Patho Test 4
A nurse is concerned about a client's continual use of nonsteroidal anti-inflammatory drugs (NSAIDs). Which problematic occurrence is the nurse concerned about?
Damage to the gastric mucosa
A nurse documents that the client has "steatorrhea." What did the nurse most likely assess?
fatty stools
What is the most common cancer of the kidney?
Renal cell carcinoma
When the glomerular transport maximum for blood glucose is exceeded and its renal threshold has been reached, what happens to the excess glucose?
Spills into the urine
The nurse teaches the client that which of these contributed to the development of acute cholelithiasis?
Stasis of bile
Which clinical manifestation would lead the nurse to suspect the client has malabsorption syndrome with a deficiency in fat absorption?
Steatorrhea
(T/F) Consequences of chronic kidney disease include fluid and electrolyte imbalances, skeletal disorders, and alterations in cardiovascular function.
True
A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?
short- acting
During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will:
stimulate the release of secretin, which then inhibits release of gastrin.
Which option identifies the function of the kidneys in maintaining normal composition of internal body fluids?
Filtration and reabsorption of physiologically essential substances
Hormones are chemical messengers that provide which function in the body?
Regulate body functions
Tubular defects that inhibit the reabsorption of bicarbonate or excretion of hydrogen ions may result in what?
Renal tubular acidosis
The nurse assessing a client with a diagnosis of cholelithiasis will look for pain in which area?
Right upper quadrant
The nurse is performing physical assessment of the gastrointestinal tract. In which area does the nurse place the hands for palpation of the liver?
Right upper quadrant
Which types of cells are supporting cells of the peripheral nervous system?
Schwann cells
The results of a client's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as:
Steatorrhea
Gastrin production, a task that is performed by the stomach, results in which effect?
Stimulation of gastric acid secretion by parietal cells
When the urologist wants to directly visualize the bladder, urethra, and ureteral orifices, what diagnostic test would he use?
cystoscopy
The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?
dietary protein
Several urine tests can be useful in establishing a diagnosis of acute renal failure (ARF). The nurse must consider that fractional excretion of sodium can be particularly affected by administration of which type of drug?
diuretics
Which of the meninges provides the major protection for the brain and spinal cord?
dura mater
Swallowing moves food from the mouth to the stomach through where?
esophagus
(T/F) Afferent neurons carry information from the central nervous system.
false
(T/F) An overactive thyroid gland contributes to a lowered metabolism.
false
(T/F) Aspirin and NSAIDs are responsible for most instances of hiatal hernia.
false
(T/F) Each of the 10 cranial nerves corresponds to specific motor and sensory functions.
false
(T/F) Most hormones are only present in body fluids at times when their action is required by the needs of the body.
false
(T/F) Most ulcers are the result of psychological stress.
false
(T/F) The adrenal cortex produces the hormones primarily responsible for regulation of physical growth and development.
false
(T/F) The most serious consequence of pancreatitis is a sharp increase in blood glucose levels.
false
(T/F) The number of hormone receptors on a body cell is determined during cell development and is static.
false
(T/F) The process of digestion begins in the stomach and finishes in the large intestine.
false
(T/F) The prognosis for individuals with cancer of the esophagus is much better than the prognosis for most other carcinomas.
false
(T/F) The small intestine constitutes the lower part of the gastrointestinal tract.
false
The swallowing reflex is an entirely voluntary activity.
false
The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance?
fats
A client with a history of cancer that metastasized to the liver has arrived at the outpatient clinic to have a paracentesis performed. The physician anticipates that the client will have more than 5 L of fluid removed. The physician has prescribed intravenous albumin following the procedure. The client asks why she needs "more fluids in my vein." The nurse responds:
"Albumin is a volume expander. Since a lot of fluid was removed, you have a decrease in your vascular volume, so without this albumin, your kidneys will try to reabsorb and hold onto water."
The gastrointestinal laboratory nurse is learning about small intestine secretions. Which explanation is most accurate?
"An extensive array of mucus-producing glands, called Brunner glands, is concentrated where contents from the stomach and secretions from the liver and pancreas enter the duodenum."
