Pathophysiology prepUs Chr11-15
Which physiologic process best exemplifies a positive feedback mechanism?
increase in prolactin secretion that occurs with more frequent breastfeeding
Open-angle glaucoma is caused by an abnormality in the trabecular meshwork, which controls the flow of aqueous humor. Where is aqueous humor in a normal eye?
Canal of Schlemm
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
Which complication of acromegaly can be life threatening?
Cardiac structures increase in size
A client calls the health care provider's office and frantically tells the nurse his TB test is red, and he is afraid this means he has tuberculosis. The best response by the nurse would be:
"A definitive diagnosis of active pulmonary tuberculosis requires cultures or DNA amplification techniques."
The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?
"Because cortisol levels fluctuate, collecting a sample over time will be more accurate."
Gate control theory
"Gate" in dorsal horn regulates which stimuli pass through to be processed and which are mitigated by another stimulus (scratching, massage, etc.)
A nurse suspects an older adult client is experiencing benign prostatic hyperplasia (BPH). Which question should the nurse ask this client?
"Has the force of your urinary stream decreased?"
The nurse is teaching a client about various methods of pain control. Which information will the nurse include when teaching the client about applying heat for pain control?
"Heat promotes more blood flow to the area to improve oxygen supply."
Which of these clients' statements would be most suggestive of retinal detachment?
"I feel like there's a shadow that's blocking my vision."
The nurse is caring for a client with visual impairment. Which statement made by the client suggests the client has diplopia?
"I have been seeing double."
An older adult client is scheduled for outpatient cataract surgery. While taking a presurgery history, which statement by the client correlates to the manifestations of cataracts, thereby verifying the client has received information about the condition?
"I have blurred vision in both my eyes and my vision is distorted."
A client is being taught how to use a TENS unit. The nurse determines that teaching was effective when the client states:
"I should take my medication and apply the TENS unit to the painful area as soon as I feel the pain."
An older adult client has been diagnosed with macular degeneration. Which statement by the client best demonstrates an accurate understanding of the new diagnosis?
"I suppose that this may be one of the things that happens when you get older."
A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?
"I will have to take my medication for the rest of my life."
Ch. 12 Question 2: A 2-year-old child has been diagnosed with uncomplicated acute otitis media by a nurse practitioner. When explaining the plan of care, which description is most appropriate? ▪ "I'll prescribe an antiviral medication and it's important that he finish the whole course." ▪ "Rinsing out his ears two or three times a day will actually be more effective than antibiotics." ▪ "I'll give you a prescription for two different antibiotics and a decongestant." ▪ "Let's keep a close eye on his condition for a couple of days before starting antibiotics."
"Let's keep a close eye on his condition for a couple of days before starting antibiotics."
An older adult client who was recently diagnosed with emphysema asks the nurse what caused the disease. Which statement is the best response?
"One of the causes of emphysema is a history of cigarette smoking that causes damage to the lungs. Have you ever smoked?"
A female client informs the nurse that she is having hot flashes on occasion, has trouble sleeping, and thinks that she is having some symptoms of menopause. The client asks the nurse how long these symptoms will last prior to experiencing menopause. What is the best response?
"Perimenopause can precede menopause by approximately 4 years."
While administering a tuberculin (TB) skin test, a client who is HIV positive asks, "I heard from my friends; this test may not work on me since I have HIV." The health care provider's best response would be:
"Sometimes immunocompromised clients will have negative results if you are unable to mount a normal immune reaction."
A beta-adrenergic blocker has been prescribed for a client diagnosed with migraines. The most important information for the nurse to teach the client would be:
"Take the medication daily as you have been directed."
The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate?
"The circumcision will not be done now; the foreskin is needed for surgical repair."
A young, male child is born with severe respiratory failure. Over the course of months, the parents note his body looks swollen. They ask, "Are our baby's kidneys not working right? Why is he so swollen?" The nurse bases the reply on which physiologic principles?
"The right side of his heart (cor pulmonale) is not pumping effectively. Blood is backlogging in his body, which is why he is so swollen."
After an office visit with her primary health provider, a female client with an elevated CA-125 test result asks the nurse if that means she has ovarian cancer. What is the nurse's best response?
"The test is not specific for ovarian cancer but suggests further evaluation to find the cause of the elevation."
A client asks the health care provider to, "Explain brachytherapy, which is recommended for my cervical cancer." Which response by the nurse is most accurate?
