Patho Exam 4

A care aide who works in a long-term care facility recognizes the high incidence and prevalence of a stage I pressure ulcer in immobile older adults. Which of the following protocols in the facility would the care aide advocate changing? A) Residents with persistently low food intake are identified. B) Immobilized residents are turned every 2 hours during both day and night. C) Residents are frequently encouraged to increase their fluid intake. D) Wound dressings are applied promptly to all identified or potential pressure ulcers.

D) Wound dressings are applied promptly to all identified or potential pressure ulcers.

A mom asks her neighbor, a nurse, why every time she takes her daughter (10 years old) out for ice cream she comes home with a stomachache and then experiences a bout of diarrhea. The nurse is thinking that this girl is experiencing A) anxiety about increasing too many calories. B) a deficiency of lactase. C) gallbladder disease. D) premature peptic ulcer formation.

B) a deficiency of lactase.

A male patient in his 50s has just been diagnosed with hyperuricemia. He has had multiple flare-ups of his first metatarsophalangeal joint pain and swelling. The pain is so severe that he cannot sleep with any covers/sheets over his feet at night. The nurse should anticipate that the patient will likely be prescribed: Select all that apply. A) Tylenol (acetaminophen) for the pain. B) allopurinol (Zyloprim) to decrease uric acid levels. C) calcium carbonate used to increase the intake of calcium. D) Anturane (sulfinpyrazone) to increase excretion of urate. E) sevelamer (Renagel) to reduce the absorption of phosphate.

B) allopurinol (Zyloprim) to decrease uric acid levels. D) Anturane (sulfinpyrazone) to increase excretion of urate.

As you are walking in the park, a huge black Labrador (dog) runs up to you and places his paws on your shoulders. Immediately your heart starts racing, you feel palpations and anxiety, and your hands become a little shaky. The nurse knows that this response is primarily caused by A) fear of dogs that make you feel like your chest is being tightened and that you have lost control of the situation. B) increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level. C) response of the cholinergic muscarinic receptors on innervational targets of postganglionic fibers. D) stimulation of the release of β2-adrenergic receptors, which will open the airway and increase oxygenation.

B) increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level.

When explaining to a class of nursing students the effects of dysregulation of the RANKL/RANK/OPG pathway, the instructor emphasizes that this plays a prominent role in the pathogenesis of: Select all that apply. A) osteomalacia. B) neoplasia of the bone. C) osteoporosis. D) genu varum. E) bone necrosis.

B) neoplasia of the bone. C) osteoporosis.

A patient has recently been diagnosed with H. pylori gastritis. The nurse knows that this form of gastritis is usually treated with a combination of an antibiotic and A) antianxiety medications. B) proton pump inhibitors. C) lactulose, to reduce the blood ammonia levels. D) calcium carbonate, an antacid.

B) proton pump inhibitors.

A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him "asleep" and could not get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the roommates in the fraternity, the nurse begins by explaining that alcohol is A) water-soluble compound that is easily absorbed by the gastric lining of the stomach. B) very lipid soluble and rapidly crosses the blood-brain barrier. C) able to reverse the transport of some substances to remove them from the brain. D) very likely to cause sedation, and therefore the patient just needs to sleep it off.

B) very lipid soluble and rapidly crosses the blood-brain barrier.

An 18-year-old female of Southeast Asian ancestry is distraught over the recent appearance of white patches on her forearms and upper arms, which have been subsequently confirmed as vitiligo. Which of the following statements by the woman express an accurate understanding of her condition? A) "I suppose it's some comfort that my patches are small and will always stay out of sight in the future." B) "I'm thankful that there are medications to cure this, but I'm nervous about the side effects." C) "I suppose this shouldn't come as too much of surprise, since this tends to run in my family." D) "I'm surprised that I ended up contacting that fungus that caused this problem for me."

C) "I suppose this shouldn't come as too much of surprise, since this tends to run in my family."

A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a patient having problems in his hand/wrist. In order to test Tinel sign, the nurse should give the patient which of the following directions? A) "Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose." B) "Hold your wrist in complete flexion; keep it in this position for 60 seconds; how does your hand feel after placing it in a neutral position?" C) "I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?" D) "I'm going to tap this tuning fork and place it on the side of your thumb; then tell me what you are feeling in your hand and wrist."

C) "I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?"

Following several days of intermittent upper right quadrant pain, a 29-year-old obese, Native American woman has been diagnosed with cholelithiasis. The nurse at the clinic has taught the client about the pathophysiology and contributing factors to her health problem, as well as some of the likely treatment options. Which of the following statements by the client demonstrates a sound understanding of her diagnosis? A) "All in all, I guess this is a result of the fact that I've been eating a diet too high in cholesterol for too long." B) "Several factors like my genetics and gender may have contributed to this, but I'm glad that medications can cure it." C) "This explains why my skin was yellow-tinged lately and why I had those pains that spread to my upper back and right shoulder." D) "I suppose the fever and vomiting I had this week was probably a sign of my gallstones too."

C) "This explains why my skin was yellow-tinged lately and why I had those pains that spread to my upper back and right shoulder."

A toddler is displaying signs and symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The patient's family asks how he got this. The nurse will respond A) "This could result from playing in soil and then ingesting bacteria that are now attacking his motor neurons." B) "No one really knows how this disease is formed. We just know that in time, he may grow out of it." C) "This is a degenerative disorder that tends to be inherited as an autosomal recessive trait." D) "This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well."

C) "This is a degenerative disorder that tends to be inherited as an autosomal recessive trait."

A 71-year-old male has been recently diagnosed with a stage III tumor of colorectal cancer and is attempting to increase his knowledge base of his diagnosis. Which of the following statements about colorectal cancer demonstrates a sound understanding of the disease? A) "If accurate screening test for this type of cancer existed, it could likely have been caught earlier." B) "The NSAIDs and aspirin that I've been taking for many years probably contributing to me getting cancer." C) "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown." D) "A large majority of patients who have my type of colon cancer survive to live many more years."

C) "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown."

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which of the following teaching points should his caregiver provide? A) "While your diet most certainly contributed to this problem, the good news is that changing your diet can help solve it." B) "Ulcers like yours do not penetrate all layers of the stomach or duodenum, so you don't have to worry about losing too much blood." C) "Your family history, your smoking history, and NSAID use may all have contributed to this problem." D) "While there aren't really any effective medications for these ulcers, changes in lifestyle can keep them well controlled."

C) "Your family history, your smoking history, and NSAID use may all have contributed to this problem."

The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents? A) "Your son's muscular dystrophy is a result of faulty connections between muscles and the nerves that normally control them." B) "He'll require intensive physical therapy as he grows up, and there's a good chance that he will outgrow this problem as he develops." C) "Your son will be prone to heart problems and decreased lung function because of this." D) "His muscles will weaken and will visibly decrease in size relative to his body size throughout his childhood."

C) "Your son will be prone to heart problems and decreased lung function because of this."

Which of the following clients may be experiencing a sensory focal seizure that has sent an abnormal cortical discharge to the autonomic nervous system (ANS)? A) A 44-year old patient complaining of constant movement and pain in the legs that gets worse when he tries to sleep B) An 85-year-old patient experiencing drooping of the right side of the face and numbness in the right arm and leg C) A 56-year-old complaining of tingling sensations and has both an elevated pulse and BP D) A 22-year-old complaining of a stiff neck and achiness, along with some nausea and vomiting

C) A 56-year-old complaining of tingling sensations and has both an elevated pulse and BP

A patient with pancreatic cancer is admitted for portal hypertension in which he is symptomatic with ascites. Following paracentesis and removal of 7.5 L of ascitic fluid, the nurse should anticipate that the physician will order which of the following medications to assist in maintaining an effective circulating fluid volume? A) Bumetanide (Bumex) B) Furosemide (Lasix) C) Albumin (human) 5% D) Epogen (epoetin alfa)

C) Albumin (human) 5%

A patient is suspected to have osteomalacia based on his clinical manifestations and lab/diagnostic workup (low calcium levels, transverse lines on x-ray). The nurse would expect the patient to have which of the following clinical manifestations? Select all that apply. A) Nerve palsy in upper extremities. B) Calcification of aortic valve. C) Bone pain. D) Muscle weakness. E) Cold limb with absent pulses.

C) Bone pain. D) Muscle weakness.

Which of the following is an aspect of the bone growth and development that occurs during the first two decades of life? A) Most bone abnormalities can be traced to anomalies in the embryonic stage of development. B) The physiological effects of in utero positioning normally remain into late adolescence. C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells. D) Bone length increases through childhood, while bone diameter remains static.

C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells.

