CYU ch 44,45,47,51,52

The disorders characterized by softening and then enlargement of bones is referred to as a. osteoporosis. b. rickets. c. Paget disease. d. osteomyelitis.

C

The physiologic change most likely to lead to an increase in intracranial pressure is a. REM sleep. b. hypernatremia. c. cerebral vasodilation. d. respiratory hyperventilation.

C

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt a. within the same dermatome. b. on the same side of the body. c. within 10 to 15 cm area. d. with slightly less intensity.

A

Rheumatoid arthritis involves joint inflammation caused by a. autoimmune injury. b. trauma. c. bacterial infection. d. congenital hypermobility.

A

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called a. tophaceous gout. b. gouty arthritis. c. complicated gout. d. asymptomatic hyperuricemia.

A

The pain of nonarticular rheumatism ("growing pain") is worse a. during the night. b. upon awakening. c. during activity. d. following strenuous exercise.

A

________ edema occurs when ischemic tissue swells because of cellular energy failure. a. Cytotoxic b. Osmotic c. Vasogenic d. Interstitial

A

The ________ is the level of painful stimulation required to be perceived. a. tolerance b. threshold c. expression d. perception

B

Upper extremity weakness in association with degeneration of CNS neurons is characteristic of a. myasthenia gravis. b. amyotrophic lateral sclerosis. c. Guillain-Barré syndrome. d. multiple sclerosis.

B

What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission? a. Faster rate of repolarization b. Slower rate of action potential conduction c. Facilitation of action potential initiation d. Increased rate of action potential conduction

B

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be a. because of an enzymatic defect. b. an autoimmune process. c. an infective process. d. caused by bacterial infection.

B

Secondary injury after head trauma refers to a. focal areas of bleeding. b. brain injury resulting from the body's response to tissue damage. c. brain injury resulting from the initial trauma. d. injury as a result of medical therapy.

B

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called a. osteomyelitis. b. Paget disease. c. osteoporosis. d. rickets.

B

The most common presenting sign/symptom with rheumatic fever is a. rash. b. polyarthritis. c. painless nodules. d. cardiac murmur.

B

It is true that Bell palsy is a a. herpetic outbreak in a facial dermatome. b. paralysis of the muscles innervated by the facial nerve. c. painful neuropathic pain affecting the trigeminal nerve. d. permanent facial paralysis after stroke.

B

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for a. education. b. intervention. c. stimulation. d. documentation.

B

Modulation of pain signals is thought to be mediated by the release of a. glutamine. b. endorphins. c. cholecystokinin. d. histamine.

B

An example of inappropriate treatment for head trauma would be a. hypoventilation. b. free water restriction. c. head elevation. d. bed rest.

A

Compartment syndrome occurs secondary to a. soft-tissue damage. b. muscle necrosis. c. breakdown of RBCs. d. bone infarction.

A

The pathophysiology of rheumatoid arthritis involves a. immune cells accumulating in pannus and destroying articular cartilage. b. cysts developing in subchondral bone and creating fissures in articular cartilage. c. excessive wear and tear and microtrauma that damage articular cartilage. d. free radicals attaching to the synovial membrane and tunneling into articular cartilage.

A

What type of seizure usually occurs in children and is characterized by brief staring spells? a. Absence b. Epileptic c. Partial d. Idiopathic

A

Which treatment is helpful in neuropathic pain but not used for acute pain? a. Anticonvulsants b. Nonnarcotic analgesics c. Nonsteroidal anti-inflammatory drugs and aspirin d. Narcotic analgesics

A

Clinical manifestations of a stroke within the right cerebral hemisphere include a. right visual field blindness. b. cortical blindness. c. left-sided muscle weakness and neglect. d. expressive and receptive aphasia.

C

"Please explain the pathophysiology of osteoarthritis to me," says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best response is a. "Yes; with increasing age, the inflammation from repeated joint use accumulates and causes the cartilage to get thin and ragged until it disappears." b. "Yes; repeated use just wears out the cartilage, until it becomes thin and denuded. That causes pain and will eventually cause joint inflammation." c. "No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone." d. "No; autoimmune cells infiltrate the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage."

C

A compound, transverse fracture is best described as a bone that is a. broken in two or more pieces. b. broken along the long axis. c. broken and protruding through the skin. d. cracked but not completely separated.

C

A compound, transverse fracture is best described as a bone that is a. cracked but not completely separated. b. broken along the long axis. c. broken and protruding through the skin. d. broken in two or more pieces.

C

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is a. positive microsomal antibodies. b. elevated serum calcium level. c. positive antinuclear antibodies. d. elevated monoclonal antibody titer.