"They will insert a radioactive device into your vagina and position it next to the cervix, so that curative levels of radiation are directly on the cancer site."
A new mother brings her infant to the clinic reporting that the child is not sleeping or eating much. Upon assessment, the health care provider notes that the infant's ear canal is reddened with a bulging tympanic membrane. Which other data collected would lead to the diagnosis of acute otitis media (AOM)?
"Yes, he has been pulling at his ear." "He's been very irritable and fussy the past couple of days."
The nurse is providing education about the detection of ovarian cancer to a client. Which statement should the nurse include in the teaching?
"This type of cancer is often asymptomatic in the early stages."
A client reports occasional ringing in the ears that worsens toward the end of the day. The most important question for the nurse to ask would be:
"What prescription medication and over-the-counter medication do you take?"
Prolonged immobility is implicated in the development of which disorder?
Atelectasis and pulmonary embolism
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis
A 51-year-old female client who is 2 days postoperative in a surgical unit of a hospital is at risk of developing atelectasis as a result of being largely immobile. Which teaching point by her nurse is most appropriate?
"You should breathe deeply and cough to help your lungs expand as much as possible while you're in bed."
A client with a family history of breast cancer has just learned that she carries the BRCA1 and BRCA2 mutation. When educating this client about follow-up care, which statement would be most appropriate?
"You should have more frequent breast evaluations using an MRI rather than standard mammography."
Place the steps of the positive feedback mechanism involved in labor and delivery in the correct order.
1 Uterine contraction pushes head of baby into the cervix 2 Nerve cells in cervix stimulate oxytocin 3 Production of more forceful uterine contractions 4 Resistant descent of baby 5 Increased stretch of the cervix
A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:
Atypical cervix cellular changes
Which female client is at risk for amenorrhea?
18-year-old with anorexia nervosa
When a woman asks the nurse at what age menopause usually occurs, what should the nurse respond?
48 to 55 years of age
What is the normal tidal volume for a person at rest?
500 mL
. What percentage of men experience trauma in their lifetime?
60%
Which client is at risk for developing acute respiratory failure?
A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has pneumonia with low O2 saturation
A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?
A hypermetabolic state
Which client is at risk for developing a preventable disorder related to prolonged immobility?
A postsurgical client who is refusing to get out of bed and walk and will not wear those "uncomfortable elastic stockings"
A client recovered from influenza 2 days ago and informs the nurse that she is feeling better but now has a fever, chills, pain when breathing, and a productive cough. What complication does the nurse anticipate the client will be treated for?
A secondary bacterial pneumonia
Dyspnea can best be described by which of the following?
A subjective sensation felt when experiencing difficulty breathing
A client with small cell carcinoma lung cancer may secrete an excess of which hormone, causing an ectopic form of Cushing syndrome due to a nonpituitary tumor?
ACTH
One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and:
ACTH
The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.
ACTH peaks in the morning and declines throughout the day.
Viral influenza has which distinguishing feature when compared to other influenzas?
Abrupt-onset, profound malaise
When pupillary dilation partially compensates for the reduced size of the retinal image by increasing the light entering the pupil, this is a component of which eye adjustment?
Accommodation
Specificity theory
Activation of receptors, pathways, brain centers all specific for pain
A client reports sudden, acute left eye pain with blurred vision and a headache on the affected side. The client is most likely experiencing:
Acute angle-closure glaucoma
An adolescent male comes to the urgent care clinic. Upon assessment, the following is noted: history of circumcision, erythema of the glans, and prepuce with a malodorous discharge. Based on symptoms, the probable diagnosis would be:
Acute superficial balanoposthitis
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of which disease process?
Addison disease
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:
Adrenal pituitary gland
Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the following?
Airway inflammation
What is ocular muscle imbalance resulting in "lazy eye" called?
Amblyopia
Select the category of hormones that include norepinephrine and epinephrine.
Amines and amino acids
Which area of the brain is key in modulating fear and anxiety?
Amygdala
Which individual displays the precursors to acromegaly?
An adult with an excess of growth hormone due to an adenoma
Ch. 14 Question 1: In females, this organ is responsible for releasing follicle stimulating hormone (FSH) and luteinizing hormone (LH) in hormonal regulation: ▪ Hypothalamus ▪ Anterior pituitary ▪ Ovary ▪ Uterus
Anterior pituitary
The nurse is caring for a client with a chronic endocrine disorder. The nurse identifies which factor(s) that influences the number or function of hormone receptors?
