Pathophysiology Module 2 PrepU
Which are functions of the digestive system? Select all that apply.
> Vitamins are synthesized. > Nutrients are absorbed. > Wastes are eliminated. > Wastes are collected
Select the client at greatest risk for developing colorectal cancer.
A 64-year-old female whose mother had colorectal cancer
Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?
Cobblestone
An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?
Colonization of Clostridium difficile
A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial infection of the urinary tract. The nurse should anticipate educating this client with regard to which common treatment regimen?
Continue taking antibiotics for 10 to 14 days even if symptoms of infection disappear.
A client presents with sudden marked elevation in plasma urea and creatinine levels. Despite intravenous fluids and medications, the client's blood pressure is 80/45 mm Hg and plasma potassium level is 6.6 mEq/l (6.6 mmol/l). For which treatment should the nurse prepare the client because it most appropriate?
Continuous renal replacement therapy
The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?
Corticosteroids
A 24-year-old woman undergoing a screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which treatment is most likely to be effective for her?
Corticosteroids and immunosuppressant drugs
A client asks, "Why did my provider order a glomerular filtration rate (GFR) to my usual blood work?" The nurse's best response is based on the fact that GFR can estimate serum levels of which substance?
Creatinine
A nurse reading a sigmoidoscopy report notes that a client was found to have skip lesions. The nurse interprets this as an indication of:
Crohn disease
A young man presents reporting diarrhea, fecal urgency, and weight loss. His stool is light-colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and reports pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect?
Crohn disease
The nursing instructor who is teaching about disorders of the lower urinary tract realizes a need for further instruction when one of the students makes which statement?
"Alterations in bladder function can only occur when there is incontinence."
The nursing instructor who is teaching about incontinence in older adults recognizes a need for further instruction when a student makes which statement?
"Frequency is not a major problem for the elderly."
With the increased risk of drug toxicity among chronically ill older adults, which statement by the nurse explains why the older adult's kidney is vulnerable to toxic injury?
"The kidney is rich in blood supply and can concentrate toxins in high levels in the medullary portion of the kidney."
A student is studying the esophagus. Which statement made by this student to a faculty member is a correct one?
"The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus."
A client has a postvoid residual (PVR) volume of 40 mL. Which information would the nurse teach the client?
"This is a normal value."
A client with bladder cancer asks the nurse, "What did the doctor mean by intravesicular chemotherapy? Am I going to lose all my hair and have to go for treatments over months and months?" The best response would be:
"This is when they put the chemotherapy directly into the bladder to kill any cancer cells."
A client takes 650 mg of aspirin every 4 hours daily for reports of joint pain. Which statement should be included in the client's teaching plan?
"This medication can damage gastric mucosa."
A client has a postvoid residual (PVR) volume of 250 mL. Which information would the nurse tell the client?
"This value indicates you are having difficulty emptying your bladder."
A client asks, "Should I start toilet training my 1-year-old child?" What is the nurse's best response?
"Your child is too young to begin toilet training."
Irritable bowel syndrome is thought to be present in 10% to 15% of the population in the United States. What is its hallmark symptom?
Abdominal pain relieved by defecation with a change in consistency or frequency of stools
Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication?
Acute tubular necrosis
Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?
Bilateral flank masses and impaired lung development
Which statement is true concerning the digestion of carbohydrates?
Carbohydrates are broken down into monosaccharides before being absorbed.
A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder?
Cholecystokinin
The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure?
Client with prostatic hyperplasia
A client who has been taking acetaminophen 1000 mg every 4 hours presents to the Urgent Care Center with increased abdominal pain, elevated ALT, AST, and bilirubin levels. The nurse suspects the client is experiencing:
Direct hepatotoxic reaction
A client is beginning to recover from acute tubular necrosis. During which phase of acute kidney injury will the nurse assess an increase in urine output?
