Patho CoursePoint Questions Exam 1

Which of the following can the nurse tell a patient about antipyretic drugs during fever? a.) "They are not recommended." b.) "They usually have little effect." c.) "Antipyretics help to protect the body." d.) "Antipyretics are ineffective in most cases."

"Antipyretics help to protect the body." Explanation: Antipyretic drugs are given to alleviate the discomfort of fever and protect vulnerable organs, such as the brain from extreme elevations in body temperature. They are usually effective.

A client has experienced an acute inflammatory response with an elevation of white blood cells. The nurse is reviewing the client's most recent lab results to determine if the counts have returned to a normal range. Select the result that suggests the client is now within normal range. a.) 1500 to 20,000 cells/μL b.) 4000 to 10,000 cells/μL c.) 14,000 to 20,000 cells/μL d.) 1000 to 3000 cells/μL

4000 to 10,000 cells/μL Explanation: A normal value of white blood cells would be 4000 to 10,000 cells/μL. In acute inflammatory conditions, the white blood cell count commonly increases from 15,000 to 20,000 cells/μL. The other results are abnormal.

A nurse is providing care for several clients on a neurological unit of a hospital. With which of the following clients would the nurse be justified in predicting a problem with thermoregulation? a.) A 66 year old male with damage to his thalamus secondary to a cerebral vascular accident. b.) A 22 year old male with damage to his cerebellum secondary to a motorcycle accident. c.) A 68 year old male with end stage neurosyphilis. d.) A 45 year old female with a T8 fracture secondary to a diving accident.

A 66 year old male with damage to his thalamus secondary to a cerebral vascular accident. Explanation: The thalamus is involved in the sensation and regulation of body temperature. Syphilis, a T8 fracture and damage to the cerebellum would be unlikely to manifest by difficulties with thermoregulation.

Which clients are showing manifestations of infection? Select all that apply. a.) A 75-year-old, temperature 37.3°C (99.2°F), declining mental status, weakness and fatigue b.) A 50-year-old, temperature 36.2°C (97.3°F), heart rate 65 beats/min, muscle aches c.) A 25-year-old, temperature 40°C (104°F), sweating, shivering, states generalized pain d.) A 5-year-old, temperature 36.8°C (98.2°F), talkative, actively engaged in playing e.) A 2-month-old, temperature 38.3°C (100.4°F), lethargy, poor feeding, and cyanosis

A 75-year-old, temperature 37.3°C (99.2°F), declining mental status, weakness and fatigue A 25-year-old, temperature 40°C (104°F), sweating, shivering, states generalized pain A 2-month-old, temperature 38.3°C (100.4°F), lethargy, poor feeding, and cyanosis Explanation: An older adult with an infection may have a minimal rise in temperature, but exhibit changes in mental status, weakness, fatigue, and weight loss. An infant younger than three months may have a relatively mild fever, but a serious infection. An adult with a high fever will exhibit sweating and chills. Aches and pains may occur with shivering and the infectious illness. A client with a temperature within the normal range, exhibiting no other signs of change, is not considered to have an infection.

Which symptom indicates the next stage of a fever after a prodrome? a.) A flush b.) A chill c.) Defervescence d.) Predrome

A chill Explanation: The physiologic behaviors that occur during the development of fever can be divided into four successive stages: prodrome, chill, flush, and defervescence. The stages are successive.

A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has: a.) A mild parasitic infection b.) A severe bacterial infection c.) A mild viral infection d.) A severe fungal infection

A severe bacterial infection Explanation: Fever and painful, palpable lymph nodes are nonspecific inflammatory conditions; leukocytosis is also common but is a particular hallmark of bacterial infection. Neutrophilia also indicates a bacterial infection, whereas increased levels of other leukocytes would indicate other etiologies. The shift to the left—the presence of many immature neutrophils—indicates that the infection is severe, because the demand for neutrophils exceeds the supply of mature cells.

A client presents with an oral temperature of 101.7°F (38.7°C) and painful, swollen cervical lymph nodes. Laboratory results indicate neutrophilia with a shift to the left. Which diagnosis is most likely? a.) A mild parasitic infection b.) A severe bacterial infection c.) A mild viral infection d.) A localized fungal infection

A severe bacterial infection Explanation: Fever and painful, palpable lymph nodes are nonspecific inflammatory conditions; leukocytosis is also common but is a particular hallmark of bacterial infection. Neutrophilia also indicates a bacterial infection, whereas increased levels of other leukocytes would indicate other etiologies. The shift to the left—the presence of many immature neutrophils—indicates that the infection is severe, because the demand for neutrophils exceeds the supply of mature cells.

An 88 year old resident of a long term care home has been suffering from a three day onset of increasing shortness of breath and decreased oxygen saturation. At the hospital, an anterior-posterior chest X-ray and sputum culture and sensitivity has confirmed a diagnosis of bacterial pneumonia, yet the client's tympanic temperature has not exceeded 37.3°C (99.2°F). The health care team would recognize that which of the following phenomena likely underlies this situation? a.) An older adult is often insensitive to exogenous pyrogens. b.) An older adult is sometimes incapable of vasodilation. c.) An older adult's hypothalamus has diminished thermoregulatory ability. d.) Infections manifest by cognitive changes in older adults.

An older adult's hypothalamus has diminished thermoregulatory ability. Explanation: The hypothalamus in older adults is often less capable of thermoregulation than in younger clients. There are sometimes alterations in the release of endogenous pyrogens and deficits in vasoconstriction. While infections do often manifest with cognitive changes in older adults, this does not explain why fever is precluded.

A client is suspected to have developed chronic inflammation. Select the potential causes of the chronic condition. Select all that apply: a.) Asbestos b.) Silica c.) Suture d.) Talc e.) Tubercle bacillus f.) Penetrating trauma

Asbestos Silica Suture Talc Tubercle bacillus Explanation: Among the causes of chronic inflammation are foreign agents such as talc, silica, asbestos, and surgical suture materials. Many viruses provoke chronic inflammatory responses, as do certain bacteria, such as the tubercle bacillus and Actinomyces, as well as fungi, and larger parasites. Acute inflammation can be triggered by a variety of stimuli, including infections, immune reactions, blunt and penetrating trauma, and physical or chemical agents.