Antibodies can destroy or block the receptor proteins. A decreased hormone level may produce increased receptor numbers. A sustained excess hormone level brings about a decrease in receptor numbers.
The number of hormone receptors on a cell may be altered for any of several reasons. The most appropriate response would be:
Antibodies may destroy or block the receptor proteins.
A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:
Antidiuretic hormone (ADH) and oxytocin
A client presents to the clinic complaining, "I have something in my eye." When questioned, the client admits to a scratching and burning sensation and light sensitivity. The health care provider suspects the client has developed:
Conjunctivitis
Which statement represents features of generalized anxiety disorder (GAD)?
Anxiety that interferes with daily life
A client is suffering from severe gastroesophageal reflux disease (GERD) and has been admitted to the hospital with a diagnosis of pneumonia. Which of the following would be the most likely cause for the development of pneumonia?
Aspiration
A 33-year-old client has been admitted to the hospital for the treatment of Graves disease. Which assessment should the client's care team prioritize?
Assessment of the client's vision and oculomotor function
An adult male reports discomfort in the groin. If the client has metastatic testicular cancer, for what other clinical manifestations should the nurse assess? Select all that apply.
Hemoptysis, neck mass, and back pain
A 65-year-old client has learned that mild nuclear cataracts are detected in both eyes and progress will need to be monitored. Which symptoms should the nurse teach the client as commonly associated with nuclear cataracts?
Blurred vision Increased sensitivity to glare Improved vision for short distances (such as reading)
Which physiologic changes result in menopause?
Cessation of ovarian function and decreased estrogen levels
Which statement best describes the limbic system?
Circuits that connect one's cognitive activity, emotions, and behavior
The nurse is caring for a client with cataracts. Which assessment findings does the nurse anticipate?
Clouding of the lens Decreased visual acuity
The client asks the health care provider, "What is the purpose of applying cold to a sprained ankle?" Which response by the health care provider is best?
Cold provides pain relief and suppresses the release of products from tissue damage.
A 22-year-old male client presents with an enlarged firm testis and scrotal edema and is suspected to have orchitis. The nurse includes what actions in the plan of care?
Collection of urethral cultures Application of cold packs Elevation of the scrotum Restriction of client's activity
The emergency department nurse is caring for a client with an acute asthma attack. Which therapy should the nurse anticipate for this client?
Corticosteroids
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
A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client?
Cystocele
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
A client's recent history of emphysema has resulted in the functional loss of many alveoli. How will this impact the physiologic function of the type II alveoli?
Decrease the production of surfactant
The nurse is caring for a client with impaired ovarian interstitial cell function. Which other finding should the nurse anticipate?
Decreased estrogen
The nurse is caring for a male client whose testes have not descended. Which resulting finding should the nurse anticipate?
Decreased spermatogenesis
A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:
Graves disease
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:
Graves disease
Which assessment is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)?
Digital rectal examination
Ch. 15 Question 1: Impaired ventilation involves which major mechanisms? Select ALL that apply. ▪ Failure of the heart to pump enough oxygenated blood to the body. ▪ Inadequate oxygen and carbon dioxide exchange at the cellular level. ▪ Disruption of the neuronal transmissions needed to stimulate the mechanisms of breathing. ▪ Compression or narrowing of the airways.
Disruption of the neuronal transmissions needed to stimulate the mechanisms of breathing. Compression or narrowing of the airways.
Which intervention would be considered a nonpharmacologic method of pain control?
Distraction by knitting Guided imagery Biofeedback
While the nurse is discussing the plan of care with the client, the client asks about nonpharmacologic strategies for managing postmenopausal symptoms. What should the nurse include in the response?
Dress in layers Avoid spicy foods Perform deep breathing exercises
A client who has no previous history of respiratory disease describes a sensation of shortness of breath and the feeling of not being able to pass enough air during exercise that has just developed over the past month. The client would be documented as having:
Dyspnea
Intensity theory
Emotional response to stronger than usual stimulus
Which brain changes may be present in those with schizophrenia?
