Pathophysiology Ch. 24, 22, 23, 11, 12, 40, & 41

A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse? "Once the symptoms go away, I will be able to stop taking my medication." "I will have to take my medication for the rest of my life." "If I have surgery, it will cure me." "I should be able to control my condition with diet and exercise."

"I will have to take my medication for the rest of my life."

When hemolytic anemia has intravascular hemolysis, it can be characterized in different ways. Which condition is not a characterization of hemolytic anemia with intravascular hemolysis? Spherocytosis Hemoglobinemia Hemosiderinuria Jaundice

Spherocytosis

The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which organ? Pancreas Heart Spleen Lungs

Spleen

Which physiologic process best exemplifies a positive feedback mechanism? regulation of blood glucose levels by insulin release of parathyroid hormone in response to decreased serum calcium levels increase in prolactin secretion that occurs with more frequent breastfeeding release of antidiuretic hormone when sodium levels are higher than normal

increase in prolactin secretion that occurs with more frequent breastfeeding

Manifestations of Kaposi sarcoma include: lesions of the skin and in the oral cavity, gastrointestinal tract, and lungs. Confusion and lethargy limb weakness, sensory loss, difficulty controlling the digits, visual disturbances, diplopia, ataxia, seizures, and changes in mental status,. Fever, shortness of breath, and weight loss

lesions of the skin and in the oral cavity, gastrointestinal tract, and lungs.

Which is the second step of hemostasis? fibrin clot clot retraction vessel spasm platelet plug

platelet plug

Which is the second step of hemostasis? platelet plug fibrin clot vessel spasm clot retraction

platelet plug

The nurse is preparing to administer a unit of blood to a client. The client says that he is not sure he wants to give consent to receive the blood transfusion because he does not want to get HIV/AIDS from the blood. How will the nurse respond? "Tell me more about your fear of getting HIV/AIDS." "All blood is now tested for HIV, so there is no risk of getting HIV/AIDS from a blood transfusion." "All blood is now tested for HIV, so the risk of getting HIV/AIDS from a blood transfusion is extremely low." "I understand what you are saying, but the health care provider prescribed the blood transfusion, so it is important that you receive it."

"All blood is now tested for HIV, so the risk of getting HIV/AIDS from a blood transfusion is extremely low."

When a client who has been newly diagnosed with HIV asks, "What are the chances that I can be cured?," what is the nurse's most therapeutic response? "Routine follow-up care of a stable, asymptomatic person infected with HIV , like yourself, will include a history and physical examination along with CD4+ cell count and viral load testing every 3 to 4 months." "The key to success is the management of your immune system so that life- threatening opportunistic diseases do not develop." "Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection." "Your doctor will want to see you on a regular basis in order to evaluate your viral load and prescribe the appropriate medications."

"Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection."

Chronic lymphocytic leukemia (CLL) commonly causes hypogammaglobulinemia. This makes clients with CLL more susceptible to infection. What is the most common infectious organism that attacks clients with CLL? Staphylococcus aureus Mycobacterium tuberculosis Pseudomonas aeruginosa Escherichia coli

Staphylococcus aureus

The kidney produces 1,25-dihydroxyvitamin D. This form of vitamin D is responsible for which action in the body? Increases the metabolic rate Stimulates calcium absorption from the intestine Delays intestinal absorption of glucose Facilitates movement of calcium into the bone

Stimulates calcium absorption from the intestine

A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing? Suppression testing Radioimmunoassay (RIA) Autoantibody testing Stimulation testing

Stimulation testing

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function. Stimulation tests Imaging studies Suppression tests Genetic testing

Stimulation tests

When assessing the mouth of a client receiving chemotherapy, which of the following should the nurse interpret as a possible indicator of neutropenia? Stomatitis Blue-tinged lips Dry mucous membranes Beefy red tongue

Stomatitis

Which statement explains how T lymphocytes and B lymphocytes differ? T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow. T lymphocytes recognize bacteria; B lymphocytes recognize viruses and cancer. T lymphocytes secrete antibodies; B lymphocytes provide cellular response to antigens. T lymphocytes are helpers that assist B lymphocytes to amplify the lysis of antigens.

T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.

An important function of the thymus is: the production of mature, immunocompetent T lymphocytes. to filter antigens from the blood and respond to systemic infections. removal of foreign material from lymph before it enters the bloodstream. to serve as a center for antibody production by immune cells.

the production of mature, immunocompetent T lymphocytes.

A client with thrombotic thrombocytopenic purpura (TTP) is signing consent for plasmapheresis. The client asks, "What is this procedure and why do I need it?" Which response by the health care provider is most accurate? "The health care provider will perform a bone marrow aspiration to withdraw plasma to analyze." "Instead of giving you packed red blood cells, the health care provider will infuse white blood cells into your veins." "It is very similar to donating a unit of blood at the Red Cross." "The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma."

"The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma."

The nurse is caring for a client who has just learned that he is HIV positive. The client asks the nurse how long he has been able to infect others. Select the best response by the nurse. "You can infect others when you start to get symptoms." "You can infect others before the HIV antibody is detectable in your blood." "You can infect others only after you have experienced seroconversion." "You can infect others only when you are actually diagnosed with AIDS."

"You can infect others before the HIV antibody is detectable in your blood."

A newborn has a clotting disorder that results in the body being unable to produce fibrin. Which of the following could be the cause? Deficiency of fibrinogen Decreased spleen function Increase in the number of megakaryocytes Iron deficiency

Deficiency of fibrinogen

The nurse is assessing an 83-year-old adult client for signs and symptoms of anemia. What normal, age-related change increases this client's risk for anemia? Aplastic anemia is common in older adults and the risks increase with each decade. Up to 20% of the RBCs in older adults are incapable of carrying oxygen. Blood cells are not replaced as quickly as they are in younger clients. Gastrointestinal "microbleeds" are common after age 75.

Blood cells are not replaced as quickly as they are in younger clients.

The nurse caring for a client in the early stage of multiple myeloma would anticipate the client to report which symptom? Pathologic fractures Kidney failure Bone pain Hypercalcemia

Bone pain

What is the first symptom of multiple myeloma that a client typically presents with on a visit to the primary care provider? Bone pain Pathologic fractures Kidney failure Hypercalcemia

Bone pain

The nurse is caring for a client with multiple myeloma and communicates to the physician the possibility of hypercalcemia based on which symptoms? Select all that apply. Pain on urination Edema Bone pain Increased respiratory rate associated with heart failure

Bone pain Increased respiratory rate associated with heart failure

Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body? Increases procoagulant factors Increases prothrombin Alters vitamin K, reducing its ability to participate in the coagulation of the blood Increases vitamin K-dependent factors in the liver

Alters vitamin K, reducing its ability to participate in the coagulation of the blood

A 75-year-old client with a history of heart valve replacement arrives at the outpatient clinic with multiple red pinpoint lesions. The nurse identifies the lesions as: Erythema Purpura Petechiae Ecchymoses

Petechiae

A client is diagnosed with infectious mononucleosis. When was this client most likely infected with the Epstein-Barr virus (EBV)? 4 to 8 weeks earlier 2 to 3 months earlier 2 to 4 days earlier 1 to 2 weeks earlier

4 to 8 weeks earlier

A client is brought to the physician's office with a raised, red macular rash on the trunk and arms accompanied by a fever. A diagnosis of measles is made. Which type of immunity does this disease process provide? Passive artificial immunity Passive natural immunity Active artificial immunity Active natural immunity

Active natural immunity

A client has been exposed to bacteria. Which term best describes the body's initiate ability to consume the foreign substances? Exocytosis Aerobic metabolism Phagocytosis Anaerobic metabolism

Phagocytosis

In which client would a clinician most suspect multiple myeloma as a diagnosis? A 68-year-old former coal miner who has white cell levels exponentially higher than normal ranges. 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. 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. A 70-year-old woman whose blood work reveals large numbers of immature granulocytes.

