EXAM 4, Porth Patho Ch 37 & 38 Preview Quiz, Exam 3 Pt 2 (36-70), NUR 529 Exam 4 review, Adv Patho Quiz 12, Ch. 43 Disorders of skeletal system: trauma, infections, neoplasms, and childerhood disorders, Patho FINAL Prep U Chapter 43, PATHO CH 50, Cha...
Which of the following characteristics differentiates cartilage from bone?
Avascularity
Which of the following measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life?
Calcium supplementation and regular physical activity
A child has been hospitalized for the treatment of hematogenous osteomyelitis. The defining characteristic of this type of osteomyelitis is:
Introduction of microorganisms from the bloodstream
Which of the following signs and symptoms should prompt a 29-year-old woman's primary care provider to assess for systemic lupus erythematosus (SLE)?
Joint pain and increased creatinine and blood urea nitrogen
A patient is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on:
upper and lower motor neurons.
To maintain adequate serum calcium levels, parathyroid hormone reduces:
serum phosphate levels.
A female client with rheumatoid arthritis has taken high doses of aspirin for several years to control inflammatory pain. Which of the following statements leads the health care provider to suspect the client has developed ototoxicity?
"I've been getting dizzy and light-headed. I seem to have a constant ringing in my ear."
Following a fracture, the nurse is educating the client and his family about bone healing. The nurse begins by stating:
"In order to initiate the cellular events essential to bone healing, within a day or so, your body will develop a blood clot at the fracture site."
A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency, and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize?
"It would be helpful for you to take control of your diet, sleep schedule, and stress levels."
A hospital patient has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the patient reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the patient's concern?
"There's only a minute chance that you will become addicted to these painkillers."
A couple has just learned that their newborn infant has been diagnosed with osteogenesis imperfecta, and they have responded by seeking out as much information as possible about their child's diagnosis. What should the clinician teach the couple about their child's health problem?
"This is something that your child may have inherited from one or both of you."
Which of the following clients are at risk for developing and acute episode of angle-closure glaucoma? Select all that apply.
- A 60-year-old female emotionally devastated after divorcing her husband of 35 years - A soldier ordered to stay in a pitch-black cave to observe enemy militants for an extended period of time - A surgical client who has received many doses of IV atropine to keep heart rate above 50
Which of the following clients are at risk for developing osteomalacia? Select all that apply.
- An elderly female who "can't stand to drink milk" and refuses calcium supplements since she has a history of kidney stones - A person who lives in a colder region of the northwest who doesn't get out much during the winter months for fear of falling - A female client whose father had a genetic predisposition to primary hyperparathyroidism resulting in increased calcium resorption from the bone
A skin care consultant informs the client that he needs to bath and use a soft cloth to remove dead cells on the skin surface. The rationale for this action is based on the fact that
A basal cell is mitotically active and pushes older dead cells to the skin's surface.
Which pregnant female is at risk of having an infant born with congenital cataracts?
A diabetic mother who regulates her blood glucose levels with insulin
Which of the following people are at high risk for developing nonulcerative inflammation of the cornea? Select all that apply.Correct response:
A welder with inadequate eye protection• A female who uses a tanning bed four to five times/week• A ski patrol who works 12 hours/day in bright, sunny mountain tops
Parents with a profoundly deaf child ask, "How can you test such a young infant for hearing loss?" The health care provider will likely explain which of the following testing procedures? Select all that apply
A)Tuning fork B)Audioscope C)EEG with auditory brain stem-evoked responses (ABRs)
A client presents to the emergency department complaining of loss of part of his vision. An MRI with contrast reveals multiple aneurysms of the circle of Willis. The client is diagnosed with "bitemporal heteronymous anopia." For this client, what effect will this have on his vision?
A)With both eyes open, the client has full binocular visual field
A new mother brings her infant to the clinic reporting that the child is not sleeping or eating much. Upon assessment, the health care provider notes that the infant's ear canal is reddened with a bulging tympanic membrane. Which other data collected would lead to the diagnosis of acute otitis media (AOM)? Select all that apply. A. "Yes, he has been pulling at his ear." B. "We like to throw him up in the air hoping any water in his ear will drain." C. "He's been very irritable and fussy the past couple of days." D. "When I dropped a pan on the floor, he jumped." E. "He jabbers all the time usually."
A,C
Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics?
Acne vulgaris
A client is experiencing severe pain in his back to the point of being immobile and running a temperature. The client also has swelling in his lower back (vertebrae). Following biopsy, the results show spinal tuberculosis. The nurse will anticipate explaining which priority intervention to this client?
Administer the four-drug antimicrobial medications
A client with a history of osteoarthritis in his hip, which he refers to as "bad hip," is also complaining of knee pain. The physiological principle behind this would include the fact that: All joints of an extremity are innervated by the same peripheral nerves as they travel down the limb.
