A&PI final

The Waldorf family was caught in a fire but escaped. Unfortunately, the father and daughter suffered burns. The father had second-degree burns on his chest, abdomen, and both arms, and third-degree burns on his entire left lower extremity. The daughter suffered first-degree burns on her head and neck and second-degree burns on both lower extremities. What percentage of the father's body was covered by burns? The father experiences a good deal of pain in the area of the chest and abdomen, but little pain in the leg. Why?

54%. The nerve endings were damaged or destroyed in third degree burns, but in second degree burns the nerve endings are only irritated.

The Waldorf family was caught in a fire but escaped. Unfortunately, the father and daughter suffered burns. The father had second-degree burns on his chest, abdomen, and both arms, and third-degree burns on his entire left lower extremity. The daughter suffered first-degree burns on her head and neck and second-degree burns on both lower extremities. What percentage of the daughter's body received first-degree burns? What part of the daughter's body has burns to both the dermis and epidermis?

9%; the legs

Robert, a surfer, has a mole that has changed its shape and size. His doctor, applying the ABCD(E) rule, diagnosed a melanoma. What do the letters ABCD(E) represent?

A = asymmetry, B = border, C = color, D = diameter, E = elevation

Mary noticed a large, brown spot on her skin. She has been playing tennis in the sun for several years without sun protection. She reported the discovery to a friend, who told her to apply the ABCD rule to determine whether or not she had malignant melanoma. Her friend told her that if her answer was "no" to the questions that were asked by the ABCD rule, she had nothing to worry about. What is the ABCD rule, and should she ignore the spot if her answers are negative?

A = asymmetry, B = border, C = color, D = diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined.

Ling, a 75-year-old grandmother, complained that her vision was becoming obscured. Upon examination by an ophthalmologist she was told she had cataracts. What are cataracts, how do they occur, and how are they treated?

A cataract is a clouding of the lens. Some cataracts are congenital, but most are due to age-related hardening and thickening of the lens, diabetes mellitus, or exposure to UV rays over time. The lens can be removed and replaced with an artificial lens.

A 45-year-old woman is admitted to the hospital for surgical removal of a tumor on her thyroid gland. The surgeon informs her that she will have only a very small scar. How could this be possible?

A thin incision will leave a small amount of scar tissue. The surface epithelium regenerates, and as scar tissue matures, it contracts, leaving only a fine white line.

The nurse is explaining Kegel exercises to strengthen the pelvic floor muscles. What factors may contribute to a weakening of the pelvic floor muscles?

Aging, multiple births, and decreased estrogen production

Albinos commonly contract skin cancer. What seems to be the reason, and what can be done to reduce the risk of skin cancer?

Albinos lack melanin and have thus lost their main defense against the damaging UV light that can cause skin cancer. They can cover all body areas and avoid bright sunlight.

A nurse is administering Pilocarpine eye drops. The nurse instructs the patient to press on the nasolacrimal duct for 30 seconds because the medication can have some systemic side effects, such as affecting the heart rate. What is the rationale for pressing on the nasolacrimal duct?

Applying gentle pressure to the nasolacrimal duct prevents the delivery of the drug to the nasal mucosa and general circulation, where it could affect heart rate.

The temperature yesterday was an uncomfortable 98°F. You unwisely chose to play tennis at noon, counting on your body's internal defenses to protect you against heat exhaustion. How did your body respond to this distress?

Blood vessels in the skin dilated; sweat was secreted onto the skin's surface and evaporated, cooling the body.

Brian decided to enter a 5-mile race designed to raise money for a class trip. He did not do any preconditioning, nor has he ever jogged before. The morning after the race, Brian had so much pain in both his legs that he was unable to go to school. What caused this pain, and why?

Brian has shin splints. This is a condition in which the anterior tibialis muscle is irritated, inflamed, and swollen. The circulation is impaired by the tight fascial wrappings, causing pain.

How can a tooth be moved in a bony socket during orthodontic treatment?

By applying slight pressure to a tooth, the bone on the forward side will reabsorb, while the bone on the reverse side will be reformed.