The nurse is caring for a client who choked on a peanut and then collapsed. After partially clearing the obstruction, it was noted the client experienced prolonged hypoxia. The nurse anticipates that the resulting cerebral infarction will lead to which phenomenon? a.) Rapid phagocytosis b.) Caspase activation c.) Coagulation necrosis d.) Protein p53 deficiency

Coagulation necrosis Explanation: Tissue infarction is caused by prolonged oxygen deprivation, and the resulting large group of dead cells coagulates in the damaged area (coagulation necrosis). Apoptosis activates caspases (proteases) early in the process of controlled cell death. Phagocytosis occurs rapidly during apoptosis, so it does not elicit an inflammatory response. Protein p53 activation initiates apoptosis.

A client has a splinter. The nurse expects a granulomatous inflammatory response. What does this involve? a.) Connective tissue encapsulating and isolating the splinter b.) Normal inflammatory mechanisms acting on the splinter c.) Splinter being digested and dissolved d.) Macrophages attacking the splinter in order to dissolve it

Connective tissue encapsulating and isolating the splinter Explanation: Granulomatous inflammatory response to a splinter would involve the connective tissue encapsulating and isolating it for removal. Each of the other options is part of the normal inflammatory response, and would not apply in this situation.

The loss of heat from the body through the circulation of air currents is known as which of the following? a.) Convection b.) Evaporation c.) Radiation d.) Conduction

Convection Explanation: Convection refers to heat transfer through the circulation of air currents, while radiation is the transfer of heat through air or a vacuum. Conduction is the direct transfer of heat from one molecule to another, and evaporation involves the use of body heat to convert water on the skin to water vapor.

A client has suffered nerve damage in his right arm. What can the nurse expect to happen to the muscles in that arm?

Decrease in the size of the cells (atrophy) Explanation: The general causes of atrophy can be grouped into five categories: disuse, denervation, loss of endocrine stimulation, inadequate nutrition, and ischemia. If a client has no innervation to the muscles in the arm, the muscle cells can atrophy from disuse.

Which risk factor is greatest in the older adult population who are experiencing a dysfunctional temperature regulator function? a.) Misdiagnosis of pathology b.) Acute dementia c.) Acute renal failure d.) Delayed initiation of appropriate treatment

Delayed initiation of appropriate treatment Explanation: The elderly often have a lower baseline temperature (36.4°C [97.6°F]) than younger persons, and although their temperature increases during an infection, it may fail to reach a level that is equated with significant fever. The absence of fever may delay diagnosis and initiation of antimicrobial treatment. Absence of fever does not result in misdiagnosis. While the remaining options may occur, they are not the greatest risks for injury.

A nurse practitioner is preparing to perform a client's Pap test and is answering the client's questions about the clinical rationale for the procedure. The nurse should describe what phenomenon? a.) Cell hypertrophy in the columnar epithelium that covers the cervix is a known risk factor for cancer. b.) Dysplasia of the cervical epithelium is associated with a high risk of cancer. c.) Epithelial samples in clients with a high risk for cervical cancer often contain metastatic cells. d.) Calcification of cervical cells is closely associated with the development of cervical cancer.

Dysplasia of the cervical epithelium is associated with a high risk of cancer. Explanation: A Pap test involves a cytologic examination of epithelial cells checking for cell dysplasia, which is associated with cervical cancer. These cells are not prone to metastasis, calcification, or hypertrophy.

The nurse is assessing a client for acute inflammation of a wound. For which symptom of infection does the nurse assess? a.) Tissue necrosis b.) Hypothermia c.) Edema d.) Pallor

Edema Explanation: Cardinal signs of inflammation include rubor (redness), tumor (swelling or edema), calor (heat), dolor (pain) and functio laesa (loss of function). Tissue necrosis occurs with chronic inflammation.

A client's condition has resulted in a decrease in work demands of most cells in the body; the anticipated result would be: a) Decreased programmed cellular death b) Increased mitochondrial growth c) Decreased size of organelles d) Increased oxygen consumption

Explanation: Cell atrophy results in a decreased number and size of cell organelles. With cell atrophy, the cell has decreased oxygen consumption and growth of the mitochondria. The cell decreases in size. When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy. Cellular death process is not affected

The nurse is reviewing assessment documentation of a client's wound and notes "purulent drainage." The nurse would interpret this as: a.) Exudate containing white blood cells, protein, and tissue debris b.) Exudate containing large amounts of fibrinogen c.) Exudate that is watery fluid, low in protein d.) Exudate that resulted from leakage of red cells

Exudate containing white blood cells, protein, and tissue debris Explanation: A purulent or suppurative exudate contains pus, which is composed of degraded white blood cells, proteins, and tissue debris. Fibrinous exudates contain large amounts of fibrinogen. Serous exudates are watery fluids low in protein. Hemorrhagic exudates occur when there is severe tissue injury that causes damage to blood vessels or when there is significant leakage of red cells

Which response by the nurse answers a client's question regarding the most common objective sign of systemic inflammation during the acute-phase response? a.) Fever b.) Edema c.) Diarrhea d.) Palpable lymph nodes

Fever Explanation: The most prominent observable systemic manifestations of inflammation during the acute-phase response is fever. Painful palpable nodes are commonly associated with a systemic inflammatory process; fever is more often recognized. Edema is a characteristic of a localized inflammation, while diarrhea is not generally recognized as a sign of inflammation unless specifically related to the GI system.

Inflammation can be either local or systemic. What are the most prominent systemic manifestations of inflammation? a.) Fever, leukocytosis or leukopenia, and the transition phase response b.) Fever, leukocytosis or leukopenia, and the acute phase response c.) Widening pulse pressure, thrombocytopenia, and the recovery phase response d.) Widening pulse pressure, thrombocytopenia, and the latent phase response

Fever, leukocytosis or leukopenia, and the acute phase response Explanation: The most prominent systemic manifestations of inflammation include the acute phase response, alterations in white blood cell count (leukocytosis or leukopenia), and fever. A widening pulse pressure is not indicative of systemic inflammation, and thrombocytopenia is a hematologic disorder, not an indication of systemic inflammation.

Which clincial manifestation supports the diagnosis of lead toxicity? a.) Hyperthermia b.) Chronic diarrhea c.) Hypertension d.) Increased hemoglobin

Hypertension Explanation: Lead toxicity leads to hypertension. Decreases in hemoglobin and decreases in the red blood cell lifespan are also seen in lead toxicity. Hyperthermia and chronic diarrhea are not leading signs of lead toxicity.