All joints of an extremity are innervated by the same peripheral nerves as they travel down the limb.
Pain assessment is likely to be most challenging when providing care for which of the following older adult patients?
An 87-year-old man with vascular dementia and numerous other health problems
A long bone, such as the humerus of the upper arm, has which of the following structural characteristics?
An endosteum composed of osteogenic cells
Which of the following statements about bone mass and the elderly is accurate?
Bone resorption and formation are no longer perfectly coupled, and bone mass is lost.
A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?
Brain contusions and hematomas
While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist diagnoses this as:
Bullae
While discussing hormonal control of bone formation, one should note that which hormone lowers blood calcium levels and decreases bone resorption?
Calcitonin
A female athlete has been diagnosed with amenorrhea due to intense training for a spot on the Olympic swimming team. As a health care provider, which of the following should be implemented to prevent premature osteoporosis?
Calcium/Vitamin D supplements
A female athlete has been diagnosed with amenorrhea due to intense training for a spot on the Olympic swimming team. As a health care provider, which of the following should be implemented to prevent premature osteoporosis?
Calcium/vitamin D supplements to support BMD.
What process accounts for the damaging effects of the sun's radiation
Damage to epidermal cell DNA and free radical production
Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?
Dosing and timing should aim for a steady serum level of the drug that is chosen.
In comparison to children with acute otitis media (AOM), those with otitis media with effusion (OME) have
Excess middle ear fluid
One of the causes of conductive hearing loss is:
Excess middle ear fluid
All seizure events are related to epilepsy.
F
Concussions are listed under the category of focal brain injuries.
F
Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of skeletal muscle fibers.
False
The condition that contributes to the pathology of all metabolic bone diseases is impaired Vitamin D synthesis.
False
Disorders that affect cortical bone typically result in:
Fractures of long bones
Which of the following statements most accurately describes the anatomy and physiology of the bone marrow?
Hematopoiesis takes place in red bone marrow.
A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is:
Hemodynamic instability
An elderly woman has been diagnosed with macular degeneration following a visit to an ophthalmologist. Which of the woman's following statements best demonstrates an accurate understanding of her new diagnosis?"I suppose this goes to show that I should have controlled my blood pressure better.""I think this is something that I might have caught from my husband.""My friend had this problem and a transplant did wonders for her vision.""I suppose that this might be one of those things that happens when you get older."
I suppose that this might be one of those things that happens when you get older."
An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?
Immunologically mediated joint inflammation
An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this patient's decline in health?
Immunologically mediated joint inflammation
A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the clients' temperature is 102°F. Which other clinical manifestations may lead to the diagnosis of encephalitis?
Impaired neck flexion resulting from muscle spasm
As part of the community health department, a nurse is educating a group of diabetic clients about prevention of blindness. Which of the following topics should be covered during this class? Select all that apply.
Importance of yearly eye exams, Tight control of blood glucose levels, Keep BP below 130.85 (Am. Heart Assoc. Guidelines)
Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the client with psoriasis, a disorder that results from:
Increased epidermal cell turnover
A 55-year-old male patient has reported joint pain in his feet. Which of the following blood work results should prompt further testing to rule out primary gout?
Increased serum uric acid
Which of the following pathophysiologic processes occurs in cases of bacterial meningitis?
Inflammation allows pathogens to cross into the cerebrospinal fluid.
Frustrated by her worsening tinnitus, a 55-year-old female patient has sought care. Which of the following teaching points should the clinician provide to the patient?"I know this can be very difficult to live with, but it normally fades over time.""I will prescribe some medication that will probably help quite well.""This might be a sign of a more serious neurologic problem that we will assess for." Initially there are some changes in your diet that you should implement
Initially there are some changes in your diet that you should implement
In third-world countries, many children experience uncontrolled itching and scratching, which may develop into:
Lichenification
A basketball player fell awkwardly when attempting to claim a rebound, a mishap that resulted in a tear to the anterior cruciate ligament of his left knee. What characteristic of ligaments makes them particularly susceptible to injury?
Ligaments are incapable of stretching when exposed to unusual stress.
The clinic health care worker notices that a client has a fungal infection on her nails that looks like the fungus is digesting the nail keratin. The nail appears opaque and white in color. The client states she has had this for years. The health care worker suspects the client has:
Onychomycosis
An adult female client visits with her health care provider about pain in her hand. She describes it as an audible grinding and cracking sound, especially in her thumb. "I had to buy an automatic jar opener...I just can't grasp and open a jar...it just hurts too badly." The health care provider suspects the client has a degenerative form of joint disease that is often evidenced by:
Osteoarthritis
A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the client notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the client's medication administration record. The nurse should conclude that this client likely has a history of: Osteoporosis
Osteoporosis
How are the oxygenation needs of the articulating areas in a synovial joint met?