Melanoma is a form of skin cancer that arises from melanocytes. Melanoma is most common in Caucasians between 40 and 70 years of age. Why do Caucasians have a greater incidence of melanoma?

Caucasians produce less melanin, resulting in less protection from the damaging effects of UV light. Dark brown or black skin does not guarantee against melanoma.

Although his cholesterol levels were not high, Mr. Martinez read that cholesterol was bad for his health, so he eliminated all foods and food products containing this molecule. He later found that his cholesterol level dropped only 20%. Why did it not drop more?

Cholesterol is produced by the liver, in addition to being ingested in foods.

Ralph sustained a leg injury in a bowling accident and had to use crutches. Unfortunately, he never took the time to learn how to use them properly. After two weeks of use, he noticed his fingers were becoming numb. Then he noticed his arms were getting weaker and had a tingling sensation. What could be his problem?

Compression of the radial nerve (in the region of the armpit) may cause temporary cessation of nervous transmission, often called "Saturday night paralysis."

Lynn has been waking up each night with intense pain in her calves. She has been playing tennis all summer for several hours each day. She does not feel that her problem is serious enough to seek medical attention. What is the diagnosis, and why?

Cramp in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have caused an electrolyte depletion.

The 68-year-old patient was admitted to the hospital medical floor with a diagnosis of chronic bronchitis. His wife asks the nurse why his skin looks blue. How would you explain cyanosis to this patient and his wife?

Cyanosis is a dusky bluish or grayish discoloration of the skin and mucous membranes that occurs with reduced oxygen levels.

Multiple sclerosis (MS) is a disease in which the myelin sheaths are destroyed. What process does this interfere with, and what would be the consequence?

Demyelination interferes with saltatory conduction, which would result in a slowing down of nerve impulse propagation.

Brenda is a 26-year-old female who is being discharged from the hospital after a vaginal delivery of an 8-pound healthy infant. Brenda is instructed by the nurse to eat a diet high in fiber and to drink 8 glasses of water per day to prevent constipation. Why?

Dietary fiber adds bulk that cannot be absorbed by the body. This results in more water remaining in the digestive tract, easing the movement of feces through the bowel.

A patient was admitted to the medical/surgical unit with a stroke that affected the motor neurons in the pyramidal pathway. This caused the loss of voluntary movement to his left side. What other problems would the patient experience?

Difficulty swallowing and problems with urinary incontinence

When a geriatric patient is admitted to the rehabilitation unit, an important nursing measure is to prevent the loss of muscle mass. What is the term used for loss of muscle mass, and how can the patient prevent it?

Disuse atrophy, where fibrous connective tissue replaces the muscle tissue that was lost. This can be prevented by regular weight-bearing exercise, unless atrophy is complete.

A patient is receiving transcutaneous electrical nerve stimulation (TENS) for back pain. How will this help with the pain?

Electrical stimulation of the skin's large touch fibers causes the gates to close on the smaller pain fibers, thereby inhibiting pain.

Emily, a 64-year-old obese woman, was brought to the hospital suffering pain in her legs, and an x-ray revealed that she had a simple fracture in her right femur and a crack in her left tibia. Other tests revealed that her bones were brittle and porous. What might have happened to Emily, and what advice would she have been given by the physician?

Emily has osteoporosis. She should lose weight because her bones may not be able to support her body mass.

In adult humans, most cancers are carcinomas or adenocarcinomas. These include cancers of the skin, lung, colon, breast, and prostate. Which of the four basic tissue types is involved, and why?

Epithelial tissue: it is exposed to the environment and is constantly dividing, both factors allowing more opportunity for damage and overcoming growth control mechanisms.

David, an aspiring baseball player, was struck on the left side of his face with a fastball pitch. He was not wearing a safety helmet. His zygomatic arch was crushed, as well as parts of the temporal bone. Following the accident and reconstructive surgery, he noted that his left lower eyelid was still drooping and the corner of his mouth sagged. What nerve damage did he sustain?

Facial nerve damage on his left side

The patient was admitted to the hospital on a hot day (100oF) for severe dehydration. What changes occur in extracellular and intracellular fluid compartments during dehydration, and what specific processes are involved at each step?