Enlarged ventricles Decreased volume in the prefrontal cortex Loss of gray matter
A parent calls 911 and states her child is having trouble breathing. The child is rushed to the emergency department. Upon assessment, the child appears pale, toxic, and lethargic and assumes a distinctive position—sitting up with the mouth open and the chin thrust forward. The parent states that the child just developed a sore throat and fever today. The health care provider determines that the child is experiencing:
Epiglottitis
Ch. 13 Question 1: The nurse is caring for a client who has sustained injury to the adrenal medulla as a result of a penetrating wound due to a trauma. Which hormones does the nurse expect to be altered as a result of the client's injury? Select all that apply. ▪ Mineralocorticoids ▪ Epinephrine ▪ Norepinephrine ▪ Glucocorticoids ▪ Estrogen
Epinephrine, Norepinephrine
A 60-year-old man comes to the clinic and has been found to have a history of type 2 diabetes mellitus and cardiovascular disease. The manifestations of these diseases will warrant the nurse to assess the client for which problem?
Erectile dysfunction
In the complex interaction of the sexual act in males, the nurse is aware that there are four stages involved. Which stage involves shunting of blood into the corpus cavernosum?
Erection
Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?
Excess ACTH production by a pituitary tumor
A parent of a child with otitis media with effusion (OME) asks, "How is this different from typical acute otitis media (AOM)?" Which response by the nurse correctly identifies the main difference?
Excess middle ear fluid
The nurse is caring for a client with adrenal hyperplasia. What is the nurse's understanding of the etiology of the condition?
Excessive hormonal stimulation
Which environmental factor increases the risk for developing generalized anxiety disorder (GAD)?
Exposure to trauma
A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?
Eye health and visual acuity The ophthalmopathy of Graves disease can cause severe eye problems
What is the greatest risk factor for the development of schizophrenia?
Family history
A client with a deficit antidiuretic hormone (ADH) reports nausea and vomiting. Which additional findings does the nurse expect to find upon assessment?
Fatigue Polyuria Muscle twitching
A client diagnosed with asthma is scheduled for a pulmonary function test. During the test, the technician instructs the client to forcefully exhale air for 1 second to evaluate:
Forced expiratory volume
Which area of the brain is the primary region responsible for regulating behavior?
Frontal lobe
While explaining the somatosensory cortex to a group of nursing students, the instructor asks, "What is involved in the final processing of somatosensory information?" Which response is most accurate?
Full localization Discrimination of intensity Interpretation of somatosensory stimuli
The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?
Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.
Which hormone is produced by the anterior pituitary gland?
Growth hormone (GH)
A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be:
HPV vaccine before becoming sexually active
The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?
Heart rate 110 and bounding
Which area of the brain is responsible for filing long-term memory?
Hippocampus
Select the factor that would increase a male's risk for the development of testicular cancer.
History of cryptorchidism
Which physiologic process allows hormones to exert influence upon some cells and not others?
Hormone receptors
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
When educating a group of teenagers about sexually transmitted infections (STIs), the school nurse also mentions that cervical cancer has been associated with which viral infection?
Human papillomavirus
A client with memory loss is concerned about the possibility that it may be inherited. Which disorder will the nurse teach the client is considered an inherited cause of dementia?
Huntington disease
The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan?
Hydrocortisone
The nurse is caring for an adult client with a deficit of growth hormone. Which complication does the nurse associate with the client's diagnosis?
Hyperlipidemia
The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being:
Hypospadias
Which diagnosis is most likely to require surgical correction?
Hypospadias
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
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?
Hypothalamus
Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
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
A nurse is assessing an older adult woman diagnosed with chronic hypothyroidism who has developed myxedema coma. The nurse will likely assess which lab and clinical manifestations in this client?
Hypoventilation Hyponatremia Hypoglycemia Lactic acidosis
While rock climbing, a 22-year-old male has endured a severe head injury. Which statement best captures expected clinical manifestations and treatments for his immediate condition?
Hypoventilation may exist, resulting in increased PCO2 and hypoxemia that may require mechanical ventilation.
A client diagnosed with congestive heart failure has an arterial blood oxygen level (PaO2) of 89%. Which term should the nurse use to document a reduced oxygenation of arterial blood?
Hypoxemia
As part of the community health department, a nurse is educating a group of diabetic clients about prevention of blindness. Which topics should be covered during this class?
Importance of yearly eye exams Tight control of blood glucose levels Keep BP below 130/85 (American Heart Association Guidelines)
In contrast to acute pain, persistent chronic pain indicates which purpose?
