Module 2: Homeostasis and Regulation

Which key feature indicates malignancy in a client with acute immunodeficiency syndrome (AIDS)? 1 Dry skin 2 Weight loss 3 Kaposi sarcoma 4 Opportunistic infections

3 Kaposi sarcoma is a key feature that indicates malignancy in an AIDS client. Dry skin is an integumentary manifestation in a client suffering from AIDS. Weight loss is a gastrointestinal manifestation in a client with AIDS. Opportunistic infection is an immunological manifestation in a client with AIDS.

Which sexually transmitted infections are caused by bacteria? Select all that apply. One, some, or all responses may be correct. 1 Syphilis 2 Hepatitis 3 Gonorrhea 4 Herpes simplex 5 Trichomoniasis

1,3 Syphilis is caused by Treponema pallidum, a motile spirochete bacterium. Gonorrhea is caused by a bacteria called Neisseria gonorrhoeae. Hepatitis A and herpes simplex are caused by viruses. Trichomoniasis is caused by a protozoan.

Which observations would indicate findings found in a child with Turner syndrome? Select all that apply. One, some, or all responses may be correct. 1 Webbed neck 2 Impaired language 3 Tall stature with long legs 4 Low position of posterior hairline 5 Shield-shaped chest with wide space between the nipples

1,4,5 Turner syndrome is a chromosomal abnormality seen in females in which an X chromosome is partly or completely absent. The clinical manifestations of Turner syndrome include a webbed neck, low posterior hairline, and shield-shaped chest with wide space between the nipples. Impaired language skills are seen in clients with triple X, or superfemale syndrome. The client with Turner syndrome has short stature. Tall stature with long legs is a finding in Klinefelter syndrome.

In which order do the events of antidiuretic hormone (ADH) secretion stimulated by plasma osmolarity occur?

1. Extracellular fluid is decreased. 2. Plasma osmolarity is increased. 3. Osmoreceptors are activated. 4. Antidiuretic hormone (ADH) is released. 5. Water is reabsorbed from renal tubules.

The nurse would assess for which electrolyte imbalance during the first 48 hours after a client has sustained a thermal injury? 1 Hypokalemia and hyponatremia 2 Hyperkalemia and hyponatremia 3 Hypokalemia and hypernatremia 4 Hyperkalemia and hypernatremia

2 Massive amounts of potassium are released from the injured cells into the extracellular fluid compartment; large amounts of sodium are lost in edema. Serum potassium will rise, leading to hyperkalemia. Serum sodium deficit will occur, leading to hyponatremia.

Which medication is used to prevent preterm labor? 1 Oxytocin 2 Nifedipine 3 Raloxifene 4 Clomiphene

2 Nifedipine is used to prevent preterm labor because it inhibits myometrial activity by blocking the influx of calcium. Oxytocin may be used to induce labor. Raloxifene is used to prevent postmenopausal osteoporosis. Clomiphene is used to cause ovulation.

Which metabolic manifestations are likely to be observed in a client with hypothyroidism? Select all that apply. One, some, or all responses may be correct. 1 Impaired memory 2 Intolerance to cold 3 Difficulty breathing 4 Decreased blood pressure 5 Decreased body temperature

2,5 Cold intolerance and decreased body temperature are the metabolic manifestations observed in a client with hypothyroidism. Impaired memory is the neuromuscular manifestation of hypothyroidism. Difficulty in breathing is the pulmonary manifestation observed in the client with hypothyroidism. Decreased blood pressure is the cardiovascular manifestation observed in the client with hypothyroidism.

Which type of vaccines triggers the recipient's immune system to produce antitoxins? 1 Live vaccines 2 Killed vaccines 3 Toxoid vaccines 4 Specific immune globulins

3 Toxoids are a nontoxic form of bacterial toxins that induce the formation of antitoxins by the recipient's immune system. Examples of these types of vaccines include tetanus toxoid and diphtheria toxoid. Both live and killed vaccines induce the body's immune system to produce antibodies, making the individual actively immune to the microbes. Specific immune globulins are high concentration of antibodies prepared from donated blood directed against specific antigens.