Diuretic phase
A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is:
Dorsiflexion of hands and feet
An older male comes to the clinic with the chief report of having difficulty voiding. The physician diagnoses him with a lower urinary tract obstruction and stasis. What should the nurse suspect to be the most frequent cause of this client's problem?
Enlargement of prostate gland
What is the most common cause of a lower urinary tract infection?
Escherichia coli
The swallowing reflex is an entirely voluntary activity.
False
A teenager who has a history of achalasia will likely complain of which clinical manifestation?
Feeling like there is food stuck in the back of the throat
A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:
Fistula formation
The most common forms of peptic ulcer are duodenal and gastric ulcers. What are the most common risk factors for peptic ulcer disease?
Helicobacter pylori (H. pylori)
Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?
Hematuria
Which diagnosis causes an increased risk of developing intrahepatic jaundice? Select all that apply.
Hepatitis liver cancer cirrhosis
When caring for the client with Laennec cirrhosis, the nurse recognizes which pathophysiologic finding to be an expected etiology of jaundice?
Impaired uptake of bilirubin
Which assessment indicates to the nurse that a client may have a spastic bladder dysfunction?
Incontinence
A nurse advises a client with recurring UTIs to drink large amounts of water. What normal protective action is the nurse telling the client to utilize?
Increase washout of urine
The client reports something "wrong" with his gallbladder. Which manifestation does the nurse recognize that supports the client's concern?
Intolerance to greasy food; burping
A client sustained acute tubular injury approximately 2 hours ago. Which cause of acute kidney injury (AKI) would the nurse suspect the client is experiencing?
Intrarenal
The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections?
Knowledge of aseptic technique when inserting urethral catheters
What laboratory markers are most commonly used to diagnose acute pancreatitis?
Lipase and amylase
Following a needlestick injury, a nurse develops hepatitis C that eventually developed into a chronic infection. The health care provider counsels the nurse to assess for which major complications that can result from this chronic condition? Select all that apply.
Liver cancer Progressive liver fibrosis
Diverticulitis is the herniation of tissue of the large intestine through the muscularis layer of the colon. It is often asymptomatic and is found in approximately 80% of people over the age of 85. Diverticulitis is often asymptomatic, but when symptoms do occur, what is the most common complaint of the client?
Lower left quadrant pain with nausea and vomiting
The nurse is caring for a client with asterixis. Which assessment should the nurse make to help a diagnosis of hepatic encephalopathy?
Mental status
Digestion of starch begins in which structure?
Mouth
A client asks the nurse what the most common sign/symptom of bladder cancer is. Which is the best response by the nurse?
Painless hematuria
Which structures are accessory organs that also aid in digestion? Select all that apply.
Pancreas Liver Salivary glands
A student is studying the interstitial cells of Cajal found in the smooth muscle tissue of the gastrointestinal tract. The student says that these cells produce slow waves that are increased in amplitude by the:
Parasympathetic nervous system
A nurse is caring for a client in spinal shock. Which intervention is appropriate in relation to the client's urinary status?
Perform intermittent catheterization
The nurse knows that which sign is one of the earliest manifestations of acute renal failure (ARF)?
Polyuria
A client has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which type of renal failure should the nurse closely monitor for?
Postrenal failure
A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience?
Prehepatic
An 86-year-old client is being treated for dehydration and hyponatremia after curtailing fluid intake to prevent urinary incontinence. Given these findings, the nurse recognizes that this client is likely in what phase of acute kidney injury?
Prerenal
A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have?
Prerenal failure
Which substance would not be found in glomerular filtrate?
Protein
Congenital bilateral renal dysplasia can cause which problems during pregnancy and following delivery? Select all that apply.
Renal failure Pulmonary hypoplasia Oligohydramnios Potter facies
One form of renal tubular acidosis (RTA) results from aldosterone deficiency or resistance to its action, which leads to impaired reabsorption of which electrolyte?
Sodium
Which meal choice is most likely to exacerbate an individual's celiac disease?
