Health Alterations Test 3 Prep U

The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?

"Because cortisol levels fluctuate, collecting a sample over time will be more accurate."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:

"Because the skull sutures are not fused there may be no brain damage."

When providing nutrition education to the client with diabetes, the nurse should include which statement regarding fat intake?

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

A client awakes after being in a coma several days following a traumatic head injury. The client is able to give the family a detailed account of what was said at the bedside while the client was in a coma. The family asks the nurse, "How is this possible?" Which response is most accurate?

"The thalamus can interpret highly emotional auditory experiences and remember them."

A client is diagnosed to be in a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her family?

"Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change."

Which are functions of the frontal lobe? Select all that apply.

-Anticipation of consequences of behavior -Prediction of consequences of behavior

When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:

06:00 to 08:00 AM

Which manifestation indicates a client is at risk for developing diabetes mellitus?

2 hour oral GTT 175 mg/dL (9.7 mmol/L)

A client has just begun to experience an ischemic stroke. The blood supply from the middle cerebral artery is being blocked by a large blood clot. How long before brain cells begin to die due to lack of ATP?

4 to 6 minutes

The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty?

A 5-year-old black female with developing breasts and pubic hair

Sweating is mediated by which neurotransmitter?

Acetylcholine

The nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Administration of intravenous fluids

Neuromodulators can produce slower and longer-lasting changes in membrane excitability by acting on postsynaptic receptors. What do neuromodulators do?

Alter the release of, or response to, neurotransmitters

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

The parasympathetic nervous system is part of which system?

Autonomic nervous system

The action potential in a neuron begins near which structure?

Axon hillock

The nurse caring for a client with an aneurysmal subarachnoid hemorrhage understands that the most common cause of this condition is:

Berry aneurysm

Which area of the brain is responsible for respiration?

Brain stem

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

CT Scan

A client who has been living with Alzheimer disease and spouse are at the doctor's office and the spouse asks the nurse why the client cannot remember much of anything from the past. The best response by the nurse is that Alzheimer disease affects which part of the brain?

Cells located in the hippocampus

Which brain structure makes continuous adjustments that result in smoothness of movement, particularly during delicate maneuvers?

Cerebellum

Which intracranial volume is most capable of compensating for increasing intracranial pressure?

Cerebrospinal fluid

The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?

Client has anuria.

The cerebellum, separated from the cerebral hemispheres by the tentorium cerebelli, lies in the posterior fossa of the cranium. What is one of the functions of the cerebellum?

Coordinates smooth and accurate movements of the body

A client with type 2 diabetes experiences unexplained elevations of fasting blood glucose in the early morning hours. Which conditions can account for this effect?

Dawn phenomenon

An adult client is scheduled for testing of a suspected growth hormone (GH)-secreting tumor. Which result from the glucose suppression test would confirm the condition?

Decreased GH levels

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis (MS) is the result of which pathophysiologic event?

Decreased oligodendrocytes

Which statement best describes the pathophysiology of Parkinson disease?

Degeneration of the nigrostriatal dopamine system

The nurse is preparing a client for a test that will measure negative feedback suppression of ACTH. Which medication will the nurse administer in conjunction for this test?

Dexamethasone

An adult client presents to the emergency department after an episode of syncope. Blood pressure is low and the pulse is thready and rapid. The client frequently voids large amounts of pale, clear urine. Lung sounds are clear and skin turgor is inelastic. Which endocrine disorder is the likely cause of these manifestations?

Diabetes insipidus

Which type of imaging is preferred to evaluate the bone density of a client with hyperparathyroidism?

Dual energy x-ray absorptiometry (DXA) scan

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?

Elevated atrial natriuretic hormone

The nurse notes that the client is experiencing visible squirming and twitching movements that can be seen as flickers under the skin. The nurse would recognize this as:

Fasciculations

Which hormone is secreted based on a cyclic rather than a diurnal manner?

Follicle-stimulating hormone (FSH)

The nurse is caring for a client who has a disorder affecting secretin levels. Which assessments will the nurse monitor related to the effects of secretin imbalance? Select all that apply.

Gastrointestinal function plasma osmolarity levels

A client is having an upper endoscopy to determine the presence of a gastric ulcer. After the procedure is performed, the nurse instructs the client that he cannot have anything to eat or drink until the return of the gag reflex. Which nerve is the nurse testing for return of function?

Glossopharyngeal

The nurse measures a blood glucose level of 40 mg/dL (2.22 mmol/L) for a client with type 1 diabetes. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client?

Glucose is not stored in the brain and is a major fuel source for brain function.

Which hormone is produced by the anterior pituitary gland?

Growth hormone (GH)

The nurse is caring for a client with thyroid crisis (hyperthyroidism). The client takes several medications for other conditions. The nurse would question continuing medications with which characteristic?

Highly protein bound

A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food?

Home-grown and canned vegetables

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

Hydrocortisone

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?

Hyperglycemia

A client arrives in the clinic after having a tongue piercing performed and is unable to control the movement of the tongue. The nurse is aware that which nerve may have been damaged from the piercing?

Hypoglossal

An extremely lethargic client arrives by ambulance at the emergency department. His blood glucose level is 32 mg/dL (1.78 mmol/L). The nurse will anticipate that this client will be diagnosed with:

Hypoglycemia

The nurse is caring for an infant in the neonatal intensive care unit who has growth hormone deficiency. What critical issues should the nurse carefully monitor for in this infant?

