Path 2 Exam 3 (7/13/21)
Increased upper airway resistance and decreased airflow into the lungs in neonates (0 to 4 weeks of age) can result from: A) Frequent crying B) Sleeping supine C) Nasal congestion D) Productive coughing
c
The client has a fractured tibia. After the cast is applied, he is at high risk for compartment syndrome caused by: A) Inflammation B) Joint immobility C) Muscle atrophy D) Extremity elevation
a
When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which of the following functions in the brain? Select all that apply. A) Impaired blood-brain barrier that allows water/proteins to leave vessels and go into the interstitial space B) Mainly allows edema to form in the white mater of the brain C) May cause herniation by displacing a cerebral hemisphere D) Causes ischemia to build up lactic acid due to anaerobic metabolism E) Allows cells to increase volume to the point of rupture, damaging neighboring cells
D, E
A distinguishing feature of viral influenza is: A) Direct contact transmission B) Abrupt-onset, profound malaise C) Constant pounding headache D) Profuse watery nasal discharge
b
Of the following conditions, which is known to have neurological implications? A.Chlamydial infections B.Gonorrhea C.Candidiasis D.Trichomoniasis E. Syphilis
E
A 22-year-old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A) Human papillomavirus (HPV) B) Chlamydia trachomatis C) Candida albicans D) Trichomonas vaginalis
a
A 51-year-old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which of the man's following statements demonstrates a sound understanding of his new diagnosis? A) "If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis." B) "I'm pretty sure that I first caught bronchitis from the person who has the cubicle next to mine at work." C) "I read on the Internet that I might have got bronchitis because I was born with an enzyme deficiency." D) "I think that I probably could have prevented this if I had got in the habit of exercising more when I was younger."
a
A 6-month-old infant has been hospitalized with acute bronchiolitis. Which of the following treatments should be prioritized in the infant's care? A) Supplementary oxygen therapy B) Intravenous antibiotics C) Transfusion of fresh frozen plasma D) Tracheotomy
a
A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this client's diagnosis? A) Weakness in the muscular wall of an artery B) Impaired synthesis of clotting factors C) Deficits in the autonomic control of blood pressure D) Increased levels of cerebrospinal fluid
a
A client presents to a STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI? A) Gonorrhea B) Chlamydial infection C) Human papillomavirus infection D) Genital herpes simplex virus infection
a
A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her: A) Arms B) Bowels C) Bladder D) Perineal musculature
a
A female receives a PAP smear result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse will emphasize the need for continued follow-up since HPV is directly associated with: A) Uterine cancer B) Cervical dysplasia C) Genital herpes lesions D) Urinary tract infections
b
A client with an 80-pack-year history of tobacco smoking has presented to the clinic complaining of "bronchitis" cough for the past 5 months, weight loss, and shortness of breath. Today, this client "got scared" when he coughed up blood in his sputum. The health care provider is concerned this client may have which of the following possible diagnoses? A) Small cell lung cancer due to smoking history B) Tuberculosis due to long period of coughing C) Pulmonary embolism due to blood in sputum D) Pneumothorax related to chronic lung infection weakening the alveoli
a
A college baseball player has seen his season cut short by a rotator cuff injury. Rotator cuff injuries are frequent because of: A) The inherent instability of the shoulder B) The absence of ligaments at the glenohumeral joint C) The vulnerability of the shoulder menisci D) The large mass of the humeral head
a
A couple presents to an infertility clinic. The health care provider will focus testing on which of the following sexually transmitted infections (STIs) that is very damaging to the reproductive system but rarely exhibits symptoms of infection? A) Chlamydial infection B) Herpes simplex virus infection C) Gonorrhea D) Syphilis
a
A female client presents an STD clinic. She is in the first trimester of pregnancy and has tested positive for gonorrhea. Because strains of N. gonorrhoeae have become resistant to penicillin, the current treatment recommendation includes: A) High-dose cefixime given in a single dose B) Ten-day supply of Flagyl C) Doxycycline over the course of 1 week D) No treatment until after the baby is born
a
A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the care provider give the client? A) "There is a chance that these will clear up on their own without any treatment." B) "It's important to start treatment soon, so I will prescribe you pills today." C) "Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease." D) "I'd like to give you an HPV vaccination if that's okay with you."