A client with diabetes mellitus states, "I can eat as many carbohydrates as I want and it will not affect my blood sugar." What is the nurse's best response?
"Carbohydrates are broken down into monosaccharides before being absorbed."
A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happened. The nurse states:
"For unknown reasons, you lose intrapleural negative pressure. This means your lungs collapsed and expelled its air when you lose negative pressure."
A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor?
"Make an appointment with your health care provider immediately."
Which factor is likely to result in decreased renal blood flow?
Stimulation of the sympathetic nervous system
A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?
Stimulation testing
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.
Stimulation tests
Which type of nervous system response can cause a marked decrease in mucous production, leaving the area susceptible to irritation, thereby causing ulcer development in the durodenum?
Sympathetic stimulation
What kind of tumor is the most common abdominal malignancy in children?
Wilms
(T/F) Transplantation is a low-success treatment option for liver disease and one that can only address a few specific liver pathologies.
false
A client is scheduled for a creatinine clearance test to measure the glomerular filtration rate (GFR). The client asks the nurse what this test is used for. What is the nurse's best response?
"This test provides a gauge of renal function."
The nurse is caring for a client who is a carrier of hepatitis B. Which of these does the nurse teach the family?
"Your loved one may not look ill, but the virus is present in his blood."
A client has just begun to experience an ischemic stroke. The blood supply from the middle cerebral artery is being blocked by a large blood clot. How long before brain cells begin to die due to lack of ATP?
4 to 6 minutes
The nervous system can be broadly divided into which two nervous systems?
-central and peripheral
The nurse is reviewing assessment data and determines which client is at highest risk for developing type 2 diabetes?
A 45-year-old obese female with a sedentary lifestyle
Select the client at greatest risk for developing colorectal cancer.
A 64-year-old female whose mother had colorectal cancer
A geriatric nurse is caring for several clients. Which alterations in health should the nurse attribute to age-related physiologic changes?
A 78-year-old woman's GFR has been steadily declining over several years.
Which client is likely at the greatest risk of developing a urinary tract infection?
A 79-year-old client with an indwelling catheter
A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?
A middle aged obese adult with a sedentary lifestyle
Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?
ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.
What is the process of moving nutrients and other materials from the external environment of the GI tract into the internal environment?
Absorption
A client has begun to display manifestations of hepatic encephalopathy. The family is concerned and asks the nurse what caused this condition to develop. Which is the best response by the nurse?
Accumulation of ammonia in the blood
What type of renal failure is caused by conditions that produce a sudden shutdown in renal function?
Acute
A client with history of alcohol abuse is brought to the emergency department after a weekend of heavy drinking, experiencing right upper quadrant pain, anorexia, nausea, jaundice and ascites. The nurse identifies these as manifestations of what disorder?
Alcoholic hepatitis
The nurse is caring for a client who is now 2 days post near-drowning. The focused assessment would involve which area of the lung involved in gas exchange?
Alveoli
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:
Anterior pituitary gland
An older adult client presents with loose mucousy stools. The nurse suspects the client has Clostridium difficile. What is a priority assessment for the nurse?
Ask the client about his or her antibiotic use.
A client has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the client's wife that care must be taken with eating to prevent:
Aspiration pneumonia
When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism?
Autoimmune destruction of pancreatic beta cells
What nervous system regulates, adjusts, and coordinates the visceral functions of the body?
Autonomic
Symptoms of gastric cancer include vague epigastric pain, which makes early detection difficult. The nurse would expect a client to undergo which diagnostic examination to determine the location of the gastric cancer?
Barium x-ray
The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal failure?
Baseline urine output of 50 mL/hr that is now 10 mL/hr
The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?
Beta cells
A practitioner is preparing to do a lumbar puncture on a client with suspected meningitis. Which area on the spine does the practitioner choose to obtain a cerebrospinal fluid (CSF) sample?
Between L3 and L4
A client with a history of chronic kidney disease (CKD) is experiencing increasing fatigue, lethargy, and activity intolerance. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. Which laboratory assessments will mostlikely be prescirbed to help determine the cause of these new symptoms?
