difficulty in articulating words D. Feelings of ear fullness E. Facial weakness

B. Inability to coordinate voluntary muscular movements C. Difficulty in articulating words E. Facial weakness

When educating a patient with a wound that is not healing, the nurse should stress which of the following dietary modifications to ward off some of the negative manifestations that can occur with inflammation? A. This is the one time whereby you should eat more fat (both polyunsaturated and saturated), so you can absorb more fat soluble vitamins. B. Increase your intake of oily fish and fish oil so that you will increase absorption of omega-3 polyunsaturated fatty acids. C. Increase the amount of calcium in the diet, especially drinking milk and eating cheese. D. Since there is a loss of plasma proteins, you should increase your intake of organ meats like liver.

B. Increase your intake of oily fish and fish oil so that you will increase absorption of omega-3 polyunsaturated fatty acids

Which of the following data would a clinician consider as most indicative of acute renal failure? A. Decreased serum creatinine and blood urea nitrogen (BUN); decreased potassium and calcium levels B. Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR) C. Decreased urine output; hematuria; increased GFR D. Alterations in blood pH; peripheral edema

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

A client with a diagnosis of atrophic gastritis and consequent pernicious anemia is receiving high oral doses of vitamin B12. Which of the following changes would be most likely expected by his care provider at the completion of his treatment? A. Increased folic acid levels B. Increased serum bilirubin C. Decreased free heme levels D. Decreased mean corpuscular volume

B. Increased serum bilirubin

Which of the following statements best captures the current understanding of the etiology of mental illness? A. Mental illness can be attributed to organic brain changes and pathophysiological processes. B. Mental illness exists from the interplay of biologic factors and psychosocial influences. C. Current understanding of mental illness has shown that both biologic psychiatry and psychosocial psychiatry are incorrect. D. The role of "nurture," experiences, and relationships has been largely disproven.

B. Mental illness exists from the interplay of biologic factors and psychosocial influences.

A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse? A. Communication between a neuron and the single neuron it is connected with will be facilitated. B. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors. C. Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses. D. The neurotransmitter will cross gap junctions more readily.

B. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

The neuroscience nursing unit has developed a set of step-by-step directions of what should occur if a nursing assessment reveals that the patient may be exhibiting clinical manifestations of a cerebrovascular accident (CVA). Which of the following statements about clinical practice guidelines are accurate? Select all that apply. A. Step-by-step guidelines are usually developed and based primarily on "how it has always been done before." B. The development of evidence-based practice guidelines requires a research review from different studies to develop the most accurate diagnostic method to implement. C. Once developed, practice guidelines only need to be reviewed if a national committee sends out an update on new research. D. A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method. E. When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot test it for further feedback.

B. The development of evidence-based practice guidelines requires a research review from different studies to develop the most accurate diagnostic method to implement. D. A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method. E. When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot test it for further feedback.

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

B. Ultrasound bladder scanning to determine the residual volume of urine after voiding

A 70-year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult? A. Difficulty in starting movement, stopping movement, and maintaining rhythmic movements. B. Unsteady gait and difficulty in speaking and swallowing C. Flaccid loss of muscle tone D. Tremor, rigidity, and bradykinesia

B. Unsteady gait and difficulty in speaking and swallowing

A 66-year-old obese man with diagnoses of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? A. He is presently volume overloaded following several days of intravenous fluid replacement. B. Ventricular dilation and wall tension are significantly lower than normal. C. His resting blood pressure is normally in the range of 150/90, and an echocardiogram indicates his ejection fraction is 30%. D. His end-diastolic volume is higher than normal, and his resting heart rate is regular and 82 beats/minute.

B. Ventricular dilation and wall tension are significantly lower than normal.

A care aide at a long-term care facility has informed a resident physician that an 80-year-old woman's eyes appear to be inflamed and that her eyelids are caked with sticky secretions. The woman has been subsequently diagnosed with posterior blepharitis. Which of the following treatments is the physician likely to initiate? A. Surgical repair of the woman's blocked meibomian glands B. Warm compresses to be applied regularly to her eyes in addition to oral antibiotics C. Intravenous steroids coupled with topical antibiotic ointment D. Regularly scheduled cleansing of the woman's eyes with normal saline

B. Warm compresses to be applied regularly to her eyes in addition to oral antibiotics

A 20-year-old has been admited to a rehabilitation center after hospital treatment for an ischemic stroke. Which of the following aspects of the client's history would be considered to have contributed to his stroke? Select all that apply. The client A. takes corticosteroids for the treatment of rheumatoid arthritis. B. blood pressure has historically been in the range of 150s/90s. C. takes iron supplements for the treatment of chronic anemia. D. was diagnosed with type 2 diabetes 8 years ago. E. is an African American male.