Spaghetti with meatballs and garlic bread
The nurse teaches the client that which of these contributed to the development of acute cholelithiasis?
Stasis of bile
Drug-related nephropathies involve functional and/or structural changes to the kidney after exposure to a drug. What does the tolerance to drugs depend on?
State of hydration
The results of a client's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as:
Steatorrhea
A 56-year-old client reports urinary incontinence when laughing. The nurse documents this as which type of incontinence?
Stress
A busy 45-year-old female executive has been diagnosed with diverticulitis. Her primary treatment is an increase in the fiber content of her diet. What effect will the fiber have on the diverticula?
The fiber increases bulk, promotes regular defecation, and increases colonic contents and colon diameter, thereby decreasing intraluminal pressure.
A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?
Uric acid
Which nerve controls the esophageal phase of swallowing?
Vagus
A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called:
Zollinger-Ellison syndrome
While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains:
a complex microbial system that contains hundreds of different species.
The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:
a loss of over half the client's normal kidney function.
A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:
acute postinfectious glomerulonephritis.
The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection (UTI). Which finding should the nurse report as evidence of a UTI?
increased nitrites
A client has been diagnosed with alcohol-induced liver disease. He admits to the nurse, "I know what the lungs do, and I know what the heart does, but honestly, I have no idea what the liver does in the body." The nurse should tell the client that the liver:
metabolizes most components of food and also cleans the blood of bacteria and drugs.
A client is not able to absorb vitamin B12. The nurse determines that the client is deficient in:
parietal (oxyntic) cells, which secrete HCl and intrinsic factor.
The nurse assessing a client with a diagnosis of cholelithiasis will look for pain in which area?
right upper quadrant
During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will:
stimulate the release of secretin, which then inhibits release of gastrin.
What are contributing factors of acute postinfectious glomerulonephritis? Select all that apply.
> Primarily infects the pharynx > Occurs after infection of group A-hemolytic streptococci > May result from impetigo
What is considered the normal amount of serum bilirubin found in the blood?
<1.5 mg/dL
A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:
"All glomeruli and all parts of the glomeruli are involved."
The nurse is caring for a female client with cholelithiasis. When teaching the client about the disease, the nurse includes which of these points?
"Gallstones have developed, which are typically composed of cholesterol."
Which statement would help a nurse best explain an "incretin effect"?
"It is an increase in insulin release after ingestion of food."
The client has just been diagnosed with bladder cancer and asks the nurse what causes it. What would be the nurse's best response to the client?
"The cause is unknown."
The nurse is caring for a client who is a carrier of hepatitis B. Which of these does the nurse teach the family?
"Your loved one may not look ill, but the virus is present in his blood."
A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes?
A 78-year-old woman's GFR has been steadily declining over several years.
Which client is likely at the greatest risk of developing a urinary tract infection?
A 79-year-old client with an indwelling catheter
Which individual most likely faces the greatest risk of developing Clostridium difficile colitis?
A 79-year-old hospital client who is being treated with broad-spectrum antibiotics
Which client likely faces the greatest risk of a gastrointestinal bleed?
A client who takes aspirin with each meal to control symptoms of osteoarthritis
The nurse is evaluating client risk for the development of overactive bladder/urge incontinence and determines that which client is at highest risk for this condition?
A client with diabetes mellitus
A 79-year-old woman reports a recent onset of "nearly constant heartburn." During the assessment interview, she states that she has "lots of aches and pains." She states that she is not on any prescription medications but often takes aspirin for pain. The nurse should suspect what diagnosis?
Acute gastritis
A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis?
Acute pyelonephritis
A nurse is caring for a client with diabetic glomerulosclerosis. The analysis is reviewed for the presence of which manifestation?
Albumin
Which of these substances should the nurse teach the client with pancreatitis to absolutely avoid?
Alcohol
A client with history of alcohol abuse is brought to the emergency department after a weekend of heavy drinking, experiencing right upper quadrant pain, anorexia, nausea, jaundice and ascites. The nurse identifies these as manifestations of what disorder?