A 30-year-old man with a diagnosis of type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which of the following physiological processes are actions of insulin? Select all that apply. A) Increasing the metabolic needs of body cells B) Promoting the breakdown of stored triglycerides C) Facilitating triglyceride synthesis from glucose in fat cells D) Inhibiting protein breakdown E) Promoting glucose uptake by target cells

C) Facilitating triglyceride synthesis from glucose in fat cells D) Inhibiting protein breakdown E) Promoting glucose uptake by target cells

Which of the following endocrine functions are responsible for increased resorption of bone that results in a reduction of the number and function of osteoclasts? Select all that apply. A) Calcitonin secretion B) Decrease in estrogen levels C) Stimulation of excess thyroid hormone D) Release of catecholamines E) Increase movement of calcium and phosphate from bone into the extracellular fluid

A) Calcitonin secretion B) Decrease in estrogen levels

A 48-year-old woman has been found to have nodules on her thyroid that must be biopsied to determine whether or not they are malignant. Which of the following imaging techniques will be most helpful to the surgeon in visualization of the nodes for fine needle aspiration? A) Ultrasound B) Magnetic resonance imaging C) Radioactive scanning using radioiodine D) Radioactive scanning using sestamibi

A) Ultrasound

31. During male ejaculation, which of the following statements addresses why sperm is not normally seen inside the bladder? A) The parasympathetic nervous system keeps the seminal fluid inside the urethra. B) The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time. C) With ejaculation, the male expels some urine along with the seminal fluid to wash any extra sperm out of the bladder. D) The detrusor muscle relaxes allowing for the closing of the sphincter at the base of the bladder.

B) The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time.

Which of the following clients is most likely to have low bone density? A) A 70-year-old woman with increased numbers of osteoblasts. B) A 78-year-old female whose osteoclast function is inhibited. C) A 65-year-old male who is noted to have osteopenia. D) A 68-year-old male who takes vitamin D supplements.

C) A 65-year-old male who is noted to have osteopenia.

Which of the following hormones are derivatives of cholesterol? A) Epinephrine and norepinephrine B) Insulin and glucagon C) Aldosterone and testosterone D) Eicosanoids and retinoids

C) Aldosterone and testosterone

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options. A) Ileum B) Pylorus C) Jejunum D) Hiatus E) Cecum F) Duodenum

D) Hiatus B) Pylorus F) Duodenum C) Jejunum A) Ileum E) Cecum

42. A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse? A) Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses. B) Communication between a neuron and the single neuron it is connected with will be facilitated. C) The neurotransmitter will cross gap junctions more readily. D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

When educating a patient about glargine (Lantus), the nurse should explain that this medication A) has a rapid onset and peaks in about 5 minutes after injection, so he will need to eat food immediately after injection. B) will have a peak effect within 30 minutes, so it can be taken after a meal. C) is a combination with short-acting and intermediate-acting insulin, so it is safe to take anytime throughout the day. D) has a prolonged absorption rate and provides a relatively constant concentration for 12 to 24 hours.

D) has a prolonged absorption rate and provides a relatively constant concentration for 12 to 24 hours.

While reviewing the bones in anatomy class, the instructor discusses this type of bone that protects the underlying structures. A good example of a flat bone is: A) metatarsal bones. B) vertebrae. C) femur. D) skull.

D) skull.

A 25-year-old Asian American man arrives in the emergency room in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine. What disease has likely caused of his hematuria and how should it be treated? A) Goodpasture syndrome and will be treated with plasmapheresis and immunosuppressive therapy B) Membranous glomerulonephritis and should be treated with corticosteroids C) Immunoglobulin A nephropathy and may be advised to use omega-3 fatty acids to delay progression of disease D) Kimmelstiel-Wilson syndrome and should be treated with medication to control high blood pressure

C) Immunoglobulin A nephropathy and may be advised to use omega-3 fatty acids to delay progression of disease

A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. The nurse knows which of the following aspects of the nervous system listed below would her health care providers focus their diagnostic efforts on? A) Her afferent and efferent cranial nerve function B) Possible damage to her pons and medulla C) Impaired function of her hypothalamus D) Potential damage to the girl's cerebellum

C) Impaired function of her hypothalamus

The nurse should anticipate she will need to teach the newly diagnosed multiple sclerosis patient how to give injections if he is prescribed which medication to modify the course of the disease by reducing exacerbations? A) Corticosteroids B) Plasmapheresis C) Interferon beta D) Mitoxantrone

C) Interferon beta

The nurse assessing a renal failure patient for encephalopathy caused by high uremic levels may observe which of the following clinical manifestations? A) Severe chest pain with pericardial friction rub on auscultation B) Stiff immobile joints and contractures C) Loss of recent memory and inattention D) Pruritus with yellow hue to skin tone

C) Loss of recent memory and inattention

A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options. A) Decrease in pH B) Breakdown of triglycerides C) Low serum insulin levels D) Ketone production by the liver E) Production of fatty acids and glycerol

C) Low serum insulin levels B) Breakdown of triglycerides E) Production of fatty acids and glycerol A) Decrease in pH D) Ketone production by the liver

A 56-year-old female with a diagnosis of breast cancer has developed bone metastases, which her oncologist would like to treat with radiation therapy. What is her physician's most likely primary goal in the treatment plan of the metastases? A) Thorough elimination of neoplastic cells in the bone structure B) Preservation of normal weight bearing and range of motion C) Ensuring vascular supply to the bone is not affected D) Prevention of pathologic fractures

D) Prevention of pathologic fractures

After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem? A) Surgical correction of the incompetent pylorus B) Antacids; avoiding positions that exacerbate reflux; a soft-textured diet C) Weight loss and administration of calcium channel blocking medications D) Proton pump inhibitors; avoiding large meals; remaining upright after meals

D) Proton pump inhibitors; avoiding large meals; remaining upright after meals

A 35-year-old female ultramarathon runner is admitted to the hospital following a day-long, 50-mile race because her urinary volume is drastically decreased and her urine is dark red. Tests indicate that she is in the initiating phase of acute tubular necrosis. Why is her urine red? A) Hematuria B) Hemoglobinuria C) Myoglobinuria D) Kidney bleeding

C) Myoglobinuria

Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace and that the man will regain full function after healing and rehabilitation. Which of the following cells is most responsible for restoring the integrity of the man's broken bone? A) Osteocyte B) Osteoclast C) Osteoblast D) Osteoma

C) Osteoblast

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD), in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur? A) Decreased absorption of ingested foods and fluids B) Impaired control of the gastric emptying rate C) Protrusion of the stomach or regurgitation of stomach contents into the esophagus D) Inappropriate release of gastric enzymes

C) Protrusion of the stomach or regurgitation of stomach contents into the esophagus

Damage to which of the following areas of a nephron would most likely result in impaired secretion and reabsorption? A) Distal tubule B) Loop of Henle C) Proximal tubule D) Collecting tubule

C) Proximal tubule

Following a car accident of a male teenager who did not have his seatbelt on, he arrived in the emergency department with a traumatic brain injury. He has severe cerebral edema following emergent craniotomy. Throughout the night, the nurse has been monitoring and reporting changes in his assessment. Which of the following assessments correspond to a supratentorial herniation that has progressed to include midbrain involvement? Select all that apply. A) Clouding of consciousness B) Decorticate posturing with painful stimulation C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

A male infant who is 48 hours postpartum is undergoing phototherapy for the treatment of jaundice and accompanying high levels of bilirubin. Place the following components of the production of bilirubin in the correct chronological order. Use all the options. A) Conjugated bilirubin B) Urobilinogen C) Red blood cells D) Biliverdin E) Free bilirubin

C) Red blood cells D) Biliverdin E) Free bilirubin A) Conjugated bilirubin B) Urobilinogen

A patient is showing the nurse some changes in his skin that he found while taking a shower. Which of the following lesions would give the nurse concern that it might be a precancerous lesion? Select all that apply. A) Soft, flesh-colored papule located on the neck and "armpit." B) Wart-like, tan-brown lesion that is sharply outlined and a few centimeters in diameter. C) Several dry, brown, scaly lesions that are approximately 1 cm in diameter, and a few of the lesions are showing some ulceration. D) Tan to brown lesions commonly called "liver spots" are located on the forearm and hands. E) Red-colored mark close to the skin surface located on the face.

C) Several dry, brown, scaly lesions that are approximately 1 cm in diameter, and a few of the lesions are showing some ulceration. D) Tan to brown lesions commonly called "liver spots" are located on the forearm and hands.

A 68-year-old woman has had her mobility and quality of life severely affected by rheumatoid arthritis (RA). Place the following pathophysiological events involved in her health problem in the correct order that they most likely occurred. Use all the options. A) Inflammatory response B) Interaction between rheumatoid factor (RF) and IgG C) T-cell-mediated immune response D) Pannus invasion E) Destruction of articular cartilage

C) T-cell-mediated immune response B) Interaction between rheumatoid factor (RF) and IgG A) Inflammatory response D) Pannus invasion E) Destruction of articular cartilage

A 61-year-old woman who has had an upper respiratory infection for several weeks has presented to her family physician with complaints of a recent onset of urinary retention. She reveals to her physician that she has been taking nonprescription cold medications over and above the suggested dose for the past 2 weeks. Which of the following phenomena will her physician most likely suspect is contributing to her urinary retention? A) Cholinergic actions of the cold medicine are triggering internal and external sphincter contraction. B) Antihistamine effects inhibit communication between the pons and the thoracolumbar cord. C) The anticholinergic effects of the medication are impairing normal bladder function. D) Over-the-counter medications such as cold medicine stimulate the parasympathetic nervous system and inhibit bladder emptying.