B. blood pressure has historically been in the range of 150s/90s. anemia. D. was diagnosed with type 2 diabetes 8 years ago. E. is an African American male.

A stroke patient is having difficulty swallowing food and beverages. The patient complains that he feels like "the food is sticking to the back of his throat." Given this information, the priority nursing interventions would be to A. warrant no action since this is a normal occurrence after a stroke. B. make the patient "nothing per os" (NPO) and call the physician. C. add a thickening agent to all of the patient's beverages. D. feed the patient while he is sitting in an upright position.

B. make the patient "nothing per os" (NPO) and call the physician.

Staphylococcus aureus commonly found in the skin, nares, and other body sites of patients without any signs and symptoms of infection is known as which of the following conditions listed below?

Bacterial colonization

The cardiologist just informed a patient that he has a reentry circuit in the electrical conduction system in his heart. This arrhythmia is called Wolff-Parkinson-White (WPW) syndrome. After the physician has left the room, the patient asks the nurse to explain this to him. Which of the following statements most accurately describes what is happening? A. "For some reason, your electrical system is not on full charge, so they will have to put in new leads and a pacemaker to make it work better." B. "You must have a large clot in one of your arteries that supply oxygenated blood to the special conduction cells in your heart." C. "There is an extra, abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly, in a circular pattern, causing the heart to beat too fast" D. "This means that the SA node (which is the beginning of your heart's electrical system) has been damaged and is no longer functioning normal."

C. "There is an extra, abnormal electrical pathway in the heart that leads to impulses traveling around the heart very quickly, in a circular pattern, causing the heart to beat too fast"

A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistulae (EA/TEF). Which of the following explanations should the care team provide to the infant's parents? A. "This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time." B. "The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs." C. "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally." D. "The biggest risk that your daughter will face until this is fixed is the danger of malnutrition and dehydration."

C. "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally."

A patient who is recovering from burn injuries is discussing his prognosis with a physician. Which of the following teaching points about expectations for healing should the physician include? A. "Once your healing is complete, your skin will be just as strong as before your accident." B. "The final remodeling phase of healing may last up to 3 months in your case." C. "You may find that the scar is a bit smaller than the area of the wound." D. "You'll find that your new tissue is more elastic and fragile than the rest of your skin."

C. "You may find that the scar is a bit smaller than the area of the wound."

In which of the following individuals would a clinician most suspect multiple myeloma as a diagnosis? A. A 70-year-old woman whose blood work reveals large numbers of immature granulocytes B. An 81-year-old male resident of a long-term care home who has an uncommon bacterial pneumonia and who is unable to produce a fever C. A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated D. A 68-year-old former coal miner who has white cell levels exponentially higher than normal ranges

C. A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated

Which of the following individuals are likely to display identified risk factors for the development of lower urinary tract obstruction? Select all that apply. A. A 32-year-old woman who had a healthy delivery of her third child 4 months ago B. A 55-year-old man with diabetes who is receiving diuretic medications for the treatment of hypertension C. A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) D. A 20-year-old man who has spina bifida and consequent impaired mobility. E. A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation F. A 30-year-old woman who has been diagnosed with gonorrhea

C. A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) D. A 20-year-old man who has spina bifida and consequent impaired mobility. E. A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation F. A 30-year-old woman who has been diagnosed with gonorrhea

Which of the following types of pneumonia listed below is best characterized by an infective agent that produces sputum samples with peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pill, and does not stain when exposed to crystal violet? A. Viral B. Chlamydial C. Bacterial D. Mycoplasmal

C. Bacterial

A nurse is providing care for a 17-year-old boy who has experienced recurrent sinus and chest infections throughout his life and presently has enlarged tonsils and lymph nodes. Blood work indicated normal levels of B cells and free immunoglobulins but a lack of differentiation into normal plasma cells. The boy is currently receiving intravenous immunoglobulin (IVIG) therapy. What is the boy's most likely diagnosis? A. IgG subclass deficiency B. Transient hypoglobulinemia C. Common variable immunodeficiency D. X-linked hypogammaglobulinemia

