PrepU patho questions
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?
hypothalamus
A serous-type fluid secreted by special cells in the intestinal mucosal layer performs which function?
vehicle for absorption
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 nurse is caring for a client with a diagnosis of post-hepatic obstruction. Which of these questions will assist the nurse in determining the underlying cause of the obstruction?
"Have you been told you have had gallstones?"
A middle-aged adult is diagnosed with diverticular disease based on recent history and the results of a computed tomography (CT) scan. Which statement demonstrates an accurate understanding of this diagnosis?
"I suppose I should try to eat a bit more fiber in my diet."
A college student has been called into the student health office because she tested positive for HIV on the enzyme-linked immunosorbent assay (ELISA). The student asks, "What is this Western blot assay going to tell you?" The best response by the health care provider is:
"The Western blot is a more sensitive assay that looks for the presence of antibodies to specific viral antigens."
What is considered the normal amount of serum bilirubin found in the blood?
<1.5 mg/dL
Which client would be considered to be exhibiting manifestations of "prediabetes"?
A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL (10.49 mmol/L).
Which factor is most strongly associated with the pathogenesis of gallstone formation?
Abnormalities or stasis of bile
Based solely on the inheritable condition, a child with Down syndrome is susceptible for developing which type of cancer?
Acute lymphocytic leukemia (ALL)
The health care provider suspects a client may have developed a leukemia that originates from the B cells. Which cancers would the nurse associate with B cell lymphocytes?
Acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL)
A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of
Arthritis treated with high levels of nonsteroidal anti-inflammatory (NSAIDs) agents
When hormones act locally rather than being secreted into the bloodstream, their actions are termed:
Autocrine and paracrine
One of the accepted methods of screening for colorectal cancer is testing for occult blood in the stool. To reduce the likelihood of a false-positive result on these tests, what instructions will the nurse provide?
Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) for 1 week prior to testing.
Definitive diagnosis of multiple myeloma includes the triad of bone marrow plasmacytosis, lytic bone lesions, and:
Bence Jones proteins in the urine.
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
A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder?
Cholecystokinin
A client receives a complete blood count as part of presurgery admission labs and is diagnosed with lymphocytosis. The nurse's plan of care should include interventions related to potential diagnosis for which disease associated with lymphocytosis?
Chronic lymphocytic leukemia
When assessing the nutritional intake of a client with generalized pancreatic cancer, which statement by the client is consistent with the disease and food intake?
Client states pain becomes worse with food intake.
The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which reason?
Clients have few early symptoms of the disease.
A client is admitted to a nursing unit with severe edema. The nursing student caring for this client overhears the physician and a medical student talking about the client's albumin level. When discussing the flow of fluids into and out of cells, albumin plays a significant role in which pressure gradient?
Colloidal osmotic
Which criterion about insulin would prompt a diagnosis of type 1 diabetes?
Complete failure of insulin secretion
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
What is the most common mechanism of hormone control?
Negative feedback
The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?
autocrine
A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?
Elevated atrial natriuretic hormone
The nurse is assessing a client who has been diagnosed with gastroesophageal reflux disease (GERD). The nurse recognizes which sign/symptom may be associated with GERD? Select all that apply.
Epigastric pain Retrosternal pain Wheezing Hoarseness
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)
A nursing student says the following to her instructor: "Malignant neoplasms are more well-differentiated than benign tumors." Which of the following is the answer?
False
The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?
Give the client a concentrated carbohydrate.
The most common forms of peptic ulcer are duodenal and gastric ulcers. What are the most common risk factors for peptic ulcer disease?
Helicobacter pylori (H. pylori)
A client is diagnosed with Crohn disease. The nurse instructs the client on which type of dietary needs?
High-calorie, vitamin, and protein diet
Which statement best explains the function of hormone receptors?
Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.
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 assessing a client diagnosed with multiple myeloma should assess for which clinical manifestation associated with this diagnosis?
Hypercalcemia
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
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? Select all that apply.