C

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache. a. tension b. sinus c. migraine d. chronic

C

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of a. Guillain-Barré syndrome. b. hydrocephalus. c. amyotrophic lateral sclerosis. d. Parkinson disease.

C

Secondary injury after head trauma refers to a. brain injury resulting from the initial trauma. b. injury as a result of medical therapy. c. focal areas of bleeding. d. brain injury resulting from the body's response to tissue damage.

D

A bone disorder that results from insufficient vitamin D is referred to as a. rickets. b. subluxation. c. osteoporosis. d. osteomalacia.

D

A malignant bone-forming tumor is referred to as a(n) a. rhabdosarcoma. b. liposarcoma. c. chondrosarcoma. d. osteosarcoma.

D

Before making a diagnosis of Alzheimer disease a. a brain biopsy demonstrating organic changes is necessary. b. biochemical tests for aluminum toxicity must be positive. c. increased protein is found in a lumbar puncture. d. other potential causes of dementia must be ruled out.

D

Before making a diagnosis of Alzheimer disease a. a brain biopsy demonstrating organic changes is necessary. b. increased protein is found in a lumbar puncture. c. biochemical tests for aluminum toxicity must be positive. d. other potential causes of dementia must be ruled out.

D

Following a bone fracture, the most likely event to occur is a. migration of osteoblasts to the fracture site. b. blood vessel growth at the fracture site. c. leukocyte infiltration into bone tissue. d. development of a blood clot beneath the periosteum.

D

Intracranial pressure normally ranges from ______ mm Hg. a. 20 to 30 b. 10 to 20 c. 15 to 25 d. 0 to 15

D

It is recommended that women of childbearing age take folic acid daily for prevention of a. seizure disorders. b. hydrocephalus. c. cerebral palsy. d. neural tube defects.

D

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for a. education. b. stimulation. c. documentation. d. intervention.

D

Leakage of CSF from the nose or ears is commonly associated with a. cerebral aneurysm. b. temporal skull fracture. c. epidural hematoma. d. basilar skull fracture.

D

Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because a. viral damage can be inhibited. b. steroids reverse the progression of the disease. c. steroids inhibit synaptic degradation of neurotransmitters. d. demyelination is mediated by immune mechanisms.

D

Prosthetic joint infection is most often because of a. injury to the joint. b. hematogenous transfer. c. arthritis. d. defective replacement material.

B

A level of ____ on the Glasgow Coma Scale indicates likely fatal damage. a. 12 b. 3 c. 15 d. 8

B

A malignant bone-forming tumor is referred to as a(n) a. chondrosarcoma. b. osteosarcoma. c. liposarcoma. d. rhabdosarcoma.

B

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes a. dry, scaly patches in the antecubital area and behind the knees. b. a butterfly pattern rash on the face across the bridge of the nose. c. lesions affecting the palms of hands and the soles of feet. d. cracked, scaly areas in the webs of fingers.

B

Ascending paralysis with no loss of sensation is characteristic of a. amyotrophic lateral sclerosis. b. Guillain-Barré syndrome. c. myasthenia gravis. d. multiple sclerosis.

B

Compartment syndrome occurs secondary to a. bone infarction. b. soft-tissue damage. c. muscle necrosis. d. breakdown of RBCs.

B

In contrast to osteoarthritis, rheumatoid arthritis may be associated with a. debilitating joint pain and stiffness. b. improvement in symptoms with aspirin therapy. c. systemic aching in the musculoskeletal system. d. changes in activities of daily living.

C

In older women, osteoporosis is thought to be primarily because of a. dietary inadequacies. b. malabsorption syndrome. c. estrogen deficiency. d. inactivity.

C

It is true that epidural bleeding is a. usually because of venous leakage. b. associated with widespread vascular disruption. c. characterized by a lucid interval immediately after injury. d. located between the arachnoid and the dura mater.

C

Pain that waxes and wanes and is exacerbated by physical exertion is likely related to a. intermittent claudication. b. neuropathy. c. fibromyalgia syndrome. d. neuralgia.

C

Rupture of a cerebral aneurysm should be suspected if the patient reports a. transient episodes of numbness. b. ringing in the ears. c. sudden, severe headache. d. transient episodes of vertigo.

C

Slow pain sensation is transmitted primarily by a. Aδ fibers. b. group Ia afferents. c. unmyelinated C fibers. d. α motor neurons.

C

The physiologic change most likely to lead to an increase in intracranial pressure is a. hypernatremia. b. respiratory hyperventilation. c. cerebral vasodilation. d. REM sleep.

C

Tophi are a. renal calculi composed of uric acid. b. painful edematous joints. c. deposits of urate crystals in tissues. d. spots that coalesce in a malar rash.