Alcoholic hepatitis
Chronic kidney disease impacts many systems in the body. What is the most common hematologic disorder caused by CKD?
Anemia
A client who suffers from spastic bladder has been catheterized to promote bladder emptying. Which medication should the nurse plan on the physician ordering to also treat this problem?
Anticholinergic medication
A client newly diagnosed with glomerulonephritis asks the nurse, "What caused me to get this disease?" Which response by the nurse is most accurate?
Antigen-antibody complexes
Which function is performed by saliva?
Antimicrobial protection
A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of:
Arthritis treated with high levels of nonsteroidal anti-inflammatory (NSAIDs) agents
An older adult client presents with loose mucus-filled stools. The nurse suspects the client has Clostridium difficile. What is a priority assessment for the nurse?
Ask the client about his or her antibiotic use.
A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client's wife that care must be taken with eating to prevent:
Aspiration pneumonia
A client presents with a perforated peptic ulcer. Which complication would be a priority for the nurse to assess for?
Assessment of a rigid, boardlike abdomen
Acute pyelonephritis is a result of:
Bacterial infection
The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which flowing lab value?
Bilirubin 15 mg/dL (256.56 µmol/L) (high)
The nursing instructor, while teaching about renal function and disorders, informs the students that the most frequent form of urinary tract cancer is:
Bladder
A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will most likely be prescribed to help determine the cause of these new symptoms?
Blood work for hemoglobin, red blood cells, and hematocrit
A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?
Calcium
The nurse is caring for a client with chronic renal failure who is on hemodialysis three times a week. In order to treat hyperphosphatemia and hypocalcemia, which medication will the nurse administer to decrease absorption of phosphate from the gastrointestinal tract?
Calcium carbonate
The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which reason?
Clients have few early symptoms of the disease.
A nursing instructor who is teaching students about urinary incontinence in older adults suggests that an easy and effective way to remember the transient and treatable causes of urinary incontinence is to use which acronym?
DIAPPERS
The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes that which altered diagnostic test is consistent with development of edema?
Decreased albumin
While studying about the process of urination, the nursing student learns that which muscle is known as the "muscle of micturition"?
Detrusor muscle
The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?
Dietary protein
Which aspect of gastrointestinal function is performed by the brush border enzymes of the villus structures?
Digestion of carbohydrates
An older adult with urge incontinence and overactive bladder begins medication treatment with oxybutynin. Which side effects would the nurse include in the education?
Dry mouth and constipation are common.
Which dermatologic problem most often accompanies chronic kidney disease (CKD)?
Dry skin and pruritus
The common bile duct and the pancreatic duct release their products into which section of the intestines?
Duodenum
The common bile duct opens into which part of the gastrointestinal tract?
Duodenum
A client is being treated for chronic kidney disease (CKD). One of the nurse's responsibilities is to explain to the client the need to keep her blood pressure under control. Why is blood pressure control so important in CKD clients?
Elevated blood pressure will exacerbate nephron loss and accelerate renal failure.
A client is admitted with chronic gastritis. The nurse expects which invasive test to be performed to establish the presence of Helicobacter pylori (H. pylori)?
Endoscopic biopsy
Which procedure is a nonsurgical method of treatment for renal calculi (kidney stones)?
Extracorporeal shock wave lithotripsy (ESWL)
The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes:
Facilitating the absorption of osmotically active particles
The nurse is teaching her client with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?
Fat
The nurse caring for a client with chronic kidney disease (CKD) would monitor for which early manifestations of uremia? Select all that apply.
Fatigue Weakness Apathy Nausea
An older adult client with a history of severe constipation tells the nurse that he has been experiencing watery stool and fecal incontinence the last 2 days. The nurse suspects this client may be experiencing which problem?