C) The anticholinergic effects of the medication are impairing normal bladder function.

When explaining the role of liver Kupffer cells to a group of nursing students, which of the following statements about the function of these cells is most accurate? A) The primary function of Kupffer cells is to secrete bile. B) These cells are the functional unit of the liver and are responsible for all liver secretions. C) The cells are capable of removing and phagocytizing old and defective blood cells. D) The role of the Kupffer cells is to provide at least 50% of cardiac output each minute to each lobular of the liver.

C) The cells are capable of removing and phagocytizing old and defective blood cells.

Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his fingers and thumb but is still able to perform gross motor movements of his hand and arm. Which of the following components of his white matter has most likely been damaged? A) The inner layer (archilayer) B) The middle layer (paleolayer) C) The outer layer (neolayer) D) The reticular formation

C) The outer layer (neolayer)

A 44-year-old man has been diagnosed with chronic urticaria, the exact cause of which cannot be determined. What is the pharmacological treatment that is most likely to be of most use to the man? A) topical retinoids B) epinephrine C) antihistamines D) benzoyl peroxide

C) antihistamines

An elderly patient has arrived at the physician's office complaining of a rash. Upon further investigation, the patient states that the rash feels like a burning pain but also has some tingling. It is extreme sensitive to touch, and it's "like crazy." The nurse notes that the rash is made up of vesicles and located on the right thoracic region. The nurse suspects the patient has A) chickenpox. B) German measles. C) herpes zoster. D) human papillomavirus.

C) herpes zoster.

While studying bones in pathophysiology class, the nursing students learn that the Haversian canals are composed of A) calcium salts. B) collagen. C) lymphatics. D) glycosaminoglycans.

C) lymphatics.

A patient who has suffered a spinal cord injury at C4 is experiencing a sudden change in condition. His BP is 186/101; heart rate is 45; and he is profusely sweating and complaining of "not feeling right." The nurse should A) call a "Code Blue." B) page physician stat. and ask for an antihypertensive medication. C) palpate his bladder for overdistention. D) place his bed flat and elevate the foot of the bed.

C) palpate his bladder for overdistention.

After being thrown off the back of a bull, the bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is usually referred to as A) tetraplegia. B) quadriplegia. C) paraplegia. D) anterior cord syndrome.

C) paraplegia.

A child comes in to show his parents (who are nurses) a blister on his foot from "breaking in" a new pair of shoes. The child wants to "pop the blister" to get all the fluid out of it, so it would not hurt so much when he puts on shoes/socks. The parents know that breaking the skin of the blister will put him at risk for A) fluid volume deficit. B) further edema due to loss of proteins. C) secondary infection. D) activity intolerance.

C) secondary infection.

One of the most reliable predictors for worsening autosomal dominant polycystic kidney disease is A) serum creatinine levels. B) blood urea nitrogen (BUN) level. C) urine albumin excretion (UAE). D) urine specific gravity.

C) urine albumin excretion (UAE).

While being tackled, a 20-year-old football player puts out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment? A) "This strain will likely resolve itself with sufficient rest." B) "You've suffered a severe sprain, and you might need a cast." C) "Your wrist contusion will have to be observed for bleeding under the skin surface." D) "It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."

D) "It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."

A diabetes education nurse is teaching a group of recently diagnosed diabetics about the potential genitourinary complications of diabetes and the consequent importance of vigilant blood glucose control. Which of the following teaching points best conveys an aspect of bladder dysfunction and diabetes mellitus? A) "People with diabetes are highly susceptible to urethral obstructions, and these can heal more slowly and cause more damage than in people without diabetes." B) "High blood sugar results in a high glucose level in your urine, and this can make your bladder muscle less able to fully empty the bladder." C) "Many people with diabetes find it necessary to live with an indwelling catheter to ensure their bladders do not become too full." D) "It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying."

D) "It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying."

A patient comes into the orthopedic clinic complaining of severe pain in his hip that was not caused by a fall. On inspection, the femur and tibia are bowed. There is also a reduced angle of the femoral neck, which gives the patient a "waddling gait" appearance. The doctor suspects Paget disease. The patient asks how he got that. The nurse will respond, A) "It's because you don't eat enough calcium-rich foods in your diet." B) "When you were a child you probably broke you hip, and since it wasn't displaced, you continued to walk on it." C) "It might be related to a thyroid condition. We will need to run some more blood work." D) "It's most likely a genetic predisposition. Do you know if anyone else in your family has this problem?"

D) "It's most likely a genetic predisposition. Do you know if anyone else in your family has this problem?"

A patient in a hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine collection test. He asks the nurse why the test is necessary since he provided a single urine sample 2 days ago. How could the nurse best respond to the patient's question? A) "A single urine sample lets your care team determine if there are bacteria in your urine, but other tests of urine chemistry need a longer-term view." B) "Current lab tests aren't able to detect the small quantities of most substances contained in a single urine sample. C) "Only a longer-term test is able to show whether your kidneys are letting sugar spill out into your urine." D) "Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine."

D) "Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine."

A 30-year-old woman, who just found out that she is pregnant, seeks a treatment for her severe acne. What is the most appropriate treatment for her skin condition? A) Accutane B) Low-dose tetracycline C) Retin-A D) A benzoyl peroxide agent

D) A benzoyl peroxide agent

A man's primary care physician has characterized his skin lesion as being a temporary eruption but has cautioned him against repeated rubbing or scratching as to avoid lichenization. What is the most likely categorization of the man's skin lesion? A) A blister B) A corn C) A callus D) A rash

D) A rash

While on tour, a 32-year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8°C (101.8°F), blood pressure 89/48 mm Hg, and heart rate 116 beats/minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of the following diagnoses would the care team suspect first? A) Hepatitis C B) Cholecystitis C) Liver cirrhosis D) Acute pancreatitis

D) Acute pancreatitis

A nurse is providing care for a client who has had a cast applied to her fractured arm 6 hours prior. The client is now complaining of severe pain that she describes as "even worse than when I broke my arm." What would be the nurse's best course of action? A) Administration of analgesics and teaching the client about the normal course of pain after a fracture B) Teaching the client simple range of motion exercises to promote circulation and perfusion C) Taking the client's temperature due to the possibility of infection D) Assessment of motor and sensory function with the goal of identifying compartment syndrome

D) Assessment of motor and sensory function with the goal of identifying compartment syndrome

A middle-aged man with diabetes reports that he must strain to urinate and that his urine stream is weak and dribbling. He also reports feeling that his bladder never really empties. The nurse knows that all of his complaints are likely caused by which of the following medical diagnoses? A) Detrusor muscle areflexia B) Detrusor-sphincter dyssynergia C) Uninhibited neurogenic bladder D) Bladder atony with dysfunction

D) Bladder atony with dysfunction

A patient is admitted to the hospital in adrenal crisis 1 month after a diagnosis of Addison disease. The nurse knows which of the following clinical manifestations would support this diagnosis? A) Hyperactive deep tendon reflexes and slow, shallow breathing B) Cerebral spinal fluid leakage and impaired swallowing C) Irregular heart rate and decreased temperature D) Change in the level of consciousness and profound hypotension

D) Change in the level of consciousness and profound hypotension

A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which of the following diagnoses best captures this pathophysiology? A) Focal hypoxia B) Cytotoxic edema C) Hydrocephalus D) Vasogenic edema

D) Vasogenic edema

Laparoscopic knee surgery in a 22-year-old basketball player has necessitated entry into the synovial cavity. The surgeon performing the procedure would be aware of which of the following relevant characteristics of synovial tissue? A) Synovial tissue has a slow rate of healing compared to muscle tissue. B) Damage to synovial tissue is known to be excruciatingly painful. C) The synovial membrane lacks direct blood supply, precluding bleeding into the joint. D) Few pain receptors are located in the synovial membrane.

D) Few pain receptors are located in the synovial membrane.

Which of the following statements best describes an aspect of the normal process of glucose metabolism? A) Blood glucose levels are primarily a result of the timing, quantity, and character of food intake. B) Ingested glucose that is not needed for cellular metabolism circulates in the blood until it is taken up to meet cellular needs. C) Blood glucose levels are kept in a steady state by selective excretion and reuptake by the kidneys. D) Glucose that exceeds metabolic needs is converted and stored by the liver.

D) Glucose that exceeds metabolic needs is converted and stored by the liver.