C

One of the most common causes of acute pain is a. malignancy. b. fibromyalgia. c. trigeminal neuralgia. d. headache.

D

People who have osteoporosis are at risk for a. rhabdomyolysis. b. osteomalacia. c. osteomyelitis. d. bone fractures.

D

The disease that is similar to osteomalacia and occurs in growing children is a. Paget disease. b. osteopenia. c. osteosarcoma. d. rickets.

D

The most common type of osteomyelitis is a. contiguous focus. b. Brodie abscess. c. direct invasion. d. hematogenous.

D

The most important preventive measure for hemorrhagic stroke is a. anticoagulation. b. thrombolytics. c. management of dysrhythmias. d. blood pressure control.

D

The pain of nonarticular rheumatism ("growing pain") is worse a. following strenuous exercise. b. during activity. c. upon awakening. d. during the night.

D

The stroke etiology with the highest morbidity and mortality is a. intracranial embolization. b. intracranial thrombosis. c. cardiac arrest. d. intracranial hemorrhage.

D

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? a. Osteopenia b. Osteoporosis c. Osteomyelitis d. Osteomalacia

D

Autonomic dysreflexia is characterized by a. hypertension and bradycardia. b. hypotension and shock. c. pallor and vasoconstriction above the level of injury. d. extreme pain below the level of injury.

A

Clinical manifestations of a stroke within the right cerebral hemisphere include a. left-sided muscle weakness and neglect. b. cortical blindness. c. expressive and receptive aphasia. d. right visual field blindness.

A

Gouty arthritis is a complication of a. inadequate renal excretion of uric acid. b. group A streptococcal infection. c. excessive production of urea. d. autoimmune destruction of joint collagen.

A

In the acute phase of stroke, treatment is focused on a. stabilization of respiratory and cardiovascular function. b. prevention of bedsores and contractures. c. risk factor modification. d. neurologic rehabilitation

A

Inflammation of the sacs that overlie bony prominences is called a. bursitis. b. arthritis. c. epicondylitis. d. tendinitis.

A

It is true that Bell palsy is a a. paralysis of the muscles innervated by the facial nerve. b. painful neuropathic pain affecting the trigeminal nerve. c. herpetic outbreak in a facial dermatome. d. permanent facial paralysis after stroke.

A

Manifestations of acute brain ischemia (Cushing reflex) are due primarily to a. sympathetic nervous system activation. b. parasympathetic nervous system activation. c. autoregulation of body systems. d. loss of brainstem reflexes.

A

Modulation of pain signals is thought to be mediated by the release of a. endorphins. b. cholecystokinin. c. histamine. d. glutamine.

A

Paget's disease is characterized by a. excessive bone resorption followed by excessive formation of fragile bone. b. overactivity of osteoblasts leading to multiple bone tumors. c. inflammatory disorder resulting in fusion of spine joints. d. failure of resorption by osteoclasts resulting in hard bones.

A

Parkinson disease is associated with a. a deficiency of dopamine in the substantia nigra. b. demyelination of CNS neurons. c. insufficient production of acetylcholine in the basal ganglia. d. a pyramidal nerve tract lesion.

A

Rickets is characterized by soft, weak bones resulting from a deficiency of a. vitamin D. b. calcium. c. estrogen. d. phosphate.

A

Seizures that involve both hemispheres at the outset are termed a. generalized. b. partial. c. focal. d. complex.

A

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is a. air embolus. b. fat emboli. c. compartment syndrome. d. bone infection.

A

In contrast to osteoarthritis, rheumatoid arthritis may be associated with a. changes in activities of daily living. b. systemic aching in the musculoskeletal system. c. debilitating joint pain and stiffness. d. improvement in symptoms with aspirin therapy.

B

An example of inappropriate treatment for head trauma would be a. head elevation. b. bed rest. c. hypoventilation. d. free water restriction.

C

Ankylosing spondylitis is characterized by a. loss of articular cartilage in weight-bearing joints. b. excessive bone remodeling leading to soft bone. c. inflammation, stiffness, and fusion of spinal joints. d. immune mechanisms leading to widespread joint inflammation.

C

Ankylosing spondylitis is characterized by a. loss of articular cartilage in weight-bearing joints. b. immune mechanisms leading to widespread joint inflammation. c. inflammation, stiffness, and fusion of spinal joints. d. excessive bone remodeling leading to soft bone.

C

Which statement is true about the incidence of multiple sclerosis? a. There is a higher rate of MS in African-Americans. b. MS is more common in men than women. c. There is a higher incidence of MS in military veterans. d. The age of onset ranges from 20 to 50 years.

D