PATHOPHYSIOLOGY Ch. 17 & Ch 18 prepu

A parent brings her 12-year-old to the clinic and informs the nurse that the child may have anorexia nervosa (AN). Using the diagnostic criteria for AN, what subjective data should the nurse obtain during the assessment? Select all that apply.

"Has there been an inability to maintain normal body weight for age and height?" "Does the child have a fear of gaining weight?" "Does the child seem to have an distorted idea of what the body size looks like?"

A nurse is assigned to care for a group of clients. Which client is most likely to be diagnosed with malabsorption syndrome?

A 40-year-old with severe inflammatory bowel disease Explanation: Some types of malnutrition are caused by acute and chronic illnesses, such as occurs in people with Crohn disease who are unable to absorb nutrients from their food. Lactose intolerance does not cause malnutrition and can be controlled with deleting lactose from the diet. Acute pancreatitis will cause a short-term electrolyte imbalance. Pancreatic enzyme replacement does not cause malnutrition.

The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate (struvite) stones based on which urinalysis results? Select all that apply.

Alkaline urine pH High urine phosphate level High bacterial count

Which of the following clients coming to a small free clinic are at high risk for malnutrition? Select all that apply.

An 88-year-old senior citizen on a fixed budget A 60-year-old homeless Vietnam veteran complaining of pain A 4-year-old child who lives with a single mom in a rooming house

The nurse is caring for a client with an iron deficiency. Which assessment finding(s) does the nurse anticipate? (Select all that apply.)

Anemia Hair loss

An adult client presents to the emergency department with manifestations of acute cystitis. For which sign/symptom would the nurse assess the client? Select all that apply.

Burning on urination Back discomfort Cloudy urine

What is the action of renin in the renin-angiotensin-aldosterone mechanism?

Converts angiotensinogen to angiotensin I Explanation: Renin acts enzymatically to convert a circulating plasma protein called angiotensinogen to angiotensin I. Angiotensin II stimulates the secretion of aldosterone by the adrenal gland, thereby exerting a more long-term effect on maintenance of blood pressure by increasing the reabsorption of sodium in the distal tubule. Renin does not alter insulin. Insulin is freely filtered in the glomeruli and neither absorbed nor secreted by the tubular cells.

A client is experiencing an increase in urinary output. Which physiologic response by the body is responsible for how the kidney concentrates urine?

Decrease in antidiuretic hormone Explanation: The ability of the kidney to respond to changes in the osmolality of the extracellular fluids by producing either a concentrated or dilute urine depends on the establishment of a high concentration of osmotically active particles in the interstitium of the kidney medulla and the action of the antidiuretic hormone (ADH) in regulating the water permeability of the surrounding medullary collecting tubules. Inhibition or reduction of antidiuretic hormone (ADH) release from the anterior pituitary increases excretion of water by the kidneys (increased urination). Activation of the angiotensin system, excessive secretion of aldosterone, and reduction in glomerular filtration rate would result in a decreased urinary output.

The nurse is preparing to care for a client with anorexia nervosa (AN). Which diagnostic results will the nurse examine to best determine risk for sudden death? Select all that apply.

Echocardiogram Body mass index (BMI)

In order for a client to have effective cellular metabolism, which body fuels will be required? Select all that apply.

Glucose Fats Amino acids

The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?

Increased creatinine and blood urea nitrogen (BUN) levels

The client who has been consuming a very low calorie diet (VLCD) of 450 kcal/day should be assessed for which high risk complications? Select all that apply.

Irregular heart rhythms Abdominal pain related to gallstones

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminuria is a predictor of future nephropathies. Explanation: The increased GFR that occurs in persons with early alterations in renal function is associated with microalbuminuria, defined as urinary albumin excretion of 30 to 300 mg in 24 hours. Microalbuminuria is an important predictor of future diabetic nephropathies. In many cases, these early changes in glomerular function can be reversed by careful control of blood glucose levels. (Hypertension and cigarette smoking have been implicated in the progression of diabetic nephropathy.) Thus, control of blood pressure (to levels of 130/80 mm Hg or less) and smoking cessation are recommended as primary and secondary prevention strategies in persons with diabetes.

Select the correct structural sequence of the GI tract.

Mouth, esophagus, stomach, duodenum, jejunum, ileum, cecum, colon, rectum

A 40-year-old female has been categorized as being obese, with a body mass index (BMI) of 33.2. Which health problems place the client at a significantly increased risk when compared with individuals with a BMI below 25? Select all that apply.

Osteoarthritis Gallbladder disease Type 2 diabetes

A nurse is caring for a client who is being treated for anorexia nervosa. Which personality traits are associated with this eating disorder?

Perfectionist and compulsive

Which medication may be responsible for a client developing increased uric acid levels by decreasing ECF volume?

Thiazide diuretics