Imposes physiologic stresses
What is the result of depolarization of the hair cells inside the cochlea?
Impulse generation and transmission to the brain
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
What is a predominant effect of a prolonged excessive growth hormone level?
Increased blood glucose levels
A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?
Increased levels of ACTH
The urology nurse is performing an assessment on a client with a history of decreased cervical secretions. For which other condition should the nurse monitor?
Infection
An older adult is being evaluated for dementia. Which assessments are not considered part of normal aging?
Is easily agitated when routines are not followed Is unable to explain the meaning of a proverb Needs cues to perform hygiene activities
While performing a Romberg test on a client, the client asks, "What is the purpose of this test?" Which response by the nurse is most accurate?
It assesses for static vestibular function.
The nurse is conducting a health promotion class on the prevention of blindness and vision impairment. The nurse determines that participants understand the information when they identify which vision disorder as most likely to have an infectious etiology?
Keratitis
A client suffering from chronic sinusitis arrives at the urgent care center complaining of a sudden onset of dizziness and difficulty walking straight. What diagnosis does the admitting nurse suspects this client has?
Labyrinthitis
When is the onset of schizophrenia most common?
Late adolescence
Which function(s) does acetylcholine control?
Learning Memory
Anticonvulsive medications are used in the treatment of bipolar depression. What other drug is used to treat bipolar disorder?
Lithium
If not treated urgently, testicular torsion can result in which complication?
Loss of testicular perfusion
A client's history documents the presence of the homonymous hemianopia. What assessment finding would the nurse anticipate this client to display?
Loss of the same side of the visual field in each eye
A nurse is teaching a client and family about best practice to minimize the cycling of bipolar disorder. Which instruction should be included in this teaching plan?
Maintain a steady pattern of sleep and activity.
A client has been admitted to a medical unit of a hospital for the treatment of pneumonia that is attributable to S. pneumonia. Which consideration is the priority in this client's treatment?
Maintaining the client's ventilation
A client who experienced a myocardial infarction 2 weeks ago reports awakening early, loss of appetite, difficulty sitting still or concentrating, and loss of interest in personal hobbies. What mental health disorder do these manifestations represent?
Major depression
What is the defining feature of bipolar affective disorder?
Mania
The nurse is assessing a client who has been diagnosed with esotropia. The nurse would expect the assessment findings to include:
Medial deviation
What is the function of the parahippocampal gyrus?
Memory encoding and retrieval
Which statement is true of migraine headaches?
Migraines may have a hormonal etiology in some clients.
What does serotonin control?
Mood Perception Sleep Appetite
Neuromatrix theory
Multidimensional network of somatic, limbic, thalamocortical components with multiple sources of input and influences
What is the most common mechanism of hormone control?
Negative feedback
Pattern theory
Nerves transmitting pain shared with other senses
What is the biological target of most pharmacologic interventions for mood disorders?
Neurotransmitters
Which neurotransmitter controls heart rate and blood pressure?
Norepinephrine
A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that the most likely cause of this infection is:
Nosocomial hospital-acquired infection (HAI)
Which statement is the counterargument for the monoamine hypothesis?
Not all patients with decreased monoamines exhibit symptoms of depression
A female client is being seen in the ED with complaints of lower abdominal pain, dyspareunia, back pain, purulent cervical discharge, and the presence of adnexal tenderness and painful cervix on bimanual pelvic examination. The nurse suspects the client has pelvic inflammatory disease (PID), and will assess the client for:
Number of sexual partners
A client is admitted to the hospital following smoke inhalation. The nurse would anticipate the need for cellular metabolism and that the client would need supplemental:
O2
The nurse is caring for a client exhibiting apnea. Which other condition(s) might this finding result from?
Obstruction during sleep Brain injury
The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which sign/symptom?
Ophthalmopathy
A client is concerned about having mumps orchitis and asks the nurse about the symptoms. What is the nurse's best response?
Painful enlargement of the testes with fever 3 days after infection
A client is complaining to the health care provider about several vague signs/symptoms. Which sign/symptom raises a "red flag" indicating the client may have developed endometrial cancer?
Painless abnormal bleeding
When a client with a history of asthma takes a walk outside on a windy day with high pollen counts, she may experience an asthma attack, resulting in an increase in respiration rate and wheezing. The body's response is likely related to which pathophysiologic principle?