C. Common variable immunodeficiency

A 79-year-old female resident of an assisted living facility receives care from a community nurse on a regular basis for treatment of a chronic venous leg ulcer. Which of the following factors would the nurse be most justified in ruling out as a contributing factor to the client's impaired wound healing? A. Decreased fibroblast synthesis B. A lower skin collagen content than in younger adults C. Decreased antibody levels D. Slow reepithelialization

C. Decreased antibody levels

Following the diagnosis of acute renal failure, the nurse knows that one of the earliest manifestations of residual tubular damage is which of the following lab/diagnostic results? A. Reduced glomerular filtration rate B. Inability to concentrate urine C. Elevated blood urea nitrogen (BUN) D. Serum creatinine elevation

C. Elevated blood urea nitrogen (BUN)

which of the following patients , when faced with acute stressful situations would be considered at highest risk for becoming noncompliant with their medication regimen? A. Teenager whose period is late by 2 weeks and afraid to tell her parents B. New mother who is breast-feeding every 2 to 3 hours throughout the day and night. C. End-stage renal failure patient experiencing electrolyte imbalances related to having trouble sticking to his prescribed diet D. Paraplegic patient who forgot his pressure control device and has a small decubitus on his coccyx

C. End stage renal failure experiencing electrolyte imbalances related to having trouble sticking to his prescribed diet.

Parents of a 20-month-old infant report that he refuses food or eats poorly and that he grimaces when he swallows. He also is irritable and cries a lot. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which of the following health problems would the care team first suspect? A. Hirschsprung disease B. Rotavirus infection C. Esophagitis from gastrointestinal reflux D. Appendicitis

C. Esophagitis from gastrointestinal reflux

If the patient's dorsal columns are not functioning, the nurse will observe which of the following responses during neurotesting, where the nurse asks the patient to close his eyes and then proceeds to touch corresponding parts of the body on each side simultaneously with two sharp points? A. Grimacing when body touched with sharp points B. Inability to identify which way his finger was moved during the test C. No response to two-point discrimination D. Heightened proprioceptive response

C. No response to two-point discrimination

A badly burned firefighter has been in an induced coma for 3 weeks. When he awakens, he thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose? A. Corpus callosum B. Basal ganglia C. Thalamus D. Hypothalamus

C. Thalamus

A patient asks the health care provider why his lower legs look purple. The health care provider will base her response on which pathophysiological principle? A. There is a problem with his plasminogen levels. B. Too much trauma breaks capillaries, and they bleed into the tissue. C. The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher. D. Morbid obesity causes veins to enlarge and bleed into tissues due to stress the abdomen is placing on the vascular system.

C. The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher.

A stroke affecting which of the following areas of the brain would be most likely to leave an individual's vestibular system intact and posture and balance maintained? A. The brain stem B. The temporal and parietal cortex C. The limbic system of the cerebrum D. The thalamus

C. The limbic system of the cerebrum

A mother is placing her child into the bathtub. The child immediately jumps out of the tub and begins to cry, stating his feet are "burning." The nurse in the emergency department knows that the child's response is based on which of the following pathophysiological principles listed below? A. It takes a long time for thermal signals to be processed before the brain can send a signal through the spinal cord and tell the foot to withdraw. B. The thermal processing center is located on the rapid conducting anterolateral system on the same side of the brain as the injury. C. The tactile sensation occurs well in advance of the burning sensation. The local withdrawal reflex reacts first. D. Children react much quicker to contact with hot water than adults.

C. The tactile sensation occurs well in advance of the burning sensation. The local withdrawal reflex reacts first.

Knowing that persons with blonde hair exhibit the phenotype of a recessive gene, which of the following genetic scenarios would most likely underlie such a trait? A. Different alleles at a gene locus B. A heterozygous pairing C. aa D. Either AA or Aa

C. aa

An elderly patient arrives to the health care provider's office complaining of a "sore" that would not heal on his lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the patient that the usual treatment is A. hydrotherapy to facilitate improvement in circulation. B. long-term antibiotic therapy to facilitate healing of the wound. C. compression therapy to help facilitate blood flow back to the vena cava. D. initiation of Coumadin therapy to maintain an INR of 2 to 3 above norm.

C. compression therapy to help facilitate blood flow back to the vena cava.

which of the following situations would be classified as a complication of a disease or outcome from the treatment regimen? Select all that apply A. Loss of short-term memory in a patient diagnosed with Alzheimer disease B. Gradual deterioration in ability to walk unassisted for a patient diagnosed with Parkinson disease C. Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma D. Burning, intense incision pain following surgery to remove a portion of colon due to intestinal aganglionosis E. Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation

C. development of pulmonary fibrosis following treatment with bleomycin an antibiotic chemotherapy agent used in treatment of lymphoma E. Massive pulmonary emobli following diagnosis of new onset atrial fibrillation

When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is A. overstimulated. B. dormant. C. inhibitory. D. positively charged.