a
A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury? A) Headaches and memory lapses B) Recurrent nosebleeds and hypersomnia C) Unilateral weakness and decreased coordination D) Neck pain and decreased neck range of motion
a
A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis and has subsequently developed latent tuberculosis infection. Which of the following is true of this nurse? A) The nurse is likely asymptomatic. B) The nurse is now immune to more severe tuberculosis infection. C) The nurse can spread tuberculosis to others. D) The nurse has active tuberculosis infection.
a
A sudden traumatic complete transection of the spinal cord results in what type of injury below the site? A) Flaccid paralysis B) Vasoconstriction C) Deep visceral pain D) 3+ tendon reflexes
a
A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication? A) Brain contusions and hematomas B) TIAs and cerebrovascular infarction C) Momentary unconsciousness D) Status epilepticus
a
A young, male child is born with severe respiratory failure. Over the course of months, the parents note his body looks swollen. They ask, "Is our baby's kidneys not working right? Why is he so swollen?" The nurse bases his or her reply on which of the following physiological principles? A) "The right side of his heart (cor pulmonale) is not pumping effectively. Blood is backlogging in his body, which is why he is so swollen." B) "We just need to call the physician and ask him to give you a prescription for more water pills." C) "Once we get his oxygenation level back to normal, then maybe his kidneys will receive enough oxygenated blood to filter better." D) "This happens when he has so many secretions in his lungs. Maybe we should try some expectorant to thin his secretions so he can cough them out."
a
An elderly client who has been restricted to bed by numerous comorbidities for several weeks has been diagnosed with a large pleural effusion. Which of the following treatment modalities is most likely to resolve the client's most recent health problem? A) Thoracentesis B) Supplementary oxygen therapy C) Administration of corticosteroids D) Administration of bronchodilators
a
An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms? A) Tertiary syphilis B) Chlamydial C) Gonorrhea D) Human papillomavirus infection
a
Following a fracture, the nurse is educating the client and his family about bone healing. The nurse begins by stating: A) "In order to initiate the cellular events essential to bone healing, within a day or so, your body will develop a blood clot at the fracture site." B) "The first thing that will happen is your body will form a soft tissue callus around the fracture site." C) "Your body will first absorb any excess bone fragments that occurred as a result of the break." D) "Just like on your hands after hard work, your body will begin the healing process by forming a callus at the fracture site."
a
Following a head injury, a client is diagnosed with a possible intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. Other clinical manifestations that correlate with this diagnosis may include: A) Ipsilateral pupil dilation B) Ipsilateral hemiparesis C) Diffuse venous bleeding from the nose D) Increased head circumference with hydrocephalus
a
Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit: A) No symptoms of infection B) Copious amounts of frothy discharge from the penis C) Numerous pustules on the penal shaft D) Redness and pain at the urethral meatus
a
Most respiratory disorders in infants produce a decrease in: A) Lung compliance B) Airway resistance C) Oxygen demand D) Respiratory rate
a
The "cold viruses" are rapidly spread from person to person. The greatest source of spread is: A) Fingers B) Sneezing C) Plastic toys D) Eye mucosa
a
The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that: A) A large percentage (70%) of those infected experience no symptoms of the disease. B) The lesions (LSILs) occur on the cervix and can only be detected by a Pap test. C) Lesions take a long time to incubate and the small papules are usually located inside the vagina. D) The organism spreads upward to the prostate gland in males and fallopian tubes in females.