Fecal impaction
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:
Fistula formation
Several clients in clinic today are reporting urinary signs/symptoms. Which reported manifestation(s) leads the health care provider to suspect acute pyelonephritis? Select all that apply.
Flank pain in the back Abrupt onset of fever and chills Urinary urgency and frequency
In clients with acute diarrhea, many require no treatment. However, the nurse knows the priority assessment in all clients with diarrhea is:
Fluid and electrolyte status
A client with chronic pancreatitis is experiencing an episode of recurring epigastric pain. The nurse teaches the client to limit which type of meal to avoid further episodes?
Fried chicken and french fries
A student is comparing the actions of the gastrointestinal hormones. Which hormone acts as an appetite-stimulating signal?
Ghrelin.
The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function.
Glomerular filtration rate (GFR)
Acute postinfectious glomerulonephritis, as its name implies, follows an acute infection somewhere else in the body. What is the most common cause of acute postinfectious glomerulonephritis?
Group A β-hemolytic streptococci
In the balance of secretions in the gastric mucosa by the parietal cells, which ion is produced to buffer the production of hydrochloric acid?
HCO3-
A client tells the nurse that he is concerned about developing hepatitis after being exposed to contaminated feces, saliva, and food. The nurse is aware that the client is at risk for:
Hepatitis A
Which factor contributes to the development of polycystic kidney disease?
Hereditary mutations in polycystin I and II
The nurse is caring for a client with right upper quadrant pain secondary to acute choledocholithiasis. If the common bile duct becomes obstructed, which manifestation will the nurse expect?
Hyperbilirubinemia
When caring for the client with acute pancreatitis, which alterations does the nurse recognize is consistent with the disease?
Hyperglycemia
The nurse is caring for the client with pancreatic cancer. The nurse monitors the client for which complication?
Hyperglycemia due to inability to synthesize insulin SUBMIT ANSWER
A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?
Hypertension
Which signs and symptoms are most suggestive of acute cholecystitis?
Upper right quadrant or epigastric pain
A client reports urinary incontinence, specifically not feeling the urge to urinate until the bladder voids uncontrollably. Client history shows type 1 diabetes of 40+ years and compliance with medication and diet. What is the most likely diagnosis?
Incontinence related to neuropathy causing overactive bladder
Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?
Increased blood pressure
The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?
Increased nitrates
The nurse is reviewing laboratory results of a client who has liver failure. Which finding would place the client at increased risk for bleeding?
Increased prothrombin time
When caring for the client with hepatic failure, the nurse recognizes that which problem places the client at increased risk for bleeding?
Increased prothrombin time
A client is to receive a radiocontrast media as part of a diagnostic scan. Which intervention is intended to reduce the nephrotoxic effects of the radiocontrast media?
Increasing the normal saline intravenous infusion rate prior to the exam
A nurse is caring for a client admitted for chemotherapy due to bladder cancer. Which route would the nurse anticipate that the chemotherapy will be administered when the goal is to minimize systemic side effects?
Intravesical
A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 30.8 lb (14 kg) overweight. What conclusion can the nurse best draw about the etiology and pathophysiology of his bladder cancer?
It is caused by carcinogens that are excreted in the urine and stored in the bladder.
Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct?
Kidneys convert inactive vitamin D to its active form, calcitriol.
An older adult presents to the primary health care provider's office with a report of bladder leakage. Which assessment correlates with a diagnosis of stress incontinence?
Loss of small amounts of urine when laughing or sneezing
If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?
Lower extremities
A client is admitted to an acute care facility with a Clostridium difficile infection. The nurse anticipates administering which medication?
Metronidazole
A nurse is teaching a client about the difference between digestion and absorption. Which action should the nurse describe as absorption?
Moving nutrients from the external environment of the GI tract into the internal environment
While teaching a family member about the development of hepatic encephalopathy, which cause is likely to be mentioned?
Neurotoxin accumulation
A client with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which problem?
Obstruction
An ultrasound confirms appendicitis as the cause of a client's sudden abdominal pain. Which etiologic process is implicated in the development of appendicitis?