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 client has the highest risk of contracting an opportunistic infection? A client who has had HIV for 30 years and has a CD4+ count of 1000 cells/μL A client who recently contracted HIV with a viral load of 1 million copies/mL A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL A client who has had HIV for 10 years and has a platelet count of 200/mL

A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL

The nursing is reviewing assessment data of four clients. Which client is at greatest risk for developing pernicious anemia? A client who is recovering from a laparoscopic surgical procedure A client who has undergone partial gastrectomy A client of Italian heritage who had a colonoscopy A client diagnosed with a neoplastic disorder

A client who has undergone partial gastrectomy

A client who had a kidney transplant 3 months ago is experiencing an organ rejection. The reaction would be classified as: Hypoacute rejection Acute rejection Chronic rejection Hyperacute rejection

Acute rejection

To form a platelet plug, platelets are attracted to the damaged vessel. What then occurs within the blood vessel? Fibrinolysis Thrombosis Adhesion of the platelets Thromboxane A2

Adhesion of the platelets

Some members of the population are so sensitive to certain antigens that they react within minutes by developing itching, hives, and skin erythema, followed shortly thereafter by bronchospasm and respiratory distress. What is this near-immediate reaction commonly known as? Antigen reaction Arthus reaction Hyposensitive reaction Anaphylactic reaction

Anaphylactic reaction

The cells that mediate humoral immunity do so because they are capable of producing: Platelets Antibodies Helper T cells Stem cells

Antibodies

In primary immune thrombocytopenia purpura (ITP), the client has which type of disorder that primarily destroys which blood component? Autoimmune; platelets Allergic; fibrinogen Immunoglobulin; B cells Alloimmune; factor VIII

Autoimmune; platelets

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source? Brain Heart Lungs Spleen

Brain

In which mature B-cell lymphoma do clients have virtually 100% evidence of previous Epstein-Barr virus (EBV) infection? Burkitt lymphoma Diffuse large B-cell lymphoma Marginal zone lymphomas Follicular lymphomas

Burkitt lymphoma

A nurse is caring for a client who recently received GPIIb/IIIa inhibitors and is concerned that the client has developed thrombocytopenia as demonstrated by: Red blood cell count less than 5.4 million/μL Platelet count less than 50,000/μL Platelet count greater than 200,000/μL Platelet count greater than 150,000/μL

Platelet count less than 50,000/μL

A client with Hodgkin lymphoma is exhibiting some central nervous system (CNS) involvement. Which treatment measures will the health care provider likely prescribe? Irradiation and chemotherapy Antiviral prophylaxis Antibiotic therapy Antiseizure therapy

Irradiation and chemotherapy

A parent has brought her 2-week-old infant to the emergency department due to the infant's persistent and increasing jaundice. Laboratory testing reveals indirect bilirubin level is 28 mg/dL (479 µmol/L), but otherwise a normal physical assessment. Which intervention will most likely be prescribed for this infant? Intravenous antibiotics Packed red blood cell transfusion Phototherapy Phlebotomy

Phototherapy

Which gland is often referred to as the master gland because it secretes many hormones? Pituitary Hypothalamus Pancreas Thyroid

Pituitary

A 57-year-old man is diagnosed with thrombocytopenia. The nurse knows that thrombocytopenia refers to a decrease in the number of circulating platelets. The nurse also knows that thrombocytopenia can result from what? Increased platelet survival Increased platelet production Decreased sequestration of platelets Decreased platelet production

Decreased platelet production

The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism? Dehydration from diarrhea Cretinism Irritability and restlessness Accelerated growth

Cretinism

An adult client with good overall health has reported headaches and dizziness in recent weeks. The nurse's assessment reveals blood pressure of 158/99 mm Hg, which is unprecedented for the client. On observation, the client's skin appears reddened, though he denies feeling warm. The nurse should anticipate what further diagnostic finding? Abnormal RBC indices coupled with low platelets. Elevated RBC, hemoglobin, and hematocrit. Normal RBC, hemoglobin, and hematocrit with alterations in morphology. Further signs and symptoms of internal hemorrhage.

Elevated RBC, hemoglobin, and hematocrit.

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism? Decreased hematocrit Decreased red blood cell count Elevated serum pH Elevated atrial natriuretic hormone

Elevated atrial natriuretic hormone

During a discussion about the first stage of hemostasis, a group of nursing students note that endothelial injury initiates release of which substance that promotes vasoconstriction? Prothrombin Prostacyclin Endothelin 1 Fibrinogen

Endothelin 1

Which hormone triggers the positive feedback mechanism that controls the secretion of luteinizing hormone (LH) levels? Oxytocin Prolactin Estrogen Testosterone

Estrogen

When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response? Hormone stimulation 24-hour urine Agglutination Antibody binding

Hormone stimulation

Select the most appropriate statement that describes the function of hormones. Hormones have little involvement in cellular and systematic responses. Hormones respond to cellular and systematic interactions. Hormones initiate reactions of cellular and systematic responses. Hormones function as modulators of cellular and systematic responses.

Hormones function as modulators of cellular and systematic responses.

Tumor lysis syndrome can occur during the initial phase of treatment of acute lymphocytic leukemia (ALL) and can lead to metabolic disorders that are life threatening. Which metabolic disorders can occur because of tumor lysis syndrome? Select all that apply. Acidosis Hypocalcemia Hypokalemia Alkalosis Hyperuricemia

Hyperuricemia Acidosis Hypocalcemia

Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body? Cell receptors Thymus gland Adrenal gland Hypothalamus

Hypothalamus

Growth hormone exerts its effects on the body in many ways. Which of these are effects of GH? Select all that apply. Decreases ACTH production Increases insulin levels Facilitates the rate of protein synthesis Decreases use of fatty acids for fuel Enhances fatty acid mobilization

Increases insulin levels Facilitates the rate of protein synthesis Enhances fatty acid mobilization

An obstetrics nurse is counseling an expectant mother. The mother is concerned about letting people hold her baby once the baby is born, fearing that the infant will get sick. What should the nurse explain to the mother? Abundant lymphoid tissues protect the infant in the first few months of life. Maternal immunoglobulins cross the placenta and protect the newborn early in life. IgA that is present at birth, and which originates with the mother, will protect the baby, The innate immune system will protect the baby.

Maternal immunoglobulins cross the placenta and protect the newborn early in life.

Progenitor cells, or parent cells, for the production of myeloid and lymphoid cells are derived from: Unipotent cells Multipotential progenitor cells Pluripotent stem cells Myeloproliferative cells

Pluripotent stem cells

A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as: Pernicious anemia Polycythemia vera Aplastic anemia Hemolytic anemia

Polycythemia vera

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion? Lower blood calcium levels Rank below 10% on the growth chart Mental sluggishness Increased susceptibility to infection

Rank below 10% on the growth chart

The results of recent research suggest that a key role in the origin of some diseases is played by inflammation. For which disease is it thought that inflammation has a role in its beginnings? Rheumatoid arthritis Osteoporosis Osteogenesis imperfecta Hydronephrosis

Rheumatoid arthritis

A client with cirrhosis has just received a liver transplant. Tissue rejection can be best prevented by what means? Suppression of macrophage activity Suppression of CD8+ cytotoxic T cells Drug-induced activation of the complement system Suppression of normal neutrophil activity

Suppression of CD8+ cytotoxic T cells

The nurse is admitting a client who is documented to be in the terminal blast crisis phase of chronic myeloid leukemia (CML). Which interpretation should the nurse make, given this information? The CML has evolved to acute leukemia. The CML is indolent. The CML is in remission. The CML has evolved to chronic lymphocytic leukemia (CLL).

