PATHOPHYSIOLOGY TEST 2

______, the infectious cause of gastritis and gastric ulcers, produces the urease enzyme on the outer cell wall. The urease converts gastric urea into ammonia, thus neutralizing the acidic environment of the stomach and allowing the organism to survive in this hostile environment. This is how ___ infections occur? A.shingles B. H. Pylori C. Virus

B. H. Pylori

children differ as to their clinical presentation of ______infection when compared to adults. Failure to thrive (gain weight/height), CNS abnormalities (listlessness), and developmental delays are the most prominent primary manifestation of _____infection in children. Therefore, assessing the child's weight is important for the management of failure to thrive children. PCP (pneumonia) is a major cause of early mortality for _____-infected children. Assessing weight and developmental tasks of a 6-month-old (can the infant rollover?) are normal growth assessments. These are the clinical manifestations of _____? A. shingles B. HIV C. HPV

B. HIV

The administration of hyperosmolar substances, such as glycerin and urea, often produces acute temporary hearing improvement in persons with _______. This method sometimes is used as a diagnostic measure of endolymphatic hydrops. Diphenhydramine is an antihistamine not prescribed for______. Usually, the treatment is with diuretics, steroids, or a suppressant drug, which acts centrally to decrease the activity of the vestibular system. This is a medication that would produce a temporary hearing loss in a patient with____? A. Cataract devlopement B. Meniere's Disease C. Limes deases

B. Meniere's Disease

_______ involves the transfer of antibodies from an outside source, such as those from breast milk. Immunization and recovery from illness involve active immunity. A. active immunity B. Passive immunity C. immunity helper cell

B. Passive immunity

Toll-like receptors are not associated with the complement system. The complement system may be activated by antibody recognition, mannose-binding, or microbial protein recognition. Phenomena results in ____? A. Deactivation of the complement system B. activation of the complement system C. activation of the transition system

B. activation of the complement system

Seasonal________ is an IgE-mediated hypersensitivity reaction precipitated by small airborne allergens such as pollen. Treatment consists of allergen avoidance, the use of cold compresses, and eye washes with tear substitutes. Also, nonsedating oral antihistamines may be helpful. Seasonal _____is not a bacterial infection; therefore, antibiotics will be of no benefit. There is itching associated with seasonal ________; however, massaging the area may introduce bacteria, which will compound the problem. The client should keep the hands away from the eyes, if possible. The nurse would educate this to a clinic with _____? A. otitis externa B. allergic conjunctivitis C. otitis edema

B. allergic conjunctivitis

The lack of familiar MHC molecules will stimulate an immune response by effector cells in the absence of _______. An innate immune response is not central to the response, but rather the adaptive immune system. The lack of known MHC molecules, not foreign antibodies, accounts for the immune response, and familiar MHC molecules will not be produced by the donor kidney cells. Needs of ____ with a transplanted organ. A. Drugs B. anti-rejection drugs C. MHC drugs

B. anti-rejection drugs

_______ is associated with blood vessels and not the fluid within the ventricles of the brain. Localized ischemia with areas of necrosis noted on CT angiography is incorrect in that there is blood flow to the area. Ischemia is associated with decreased arterial flow resulting in the death of brain tissue. In arteriovenous malformations, a tangle of arteries and veins acts as a bypass between the cerebral arterial and venous circulation, in place of the normal capillary bed. However, the capillaries are necessary to attenuate the high arterial blood pressure before this volume drains to the venous system. As a result, the venous channels experience high pressure, making hemorrhage and rupture more likely; the lack of perfusion of surrounding tissue causes neurologic deficits such as learning disorders. Headaches are severe, and people with the disorder may describe them as throbbing (synchronous with their heartbeat). Increased tissue profusion means that more oxygenated blood is brought to the area, which is not the case. The elevated arterial and venous pressures divert blood away from the surrounding tissue, impairing tissue perfusion. A. ischemic stroke B. arteriovenous malformation C. Tribbing malfromation