Parasympathetic nervous system stimulation resulting in airway constriction
How is a psychiatric disorder diagnosed?
Patient history
The nurse is assessing a client who exhibits purulent cervical discharge, cervical motion tenderness, fever, and malaise. For which condition should the nurse anticipate treatment?
Pelvic inflammatory disease
Which factor is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?
Pet dander
Which structure controls the functions of the greatest number of target glands and cells?
Pituitary gland
Which disorder of the female genitourinary system is most likely to result from a disruption in normal endocrine function?
Polycystic ovary syndrome (PCOS)
Which statement best describes the relationship between the hypothalamus and the posterior pituitary in the normal functioning of the endocrine system?
Posterior pituitary hormones are produced in the cell bodies of neurons in the hypothalamus but released from the pituitary gland.
A client with a brain lesion displays altered judgment and decision-making abilities. Which area of the brain does the nurse suspect is injured?
Prefrontal cortex
Ch. 11 Question 2: Which brain structure is primarily responsible for judgement, decision making, and problem solving, including in the regulation of mood? ▪ Hypothalamus ▪ Prefrontal cortex ▪ Amygdala ▪ Hippocampus
Prefrontal cortex
Which visual deficit is a clinician justified in attributing to the normal aging process?
Presbyopia
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?
Prevent accumulation
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone
The nurse is caring for a client with low-tension glaucoma. Which characteristics does the nurse associate with this condition?
Progressive optic nerve damage Loss of visual field Normal intraocular pressure Decreased blood flow to the optic nerve
A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?
Prolactin
Which sign of congenital hypothyroidism in a neonate is one of the first signs the nurse would pick up on?
Prolonged period of physiologic jaundice
The nurse is caring for a client with a history of resection of squamous cell carcinoma in the left nare, and has a nasal prosthesis in place. Which defensive mechanism of the pulmonary system is affected in this client?
Protective structures
Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?
Proteins
A child has been diagnosed with classic growth hormone deficiency. Which physical findings may occur in this child?
Short stature Delayed skeletal muscle maturation Obesity
A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:
Psychosexual counseling and PDE-5 inhibitor medications
The nurse is assessing a client's hearing and wants to determine if the client has hearing loss of certain frequencies. Which audiometry test will the nurse perform?
Pure-tone audiometry
A child with autism displays echolalia. What is the best description of this manifestation?
Repeating another's words
A client expresses concern about feeling fullness in the ear. Which additional manifestation leads the health care provider to suspect Menière disease?
Rotary vertigo and tinnitus
The nurse is caring for an older adult client with a suspected diagnosis of presbycusis. Select the most likely manifestation.
Sensorineural hearing loss caused by natural aging
What is the most common pharmacologic treatment for generalized anxiety disorder (GAD)?
Serotonin reuptake inhibitors (SSRIs)
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory findings will the nurse associate with the client's diagnosis? Select all that apply.
Serum sodium 128 mEq/L (136 mmol/L) Plasma osmolality 200 mOsm/kg (200 mmol/kg)
Primary adrenal insufficiency is manifested by:
Serum sodium level of 120 mmol/L (low) and blood glucose level of 48 mg/dL (low)
A child struggling to breathe is brought to the emergency department with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. What is the most likely diagnosis?
Severe asthma attack
When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with:
neck pain. pain that radiates to the left arm. substernal chest pain.
A client with an 80-pack-year history of tobacco smoking has presented to the clinic complaining of "bronchitis" cough for the past 5 months, weight loss, and shortness of breath. Today, this client "got scared" when he coughed up blood in his sputum. The health care provider is concerned this client may have which possible diagnosis
Small cell lung cancer due to smoking history
Which risk factor is associated with erectile dysfunction (ED) and considered preventable?
Smoking
Full localization, discrimination of intensity, and interpretation of somatosensory stimuli requires processing by which region of the brain?
Somatosensory cortex
An adolescent boy asks the nurse what increases the secretion of growth hormone (GH). Which response by the nurse is best?
Starvation
A 21-year-old female is suspected of having inadequate function of her hypothalamic-pituitary-thyroid system. Her care provider is planning to inject thyrotropin-releasing hormone (TRH) and then measure her levels of TSH. Which diagnostic test is being performed?
Stimulation test
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.
Stimulation tests
A client who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive?
Stopping the drug suddenly may cause acute adrenal insufficiency.