Hypoventilation Lactic acidosis Hypoglycemia Hyponatremia
An adult client is scheduled for testing of a suspected growth hormone (GH)-secreting tumor. Which result from the glucose suppression test would confirm the condition?
Increased GH secretion
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 nursing student studying about cancer growth correctly identifies "cell proliferation" to mean which of the following?
Increasing cell numbers by mitotic cell division
Crohn disease is treated by several measures. Treatment with sulfasalazine will focus on which aspect of this disease?
Inflammatory suppression
A client is diagnosed with an adenoma. The nursing student identifies this as a:
benign tumor of glandular epithelial tissue.
Which are examples of a negative feedback system? Select all that apply.
Insulin and glucagon Cortisol and adrenocorticotropic hormone Somatostatin and thyroid-stimulating hormone (TSH) Calcium and parathyroid hormone
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
A hospital client with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which effect will result from the action of insulin?
Promotion of glucose uptake by target cells
After several months of persistent heartburn, an adult client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to be prescribed for this client's GERD?
Proton pump inhibitors; avoiding large meals; remaining upright after meals
An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region?
Pyloric region
Kostmann syndrome is a severe congenital neutropenia. Which disorder/infection is characteristic of this condition?
Severe bacterial infections
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
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 assessing the mouth of a client receiving chemotherapy, which of the following should the nurse interpret as a possible indicator of neutropenia?
Stomatitis
An infant has been born to a client who is HIV positive. What is the infant's most likely prognosis for developing AIDS?
The infant can be HIV antibody positive by ELISA for up to 18 months of age without being actively infected with HIV.
When caring for a client with primary biliary cirrhosis, which of these statements by the nurse will best teach the client about the cause of this problem?
There is autoimmune destruction of the bile ducts.
The nurse is evaluating a client's blood work results. About which laboratory result should the nurse notify the health care provider because it falls outside normal parameters?
absolute neutrophil count 950/μl (0.95 x 109/l)
A client diagnosed with chronic myeloid leukemia (CML) is reporting a feeling of abdominal fullness/discomfort, low-grade fever, night sweats, and bone pain. Based on these data, the nurse recognizes the client is most likely in which phase of the disease?
accelerated
Paracrine action involves which characteristic?
act locally on cells other than those that produce the hormone
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 client diagnosed with a primary immunodeficiency disorder has asked her siblings to be tested as possible stem cell donors. When discussing this procedure with the family, the nurse emphasizes that stem cells can be harvested from which parts of the body? Select all that apply.
bone marrow and peripheral blood
A nursing student has learned in class that with abdominal cancer the tumor may compress the viscera, which will cause which of the following?
bowel obstruction
The client tells the nurse that she is very anxious and that her pulse is racing. What will the nurse expect to see?
dry mouth
A nurse caring for a client with progressive cancer notes that the client has experienced significant loss of skeletal muscle rather than only fat loss. The nurse documents this as:
cachexia
A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increased risks associated with exercise, the health care provider should encourage the client to:
carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia.
The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?
client has anuria
Crohn disease is recognized by sharply demarcated, granulomatous lesions that are surrounded by normal-appearing mucosal tissue. The nurse recognizes these lesions to be defined by which description?
cobblestone
The nurse is caring for a client with cyclic neutropenia. The nurse understands that this is which type of neutropenia?
congenital
What is the condition that is characterized by the rapid emptying of highly acidic and hyperosmotic gastric secretions into the duodenum and jejunum?
dumping syndrome
The common bile duct and the pancreatic duct release their products into which section of the intestines?
duodenum
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)
The nurse is caring for a client with advanced liver disease who has ascites. Which treatment will the nurse anticipate being used for the daily management of ascites?
diuretics
The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation?
random blood glucose 195 mg/dl (10.8 mmol/l)
The nurse is caring for a client with multiple myeloma with Bence Jones proteins. With this "light chain" form of the disease, it is important for the nurse to include assessment for:
renal disease
A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma?
slow-growing
A client is admitted to the hospital for further evaluation of problems experienced with gastrointestinal digestion and absorption. The nurse anticipates the health care provider will further assess the:
small intestine
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
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.
stimulation tests
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
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
A client has just been diagnosed with cirrhosis and has been told he needs a transplant. What changes have occurred in the liver due to cirrhosis that results in an inability to heal and require transplant?