Blood work for hemoglobin, red blood cells, and hematocrit
A nurse educator is explaining basic neuroanatomy to a class of prospective nursing students. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?
CSF cushions the brain and provides a near-water medium for diffusion of nutrients.
Which statement is true concerning the digestion of carbohydrates?
Carbohydrates are broken down into monosaccharides before being absorbed.
While discussing carbon dioxide transport within the body, the instructor asks, "What enzyme helps carbon dioxide with water to form bicarbonate?" Which student response is correct?
Carbonic anhydrase
When caring for the client with pancreatic cancer, for which of these signs and symptoms does the nurse assess?
Central abdominal pain, jaundice, and weight loss
All diseases have risk factors. What is the most significant environmental risk factor for pancreatic cancer?
Cigarette smoking
An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?
Colonization of Clostridium difficile
Select the function of the occipital lobe.
Color, motion, and depth perception
An older adult client expresses concern about straining to pass stools that are small and hard. What term will the health care provider use to document this in this client's chart?
Constipation
The thick area of myelinated axons that connects the two sides of the cerebral cortex is known as which component?
Corpus callosum
A 24-year-old woman undergoing a screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which treatment is most likely to be effective for her?
Corticosteroids and immunosuppressant drugs
The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?
Cretinism
What syndrome is the diagnosis is most commonly associated with glucocorticoid excess?
Cushing
A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism?
Decreased thyroid-stimulating hormone (TSH)
Select the primary function of bronchial circulation.
Delivers the blood supply for the conducting airways and supporting structures
An adult client presents to the emergency department after an episode of syncope. Blood pressure is low and the pulse is thready and rapid. The client frequently voids large amounts of pale, clear urine. Lung sounds are clear and skin turgor is inelastic. Which endocrine disorder is the likely cause of these manifestations?
Diabetes insipidus
What are drugs that increase the volume of urine?
Diuretics
The nurse is caring for a client with prolonged growth hormone excess who is exhibiting syncope. What laboratory finding does the nurse recognize as consistent with this diagnosis?
Elevated blood glucose levels
Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on:
Eradicating Helicobacter pylori (H. pylori)
Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.
Escherichia coli
The nurse is caring for a client with a condition of deficiency of antidiuretic hormone (ADH). When assessing the client, which finding does the nurse anticipate?
Excessive urine output
The physiologic rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes:
Facilitating the absorption of osmotically active particles
(T/F) Damage to the functional structures of the kidneys themselves is likely to result in prerenal failure.
False
(T/F) Normal urine contains metabolic wastes, plasma proteins, and glucose molecules.
False
A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be:
Fistula formation
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:
Fistula formation
In clients with acute diarrhea, many require no treatment. However, the nurse knows the priority assessment in all clients with diarrhea is:
Fluid and electrolyte status
A family member asks the nurse, "What should I do if there is blood in my parent's urine and some pain in the lower abdomen?" Which response is the best advice to give this family member?
Get an appointment with the family doctor.
A student is comparing the actions of the gastrointestinal hormones. Which hormone acts as an appetite-stimulating signal?
Ghrelin
A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:
Glycosylated hemoglobin, hemoglobin A1C (HbA1C)
A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?
Helping the client make meaningful changes to his diet and activity level.
Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?
Hematuria
A health care provider suspects a client may have developed pancreatitis. Which laboratory value will confirm this diagnosis?
High serum amylase and lipase
Which statement best explains the function of hormone receptors?
Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?
Hormone stimulation
A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?
Hypertension
A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?
Hypothalamus
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
Neurotransmitters are small molecules that exert their actions through specific proteins, called receptors, embedded in the postsynaptic membrane. Where are neurotransmitters synthesized?
In the axon terminal
When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?
Increase in appetite
Ventilation is driven by which alteration in arterial blood?
Increased PCO2
The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?
Increased blood pressure
Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?
Increased blood pressure
A 45-year-old client with type 1 diabetes has just been admitted with osteomyelitis. Which reason for diabetic susceptibility to infection is the most significant?