Which situation causes hypertrophy? a.) Decrease in blood flow b.) Increase in blood flow c.) Decrease in workload d.) Increase in workload

Increase in workload Explanation: Hypertrophy represents an increase in cell size and with it an increase in the amount of functioning tissue mass, resuting from an increased workload imposed on an organ.

The nurse caring for older adults in an extended care facility suspects one of the clients has an infection. What is the earliest manifestation the client could exhibit? a.) Increased mental confusion b.) Dehydration c.) Elevated temperature d.) Shivering and chills

Increased mental confusion Explanation: Change in functional capacity, decreased mental function, weakness and fatigue, and weight loss are all indicators that an older client may have an infection. Fever and corresponding chills are not reliable indicators of infection in an older adult because approximately one-third of older clients have a blunted febrile response to infection. Dehydration is more common with fever.

A client has been diagnosed with osteomyelitis and admitted to the hospital. The client's fever persists throughout most of the day but returns to normal at least twice a day. Which pattern of fever is this client displaying? a.) Intermittent b.) Relapsing c.) Remittent d.) Erratic

Intermittent Explanation: Intermittent fever patterns are very changeable, but they do return to normal at least once every 24 hours. A remitting fever pattern temperature does not return to normal and varies a few degrees in either direction. In a sustained fever pattern, the temperature remains above normal with minimal variations. A relapsing fever is one in which there is one or more episodes of fever, each as long as several days, with 1 or more days of normal temperature between episodes.

Small amounts of lead accumulate to reach toxic levels in the human body. Lead is found in many places in the environment and is still a major concern in the pediatric population. What would the nurse teach the parents of a child who is being tested for lead poisoning? a.) Keep your child away from peeling paint. b.) Keep your child away from anything ceramic. c.) Do not let your child read newspapers. d.) Do not let your child tour a mine on a school field trip.

Keep your child away from peeling paint. Explanation: Children are exposed to lead through ingestion of peeling lead paint, by breathing dust from lead paint (e.g., during remodeling), or from playing in contaminated soil. The lead danger to potters is from the ceramic glaze before it is fired. Parents do not have to keep children away from everything ceramic. Newsprint contains lead, but a person is not exposed to a significant amount of lead when reading the newspaper. A person would have to work directly with ore to be exposed to toxic levels of lead. Walking through part of a mine on a field trip is not a contributing factor to lead poisoning.

The parents of an anemic 4-year-old child tell the pediatrician that the child has been behaving differently and having abdominal discomfort. Realizing that the family lives in an older, urbanized community, the provider tests the child for which toxicity? a.) Lead b.) Calcium c.) Iron d.) Mercury

Lead Explanation: The prevalence of elevated blood lead levels is higher for children living in more urbanized areas. Anemia is a cardinal sign of lead toxicity. Behavioral changes or abdominal complaints may also be seen in lead toxicity.

The nurse is evaluating the bloodwork results of a client with an infected leg ulcer. The white blood cell count is 18,000 cells/uL. The nurse interprets this as: a.) Leukocytosis b.) Lymphocytosis c.) Neutropenia d.) Lymphadenitis

Leukocytosis Explanation: A white blood cell count of 18,000 cells/uL is indicative of an elevated white blood cell count or leukocytosis (normal range is 4000-10,000 cells/uL). This would be an expected finding in a client with an infected leg ulcer. An increase in lymphocytes is lymphocytosis and neutropenia is a decrease in neutrophils. Lymphadenitis is an inflammation of the lymph nodes.

A public health nurse is conducting a wellness seminar in which a participant has asked how to minimize the potentially harmful effects of free radicals. What should the nurse recommend? a.) Monitor blood cholesterol levels and get sufficient sleep each night. b.) Exercise regularly and take acetylsalicylic acid (ASA) 81 mg daily. c.) Make dietary changes and limit UV exposure. d.) Monitor blood glucose levels regularly and avoid tobacco use.

Make dietary changes and limit UV exposure. Explanation: The harmful effects of free radicals can be partially mitigated by increasing intake of foods known to be antioxidants. UV radiation causes oxidative damage, so limiting exposure prevents damage. ASA has no known effect on oxidative stress. All of the other listed actions are congruent with health but none directly addresses the effects of oxidative stress.

A patient has a fever that was induced by damage to the hypothalamus due to intercranial bleeding. The nurse plans care for the patient with which of the following types of fever? a.) Neurogenic b.) Exdogenous c.) Intrinsic d.) Systemic

Neurogenic Explanation: Neurogenic fever has its origin in the central nervous system and is usually caused by damage to the hypothalamus from trauma, intercranial bleeding, or increased intercranial pressure. The nurse should plan care for a patient with a neurogenic fever.

A client presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The client's physician has ordered a complete blood count and white cell differential. Which blood component would the physician most likely anticipate to be elevated? a.) Basophils b.) Neutrophils c.) Eosinophils d.) Platelets

Neutrophils Explanation: Increased neutrophils are associated with inflammation, in general, and bacterial infections in particular. Platelets play a role in inflammation but their levels would not rise to the same extent as would neutrophils. Eosinophils are not strongly associated with bacterial infection and basophils would not increase to the same degree as neutrophils.

A nurse is caring for a patient with fever of unknown origin (FUO). The nurse anticipates that the patient may have which of the following underlying conditions? Select all that apply. a.) Non-Hodgkin's lymphoma b.) Abscessed infection c.) Urinary tract infection d.) Pneumonia

Non-Hodgkin's lymphoma Abscessed infection Explanation: Underlying causes of FUO include malignancies, infections such as human immunodeficiency virus, tuberculosis, abscessed infections, and drug fever.

Mechanical forces that produce tissue trauma would be classified as which type of cellular injury? a.) Physical agent b.) Nutritional factors c.) Chemical agent d.) Biologic agents

Physical agent Explanation: Cell injury can be caused by a number of agents, including physical agents, chemicals, biologic agents, and nutritional factors. Among the physical agents that generate cell injury are mechanical forces that produce tissue trauma, extremes of temperature, electricity, radiation, and nutritional disorders. Chemical agents can cause cell injury through several mechanisms: they can block enzymatic pathways, cause coagulation of tissues, or disrupt the osmotic or ionic balance of the cell. Biologic agents differ from other injurious agents in that they are able to replicate and continue to produce injury. Among the nutritional factors that contribute to cell injury are excesses and deficiencies of nutrients, vitamins, and minerals.