C. inhibitory.

A 13-year-old boy has had a sore throat for at least a week and has been vomiting for 2 days. His glands are swollen, and he moves stiffly because his joints hurt. His parents, who believe in "natural remedies," have been treating him with various herbal preparations without success and are now seeking antibiotic treatment. Throat cultures show infection with group A streptococci. This child is at high risk for A. myocarditis. B. vasculitis. C. mitral valve stenosis. D. infective endocarditis.

C. mitral valve stenosis.

Of the following aging theory examples, which one supports the non stochastic beliefs about aging? A. Oxidative free radicals result in by-products that react with DNA to lead to cellular damage. B. The wear-and-tear theory of aging states that accumulated damage to vital parts of cells leads to cellular aging and death. C. Mutations in BRCA1 and BRCA2 have been associated with increased risk for developing breast and ovarian cancer. D. Mitochondrial DNA damage has accumulated to such a level that the person has physiological symptoms of declining health.

C. mutations in BRACA1 and BRCA2 have been associated with increased risk for developing breast and ovarian cancer

Which of the following patients is most likely to have impairments to the wound-healing process? A patient with A. congenital heart defects and anemia. B. chronic obstructive pulmonary disease. C. poorly controlled blood sugars with small blood vessel disease. D. a diagnosis of multiple sclerosis and consequent impaired mobility.

C. poorly controlled blood sugars with small blood vessel disease.

A nurse at a long-term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which of the following statements best identifies future complications associated with TIAs? TIAs A. are an accumulation of small deficits that may eventually equal the effects of a full CVA. B. are caused by small bleeds that can be a warning sign of an impending stroke. C. resolve rapidly but may place the client at an increased risk for stroke. D. are a relatively benign sign that necessitates monitoring but not treatment.

C. resolve rapidly but may place the client at an increased risk for stroke.

A nurse is providing care for an older, previously healthy adult male who has been diagnosed today with pneumococcal pneumonia. Which of the following signs and symptoms is the nurse most likely to encounter? A. The man will be hypotensive and febrile and may manifest cognitive changes. B. The patient will lack lung consolidation and will have little, if any, sputum production. C. The patient will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles. D. The patient will have copious bloody sputum and diffuse chest pain and may lose his cough reflex.

C. the patient will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles

A hospital patient has a large, superficial wound on her elbow that was the result of shearing action when she was moved up in her bed. The patient's husband mentions that the wound looks infected and irritated because the wound bed is completely red. Which of the following responses would be inappropriate? A. "The red areas show that there is enough circulation to facilitate healing." B. "Those are fresh blood vessels that are a sign of healthy healing." C. "Even though it is red, it doesn't mean that the wound is infected." D. "A thin sheet of blood clotting is actually desirable and not a sign that your wife's wound is infected."

D. "A thin sheet of blood clotting is actually desirable and not a sign that your wife's wound is infected."

Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? A. "Your daughter has lost all her cognitive functions as well as all her basic reflexes." B. "If you or the care team notices any spontaneous eye opening, then we will change our treatment plan." C. "Your daughter's condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions." D. "Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change."

D. "Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change."

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which of the following teaching points should his caregiver provide? A. "While your diet most certainly contributed to this problem, the good news is that changing your diet can help solve it." B. "While there aren't really any effective medications for these ulcers, changes in lifestyle can keep them well controlled." C. "Ulcers like yours do not penetrate all layers of the stomach or duodenum, so you don't have to worry about losing too much blood." D. "Your family history, your smoking history, and NSAID use may all have contributed to this problem."

D. "Your family history, your smoking history, and NSAID use may all have contributed to this problem."

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

D. A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed.

Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)-compatible bone marrow? A. A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells B. A 9-year-old girl who has a diagnosis of IgA deficiency C. A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use D. A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM

D. A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM

Mary is heterozygous for blue eyes, a recessive trait. john is homozygous for brown eyes a homozygous trait. what color will their four children have? A. Some will have blue, and some will have brown B. Blue C. Impossible to tell D. Brown

D. Brown

A newborn male has been diagnosed with hypospadias following his postpartum assessment by a pediatrician. Which of the following diagnostics and treatment options is the physician most likely to rule out first? A. Surgical repair B. Chromosomal studies C. Testosterone supplementation D. Circumcision