Which of the following statements most accurately captures the function of the ascending loop of Henle? A) Urine is concentrated by the selective absorption of free water in the ascending limb. B) Sodium and water are reabsorbed in equal amounts, reducing filtrate quantity but maintaining osmolality. C) The majority of solute and water reabsorption occurs in the ascending loop of Henle. D) Impermeability to water and absorption of solutes yields a highly dilute filtrate.

D) Impermeability to water and absorption of solutes yields a highly dilute filtrate.

A 79-year-old male resident of a long-term care facility has contracted Clostridium difficile and is experiencing consequent diarrhea. Auscultation of the man's abdomen indicates hyperactive bowel sounds. What process in the man's small intestine is most likely accompanying his current status? A) Pathogenic microorganisms are causing dilation of his small intestine, increasing motility. B) Segmentation waves have become more frequent as a result of his infection. C) Intestinal stasis brought on by infection is preventing his small intestine from sufficiently slowing the rate of motility. D) Inflammation is accompanied by an increase in peristaltic movements of his small intestine.

D) Inflammation is accompanied by an increase in peristaltic movements of his small intestine.

A Tae Kwon Do (TKD) master is applying downward pressure just above the elbow joint on an attacker who immediately collapses to the ground. The TKD master knows the elbow joint can bend inward toward the body but not in the opposite direction. Which of the following reflexes is applicable to this example? A) Knife-clasp B) Withdrawal C) Myotatic D) Inverse myotatic

D) Inverse myotatic

A 77-year-old woman has been admitted to hospital following several weeks of increasing fatigue. On observation, she is pale, and blood work indicates she has low hemoglobin and red cell counts. Stool tests for occult blood are positive, and following endoscopy, she has been diagnosed with an upper GI bleed that has been shown to originate in her stomach. She admits to regularly exceeding the recommended doses of nonsteroidal anti-inflammatory drugs (NSAIDs) in an effort to control her rheumatoid arthritis. Which of the following phenomena is most likely responsible for her present health problems? A) NSAIDs increase the gastric production of gastrin, increasing gastric secretions and lowering stomach pH. B) Drugs such as NSAIDs increase the H+ levels and thus decrease gastric pH, resulting in insult to the stomach lining. C) NSAIDs, aspirin, and other drugs increase prostaglandin synthesis, resulting in disruption of cellular structures lining the stomach. D) NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

D) NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? Select all that apply. A) "A bodily process can be the result of the combined effect of several different hormones from different sources." B) "A single hormone can act not only on one process or organ but often on several different locations or processes." C) "It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." D) "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions." E) "The regulation in homeostasis requires that hormones be absent from the body when their effect is not needed."

A) "A bodily process can be the result of the combined effect of several different hormones from different sources." B) "A single hormone can act not only on one process or organ but often on several different locations or processes." C) "It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." D) "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions."

During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-Barré syndrome in his medical history. The patient asks, "What is that?" How should the nursing student reply? A) "A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles" B) "Swelling of your arm where you got your flu shot, and maybe your eyes and lips had some swelling as well" C) "A degenerative disease where you have trouble walking without the help of a cane or walker" D) "Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot"

A) "A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles"

The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? A) "Have you ever given your child any honey or honey-containing products?" B) "Is there any family history of neuromuscular diseases?" C) "Has your baby ever been directly exposed to any chemical cleaning products?" D) "Is there any mold in your home that you know of?"

A) "Have you ever given your child any honey or honey-containing products?"

A public health nurse has learned that a colleague has been screening for scoliosis during visits made to schools even though such screening is not mandated. How should the nurse best respond to the colleague? A) "The potentially harmful outcomes of screening have been shown to outweigh the benefits." B) "Screening for scoliosis has been proven to be inaccurate." C) "Screening is unnecessary now that we know scoliosis is a benign condition." D) "The low prevalence and incidence of scoliosis have made screening unnecessary."

A) "The potentially harmful outcomes of screening have been shown to outweigh the benefits."

A 35-year-old woman who has been in recovery from alcoholism for 2 years presents at her primary care physician's office with chronic hip pain. She reports that as part of her commitment to her recovery, she began exercising regularly about a year earlier. After a month or two, her hip began to hurt when she ran on the treadmill. She stretches, has had a physical trainer check her form to ensure that it is correct, and rests adequately between each workout. Six months ago, the pain began waking her at night, and now it is constant. She is not aware of any injury to her hip and has no other outward symptoms. Which of the following is most likely to be the cause of her pain? A) Hematogenous osteomyelitis B) Osteomyelitis with vascular insufficiency C) Tuberculosis of the bone D) Osteonecrosis

D) Osteonecrosis

A client has been diagnosed with having calcium oxalate kidney stones following intravenous pyelography. Which of the following teaching points about the treatment of the health problem are justifiable? Select all that apply. A) "You may need to cut out cocoa, chocolate, and some nuts from your diet." B) "It's important that you avoid high-calcium foods like milk, cheese, and yogurt." C) "We will come up with a plan to safely limit your fluid intake over the next few weeks." D) "Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones." E) "Most likely your stones can be dissolved by medications over the next several days."

A) "You may need to cut out cocoa, chocolate, and some nuts from your diet." D) "Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones."

Which of the following clients would be considered to have a significant risk of developing the prerenal form of acute renal failure? Select all that apply. A) A 22-year-old male who has lost large amounts of blood following a workplace injury B) A 41-year-old female who is admitted for intravenous antibiotic treatment of pyelonephritis C) A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure D) A 20-year-old male who is admitted for treatment of an overdose of a nephrotoxic drug E) A 68-year-old male with a diagnosis of benign prostatic hyperplasia (BPH) F) An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

A) A 22-year-old male who has lost large amounts of blood following a workplace injury C) A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure F) An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

Of the following patient conditions, which patients would be at risk for experiencing a thyroid problem due to a decrease in thyroxine-binding globulin (TBG)? Select all that apply. A) A 55-year-old male with cirrhosis due to alcohol abuse B) A 47-year-old female experiencing hot flashes and excess diaphoresis related to menopause C) A 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) D) A 18-year-old female anorexia nervosa patient weighing 78 lb and has consumed no protein for the past 3 years

A) A 55-year-old male with cirrhosis due to alcohol abuse C) A 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) D) A 18-year-old female anorexia nervosa patient weighing 78 lb and has consumed no protein for the past 3 years

Of the following list of nursing interventions, which would be considered priority when managing a patient with life-threatening myxedematous coma? Select all that apply. A) Administer 3% sodium IV solution to increase sodium levels. B) Administer 50% dextrose to raise glucose levels. C) Place on oxygen therapy to encourage deep breathing. D) Place on a warming bed to raise body temperature. E) Administer sedatives frequently to prevent seizures.

A) Administer 3% sodium IV solution to increase sodium levels. B) Administer 50% dextrose to raise glucose levels. C) Place on oxygen therapy to encourage deep breathing.

A 4-year-old boy who has been deaf since birth and has bilateral cataracts has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the health care team's initial differential diagnosis most likely be? A) Alport syndrome B) Systemic lupus erythematosus glomerulonephritis C) Henoch-Schönlein purpura nephritis D) Immunoglobulin A nephropathy

A) Alport syndrome

7. Which of the following clients on a medical unit of a hospital is most likely to be experiencing health problems that may be attributable to kidney disease? A) An 81-year-old female client with osteoporosis and anemia B) A 77-year-old client with urinary retention due to benign prostatic hyperplasia (BPH) C) A 55-year-old woman with a recent stroke secondary to long-standing hypertension D) A 60-year-old man with a systemic fungal infection requiring intravenous antibiotics.