The nurse needs to assess a 1-year-old child for fever. Which approach will produce the most accurate reading? a.) Rectal b.) Oral c.) Forehead d.) Axillary

Rectal Explanation: Measurement of core body temperature is important when evaluating fever. The rectal route is considered the most accurate. In adults and older children, the oral route is lower, but still accurate; however, in young children the oral route may be unreliable. Forehead thermometers can predict trends, but are not as accurate as other routes. The axillary route requires up to 10 minutes for the temperature to register appropriately.

A nurse is assessing a client for the classic signs of acute inflammation. The nurse would assess the client for: a.) Rubor, swelling, and pain b.) Pain, pulselessness, and edema c.) Paresthesias, redness, and coolness d.) Cyanosis, heat, and swelling

Rubor, swelling, and pain Explanation: The classic signs of inflammation are rubor (redness), tumor (swelling), calor (heat), and dolor (pain). The remaining options are more characteristic of symptomatology resulting from circulatory dysfunction.

A client with pneumonia is admitted with these vital signs: temperature 99.7ºF, pulse 80 beats/min, respirations 18/minute, and BP 120/80 mmHg. Which set of vital signs does the nurse anticipate when the client begins to shiver and requests another blanket several hours later? a.) T 100.9ºF, P 90/min, R 20/min, BP 126/80 mmHg b.) T 99.7ºF, P 86/min, R 18/min, BP 130/82 mmHg c.) T 98.4ºF, P 82/min, R 16/min, BP 106/70 mmHg d.) T 97.2ºF, P 70/min, R 12/min, BP 114/60 mmHg

T 100.9ºF, P 90/min, R 20/min, BP 126/80 mmHg Explanation: During the chill phase of fever, the client feels cold and may experience pale skin with goosebumps, but the temperature is rising. When the body reaches the new set point, shivering will stop, and flushing will begin.

The nurse assessing a client admitted with a diagnosis of "fever of unknown origin" notes that the temperature is elevated, but the heart rate is within normal range. What further assessment will the client require? a.) Test for Legionnaire disease b.) V/Q scan for pulmonary emboli c.) Thyroid scan for nodules d.) Sedimentation rate for RA

Test for Legionnaire disease Explanation: Typically, the heart rate rises with an elevation of temperature. If the heart rate is more rapid than anticipated, it could be from hyperthyroidism or pulmonary emboli. A heart rate that is slower than expected could result from Legionnaire disease or drug fever. Further testing is needed to confirm the cause of the fever and determine proper treatment.

A client has presented to the emergency department after he twisted his ankle while playing soccer. Which assessment findings are cardinal signs that the client is experiencing inflammation? Select all that apply. a.) The client's ankle is visibly red b.) The ankle appears to be swollen c.) The ankle is warmer than the unaffected ankle d.) The client is experiencing pain e.) The ankle is bleeding

The client's ankle is visibly red The ankle appears to be swollen The ankle is warmer than the unaffected ankle The client is experiencing pain Explanation: The cardinal signs of inflammation are rubor (redness), tumor (swelling), calor (heat), and dolor (pain). Bleeding is not among the cardinal signs.

A 33-year-old client is brought into the emergency room with a core temperature of 39°C (102.2°F). The client is red in the face, chest, and back due to significant cutaneous vasodilation. The client is likely in which stage of fever? a.) First b.) Second c.) Fourth d.) Third

Third Explanation: The first stage of a fever is marked by headache and body aches, the second stage is marked by the chills, and the third stage is the flush state. The fourth stage is defervescence.

A patient with gastroesophageal reflux disease has metaplasia. Which of the following is the cause? a) Cells are replaced in response to chronic irritation. b) This represents cancerous cells. c) Cells are increased in size due to increased oxygenation. d) These are nonreversible cell changes.

a) Cells are replaced in response to chronic irritation. Explanation: Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type in response to chronic irritation and inflammation.

Which of the following causes atrophy? Select all that apply. a) Decreased blood flow b) Disuse c) Denervation d) Increased endocrine stimulation e) Increased nutrition.

a) Decreased blood flow b) Disuse c) Denervation Explanation: Atrophy is caused by disuse, denervation, decreased blood flow, decreased endocrine stimulation, and decreased nutrition.

Mercury is a toxic substance, and the hazards of mercury-associated occupational and accidental exposures are well known. What is the primary source of mercury poisoning today? a) Fish such as tuna and swordfish b) Mercury from thermometers and blood pressure machines c) Amalgam fillings in the teeth d) Mercury found in paint that was made before 1990

a) Fish such as tuna and swordfish Explanation: The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Although there is mercury in amalgam fillings, the amount of mercury vapor given off by the fillings is very small. Most thermometers today are made without mercury. The same holds true for most blood pressure machines. Lead in paint is a concern, not mercury

A 7 year old boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which of the following assessment findings is most congruent with the client's diagnosis? a) Hemoglobin 9.9 g/dL b) Diffuse muscle pain. c) White blood cells (WBC) 11,000/mm3 d) Decreased deep tendon reflexes.

a) Hemoglobin 9.9 g/dL Explanation: Anemia is the cardinal sign of lead toxicity. Neither muscle pain, decreased deep tendon reflexes nor changes in WBC levels is associated with lead toxicity

select the statement the best describes apoptosis. a) Highly selective in eliminating injured or aged cells b) The release of products of cell death is uncontrolled c) Unregulated by enzymatic digestion of cell components d) Responsible for initiating an inflammatory response

a) Highly selective in eliminating injured or aged cells Explanation: Apoptosis is a highly selective process that eliminates injured and aged cells in a manner that maintains the integrity of the plasma membrane and does not initiate inflammation. All the other options describe the occurrences of necrosis.

A client has developed heart failure. The doctor reviews the client's chest x-ray and notes that the heart has enlarged. The changes in the size and shape of the heart are the result of: a) Hypertrophy b) Hypoplasia c) Atrophy d) Hyperplasia

a) Hypertrophy Explanation: Cells adapt to changes in their environment and in their work demands by changing their size, number, and characteristics. An increase in work results in cells undergoing hypertrophy and increasing in size. Hyperplasia is an increase in the number of cells in an organ or tissue. A decrease in work demands or adverse environmental conditions results in cells atrophy, or reducing in size. Hypoplasia is underdevelopment or incomplete development of a tissue or an organ

A patient is admitted with an alteration in arterial blood gases. Cellular injury is most likely to result from which of the following aspects of this abnormality? a) Hypoxia b) Alkalemia c) Hypocapnea d) Hypercapnea

a) Hypoxia Explanation: Lack of oxygen or hypoxia is a common cause of cell injury. Hypocapnea, alkalemia, and hypercapnea are not typical mechanisms of injury. The other common major mechanisms of cell injury are free radical formation, adenosine triphosphate depletion and disruption of intracellular calcium homeostasis.