The CML has evolved to acute leukemia.

A nurse practitioner is explaining the current methods of detection of HIV to a community group. In explaining the definitive method of detection, which statement is most accurate? The saliva test has been found to be more accurate than blood tests. Electrophoresis of white blood cell samples will indicate the presence or absence of HIV. The gold standard in testing is the enzyme-linked immunosorbent assay. The most sensitive and specific test is the Western blot analysis.

The most sensitive and specific test is the Western blot analysis.

A 14-year-old boy has been diagnosed with infectious mononucleosis. Which pathophysiologic phenomenon is most responsible for his symptoms? Viruses are killing some of his B cells and becoming incorporated into the genome of others. EBV inhibits the maturation of white cells within his peripheral lymph nodes. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes. The Epstein-Barr virus (EBV) is lysing many of the boy's neutrophils.

Viruses are killing some of his B cells and becoming incorporated into the genome of others.

A client with an apparent clotting disorder is admitted to hospital. His health record reveals that he has been treated for complications of chronic alcoholism for the past 10 years. The nurse should suspect what cause of his clotting disorder? Von Willebrand disease Vitamin K deficiency Hemophilia Immune thrombocytopenic purpura (ITP)

Vitamin K deficiency

Leukocytes

WBC

A 67-year-old client diagnosed with myasthenia gravis will likely display which clinical manifestations as a result of autoantibodies ultimately blocking the action of acetylcholine, resulting in destruction of the receptors? Weakness of the eye muscles, difficulty in swallowing and slurred speech, impaired gait. Tremor of hands/arms, rigidity of the arms, shuffling gait. Short-term memory lapses, problems with orientation, a lack of drive or initiative. Facial droop, slurred speech, weakness on one side of the body.

Weakness of the eye muscles, difficulty in swallowing and slurred speech, impaired gait.

A 25-year-old female client with primary antiphospholipid syndrome is discussing the possibility of becoming pregnant. The nurse shares which possible complication(s) that can occur as a result of this syndrome? Select all that apply. premature birth spontaneous miscarriage placental insufficiency gestational diabetes prolonged labor

spontaneous miscarriage premature birth placental insufficiency

A client who is being treated for small-cell lung cancer has been placed in protective isolation due to neutropenia. The most likely cause of this client's neutropenia is: the effects of chemotherapy on white blood cell development. chromosomal disruption caused by the client's tumor. tumor invasion into the bone marrow and destruction of progenitor cells. the effects of tumor necrosis factor (TNF) on immature neutrophils.

the effects of chemotherapy on white blood cell development.

The father of a 2-year-old boy recently diagnosed with hemophilia A asks the nurse how to prevent complications for his son. The best response would be: "Hemophilia A will no longer be a concern once treated with a blood transfusion." "Small bleeding in the joints is to be expected and can be treated at home." "Do not allow the child to play outside or with other children." "Avoid administering aspirin and nonsteroidal anti-inflammatory drugs."

"Avoid administering aspirin and nonsteroidal anti-inflammatory drugs."

The nurse working at a community clinic is caring for a young male client. The client asks the nurse if he could get HIV/AIDS from being sprayed in the face with breast milk. Select the best response by the nurse. "Breast milk is not a mode of HIV transmission." "Breast milk can contain HIV. You should be tested immediately." "Tell me more about your fear of HIV/AIDS." "Breast milk can contain HIV, which causes AIDS, but to be infected, the milk needs to be in contact with your mucous membranes or an open sore."

"Breast milk can contain HIV, which causes AIDS, but to be infected, the milk needs to be in contact with your mucous membranes or an open sore."

A nursing student asks her instructor, "I don't understand this coagulation system. When we donate blood, what keeps it from clotting in the bag?" The instructor responds: "If the blood is used within 24 hours from retrieval, there will be no clot formation yet." "Citrate is added to the blood bag, which prevents it from clotting." "Calcium gluconate is added to the bag to keep it from clotting." "The blood bank adds heparin to every bag prior to actually collecting the blood from the donor."

"Citrate is added to the blood bag, which prevents it from clotting."

A client is newly diagnosed with impaired platelet function, thrombocytopathia. Which question is most appropriate for the nurse to ask in order to determine the possible cause of this problem? "Have you recently vacationed out of the country?" "Have you recently been exposed to any organic pesticides?" "Do you have a family history of hemophilia?" "Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"

"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?"

A 23-year-old female client has been diagnosed with von Willebrand disease following a long history of "heavy periods" and occasional nosebleeds. Which of the client's statements demonstrates a sound understanding of the new diagnosis? "I hope my insurance covers the injections that I'll need to help my blood clot." "I read on a website that I might have to get blood transfusions from time to time." "I'll make sure to take acetaminophen instead of aspirin when I get aches and pains." "I'm really disappointed that I won't be able to play sports anymore."

"I'll make sure to take acetaminophen instead of aspirin when I get aches and pains."

When providing nutrition education to the client with diabetes, the nurse should include which statement regarding fat intake? "Individuals with type 2 diabetes may consume more fat calories than those with type 1 diabetes." "If you have diabetes, avoiding saturated fats is important." "When diabetes is present, 40% of calories may be from fat." "People with diabetes should not consume fats."

"If you have diabetes, avoiding saturated fats is important."

The nurse is providing dietary instruction for a client diagnosed with folic acid deficiency. Which information will help ensure the client ingests sufficient amounts of folic acid? Select all that apply. "Increase the consumption of daily alcohol." "Include green leafy vegetables in your diet." "Include cereals in the daily diet." "Increase the consumption of carbohydrates in your diet." "Make sure all vegetables are cooked."

"Include green leafy vegetables in your diet." "Include cereals in the daily diet."

The mother of a newborn infant questions why her baby needs a vitamin K injection immediately after birth. The best response by the nurse would be: "It is hospital policy to administer the injection to newborns." "Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting." "The infant was exposed to high levels of heparin upon birth." "Infants have a higher body fat content, which prohibits the absorption of vitamin K."

"Infants are not born with the normal intestinal bacteria that synthesize vitamin K for clotting."

A client describes himself as being "devastated" after hearing that his HIV test has come back positive. Which response by the nurse is most appropriate? "It's entirely normal to feel that way. We are going to try our best to help you get all the support you need." "This is certainly scary news, but the care team is going to make sure that you get all the information you need." "I understand how difficult this must be for you, but it's nothing that you should be ashamed of." "I've provided care for many clients living with HIV and AIDS, so I understand how you feel."

"It's entirely normal to feel that way. We are going to try our best to help you get all the support you need."

A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At the annual physical, the client asks whether to get the hepatitis A "shot." How will the nurse respond, based on the concepts of adaptive immunity? "Yes, because you could get a worse case the next time you are exposed." "No, because having an active case, you have already developed antibodies against hepatitis A." "Of course. The virus changes every year." "I would not recommend getting it; the vaccine can damage your liver."

"No, because having an active case, you have already developed antibodies against hepatitis A."

The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that additional teaching is needed? "If I work on losing some weight, that might help prevent complications later." "So I can stop my insulin if I start an exercise program." "If I forget my insulin in the morning, I should take it as soon as I can to prevent hyperglycemia." "An exercise plan will be helpful for prevention of long-term complications."

"So I can stop my insulin if I start an exercise program."

A woman who has given birth 12 hours ago is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client's husband is confused as to why a disease of excessive coagulation can result in bleeding. Which of the nurse's explanations best characterizes DIC? "Excessive activation of clotting causes an overload of vital organs, resulting in bleeding." "So much clotting takes place that there are no available clotting components left and bleeding ensues." "Massive clotting causes irritation, friction, and bleeding in the small blood vessels." "These same hormones and bacteria that cause clotting also cause bleeding."