Infections that are less serious in healthy people are often more virulent in people with diabetes due to hyperglycemia and glucosuria.
gastritis
Inflammation of the gastric mucosa
Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease?
Inflammatory suppression
What is an advantage of assessing hormone levels through collection of a 24-hour urine?
It does not require serum collection for an accurate reading.
Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct?
Kidneys convert inactive vitamin D to its active form, calcitriol.
The health care provider is performing a spinal tap on a client with suspected infection. The provider would perform the procedure at:
L3 or L4
The major sites where aldosterone exerts its action on sodium reabsorption and potassium regulation occur in which tubule location?
Late distal and cortical collecting tubule
The home care nurse is caring for a client who has sustained phrenic nerve damage from a skiing accident. The nurse understands that the client must be on a ventilator for which reason?
Loss of diaphragmatic function
The nurse is caring for a client with mediastinal carcinoma. Which body structures located in this area are responsible for filtering foreign particles from the interstitial spaces of the lungs to prevent the spread of this cancer?
Lymph nodes
Dyspnea is defined as an uncomfortable sensation or difficulty in breathing that is subjectively defined by the client. Which disease state is not characterized by dyspnea?
Multiple sclerosis
Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)?
Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month
What nervous system is responsible for bladder emptying?
Parasympathetic
The basis for assessing the function of any peripheral nerve lies in which principle?
Peripheral nerves contain processes of more than one of the four afferent and three efferent cell columns.
While assessing a peritoneal dialysis client in the home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as:
Peritonitis
A client with CKD is being treated for hyperphosphatemia and hypocalcemia. Select the mostappropriate interventions. Select all that apply.
Phosphate-binding antacids Activated vitamin D Restriction of foods high in phosphate
Which gland is often referred to as the master gland because it secretes many hormones?
Pituitary
The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?
Plasma proteins
A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?
Plasmapheresis
Which statement best describes the pressure that drives breathing?
Pressure in the pleural cavity
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?
Prevent accumulation
A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?
Prolactin
When there is a mismatching of ventilation and perfusion within the lung itself, insufficient ventilation occurs. What causes a physiologic right-to-left shunting of blood in the respiratory system?
Pulmonary insufficiency or heart failure
A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?
Random blood glucose 85 mg/dL (4.72 mmol/L)
Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?
Rank below 10% on the growth chart
A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which manifestation related to the necrosis of liver cells?
Rapid onset of jaundice
A client's primary care provider has prescribed a β-adrenergic receptor blocker. Which therapeutic effects do the client and care provider likely seek?
Reduction in heart rate and blood pressure
The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?
Serum creatinine
The nurse knows that a child with chronic kidney disease (CKD) may experience which manifestations? Select all that apply.
Severe growth deficit High bone turnover
The community health nurse is offering education about hepatitis. Which of these groups does the nurse relate are at risk for hepatitis C? Select all that apply.
Sexually active homosexual men Injection drug users
A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client?
Slow rewarming of the client to prevent vasodilation and vascular collapse
A nurse explains to her client that food is moved along the gastrointestinal (GI) tract with intermittent contractions that mix the food and move it along. These movements are found in which organ?
Small intestine
The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?
Smoking cessation program
A client has experienced severe hemorrhage and is in prerenal failure. The nurse anticipates the client's blood urea nitrogen (BUN) and serum creatinine laboratory results will be in which range?
The BUN-to-creatinine ratio is 20:1.
The nurse is performing a neurologic assessment on a client. Which assessment finding would the nurse determine is considered normal?
The client is able to swing arms when walking.
A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.
The client is achieving normal glycemic control.
A child is born with dwarfism to normal-sized parents. The physician is explaining how growth hormone (GH) plays a central role in the increase in stature that characterizes childhood and adolescence. What is the first step in the growth hormone chain of events?
The hypothalamus secretes GHRH.
A client with long-standing type 2 diabetes is surprised to see high blood sugar readings while recovering from an emergency surgery. Which factor may have contributed to the client's inordinately elevated blood glucose levels?