The radiologist is reviewing potential types of radiation therapy for a client. Select the type of radiation that directly breaks down chemical bonds in a cell. a) Ionizing radiation b) Sunlight radiation c) Ultraviolet radiation d) Nonionizing radiation

a) Ionizing radiation Explanation: Ionizing radiation affects cells by causing ionization of molecules and atoms in the cell by directly hitting the target molecules of the cell and/or by producing free radicals that interact with critical cell components. Nonionizing radiation exerts it effects on the cell by causing a vibration and rotation of atoms and molecules. Sunlight is a form of ultraviolet radiation that induces skin damage by reactive oxygen species and by damage to the melanin-producing processes in the skin.

Which of the following statements is true concerning hyperplasia? a) It is a response to a stimulus. b) It is an abnormal response to stimulation. c) It is an increase in the size of a cell. d) It is an uncontrolled process.

a) It is a response to a stimulus Explanation: Hyperplasia is an increase in the number of cells in an organ, not the size of cells, and is the response to a stimulus that is a controlled process that occurs in response to an appropriate stimulus.

A client with diabetes who is diagnosed with a gangrenous right heel ulcer presents with a wound that has no line of demarcation, is spreading rapidly, and has a foul odor. The health care worker recognizes these manifestations as: a) Moist gangrene b) Internal gangrene c) Gas gangrene d) Dry gangrene

a) Moist gangrene Explanation: In moist gangrene, there is no line of demarcation between the normal and diseased tissues, and the spread of tissue damage is rapid. Moist gangrene often results in a foul odor caused by bacterial action at the site. Dry gangrene has a clear demarcation and spreads slowly. Gas and internal gangrene do not apply to this client's symptoms.

The nurse is providing care for a 21 year old female client with gas gangrene secondary to her compound fracture in her arm. Which of the following assessment finding would the nurse most reasonably expect to find when caring for a client with a diagnosis of gas gangrene? a) Spreading edema b) Inflammation of the affected tissue. c) Impaired alveolar gas exchange d) A positive culture for Staphylococcus

a) Spreading edema Explanation: Spreading edema is a cardinal sign of gas gangrene. It is often caused by Clostridium bacteria, not Staphylococcus. Inflammation may exist at the interface between affected and unaffected tissue, but not in the dead, affected tissue. Impaired gas exchange would not be a sign

Hypertrophy may occur as the result of normal physiologic or abnormal pathologic conditions. The increase in muscle mass associated with exercise is an example of physiologic hypertrophy. Pathologic hypertrophy occurs as the result of disease conditions and may be adaptive or compensatory. Examples of adaptive hypertrophy are the thickening of the urinary bladder from long-continued obstruction of urinary outflow and the myocardial hypertrophy that results from valvular heart disease or hypertension. What is compensatory hypertrophy? a) When one kidney is removed, the remaining kidney enlarges to compensate for the loss. b) When the body controls myocardial growth by stimulating actin expression to enlarge the heart c) When the body stimulates gene expression to begin a progressive decrease in left ventricular muscle mass d) When the body increases its major organs during times of malnutrition

a) When one kidney is removed, the remaining kidney enlarges to compensate for the loss. Explanation: Compensatory hypertrophy is the enlargement of a remaining organ or tissue after a portion has been surgically removed or rendered inactive. The body does not enlarge its major organs during times of malnutrition. Gene expression, not actin expression, stimulates the body to increase the muscle mass of the heart. Hypertrophy is not a progressive decrease in the size of anything

The student is reviewing the aging process. One group of theories of aging involves the shortening of telomeres until a critical minimal length is attained and then senescence ensues. These theories are known as which of the following? a) Systems-level theories b) Cellular theories c) Molecular theories d) Evolutionary theories

b) Cellular theories Explanation: There are a number of cellular theories of senescence that are under investigation, including those that focus on telomere shortening.

A patient is admitted with frostbite. Which of the following will the nurse tell the patient about the changes that have occurred due to cold exposure? a) Cold exposure results in hypertrophy of cells in the affected are b) Cold increases blood viscosity and thrombosis. c) Cold increases the speed of blood flow through vessel d) Cold causes vasodilation and redness.

b) Cold increases blood viscosity and thrombosis. Explanation: Cold temperature exposure causes increased blood viscosity and can cause clots to form. Vasoconstriction is induced, and the flow of blood is slowed due to this. Cells do not hypertrophy in response to temperature change.

The nurse is teaching a patient about genetic disorders. Which of the following contains the genetic code? a) mRNA b) DNA c) tRNA d) rRNA

b) DNA Explanation: DNA contains genetic code, and injury to DNA can cause a variety of genetic mutations.

A group of elderly residents were commenting on how many cell functions decline with age. One resident commented that many of his friends who lived under large electromagnetic towers seemed to experience aging at an accelerated rate in comparison with residents who lived nearby in lakefront housing. This observation is the basis for which theory on aging? a) Insufficient telomerase enzyme theory b) Error theory associated with DNA damage c) Theories of genetic influences d) Programmed cell receptor theories

b) Error theory associated with DNA damage Explanation: Error theory suggests that aging results from DNA mutation or faulty repair. Another group of theories of aging focuses on programmed cell changes with genetic influences that systematically cause cell senescence. Elimination of receptor sites is not part of aging theory. Telomerase enzyme is thought to reduce the shortening of the chromosomes and loss of telomere DNA with each cell replication

A nurse is assessing a patient who is a body builder. The nurse documents the increased size of the patient's muscle as resulting from which of the following? a) Atrophy b) Hypertrophy c) Dysplasia d) Hyperplasia

b) Hypertrophy Explanation: Hypertrophy represents an increase in cell size and with it an increase in the amount of functioning tissue mass (Fig. 5.2). It results from an increased workload imposed on an organ or body part and is commonly seen in cardiac and skeletal muscle. tissue, which cannot adapt to an increase in workload through mitotic division and formation of more cells.1

The nurse is conducting a physical assessment of a homeless man during a night when the windchill factor is -10 degrees Farenheit. When assessing the man's fingers and toes for frostbite, the nurse looks for which of the following types of cellular injury? a) Endogenous b) Hypoxic c) Mechanical d) Chemical

b) Hypoxic Explanation: Exposure to cold increases blood viscosity and induces vasoconstriction by direct action on blood vessels and through reflex activity of the sympathetic nervous system. The resultant decrease in blood flow may lead to hypoxic tissue injury, depending on the degree and duration of cold exposure.