The nurse understands which antiepileptic medication would be used as the first-line treatment for absence seizures? 1 Phenytoin 2 Diazepam 3 Valproic acid 4 Acetazolamide

3 Valproic acid is used as the first-line treatment for absence seizures. Phenytoin is used to treat partial, secondary, and generalized tonic-clonic seizures. Diazepam is used to treat status epilepticus. Acetazolamide is used as an adjunct medication for the treatment of absence seizures.

Which sign or symptom would the nurse expect to find on assessment of a client with a blood glucose level of 55 mg/dL? Select all that apply. One, some, or all responses may be correct. 1 Increased thirst 2 Abdominal pain 3 Frequent urination 4 Cold, clammy skin 5 3+ glucose in urinalysis

4 A client with a blood glucose level of 55 mg/dL indicates hypoglycemia. Clinical manifestations would include cold, clammy skin; tachycardia; nervousness; and slurred speech. A client with hyperglycemia would present with increased thirst (polydipsia), abdominal pain, increased urination (polyuria), and polyphagia. The client with hyperglycemia would have glycosuria.

Which hormonal deficiency causes diabetes insipidus in a client? 1 Prolactin 2 Thyrotropin 3 Luteinizing hormone 4 Antidiuretic hormone (ADH)

4 ADH deficiency causes diabetes insipidus. Decreased levels of prolactin may cause decreased amounts of milk secretion after birth. Decreased levels of thyrotropin cause hypothyroidism, weight gain, and lethargy. Luteinizing hormone deficiency causes menstrual abnormalities, decreased libido, and breast atrophy.

Which clinical finding would the nurse associate with hypokalemia? 1 Edema 2 Muscle spasms 3 Kussmaul respirations 4 Muscle weakness

4 Serum hypokalemia diminishes the magnitude of the neuronal and muscle cell resting potentials. This can result in observable muscle weakness. Edema is associated with electrolyte imbalances, including sodium excess (hypernatremia). Muscle spasms and twitching are often seen in the setting of hypocalcemia. Kussmaul respiration is a breathing pattern characterized by deep and labored breaths in response to metabolic acidosis, especially diabetic ketoacidosis.

The nurse is assessing a client's degree of edema and finds 8 mm of depth. Which would be correct to document this condition? A. 1+ B. 2+ C. 3+ D. 4+

D Edema of 8 mm is documented as 4+. If the edema has a depth of 2 mm, then it is documented as 1+. If the edema has a depth of 4 mm, it is documented as 2+. If the edema has a depth of 6 mm, then it is documented as 3+.

Which antipyretic medication may cause Reye syndrome in children? 1 Aspirin 2 Naproxen 3 Ibuprofen 4 Dantrolene

1 Aspirin increases the risk of swelling in the brain and liver, which are the main symptoms of Reye syndrome in children. Aspirin is not recommended in children. Medications such as naproxen and ibuprofen do not induce swelling in the brain and liver; therefore, these medications may not cause Reye syndrome. Dantrolene does not induce swelling in the brain and liver; instead, it decreases calcium levels during malignant hyperthermia conditions.

Which autoantigens are responsible for the development of Crohn disease? 1 Crypt epithelial cells 2 Thyroid cell surface 3 Basement membranes of the lungs 4 Basement membranes of the glomeruli

1 Crypt epithelial cells are considered the autoantigens responsible for Crohn disease. Thyroid cell surfaces are autoantigens responsible for Hashimoto thyroiditis. The pulmonary and glomerular basement membranes act as autoantigens responsible for Goodpasture syndrome.