D. Circumcision

A hospital client with a diagnosis of chronic renal failure has orders for measurement of her serum electrolyte levels three times per week. Which of the following statements best captures the relationship between renal failure and sodium regulation? A. Restricting sodium intake helps to preserve nephron function and has the additional benefit of lowering blood pressure. B. Clients with renal failure often maintain high sodium levels because of decreased excretion. C. Renal clients often require a sodium-restricted diet to minimize the excretion load on remaining nephrons. D. Client with advanced renal failure are prone to hyponaturemia because of impaired tubular reabsorption

D. Client with advanced renal failure are prone to hyponaturemia because of impaired tubular reabsorption

A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment? A. Vegetative state B. Delirium C. Brain death D. Coma

D. Coma

A 50-year-old woman has experienced devastating consequences in her family and work life as a result of her long-standing alcohol addiction. The levels and pathways of which of the following neurotransmitters in her body are likely to differ from an individual without addiction? A. Serotonin B. Norepinephrine C. Acetylcholine D. Dopamine

D. Dopamine

Which of the following diagnostic findings is likely to result in the most serious brain insult? A. Moderate decrease in brain tissue volume secondary to a brain tumor removal B. Increased ICP accompanied by hyperventilation C. High intracellular concentration of glutamate D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

Which of the following phenomena contributes to the difficulties with absorption, distribution, and elimination of drugs that are associated with kidney disease? A. Acute tubular necrosis is associated with impaired drug reabsorption through the tubular epithelium. B. Dialysis removes active metabolites from circulation minimizing therapeutic effect. C. Decreased retention by the kidneys often renders normal drug dosages ineffective. D. Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.

D. Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.

Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which of the following drug actions is most likely to result in diminished sensation of pain for the player? A. The drug slows the conduction velocity of myelinated Aδ fibers in the pain pathway. B. The drug inhibits communication by third-order neurons between the thalamus and cerebral cortex. C. The drug changes the postexcitatory potential in C fibers, leading to pain sensitization. D. The drug inhibits the enzyme needed for prostaglandin synthesis

D. The drug inhibits the enzyme needed for prostaglandin synthesis

Which of the following clients in a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? An adult with A. blood pressure of 189/103, jaundice, and multiple thromboses. B. sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT. C. ascites, fever, and recent onset of atrial fibrillation. D. low hemoglobin levels, low platelet levels, and spider angiomas present.

D. low hemoglobin levels, low platelet levels, and spider angiomas present.

A 66-year-old male presents to the emergency room accompanied by his wife who claims that he has been acting confused. The man is complaining of a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 102.8°F, and his blood work indicates his sodium level at 126 mEq/L (normal 135 to 145 mEq/L). Based on this assessment, the nurse suspects the patient has A. Mycoplasma pneumonia. B. bronchopneumonia. C. pneumococcal pneumonia. D. Legionella pneumonia.

D.Legionella pneumonia.

The physician is considering prescribing an anti-tumor necrosis factor (TNF) like infliximab for a rheumatoid arthritis patient. Which of the following statements is accurate about the advantages of using a TNF inhibitor?

TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions

Which of the following statements describes phase 4 of the action potential of cells in the sinoatrial (SA) node?

a slow depolarization occurs when Na is transported out of the cell and K moves back in, resulting in membrane potential .

Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture?

an 8 year old boy who fell out of a tree and on to his arm

A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider most likelysuspect?

coarctation of the aorta

While batting, a baseball player is struck in the ribs by a pitch. Place the following components of the player's pain pathway in the chronological order as they contribute to the player's sensation of pain. Use all the options

dorsal root ganglion periphery, doral root ganglion body, axon, thalamus, cerebral cortex

A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last 2 days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's first priority?

gonorrhea

A patient with a yeast infection asks the nurse how they diagnose this infection. The nurse will base her response knowing this is primarily diagnosed by

looking at the spores on a wet- mount slide using 20% potassium hydroxide

A patient who has suffered a spinal cord injury at C4 is experiencing a sudden change in condition. His BP is 186/101; heart rate is 45; and he is profusely sweating and complaining of "not feeling right." The nurse should

palpate his bladder for over-distention

A 74-year-old man is being assessed by a nurse as part of a weekly, basic health assessment at the long-term care facility where he resides. His blood pressure at the time is 148/97 mm Hg, with a consequent pulse pressure of 51 mm Hg. The nurse would recognize that which of the following is the most significant determinant of the resident's pulse pressure?

the amount of blood that his heart ejects from the left ventricle during each beat