Oxygen is provided to the articulating areas by synovial fluid rather than by blood.
How are the oxygenation needs of the articulating areas in a synovial joint met?
Oxygen is provided to the articulating areas indirectly by synovial fluid.
A client with a diagnosis of small cell lung carcinoma has developed bone metastases, a finding that has prompted a series of new interventions. What are the primary goals of the treatment reigimen
Prevention of pathologic fractures and maximization of function
Which of the following actions involves the greatest risk of skin shearing?
Pulling the patient up in bed
A 79-year-old client has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize in the prevention of pressure ulcers?
Repositioning the patient on a scheduled basis
While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is:
Sebum, secreted by the sebaceous gland
Hearing impairment may have a detrimental effect on language development in children.
T
The eustachian tube is lined with a mucous membrane that is continuous with the nasopharynx, and provides a passageway for pathogens to enter the middle ear.
T
Intercellular collagen fibers provide what function for tendons and ligaments?
Tensile strength
A patient has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this patient's health?
The presence of diffuse lesions and skin sloughing on the patient's mucous membranes
When asking pathophysiology students, "Why do sebaceous glands secrete sebum?" the student with the correct answer would be:
To lubricate skin and hair
A cardinal symptom of Parkinson disease is bradykinesia.
True
Cartilage is a firm but flexible type of connective tissue that is essential for growth of long bones.
True
Glucose provides the majority of the fuel needs of the neurologic system?
True
The most commonly occurring early symptom of systemic lupus erythematosus (SLE) is arthralgia.
True
A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile, but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect?
Varicella
While on a cruise to the Caribbean, a person develops "motion sickness" with associated malaise, and nausea/vomiting. The nurse notes the client's BP is 88/52; pulse is 110; and skin moist with perspiration. The client diagnosis related to the clinical manifestations would most likely be:
Vertigo
A client presents to the emergency department complaining of loss of part of his vision. An MRI with contrast reveals multiple aneurysms of the circle of Willis. The client is diagnosed with "bitemporal heteronymous anopia." For this client, what effect will this have on his vision?
With both eyes open, the client has full binocular visual fields
Which of the following processes is most likely to occur as a result of a spinal reflex?
Withdrawal of a hand from a hot stove element
For many patients, the first indication that they have osteoporosis is:
a bone fracture
Whereas PTH increases blood calcium levels, the hormone _____ lowers blood calcium levels and decreases bone resorption.
calcitonin
A client presents to the clinic complaining, " I have something in my eye." When questioned, the client admits to a scratching and burning sensation and light sensitivity. The health care provider suspects the client has developed:
conjunctivitis
Osteoarthritis is a degenerative form of joint disease that is often evidenced by:
crepitus and grinding.
The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis is the result of:
decreased oligodendrocytes
In contrast to osteoporosis, osteomalacia causes _______ without the loss of bone matrix.
defective mineralization
A patient's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patient's levels of:
dopamine.
One of the causes of conductive hearing loss is:sudden loud noise.ototoxic medication.auditory nerve damage.excess middle ear fluid.
excessive middle ear fluid
The main cause of decubitus ulcers (bedsores) is _______ that impairs the flow of blood and lymph.
external pressure
A sudden traumatic complete transection of the spinal cord results in _______ below the level of injury.
flaccid paralysis
A thermal burn described as involving the entire epidermis and dermis is classified as:
full-thickness second-degree.
Diabetic and hypertensive retinopathy are both characterized by the appearance of: macular edema. cloudy corneas. microinfarctions .intraretinal hemorrhages.
intraretinal hemorrhages
The clinical course of osteoarthritis (OA) culminates in:
osteophyte formation and erosion of cartilage.
A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the patient notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the patient's medication administration record. The nurse should conclude that this patient likely has a history of:
osteoporosis.
A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of:
pannus tissue.
Disorders of the pyramidal tracts, such as a stroke, are characterized by:
paralysis
Rheumatoid arthritis is a systemic inflammatory disease with joint manifestations described as:
polyarticular.
A patient has wrist inflammation causing compression of the median nerve in the carpal tunnel. Manifestations of this syndrome include:
precision grip weakness
More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by the ______ cortex in the frontal lobe.
premotor
Which of the following vision deficits is a clinician justified in attributing to the normal aging process?
presbyopia-farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age.
A 26-year-old woman has sought care for increasing pain at the back of her ankle and the bottom of her foot over the past 2 weeks. The patient states that she is generally in good health, although she completed a course of antibiotics for a chlamydial infection 6 weeks earlier. This patient's recent history suggests the possibility of:
reactive arthritis.
A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous small blisters on the shaft of his penis. On examination, the clinician notes that the lesions are between 2 and 4 mm in diameter and are filled with serous fluid. The clinician would document the presence of:
vesicles
The sites of referred pain are determined by:
visceral embryonic development.