A) An 81-year-old female client with osteoporosis and anemia

For several years, a 39-year-old female has been averaging two to three bottles of wine each night after her children go to sleep and has included several ounces of brandy in recent years as well. Despite negative consequences to her career and the dissolution of her marriage, her drinking has culminated in a diagnosis of cirrhosis. Which of the following physical manifestations of the health problem would her care team anticipate? Select all that apply. A) Ascites B) Anorexia C) Fever D) Bleeding tendencies E) Epigastric pain F) Obesity

A) Ascites B) Anorexia D) Bleeding tendencies E) Epigastric pain

If the nurse suspects a spinal cord injury, the patient has developed autonomic dysreflexia. Which of the following assessments would confirm this complication? Select all that apply. A) BP 180/98 B) Skin covered with macular rash C) Pulse rate 49 D) Complains of a pounding headache E) Cold, cyanotic lower legs

A) BP 180/98 C) Pulse rate 49 D) Complains of a pounding headache

While speaking to a senior citizen club about osteoarthritis (OA), which of the following facts are accurate to share? Select all that apply. A) By the time you are in your 70s, about 85% of adults will have some form of OA B) Men usually get OA in their hands, whereas women get OA primarily in their hips C) Obesity in women has been correlated to having OA in the knees D) Heredity does not play a significant role in the development of OA

A) By the time you are in your 70s, about 85% of adults will have some form of OA C) Obesity in women has been correlated to having OA in the knees

A 42-year-old female client with a long-standing history of chronic nausea and vomiting but a near-insatiable appetite has had her symptoms attributed to an enzyme deficiency. Further diagnostic testing indicates that she has inadequate pancreatic enzyme levels and that her large appetite is due to a lack of enzyme control of food intake inhibition. In which of the following enzymes is the woman most likely deficient? A) Cholecystokinin B) Ghrelin C) Gastrin D) Secretin

A) Cholecystokinin

Which of the following medications used in the treatment of peptic ulcers and gastroesophageal reflux binds to H2 receptors and blocks the action of histamine on parietal cells? A) Cimetidine (Tagamet) B) Levbid (hyoscyamine) C) Lotronex (alosetron) D) Nexium (esomeprazole)

A) Cimetidine (Tagamet)

A patient has just been admitted to a nursing unit with the diagnosis of obstructive jaundice. Which of the following assessment findings would the nurse expect to see in this patient? Select all that apply. A) Clay-colored stools B) Dark urine C) Elevated conjugated bilirubin levels D) Decreased serum alkaline phosphatase levels E) Severe itching

A) Clay-colored stools B) Dark urine C) Elevated conjugated bilirubin levels E) Severe itching

A hospital client with a diagnosis of chronic renal failure has orders for measurement of her serum electrolyte levels three times per week. Which of the following statements best captures the relationship between renal failure and sodium regulation? A) Clients with advanced renal failure are prone to hyponatremia because of impaired tubular reabsorption. B) Renal clients often require a sodium-restricted diet to minimize the excretion load on remaining nephrons. C) Clients with renal failure often maintain high sodium levels because of decreased excretion. D) Restricting sodium intake helps to preserve nephron function and has the additional benefit of lowering blood pressure.

A) Clients with advanced renal failure are prone to hyponatremia because of impaired tubular reabsorption.

The parents of an active 9-year-old are leaving the emergency department (ED) following cast placement for their son's lower extremity as a result of a fall in soccer. The nurse should emphasize that assessment of the cast is important and that they should bring their son back to the ED if they note which of the following signs and symptoms? Select all that apply. A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg. C) Swelling in the lower leg has remained the same since they left the ED 12 hours ago. D) Pulses are palpable below the level of the cast. E) Bruising noted in the lower foot and toes.

A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg.

A patient has been admitted with a fractured pelvis that occurred in an auto accident just a few hours ago. The nurse notices a slight change in behavior. Which of the following clinical manifestations would lead the nurse to suspect that the patient has fat emboli that has migrated? Select all that apply. A) Complaints of substernal chest pain B) Complaints of pain in the lower abdomen and back C) Pulse rate 120 with temperature of 99.7°F D) Profuse diaphoresis with pallor noted E) Urine output of 30 mL/hour

A) Complaints of substernal chest pain C) Pulse rate 120 with temperature of 99.7°F D) Profuse diaphoresis with pallor noted

A 41-year-old woman was diagnosed with multiple sclerosis (MS) 7 years ago and is sharing her story with members of an MS support group, many of whom have been diagnosed recently. Which of the following aspects of her health problem should the woman warn others to expect at some point in the progression of the disease? Select all that apply. A) Debilitating fatigue B) Progressive loss of visual acuity C) Gradual development of a resting tremor D) Loss of mental acuity E) Shuffling gait

A) Debilitating fatigue B) Progressive loss of visual acuity D) Loss of mental acuity

A 22-year-old woman has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the woman expect over the course of recovery? Select all that apply. A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity D) Presence of infectious microorganisms in the synovial capsule E) Rapid restoration of the cartilage cells in the meniscus

A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity

The nurse should anticipate that a patient diagnosed with spastic bladder dysfunction may be prescribed which of the following medications that will help decrease detrusor muscle tone and increase bladder capacity? Select all that apply. A) Ditropan (Oxybutynin), an antimuscarinic drug B) Detrol LA (tolterodine tartrate), an antimuscarinic drug C) Uroxatral (alfuzosin), an -adrenergic antagonist D) Flomax (tamsulosin), an -blocker E) Bactrim (sulfamethoxazole and trimethoprim), antibiotics

A) Ditropan (Oxybutynin), an antimuscarinic drug B) Detrol LA (tolterodine tartrate), an antimuscarinic drug

When educating the patient with ankylosing spondylitis, the nurse should emphasize which of the following treatment interventions? Select all that apply. A) Encourage sleeping supine on an extra firm mattress if possible. B) Prop self up in bed with extra pillows if having respiratory congestion. C) Try using the heating pad prior to exercise to help stretching and improve movement. D) Wear a knee immobilizer while biking to facilitate ability to exercise for longer periods. E) Modify diet to include more protein from red meats and green vegetables for vitamin K.

A) Encourage sleeping supine on an extra firm mattress if possible. C) Try using the heating pad prior to exercise to help stretching and improve movement.

A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the client's liver and diagnostic results would the care team most likely anticipate? A) Hepatocellular necrosis evidenced by increased ALT and AST levels B) Allergic inflammation accompanied by an increase in serum IgE and basophils C) Cholestatic reaction with increased bilirubin count D) Rapid onset of hepatitis and increased GGT, ALT, and bilirubin

A) Hepatocellular necrosis evidenced by increased ALT and AST levels

A 73-year-old man presents to his family physician with complaints of recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which of the following clinical consequences would his care provider expect prior to the resolution of his health problem? A) Hydroureter and pain B) Development of renal calculi and renal cysts C) Unilateral hydronephrosis and pain D) Development of glomerulonephritis or nephrotic syndrome

A) Hydroureter and pain

A 68-year-old woman with a new onset of vascular dementia has recently begun retaining urine. Which of the following physiological phenomena would her care providers most realistically expect to currently occur as a result of her urinary retention? A) Hypertrophy of the bladder muscle and increased bladder wall thickness B) Decreased urine production and nitrogenous waste excretion by the kidneys C) Decompensation, bladder stretching, and high residual urine volume D) Overflow incontinence and loss of contraction power

A) Hypertrophy of the bladder muscle and increased bladder wall thickness

A female tennis player has suffered an injury to her shoulder that has affected her bursae in the joint. Which of the following consequences would be most expected from this aspect of her injury? A) Increased friction on the tendons of the shoulder joint B) Direct contact between the humerus and scapula bones C) Loss of connection between the humerus bone and biceps muscle. D) Fusing of the head of the humerus with the glenoid capsule of the scapula.

A) Increased friction on the tendons of the shoulder joint

Testing for short stature growth hormone (GH) problems can be done by pharmacologic means. Which of the following medications can be utilized to test for a rise in GH? Select all that apply. A) Insulin B) Levodopa C) Persantine D) Dobutamine E) Sestamibi

A) Insulin B) Levodopa

A brain tumor causing clinical manifestations of headache, nausea, projectile vomiting, and mental changes is likely located in which parts of the brain? Select all that apply. A) Intra-axially B) Extra-axially C) Brain stem D) Temporal lobe E) Frontal lobe

A) Intra-axially B) Extra-axially E) Frontal lobe

When educating the patient about possible treatments following surgery for bladder cancer, the nurse might include which of the following chemotherapy options? Select all that apply. A) Intravesical chemotherapy with doxorubicin (Adriamycin) B) Intravenous chemotherapy with at least three agents C) Bacillus Calmette-Guérin (BCG) vaccine D) Endocan, a tumor angiogenesis inhibitor

A) Intravesical chemotherapy with doxorubicin (Adriamycin) C) Bacillus Calmette-Guérin (BCG) vaccine D) Endocan, a tumor angiogenesis inhibitor

While living and hiking in the Rocky Mountains, a gentleman slipped and fell. He goes to an urgent care where an x-ray was done, and some blood was drawn for a CBC. The clinic informs him that he is anemic. What may contribute to this person's anemia? Select all that apply. A) Living in a high altitude B) Tissue hypoxia C) Inability to manufacture erythropoietin D) Destruction of RBCs caused by natural killer cells E) Dehydration

A) Living in a high altitude B) Tissue hypoxia C) Inability to manufacture erythropoietin

Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis? A) Loss of motion in the spinal column and eventual kyphosis B) A progressive loss of range of motion in the knee and hip joints C) A facial "butterfly rash" and multiorgan involvement D) Decreased bone density in long bones

A) Loss of motion in the spinal column and eventual kyphosis

The nurse knows that a diabetic patient admitted for a lower limb infection likely is experiencing which of the following pathophysiologic principles listed below? Select all that apply. A) Many diabetic patients have sensory deficits and ignore minor trauma just because they can't feel it in their feet. B) Patients with chronic diabetes may have vascular problems that impair circulation, and therefore cells needed for adequate inflammatory response cannot reach the site. C) Hyperglycemia may provide an environment that enhances the growth of microorganisms. D) Infections happen to all age groups and people, and the diabetic patient has the same risk for developing an infection as other patients without diabetes. E) Any exercise that creates diaphoresis in the feet can cause a fungal infection in diabetic patients.