B. arteriovenous malformation

Advanced age, steroid use, and sunlight exposure are all significant risk factors for the development of ______. Metabolically induced _____ are caused by disorders of carbohydrate metabolism (diabetes). Use of bronchodilators is not noted to be strongly associated with ______. These risk factors for _____? A. Thromblyic development B. cataract development C. shingles

B. cataract development

Being of the black race, male gender, having hypertension, and having diabetes are all well-documented risk factors for ____. Anemia, autoimmune disorders like rheumatoid arthritis, and the use of corticosteroids are not noted to predispose to _____. These are the risk factors for ____? A. MS B. ischemic stroke C. hypertension

B. ischemic stroke

While food may ______ in some individuals, food allergies are not an identified contributor to ____, and their presence or absence would be unlikely to provide a differential diagnosis of ______. ____ have a strong genetic component and, in children, nausea and vomiting during a headache are suggestive of migraine. Individuals who are prone to migraines are pain-free in the times between episodes. This is historical subjective data that would indicate the patient is experiencing _______. A. Shingles B. migraines C. head tumor

B. migraines

________ treatment usually includes the use of eardrops containing an appropriate antimicrobial agent. Systemic oral agents are not indicated. Protection of the ear from additional moisture is important; thus, the client should use ear plugs to help avoid getting water in the ear canal. Vaccines are recommended to prevent otitis media, not __________. A. otitis media B. otitis externa C. otists interna

B. otitis externa

______a are mediators of the acute-phase responses associated with infection or injury. Features of these systemic responses include fever [elevated temperature], hypotension, tachycardia [increased heart rate], anorexia, increase in neutrophil count, and increased levels of corticosteroid hormones. Identify the clinical manifestations when ________ are major cytokines that mediate inflammation are released. A. shingles B. tumor necrosis factor-a and IL-1 C. CD4 T helper cells

B. tumor necrosis factor-a and IL-1

The onset and course of hearing loss, and the presence or absence of tinnitus, do not necessarily help to differentiate between _____ and ________ hearing loss. The subjective effect of the client's hearing loss, while a valid concern, does not help with the differential diagnosis. A. conductive and interceptor B.conductive and sensorineural C sensorineural and compactor

B.conductive and sensorineural

The most common conditions causing increased intracranial pressure include cerebral tumors, subdural hematoma, hydrocephalus, and malignant hypertension. Possible MI or menstrual cramping are not causes of increased intracranial pressure. Identify clients who would be considered high risk for developing _______? A. fragile X syndrome B. papilla C. klienfield syndrome

B.papilla

_______ represents an acute episode of exaggerated sympathetic reflex responses that occur in people with injuries at T6 and above, in which CNS control of spinal reflexes is lost. It is characterized by hypertension (BP 180/98 mm Hg), skin pallor, vagal slowing of the heart rate (pulse 49), and headache ranging from dull to severe and pounding. These are the exam findings of someone with ____? A. Gillian-Barre syndrome B. MS C. Autonomic dysreflexia

C. Autonomic dysreflexia

Helper T cells are central to the regulation, proliferation, and stimulation of the immune system. They do not play a central role in antigen presentation or early hematopoiesis, however. Their absence would not result in incorrect antibody production, but rather the insufficient or absent immune response. What is the role of ____ cells in immunity? A. Passive helper cells B. tumor necrosis factor-a and IL-1 C. CD4 T helper

C. CD4 T helper

___bites, and particularly ______bites, are often infected at the time of presentation and require irrigation, debridement, and prophylactic antibiotics; neither suturing nor corticosteroids are recommended. Postexposure rabies prophylaxis should be administered since this was a stray ____ and its vaccination history is unknown. The nurse should also inquire as to the client's last tetanus immunization. These are nursing interventions for a ____? A. Dog bite B.Stray animal C. Cat bite