Obstruction of the intestinal lumen
A client with stage 5 chronic kidney disease (CKD) is presenting with fever and chest pain, especially when taking a deep breath. The nurse detects a pericardial friction rub on auscultation. Which condition does the nurse suspect is common with this stage of kidney disease? in bladder function can only occur when there is incontinence."
Pericarditis
Serous fluid is contained in the:
Peritoneal cavity
Which layer of the digestive tract constitutes the outer wall of the intestine and contains a serous fluid between its two layers?
Peritoneum
While assessing a peritoneal dialysis client in the home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as:
Peritonitis
Which assessment does the nurse recognize is consistent with signs and symptoms of acute pancreatitis?
Periumbilical pain
The swallowing reflex is an ordered sequence of events. In which phase is the epiglottis moved so that it covers the larynx?
Pharyngeal phase
A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?
Plasmapheresis
When teaching a client about chronic pancreatitis, which of these does the nurse relate is the long term result of this condition?
Progressive destruction
After several months of persistent heartburn, an adult client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to be prescribed for this client's GERD?
Proton pump inhibitors; avoiding large ...
An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region?
Pyloric region
Regurgitation of bile salts and duodenal contents can lead to gastric ulcers. Which structure prevents this from happening?
Pyloric sphincter
The nurse recognizes that acute renal injury is characterized by which of the following?
Rapid decline in renal function
A nurse is completing an abdominal assessment on a client suspected to have appendicitis. When the nurse applies and then releases pressure in the client's right lower quadrant, the client experiences tenderness. The nurse is documenting the presence of:
Rebound tenderness
An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?
Recently had a urinary tract infection
The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause?
Reduced production of erythropoietin
What is the most common cancer of the kidney?
Renal cell carcinoma
A client diagnosed with chronic kidney disease (CKD) is experiencing nausea and vomiting. Which intervention would be most appropriate for the nurse to provide?
Restrict intake of dietary protein
When acidic chyme enters the duodenum, it stimulates secretion of which hormone?
Secretin
The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?
Serum creatinine
An 86-year-old female client has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to minimize urinary incontinence. The client's admitting laboratory results are suggestive of prerenal failure. The nurse should be assessing this client for which early sign of prerenal injury?
Sharp decrease in urine output
Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn's disease?
Skip lesions
Gastroesophageal reflux (GERD) is a common comorbidity of hiatal hernia, and when this occurs, how may the hernia respond?
Slow down esophageal acid clearance
A nurse explains to her client that food is moved along the gastrointestinal (GI) tract with intermittent contractions that mix the food and move it along. These movements are found in which organ?
Small intestine
Which clinical manifestation would lead the nurse to suspect the client has malabsorption syndrome with a deficiency in fat absorption?
Steatorrhea
Gastrin production, a task that is performed by the stomach, results in which effect?
Stimulation of gastric acid secretion by parietal cells
A client has been diagnosed with an incompetent pyloric sphincter. The nurse educating the client mentions that this is due to abnormal communication between which components of the gastrointestinal tract?
Stomach and duodenum
A nurse is caring for a client who has been diagnosed with kidney colic but has yet passed the stone. Which interventions would the nurse emphasize when planning the care for this client?
Strain the urine
The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?
Stress
A 40-year-old mother of three reports incontinence. Her physician suggests Kegel exercises because they strengthen the pelvic floor muscles. Kegel exercises are most likely to help which type of incontinence?
Stress incontinence
A nurse administering a client's medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent:
Stress ulcer
Motility along the length of the GI tract, controlling the function of each segment of the GI tract and integrating signals for absorption of nutrients, primarily is innervated by which portion of the enteric nervous system?
Submucosal plexus
A female teenager has experienced three uncomplicated urinary tract infections in the past 3 months. Which action should the nurse include in education for this teenager?
