Exam 1
What is the temperature range for moderate hypothermia?
86° to 93° F (30° to 33.9° C).
What is the temperature range of mild hypothermia?
93-95 F (33.9-35 C).
What is the average normal temperature range?
96.8-100.4 F (36-38 C).
What is the temperature range for heat exhaustion?
99.6°-105.8° F (37.5° to 41° C).
Hyperthermia.
A body temperature above normal range (>36.2°C).
Hypothermia.
A body temperature below normal range (<36.2°C).
Mutation.
A change in a gene that affects function.
What are the three most common inheritance patterns of genetic disorders?
Autosomal dominant (heterozygous), Autosomal recessive (homozygous), and X-linked recessive disorders.
What are nursing interventions to optimize thermoregulation?
Avoid exposure to temperature extremes, maintain the optimal ambient temperature in the home, dress appropriately for the temperature, and engage in physical activity appropriate to temperature conditions.
Multifactorial inherited conditions.
Complex diseases that result from inherited variations in genes acting together with environmental factors.
Hypothermia.
Core temperature lower than 95° F (35° C), body heat produced less than body heat lost.
What is the temperature range for heatstroke?
Core temperature rises within 10 to 15 minutes, higher than 105.8° F (41° C).
Acquired (somatic) mutations.
Error during cell division or related to environmental factors.
X-linked gene.
Gene found on the X chromosome rather than an autosome.
Dominant alleles.
Gene that is expressed in the phenotype of a heterozygous person.
Germline mutations.
Inherited from the parent.
What are some methods of therapeutic management of cystic fibrosis?
Maintain a patient airway, administer bronchodilators, perform or supervise respiratory treatments, administer antibiotics and pancreatic enzymes, increased exercise tolerance, and teach the child and the family about cystic fibrosis and its treatment.
What is the role of pharmacogenomics in developing personalized drug therapy?
Pharmacogenomic studies could lead to the development of drugs that can be tailor-made or adapted to each person's genetic makeup, it allows for the right drug and the right dose to be chosen for the right person.
Cystic Fibrosis.
Single cell disorder, inherited multisystem disorder characterized by widespread dysfunction of the exocrine glands.
What are the most common classifications of genetic disorders?
Single gene disorders, multifactorial inherited conditions, and chromosome disorders.
Autosomal Dominant (Heterozygous).
Single gene pair.
Pharmacogenetics.
The study of genetic variability of drug responses due to variation in single genes.
What are the ethical and social implications of genetic testing?
The test results may not be private, therefore there is a potential for discrimination by employers and insurance companies.
Autosomal recessive (Homozygous).
Two gene pairs.
Y-linked recessive disorders.
A genetic disorder where the mutated gene is found on the Y chromosome mutation, fathers transmit to sons, only men can be affected.
Carrier.
A person who is heterozygous for a gene variant that causes autosomal recessive or X-linked recessive disease.
Thermoregulation.
Processes that balance heat production and heat loss to maintain the body's temperature.
Pharmacogenomics.
The study of genetic variability of drug response due to variation in multiple genes.
Which pathophysiological abnormality is present in cystic fibrosis? a. Dysfunction of sweat glands b. Inactivity of respiratory tract cilia c. Dysfunction of mucus-secreting glands d. Overproduction of endocrine gland activity
c. Dysfunction of mucus-secreting glands
What are some signs and symptoms of cystic fibrosis.
Abnormal secretions of thick, tenacious mucus, obstruction and disfunction of the pancreas, lungs, salivary glands, seat glands, and reproductive organs, and transmitted as an autosomal recessive trait.
What are the cues that a person has thermoregulation problems?
An assessment and history of the patient are taken. The assessment begins with the outward appearance of the patient, looking for sweating and/or shivering, the color of the skin, and touching the skin to assess its temperature. The history involved assessing the patient's age, health history, family history, and social history.
Autosomal dominant (heterozygous).
Caused by a mutation of a single pair in a chromosome, affected.