Hypoglycemia and seizures

An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?

Hypothyroidism

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?

Increase in appetite

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production

Neurons that connect sensory and motor neurons are known as which of the following?

Interneurons

Which neuron connects sensory and motor neurons?

Interneurons

The nurse reading a client's lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted?

Large number of polymorphonuclear neutrophils

Which complications could occur when an adult client has a secreting tumor of the anterior pituitary gland that results in excess hormone production? Select all that apply.

Metrorrhagia Acromegaly Diabetes mellitus

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Multiple sclerosis (MS)

Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category?

Myasthenia gravis

A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the client's central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely to be affected by this disease process?

Nerve conduction

During embryonic development, which structure develops into the central nervous system (CNS)?

Neural tube

A client who has experienced a spinal cord injury still has use of the arms but has impaired motor and sensory function of the trunk, legs, and pelvic organs. Which term best describes how this injury is classified?

Paraplegia

A teen with newly diagnosed pituitary dwarfism asks the nurse why growth hormone must be taken as an injection rather than a pill like the steroids used for arthritis. Which response best answers the client's question?

Peptide proteins will be digested instead of entering the bloodstream

Which gland is often referred to as the master gland because it secretes many hormones?

Pituitary

Which structure controls the functions of the greatest number of target glands and cells?

Pituitary gland

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

Which structural change can contribute to mixed sensorimotor deficit?

Polyneuropathies involving demyelination of peripheral nerves

Multiple sclerosis is characterized by what type of neuron damage?

Polyneuropathy

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?

Prolactin

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?

Rank below 10% on the growth chart

Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?

Reading

Which types of cells are supporting cells of the peripheral nervous system?

Schwann cells

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Significant genital enlargement

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which abnormality in the client's gait?

Slow to start walking and has difficulty when asked to "stop" suddenly

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

Stimulation testing

A nurse caring for a client with a spinal cord injury knows that control of sweat gland activity and temperature regulation is managed by the direct action of which body system?

Sympathetic nervous system

A nurse at a long-term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the client's TIAs?

TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke

The nurse is caring for a client who has been taking prednisone for the treatment of asthma. The nurse is monitoring the client for increased levels of stress. When glucocorticoid levels are increased, what symptoms should the nurse monitor for?

Tachycardia

The nurse is performing a neurologic assessment on a client. Which assessment finding would the nurse determine is considered normal?

The client is able to swing arms when walking.

A 60-year-old office worker has presented to a clinic reporting recent episodes of lower back pain. Which component of the client's assessment and history would be most indicative of a serious pathologic process?

The client's onset of pain has been gradual and the client has no prior history of back problems

A male newborn infant has been diagnosed with spina bifida occulta. Which pathophysiologic process has most likely contributed to the infant's health problem?

The neural groove failed to fuse and completely close across the top of the neural plate.

A neuron has been hyperpolarized. How will this affect the excitability of the neuron?

The neuron will have a membrane potential farther from the threshold.

Which message is most likely to be carried by general somatic afferent (GSA) neurons?

The sensation of cold when touching ice

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

Thrombolysis

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Vasospasms and hypertension

Which type of reflex is stimulated by a nociceptive stimulus?

Withdrawal reflex

College students were given various amounts of alcohol within a specified time frame and then asked to drive an obstacle course. The rationale for poor performance in driving as the amount of alcohol intake increased includes, "The blood-brain barrier:

allows alcohol, a very lipid-soluble molecule, to rapidly enter the brain."

A client has developed shock and the physician has instructed the nurse to begin the administration of intravenous dopamine. The nurse anticipates that the medication will:

cause vasodilatation of the coronary blood vessels.

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced:

generalized seizure.

A client has sustained damage to cranial nerve VIII. The nurse recognizes that the client may experience difficulty with:

hearing

Which physiologic process best exemplifies a positive feedback mechanism?

increase in prolactin secretion that occurs with more frequent breastfeeding

Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:

is morbidly obese (defined as greater than 100 pounds over ideal weight)

A middle-aged female client has been diagnosed with a thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases the answer on the knowledge that thyroid hormones:

may take days for the full effect to occur, based on the mechanism of action

Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of:

milliseconds

A client has been brought to the emergency department following an overdose of insulin that resulted in unconsciousness. When explaining the rationale for this to the family, the nurse will emphasize that neurons:

must rely on glucose from the blood to meet their energy needs.

Two types of imaging studies are useful when dealing with endocrine disorders, isotopic imaging and nonisotopic imaging. What is an example of isotopic imaging?

positron emission tomography (PET)

The nurse is teaching a client newly diagnosed with hypothyroidism. The nurse teaches that thyroid hormone is transported by which?

protein carriers

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation?

random blood glucose 195 mg/dl (10.8 mmol/l)

The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that:

resistance should be provided with the knee in a flexed position

When providing discharge teaching related to some newly prescribed medications, the client who received a head injury on the left temporal lobe area will need for the health care provider to:

sit on the right side and speak slowly and clearly during the education.

A client reports multiple nonspecific concerns, and the health care provider has ordered a positron emission tomography (PET). For which is the client being evaluated?

tumors located on the endocrine glands