A) Many diabetic patients have sensory deficits and ignore minor trauma just because they can't feel it in their feet. B) Patients with chronic diabetes may have vascular problems that impair circulation, and therefore cells needed for adequate inflammatory response cannot reach the site. C) Hyperglycemia may provide an environment that enhances the growth of microorganisms.

Which of the following diagnostic findings is likely to result in the most serious brain insult? A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP) B) Moderate decrease in brain tissue volume secondary to a brain tumor removal C) Increased ICP accompanied by hyperventilation D) High intracellular concentration of glutamate

A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

During a lecture about medication therapy for type 2 diabetic patients, the pharmacology instructor discusses side effects to monitor following subcutaneous injection of exenatide (Byetta), a glucagon-like peptide-1 (GLP-1) agonist. Of the following list, which signs and symptoms should the students be assessing in this patient? Select all that apply. A) Nausea B) Weight loss C) Dizziness D) Tachycardia E) Dehydration

A) Nausea B) Weight loss

A pediatric unit will be receiving an 8-day-old infant with a suspected congenital renal disorder. Which of the following renal abnormalities could be the possible cause? Select all that apply. A) One of the infant's kidneys may have failed to develop normally. B) The kidneys may be misshapen and have cysts present. C) The upper or lower poles of the two kidneys may be fused. D) Renal cell carcinoma may be present. E) Urine-filled dilation of renal pelvis associated with atrophy of the kidney may be present.

A) One of the infant's kidneys may have failed to develop normally. B) The kidneys may be misshapen and have cysts present. C) The upper or lower poles of the two kidneys may be fused.

A 13-year-old girl and her father come in to the local health clinic hoping to see an orthopedic doctor about the girl's stiff and warm knee. The father reports that she hurt it sliding into base during a softball game, and the daughter concurs, but with further discussion, it becomes clear that the slide made an existing pain worse. Her knee had been stiff, warm, and shiny and had been keeping her awake at night for a week or so before the game. Which of the following might be the cause of the girl's symptoms? A) Osteosarcoma B) Osteoma C) Chondroma D) Osteochondroma

A) Osteosarcoma

When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which of the following medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply. A) Penicillin B) Aspirin C) Morphine sulfate D) Potassium chloride E) Sodium chloride

A) Penicillin B) Aspirin C) Morphine sulfate

A boy has arrived home after experiencing his first outdoor camping trip with his Boy Scout troupe. Upon arrival at home, he is very uncomfortable and scratching at a rash. It appears that he contacted poison ivy and that it has spread to many areas on his body. The nurse in the clinic will likely prescribe which of the following treatment measures for this child? Select all that apply. A) Prescription for corticosteroids. B) Cool showers especially right before bedtime. C) Over-the-counter antihistamines. D) Occlusive ointments with high petroleum content.

A) Prescription for corticosteroids. B) Cool showers especially right before bedtime. C) Over-the-counter antihistamines.

A nurse practitioner student is trying to distinguish the various rashes they will be seeing in their pediatric rotation. Their nurse preceptor is assisting by describing the rash associated with rubeola. Which of the following characteristics would apply to rubeola? Select all that apply. A) Rash is macular and blotchy. B) Maculopapular rash covering the trunk and spreading to the appendages. C) The rash usually begins on the face and then spreads to the legs/arms. D) The rash forms vesicles with depressed centers that are filled with yellow-colored fluid. E) The painful rash follows a nerve root usually on only one side of the body.

A) Rash is macular and blotchy. C) The rash usually begins on the face and then spreads to the legs/arms.

Which of the following phenomena contributes to the difficulties with absorption, distribution, and elimination of drugs that are associated with kidney disease? A) Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug. B) Acute tubular necrosis is associated with impaired drug reabsorption through the tubular epithelium. C) Decreased retention by the kidneys often renders normal drug dosages ineffective. D) Dialysis removes active metabolites from circulation minimizing therapeutic effect.

A) Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.

Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system? A) Second messengers act as the intracellular signal that responds to the presence of a hormone. B) Endocrine-producing cells must release both a hormone and a second messenger in order to exert a distant effect. C) Second messengers act to supplement hormone effects on cell receptors when the desired hormonal effect must be either increased. D) Second messengers provide an alternative pathway for endocrine effects on a cell that bypass the normal receptor pathways.

A) Second messengers act as the intracellular signal that responds to the presence of a hormone.

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply. A) Secretion of mucus to lubricate and protect the inner surface of the alimentary canal B) Smooth muscle cells that facilitate movement of contents of the GI tract C) Holding the organs in place and storage of fats D) Barrier to prevent the entry of pathogenic organisms E) A cushioning to protect against injury from sports or car accidents

A) Secretion of mucus to lubricate and protect the inner surface of the alimentary canal D) Barrier to prevent the entry of pathogenic organisms

A female client with suspected glomerular disease has been referred to a nephrologist. The nurse knows that which of the following clinical manifestations may be present with the diagnosis of acute nephritic syndrome? Select all that apply. A) Sudden onset of hematuria B) Proteinuria C) Flank pain D) Excess urine output E) Edema

A) Sudden onset of hematuria B) Proteinuria E) Edema

A 17-year-old male experienced third-degree full-thickness burns 2 days ago to his lower limbs after a fire at his workplace. Which of the following complications should his care team foresee and regularly assess for? Select all that apply. A) Systemic infection B) Fluid volume deficit C) Respiratory dysfunction D) Hypermetabolic response E) Constipation and bowel obstruction

A) Systemic infection B) Fluid volume deficit C) Respiratory dysfunction D) Hypermetabolic response E) Constipation and bowel obstructio

Parents have brought their 7-year-old child into the emergency room with abdominal pain. Which of the following clinical manifestations would lead the health care team to suspect the child has appendicitis? Select all that apply. A) Tenderness in right lower quadrant with palpation B) Rebound tenderness in inguinal areas with palpation C) Redness and warmth over right lower quadrant D) Bloating and flatulence noticeable E) Urine has the smell of stool with brown coloring

A) Tenderness in right lower quadrant with palpation B) Rebound tenderness in inguinal areas with palpation

Following bone density scanning and diagnostic imaging, a 4-year-old boy has been diagnosed with Legg-Calvé-Perthes disease. Which of the following findings, signs, and symptoms would lead clinicians to this conclusion? Select all that apply. A) The boy has significant difficulty in walking. B) The boy's feet toe-in when standing upright. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic. E) There are numerous microfractures where his patellar tendon and tibia articulate.

A) The boy has significant difficulty in walking. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic.

A 54-year-old male who lives alone and has poorly controlled type 1 diabetes has been admitted to hospital for treatment of sepsis resulting from a chronic foot ulcer. Which of the other findings from the man's admission assessment and history would his care team likely to attribute to his diabetes? Select all that apply. A) The client complains of bloating after eating a meal and states that he is unable to eat much food at any one sitting. B) The man's resting heart rate is noted to be irregular. C) He states that his bowel movements are almost always loose. D) The client states that he has been unable to maintain an erection in recent years. E) Crackles are audible in his lower lung fields bilaterally. F) The man's temperature is 38.2°C (100.8°F) orally.

A) The client complains of bloating after eating a meal and states that he is unable to eat much food at any one sitting. C) He states that his bowel movements are almost always loose. D) The client states that he has been unable to maintain an erection in recent years.

A physician is attempting a differential diagnosis of a 30-year-old female who is suspected of having systemic lupus erythematosus (SLE). Which of the following aspects of the physician's assessment and the client's history would be considered potentially indicative of SLE? Select all that apply. A) The client has a "butterfly rash" on her nose and cheeks. B) She complains of intermittent joint pain. C) The woman states that she has numerous environmental allergies. D) The client has been hospitalized twice in the past for pleural effusions. E) Blood work indicates low red cells, white cells, and platelets.

A) The client has a "butterfly rash" on her nose and cheeks. B) She complains of intermittent joint pain. D) The client has been hospitalized twice in the past for pleural effusions. E) Blood work indicates low red cells, white cells, and platelets.

A male newborn infant has been diagnosed with spina bifida occulta. Which of the following pathophysiological processes has most likely contributed to the infant's health problem? A) The neural groove failed to fuse and completely close across the top of the neural plate. B) The infant's spinal cord and meninges protrude through his skin. C) The child's central and peripheral nervous systems have insufficiently differentiated during embryonic development. D) The infant's soma and viscera are underdeveloped.