Fluid is initially lost from the intravascular compartment due to sweating, which is replaced by fluid from the interstitial compartment by osmosis, which then pulls fluid from the intracellular compartment by osmosis.

Donna was rushing to class and slipped on a patch of ice and fell backward. An x-ray revealed a broken coccyx. All the associated muscles were bruised. Which muscles were they?

Gluteus maximus, coccygeus, and levator ani

Why does an open wound need a bed of granulation tissue for wound healing to occur?

Granulation tissue forms new capillary beds that provide oxygen-rich blood for the healing process.

Propranolol hydrochloride (Inderal) is a beta-adrenergic blocker often used as an antianginal, antiarrhythmic, and antihypertensive drug. Before giving Inderal to a patient, what physiological parameters should the nurse assess?

Heart rate for bradycardia, and the blood pressure for hypertension

A 23-year-old male was riding his road bike in 100-degree heat, when he suddenly became nauseated and weak. He called 911 from his cell phone. When the ambulance came, the paramedics started intravenous therapy for severe dehydration. Which physical property and which physiological role of water caused the dehydration, and why?

High heat of vaporization; water was lost when evaporating from the skin to cool the body.

Your patient has a respiratory disease that has literally paralyzed the cilia. Why would this patient be at an increased risk for a respiratory infection?

If cilia are paralyzed then mucus-containing particles, including bacteria, will remain in the lungs and may cause a respiratory infection.

Gary was injured in an automobile accident that severed the motor neurons innervating his quadriceps. Even though he has had extensive physical therapy, he is still suffering muscle atrophy. Why is the therapy not working?

In denervation (disuse) atrophy, fibrous connective tissue replaces the muscle tissue that was lost. When atrophy is complete, fibrous tissue cannot be reversed to muscle tissue.

Sam is an accountant who is especially busy during tax season. By the end of each day he complains of shoulder stiffness and tightness, as well as some upper back pain. What might be Sam's problem, and how could he prevent the discomfort?

Incorrect posture when sitting at a desk can result in kyphosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain the proper thoracic vertebral curve.

A 6-year-old child fell off his bike and scraped his knee. What is the first stage of wound healing, and what occurs during this stage?

Inflammatory stage, characterized by dilation and increased permeability of capillaries, movement of white blood cells and plasma into the area, clot formation, and removal of foreign material and cell debris.

A patient is admitted for electroconvulsive treatment (ECT). The physician orders the neuromuscular blocking agent metocurine iodide (metubine) to reduce trauma by relaxing skeletal muscles. How does a neuromuscular blocking agent such as metubine interfere with muscle contraction?

It acts at the postsynaptic membrane by competing with the ACh for the receptor sites, or by blocking depolarization.

A nurse can facilitate respiratory functioning by encouraging deep breathing exercises such as diaphragmatic breathing. What is diaphragmatic breathing?

It is the alternating contraction and relaxation of the diaphragm, causing an increase in pressure in the abdominopelvic cavity and facilitating blood flow to the heart.

Akira, a 2.5-ranked tennis player (who thought he was a 4.5 player!), experienced severe pain in his elbow joint after playing for five straight hours, well beyond his limit. He told everyone it was due to a fall while diving to retrieve a difficult shot. What do you think?

It was probably inflammation of the bursa close to the olecranon process, because he overextended his abilities.

How might probenecid be useful in treating gout?

It would lower the uric acid concentrations in the blood by stopping absorption of uric acid in the kidneys.

While on vacation last spring, June, a 24 year old woman, fell on the pavement and broke her wrist. At the emergency room, a resident placed a cast on her wrist after manipulating the bones. It seemed to heal within a few months. However, recently she has noticed hard lumps in the area where the break happened and she has been complaining of pain. What could be causing the lumps and the pain?

June probably has "bony spurs," which are abnormal projections from a bone due to bone overgrowth.

A young pregnant woman went to a childbirth class and the instructor informed them about strengthening the muscles of the pelvic floor. What are these muscles, and why should she strengthen them?

Levator ani and coccygeus; strengthening these muscles helps in the delivery of the child by resisting downward forces when "pushing."