C. Cat bite

_______ is an acute immune-mediated polyneuropathy. The majority of people report having had an acute, influenza-like illness before the onset of symptoms. It progresses along the ascending muscle weakness of the limbs, producing symmetric flaccid paralysis. The rate of disease progression varies, and there may be disproportionate involvement of the upper or lower extremities. Swelling of the arm, eyes, and lips is anaphylaxis following the flu shot. It is not a degenerative disease. A. Migrianes B. anerusym C. Gillian- Barre syndrome

C. Gillian- Barre syndrome

Autonomic signs [of motion sickness], including lowered BP, tachycardia, and excessive sweating may occur. Hyperventilation produces changes in blood volume and pooling of blood in the lower extremities, leading to postural hypotension and sometimes syncope. A Red, flushed face is usually associated with elevated temperature. Severe balance problems are usually associated with irritation or damage of the vestibular end organs. These are the manifestations of ____? A. conductive hearing loss B. H. pylroi C. motion sickness

C. motion sickness

Antimicrobiotic ear drops are the standard treatment for _____, and the ears must be protected from trauma during infection. Oral antibiotics are not commonly used, and flushing the ears is not indicated for the condition. A lack of normal ear drainage is not part of the etiology of _______. These are the treatment for a client with_____? A. otits enderma B. Kragile X syndrome C. otitis externa

C. otitis externa

The primary symptom of retinal detachment consists of painless changes in vision. Commonly, flashing lights or sparks followed by small floaters or spots in the field of vision occur as the vitreous pulls away from the posterior pole of the eye. As detachment progresses, the person perceives a shadow or dark curtain progressing across the visual field. This is the subjective history of a patient experiencing a _______ A. Virus B. H. Pyroli C. retinal detachment.

C. retinal detachment.

______ is characterized by a period of unconsciousness and may be associated with focal manifestations such as hemiparesis (weakness or slight paralysis affecting one side of the body), aphasia, and cranial nerve palsy. Coma with total paralysis is seen in severe brain injury. Nuchal rigidity is a classic sign of meningitis Which are the clinical manifestations of a ____? _A. moderate brain contusion B. Single brain contusion C. MS

_A. moderate brain contusion

While opioids carry side effects such as constipation, these can be managed to continue treatment; constipation would not preclude the continued use of opioids but would require management. Pain medication should precede the onset of pain, and tolerance is not grounds for discontinuing treatment. identify teaching points in a patient with______to his/her hand who is taking opioids A. 1st-degree burn b. 3rd-degree burn c. 2nd-degree burn

b. 3rd-degree burn

Early in pregnancy, the embryo is particularly sensitive to toxic substances, including ototoxic drugs such as aminoglycosides and loop diuretics. Trauma, particularly head trauma, may also cause sensorineural hearing loss. Toluene and styrene are the most widely and extensively used aromatic solvents in industry and can cause ototoxicity. Toluene is a major component of adhesives, paints, lacquers, varnishes, printing inks, degreasers, fuel additives, glues, and thinners, whereas styrene is present when manufacturing plastics, rubber articles, and glass fibers. The businesswoman working long hours is at no greater risk than any pregnant female. Nurses are exposed to numerous infections, but standard precautions recommended by the CDC provide good protection. These are risk factors for the development of ___? A sensorineural hearing loss B. Conductive hearing loss C. toluene hearing loss

A sensorineural hearing loss

Antibody production is not a noted component of the inflammatory response. Removing damaged cells, generating new tissue, and eliminating the cause of cell injury are all documented components of the inflammatory response. These are all developmental teaching points for a 23-year-old male patient with ________ (remember it's an inflammatory response) A. Appendicitis B. tumor necrosis C. H. Pylori infections

A. Appendicitis

________ and _____ (varicella-zoster or herpes-zoster, also known as _____) are caused by the same virus. It has the initial manifestation as _____but the resumption of the latent virus manifests as shingles. The client would not have required recent exposure. Herpes ____ is a latent virus rather than having a long prodromal stage. Cold sores are caused by herpes simplex virus I, not ____ A. Chickenpox and zoster; shingles B. Shingles and zoster; chickenpox C. Chick pox and shingles; zoster