a
Which of the following clients is at risk for developing acute respiratory failure? A) A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has pneumonia with low O2 saturation B) An elderly female living in senior housing who has been exposed to a "cold" while her grandchildren visited C) A teenager in a high school that has had an increase in student absences due to an outbreak of strep throat D) A toddler in daycare who has been sharing toys with peers before the staff could sanitize properly
a
Which of the following has been implicated as a causative factor in right ventricular failure? A.Cor pulmonale B.Pneumothorax C.Cystic fibrosis D.ARDS
a
Which of the following individuals is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of a granuloma on chest x-ray? A) A 30-year-old African American man who has been diagnosed with sarcoidosis B) An infant whose routine screening is suggestive of cystic fibrosis C) An elderly, lifelong smoker who has been admitted to hospital with emphysema exacerbation D) A 16-year-old girl who must limit her physical activity to prevent the onset of acute asthmatic attacks
a
Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination? A) An 81-year-old resident of a long-term care facility B) A 19-year-old man who was admitted to a hospital for an appendectomy C) A neonate who was born in a busy, inner-city hospital in late October D) An 86-year-old client whose flu symptoms have required hospitalization
a
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma? A) Pet dander B) Cold weather C) Stress D) Respiratory tract infections
a
Which of the following is not a common cause of neural injury? A.Recreational drug use B.Ischemia C.Excitatory amino acids D.Cerebral edema Increased intracranial pressure (ICP)
a
Which of the following statements by the husband of a client with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen? A) "I'm really hoping these medications will slow down her mental losses." B) "We're both holding out hope that this medication will cure her Alzheimer's." C) "I know that this won't cure her, but we learned that it might prevent a bodily decline while she declines mentally." D) "I learned that if we are vigilant about her medication schedule, she may not experience the physical effects of her disease."
a
A male diagnosed with gonorrhea will likely complain of which of the following clinical manifestations? Select all that apply. A) Creamy, yellow discharge B) Pain in the urethra with urination C) Difficulty starting a stream of urine D) "Fish"-smelling discharge from the penis E) Diffuse pelvic pain
a, b
Which of the following clients at the clinic should be encouraged to receive the pneumococcal polysaccharide vaccine (PPSV23)? A client: Select all that apply. A) Who is 65 years old with chronic asthma B) With a smoking history C) Who is a young adult with HIV-positive results D) Who is school-aged and has received a liver transplant E) Who is a teenager with history of kidney disease
a, b
A 2-year-old child is admitted to pediatric unit with bronchiolitis. The nurse calls the physician fearing the child is going into respiratory failure based on which of the following assessment findings? Select all that apply. A) Increased respiratory rate to 44 breaths/minute B) Substernal retractions becoming more pronounced C) New-onset expiratory grunting D) Productive cough with white secretions E) Faint wheezes noted in the posterior lung base
a, b, c
A child in gymnastics class has fallen off the balance beam and hurt her ankle. X-rays are negative for fracture, so the health care provider has diagnosed a severe sprain. Which of the following treatment measures should be taught to the family and child? Select all that apply. A) Immobilization for several weeks B) Elevate the ankle on pillows C) Apply ice packs to the ankle D) Perform active and passive range-of-motion exercises daily
a, b, c
A client with newly diagnosed squamous cell carcinoma of the lung asks, "So how do we treat this cancer?" Which response from the health care provider is most accurate? Select all that apply. A) Surgery to remove tumor B) Radiation therapy C) Chemotherapy D) Stem cell transplant E) Monoclonal antibody
a, b, c
A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the clinic with the following complaints: auscultation of breath sounds reveal absent/diminished breath sounds in the right lower lobe. Which other manifestations lead the health care provider to suspect the client may have developed atelectasis? Select all that apply. A) Respiratory rate—32; pulse rate—122 beats/minute. B) "Having a hard time catching my breath." C) "Seems like I'm not making much water (decreased urine production)." D) Using accessory muscles to help him breathe. E) Copious amounts of thick, green sputum.