Autosomal recessive (homozygous).
Caused by mutations of two gene pairs on a chromosome, Carrier.
Chromosome disorders.
Caused by structural changes within chromosomes or by an excess or deficiency of the genes that are found on chromosomes.
Homozygous.
Having two identical alleles for one given gene, one inherited from each parent.
What is the nurse's role in assisting the patient and family in dealing with genetic issues?
To assist in providing information and making critical decisions related to genetic testing and issues.
An older adult with a history of diabetes reports giddiness, excessive thirst, and nausea. During an assessment, the nurse notices the client's body temperature is 105°F (40.6°C), orally. Which condition would the nurse suspect? a. Heat stroke b. Heat exhaustion c. Accidental hypothermia d. Malignant hyperthermia
a. Heat stroke
X-linked recessive disorders.
X chromosome mutation.
When both parents have sickle cell trait, what is the chance that a child will have sickle cell disease? a. 25% b. 50% c. 75% d. 100%
a. 25%
A pediatric client with a past history of chicken pox reports a fever and headache. Which medication would the nurse avoid giving to the client? a. Aspirin b. Tetracycline c. Nalidixic acid d. Chloramphenicol
a. Aspirin
Which antipyretic medication may cause Reye syndrome in children? a. Aspirin b. Naproxen c. Ibuprofen d. Dantrolene
a. Aspirin
Common causes of genetic mutations include (select all that apply) a. DNA damage from toxins. b. DNA damage from UV radiation. c. inheritance of altered genes from father. d. inheritance of altered genes from mother. e. inheritance of somatic mutations from either parent.
a. DNA damage from toxins. b. DNA damage from UV radiation. c. inheritance of altered genes from father. d. inheritance of altered genes from mother.
The nurse notes that a client has mild hypothermia based on which body temperature? a. 29°C (84.2°F) b. 30°C (86°F) c. 33°C (91.4°F) d. 35°C (95°F)
d. 35°C (95°F)
Recessive alleles.
Allele that has no noticeable effect on the phenotype in a heterozygous person.
If a person is heterozygous for a given gene, it means that the person a. is a carrier for a genetic disorder. b. is affected by the genetic disorder. c. has 2 identical alleles for the gene. d. has 2 different alleles for the gene.
d. has 2 different alleles for the gene.
What role does pharmacogenomics have in health care? a. It can assess individual variability to many drugs. b. It can be used to assess the effectiveness of a drug. c. It provides important assessment data for gene therapy. d. It can assess the variability of drug responses due to single genes.
d. It can assess the variability of drug responses due to single genes.
The nurse concludes that a client with a body temperature of 98.6°F (37°C) is experiencing which condition? a. Hypothermia b. Hyperpyrexia c. Hyperthermia d. Normothermia
d. Normothermia
Which activity places a client at risk for hyperthermia? a. Snowmobiling b. Skiing in the winter c. Hiking Alaskan mountains v d. Performing strenuous activity in high humidity
d. Performing strenuous activity in high humidity
Autosomal.
A genetic disorder where the mutant gene is found on an autosome.
X-linked recessive disorders.
A genetic disorder where the mutated gene is found on the X chromosome, men affected, women are carriers.
The nurse anticipates that a child born with a missing chromosome is most likely to have which condition? a. Cretinism b. Phenylketonuria c. Down syndrome d. Turner syndrome
d. Turner syndrome
A couple who recently had a son with hemophilia A is consulting with a nurse. They want to know if their next child will have hemophilia A. The nurse can tell the parents that if their child is a a. boy, he will have hemophilia A. b. boy, he will be a carrier of hemophilia A. c. girl, she will be a carrier of hemophilia A. d. girl, there is a 50% chance she will be a carrier of hemophilia A.
d. girl, there is a 50% chance she will be a carrier of hemophilia A.
What are the risk factors that put people at risk for thermoregulation problems?
Old age, young age, being cognitively impaired, people under the influence of drugs, having heart failure, having diabetes, having experienced a traumatic brain injury.