The stress of the event caused the release of adrenal cortical hormones.
A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?
There is possible obstruction in the urinary tract.
What is the function of the mucociliary blanket that lines the conducting airways?
To remove foreign materials
A nurse experiences a person having seizure activity in the grocery store. Once the seizure activity has subsided the nurse places the person in a side lying position to avoid occlusion of the airway, which could cause cessation of ventilation due to which of the following?
Tongue falling back and blocking the airway
A client with chronic kidney disease (CKD) will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate?
Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time.
(T/F) A flaccid bladder is characterized by an inability to empty itself of urine.
True
(T/F) Loss of bladder function can often be recovered by using drugs, by surgery, or by retraining.
Tue
Biopsy results reveal that a client has a deficient amount of parietal (oxyntic) cells in his stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:
Vitamin B12
The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which risk factor in the teaching?
Woman with a family history of diabetes
A child has been brought to an urgent care clinic. The parents state that the child is "not making water." When taking a history, the nurse learns the child had a sore throat about 1 week ago but seems to have gotten over it. "We [parents] only had to give antibiotics for 3 days for the throat to be better." The nurse should suspect the child has developed:
acute postinfectious glomerulonephritis.
What are common, neoplastic masses that protrude into the lumen of the gut?
adenomatous polyps
Fatty liver disease, hepatitis, and cirrhosis can all result from the high, long-term intake of what?
alcohol
Chronic kidney disease impacts many systems in the body. What is the most common hematologic disorder caused by CKD?
anemia
What action exists when a hormone exerts an action on the cells that produced it?
autocrine
One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. Because it is possible to get a false-positive result on these tests, the nurse would instruct the client to:
avoid nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 week prior to testing.
When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source?
brain
A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?
calcium
What must be broken down into simple sugars before they can be absorbed?
carbohydrates
A client with diabetes mellitus has sudden onset of slurred speech, incoordination, and cool, clammy skin. What will the nurse do first?
check blood glucose
What represents the end stage of chronic liver disease in which much of the functional liver tissue has been replaced by fibrous tissue?
cirrhosis
The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:
concentrate urine.
Renal replacement therapy includes dialysis and transplantation, whereas __________ treatment consists of measures to slow deterioration and maintain renal function.
conservative
A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will:
decrease
What process is controlled by the internal and external anal sphincters?
defecation
The nurse is explaining to the parents of a 23-week premature infant the reason their baby needs to be on mechanical ventilation. The education is successful when the parents state that they understand their baby was born before the type II alveolar cells could mature, which has caused a:
deficiency of surfactant.
A client's most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (12.85 mmol/L). Which factor may have contributed to this finding?
dehydration
A new client presents with elevated BUN, systemic edema, a BP of 145/93 mm Hg, recurrent infections, and a GFR of 51 mL/min/1.73 m2. Which treatment should the nurse anticipate?
dialysis
Herniations of the mucosal layer of the colon through the muscularis layer results in what?
diverticulosis
Cholelithiasis is commonly referred to as what?
gallstones
What is an inflammatory process involving glomerular structures, and the second leading cause of kidney failure?
glomerulonephritis
When caring for the client with proteinuria, the nurse recognizes that dysfunction in which structure of the kidney allows protein to leak into the urine?
glomerulus
What is a visible increase in the size of the thyroid gland and can be caused by either hyperthyroidism or hypothyroidism?
goiter
What hormone has multiple roles, including anti-insulin effects and effects on the length of linear bones and rates of cell division?
growth
Inflammation of the liver is more commonly known as what?
hepatitis
What regions is the brain divided into?
hindbrain, midbrain, forebrain
What can be characterized as chemical messengers that act either locally or on distant sites of action?
hormones
refers to the urine-filled dilation of the renal pelvis due to an obstruction
hydronephrosis
In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:
innervation of the sympathetic nervous system, causing constriction of the afferent arteriole.