A 52-year-old woman states she has been "leaking urine" during such times as laughing, sneezing, or exercise. Which muscles are affected, and what can cause this problem?

Levator ani and coccygeus; weakening of the pelvic floor muscles could cause this problem.

Research shows that neurofibrillary tangles are the primary cause of Alzheimer's disease. Neurofibrillary tangles are associated with microtubules. What may happen if microtubules collapse to cause Alzheimer's disease?

Loss of cell shape and movement of cellular organelles

Without macrophages, wound healing is delayed. Why?

Macrophages phagocytose many foreign materials, as well as cell debris and dead cells. This cleans the wound, allowing granulation tissue to form.

Aaron arrived at the hospital with the following symptoms: drooping eyelids; fatigue and weakness of his muscles; and difficulty talking, breathing, and swallowing. What was his diagnosis?

Myasthenia gravis

What is the difference in cell division between normal cells and cancer cells?

Normal cells undergo controlled division, as the body requires; cancer cells have overcome the body's controls of cell division and will replicate continuously.

What are the local clinical signs and symptoms of the inflammatory stage of wound healing?

Pain, swelling, redness, and heat

Why should people who live in the north take supplemental calcium with vitamin D?

People who live in the north have a decreased amount of sunlight exposure. Vitamin D is manufactured by skin cells when exposed to sunlight, and is needed for absorption of dietary calcium.

Aunt Jessie woke up one morning with excruciating pain in her chest. She had trouble breathing for several weeks. Following a visit to the doctor, she was told she had pleurisy. What is this condition and what did it affect?

Pleurisy is inflammation of the serous membranes covering the lungs. Inflamed pleural serous membranes create friction, resulting in pain as the lungs move during breathing.

A 64-year-old man is admitted to the hospital for nonhealing pressure ulcers in his heels. He has been bedridden for 10 years because of a degenerative muscle disease. Which type of organic compound would be an important part of his diet to promote wound healing, and why?

Proteins, as they are the basic structural material of the body, and are essential for growth, repair, and maintenance of tissue.

Maggie is a 28-year-old Caucasian woman who has newly diagnosed rheumatoid arthritis (RA). She complains of painful, stiff hands and feet, feeling tired all the time, and reports an intermittent low-grade fever. She asks the nurse if she is going to be "crippled." How should the nurse respond?

RA is a chronic, systemic, inflammatory disorder. Inflammation occurs in the joint, and the fluid that accumulates causes swelling, stiffness, impairment of joint movement, and extreme pain.

A 19-year-old model for Glamour magazine tripped over an extension cord, causing injury to her epidermis. She is afraid the injury will leave a scar. What would be the best thing to say to the patient in response?

Regeneration is the replacement of destroyed epithelial tissue cells by cells that are identical or similar in structure and function. Scaring would be minimal, if there are no complications such as infection.

Which of the following outcome criteria show that a patient is effectively coping with a stressful problem?

Regular heart beat, unlabored breathing, warm and dry skin, constricted or normal pupils

Johnny fractured the lower third of his right tibia in a skiing accident. The soft tissues in the area were severely damaged and their surgical removal was necessary. After prolonged immobilization, it was found that Johnny was healing very poorly. Why did Johnny have poor healing?

Removal of the soft tissue reduced blood flow to the affected area, resulting in a decreased supply of nutrients required for repair.

Why is it possible to safely drink a solution that contains a 50:50 mixture of equal concentrations of a strong acid and a strong base, either of which, if ingested separately, would be very caustic and damaging?

Salt and water are formed when a strong acid and base are mixed.

A patient was admitted for depression. What class of neurotransmitter is serotonin, and what should the nurse explain to the patient regarding the role of serotonin in depression?

Serotonin is a biogenic amine neurotransmitter widely distributed in the brain; it plays a role in emotional behavior and mood, and helps to regulate the "biological clock."

An 86-year-old patient with Alzheimer's disease was admitted to the hospital with dehydration. Her daughter states that her mother has been very confused and combative lately. Why did the patient develop dehydration?

She is probably refusing or forgetting to eat or drink.

A 60-year-old woman is experiencing vertigo. She ignores the symptoms initially, but now her attacks are accompanied by severe nausea and vomiting. Following an attack, she hears a crackling in her ears that causes temporary deafness for some time after. What do you think her problem is, and what is its suspected cause?