Fibrosis has occurred and there are constrictive bands that disrupt biliary flow.
The nurse is teaching her client with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?
fat
The nurse is assessing a client who underwent a thyroidectomy earlier in the day. Assessment reveals a heart rate of 133 beats per minute, oral temperature of 101.3°F (38.5°C), and the client is uncharacteristically agitated and disoriented. After informing the primary care provider, which action by the nurse is the priority?
Closely monitor the client's cardiac status.
While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?
Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.
A client with a systemic infection has been given strong doses of broad-spectrum antibiotics for a period of 10 days. The infection recedes and he is taken off the antibiotic therapy. Two days later he presents with a Clostridium difficile infection. How should the nurse best interpret this situation?
The client's antibiotics disrupted the microbial balance and allowed overgrowth
While discussing the elimination of hormones from the body to prevent overaccumulation, which hormones are eliminated in bile? Select all that apply.
Thyroid hormones Gonadal steroid hormones Unbound adrenal hormones
Primary biliary cirrhosis is an autoimmune disease that destroys the small intrahepatic bile ducts causing cholestasis. It is insidious in onset and is a progressive disease. What are the earliest symptoms of the disease?
Unexplained pruritus
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 with hepatic encephalopathy who is receiving neomycin. Which of these does the nurse monitor to determine if a positive outcome to the medication has resulted?
ammonia levels
The nurse caring for a client diagnosed with hyperglycemic hyperosmolar state (HHS) knows that the client's elevated serum osmolality has pulled water out of the brain cells based on which assessment findings? Select all that apply.
Weakness one side of the body Body shakes rapidly and uncontrollably for a short period of time Increase in urine output in proportion to the increase in blood glucose Unable to respond verbally to questions
The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes?
acromegaly
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
Select the option that best identifies how adult cancers differ in origin from childhood cancers. Adult cancers originate from:
epithelial cells
The angiogenesis process, which allows tumors to develop new blood vessels, is triggered and regulated by tumor-secreted:
growth factors
Which topic should the nurse include in the discharge teaching plan for a client with Felty syndrome?
handwashing
The nurse is caring for an infant in the neonatal intensive care unit who has growth hormone deficiency. What critical issues should the nurse carefully monitor for in this infant?
hypoglycemia and seizures
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
hypothalamus
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
Which physiologic process best exemplifies a positive feedback mechanism?
increase in prolactin secretion that occurs with more frequent breastfeeding
The nurse is teaching a client about surgical treatments available for chronic viral hepatitis. Which of these is appropriate for the nurse to relate?
liver transplant
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
Which cancer is the leading cause of cancer death?
lung
Which body function is regulated by several hormones?
lypolysis
digestion of starch begins in which structure?
mouth
Which intervention would be most appropriate by the nurse caring for a client in the neutropenic phase of cyclic neutropenia?
perform/assist with oral care
Which layer of the digestive tract constitutes the outer wall of the intestine and contains a serous fluid between its two layers?
peritoneum
A nurse administering a client's medication tells the client that a proton pump inhibitor has been added. When the client asks the purpose of the medication, the nurse responds that it is to prevent:
stress ulcer
A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:
teach the client about the safe and effective use of synthetic thyroid hormones.
Which statement describes how water-soluble peptides, such as parathyroid hormone or glucagon, exert their effect on cells?
they bind to receptors
A 20-year-old male presents at the clinic complaining of severe fatigue, night sweats, and fever. While taking the client's history, he reports having multiple sexual partners and unprotected sex. HIV/AIDS is suspected. What diagnostic test would be ordered to confirm the diagnosis?
western blot assay