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

A number of clients on a geriatric subacute medical floor of a hospital have developed foul-smelling diarrhea over the last several days, and subsequent culture of stool samples has confirmed the presence of Clostridium difficile in each case. The care team in the unit would recognize that which of the following factors likely contributed to the health problem and would anticipate which of the following treatments? A) The use of broad-spectrum antibiotics likely played a role in the development of infections, and most clients would likely receive metronidazole as a treatment. B) Genetic predisposition and the presence of the bacterium in clients' normal flora likely contributed, and treatment would consist of broad-spectrum antibiotics. C) Poor hand washing practice on the part of care providers led to the outbreak, and treatment will consist of hydration and nutritional support. D) Ingestion of contaminated food probably contributed to the infections, and corticosteroids will be needed to treat them.

A) The use of broad-spectrum antibiotics likely played a role in the development of infections, and most clients would likely receive metronidazole as a treatment.

A female client who is suspected of having psoriasis. Which of the following aspects of the woman's history and her care provider's assessment would be potential contributors to her health problem? Select all that apply. A) The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension. B) She has been diagnosed with arthritis. C) The woman has a family history of diabetes. D) Skin trauma of any kind often precedes an outbreak. E) The woman has dark skin.

A) The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension. B) She has been diagnosed with arthritis. D) Skin trauma of any kind often precedes an outbreak.

Which of the following substances is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms? A) Water B) Sodium C) Phosphate D) Calcium

A) Water

Which of the following clinical manifestations would lead the nurse to suspect the renal failure patient is developing uremia? Select all that apply. A) Weakness and fatigue B) Lethargy and confusion C) Extreme itching D) Blood in urine E) Urine smell in the stool

A) Weakness and fatigue B) Lethargy and confusion C) Extreme itching

Following kidney transplantation, the patient is prescribed maintenance immunosuppressive therapy consisting of prednisone, azathioprine, and cyclosporine. Educating the patient about long-term maintenance on immunosuppressive therapy should include discussion of side effects that may include: (Select all that apply). A) cardiovascular complications. B) increased risk of developing cancer. C) nephrotoxicity of a newly transplanted kidney. D) development of moon face and buffalo hump. E) ringing or buzzing of the ears.

A) cardiovascular complications. B) increased risk of developing cancer.

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by A) decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials. B) increasing the peristaltic motion of the GI tract, thereby causing explosive diarrhea. C) increasing the amount of secretions being entered into each segment of the intestinal tract. D) signaling the vagus nerve to slow down motility and increase absorption of water from the large intestine.

A) decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials.

A 20-year-old has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which of the following aspects of the client's history would be considered to have contributed to his stroke? Select all that apply. The client A) is an African American male. B) takes iron supplements for the treatment of chronic anemia. C) blood pressure has historically been in the range of 150s/90s. D) was diagnosed with type 2 diabetes 8 years ago. E) takes corticosteroids for the treatment of rheumatoid arthritis.

A) is an African American male. C) blood pressure has historically been in the range of 150s/90s. D) was diagnosed with type 2 diabetes 8 years ago.

Which of the following clients in a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? An adult with A) low hemoglobin levels, low platelet levels, and spider angiomas present. B) blood pressure of 189/103, jaundice, and multiple thromboses. C) sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT. D) ascites, fever, and recent onset of atrial fibrillation.

A) low hemoglobin levels, low platelet levels, and spider angiomas present.

Child/parents are coming into the physician's office to get the results of some diagnostic testing relating to his knee pain and unusual stiffness and fatigue. The physician suspects the child may have slipped capital femoral epiphysis. The nurse should anticipate that the treatment will involve: Select all that apply. A) no weight bearing on the femur. B) bed rest. C) traction. D) injection of steroids into the joint. E) high dose of calcium supplements.

A) no weight bearing on the femur. B) bed rest. C) traction.

A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the patient that the venous blood supply to the penis is controlled by A) sacral parasympathetic fibers. B) the hypothalamus. C) the vagus nerve. D) postganglionic sympathetic neurons.

A) sacral parasympathetic fibers.

A dialysis technician is providing care for a client with chronic renal failure. The technician would recognize which of the following characteristics of healthy kidneys? Select all that apply. A) The kidneys are contained within the peritoneal cavity. B) Blood vessels, nerves, and ureters all connect with the kidney at the hilus. C) The medulla of the kidney contains the glomeruli. D) Each kidney consists of lobes, with each lobe comprised of nephrons. E) Each nephron contains several hundred glomeruli that perform filtration.

B) Blood vessels, nerves, and ureters all connect with the kidney at the hilus. D) Each kidney consists of lobes, with each lobe comprised of nephrons.

Which of the following statements about mesangial cells within the glomerulus is accurate? Select all that apply. a) Mesangial cells cover the entire amount of endothelial cells contained within the capillaries. b) have phagocytic properties that remove macromolecular materials. c) exhibit vasodilator properties to assist with increase in blood flow in times of stress. d) enlarge (hyperplasia) in response to glomerular diseases. are coiled and drain Bowman capsule.

B) have phagocytic properties that remove macromolecular materials. D) enlarge (hyperplasia) in response to glomerular diseases.

Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the emergency department with malaise, nausea, and "yellow eyes." Serology has confirmed a diagnosis of hepatitis A (HAV), to the shock of the client. What teaching is most appropriate for this client? A) "You can expect these symptoms to disappear after about 2 months, but you'll be a carrier of the disease indefinitely." B) "A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time." C) "You likely came in contact with blood or body fluids at some point, and you'll have to ensure no one is subsequently exposed to your own blood or body fluids." D) "You likely got this by way of what we call the 'fecal-oral' route; you will have chronic hepatitis now, but the symptoms can be controlled with medication."

B) "A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time."

A nurse is collecting a urine specimen prior to measuring the albumin level in a client's urine. A colleague questions the rationale for the test, stating, "I thought albumin was related to liver function, not kidney function." How can the nurse best respond to this statement? A) "Urine should normally be free of any proteins, and albumin is one of the more common proteins to be excreted in chronic renal failure." B) "Urine albumin levels are useful for diagnosing diabetic kidney disease." C) "A urine dipstick test will tell us exactly how much albumin is being spilled by the client's kidneys." D) "A urine test for albumin allows us to estimate the client's GFR quite accurately."

B) "Urine albumin levels are useful for diagnosing diabetic kidney disease."

A frantic mother brings her young child into the emergency department. She states that during the evening bath, she noticed a large mass in her child's abdomen. After diagnostic testing, the pediatrician tells the parents that their child has Wilms tumor, stage IV. After the doctor leaves the room, the parents ask the nurse, "What does this mean?" The nurse will respond, "Your child ('s) A) "has cancer in his stomach." B) "has cancer in the kidney that has spread most likely to his lungs." C) "will need to undergo surgery to remove both kidneys and then go on dialysis." D) "tumor can be easily treated with chemotherapy. We will start this soon."

B) "has cancer in the kidney that has spread most likely to his lungs."

Which of the following patients would the nurse expect to find woven bone scaffolding in place to facilitate healing? Select all that apply. A) A 14-year-old patient recovering from a head injury following a diving accident B) A 22-year-old patient recovering from an auto accident where he incurred a fracture of his femur C) An 85-year-old nursing home patient who is undergoing rehabilitation therapy for the arthritis in his knee D) A 55-year-old prostate cancer patient undergoing radiation therapy for bone metastasis

B) A 22-year-old patient recovering from an auto accident where he incurred a fracture of his femur D) A 55-year-old prostate cancer patient undergoing radiation therapy for bone metastasis

Which of the following patients scheduled for an interventional radiology procedure requiring administration of radiocontrast dye would be considered at high risk for nephrotoxicity? Select all that apply. A) A 14-year-old with severe abdominal pain B) A 25-year-old with a history of glomerular nephritis who is complaining of severe flank pain C) A 67-year-old diabetic undergoing diagnostic testing for new-onset proteinuria D) A 45-year-old with elevated liver enzymes possibly due to fatty liver cirrhosis E) A 53-year-old male undergoing biopsy for a suspicious "spot" on his chest x-ray

B) A 25-year-old with a history of glomerular nephritis who is complaining of severe flank pain C) A 67-year-old diabetic undergoing diagnostic testing for new-onset proteinuria

A nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which of the following individuals are at risk of developing urinary obstructions? Select all that apply. A) A 43-year-old male with an acid-base imbalance secondary to malnutrition B) A 29-year-old female, pregnant for the first time C) A 69-year-old female with anemia secondary to insufficient erythropoietin production D) A 70-year-old male with benign prostatic hyperplasia (BPH) E) A 58-year-old male with renal calculi F) A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

B) A 29-year-old female, pregnant for the first time D) A 70-year-old male with benign prostatic hyperplasia (BPH) E) A 58-year-old male with renal calculi F) A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

Which of the following individuals demonstrates a health problem with his or her axial skeleton? A) A 21-year-old male who fractured his humerus while snowboarding. B) A 40-year-old man who has a contusion to the left temporal bone of his skull following a motor vehicle accident. C) A 79-year-old female who has undergone hemiarthroplasty (hip replacement surgery). D) A 30-year-old pregnant woman who has a separated pubic symphysis.

