davis for patho exam 4

A nurse expects a patient with liver failure to have which of the following lab values to be increased?

-AST -ALT -prothrombin time -alkaline phosphatase

What enzymes are associated with the exocrine function of the pancreas?

-amylase secretion -lipase secretion -bicarbonate secretion

Mabel suffers from a history of atrial fibrillation, high blood pressure, and diabetes. She is taking antihypertensive medications. She used to smoke but she quit 4 years ago. Cardiovascular disease runs in her family. Her father died of a heart attack at age 52. Which of the following factors increase Mabel's risk for cerebrovascular disorders?

-atrial fibrillation -high BP -diabetes -family history of cardiovascular disease

Which of the following may cause hyperbilirubinemia?

-bile duct obstruction -increased RBC breakdown -injury to hepatocytes

A nurse is explaining how problems in the liver can result in vomiting of blood. What is the correct sequence of events that occurs to result in hematemesis?

-cirrhosis of liver -portal hypertension -blood backs up into esophageal vein -esophageal varices rupture -blood appears in vomitus

What assessment results may point to liver dysfunction in a patient?

-dark-colored urine -hepatomegaly -elevated serum ammonia levels

The liver plays an important role in carbohydrate metabolism. What processes does the liver engage in related to carbohydrate metabolism?

-glycogen storage -glycogenolysis -gluconeogenesis -glycolysis

A patient needs to be evaluated for specific signs of acute pancreatitis. What signs should be considered?

-grey turner's sign -cullen's sign

What is the correct sequence of events in the process of conjugation of bilirubin?

-hemoglobin broken down to heme -heme converted to porphyrin -porphyrin converted to biliverdin -biliverdin converted to unconjugated bilirubin -unconjugated bilirubin conjugated by liver

Which of the following are common signs of liver disorders?

-hepatomegaly -jaundice -increased liver enzyme levels in blood

A patient is severely obese, and the nurse is talking to her about her heartburn. What is the correct sequence of how the patient's weight may play a role in her heartburn and also lead to changes in esophageal cells?

-increased body weight -poor closure of LES -stomach acid enters esophagus -burning sensation in sternal area -metaplasia of esophageal cells in response to stomach acid

A nurse is reviewing the progression of a hepatitis B infection in a patient. The patient is concerned that this infection can result in cirrhosis. What is the correct sequence of events from infection of hepatitis B leading to cirrhosis?

-inoculation with hepatitis B -inflammatory response to infection within hepatocytes -immune response to infection, with increasing antibody production -prolonged immune response results in irreversible liver damage -cirrhosis develops

What is the proper sequence of events related to enterohepatic recycling of bile salts, beginning with bile salt formation?

-liver synthesizes bile -bile is stored in the gallbladder -gallbladder releases bile in response to fat in diet -bile salts in ileum are reabsorbed -bile salts enter portal veins

this is the term used for blood-containing stool

-melena

A nurse is assessing a patient for peritonitis. Which of the following signs and symptoms are present with peritonitis?

-rebound tenderness of abdomen -abdominal pain -decreased of absent bowel sounds -abdominal rigidity

For which of the following may immunosuppressants be a therapeutic option?

-ulcerative colitis -crohn's disease

A nurse is speaking to a patient about an EEG test. Which of the following statements by the nurse is correct?

EEG sensitivity has been shown to be increased with sleep deprivation

Which medication may increase the risk for an upper GI disorder?

NSAIDs

A patient with Parkinson's disease has developed difficulty swallowing and has experienced bladder and bowel dysfunction. What is the correct understanding?

Patients with Parkinson's disease may develop nonmotor signs and symptoms

Jonah presents in the emergency department with a rapid pulse and lightheadedness. Further questioning reveals Jonah has recently experienced hematemesis and melena.