Which of the following statements is true in relation to lead exposure? a) Lead is absorbed through the skin. b) Lead is absorbed through the gastrointestinal tract or the lungs. c) Increased calcium levels increases the risk of lead poisoning. d) Increased iron increases the risk of lead poisoning.

b) Lead is absorbed through the gastrointestinal tract or the lungs. Explanation: Lead is absorbed through the gastrointestinal tract and the lungs. It is not absorbed through the skin. Decreased calcium and iron increases the risk of lead poisoning.

A 68 year old male client with aortic stenosis secondary to calcification of the aortic valve is receiving care. Which of the following statements best captures an aspect of this client's condition? a) Paget's disease, cancer with metastases or excess vitamin D may have been contributors. b) The client has possibly undergone damage as a result of calcification following cellular injury. c) Increased calcium intake over time may have contributed to the problem. d) The client has possibly exhibited phosphate retention leading to calcium deposits.

b) The client has possibly undergone damage as a result of calcification following cellular injury. Explanation: Dystrophic calcification is a result of deposition of calcium following cellular injury, such as that which commonly occurs in heart valves. Answers A, B and D all refer to phenomenon associated with metastatic calcification and the associated increases in serum calcium levels.

When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower, more efficient level of functioning that is compatible with survival. This decrease in cell size is known as: a) dysplasia b) atrophy c) hyperplasia d) hypertrophy e) metaplasia

b) atrophy Explanation: When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy. Hypertrophy, metaplasia, and hyperplasia are all cellular adaptations that result in greater number or size. Dysplasia is a loss of cellular organization.

The nurse in an infectious-disease clinic will primarily treat injuries to tissues and cells caused by: a.) oncogenic agents. b.) chemical agents. c.) biologic agents. d.) calcification.

biologic agents. Explanation: Injury from biologic agents derives from bacterial and viral infections. The injuries differ from the other forms because they are able to replicate and can continue to produce their injurious effects. The etiology of infections does not normally include oncogenic agents, chemical agents, or calcifications.

Which of the following clients are at high risk for developing dilated cardiomyopathy? a) 17 year old with a diving injury resulting in paraplegia. b) 78 year old Alzheimer's patient who received a third degree burn following an oven fire. c) 44 year old noncompliant female who forgets to take her hypertensive medications. d) 4 year old child born with cerebral palsy and confined to a wheelchair.

c) 44 year old noncompliant female who forgets to take her hypertensive medications. Explanation: In hypertension, the increased workload required to pump blood against an elevated arterial pressure in the aorta results in a progressive increase in LV muscle mass and need for coronary blood flow. The pressure overload causes hypertrophied cells to have greater width and length. Paraplegia, cerebral palsy and Alzheimer's disease does not increase the workload of the cardiac muscle per se.

A client is experiencing muscle atrophy following two weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the client's muscle cells? a) Reduced oxygen consumption and cellular function that ensures muscle cell survival. b) Denervation of the affected muscles during the time of traction. c) A reduction of skeletal muscle use secondary to the traction treatment. d) High levels of insulin and IGF-1 in the client's blood during immobilization.

c) A reduction of skeletal muscle use secondary to the traction treatment. Explanation: Disuse atrophy results from the reduction in skeletal muscle use such as that following encasement in plaster casts or traction. Low levels of insulin and IGF-1 contribute to atrophy, and denervation only occurs in paralyzed limbs. Reduced oxygen consumption and cellular function are the mechanisms of cell atrophy but not the causes of the process.

Which of the following statements is true regarding drug therapy and its effects on the body? a) Drugs only have positive effects on cells. b) Drugs do not injure tissues or cells. c) Antineoplastic cells directly damage cells. d) Drugs only have bad effects when they have side effects.

c) Antineoplastic cells directly damage cells. Explanation: Antineoplastic drugs directly injure cells. Many drugs injure tissues and cells either through their direct mechanism of action, side effects, or adverse effects.

The obstetric nurse explains to the client that when she stops breast feeding, her breast tissue will reduce in size. The nurse understands that this regression is due to which of the following? a) Hypoxia b) Cell necrosis c) Apoptosis d) Atrophy

c) Apoptosis Explanation: Apoptosis is thought to be responsible for several normal physiologic processes, including hormone-dependent involution of tissues (e.g., the regression of breast tissue after weaning from breastfeeding).

A client has developed dystrophic calcification as a result of macroscopic deposition of calcium salts. The tissue that would be most affected would be: a) Dead tissue b) Normal tissue c) Injured tissue d) Regenerated tissue

c) Injured tissue Explanation: Pathologic dystrophic calcification occurs in injured tissue. The components of the calcium deposits are derived from the bodies of dead or dying cells as well as from the circulation and interstitial fluid. It also occurs when the tissues have smaller amounts of iron, magnesium, and other minerals. Metastatic calcification occurs in normal tissue

A mother rushes her 4-year-old child to the emergency department after she found an empty Tylenol (acetaminophen) bottle beside her child. The nurse is trying to explain why it is so important to give the child Ipecac to induce vomiting in order to prevent: a) Hemorrhage b) Seizures c) Liver failure d) Renal failure

c) Liver failure Explanation: Acetaminophen, a commonly used over-the-counter analgesic drug, is detoxified in the liver, where small amounts of the drug are converted to a highly toxic metabolite. This metabolite is detoxified by a metabolic pathway that uses a substance normally present in the liver. When large amounts of the drug are ingested, this pathway becomes overwhelmed and toxic metabolites accumulate, causing massive liver necrosis.