A client has bright-red erythematosus macules and papules on the skin. The nurse would expect to teach the client about which condition? 1 Medication eruption 2 Atopic dermatitis 3 Contact dermatitis 4 Nonspecific eczematous dermatitis

1 Medication eruptions are characterized by bright-red erythematosus macules and papules on the skin, which occur because of an adverse reaction to a medication. Atopic dermatitis is characterized by scaling and excoriation, which occurs due to food allergies, chemicals, or stress. Contact dermatitis manifests as localized eczematous eruption when the skin comes into direct contact with irritants or allergens. Nonspecific eczematous dermatitis results in evolution of lesions from vesicles to weeping papules and plaques.

Which would the nurse identify as the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone? 1 Misoprostol 2 Mifepristone 3 Dinoprostone 4 Methylergonovine

1 Misoprostol is the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone because it is relatively affordable. Mifepristone is used to induce labor. Dinoprostone is used for cervical ripening but is not an off-label medication for cervical ripening. Methylergonovine is used to enhance myometrial tone but is not used to augment labor.

Which hormone has both inhibiting and releasing action? 1 Prolactin 2 Somatostatin 3 Somatotropin 4 Gonadotropin

1 Prolactin secreted by the hypothalamus has both inhibiting and releasing action. Somatostatin inhibits the secretion of growth hormone. Somatotropin and gonadotropin are releasing hormones.

Which is the regulator of extracellular osmolarity? 1 Sodium 2 Potassium 3 Chloride 4 Calcium

1 Sodium is the most abundant extracellular fluid cation and regulates serum (extracellular) osmolarity, as well as nerve impulse transmission and acid-base balance. Potassium is the major intracellular osmolarity regulator, and it also regulates metabolic activities, transmission and conduction of nerve impulses, cardiac conduction, and smooth and skeletal muscle contraction. Chloride is a major extracellular fluid anion and follows sodium. Calcium is an extracellular cation necessary for bone and teeth formation, blood clotting, hormone secretion, cardiac conduction, transmission of nerve impulses, and muscle contraction.

Which pulse site is used for the Allen test? 1 Ulnar 2 Popliteal 3 Brachial 4 Femoral

1 The radial site is used for the Allen test. The popliteal pulse is used to assess status of circulation to lower leg. The status of the circulation in the lower arm and blood pressure are assessed using the brachial pulse. The femoral pulse is used to assess the character of the pulse during physiological shock or cardiac arrest when other pulses are not palpable.

Which medication is a leukotriene modifier used to manage and prevent allergic rhinitis? 1 Zileuton 2 Ephedrine 3 Scopolamine 4 Cromolyn sodium

1 Zileuton is a leukotriene modifier used to manage and prevent allergic rhinitis. Ephedrine is an ingredient in decongestants used to treat allergic rhinitis. Scopolamine is an anticholinergic used to reduce secretions. Cromolyn sodium is a mast cell stabilizing medication used to prevent mast cell membranes from opening when an allergen binds to immunoglobulin E (IgE).

Which medication is indicated for evacuation in case of a miscarriage? 1 Clomiphene 2 Dinoprostone 3 Methylergonovine 4 Magnesium sulfate

2 Dinoprostone is a prostaglandin E2 abortifacient and cervical ripening medication, which is indicated for uterine evacuation in cases of miscarriage. Clomiphene is indicated for female infertility in some clients. Methylergonovine is used to treat postpartum uterine atony and hemorrhage. Magnesium sulfate is used to treat pregnancy-induced hypertension.

Which mechanism of action applies to penicillin? 1 Prevents reproduction of the pathogen 2 Inhibits cell wall synthesis of the pathogen 3 Inhibits nucleic acid synthesis of the pathogen 4 Injures the cytoplasmic membrane of the pathogen

2 Penicillin is an antimicrobial medication that inhibits cell wall synthesis of the susceptible pathogen. Gentamicin is an antimicrobial medication that prevents the reproduction of the susceptible pathogen. Actinomycin is an antimicrobial medication that inhibits nucleic acid synthesis of the susceptible pathogen. Antifungal agents injure the cytoplasmic membrane of the susceptible pathogen.