"So much clotting takes place that there are no available clotting components left and bleeding ensues."

A client is prescribed low-dose (81 mg) aspirin daily. The client refuses the medication stating, "I do not have any pain." How will the nurse respond? "This dose of aspirin will break apart the blood clot that you have in your leg." "The 81 mg of aspirin daily will help protect you from a stroke or a heart attack." "The primary health care provider wants you to take the medication to prevent you from experiencing pain." "Low-dose aspirin will help prevent you from having increased bleeding after surgery."

"The 81 mg of aspirin daily will help protect you from a stroke or a heart attack."

A client was tested for HIV and received a positive result from the enzyme-linked immunosorbent assay (ELISA) followed by a negative Western blot test. The client asks the nurse what this means. What is the nurse's best response? "The ELISA test gives some false positives, but the Western blot confirms you don't have HIV." "This result is inconclusive and you will need to repeat the tests in 1 month." "The ELISA looks for antibodies while the Western blot looks for the actual antigen. You have HIV." "The tests give similar results. There must have been contamination and you need a retest."

"The ELISA test gives some false positives, but the Western blot confirms you don't have HIV."

A sixth-grade science teacher asks the students to explain the role of cilia in the lower respiratory tract. Which student response is best? "Cilia help facilitate a chemical defense against germs by secreting an enzyme that will cement the germ to the lining of the airways." "Cilia can trap the microbes in one location so the body can grow scar tissue around them and wall them off so they can't cause disease." "These little hairs move germs trapped in mucus toward the throat so the body can cough them out." "Cilia help to warm the airways so that moisture in the air can neutralize any germs that get in our lungs."

"These little hairs move germs trapped in mucus toward the throat so the body can cough them out."

A 24-year-old pregnant client presents to the clinic for her second prenatal visit. The results of her ELISA test are positive. Which statement by the nurse projects the best way to counsel this client? "There is a good chance this is a false positive result. We can repeat it to confirm." "We will need to wait for the Western Blot results to confirm the diagnosis of HIV." "We will need to inform your partner to be tested for HIV as soon as possible." "You are HIV positive. There are measures we can take to prevent transmission to the baby."

"We will need to wait for the Western Blot results to confirm the diagnosis of HIV."

A client with leukemia asks the health care worker, "Why am I taking allopurinol. I do not have gout. My grandpa took this for gout." What is the nurse's best response? "Everyone who is on chemotherapy will develop gout. We give it prophylactically to prevent you from getting the severe pain associated with gout." "I will check with the doctor. Maybe it is a mistake." "When your chemotherapy kills the leukemia cells, this causes your uric acid levels to rise. Allopurinol will help lower uric acid levels." "We just do not want you to hurt in your toes if you do not have to."

"When your chemotherapy kills the leukemia cells, this causes your uric acid levels to rise. Allopurinol will help lower uric acid levels."

A client with infectious mononucleosis asks the nurse why the lymph nodes are enlarged. Which statement is the nurse's appropriate response? "Your lymph nodes are infected and should be removed." "Your lymph nodes multiply to fight infection." "Your lymph nodes are blocked and need to be drained." "Your lymph nodes trap and destroy viruses."

"Your lymph nodes trap and destroy viruses."

The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML? Terminal Accelerated Remissive Chronic

Accelerated

A client diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified? Acquired, autoimmune secondary neutropenia Congenital, alloimmune neonatal neutropenia Acquired, drug-related neutropenia Congenital, cyclic neutropenia

Acquired, autoimmune secondary neutropenia

A teenager with an infected wound asks, "How does my body fight off the germs in my scraped arm?" Which response by the nurse correctly identifies the cells that play a central role to the innate immune response to an infectious microorganism? B lymphocytes Neutrophils Antibodies T lymphocytes

Neutrophils

The nurse is caring for a client who is HIV positive and is newly diagnosed with Mycobacterium tuberculosis (TB). Which manifestations does the nurse associate with TB? Select all that apply. Weight gain Rash Night sweats Cough Fever

Night sweats Cough Fever

Typical symptoms seen in the latent period of HIV infection include which of the following? Night sweats Gastrointestinal problems No signs or symptoms Skin lesions

No signs or symptoms

Granulocytes

A group of leukocytes containing granules in their cytoplasm; neutrophils, eosinophils, basophils.

The classic triad of multiple myeloma includes which diagnostic testing procedures? Select all that apply. Iron levels Serum M-protein spike Plasmacytosis Lytic bone lesions Neutropenia

Plasmacytosis Serum M-protein spike Lytic bone lesions

The nurse evaluating a client's blood work determines that a client has an increased risk for infection based on which lab result? Absolute neutrophil count of 800/μL (0.80 x 109/L) Absolute neutrophil count of 1000/μL (1.0 x 109/L) Absolute neutrophil count of 1100/μL (1.1 x 109/L) Absolute neutrophil count of 1200/μL (1.2 x 109/L)

Absolute neutrophil count of 800/μL (0.80 x 109/L)

Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system? Acting as a high-affinity receptor on the surface of target cells Inactivating hormones to prevent excess accumulation Acting as a second messenger to mediate hormone action on target cells Mediating hormone synthesis by non-vesicle-mediated pathways

Acting as a second messenger to mediate hormone action on target cells

A student asks a nurse educator why a platelet will stick in the injured site but not in the normal uninjured blood vessel. What would be the best response? Adhesion occurs when the platelet receptor binds to von Willebrand factor (vWF) at the injury site. The release of platelet-derived growth factor (PDGF) from endothelial cells produces a platelet plug. Platelets are naturally attracted to a damaged vessel wall and will stick. Platelet degranulation results in an aggregation and the formation of the plug.

Adhesion occurs when the platelet receptor binds to von Willebrand factor (vWF) at the injury site.

An infant is suspected of having a severe primary immunodeficiency disease. Which effect on the infant makes early detection a priority? The infant may develop food allergies. The infant is at risk for cardiovascular disease. The infant may have developmental delays. Administering live attenuated virus vaccines can be fatal.

Administering live attenuated virus vaccines can be fatal.

A client with a diagnosis of hemophilia A has been admitted with bilateral knee pain. The nurse should anticipate performing what intervention during the client's treatment? Administration of corticosteroids and desmopressin acetate (DDAVP) Protective isolation and daily administration of subcutaneous vitamin K to prevent bleeding Passive range of motion exercises and transfusion of platelets Administration of factor VIII and implementation of fall prevention measures

Administration of factor VIII and implementation of fall prevention measures

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time? Administration of intravenous fluids Monitoring for fever Education related to prevention of DKA Orienting the client to the events surrounding his admission

Administration of intravenous fluids

Which client is at risk for developing a type II, antibody-mediated hypersensitivity reaction caused by complement-activated cellular destruction? A client with Goodpasture disease experiencing tissue injury from antibody-mediated inflammation A client with Graves disease whose autoantibodies bind to and activate thyroxine production A client with an antiviral mechanism caused by antibody-dependent cell cytotoxicity An Rh-negative mother who produces anti-D antibodies when the fetus is Rh-positive

An Rh-negative mother who produces anti-D antibodies when the fetus is Rh-positive

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of: Somatostatin and prolactin Adrenocorticotropic hormone (ACTH) and vasopressin Growth hormone-releasing hormone (GHRH) and dopamine Antidiuretic hormone (ADH) and oxytocin

Antidiuretic hormone (ADH) and oxytocin

A client has been admitted to the hospital for the treatment of HIV infection, which has recently progressed to overt AIDS. Which nursing action should the nurse prioritize when providing care for this client? Careful monitoring of fluid balance and neurologic status Hemodynamic monitoring and physical therapy Astute infection control and respiratory assessments Frequent neurologic vital signs and thorough skin care

Astute infection control and respiratory assessments

Select the statement that best describes autoimmune disease. Autoimmune diseases represent overuse of the immune system that causes damage to the body tissues. Autoimmune diseases represent a disruption in self-tolerance that results in damage to body tissues by the immune system. Autoimmune diseases represent an increase in self-tolerance that results in damage to body tissues by the immune system. Autoimmune diseases result from an overuse of antibiotics that causes damage to body tissues by the immune system.