The provider explains to the client, who smokes, that cells in the trachea are substituted with cells that are better able to survive. This process is known as which of the following? a) Hyperplasia b) Atrophy c) Metaplasia d) Dysplasia

c) Metaplasia Explanation: Metaplasia represents a reversible change in which one adult cell type is replaced by another adult cell type. An example of metaplasia is the adaptive substitution of stratified epithelial cells for the ciliated columnar epithelial cells in the trachea and large airways of a habitual cigarette smoker.

A patient is admitted with an electrical burn and a fractured arm. Which of the following causes the fracture related to the burn? a) The client most likely fell after the electrical injury. b) The client had a predisposing condition. c) The client had violent muscle contractions during the electrical injury. d) The client may have fallen into the electrical cord.

c) The client had violent muscle contractions during the electrical injury Explanation: The most likely scenario is that the client had an injury with alternating current (AC) that is usually more dangerous than direct current as it causes violent muscle contractions that can result in fractures and dislocations.

Which of the following is an example of physiologic hyperplasia? a) Benign prostatic hyperplasia b) Skin warts c) Uterine enlargement in pregnancy d) Endometrial hyperplasia

c) Uterine enlargement in pregnancy Explanation: Two common types of physiologic hyperplasia are hormonal and compensatory. Breast and uterine enlargements during pregnancy are examples of a physiologic hyperplasia. The other examples are nonphysiologic hyperplasia

The nurse is caring for a client with arterial insufficiency of the left leg with gangrenous wounds on the second and third toes. What characteristics of the wounds should the nurse evaluate as expected? Select all that apply. a.) Moist wound with evidence of liquefaction b.) Edema to the left lower leg c.) Diminished pulse strength d.) Atrophy to the affected toes e.) A clear demarcation between the healthy and affected tissue f.) Darkened appearance of affected tissue

c.) Diminished pulse strength d.) Atrophy to the affected toes e.) A clear demarcation between the healthy and affected tissue f.) Darkened appearance of affected tissue Explanation: Due to the lack of arterial blood supply in this client, there would be a diminished pulse strength; the nurse would expect this to be dry gangrene. In dry gangrene the affected body part becomes dry and shrinks. Its color changes to dark brown or black. There would be a clear line of demarcation between the dead tissue of the gangrenous area and the healthy tissue. Wet gangrene is associated with edema and liquefaction but, because there is no issue with venous return in dry gangrene, this would not be seen.

A nurse is teaching a class on health promotion and includes information about the risk from ultraviolet radiation. Which concepts should be included in this class? Select all that apply. a.) Ultraviolet radiation does not pose a risk if it's cloudy or overcast outside. b.) Ultraviolet radiation, in small doses, poses no risk of skin cancer. c.) Ultraviolet radiation increases the risk of skin cancer. d.) Ultraviolet radiation damages DNA. e.) Ultraviolet radiation is only a problem in the summer months near the beach.

c.) Ultraviolet radiation increases the risk of skin cancer. d.) Ultraviolet radiation damages DNA. Explanation: Ultraviolet radiation increases the risk of skin cancer and damages DNA. It is a concern year-round. Eighty percent of the sun's UV rays are able to pass through the clouds and fog. They block most UVB rays but won't block out UVA rays, which penetrate deep into the skin.

Which of the following statements would a nurse tell a patient that best describes a lab finding of metaplasia? a) "This is a decrease in the oxygen-carrying capacity of the cells." b) "This is a change in the number of cells as they adapt to change." c) "this is a decrease in the size of the cell." d) "This is a change in cell form as it adapts to increased work demands or threats to survival."

d) "This is a change in cell form as it adapts to increased work demands or threats to survival." Explanation: Metaplasiais a change in the cell's form as it adapts to increased work demands or threats to survival. Hyperplasia is the change in the number of cells, and atrophy and hypertrophy are changes in a cell's size. Hypoxia or hypoxemia are decreases in oxygen

A nurse is caring for four clients. Select the client at greatest risk for high blood levels of lead. a) A 62-year-old male with hypercalcemia who smokes b) A 30-year-old Caucasian female office worker with asthma c) A 17-year-old Hispanic male student who takes a wood working class d) A 2-year-old anemic child who lives in a turn-of-the-century home

d) A 2-year-old anemic child who lives in a turn-of-the-century home Explanation: The client at the highest risk of having higher blood levels would be a young child who is likely to puts small toys in his or her mouth or ingests lead dust form soil. Factors that increase the risk of lead toxicity include preschool age, low socioeconomic status, and living in older housing built primarily before 1960. A client with a deficiency in calcium (hypocalcemia), iron, or zinc increases his or her risk of lead absorption. Behaviors that include smoking and working around wood have no apparent affect on the development of lead poisoning.

A client's condition has resulted in a decrease in work demands of most cells in the body; the anticipated result would be: a) Decreased programmed cellular death b) Increased mitochondrial growth c) Increased oxygen consumption d) Decreased size of organelles

d) Decreased size of organelles Explanation: Cell atrophy results in a decreased number and size of cell organelles. With cell atrophy, the cell has decreased oxygen consumption and growth of the mitochondria. The cell decreases in size. When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower and more efficient level of functioning that is compatible with survival. This decrease in cell size is called atrophy. Cellular death process is not affected.

Biologic agents differ from other injurious agents in that they are able to replicate and can continue to produce their injurious effects. How do Gram-negative bacteria cause harm to the cell? a) Gram-negative bacilli enter the cell and disrupt its ability to replicate. b) Gram-negative bacilli cannot cause harm to the cell; only Gram-positive bacilli can harm the cell. c) Gram-negative bacilli excrete elaborate exotoxins that interfere with cellular production of ATP. d) Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability.

d) Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability Explanation: Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability. Certain bacteria excrete elaborate exotoxins that interfere with cellular production of ATP. Gram-negative bacilli do not disrupt a cell's ability to replicate. Many Gram-negative bacilli cause harm to cells

Which of the following assessments supports the finding of lead toxicity? a) Heart rate 70 beats/min b) Hematocrit 40% c) Blood pressure 140/90 mm/Hg d) Hemoglobin 9 g/dL

d) Hemoglobin 9 g/dL Explanation: Anemia is a cardinal sign of lead toxicity. Lead competes with the enzymes required for hemoglobin synthesis and with the membrane-associated enzymes that prevent hemolysis of red blood cells. The other findings are not necessarily found in lead toxicity.