An unconscious adolescent with type 1 diabetes is brought to the emergency department. The blood glucose level is 742 mg/dL (41.2 mmol/L). Which finding would the nurse expect during the initial assessment? 1 Pyrexia 2 Hyperpnea 3 Bradycardia 4 Hypertension

2 Rapid breathing (hyperpnea) is an attempt by the respiratory system to eliminate excess carbon dioxide; it is a characteristic compensatory mechanism for correcting metabolic acidosis. An increase in temperature (pyrexia) will occur if an infection is present; it is not a response to hyperglycemia. Tachycardia, not bradycardia, results from the hypovolemia of dehydration. Hypotension, not hypertension, may result from the decreased vascular volume associated with hyperglycemia.

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops an infection with anorexia. Which advice will the nurse provide to the client? Select all that apply. One, some, or all responses may be correct. 1 Avoid solid food. 2 Continue to take the oral medication. 3 Drink fluids throughout the day. 4 Monitor capillary glucose levels. 5 Do not take medication until tolerating food.

2,3,4 Physiological stress increases gluconeogenesis, requiring continued pharmacological therapy despite an inability to eat; fluids prevent dehydration; monitoring of glucose levels permits early intervention if necessary. Skipping the oral hypoglycemic agent may precipitate hyperglycemia. Food intake will be attempted to prevent acidosis. Delaying an oral hypoglycemic agent may precipitate hyperglycemia.

The home health nurse provides education for a client with cancer of the tongue who will begin gastrostomy feedings at home. Which client statement indicates effective teaching? 1 "Before I start the procedure, I will don sterile gloves." 2 "Before I start the procedure, I will obtain my body weight." 3 "Before I start the procedure, I will measure the residual volume." 4 "Before I start the procedure, I will instill 1 oz [30 mL] of a carbonated liquid."

3 Measuring the residual volume establishes the absorption amount of the previous feeding. If a residual exceeds the parameter identified by the health care provider or is over 200 mL, a feeding may be held. This safety measure prevents adding excess feeding solution that may lead to abdominal distention, nausea, vomiting, and aspiration. Clean, not sterile, gloves are necessary to protect the client from contamination with gastric secretions. The client obtains and reports weekly or monthly weights, depending on the client's condition and clinical goals. If the tube becomes clogged, the client may instill 30 mL of a carbonated beverage; this action is not used routinely.

Which medication can cause diabetes insipidus? 1 Cabergoline 2 Metyrapone 3 Demeclocycline 4 Aminoglutethimide

3 Prolonged administration of demeclocycline may cause diabetes insipidus, because this medication decreases the production of antidiuretic hormone by the kidneys. Cabergoline inhibits the release of growth hormone and prolactin by stimulating dopamine receptors in the brain. Metyrapone and aminoglutethimide decrease cortisol production.

A client with a high cholesterol level says to the nurse, "Why can't I take a medication that will eliminate all of the cholesterol in my body so it isn't a problem?" The nurse explains that some cholesterol is needed to perform which body function? 1 Blood clotting 2 Bone formation 3 Muscle contraction 4 Cellular membrane structure

4 Cholesterol is an essential structural and functional component of most cellular membranes. The fact that it is associated with atherosclerotic plaques does not detract from its essential functions. Cholesterol is not necessary for blood clotting; calcium and vitamin K are. Cholesterol is not essential for bone formation; calcium, phosphorus, and calciferol are. Cholesterol is not involved in muscle contraction; potassium, sodium, and calcium are.

What would the presence of ketones in the urine of a client indicate? 1 Cystitis 2 Heart failure 3 Urinary calculi 4 Fat metabolism

4 The body of a client, who is ingesting fewer calories than are needed for maintenance, produces ketones from fat metabolism as an alternate source of fuel for muscles and organs. Increased red blood cells in the urine indicate cystitis. Increased specific gravity of the urine indicates heart failure. The presence of casts in the urine indicates urinary calculi.