B) A 40-year-old man who has a contusion to the left temporal bone of his skull following a motor vehicle accident.

Which of the following individuals are likely to display identified risk factors for the development of lower urinary tract obstruction? Select all that apply. A) A 32-year-old woman who had a healthy delivery of her third child 4 months ago B) A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) C) A 55-year-old man with diabetes who is receiving diuretic medications for the treatment of hypertension D) A 30-year-old woman who has been diagnosed with gonorrhea E) A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation F) A 20-year-old man who has spina bifida and consequent impaired mobility.

B) A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) D) A 30-year-old woman who has been diagnosed with gonorrhea E) A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation F) A 20-year-old man who has spina bifida and consequent impaired mobility.

Which of the following clients' diagnostic blood work is most suggestive of chronic kidney disease (CKD)? A) A client with high pH; low levels of calcium; and low levels of phosphate B) A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels C) A client with low bone density; low levels of calcium; and low levels of phosphate D) A client with low potassium levels; low calcitriol levels; and increased PTH levels

B) A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels

A 26-year-old female is resting after a one-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced? A) A myoclonic seizure B) A tonic-clonic seizure C) An absence seizure D) A complex partial seizure

B) A tonic-clonic seizure

A 43-year-old male client has presented to the emergency department with vomiting that he claims is of a sudden onset. The client also states that the emesis has often contained frank blood in the hours prior to admission. His vital signs are stable with temperature 98.3°F, pulse 88, BP 140/87, and respiratory rate 18. Which of the following potential contributing factors would the health care team suspect first? A) Overuse of antacids B) Alcohol consumption C) Staphylococcal enterotoxins D) Effects of Helicobacter pylori

B) Alcohol consumption

Which of the following statements best conveys an aspect of the role of cerebrospinal fluid (CSF)? A) It provides physical protection for the brain and ensures that leukocytes and erythrocytes are evenly distributed in the CNS. B) CSF cushions the brain and provides a near-water medium for diffusion of nutrients. C) CSF distributes plasma proteins throughout the superficial gray matter of the CNS. D) It ensures that the high metabolic and oxygenation needs of the brain are met, as well as absorbing physical shocks.

B) CSF cushions the brain and provides a near-water medium for diffusion of nutrients.

An 81-year-old woman has noted a gradual decrease in the moisture of her skin over many years. Which phenomena associated with the aging process are known to contribute to her xerosis? Select all that apply. A) Separation of the basement membrane from adjacent dermal and epidermal layers B) Changing composition of sebaceous gland secretions C) Flattening of the dermal rete ridges D) Decreased moisture secretions from sweat glands E) Decrease in skin capillaries

B) Changing composition of sebaceous gland secretions C) Flattening of the dermal rete ridges D) Decreased moisture secretions from sweat glands E) Decrease in skin capillaries

Which of the following facts accounts for the variation in skin tone that exists between individuals? A) Someone with dark skin has more melanocytes in his or her skin layers. B) Darker-skinned individuals have melanosomes that produce melanin faster. C) Dark skin is associated with spherical melanosomes, which produce and "package" pigment differently. D) Greater numbers of keratinocytes result in darker skin tone.

B) Darker-skinned individuals have melanosomes that produce melanin faster.

Following exposure to poison oak while camping, a 20-year-old male is experiencing pruritus as a consequence of his immune response to irritants in the plant. What physiological process best accounts for his complaint? A) His body is communicating a low-level pain response as a protective measure. B) Free nerve endings are initiating an itch-specific signal to the somatosensory cortex. C) Local irritation of Langerhans cells is sending signals by way of myelinated type C nerve fibers. D) Ruffini corpuscles are transmitting the message of pruritus to the cerebral cortex.

B) Free nerve endings are initiating an itch-specific signal to the somatosensory cortex.

During pathophysiology class, a nursing student asks the faculty what purpose do the osteoprogenitor cells serve. From the following list, identify the purpose of these cells. Select all that apply. A) Formation of red blood cells B) Growth and remodeling of bone C) Anchorage point for blood vessels D) Repair of bone E) Supply nerves to the bone matrix

B) Growth and remodeling of bone D) Repair of bone

An infant born with congenital hypothyroidism and has not sought care from any health care provider is likely to develop which of the following complications? Select all that apply. A) Deformed joints and bone spurs B) Impaired physical growth C) Mental retardation D) Loss of fine motor control and arthritis E) Down syndrome

B) Impaired physical growth C) Mental retardation

Which of the following lab results would be associated with abnormalities in kidney function? Select all that apply. A) An absence of protein in a urine sample B) Increased creatinine levels C) Urine gravity of 1.038 and normal serum creatinine levels D) Decreased blood urea nitrogen (BUN) level E) Detectable levels of glucose in a urine sample F) Elevated cystatin-C level.

B) Increased creatinine levels E) Detectable levels of glucose in a urine sample F) Elevated cystatin-C level.

A 9-year-old boy has been diagnosed with the nephrotic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options. A) Hypoalbuminemia B) Increased glomerular membrane permeability C) Decreased colloidal osmotic pressure D) Proteins escape from the plasma to the glomerular filtrate E) Accumulation of fluid in the interstitial tissue (edema)

B) Increased glomerular membrane permeability D) Proteins escape from the plasma to the glomerular filtrate A) Hypoalbuminemia C) Decreased colloidal osmotic pressure E) Accumulation of fluid in the interstitial tissue (edema)

The nurse knows which of the following phenomena listed below is an accurate statement about axonal transport? A) Anterograde and retrograde axonal transport allow for the communication of nerve impulses between the neuron and the central nervous system (CNS). B) Materials can be transported to the nerve terminal by either a fast or slow component. C) The unidirectional nature of the axonal transport system protects the CNS against potential pathogens. D) Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

B) Materials can be transported to the nerve terminal by either a fast or slow component.

Following an injury where a child hit his head from a fall, the CT scan reveals a contusion that the doctor classifies as a moderate brain injury. Which of the following manifestations will the nurse more than likely assess on this child that support this diagnosis? Select all that apply. A) Coma with total paralysis B) Periods of unconsciousness C) Aphasia at times D) Nuchal rigidity E) Weakness or slight paralysis affecting one side of the body

B) Periods of unconsciousness C) Aphasia at times E) Weakness or slight paralysis affecting one side of the body

The nurse is caring for a patient in the hospital for pneumonia but also has a severe case of psoriasis that is being treated with methotrexate. During the morning assessments, which of the following lab values would alert the nurse that the patient may be experiencing a side effect to this medication? Select all that apply. A) Serum potassium (K+) level 3.6 mmol/L B) Platelet count 37 × 103/µL C) Alanine aminotransferase (ALT) 28 units/L D) White blood cell count 1.2 × 103/µL

B) Platelet count 37 × 103/µL D) White blood cell count 1.2 × 103/µL

A few of the more experienced nurses are sitting around a lunch table discussing the changes they are seeing in their skin. Which of the following would be considered normal age-related changes? Select all that apply. A) Thickening of the dermis layer. B) Reduction in subcutaneous tissue. C) Increased hair growth on back and legs. D) Dry, scaly skin.

B) Reduction in subcutaneous tissue. D) Dry, scaly skin.

A 51-year-old woman diagnosed with a cerebrovascular accident (CVA) 5 months prior is distressed that she has had several recent episodes of urinary incontinence. She has asked her nurse practitioner why this is the case. Which of the following statements best captures the fact that would underlie the nurse's response to the client? A) Neurological diseases like MS often result in flaccid bladder dysfunction. B) She may be unable to sense her bladder filling as a result of her MS. C) Lesions to the basal ganglia or extrapyramidal tract associated with MS inhibit detrusor contraction. D) Pathological reductions in bladder volume brought on my MS necessitate frequent micturition.

B) She may be unable to sense her bladder filling as a result of her MS.

A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? A) The client has decreased deep tendon reflexes. B) The client displays increased muscle tone. C) The client's muscles appear atrophied. D) The client displays weakness in the distal portions of his limbs.

B) The client displays increased muscle tone.

Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system? A) Adrenocorticotropic hormone (ACTH) released by the hypothalamus controls to release of cortisol. B) The pituitary gland communicates with the adrenal cortex through the release of ACTH. C) The adrenal cortex receives corticotrophin-releasing hormone (CRH) and in turn releases cortisol. D) The pituitary gland causes a release of CRH from the hypothalamus, which promotes hormone release from the adrenal cortex.

B) The pituitary gland communicates with the adrenal cortex through the release of ACTH.

Which of the following statements best captures an aspect of the process of fat digestion and absorption? A) Ingested triglycerides are broken down into absorbable form by gastric lipase. B) Triglycerides are digested with the aid of bile salts. C) Long-chain fatty acids are absorbed directly into the portal blood. D) Stool is not excreted until all fat is absorbed.

B) Triglycerides are digested with the aid of bile salts.