A patient asks why her breasts are enlarged during pregnancy. Which of the following is the best answer? a) Atrophy due to decreased workload b) Decreased workload of the glands c) Increased blood flow to the area d) Hyperplasia due to estrogen stimulation

d) Hyperplasia due to estrogen stimulation Explanation: Physiologic hyperplasia results from estrogen stimulation during pregnancy, causing the breasts and uterus to enlarge

Which of the following exemplifies physiologic hypertrophy? a) Heart size increase in hypertension b) Lung size increase in emphysema c) Cell size increase with hypoxia d) Muscle mass increase with exercise

d) Muscle mass increase with exercise Explanation: Hypertrophy that occurs as the result of normal physiologic conditions is seen as muscle mass increases with exercise. Heart size increase in hypertension is an example of pathologic increase, as is lung size increase in emphysema and cell increase with hypoxia

Which of the following should be included in the teaching plan of care for the parents of a child diagnosed with Tay-Sachs disease? a) The primary organ affected is the heart. b) The disorder involves tissue hyperplasia. c) Symptoms are often noted at birth. d) The disorder involves accumulation of abnormal lipids.

d) The disorder involves accumulation of abnormal lipids. Explanation: In Tay-Sachs disease, a genetic disorder, abnormal lipids accumulate in the brain and other tissues, causing motor and mental deterioration beginning at approximately 6 months of age, followed by death at 2 to 5 years of age

A pregnant client is attending a nutrition class for first-time moms. During the class, the instructor stressed that they should avoid consumption of which food that may cause brain damage from methyl mercury exposure? a) Fresh milk b) Beets c) Raw hamburger d) Tuna

d) Tuna Explanation: The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Fish concentrate mercury from sediment in the water. Because the developing brain is more susceptible to mercury-induced damage, it is recommended that young children and pregnant and nursing women should avoid consumption of fish known to contain high mercury content. None of the other foods listed pose a threat of mercury toxicity.

Assessment of a client with diabetes reveals that the toes are dark in color and the skin is shrunken and wrinkled, with a clear delineation between affected and unaffected regions. This client likely has: a.) gas gangrene. b.) liquefactive gangrene. c.) wet gangrene. d.) dry gangrene.

dry gangrene. Explanation: Dry gangrene is marked by a distinct area that becomes dry and shrinks; the skin wrinkles and its color changes to dark brown or black. Wet gangrene is marked by an area that is cold, swollen, and pulseless. Gas gangrene is the result of infection. Liquefactive gangrene is used to refer to a type of necrosis that will lead to wet gangrene.

In a genetic disorder called xeroderma pigmentosum, an enzyme needed to repair sunlight-induced DNA damage is lacking. This autosomal recessive disorder is characterized by: a.) white, scaly patches of skin that appear on black people after they have a sunburn. b.) extreme photosensitivity and a greatly increased risk of skin cancer in skin that has been exposed to the sun. c.) photosensitivity and a decreased risk of skin cancer in skin that has been exposed to the sun. d.) patches of pink, leathery pigmentation that replace normal skin after a sunburn.

extreme photosensitivity and a greatly increased risk of skin cancer in skin that has been exposed to the sun. Explanation: In a genetic disorder called xeroderma pigmentosum, an enzyme needed to repair sunlight-induced DNA damage is lacking. This autosomal recessive disorder is characterized by extreme photosensitivity and a 2000-fold increased risk of skin cancer in sun-exposed skin. Exposure to sun causes the skin to toughen and become leathery feeling, but not in patches of pink pigmented skin. Vitiligo is a benign acquired skin disease of unknown cause, consisting of irregular patches of various sizes totally lacking in pigment and often having hyperpigmented borders. It can appear in the skin of any race and is not scaly. Photosensitivity is a sign of xeroderma pigmentosum, but this disease increases, not decreases, the person's risk of skin cancer.

A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as a/an: a.) increase in cell production. b.) increase in circulating neutrophils. c.) decrease in blood supply to the affected area. d.) decrease in eosinophils at the tissue injury site.

increase in circulating neutrophils. Explanation: Leukocytosis, or the increase in white blood cells, is a frequent sign of an inflammatory response, especially those caused by bacterial infection. Leukocytosis occurs due to an increase in circulating neutrophils and eosinophils. Leukocytosis does not occur because of increased cell production, and blood supply is typically increased as part of the inflammatory process.

Which client is most likely to have impairments to the wound healing process? A client with: a.) chronic obstructive pulmonary disease. b.) a diagnosis of multiple sclerosis and consequent impaired mobility. c.) poorly controlled blood sugars with small blood vessel disease. d.) congenital heart defects and anemia.

poorly controlled blood sugars with small blood vessel disease. Explanation: Diabetes mellitus is strongly associated with impaired wound healing. The other noted pathologies are less causative of deficiencies in the healing process.

Which of the following should a nurse stress when teaching patients to avoid exposure to lead in the environment? Select all that apply. a) Lead can contaminate soil. b) Avoid flaking paint. c) Not everyone has a reaction to lead. d) Root vegetables can contain more lead than other vegetables. e) Repeated exposure to small amounts of lead is not a problem.

• Avoid flaking paint. • Lead can contaminate soil. • Root vegetables can contain more lead than other vegetables Explanation: Lead is a very toxic metal and small amounts can accumulate to reach toxic levels. The nurse should teach patients to avoid flaking paint, especially in older homes, as older paint contains lead. Lead can contaminate soil, and root vegetables tend to contain more lead.

What happens as a cell's workload declines? Select all that apply. a) Cell size decreases. b) Insulin levels increase. c) Energy expenditure increases. d) Oxygen consumption decreases. e) Protein synthesis decreases

• Cell size decreases. • Oxygen consumption decreases. • Protein synthesis decreases. Explanation: As the cell's workload declines, oxygen consumption decreases, protein synthesis decreases, and cell size decreases. Insulin levels do not increase, and energy expenditure would decrease.

A client has developed acute encephalopathy from lead toxicity. The nurse is aware that the client may display: Select all that apply. a) Increase in alertness b) Increased appetite c) Seizures d) Vomiting e) Coma f) Papilledema g) Ataxia

• Vomiting • Ataxia • Seizures • Papilledema • Coma Explanation: The most serious manifestation of lead poisoning is acute encephalopathy. It is manifested by persistent vomiting, ataxia, seizures, papilledema, impaired consciousness, and coma. Acute encephalopathy may manifest suddenly, or it may be preceded by other signs of lead toxicity such as behavioral changes or abdominal complaints.