A. Chickenpox and zoster; shingles

_____hearing loss occurs when auditory stimuli are not adequately transmitted through the auditory canal, tympanic membrane, middle ear, or ossicle chain to the inner ear. It can be a temporary loss from impacted cerumen. A. Conductive B. sensorineural C. peral

A. Conductive

Because ____ can mediate diverse effects due to their pleotropic properties, they can have significant side effects. _____production is brief, not constant, and production does not normally take place in granulocytes. Activation of a _____ does not necessarily limit other similar _____, and additive effects are not uncommon. These are the fiction and nature of? A.cytokines B.cytoplasm C.virus

A. Cytokines

Exacerbations of symptoms in _________have been linked to excessive fatigue, physical deterioration, emotional stress, viral infections, and extremes of environmental temperature. Though the client should ask the health care provider before using over-the-counter medications, this is related to interactions with prescribed medications and not because it would trigger exacerbations. There has been no evidence that exposure to sunlight is linked to increased symptoms in ______. A. MS B. SIAHD C. HS

A. MS

Interferon beta helps modify the course of treatment of________. It may also reduce exacerbations in persons with relapsing-remitting ______. It is a cytokine that acts as an immune enhancer. It is administered by injection. The other medications are prescribed for _____but not given by injection. This is injectable medication is given to reduce exacerbations of ______? A. MS B. Gullian-Barre syndrtome C. dysreflexia

A. MS

____ may offer fetal and neonates' passive immunity against common infections such as influenza or herpes zoster. The nurse should not state that vaccines are a personal choice as this does not inform the client of the purpose of the vaccine (to protect both the mother and the fetus/neonate from the virus). Simply saying the vaccine is considered safe is not as informative. A. Maternal vaccination B. Adult Vaccination C. Client administration

A. Maternal vaccination

_________innervate brachial arch skeletal muscles—muscles of mastication and facial expression, and muscles of the pharynx and larynx. They also innervate muscles responsible for moving the head. General visceral efferent neurons and pre-ganglionic neurons (same) innervate smooth and cardiac muscle and glandular cells of the body, most of which are in the viscera. __________post have no effect of moving the head. A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons? A. Pharyngeal efferent neurons B. Efferent neurons C. Cardiac neurons

A. Pharyngeal efferent neurons

_______that are categorized as oncogenic are able to induce malignancy in host cells. _____have limited genetic material (either RNA or DNA) but no virus lacks genetic material. Transmissible neurodegenerative disease is associated with prions. Not all ____ include a latent period. A. Role of virus on human infection B. Role of disease in human infection C. Virus makeup in humans

A. Role of virus on human infection

Which component of his physical assessment and history is most indicative of a serious pathologic process (like aortic aneurysm or cancer? A. The gradual onset of back pain unrelated to injury and initial presentation after age 50 are considered red flags for more serious pathologies such as aortic aneurysm, malignancy, or compression fracture. Pain that is aggravated by lying down is a red flag for malignancy or infection. The onset of hamstring pain at 90° of hip flexion is a normal finding. The need for and use of NSAIDs for lower back pain relief is not indicative of serious pathology in and of itself.] B. The delayed onset of neck pain unrelated to injury and initial presentation after age 45 is considered serious pathologies such as aortic aneurysm, malignancy, or compression breaks. Pain that is aggravated by lying down is a red flag for malignancy or infection. The onset of hamstring pain at 65° of hip flexion is a normal finding. The need for and use of NSAIDs for upper back pain relief is not indicative of serious pathology in and of itself.] C. Pain that is aggravated by lying down is a red flag for malignancy or infection. The onset of hamstring pain at 45% of hip flexion is a normal finding. The need for and use of happiness for middle back pain relief is not indicative of serious pathology in and of itself.]