She most likely has a condition known as Ménière's syndrome. The cause of the syndrome is uncertain, but it may result from distortion of the membranous labyrinth by excessive endolymph accumulation.

Mrs. Sagalov has recently been diagnosed with Alzheimer's disease. What clinical symptoms is she likely to show?

She will show increasing cognitive deficits, including difficulties with memory and attention, and personality changes such as irritability, moodiness, and confusion.

A nurse is instructing the patient care assistants (PCAs) on transfer techniques. For patients requiring more assistance, the nurse tells the PCAs to reach through the patient's axillae and place their hands on the patient's scapulae during the transfer. She tells them to avoid placing hands or pressure in the axillae area. Based on your knowledge of the shoulder joint, why should this area be avoided?

Shoulder dislocations are fairly common, as stability was sacrificed for range of movement; therefore, pressure in this area should be avoided.

Mrs. Mulligan goes to her dentist and, after having a couple of cavities filled, her dentist strongly suggests that she reduce her intake of sodas and increase her intake of calcium phosphates in the foods she eats. Why?

Sodas are strong acids that can dissolve the calcium phosphate in bone and teeth.

Why is heparin used as an anticoagulant in the treatment of thrombotic strokes but contraindicated in a subarachnoid hemorrhage?

Strokes are commonly caused by clots blocking a cerebral artery, and heparin would prevent more clots from forming. In contrast, you want clots to form in hemorrhages to stop the bleeding.

Mrs. Brown was outside on her patio cleaning windows when she fell off her step ladder and fractured her right hip. She had emergency surgery for an open reduction and internal fixation of the right hip. After surgery, she asks you if she will have trouble going through airport security. What has prompted her concern?

Surgical repair of this fracture may involve use metal items (such as rods, wire, screws, pins, or nails) that could trigger security alarms.

Baby Susie's pediatrician notices that one of her eyes rotates outward and that she does not appear to be using it for vision. What is her condition, and what does the pediatrician recommend?

Susie has strabismus. The doctor's recommendations are for eye exercises and/or placing a patch over the unaffected eye; in severe cases, the condition may require surgery.

Why, or why not, is swimming recommended as an exercise to prevent osteoporosis?

Swimming is not recommended to prevent osteoporosis, as it is not considered a weight-bearing exercise.

You are giving a tap water enema to a patient. An adverse effect of the tap water enema is water intoxication. Why does tap water cause water intoxication?

Tap water is a hypotonic solution, and thus more water moves into the body and the cells, causing water intoxication.

Farhad begins typing his term paper on his new computer early one morning. After 8 hours of typing, he notices that his wrists are stiff and very sore. The next morning, Farhad begins to finish his paper, but soon finds his wrists hurt worse than last night. What is Farhad suffering from?

Tendonitis

A patient is admitted to the hospital with exacerbation of multiple sclerosis (MS). She asks the nurse "Why did this have to happen to me again? I was doing so well." Why are some forms of MS characterized by periods of remission and exacerbation?

The axons are not damaged; growing numbers of sodium channels appear spontaneously in the demyelinated fibers, allowing conduction to resume.

Why might soap that has an alkaline base not be healthy for some patients to use daily?

The base will neutralize the acid on the skin that retards the growth of bacteria, and the removal of the normal microbiota of skin will leave the person exposed to opportunistic pathogens.

A 75-year-old woman and her 9-year-old granddaughter were victims of a train crash. In both cases, trauma to the chest was sustained. X-rays of the grandmother revealed several fractured ribs, but her granddaughter had no fractured ribs. Why are the injuries different for the granddaughter and grandmother?

The child has more organic material in her bones, which allows them to bend; her grandmother's bones are extensively calcified, and are less flexible.

You are a school nurse in a middle school. You are responsible for screening the children for scoliosis. What is involved in this screening?

The child is observed from behind and the nurse would note any asymmetry of the shoulders and hips.

Alice and James adopted a 3-year-old child from a developing country. They noticed that her legs were bowed and there were some deformities in her cranial and pelvic bones. They brought her to a physician for a diagnosis. What was the diagnosis, and what was the treatment for the disorder?