Autoimmune diseases represent a disruption in self-tolerance that results in damage to body tissues by the immune system.

Which process that contributes to immunity takes place in a child's thymus gland? Differentiation of B cells Production of natural killer (NK) cells Production of mature, immunocompetent T lymphocytes Filtration of antigens from the blood

Production of mature, immunocompetent T lymphocytes

A diagnosis of acquired immunodeficiency syndrome (AIDS) is identified when the CD4+ T cell count reaches which level? Below 200 cells/μL 500 to 800 cells/μL 200 to 499 cells/μL 800 to 1000 cells/μL

Below 200 cells/μL

Definitive diagnosis of multiple myeloma includes the triad of bone marrow plasmacytosis, lytic bone lesions, and: oligoclonal bands in the CSF. BCR-ABL fusion protein in serum. Bence Jones proteins in the urine. serum M-protein depression.

Bence Jones proteins in the urine.

When an Rh-negative mother has been sensitized and is pregnant with an Rh-positive fetus, what happens to the fetus? Profound red cell hemolysis Nothing, this is normal Plasma volume depletion Bilirubin deficiency

Profound red cell hemolysis

A young adult client presents with an enlarged, firm cervical lymph node on the right side of the neck. Palpation of the node is painless. The nurse should document this assessment finding and anticipate preparing the client for which diagnostic procedure to confirm diagnosis? Watchful waiting and close monitoring of the node over the following weeks Bone marrow transplant (BMT) Lymph node biopsy Radioactive isotope insertion

Lymph node biopsy

Clients with lung disease can develop polycythemia as a result of which condition? Decreased blood viscosity Hyperventilation Chronic hypoxia Excessive respiratory fluid loss

Chronic hypoxia

Clients with lung disease can develop polycythemia as a result of which condition? Excessive respiratory fluid loss Chronic hypoxia Decreased blood viscosity Hyperventilation

Chronic hypoxia

A client suspects he may have developed an allergic response to latex. What most common allergic response would the nurse expect to find? Rhinorrhea Angioedema Contact dermatitis Airway obstruction

Contact dermatitis

A nurse working in an ambulatory care unit is working with a client who has recently been diagnosed with a V Leiden mutation. The nurse tells the client the importance of smoking cessation to avoid: Pulmonary hypertension Essential hypertension Deep vein thrombosis (DVT) Coronary artery disease

Deep vein thrombosis (DVT)

Which hormone is secreted based on a cyclic rather than a diurnal manner? Growth hormone Antidiuretic hormone (ADH) Adrenocorticotropic hormone (ACTH) Follicle-stimulating hormone (FSH)

Follicle-stimulating hormone (FSH)

Bilirubin is measured in the blood and reported on the laboratory results using which terms? Positive Soluble and insoluble Direct and indirect Conjugated

Direct and indirect

A nurse is caring for a client receiving heparin therapy who has developed heparin-induced thrombocytopenia. Which nursing intervention does the nurse anticipate? Monitoring the client's blood pressure every 2 hours Switching the client to warfarin therapy Administration of platelets Discontinuation of heparin therapy

Discontinuation of heparin therapy

A week after starting atorvastatin for high cholesterol, the client returns reporting bleeding from the mouth (mucous membranes) and nose. What priority intervention should the health care provider perform? Discontinue the atorvastatin immediately. Request prescription for a good blood thinner to interrupt the coagulation. Send the client to see an ears, nose, throat (ENT) specialist. Apply an ice bag to the mouth and nose.

Discontinue the atorvastatin immediately.

A client has been placed on sulfamethoxazole/trimethoprim as treatment for community-acquired methicillin-resistant Staphylococcus aureus (MRSA) for 10 days. After taking the medication for 8 days, the client comes to the health care provider's office complaining of multiple nosebleeds over the past day. Laboratory work shows a platelet count of 80,000/μL. The nurse practitioner suspects which condition? Antiphospholipid syndrome Hypersplenic thrombocytopenia Drug-induced thrombocytosis Drug-induced thrombocytopenia

Drug-induced thrombocytopenia

A client is admitted to the hospital with a diagnosis of deep vein thrombosis and started on intravenous heparin therapy. Seven days later, the client's lab values identify a rapid decrease in platelets. The health care provider recognizes this as: Hemolytic-uremic syndrome (HUS) Drug-induced thrombocytopenia Thrombotic thrombocytopenic purpura (TTP) Immune thrombocytopenic purpura (ITP)

Drug-induced thrombocytopenia

The nurse is conducting a staff in-service program on non-Hodgkin lymphomas. The nurse should include that essentially all people with Burkitt lymphoma have evidence of infection with: HIV HTLV-1 EBV Helicobacter pylori

EBV

The nurse is conducting education for a client who is scheduled to undergo diagnostic testing for non-Hodgkin lymphoma (NHL). The nurse includes information on: White blood cell counts Lymph node biopsy Blood cultures Diagnostic X-ray

Lymph node biopsy

A teenage client has been diagnosed with infectious mononucleosis and asks the health care provider what caused the condition. Which response is most accurate for the nurse to share with this client? Abnormal cell nucleus development Non-Hodgkin lymphoma Human immunodeficiency virus (HIV) Epstein-Barr virus (EBV)

Epstein-Barr virus (EBV)

A client has been diagnosed with inherited hypercoagulability. Select the most likely cause. Factor V gene mutation Myocardial infarction Hyperestrogenic state Prolonged immobility

Factor V gene mutation

Hemophilia A is a hereditary blood disorder caused by inadequate activity or absence of which blood component? von Willebrand complex Factor VIII Intrinsic factor Prothrombin

Factor VIII

A client has developed disseminated intravascular coagulation (DIC), which the health care providers think was initiated by the intrinsic pathway, requiring which substance to begin the step-wise coagulation cascade? Thrombin Factor XII Protein C Tissue factor

Factor XII

A 70-year-old female client has had her mobility and independence significantly reduced by rheumatoid arthritis. Which process likely contributed to the development of her health problem? Deletion of autoreactive B cells Proliferation of cytotoxic T cells Delayed-type hypersensitivity (DTH) reaction Failure of normal self-tolerance

Failure of normal self-tolerance

The provider notes that the client's hemoglobin is 8.2 g/dL (82 g/L). Which supplement will the provider recommend to the client? Magnesium oxide Ferrous sulfate Calcium carbonate Potassium chloride

Ferrous sulfate

Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease? CT scan Ultrasonography MRI Fine-needle aspiration biopsy

Fine-needle aspiration biopsy

A client has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that originates in which body site?

Lymph nodes

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best? When a person's body pH is decreasing, the stomach lining becomes more acidic to offset this. In children, the body knows to release growth hormones while they are sleeping instead of when they are awake and running around. Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas. When a female is thinking about getting pregnant, the body knows to release female sex hormones in greater proportion than usual.

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

A lactation nurse visits a new mother after delivery of her first child and encourages the mother to breast-feed her infant, even for a short time. Which statement made by the nurse correctly explains the importance of breast-feeding?

For several months, colostrum will provide the infant with passive immunity to diseases to which the mother has immunity.

The nurse's plan of care for a client with multiple myeloma should include interventions to prevent: GI bleed Diarrhea Fractures Urinary tract infections

Fractures

The nurse is caring for a postsurgical client who is recovering from knee replacement surgery secondary to rheumatoid arthritis. When planning the client's care, the nurse should include what action? Administration of vitamin K injections as ordered. Passive range of motion exercises to the nonsurgical joints to prevent hemorrhage. Administration of a platelet transfusion, if deemed necessary. Frequent assessment for signs of thrombosis or hemorrhage.