UGIB

A patient is suffering an attack of diverticulitis. Which of the following should be used to enable the colon to rest?

a nasogastric tube

A nurse is helping a patient diagnosed with a hiatal hernia. He does not understand what this means. Which of the following is the correct explanation for the nurse to provide?

a portion of your stomach is pushing up through the opening of your diaphragm

When is a patient with gallbladder dysfunction most likely to note pain?

after eating fatty foods

Acute pancreatitis may cause autodigestion of the pancreas and result in elevation in the serum of pancreatic ______________ and _________________.

amylase and lipase

David is a retired football player who has been recently diagnosed with a neurological disorder. The first signs and symptoms included weakness of his extremities and speech changes. David's disease is progressing; he now experiences dysphagia and muscle spasticity. His treatment plan is designed to manage his symptoms, as there is no cure.

amyotrophic lateral sclerosis (ALS)

An inability to pass gas or produce a bowel movement may indicate _____________.

an intestinal obstruction

which medication can be part of the treatment strategy for an ischemic stroke

antiplatelet medications

Albert presents in intense pain that has been increasing over the last 2 days. The pain began in the center of the abdomen but has now localized more to the right lower quadrant (RLQ). The pain increases when he coughs or takes a deep breath. During his physical exam, he yelps in pain after the RLQ is palpated at McBurney's point. Surgery is scheduled.

appendicitis

Tom wants to know why his mother's heart condition, atrial fibrillation, may increase her risk for stroke. Which of the following response is correct?

atrial fibrillation increases the risk of clot formation, which can lead to stroke

The physical examination findings of a patient who has liver disease show dilated veins over the umbilical area of the abdomen. What is this finding called?

caput medusa

Anna's disorder is detected by a positive antibody test and confirmed through a biopsy of the small intestine and is also known as gluten-sensitive enteropathy.

celiac disease

A patient complains of nausea and vomiting after eating, along with right upper quadrant pain that radiates to the right shoulder. What condition do you suspect?

cholecystitis

Nick complains of abdominal pain and bouts of diarrhea. He thinks that there may be blood in his stool and he has lost 15 pounds since his last visit 6 months ago. Nick is scheduled for a colonoscopy, which reveals a cobblestone appearance in areas of the colon, interspersed with normal-looking portions. A biopsy sample of the colon shows transmural damage.

crohn's disease

A patient is vomiting blood. Which of the following values would support the nurse's concerns about an upper gastrointestinal (GI) bleed (UGIB)?

decreased hematocrit

Henry complains of constipation and has a low-grade fever, as well as pain in the abdominal lower left quadrant (LLQ). Acute pain results from certain foods, whereas dull aching pain or no pain occurs after other meals. When reviewing his diet, you notice a lack of dietary fiber.

diverticular disease

The production of which neurotransmitter is disrupted in Parkinson's disease?

dopamine

In the emergency department, a patient arrives complaining of dizziness, sweating, and diarrhea after he eats. He is wondering if he has food poisoning. The nurse sees on his chart that he has had bariatric surgery. What does the nurse suspect?

dumping syndrome

Hepatic encephalopathy may begin to develop in a patient with

elevated serum ammonia levels

A patient is suffering a severe attack of ulcerative colitis. Which may be of greatest concern?

fluid and electrolyte loss due to severe diarrhea

Several months ago, Julianne had gastroenteritis. Since that infection resolved, she has been healthy until a few days ago when she started having weakness in her extremities. She is now having difficulty walking. After running diagnostic tests, her physician expects her to fully recover.

guillain-barre syndrome

Which bacteria is the most common cause of chronic gastritis?

helicobacter pylori

this is the term used for vomit containing bright-red blood or dark coffee ground appearance

hematemesis

A nurse is treating a patient with hepatic encephalopathy. Which of the following is true about this condition?

hepatic encephalopathy is often associated with elevated ammonia levels

Which form of hepatitis is primarily transmitted through the blood, often through IV drug use?

hepatitis C

When you speak with Laura to review her symptoms further, you ask what type of food she eats that tends to result in pain. You know that ________________ foods tend to worsen gallbladder pain.

high-fat

Which of the following risk factors should be controlled in order to reduce the risk of hemorrhagic stroke?

hypertension

A patient with advanced liver failure has presented with edema. What likely played a role in this development?

hypoalbuminemia

A nurse is caring for a patient diagnosed with portal hypertension. What development should the nurse be concerned about?

increased risk for esophageal varices

A biliary duct obstruction may cause _______________.