The child most likely has rickets. Treatment is to increase the intake of calcium and vitamin D in the diet, and to get some sunshine every day.

Roger went for his yearly eye examination and was informed that his intraocular pressure was slightly elevated (at 22 mm Hg). The physician expressed concern over this condition and noted that if the condition got worse, eyedrops would be merited. What is wrong with Roger's eyes? What are the possible consequences of this condition? What is the function of the eyedrops?

The condition is glaucoma. Blindness could result if not treated or caught early. The eyedrops increase the rate of aqueous humor drainage or decrease its production.

The nurse encourages the patient to do his own activities of daily living such as bathing, eating, dressing, and toileting activities. How do these activities promote physical conditioning?

The contraction of the muscles in these activities helps maintain the shape, size, and strength of muscles, as well as joint mobility.

Sharon is a 32-year-old horse trainer. While training a young horse, she was thrown off of the horse and suffered a mild head injury. The nurse inquires about the use of a helmet. Sharon replies, "This is the first time I have ever had a head injury from a horse. I don't think I need a helmet." Based on your understanding of the skull, how should the nurse respond to the patient?

The cranial bones enclose and protect the fragile brain. A helmet would add extra protection in sports such as this, where there is an increased risk for head injury.

Mrs. Oberhaus needs surgery to correct a severe case of Raynaud's disease, affecting one of her hands. What surgical procedure will be performed? After the surgery, will she be more likely to suffer from anhidrosis (lack of sweating) or hyperhidrosis (profuse sweating) in the affected hand?

The doctor will perform a sympathectomy, and the affected hand will suffer from anhidrosis.

Mary has been suffering from a "bad knee" for several months. She is a tennis player who often slides in to attack a ball; she is an aerobic devotee and a jogger. She visited an orthopedic surgeon last week who told her that he would "like to have a look at her knee joint." He also told her that her symptoms indicated damage to the meniscus, which might have to be removed. What will the doctor do to see the joint and, if the meniscus is removed, will Mary's knee be healthy enough to enable her to play tennis again?

The doctor will perform arthroscopic surgery. If Mary has severely damaged the meniscus, it can be removed with little impairment to the knee except some loss in stability.

An elderly patient in a nursing home has recurrent episodes of fainting when he stands. An alert nurse notes that this occurs only when his room is fairly warm; on cold mornings, he has no difficulty. What is the cause of the fainting, and how does it relate to the autonomic nervous system and to room temperature?

The fainting episodes are a result of orthostatic hypotension. The condition is exaggerated when blood supply to the skin is increased, such as when the room is warm.

After having a severe cold accompanied by nasal congestion, Jamila complained that she had a headache just above her eyes and that the right side of her face ached. What specific bony structures probably became infected by the bacteria or viruses causing the cold?

The frontal sinus located in the frontal bone, and the right maxillary sinus located in the right maxilla

Sensory nerve endings that are located in the carotid bodies are rich in vagal fibers. How, and why, would external stimulation of the carotid artery, such as carotid massage, affect the heart rate?

The heart rate would slow down because of stimulation of the parasympathetic system.

John, a younger teenager, notices that he is experiencing a lot of pimples and blackheads, which frequently become infected. What is causing this problem?

The hormonal changes are causing the sebaceous glands to become overactive, resulting in them becoming clogged and infected.

A skeleton was found in a wooded area. It was brought to a forensic medicine laboratory for identification. The first thing the coroner did was determine the age, sex, and possible size of the person. What was examined in order to get this information?

The ilium, ischium, and pubic bones

After removal of an elbow cast, Lauren noticed her arm was immovable. What happened to her arm?

The immobilization of the arm caused some muscle mass to atrophy, and the loss of muscle was replaced with tough connective tissue that locked her arm in place.

An infection may occur in a tissue injury. Why?

The increased availability of nutrients allows microorganisms to replicate. The skin and mucous membranes are body's first line of defense and are mostly impenetrable to microorganisms, unless broken or damaged by tissue injury.