Frequent assessment for signs of thrombosis or hemorrhage.

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

Frequent monitoring of temperature Maintaining oral intake to prevent dehydration

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur? Diabetogenic gene from both parents, physiologic triggering event, and an allergic reaction to pancreatic delta cells Diabetogenic gene from both parents, environmental triggering event, and a B-lymphocyte reaction to alpha cell antigens Genetic predisposition, physiologic triggering event, allergic reaction to pancreatic alpha cells Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority? Bathe the client with tepid water. Give the client a concentrated carbohydrate. Place the client in the supine position. Repeat the dose of insulin.

Give the client a concentrated carbohydrate.

A nurse assessing an 8-year-old child notes that the child is 6 feet tall. Which diagnostic test will be performed to evaluate the cause of the condition? Glucose load Urine for catecholamines Thyrotropin-releasing hormone stimulation Antithyroid peroxidase

Glucose load

The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which complete blood count (CBC) result is characteristic of this type of anemia? Hematocrit 44% (0.44) Hemoglobin 7.8 g/dL (78 g/L) Band cells 700/µL (0.7 ×109/L) Reticulocytes 1.5% (0.015)

Hemoglobin 7.8 g/dL (78 g/L)

A nurse is assessing a client who displays pale skin and nail beds. Which laboratory data should the nurse evaluate? Neutrophil count Hemoglobin level White blood cell count Erythrocyte sedimentation rate

Hemoglobin level

The emergency department nurse is concerned that the client's snake bite may trigger disseminated intravascular coagulation (DIC). If this should occur, which clinical manifestations would be seen? Hypertension Platelet loss Headaches Hemorrhage

Hemorrhage

A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a client suspected of having a lymphoma. The nurse interprets the report as indicating: Multiple myeloma Hodgkin lymphoma Non-Hodgkin lymphoma Leukemia

Hodgkin lymphoma

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan? Insulin Potassium supplements Hydrocortisone Ketoconazole

Hydrocortisone

A client has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that originates in which body site? Lymph nodes Bone marrow Thymus Spleen

Lymph nodes

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland? Thyroid Hypothalamus Posterior pituitary Parathyroid

Hypothalamus

A nurse is monitoring a client with anemia and low oxygen levels. The nurse knows that which condition stimulates the secretion of erythropoietin? Low blood pressure Tachycardia Hypoxia Inflammation

Hypoxia

A client with common variable immunodeficiency (CVID) is admitted to the hospital for treatment. Which type of treatment will the nurse be administering to the client? IV immunoglobulin Bone marrow transplant IV antibiotics IV corticosteroids

IV immunoglobulin

The client presents with a reduction in red blood cells, white blood cells, and platelets. The practitioner is unable to determine the cause of the client's condition. Which type of anemia does the client have? Extrinsic hemolytic Idiopathic aplastic Intrinsic hemolytic Acquired hemolytic

Idiopathic aplastic

The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory immunoglobulin (Ig) that is found in the colostrum? IgA IgM IgD IgE

IgA

Which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces? IgA IgG IgD IgM

IgA

Which immunoglobulin (Ig) is released in response to allergy or parasitic infections? IgE IgA IgM IgG

IgE

The nurse is aware that the only class of immunoglobulins to cross the placenta is: IgA IgG IgM IgD

IgG

The nurse is reviewing the functions of immunoglobulins and determines which immunoglobulin is associated with its correct action? IgA, plays a role in B-cell differentiation. IgM, the first antibody to be produced by a developing fetus. IgE, functions as a receptor for antigen. IgD, prevents the attachment of viruses and bacterial to epithelial cells.

IgM, the first antibody to be produced by a developing fetus.

The nurse is teaching a new mother about caring for her baby and reducing the risk for infection. On what principle does the nurse base the knowledge of passive immunity? Infants are protected at birth from infection by maternal IgM. Infants are protected at birth from infection by maternal IgD. Infants are protected at birth from infection by maternal IgA. Infants are protected at birth from infection by maternal IgG.

Infants are protected at birth from infection by maternal IgG.

Following a lecture on hemostasis, a nursing student accidently cuts her hand while preparing supper for her family. She watches the laceration very closely. Sure enough, the first thing she notes is: Small hair-like strands form a blood (fibrin) clot. Clot retraction by pushing serum out of the clot and joining the edges of the broken vessel Initially, it takes a few seconds for blood to appear as a result of vessel spasm. Limited bleeding, initially as a response to the small vessel walls being sealed by a platelet plug

Initially, it takes a few seconds for blood to appear as a result of vessel spasm.

A client has been admitted for immune thrombocytopenic purpura. The client has not responded to corticosteroid treatment. The priority nursing intervention for this client would include which treatment measure? Prepare a surgical permit for an emergency splenectomy. Insert a Foley catheter to monitor hourly urine output. Place the client in isolation, so the skin rashes will not spread to other clients. Insert an intravenous catheter, so immune globulin can be administered in a timely manner.

Insert an intravenous catheter, so immune globulin can be administered in a timely manner.

The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as: Changes in blood viscosity Insufficient hemoglobin Presence of systolic murmur Tissue hypoxia to the brain

Insufficient hemoglobin

A woman in her 28th week of pregnancy develops gestational diabetes mellitus and has persistent elevated blood glucose when using the diet plan. What medications are appropriate? Select all that apply. Acarbose Insulin Metformin Glyburide Sitagliptin

Insulin Glyburide

A client has common variable immunodeficiency (CVID), a form of humoral primary immunodeficiency. Which alteration in serum levels would the nurse expect to see? Elevated serum IgA levels Low serum IgD levels Low serum IgG levels Elevated serum IgM levels

Low serum IgG levels

A client was recently diagnosed with iron deficiency anemia. The nurse anticipates which treatment to be prescribed? Iron supplementation and dietary teaching Steroid therapy Red blood cell transfusion Bone marrow transplant

Iron supplementation and dietary teaching

A client's bone marrow study report reveals the findings of blast cells in the bone marrow. What does the nurse interpret this as indicating? Leukemia Neutropenia Hodgkin disease Non-Hodgkin disease

Leukemia

The pediatrician knows that the most common cause of cancer in children is: Non-Hodgkin lymphomas Leukemia Infectious mononucleosis Multiple myeloma

Leukemia

A nurse educator is explaining to a group of students the differences between leukemias and lymphomas. With respect to classification of these diseases, which explanation is most accurate? Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures. Leukemia arises from peripheral lymphoid structures, and lymphomas originate in precursors in marrow. Leukemia arises from precursors in marrow, and lymphomas originate in spleen or bone marrow. Leukemias originate in lymph nodes, and lymphomas originate in peripheral lymphoid structures.

Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures.

Which factor differentiates chronic leukemias from acute leukemias? They are cancers of the hematopoietic progenitor cells. Leukemic cells are disseminated throughout the body by the circulatory system. The prevalence among individuals with Down syndrome is high. Leukemic cells are more fully differentiated in chronic than in acute leukemias.

Leukemic cells are more fully differentiated in chronic than in acute leukemias.