a, b, d
A woman who has developed vulvovaginal candidiasis will likely go to her health care provider complaining of: Select all that apply. A) Redness B) Edema C) Frothy, foul-smelling discharge D) Painful urination E) Pustules on labia
a, b, d
A 6-hour-old newborn develops a critical respiratory problem and is rushed to the ICU. The ICU nurses suspect the infant has respiratory distress syndrome (RDS) based on which findings? Select all that apply. A) Bluish discoloration of the skin and mucous membranes (central cyanosis) B) Substernal retractions with each breathe C) Periorbital edema D) Clubbed fingers E) Expiratory grunting
a, b, e
A client is admitted to hospital to rule out Legionnaire disease following a canoe trip where he was sprayed in the face with a lot of "creek" water. Which of the following manifestations are characteristic of Legionnaire pneumonia? Select all that apply. A) Temperature of 103.5°, pulse 80 B) "Talking but not making a lot of sense" (confusion) C) Decreased abdominal bowel sounds D) Productive cough with thick, yellow secretions E) Chest x-ray that reveals areas of consolidation suggestive of pneumonia
a, b, e
A nurse runs into an old high school friend after 20 years. She notes her friend continues to smoke after all these years. The friend asks, "Do you think I sound hoarse?" Upon further assessment, the nurse/friend notes her friend has several warning signs of cancer. Which manifestations would lead to this conclusion? Select all that apply. A) "I seem to have some difficulty swallowing food... this is new for me." B) "I seem to have more trouble holding my urine than I use to." C) "Can you feel how large my lymph nodes are on my neck and armpits (axillae)?" D) Pericardial friction rub heard on auscultation. E) Feels subcutaneous emphysema in upper chest area.
a, c
While lecturing on COPD, the instructor mentions emphysema. The instructor asks the students, "If the client is a smoker, explain the physiology behind cellular changes occurring in the lung which allow destruction of the alveoli." Which students have an accurate response? Select all that apply. A) "Antiprotease production and release is not adequate to neutralize the excess protease production." B) "The capillary beds can no longer bring the cells to the lung to fight off the infection since they are blocked by fatty plaque." C) "There is α1-antitrypsin deficiency, so this enzyme can't protect the lung from damage." D) "The alveolar tissue is being digested by enzymes; therefore, they can't grow back to restore normal ventilation."
a, c
A chronic kidney disease client who has renal osteodystrophy should be assessed for which of the following complications? Select all that apply. A) Muscle weakness B) Kidney stones C) Bone pain D) Stress fractures E) Urosepsis
a, c, d
Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department. Diagnosis of Guillain-Barré syndrome was made based on which of the following assessment findings? Select all that apply. A) Rapid deterioration of respiratory status B) Lack of any physical pain C) Flaccid paralysis of limbs D) BP 90/62 E) Pale, cool, dry skin
a, c, d
A toddler seems to have a little "cold" and runny nose. At bedtime, he appears to be OK. A few hours later, parents awaken hearing a "tight" coughing sound. They recognize the child is not breathing well, so they rush to the emergency department. On arrival, the nurses suspect bronchial asthma based on which of the following assessment data? Select all that apply. A) Audible wheezing B) "Crowing sound with inspiration" C) Respiratory rate—44 with prolonged exhalation D) Coughing up blood-tinged sputum E) Sitting upright, leaning forward, and using accessory muscles to breathe
a, c, e
A traumatic brain injury client has developed extreme cerebral edema. The nurse is monitoring the client closely for signs of brain herniation. Which clinical manifestations would correlate to upward herniation of the midbrain from the infratentorial compartment? Select all that apply. A) Deep coma B) Rhythmic movement of arms and legs C) Respiratory rate of 8 with intermittent sighs D) Intracranial bleeding from nose and ears E) Bilateral small, fixed pupils
a, c, e
The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply. A) Extreme confusion and disorientation B) Incontinence of urine and bowel C) Need for direct supervision for ADLs D) Social withdrawal from all family and friends E) Inability to problem solve simple tasks
a, c, e
As nitrogenous wastes increase in the blood, the CKD client may exhibit which of the following clinical manifestations? Select all that apply. A) Numbness in lower extremities B) Photophobia C) Extremely low platelet counts D) Restless leg syndrome E) Pruritis
a, d, e
Following a dust storm in Arizona, several clients have presented to the clinic complaining of productive cough, fever, and night sweats. The health care provider suspects a fungal infection related to breathing dust. One particular client is critical. They suspect the infection has progressed outside the lung when they observe the client has: Select all that apply. A) Generalized lymph node enlargement B) Urine output decreased to 40 mL/hour C) Requires guaifenesin to cough up sputum D) An enlarged liver via palpation E) Copious bleeding at the site where the lab technician drew some blood
a, d, e
Soon after delivery, the mother grabs the nurses arm and states, "Something's wrong...I can't get my breath." Which of the following assessments lead the nurse to suspect the client has had an amniotic emboli travel to the lungs? Select all that apply. A) BP 90/65; pulse 130, irregular; respiratory rate 35, shallow. B) Intercostal traction noted on inspiration. C) +3 pitting edema in lower extremities. D) Trachea has shifted and is no longer midline. E) Productive cough with blood-streaked sputum.