A. The gradual onset of back pain unrelated to injury and initial presentation after age 50 are considered red flags for more serious pathologies such as aortic aneurysm, malignancy, or compression fracture. Pain that is aggravated by lying down is a red flag for malignancy or infection. The onset of hamstring pain at 90° of hip flexion is a normal finding. The need for and use of NSAIDs for lower back pain relief is not indicative of serious pathology in and of itself.]

______typically produce increased muscle tone, while hyporeflexia, muscle atrophy, and weakness in the distal portion of limbs are more commonly indicative of LMN lesions. Identify assessment findings that would suggest a possible ______ lesion A. UMNS upper motor neuron B. LMNS Lower motor neuron C. motor neuron

A. UMNS upper motor neuron

Repeated exposure to allergens causes an increase in IgG, which binds with antigens before they can stimulate IgE. It does not bind mast cells or basophils, nor does it overwhelm the IgE antibodies or stimulate epinephrine production. Does this phenomenon best capture the rationale ____? A. allergy desensitization therapy B. Physical therapy C. occupational therapy

A. allergy desensitization therapy

Nonpharmacologic therapies for ___________ using habituation exercises and canalith repositioning are successful in many people. Canalith repositioning involves a series of maneuvers in which the head is moved to different positions in an effort to reposition the free-floating debris in the endolymph of the semicircular canals. Surgery is not a noted treatment option and even in the absence of hearing loss, treatment is warranted. A. benign paroxysmal positional vertigo (BPPV) B. Malignant paroxysmal positional vertigo (MPPV) C. benign xysmal positional vertigo (BXPV)

A. benign paroxysmal positional vertigo (BPPV)

_____ is a turning in of the lid margin caused by scarring of the palpebral conjunctiva or degeneration of the fascial attachments to the lower lid that occurs with aging. Corneal irritation may occur as the eyelashes turn inward. _____ and ectropion can be treated surgically. Blepharitis and conjunctivitis are treated with antibiotics; herpes simplex keratitis is treated with antiviral medications. These are the signs and symptoms of _______? A. entropion B. Ectropion C. Endotrophin

A. entropion

The nurse should determine if the client is prescribed anticonvulsant medications and if these have been taken consistently since the most frequent cause of recurrent seizures is a failure to adhere to drug regimens. Whether the client has a family history of seizure disorders is not relevant to the treatment being administered. The type of seizure activity and the client's allergies to medications is important for the nurse to determine, but these will not inform the treatment plan to the same extent as knowing the client's medication history. A client with a history of ______ is brought to the emergency department due to seizure activity. This is the information about the client is most important for the nurse to collect. A. epilepsy B. Seizures C. MS

A. epilepsy

Damage to the auditory association cortex, especially if bilateral, results in deficiencies in sound recognition and memory (auditory agnosia). If the damage is in the dominant hemisphere, speech recognition can be affected (sensory or receptive aphasia). The others are not caused by focal seizures. These are the following _____ that have damaged the dominant hemisphere of a client's auditory association cortex, the nurse may observe? A. focal seizures B. cortex seizures C. infocal seizures

A. focal seizures

_______ is a cytokine that acts as an immune enhancer; it is administered by injection. The most common side effects are flu-like symptoms for 24 to 48 hours after each injection, so the client should be taught this is expected and normal. Because this medication reduces the destruction of myelin, it does alter the underlying disease process and is sometimes referred to as a "disease modifying drug." These are teaching points to a patient taking___? A. interferon beta B. beta blockers C. blocker gillian

A. interferon beta

Increased carbon dioxide (greater than 45 mm Hg) causes vasodilation, which can increase i_________Increased hydrogen ion concentrations, or acidosis correlates with a pH less than 7.35 and also increases cerebral blood flow. Decreased oxygen concentration or hypoxia (PaO2 less than 80 mm Hg [10.64 kPa]) also increases vasodilation and cerebral blood flow, which would increase ________. Neither a slightly low potassium level of 3.3 (normal is 3.5 to 4.5 mEq/L [mmol/L]) nor a low PaCO2 level is associated with increased _______ These are the clinical findings associated with increasing______ in a patient with traumatic brain injury. A. intracranial pressure B. Cranial pressure C. MS