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct? Target Self Stored Local

Local

A client is experiencing fatigue and laboratory results reveal: Hct 40% (0.40); Hgb 8 g/dL (80 g/L); WBC 8000 (8 x 109/L); and platelets 175,000/ µL (175 ×109/L). The nurse would interpret these results as indicative of which diagnosis? High hematocrit/polycythemia High platelets/thrombocytosis Low white blood cell (WBC) count/granulocytopenia Low hemoglobin/anemia

Low hemoglobin/anemia

A client is experiencing fatigue and laboratory results reveal: Hct 40% (0.40); Hgb 8 g/dL (80 g/L); WBC 8000 (8 x 109/L); and platelets 175,000/ µL (175 ×109/L). The nurse would interpret these results as indicative of which diagnosis? High platelets/thrombocytosis Low white blood cell (WBC) count/granulocytopenia Low hemoglobin/anemia High hematocrit/polycythemia

Low hemoglobin/anemia

When collecting a client's history the client states that he is receiving treatment to maintain remission from leukemia. What does the nurse document that the client is receiving? Induction therapy Lysis therapy Maintenance therapy Intensification therapy

Maintenance therapy

Which cellular mediator is involved in the development of type I hypersensitivity reactions? Mast cells Arachidonic acid Plasma cells Monocytes

Mast cells

Systemic lupus erythematosus is best characterized by which principle? It is a consequence of streptococcal infection. The main immune problem is anaphylactic (type I immune) reaction. It is principally a disease of men. Most clients have antinuclear antibodies present in their blood.

Most clients have antinuclear antibodies present in their blood.

A student nurse is taking microbiology and reviewing various types of cells. From which cell type are granulocytes derived? Myeloid stem cells Macrophage stem cells Myocyte stem cells Lymphoid stem cells

Myeloid stem cells

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body? Regulated feedback loop Sensory feedback loop Positive feedback loop Negative feedback loop

Negative feedback loop

The physician reviews a client's lab results and notes that the neutrophil count is 900/μL (0.90 x 109/L). This is known as: Agranulocytosis Aplastic anemia Neutropenia Leukopenia

Neutropenia

The entrance of a microbe into an individual's vascular space has initiated opsonization. Which statement explains this process? Opsonization stimulates B cells by helper T cells. Opsonization releases proteins that stimulate cell production by the bone marrow. Opsonization coats a microbe to activate phagocytosis recognition. Opsonization involves lysis of intracellular microbes by cytotoxic T cells.

Opsonization coats a microbe to activate phagocytosis recognition.

A female adolescent is reporting general malaise and lethargy. Which clinical assessment should the nurse perform in an effort to confirm or rule out infectious mononucleosis? Palpating the client's lymph nodes Auscultating the client's lungs Assessing the client for bone pain Assessing the client's cranial nerve reflexes

Palpating the client's lymph nodes

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

Promotion of glucose uptake by target cells

Secondary diabetes occurs because of disorders that produce hyperglycemia by stimulating the hepatic production of glucose or decrease the cellular use of glucose. Which disorders can be causes of secondary diabetes? Hepatomegaly and pheochromocytoma Acromegaly and pancreatic hyperplasia Pancreatic disease and dwarfism Pheochromocytoma and Cushing syndrome

Pheochromocytoma and Cushing syndrome

The client explains to her new provider that she receives periodic phlebotomies to decrease her red blood cell mass. The provider believes the client may have: Polycythemia vera Sickle cell disease Megaloblastic anemia Beta-thalassemia

Polycythemia vera

A child has a congenital condition in which the thymus gland is absent. Which information should the nurse include as the priority when providing caregiver education? Practice strict infection control practices. Feed in an upright position, due to high risk for aspiration. Report if the child has 2 to 3 loose stools in a day. Observe and report any signs of bleeding.

Practice strict infection control practices.

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication? Measuring urine catecholamine levels before stopping the drug Scheduling a positron emission tomography scan a week after stopping the drug Instructing the client to stop taking the medication Prescribing a tapering dose of the medication over weeks

Prescribing a tapering dose of the medication over weeks

A client is admitted with a suspected diagnosis of Hodgkin lymphoma (HL). Which diagnostic test would the nurse look for to confirm the diagnosis? Epstein-Barr virus Positive Bence Jones proteins Presence of Reed-Sternberg cells H. pylori infection

Presence of Reed-Sternberg cells

Following peripheral blood testing and a bone marrow biopsy, a client has been diagnosed with chronic myelogenous leukemia. Which abnormality is most likely to have preceded the client's diagnosis? Presence of a Philadelphia chromosome Radiation exposure Down syndrome Exposure to the Epstein-Barr virus

Presence of a Philadelphia chromosome

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated? Absorb metabolic waste Free receptor sites Stimulate production Prevent accumulation

Prevent accumulation

A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which lab results to determine if an allergy is present? Serum IgE Basophils Neutrophils Serum IgG

Serum IgE

A 26-year-old client has an absolute neutrophil count of less than 500 cells/mm3 (0.50 x 109/L) Which interpretation of this lab value is accurate? Normal neutrophil count Severe neutropenia Slight neutropenia Mild neutropenia

Severe neutropenia

The first physical line of defense in innate immunity is: Neutrophils Specialized lymphocytes Plasma proteins Skin and mucous membranes

Skin and mucous membranes

A client with a gastrointestinal bleed has been prescribed two units of packed red blood cells. Ten minutes after starting the transfusion, the client's temperature has risen from 37.2°C to 38.2°C. The client's other vital signs remain largely unchanged. What is the nurse's best action? Slow the transfusion and administer antipyretics. Stop the transfusion, remove the IV cannula, and retain the blood and tubing. Stop the transfusion and inform the physician STAT. Stop the transfusion and administer a bolus of normal saline.

Slow the transfusion and administer antipyretics.

A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma? Diffuse Encapsulated Slow-growing Aggressive

Slow-growing

When red blood cells age, which organ is responsible for their destruction? Red bone marrow Liver Kidneys Spleen

Spleen

An infant has been born to a client who is HIV positive. What is the infant's most likely prognosis for developing AIDS? The infant's immune system possesses high immunoglobulin levels due to passive immunity and will not likely develop HIV. The infant can be HIV antibody positive by ELISA for up to 18 months of age without being actively infected with HIV. The infant's immune system may or may not be able to eradicate HIV during the first few months of life. The infant will most likely have AIDS by his or her first birthday.

The infant can be HIV antibody positive by ELISA for up to 18 months of age without being actively infected with HIV.

The spouse of a client with a history of hepatitis C admitted for upper gastrointestinal bleeding asks the nurse why these bleeding episodes occur. Having reviewed the client's laboratory values and noting a severe vitamin K deficiency, which response by the nurse would be best? Liver failure that puts the client in need of a liver transplant Destruction of the liver caused by endotoxins that are digesting cells The liver producing an inactive form of clotting factors Decrease in clotting factors due to the liver not producing

The liver producing an inactive form of clotting factors

A nurse is assigned to care for a client who is positive for HIV. What personal protective equipment (PPE) will the nurse wear while caring for this client? No precautions are needed by the nurse or client. The client wears a mask when being transported from one area of the hospital to another. The nurse wears gloves if there is a chance of coming in contact with the client's blood or body fluids. The nurse wears gloves, gown, and mask when in contact with the client.

The nurse wears gloves if there is a chance of coming in contact with the client's blood or body fluids.

When it is determined that a client's red blood cells (RBCs) have a biconcave shape, what will be the nurse's reaction? The nurse will arrange for bedside oxygen for the client to use as needed. The nurse will immediately notify the client's health care provider of this serious finding. The nurse will be pleased, as that shape allows for increased oxygen diffusion. The nurse will be concerned, as this is an indication of sickle cell anemia.

The nurse will be pleased, as that shape allows for increased oxygen diffusion.

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate? The thyroid gland is responsible for increasing the metabolic rate. The thyroid gland releases neurotransmitters when the "flight or flight" mechanism is stimulated. The thyroid gland is responsible for regulating serum calcium levels. The thyroid gland promotes development of secondary sex characteristics.

The thyroid gland is responsible for increasing the metabolic rate.