a, e
A client is beginning to recover from acute tubular necrosis. The nurse would likely be assessing which of the following manifestations of the recovery phase of ATN? A) Edema B) Diuresis C) Proteinuria D) Hypokalemia
b
A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has: A) Candidiasis B) Trichomoniasis C) Bacterial vaginosis D) Chlamydial infection
b
A client with herpes simplex virus (HSV) presents to the clinic stating, "I can stop taking my drugs because I'm cured. My lesions are gone." The health care provider bases his or her response knowing the pathophysiology behind the disappearance of HSV symptoms infection relates to: A) Replication of the squamous epithelium B) Periods of latency in the nervous system C) Inhibition of cell-mediated immunity D) Production of exotoxins
b
A client with significant burns on his lower body has developed sepsis on the 3rd day following his accident. Which of the following manifestations would the nurse anticipate for an ischemic acute tubular necrosis rather than prerenal failure? The client: A) Exhibits pulmonary and peripheral edema B) GFR does not increase after restoration of renal blood flow C) Undergoes emergent hemodialysis that does not result in decreased BUN and creatinine D) Exhibits oliguria and frank hematuria
b
A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem? A) Aggressive diuresis B) Placement of a shunt C) Administration of hypertonic intravenous solution D) Lumbar puncture
b
A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because: A) Expired air exits the bleeding wound. B) Trapped, inspired air collapses the lung. C) The opposite lung hyperinflates. D) Blebs on the lung surface rupture.
b
A teenaged cystic fibrosis client presents to the clinic. The health care provider (HCP) knows that cystic fibrosis (CF) causes severe chronic respiratory disease in children. In addition, the HCP should also focus his or her assessment on which of the other body systems affected by CF? A) Renal B) Pancreatic C) Cardiac D) Central nervous system
b
Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include: A) Diplopia B) Petechiae C) Papilledema D) Focal paralysis
b
During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? A) Uterine cancer B) Fallopian tube damage C) Amenorrhea D) Vaginal adhesions
b
Pleuritic chest pain associated with respiratory movements is usually described as: A) Bilateral B) Localized C) Continuous D) Substernal
b
Rotational acceleration of the head may result in which type of injury? A.Coup B.Contrecoup
b
The most prevalent vaginal infection to be spread through sexual contact is: A) Candidiasis B) Trichomoniasis C) Vulvovaginitis D) Bacterial vaginosis
b
The nurse is caring for a spinal cord injury client. Assessment reveals shallow breath sounds with a very weak cough effort. The nurse correlates this with which level of injury on the spinal column? A) C2 B) C5 C) T1 D) T10
b
The physiological reasoning behind giving acyclovir, an antiviral medication, to a client diagnosed with genital herpes would include the fact that these drugs: A) Attack the cell wall and totally destroy the virus, thus curing the client B) Interfere with viral DNA replication, which can decrease the frequency of recurrences C) Will prevent the organism from developing a resistance to the treatment protocols D) Can be obtained without a prescription and usually applied topically
b
When educating a teenager diagnosed with genital herpes (herpes simplex virus type 2, HSV-2), the health care provider needs to inform her of the importance of careful follow-up since she may be at greater risk for future development of: A) Cervical cancer B) HIV transmission C) Localized necrosis D) Urinary tract infection
b
When evaluating the pulmonary function test results for a COPD client, which one correlates to the mismatch of ventilation and perfusion associated with this diagnosis? A) Forced vital capacity (FVC) is elevated. B) Forced expiratory volume (FEV) is decreased. C) Total lung capacity (TLC) is decreased. D) Marked decrease in residual volume (RV).