A neonate delivered at 36 weeks' gestation is in respiratory distress and requires ventilation. Tests reveal prematurity of the lungs and an underdevelopment of type II alveolar cells. Based on these results, the nurse will anticipate the administration of which of the following to improve respiratory function?
Surfactant
A client has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which treatment modality is most likely to benefit this client?
Synthetic preparations of T3 or T4
Following an automobile accident that resulted in a traumatic amputation of the right lower leg, the client complains of feeling tingling, heaviness, and shooting pain in the amputated limb. The health care providers treat phantom limb pain by using which interventions?
TENS of the large myelinated afferents innervating the area Hypnosis Relaxation techniques
Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm?
Tachycardia Delirium Very high fever
Ch. 11 Question 1: A stable representation of outlook is known as which of the following? ▪ Emotion ▪ Mood ▪ Temperament ▪ Behavior
Temperament
Which statement best describes the difference between mood and temperament?
Temperament is less likely to change over time
Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm?
Temperature of 104.2°F (40.1°C) Telemetry showing heart rate of 184 Extremely agitated
A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. His pulse rate is 120 beats/min. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:
Testicular torsion
The testes secrete several male sex hormones. Which of these hormones is the most abundant and considered the main testicular hormone?
Testosterone
When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism?
The hypothalamic-pituitary-target cell system
When thinking in terms of airway radius with regard to resistance, the lung structure responsible for the most airway resistance to airflow would be:
The bronchioles near the trachea
The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?
The client should be strongly urged not to smoke.
The nurse is caring for the following clients. Select the client at highest risk for the development of atelectasis.
The client who is postoperative after a total knee replacement and receiving patient-controlled analgesia
A client with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which assessment components should the nurse prioritize when assessing the client's pain?
The client's subjective report of the character and severity of pain
After surviving an ischemic stroke, a client has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings and exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which brain structure?
The components of the client's limbic system
Which statement best describes a secondary disorder of endocrine function?
The disorder occurs when the target organ is normal, but stimulating hormones alter its function.
A nurse working in an outpatient pediatric clinic notes a large number of ear infections among children. What is the nurse's understanding of this increased rate?
The eustachian tube is narrower in children.
A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?
The hypothalamic-pituitary-target cell system
A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?
The nurse is likely asymptomatic.
A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the backpack. Which component of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items?
The primary dorsal root ganglion neuron, dorsal column neuron, and the thalamic neuron
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.
The nursing student is studying the structure and function of the female reproductive system. The student wants to know why the urinary system is included in the content. The best reason for inclusion of the information is:
The urethra and the vagina, although two separate openings, exist in close proximity.
The health care provider is assessing the functional integrity of all spinal nerves utilizing a pinpoint pressed against the skin. A normal response would be interpreted as:
The withdrawal reflex is activated.
The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication?
To decrease airway inflammation
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
The client is experiencing severe signs of urinary obstruction. The client has an existing diagnosis of benign prostatic hyperplasia (BPH). Which treatment option will the health care provider most likely recommend?
Transurethral prostatectomy
Which pain disorder is a manifestation of a disruption of cranial nerve function?
Trigeminal neuralgia
A 2-year-old child who has had otitis media (OM) for 4 months and been treated with several courses of antibiotics now appears to have some hearing loss. The nurse anticipates that the most appropriate treatment for the child would be:
Tympanostomy tube insertion
Which manifestations of attention-deficit hyperactivity disorder (ADHD) occur in the predominantly hyperactive-impulsive subtype?
Unable to sit still Interruptive Touch and play with everything Continuous talking
While discussing the elimination of hormones from the body to prevent overaccumulation, which hormones are eliminated in bile?
Unbound adrenal hormones Gonadal steroid hormones Thyroid hormones
Which factor places a male client at risk for balanitis?
Uncircumcised penis
When evaluating a client with suspected benign prostatic hyperplasia (BPH), the health care worker should collect data related to which signs/symptoms
Urinary frequency issues Weak urine stream Straining to empty the bladder
Which complication is associated with prostatic hyperplasia?
Urine retention
Which characteristic differentiates a migraine with aura from a migraine without aura?
Visual symptoms such as flickering lights precede the headache
Which clinical manifestation is most likely to accompany a diagnosis of vulvodynia?
Vulvar pain
Paracrine action involves which characteristic?
act locally on cells other than those that produce the hormone
The nurse is teaching a client about the treatment of open-angle glaucoma. The most appropriate information for the nurse to give the client would be:
administration of topical beta-adrenergic antagonists to lower the pressure.