increased serum bilirubin levels

The CT scan results show no cerebral bleeding. What type of stroke is Mabel experiencing?

ischemic

What is the term for the cells surrounding an area of ischemia that are not irreversibly damaged?

ischemic penumbra

A patient has experienced a vertebral-basilar insufficiency. Which of the following will the nurse expect the patient to experience?

loss of coordination

Wendell complains that his stool has recently been much darker than normal. He states this occurs regardless of what he has eaten. He reports that the darkened stools are happening with increasing frequency.

melena

A clinician is assessing a patient for cholelithiasis. What sign, if positive, would support this diagnosis?

murphy's sign

Laura is a 48-year-old woman who recently appeared at the clinic complaining of right upper quadrant (RUQ) pain that worsens after eating. From her records, you see that Laura has been in poor health for some time. She is obese and leads a sedentary lifestyle. Her medical history shows prolonged alcohol abuse, although Laura reports that she has been attending Alcoholics Anonymous meetings "on and off" for the past 2 years. You want to evaluate Laura's reported pain further. Upon palpation of the right abdomen, Laura cringes as you press down while asking her to breathe in deeply. You consider this to be positive for _______________.

murphy's sign

Michael's disorder initiates in substantia nigra of basal ganglia. His disorder causes slow movements and muscle rigidity. He often experiences a pill-rolling tremor. He is currently on dopamine replacement therapy.

parkinson's disease

Lisa presents in the emergency department with severe abdominal pain, abdominal rigidity, and significant rebound tenderness. Bowel sounds are hypoactive, and Lisa appears in distress and says even a cough or movement will cause abdominal pain.

peritonitis

Noah, a newborn, is experiencing projectile vomiting, and his family rushes him to the emergency department. The family states that it seems as if anything Noah recently has tried to eat is not being absorbed. An X-ray reveals surgery will be necessary.

pyloric stenosis

A patient has been diagnosed with a gastric ulcer. He wants to discuss dietary recommendations. Which of the following may the nurse share that will be helpful?

refrain from or severely limit alcohol intake

A patient is suspected to have a hepatitis infection. What is the most helpful for the clinician's diagnosis?

serology results

Laura finds it strange when you ask if she feels any pain in her _________________. You tell her you are asking this question because you suspect she may have inflammation of her gallbladder and the pain from this condition often radiates.

shoulder

this is the term used for the loss of fat in stool

steatorrhea

A patient has tested positive for hepatitis B surface antigen (HBsAg). What is the correct interpretation?

the patient has active hepatitis B

A patient has atrial fibrillation. Which stroke type does the patient have increased risk of developing?

the pt has an increased risk of developing an ischemic stroke

A patient presents with jaundice. A nurse is reviewing their lab values and notes the following: normal AST, normal ALT, and elevated reticulocyte percentage. What is the correct interpretation?

the rate of hemolysis is increased

A nurse sees Levodopa on a patient's medication list. Which of the following disorders does the nurse expect?

this medication is commonly used to treat Parkinson's disease

what is dysphagia

this term means difficulty swallowing and is a disorder of the esophagus

A patient is taking a proton pump inhibitor (PPI) medication. Which of the following is the most likely purpose of this medication?

to decrease acidity of stomach secretions

A nurse notes on a patient's chart a prescription for corticosteroids. The patient has severe Crohn's disease. What is the primary purpose of the medication?

to suppress inflammatory response in the GI tract

A clinician is working with Naomi, who appears to have an inflammatory bowel disease. Naomi has symptoms that could indicate ulcerative colitis or Crohn's disease. Her colonoscopy results show inflammation beginning in rectal areas of mucosa only, no cobblestone appearance, and presence of several pseudopolyps.

ulcerative colitis

A patient has a disruption of bile function. Which nutrient absorption will be affected the most?

vitamins A, D, E, and K

John presents in the emergency department with a swollen abdomen. He is bent over in intense pain. When asked to describe the pain, John states that it is cramping in nature and going in waves. His abdomen feels tender to touch. John starts vomiting. A lower GI series is ordered, with results indicating surgery is needed.

volvulus