b
Which motor system is responsible for crude muscle movements? A.Pyramidal motor system B.Extrapyramidal motor system
b
Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis? A) "Have you recently begun a new sexual relationship?" B) "Have you been on antibiotics recently?" C) "Have you noticed any new growths on your vagina in recent months?" D) "Do you use condoms during sexual activity?"
b
Which of the following characteristics of the lungs of infants and small children creates an increased risk of respiratory disorders? A) Type II alveoli in children may overproduce surfactant. B) Smaller airways create a susceptibility to changes in airway resistance and airflow. C) The pneumotaxic center in the pons is underdeveloped until 8 years of age. D) There are fewer chemoreceptors in the young medulla.
b
Which of the following clients presenting to the emergency department would most likely be diagnosed with a pathologic stress fracture? A) A teenager who fell of a ladder and hit the concrete driveway, landing on his hip B) A postmenopausal female who was diagnosed with breast cancer with metastasis to bone C) A competitive volleyball player diving to retrieve a volley and landing on his hip D) A weight lifter who bench-presses 200 kg lost balance and fell to the side, landing on his hip
b
Which of the following is a disorder caused by abnormal accumulation of fluid in the pleural space? A.Pneumothorax B.Pleural effusion C.Atelectasis D.Hypercapnia
b
Which of the following medications helps treat the inflammatory reaction of asthma clients diagnosed with late-phase asthma response? A) Anticholinergic agents B) Systemic corticosteroids C) Long-acting β2-agonists D) Phosphodiesterase inhibitors
b
While administering a tuberculin (TB) skin test, a client who is HIV positive asks, "I heard from my friends, this test may not work on me since I have HIV." The health care provider's best response would be: A) "This test is 99.9% specific, so it will give us an accurate result." B) "Sometimes immunocompromised clients will have negative results if you are unable to mount a normal immune reaction." C) "Most of the time, with HIVpositive clients, we see more false-positive results since you may have a similar infection in your body." D) "If your test comes back positive, we will send a blood test off to a special lab to confirm you really have TB before we start treatment."
b
While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels thereby increasing cerebral blood flow to the brain?" The student with the best response would be: A) Increased oxygen saturation B) Increased carbon dioxide level C) Decreased serum sodium level D) Decreased hydrogen ion concentration
b
A diabetic client with a history of hypertension may receive a prescription for which medication to provide a renal protective effect by reducing intraglomerular pressure? Select all that apply. A) Loop diuretics B) ACE inhibitors C) Angiotensin receptor blockers D) Calcium channel blockers E) A digitalis preparation
b, c
Following surgery for a large malignant brain tumor, the nurse should anticipate discussing which further treatment option with the family that may ensure that any remaining cancer cells will be killed? A) Chemotherapy B) Immunotherapy C) Gamma knife radiation D) Stem cell transplant Ans:
c
A 25-year-old cystic fibrosis client presents to the clinic in obvious respiratory distress. Following physical exam, the health care provider suspects bronchiectasis based on which of the following findings? Select all that apply. A) Crushing, substernal chest pain B) Copious amounts of foul-smelling purulent sputum C) Neck vein distention D) Blood-tinged sputum E) Wheezing throughout the lung fields
b, d, e
A family brings their elderly father to emergency department. He has been exposed to pneumococcal pneumonia at his retirement home. Today, they noted a change in his mental status. They thought he might need some oxygen. Which of the other assessment findings would correlate with this diagnosis? Select all that apply. A) Expiratory wheezes throughout all lung fields B) Increase in chest pain with deep inspiration C) Absent breathe sounds on the entire right side of the lung D) Loss of appetite for past few days E) Purulent sputum with bloody patches
b, d, e