In emphysema, the lungs become overdistended with trapped air. Effective abdominal breathing is decreased. Which muscles are involved when breathing becomes an active process, such as in a patient who has emphysema?

The internal intercostal muscles aid active (forced) expiration by depressing the rib cage.

We are told that every surface we touch is teeming with bacterial cells, and bacteria are found in the pools we swim in, the water we wash with, and on the hands of friends. Why are we not inundated with bacterial infections on our skin?

The low pH of the skin secretions retards the multiplication of bacteria on the skin. Many bacteria are killed by bactericidal substances in the sebum and sweat. Not all bacteria are harmful or thrive on the skin. All of these answers are correct.

A patient suffers nerve damage to the sciatic nerve, requiring surgery to suture the nerve back together. After surgery, the patient reports that sensation from the lateral and medial sides of the knee seem to be reversed. How could this happen?

The nerve fibers were sutured back in the wrong orientation and may have grown back into different pathways.

A 65-year-old patient came to the emergency room with complaints of severe heartburn unrelieved by taking a "large handful" of antacids. Would you expect the pH to be relatively high, low, or normal for the patient's stomach contents, and why?

The pH would be high. Antacids are basic, and too many antacids would result in a relatively alkaline state.

A patient has no peristalsis in the gastrointestinal tract. Why would this be problematic?

The patient would be unable to expel his or her stool, leading to intestinal obstruction.

When should prevention of osteoporosis start?

The prevention of osteoporosis should begin with children while bones are still growing. Children should increase their bone mass to provide additional protection from osteoporosis in the future.

Susan and Robert are the parents of three children. One night while the family was sleeping, a fire broke out next door. Susan and Robert heard the fire trucks and rushed out to see what was happening. None of the children woke up, even with the sound of sirens close to the house. Why did the parents wake up, but the children didn't wake up?

The reticular activating system awakened the parents, who were responsible for the safety of their children. The children ignored the stimuli, confidant that their parents were in charge of the situation.

Why can DNA be used to "fingerprint" a suspect in a crime?

The sequence and fragmentation pattern of a person's DNA is unique to that individual.

The patient has a stroke and has weakness on his right side. Which muscles are involved in swallowing, and how will the patient's weakness affect his ability to swallow?

The suprahyoid muscles (digastrics, stylohyoid, mylohyoid, and geniohyoid muscles); weakness or paralysis in these muscles will make it difficult to swallow.

When administering cardiopulmonary resuscitation, the nurse should locate the tip of the xiphoid by placing two fingers on the xiphoid process and then placing the heel of the other hand just above this site on the lower half of the sternum. What complications, if any, do you think could occur if the nurse places his or her hand on the xiphoid process?

The xiphoid process could break off and potentially puncture internal organs.

A patient is admitted to the rehabilitation unit five days after having a stroke. The nurse assesses his muscle strength and determines that he has right-sided weakness. Based on this assessment data, what part of the brain was injured?

There was damage to localized areas of the primary motor cortex in the left cerebral hemisphere.

Jason is a 14-year-old who recently had his nose pierced. He tells his mother that the area is very tender and warm to the touch. The area is also red. The mother calls the pediatrician's office and the nurse recommends that the mother bring Jason in for evaluation. The nurse explains to the mother that a local infection from the nose piercing can spread to the brain. What is the most likely route for the infection to spread to the brain?

Through the ethmoidal and sphenoid sinuses

What symptoms would a nurse focus on in his or her care of a patient with multiple sclerosis?

Visual disturbances, paralysis, and weakness

Your patient has the flu and reports 5 to 6 loose stools a day. He has experienced an isotonic fluid volume loss. What does "isotonic fluid loss" mean?

Water and electrolytes are lost in equal proportions.

Death from amyotrophic lateral sclerosis usually results from respiratory infection secondary to compromised respiratory function. Why?

When the lungs have difficulty fully expanding, secretions may develop, causing respiratory infection.

If your elderly patient's blood calcium level is normal, does that tell you anything about the likelihood that your patient has osteoporosis? Why or why not?

With normal levels of calcium in the blood, she may still have osteoporosis. In osteoporosis the level of calcium in the blood is expected to be normal, but the calcium level in the bones will be low.