When should rewarming be discontinued?
once core temperature is 90° to 95° F (32.2° to 35° C).
Single gene disorders.
Genetic disorders resulting from a single gene mutation, can be dominant, autosomal, or x-linked, rare.
Heterozygous.
Having two different alleles for one given gene, one inherited from each parent.
The parents of a child with sickle cell anemia (SCA) tell the nurse, "We have never had any symptoms of SCA and do not understand why our child has this problem." Which information will the nurse include when teaching the parents? a. SCA is caused by a random genetic mutation with no known cause. b. People who are carriers of SCA may not have symptoms, but all of their children will have SCA. c. If both parents are carriers of SCA, there is a 25% chance that offspring will have SCA. d. When a child is born with SCA, genetic testing of both parents is needed to determine if they have sickle cell trait.
c. If both parents are carriers of SCA, there is a 25% chance that offspring will have SCA.
The nurse finds the client's fever spikes and falls without a return to a normal level. Which pattern of fever is this a characteristic? a. Relapsing b. Sustained c. Remittent d. Intermittent
c. Remittent
Arrange the sequence of events occurring during a fever in chronological order. 1. Pyrogens are destroyed. 2. The set point of the hypothalamus is raised. 3. Immune system response is triggered. 4. Heat loss responses are initiated. 5. Body temperature is increased.
3. Immune system response is triggered. 2. The set point of the hypothalamus is raised. 5. Body temperature is increased. 1. Pyrogens are destroyed. 4. Heat loss responses are initiated.
Recessive allele.
Allele that has no noticeable effect on the phenotype in a heterozygous person.
What are the two common causes of genetic mutations?
Germline mutations and acquires (somatic) mutations.
Which symptom is common. during the fulminant stage of inhalation of anthrax? Select all that apply. One, some, or all responses may be correct. a. Dyspnea b. Dry cough c. Diaphoresis d. Mild chest pain e. High temperature
a. Dyspnea c. Diaphoresis e. High temperature
The nurse is caring for a school-aged child with cystic fibrosis. Which pathophysiologic factor has the greatest effect on the child's health status? a. Extremely thick mucus causing obstructed airways b. Acute inflammation of the lung parenchyma c. Endocrine glands secreting increased levels of hormones d. Increased irritability of the airways resulting in obstruction
a. Extremely thick mucus causing obstructed airways
Which clinical manifestation is associated with inhalation anthrax? Select all that apply. One, some, or all responses may be correct. a. Fever b. Fatigue c. Rhinitis d. Dry cough e. Sore throat
a. Fever b. Fatigue d. Dry cough
The nurse is instructing a community group regarding risk factors for coronary artery disease. Which risk factor cannot be modified? a. Heredity b. Hypertension c. Cigarette smoking d. Diabetes mellitus
a. Heredity
Which pathophysiological process would the nurse expect to account for growth failure in a 4-year-old child with newly diagnosed cystic fibrosis? a. Impaired digestion and absorption because of the lack of pancreatic enzymes b. Dyspnea and shortness of breath, which cause anorexia and disinterest in food c. Increased bowel motility and diarrhea, which lead to inadequate absorption of nutrients d. Pulmonary obstruction, which causes an oxygen deficit and inadequate tissue nourishment
a. Impaired digestion and absorption because of the lack of pancreatic enzymes
A male adolescent with cystic fibrosis, whose parents are both carriers of the disease, asks the nurse, 'When I have children, could they have cystic fibrosis like me?' Which information would the nurse consider before responding? a. Men with cystic fibrosis usually are sterile, although sexual function is not affected. b. Men with cystic fibrosis generally have a 50% chance of having children with the disease. c. Women will pass this disease to their children because it is carried on the sex chromosome. d. Women have a 25% chance of passing the disease to their children if their parents are carriers.
a. Men with cystic fibrosis usually are sterile, although sexual function is not affected.