What are crystalline structures formed from the components of urine known as?
kidney stones
A client tells the nurse that he experiences diarrhea after eating ice cream or cheese. The nurse tells the client he may have a deficiency of:
lactase
What does the equation C = ΔV/ΔP stand for?
lung compliance
Digestion of starch begins in which structure?
mouth
A client has been brought to the emergency department following an overdose of insulin that resulted in unconsciousness. When explaining the rationale for this to the family, the nurse will emphasize that neurons:
must rely on glucose from the blood to meet their energy needs.
Which is the primary component of white matter?
myelinated fibers
What are the basic functional units of the kidneys called?
nephrons
During embryonic development, which structure develops into the central nervous system (CNS)?
neural tube
What does disruption of the neural control of bladder function result in?
neurogenic bladder
Synaptic communication between neurons often involves the release and reception of what across the synaptic cleft?
neurotransmitters
Rapid removal of a neurotransmitter is necessary to maintain precise control of neural transmission. Which transmitter is largely removed by the reuptake process and taken back into the neuron in an unchanged form and reused?
norepinephrine
A nursing student studying pharmacology is learning how angiotensin converting enzyme inhibitors (ACE) work. The student is correct when stating that the mechanism of action of ACE inhibitors is to:
prevent conversion of angiotensin I to II.
A client has inhaled, drawing air into the oropharynx. From this location, air will:
proceed through the trachea, bronchi, and then bronchioles.
The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include:
protein in the urine.
The nurse recognizes that acute renal injury is characterized by which of the following?
rapid decline in renal function
Neurotransmitters exert their actions through specific proteins that are known as:
receptors
Target cells must have what that can recognize a hormone and translate the hormonal signal into a cellular response?
receptors
What protects, lubricates, has an antimicrobial effect, and contains enzymes that initiate the digestive process?
saliva
In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find:
significant decrease in urine output due to decrease in renal blood flow.
What is the name of when there is failure of the bladder to store urine?
spastic bladder
An individual has sensitivity to perfumes and experiences shortness of breath when exposed to them. This occurs because:
stimulation of irritant receptors causes bronchoconstriction.
A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:
surgery to release the bowel.
What hormone is central to the maintenance of body metabolism and growth and development in children?
thyroid
Helicobacter pylori proteobacteria cause peptic ulceration by producing which substance that interferes with local protection of gastric acid?
toxins
(T/F) A unique feature of the liver is that it has a dual blood supply.
true
(T/F) Adrenal insufficiency, or Addison disease, requires hormone replacement therapy.
true
(T/F) Bacterial infections of the intestines normally produce more severe effects than viral infections.
true
(T/F) Direct measurement of serum levels of particular hormones is not normally practical.
true
(T/F) Hepatitis B is considered a more serious health problem than hepatitis A.
true
(T/F) Hypofunction of the pituitary gland is associated with short stature.
true
(T/F) Primary defects in endocrine function originate in the target gland responsible for producing the hormone.
true
(T/F) Reflexes can be considered predictable responses to stimuli that are "wired in" to the central nervous system.
true
A young child is brought to the ER with CPR in progress. The parent found the child lying on the kitchen floor without respirations, although a heartbeat was initially detected. The triage nurse anticipates the most likely cause of the situation is an obstruction of the conducting airways that caused an interruption in:
ventilation
Colonic microorganisms play a role in the synthesis of which vitamin?
vitamin K
Which type of reflex is stimulated by a nociceptive stimulus?
withdrawal reflex
What is the most common mechanism of hormone control?
Negative feedback
(T/F) The kidneys are particularly resistant to damage from drug exposure.
False
(T/F) The majority of reabsorption occurs in the efferent arteriole.
False
A client with chronic kidney disease who has renal osteodystrophy should be assessed for which complications? Select all that apply.
Muscle weakness Bone pain Stress fractures
Consistently ignoring the urge to defecate can result in what?
constipation
In a blood sample, what is the most reliable indicator of glomerular filtration rate?
creatinine
Spinal nerves form complicated networks called what where different nerve branches intermix?
plexuses
A client in 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. The client asks the nurse why the test is necessary since the client provided a single urine sample two days prior. How could the nurse best respond?
"Often when an abnormal substance shows up in a urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."