Taking antimicrobials to treat Escherichia coli while forcing fluids
A client is diagnosed with choledocholithiasis and acute suppurative cholangitis and is being rushed to surgery to prevent which possible complication?
The accumulation of purulent bile, which can cause sepsis.
An older adult client with an upper respiratory infection for several weeks has presented with urinary retention. The client reports taking nonprescription cold medications over and above the suggested dose. Which medication most likely is contributing to this urinary retention?
The anticholinergic effects of the medication are impairing normal bladder function.
A client with a systemic infection has been given strong doses of broad-spectrum antibiotics for a period of 10 days. The infection recedes and he is taken off the antibiotic therapy. Two days later he presents with a Clostridium difficile infection. How should the nurse best interpret this situation?
The client's antibiotics disrupted the microbial balance and allowed overgrowth.
A nurse observes that a client's urine is cola colored and considers which factor as a possible reason?
The client's urine contains material from the degradation of red blood cells.
Which statement regarding the defecation process is most accurate?
The external sphincter is controlled by nerve fibers in the pudendal nerve.
An older adult client who recently started taking furosemide tells the nurse about now experiencing problems with urine incontinence. Which type of incontinence is this client likely experiencing?
Transient
The older adult client tells the health care provider about experiencing incontinence ever since starting diuretic therapy 2 weeks ago. What term should the provider document in the medical record related to the type of incontinence?
Transient
A client with chronic kidney disease (CKD) will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate?
Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time.
Which substance is broken down by the emulsification process?
Triglycerides
The nurse understands that medications, although very beneficial to clients, can have harmful effects. When working with older adult clients the nurse should recognize that which outcome is a common result of potent, fast-acting diuretics?
Urge Incontinence
A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:
Urge incontinence
A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?
Uric Acid
Which is the most important factor in reducing hospital-acquired (nosocomial) urinary tract infections?
Using urinary catheters only when necessary and their prompt removal when no longer needed
A nurse is caring for a 6-year-old girl who exhibits manifestations of a urinary tract infection but whose urine culture is negative for microorganisms. Which cause must be considered when urinary symptoms are present in the absence of bacteriuria? Select all that apply.
Vaginitis Pinworms Viral cystitis Sexual molestation
A client admitted to the emergency department with early symptoms of appendicitis should be assessed for which manifestation?
Vague pain that is referred to the epigastric or periumbilical area
Biopsy results reveal that a client has a deficient amount of parietal (oxyntic) cells in his stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:
Vitamin B12
A client has been diagnosed with cholestasis and is experiencing pruritus. The nurse caring for this client should be educating the client about reduced bile flow that will interfere with intestinal absorption of which vitamins? Select all that apply.
Vitamin D Vitamin A Vitamin K
Which clinical manifestations would tell a nurse that a client is having progressive decompensation related to obstruction of urinary outflow?
When tested for residual urine volume, 1400 mL of urine is obtained when client is catheterized.
Select the option that best describes the sensory process involved in the inhibition of micturition.
When the bladder is distended to 150 to 250 mL in the adult, the sensation of fullness is transmitted to the spinal cord and then to the cerebral cortex, allowing for conscious inhibition of the micturition reflex.
A young adult male presents to the emergency department with a new onset of lower abdominal pain that has worsened significantly over the past 12 hours. Admission blood work shows stable electrolyte levels but leukocytosis. What nursing action is most appropriate?
Withhold food and drinks in anticipation of surgery
A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL (222.35 µmol/L). The assessment data related to this lab value includes:
Yellowish discoloration of the skin Dark-colored urine Yellowing of the sclera of the eye
The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection. Which finding should the nurse expect?
increased nitrites
The nurse is caring for a client with viral hepatitis who has general malaise, easy fatigability, arthralgia, and anorexia. These manifestations correspond with what stage of the disease?
prodromal period
A client who has a problem with incontinence loses a small amount of urine every time she coughs or sneezes. This type of incontinence is known as:
stress
A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:
surgery to release the bowel.