A nurse is discussing precautions necessary to avoid excessive bleeding with a client who has been diagnosed with type 1 von Willebrand disease. Which statement is most accurate to share with this client? There is no treatment except to avoid aspirin. Dietary restrictions are necessary. Avoid all aspirin, acetaminophens, and nonsteroidal anti-inflammatory drugs. Acetaminophen avoidance is suggested.

There is no treatment except to avoid aspirin.

A client has an impaired platelet function that may have developed from inheritance, drugs, disease, or extracorporeal circulation. The health care provider would document this as: Plasmapheresis Disseminated intravascular coagulation Fibrinolysis Thrombocytopathy

Thrombocytopathy

A nurse is assessing a client and finds these results: Areas of bruising (purpura) on the client's arms and legs Pinpoint hemorrhages (petechiae) on the legs Pinpoint hemorrhages (petechiae) in the mouth Platelets level of 90,000/μL (90 ×109/L) What condition should the nurse suspect the client is exhibiting? Thrombocytopenia Leukopenia Thrombocytosis Neutropenia

Thrombocytopenia

A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication? Thyroid storm Myxedema coma Addisonian crisis Hypothyroidism

Thyroid storm

What is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis? To relieve fever, headache, and sore throat To decrease the risk of neutropenia To eliminate the causative organism To increase the white blood count

To relieve fever, headache, and sore throat

Drug-induced neutropenia is a disease that has significantly increased in incidence over the last several decades. What is the attributing factor in the increased incidence of drug-induced neutropenia? Treatment of cancer by chemotherapeutic drugs The decrease in the use of street drugs The new drugs developed to treat autoimmune diseases The destruction of tissue cells by cocaine

Treatment of cancer by chemotherapeutic drugs

What is the most common mode of transmission of HIV? Vaginal and anal intercourse Occupational exposure Infection from shared needles Mother to newborn via perinatal transmission Blood transfusion

Vaginal and anal intercourse

Select the first stage of hemostasis. Clot dissolution Formation of the platelet plug Vessel spasm Clot retraction

Vessel spasm

The nurse is caring for a client with common variable immunodeficiency (CVID) disorder. Which clinical manifestation of the disorder is common with this client? Colonic polyps Viral pneumonia Glomerulonephritis Perirectal abscesses

Viral pneumonia

In a course of chronic myelogenous leukemia (CML), which clinical manifestations will the client experience in the accelerated phase? Select all that apply. Weight loss Low-grade fever Abdominal fullness Weakness

Weight loss Low-grade fever Abdominal fullness

The nurse is conducting the initial assessment on a client with newly diagnosed Hodgkin lymphoma. Which symptoms should the nurse interpret as manifestation of the disease process? Select all that apply. Weight loss Acute renal failure Night sweats Tinnitus Pruritus

Weight loss Night sweats Pruritus

An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics? Weight loss, glucose monitoring, and oral antihyperglycemic medications Injectable insulin, nutrition management, and adequate hydration Daily monitoring for urine ketones and weight loss measures. Continuous subcutaneous insulin infusion (CSII) and nutrition management

Weight loss, glucose monitoring, and oral antihyperglycemic medications

A 20-year-old male presents at the clinic complaining of severe fatigue, night sweats, and fever. While taking the client's history, he reports having multiple sexual partners and unprotected sex. HIV/AIDS is suspected. What diagnostic test would be ordered to confirm the diagnosis? Eastern blot assay Western blot assay ALEA Complete metabolic panel

Western blot assay

A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the Philadelphia chromosome. This client is likely to experience: a high risk of pathologic bone fractures. a prolonged chronic phase of leukemia. a self-limiting infection with the Epstein-Barr virus. hyperuricemia.

a prolonged chronic phase of leukemia.

Paracrine action involves which characteristic? autoregulation act on a distant target cell act on the same cells which secreted the hormone act locally on cells other than those that produce the hormone

act locally on cells other than those that produce the hormone

The nurse is explaining the quality of pleiotropism that is possessed by many cytokines. The quality of pleiotropism implies that such cytokines: perform unique functions in a specific body cell. are able to act on different types of cells. have a unique function in all cells. can perform different functions in the same cells.

are able to act on different types of cells.

A 10-month-old infant has begun to take his first steps and his mother has brought him for assessment because of swelling in his ankles and knees. The mother also states that he was eager to walk but has now regressed and cries when she tries to encourage it. The clinician should: administer vitamin K STAT. assess the child for signs and symptoms of hemophilia A. order testing to rule out disseminated intravascular coagulation (DIC). prescribe a trial of desmopressin acetate (DDAVP) to rule out von Willebrand disease.

assess the child for signs and symptoms of hemophilia A.

Which client would be diagnosed with wasting syndrome? client with AIDS with pneumonia, chronic fever, and chronic fatigue client with HIV with a CD4+ T-cell count of 1000 cells/μl, Kaposi sarcoma, and nausea and vomiting for more than 2 weeks client with AIDS, fever, diarrhea, and significant involuntary weight loss client with chronic fatigue syndrome, no fever and herpes simplex, and candidiasis around the oral mucosa

client with AIDS, fever, diarrhea, and significant involuntary weight loss

The nurse is planning a prevention program for infectious mononucleosis. The best target audience for the program is: older adults living in a senior apartment building. employees of a large factory. college students living in a dorm. parents of preschool children.

college students living in a dorm.

Which regimen serves as the rationale for HIV/AIDS treatment with antiretroviral therapy? monotherapy with fusion inhibitors combination therapy incorporating the five classes of antiretroviral drugs monotherapy with reverse transcriptase inhibitors monotherapy with protease inhibitors

combination therapy incorporating the five classes of antiretroviral drugs

A client is prescribed the recumbent granulocyte colony-stimulating factor (CSF) filgrastim. The nurse evaluates the effectiveness by monitoring which laboratory value? international normalized ratio (INR) hemoglobulin and hematocrit (H&H) complete blood count (CBC)/differential Prothrombin time (PT)/partial thromboplastin time (PTT)

complete blood count (CBC)/differential

A nurse is caring for a client on a cardiac step-down unit who is recovering from a myocardial infarction (MI) and is getting ready to be discharged. The nurse is reviewing the physician's discharge instructions with the client when the client asks why aspirin is ordered every day and at such a low dose. The most accurate response by the nurse is that the purpose of the daily aspirin is to: enhance blood flow to the myocardium. ease any chest pain that may occur. prevent arterial thrombi formation. prevent venous thrombi formation.

prevent arterial thrombi formation.

A 6-month-old infant was born with a heart murmur. The pediatrician is recommending valve replacement/repair surgery, based on which laboratory result indicating intravascular hemolysis? decreased number of reticulocytes evidence of sickling of red blood cells excess of hemoglobin in the blood plasma (hemoglobinemia) increase in the number of red blood cells (polycythemia)

excess of hemoglobin in the blood plasma (hemoglobinemia)

While explaining immunity to a client, the nurse responds, "The body's internal organs are protected from pathogens because: the tonsils store a large amount of natural killer cells at that location." we have special glands that can secrete cytokines on a moment's notice." the actions of the cytokines in the mouth can act on different cell types at the same time it is fighting pathogens." our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response."

our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response."

A 42-year-old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of: a vitamin C deficiency in the diet. weakening of the organ walls as a result of inflammation. the reduction of clotting factors synthesized in the liver. increased amounts of vitamin K being produced in the liver.

the reduction of clotting factors synthesized in the liver.

A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color, and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which complication? infection in the right leg thrombosis in the right leg compartment syndrome in the right leg edema in the right leg

thrombosis in the right leg

Many different proteins, enzymes, and hormones are involved in maintaining hemostasis. Which protein is required for platelet adhesion? Platelet factor 4 Growth factors von Willebrand factor Ionized calcium

von Willebrand factor