While studying for a renal test in pathophysiology class, a student helps a peer by reviewing facts about the cells of the proximal tubule. Which functions should be included in this discussion? Select all that apply.
Aids in reabsorption Rich in mitochondria Supports active transport processes
A client is admitted with a diagnosis of pulmonary embolism (PE) associated with severe dyspnea for the past week. The nurse would explain that which of the following is the most likely cause for the dyspnea? Select all that apply.
Impaired gas exchange Ventilation/perfusion mismatch Increased dead space Impaired alveolar blood flow
When caring for the client with Laennec cirrhosis, the nurse recognizes which pathophysiologic finding to be an expected etiology of jaundice?
Impaired uptake of bilirubin
The health care provider has completed the assessment on a client with jaundice. The provider determines that which pathophysiologic abnormality could cause the jaundice?
Impaired uptake of bilirubin by the liver
The client with chronic kidney disease asks the nurse why he must take active vitamin D (calcitriol) as a medication. What is the most appropriate response by the nurse?
In renal disease, vitamin D is unable to be transformed to its active form
(T/F) The GI tract is innervated autonomically.
true
(T/F) The GI tract produces both enzymes and hormones.
true
Dyspnea can best be described by which of the following?
A subjective sensation felt when experiencing difficulty breathing
A client with multiple pain-related injuries to the back, knees, and hips is admitted with acute liver failure. Upon procuring a medication list, the nurse notes that the client is taking several over-the-counter medications that contain a preparation known to be the drug that most commonly causes liver failure. Which drug is this?
Acetaminophen
The nurse is preparing the client with suspected bladder cancer for a biopsy via cystoscopy. What does the nurse teach the client about cystoscopy?
A flexible, lighted tube will be inserted into the bladder and a tissue sample will be taken.
A 79-year-old woman reports a recent onset of "nearly constant heartburn." During the assessment interview, she states that she has "lots of aches and pains." She states that she is not on any prescription medications but often takes aspirin for pain. The nurse should suspect what diagnosis?
Acute gastritis
Which client is displaying manifestations of having a kidney stone?
Acute onset of colicky flank pain radiating to lower abdomen
A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis?
Acute pyelonephritis
A client who developed acute pyelonephritis asks the nurse what caused the infection. What should be included in the nurse's response? Select all that apply.Acute pyelonephritis is caused by bacterial infection.
Acute pyelonephritis is caused by bacterial infection. Escherichia coli is the causative agent in about 80% of cases. Outflow obstruction, catheterization, and urinary instrumentation
Hormones are usually divided into categories according to their structure. The release of epinephrine would be classified as:
Amines and amino acids
The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure?
Client with prostatic hyperplasia
During the admission interview the client, who is admitted with bacterial pneumonia, reveals a 20 pack per year smoking history. The nurse relates the possible cause of this pneumonia to the decreased defense of the pulmonary system caused by cigarette smoking. Smoking affects the pulmonary defense system in what way?
Damage or destruction of cilia
(T/F) Overfilling of the bladder between voids is characteristic of urge incontinence.
False
(T/F) Renal calculi can usually be attributed to a high-salt diet.
False
(T/F) Stress incontinence is normally a result of neurogenic or myogenic disorders.
False
(T/F) Success rates of kidney transplantation have declined in recent decades.
False
(T/F) The effectiveness of dialysis treatment declines significantly over time.
False
The nurse measures a blood glucose level of 40 mg/dL (2.22 mmol/L) for a client with type 1 diabetes. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client?
Glucose is not stored in the brain and is a major fuel source for brain function.
In the balance of secretions in the gastric mucosa by the parietal cells, which ion is produced to buffer the production of hydrochloric acid?
HCO3-
Excitatory or inhibitory responses of organs to sympathetic neurotransmitters are mediated by interaction with receptors designated as alpha and beta receptor sites. Beta receptors are most prevalent in which sites? Select all that apply.
Heart Bronchioles
An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?
Hypothyroidism
The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?
Increased creatinine and blood urea nitrogen (BUN) levels
The nurse is reviewing laboratory results of a client who has liver failure. Which finding would place the client at increased risk for bleeding?