Which signs and symptoms are observed in the human body with a decrease in body temperature? Select all that apply. One, some, or all responses may be correct. a. Shivering b. Profuse sweating c. Flushed appearance d. Dilation of blood vessels e. Contraction of blood vessels
a. Shivering e. Contraction of blood vessels
Which site would be safer and less expensive for temperature measurement of a human? Select all that apply. One, some, or all responses may be correct. a. Skin b. Oral c. Axilla d. Rectal e. Tympanic membrane
a. Skin c. Axilla
If a person tests positive for a genetic mutation, it means (select all that apply) a. the laboratory found an alteration in a gene. b. the person is predisposed to develop a genetic disease. c. there is the chance other family members may be at risk. d. the person will develop the disease at some point in time. e. the person should not have any children or any more children.
a. the laboratory found an alteration in a gene. c. there is the chance other family members may be at risk.
The nurse is discussing the need for genetic counseling with a teenager who has a sibling with cystic fibrosis (CF). The identification of which test by the teenager indicates that they understand the genetic counseling? a. Chest x-ray b. Carrier testing c. Sweat chloride d. Chromosomal assay
b. Carrier testing
The nurse is measuring the body temperature of four 'clients in a clinical setting. Which client is in need of rewarming through cardiopulmonary bypass? Client A- 94.2 F (34.5 C) Client B- 85.3 F (29.6 C) Client C- 89.4 F (31.9 C) Client D- 91.5 F (33.1 C) a. Client A b. Client B c. Client C d. Client D
b. Client B
Which part of the client's body would the nurse assess to confirm a diagnosis of frostbite? Select all that apply. One, some, or all responses may be correct. a. Axilla b. Fingers c. Ear lobes d. Forehead e. Upper thorax
b. Fingers c. Ear lobes
Which condition is the nurse trying to prevent when teaching a client, undergoing diuretic therapy, to avoid working in the garden on hot summer days? a. Frostbite b. Heatstroke c. Hypothermia d. Hyperthermia
b. Heatstroke
Which complication of cystic fibrosis is related to frequent stools and tenacious mucus? a. Anal fissures b. Rectal prolapse c. Intussusception d. Meconium ileus
b. Rectal prolapse
After assessing the vital signs and medical history of a client admitted to the hospital experiencing chills and fever, the nurse concludes the fever pattern is remittent. Which assessment finding led to this conclusion? a. The client's temperature returns to an acceptable value at least once in the past 24 hours. b. The client's fever spikes and falls without a return to normal temperature levels. c. Periods of febrile episodes and periods with acceptable temperature values occur. d. The client has a constant body temperature continuously above 100.4°F (38°C) with minimal fluctuation
b. The client's fever spikes and falls without a return to normal temperature levels.
Which education would the nurse provide to the family of a 10-year-old child diagnosed with hemophilia about the genetic inheritance of the condition? a. It follows the Mendelian law of inherited disorders. b. The mother is a carrier of the disorder but usually is not affected by it. c. It is an autosomal dominant disorder in which the woman carries the trait. d. A carrier may be male or female, but the disease occurs in the sex opposite that of the carrier.
b. The mother is a carrier of the disorder but usually is not affected by it.
The nurse genetic counselor is working with a couple, each of whom is a carrier of an autosomal-recessive disorder. Which statement indicates that the couple has understood the teaching about this disorder? a. 'Most of our children will have the disorder.' b. 'None of our children will have the disorder' c. 'There is a 1-in-4 chance of having a child with the disorder. d. 'There is a 1-in-2 chance of having a child with the disorder!
c. 'There is a 1-in-4 chance of having a child with the disorder.
Which assessment finding would the nurse recognize as common in infants with Down syndrome? a. Bulging fontanels b. Stiff lower extremities c. Abnormal heart sounds d. Unusual pupillary reactions
c. Abnormal heart sounds
A 26-year-old woman whose sister recently had a lumpectomy for breast cancer calls the local women's health center and asks for an appointment for a mammogram. Which guidance would the nurse provide the client? a. Mammograms are not done before age 40. b. Genetic testing is required before evaluation when there is a family history of breast cancer. c. An appointment should be given for history, assessment, and indicated imaging. d. A magnetic resonance imaging (MRI) scan would be the recommended imaging for a client with this history.
c. An appointment should be given for history, assessment, and indicated imaging.