A. intracranial pressure

In chemical synapses, _______ cross the synaptic cleft and bind with postsynaptic receptors to facilitate communication between neurons. This communication is one-way, not two-way, and each ____ has synaptic connections with thousands of other neurons. Gap junctions are associated with electrical synapses, not chemical synapses. This is the process will accompany the actions of the _______ in a chemical synapse A. neurotransmitter B. Mechanifical synthase C. chemical synthase

A. neurotransmitter

Mastoiditis, suspected or confirmed, warrants immediate referral to the closest surgical hospital. Given the child's history of frequent acute otitis media, mastoiditis or suppurative ________leading to neurologic complications should be ruled out. Signs and symptoms include tinnitus, which could decrease auditory acuity, and a stiff neck due to meningitis. Supra-auricular or postauricular swelling is also a sign of mastoiditis. Having increased sensitivity to hearing or cold symptoms does not support mastoiditis or neurologic complications that would warrant immediate attention. These are the assessment findings in an 8-month-old with frequent \ A. otitis media B. otitis externa C. otists interna

A. otitis media

There are numerous causes of _________, including malnutrition, burns, gastrointestinal loss, nephrotic syndrome, and malignancy and as a side effect of certain medications like antiepileptics, antihypertensives, and glucocorticoids. These conditions can result in an increase in immunoglobulin loss and/or a decrease in immunoglobulin production. Allergies to environmental surroundings and anxiety/depression are not causes of __________. A. secondary hypogammaglobulinemia B. Primary hypogammaglobulinemia C. hymoglocimega

A. secondary hypogammaglobulinemia

-_____hearing loss occurs with disorders that affect the inner ear, auditory nerve, or auditory pathways to the brain. Numerous drugs have ototoxic potential, a consequence of which is _______hearing loss. A. sensorineural\ B. compactor C. conductive

A. sensorineural

Prior stroke or head injury within 3 months, blood pressure greater than 185/110 mm Hg, or symptoms that have been present for greater than 4.5 hours exclude the client as a candidate for t_______. Neither age nor heart rate is part of _______ treatment criteria. This is information necessary in a stroke patient that qualifies him/her for_____? A. thrombolytic therapy. B. physical therapy C. occupational therapy

A. thrombolytic therapy.

Identify the pain associated with ______? symptoms are characteristic of________, caused by damage to the fifth cranial nerve, which carries impulses of touch, pain, pressure, and temperature to the brain from the face and jaw. A. trigeminal neuralgia B. singular neuralgia C. double neuralgia

A. trigeminal neuralgia

Injury to the _______ leads to vertigo, nystagmus, and postural instability. Thus, the priority will be on preventing motion sickness and protecting the client from injury. The client should have no hearing impairment so alternate communication techniques are not needed. A. vestibular division B. External divisoon C. Occuptional divsion

A. vestibular division

Analgesia is the absence of pain on noxious stimulation or the relief of pain without loss of consciousness. __________ is when a peripheral nerve defect apparently exists such that the transmission of painful nerve impulses does not result in the perception of pain. Pins-and-needles sensation is called paresthesia. Burning sensations are usually associated with temperature (hyperthermia). Pain associated with wind (or any non-noxious stimuli) is called allodynia. Identify examples of a child born with ________to pain A.congenital insufficiency B. expert insufficiency C. Congenital sufficiency

A.congenital insufficiency

______is characterized by the deposition of antigen-antibody complexes in blood vessels, joints, heart, and kidney tissue. The deposited complexes activate complement, increase vascular permeability, and recruit phagocytic cells, all of which can promote focal tissue damage and edema. _________s is not synonymous with an Arthus reaction. Antibody binding to specific target cell receptors causing a change in cell function is characteristic of antibody-mediated cellular dysfunction. ______ is not associated with the activation of the complement system. These are the effects of ___? A.serum sickness B. passive immunity C. apoapsis

A.serum sickness