Increased prothrombin time
A client is to receive a radiocontrast media as part of a diagnostic scan. Which intervention is intended to reduce the nephrotoxic effects of the radiocontrast media?
Increasing the normal saline intravenous infusion rate prior to the exam
When caring for the client with portal hypertension and ascites, which dietary intervention does the nurse suggest to prevent the progression of fluid accumulation?
Limit intake of sodium.
A nurse is assessing an older adult with reports of constipation, for which the client often takes over-the-counter medications. What assessment should the nurse perform to address the etiology of the client's problem?
Medication regimen for drugs like anticolinergic agents or calcium
A nurse is teaching a client about the difference between digestion and absorption. Which action should the nurse describe as absorption?
Moving nutrients from the external environment of the GI tract into the internal environment
An ultrasound confirms appendicitis as the cause of a client's sudden abdominal pain. Which etiologic process is implicated in the development of appendicitis?
Obstruction of the intestinal lumen
The client with substance use disorder was found unconscious after overdosing on heroin 2 days prior. Because of prolonged pressure on the muscles the client has developed myoglobinuria, causing which complication?
Obstruction of the renal tubules with myoglobin and damaged tubular cells
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?
The thyroid gland is responsible for increasing the metabolic rate.
(T/F) Glomerular disorders often result in protein being present in the urine.
True
(T/F) Inflammation of the serous membrane that lines the abdominal cavity is known as peritonitis.
True
(T/F) Micturition is a result of the interplay between sensory and motor nerves, involving both the brain and spinal cord.
True
(T/F) Polycystic kidney disease is most commonly an inherited disorder.
True
(T/F) Pregnant women and individuals with indwelling catheters are at particular risk of urinary tract infections.
True
(T/F) The glomerular filtration rate (GFR) is a key lab measurement of the presence and/or degree of kidney failure.
True
(T/F) The glomerular filtration rate can be used as a measure of the efficiency of kidney function.
True
(T/F) The loop of Henle plays a key role in the production of concentrated or diluted urine.
True
A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called:
Zollinger-Ellison syndrome
While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains:
a complex microbial system that contains hundreds of different species.
What does the liver secret that is central to the digestion and absorption of fats?
bile
A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?
hypoglycemia
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?
hypothalamus
The production and release of hormones by the pituitary gland require stimulation by the what?
hypothalamus
What does the kidney consist of?
outer cortex and inner medulla
By conserving bicarbonate and eliminating hydrogen ions, what do the kidneys regulate in the body?
pH
What is the most common sign of bladder cancer?
painless hematuria
When hormones act locally on cells other than those that produced the hormone, the action is called what?
paracrine
The two broad categories of dialysis are hemodialysis and __________ dialysis.
peritoneal
What gland plays a key role in the control of hormone levels?
pituitary
What kinds of failure are ureteral obstructions and bladder outlet obstructions are examples of?
postrenal
A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience?
prehepatic
The client who has experienced third-degree burns is susceptible to which specific type of gastrointestinal (GI) ulceration?
stress
What type of incontinence is often precipitated by coughing or by coughing, laughing, or lifting?
stress
(T/F) The accumulation of large amounts of fluid in the peritoneal cavity as a result of liver disease is known as ascites.
true
(T/F) The cerebellum is considered to be part of the hindbrain.
true
(T/F) The hypothalamus is the coordinating center of the brain for endocrine, behavioral, and autonomic nervous system function.
true
(T/F) The kidneys are responsible for the elimination of numerous drugs.
true
(T/F) The low pH of the stomach is due to the presence of large amounts of HCl.
true
(T/F) The roles of the supporting cells of the nervous system include providing metabolic support and protection.
true
(T/F) To prevent their accumulation, hormones must eventually be inactivated.
true
H. pylori is commonly implicated in the formation of what in the stomach lining?
ulcers
Which component of glomerular filtrate can passively cross the tubular epithelial cell membrane?
urea
What term means "urine in the blood," captures many of the clinical manifestations of renal failure.
uremia