The couple in the fertility clinic has learned that one of them carries a gene for a serious condition and that the other parent does not carry the gene. They have been told that there is a 50% chance that their child will have this condition. Which pattern of genetic inheritance is this? a. X-linked recessive b. Autosomal recessive c. Autosomal dominant d. Chromosomal trisomy
c. Autosomal dominant
The parent of an infant with Down syndrome asks the cause. Before responding, the nurse recalls that the genetic factor of Down syndrome results from which finding? a. An intrauterine infection b. An X-linked genetic disorder c. Extra chromosomal material d. An autosomal recessive gene
c. Extra chromosomal material
The nurse is measuring the body temperature of four neonates born at term in a pediatric health setting. Which neonate has normal body temperature? Neonate 1- 35.5 C Neonate 2- 36.0 C Neonate 3- 37.1 C Neonate 4- 38.5 C a. Neonate 1 b. Neonate 2 c. Neonate 3 d. Neonate 4
c. Neonate 3
A father who has an X-linked recessive disorder and a wife with a normal genotype will a. pass the carrier state to all his children. b. pass the carrier state to his male children. c. pass the carrier state to his female children. d. not pass on the genetic mutation to any of his children.
c. pass the carrier state to his female children.
A healthy couple whose child has cystic fibrosis (CF) is concerned about having another child with the disease. Knowing that this disorder has an autosomal-recessive mode of inheritance, how would the nurse respond? a. 'There is a 50% chance that this baby will also be affected.!' b. 'If this baby is male, there is a 50% chance of his being affected.!' c. 'If this baby is female, there is no chance of her being affected, but she will be a carrier.' d. 'There is a 25% chance the baby will be affected and a 50% chance that the baby will be a carrier.'
d. 'There is a 25% chance the baby will be affected and a 50% chance that the baby will be a carrier.'
The nurse assesses an older client reporting chills and determines the client has a fever. Which rectal temperature would the nurse anticipate? a. 36.0°C (96.89F) b. 36.8°C (98.249F) c. 37.2°C (98.96°F) d. 38.5°C (101.3°F)
d. 38.5°C (101.3°F)
Which assessment finding in a newborn is suggestive of cystic fibrosis? a. Rapid heart rate b. Excessive crying c. Sternal retractions d. Abdominal distention
d. Abdominal distention
Which genetic pattern describes an autosomal recessive pattern of inheritance? a. One parent has cystic fibrosis. b. Both parents have cystic fibrosis. c. One parent is a carrier of cystic fibrosis. d. Both parents are carriers of cystic fibrosis.
d. Both parents are carriers of cystic fibrosis.
What characterizes multifactorial genetic disorders? a. Often caused by single gene alterations b. Genetic testing available for most disorders c. Many family members report having the disorder d. Caused by complex interactions of genetic and environmental factors
d. Caused by complex interactions of genetic and environmental factors
Immediately after birth, a newborn is dried before being placed in skin-to-skin contact with the mother. Which type of heat loss would this intervention prevent? a. Radiation b. Convection c. Conduction d. Evaporation
d. Evaporation
Which characteristic is associated with the apocrine glands that secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action? a. Highly active in childhood b. Absent around the umbilicus c. Widely distributed throughout the body d. Grow in conjunction with axillary hair follicles
d. Grow in conjunction with axillary hair follicles
Which common concern of most parents of children with sickle cell anemia would the nurse address at a family education conference? a. Finding special school facilities b. Planning to move to a more therapeutic climate c. Choosing effective birth control measures in the future d. Sharing feelings regarding the transmission of the disorder
d. Sharing feelings regarding the transmission of the disorder