Ch. 14 Question 2: Which is a common clinical manifestation for testicular cancer? ▪ small, painless testicular mass ▪ slight enlargement of the testicles ▪ heaviness of the scrotum ▪ all of the above
all of the above
Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes:
an illusion of motion.
A client develops fever, headache, and burning/itching in the periorbital area. After a few days, a vesicular rash appears around the eyelid margins. The health care provider will likely prescribe:
antiviral medication for herpes zoster ophthalmicus.
A client involved in a car accident is admitted with a chest tube following pneumothorax. He also has an elevated blood alcohol level. When the nurse enters his room, she notes the client is dyspneic, short of breath, and holding his chest tube in his hand. When the nurse pulls the linens back, she finds a "sucking" chest wound. After calling a "code blue," the next priority intervention would be to:
apply a Vaseline gauze (airtight) dressing over the insertion site
What is the direct result of the fight or flight response?
decreased cortisol increased epinephrine increased norepinephrine increased dopamine
The nurse caring for a client with bilateral rib fractures explains to the client that the pain causes him to take more shallow respirations, which will contribute to feeling short of breath due to a:
decreased tidal volume
The nurse caring for a client with bilateral rib fractures explains to the client that the pain causes him to take more shallow respirations, which will contribute to feeling short of breath due to a:
decreased tidal volume.
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.
Ch. 15 Question 2: Which of the following refers to the exchange of oxygen and carbon dioxide at the alveolar capillary junction? perfusion Respiration ventilation or Diffusion
diffusion
When explaining polycystic ovary syndrome (PCOS) to a newly diagnosed client, the health care worker states, "This ovarian dysfunction is caused by:
elevated LH.
The nurse is caring for a client with a hormonal disorder that is widely affecting many body systems. The nurse recognizes that which form of hormone signaling pathway is most likely involved in the client's disorder?
endocrine
While teaching a health class to junior and senior male high school students, the school nurse educates them that the first sign of testicular cancer is:
enlargement of the testicle
A client tells the health care provider he has noticed a recent change in his vision: he can bring distant images into focus, but near images become blurred. The client has most likely developed:
hyperopia
The ophthalmologist is performing a client's annual eye exam and notes an increase in intraocular pressure. The condition most likely is the result of:
imbalance between aqueous production and outflow.
A client has developed priapism. For which outcome is this client at risk?
impotence
A client is experiencing oligomenorrhea. The nurse interprets this as:
infrequent menstruation with periods more than 35 days apart
The nurse documents the presence of nystagmus when assessing a client. This can be interpreted as:
involuntary eye movements that preserve eye fixation on stable objects in the visual field.
While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct?
local
The nurse is caring for a client who admits to long-term substance use disorder. For which type of coexisting condition should the nurse prioritize assessing?
mental health disorders
During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should:
order an ultrasound or biopsy to rule out testicular cancer.
Ch. 13 Question 2: The nurse is caring for a client with a hormonal disorder in which the dysregulated hormone is being released by a hormone-producing cell and affecting only nearby responding/target cells. This describes which form of cell-to-cell communication? ▪ endocrine ▪ paracrine ▪ autocrine ▪ synaptic
paracrine
Which stimulus would be used to elicit the withdrawal reflex when testing response to nociceptive stimuli?
pressure from a sharp object
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 teaching a client newly diagnosed with hypothyroidism. The nurse teaches that thyroid hormone is transported by which?
protein carriers
A client is experiencing a cluster headache. The client would most likely manifest:
severe pain behind the eye.
Clients who have been bedridden for a long time likely will experience:
shallow, quiet breathing, which impairs the spreading of surfactant.
Which treatment intervention is recommended for infants who have a severe case of hypospadias?
surgical repair
While talking about their migraine headaches, two women have found that they have some common triggers for their migraines, which may include:
their menstrual cycle. consuming chocolate
In major athletic competition, athletes are required to submit to liquid chromatography testing looking for:
use of performance-enhancing agents to increase the chances of winning.
Ch. 12 Question 1: Photoreceptors are a type of somatosensory receptor that are responsible for which function? ▪ Hearing ▪ Vision ▪ Taste ▪ Smell
vision
A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique?
"Sperm can no longer pass through the ductus deferens."