Which of the following clients would be considered at high risk for developing pneumonia (both community and hospital setting)? Select all that apply. A) A teenager who spends a lot of time at local coffee shops using Wi-Fi to chat with friends B) A young adult in motorcycle accident with head injury requiring tracheostomy and mechanical ventilation C) A college female who is pregnant (unplanned) who has been consuming alcohol prior to positive pregnancy test D) A HIV-positive client with a WBC count of 2000 who has been camping near a commercial farm raising chickens for food E) A school-aged child with severe asthma controlled by steroids admitted for an exacerbation
b, d, e
A motor vehicle accident has resulted in critical injury for the driver of the car. The driver has hit the steering wheel with his chest and fractured his sternum and some ribs. Which of the following manifestations would lead the staff to suspect the driver has developed a tension pneumothorax? Select all that apply. A) Audible friction rub over the affected lung B) Mediastinal shift of the trachea toward one side C) Marked peripheral edema in lower limbs and ascites D) Atrial fibrillation noted on ECG printout E) Subcutaneous emphysema palpated in the upper chest/neck region
b, e
A child is brought to the emergency department with a respiratory infection. The child is struggling to breath and is very anxious. The health care providers suspect epiglottitis. Which of the following interventions would be a priority? A) Have parents help hold the child down so blood work can be drawn and sent to lab so WBC count can be reviewed. B) Try to get the child to open his mouth so you can put a tongue blade in the back of the throat to look for swelling or pustules. C) Place the child upright in bed and begin preparing for a tracheostomy placement. D) Administer the first dose of an antibiotic vial liquid suspension as soon as possible to begin fighting the infection.
c
A client has just been admitted to the postsurgical unit following a below-the-knee amputation. Which of the following measures should her care team prioritize to prevent atelectasis during the client's immediate recovery? A) Bedrest and supplementary oxygen by nasal cannula B) Administration of bronchodilators by nebulizer C) Deep-breathing exercises and early mobilization D) Adequate hydration and a high-humidity environment
c
A client presents to the out-client clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of: A) Trichomonas vaginalis B) Chlamydial C) Bacterial vaginosis D) Syphilis
c
A client with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The client's psychomotor deficits are likely the result of: A) Alzheimer disease B) Frontotemporal dementia (FTD) C) Vascular dementia D) Wernicke-Korsakoff syndrome
c
A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis? A) Status epilepticus B) Subarachnoid hemorrhage C) Ischemic stroke D) Encephalitis
c
A college student is lamenting the fact that she has developed a cold on the weekend prior to exam week. Which of the following statements shows that the student has an accurate understanding of her upper respiratory infection? A) "I'm just going to try to rest as much as I can until these bacteria clear up." B) "I think I'll go to the campus clinic and see if I can get a prescription for antibiotics." C) "I suppose I should have been washing my hands more in the past few days." D) "If I can just start some antihistamines as soon as possible I bet I'll get over this faster."
c
A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the clients' temperature is 102°F. Which other clinical manifestations may lead to the diagnosis of encephalitis? A) Petechia over entire body B) BP 100/72 C) Impaired neck flexion resulting from muscle spasm D) Appearance of red-purple discolorations on the skin that do not blanch on applying pressure
c
A mother rushes her toddler into the emergency department stating, "My baby can't breathe." Initial assessment reveals the child is struggling to breathe in an upright position. He has both inspiratory and expiratory stridor and is using his chest muscles to breath. The nurse suspects the child has which of the following acute respiratory infections? A) Croup B) Asthma C) Epiglottitis D) Bronchiolitis
c
An elderly male client has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation? A) Failure to restore blood flow creates a severe risk for future transient ischemic attacks. B) Necrosis will continue unabated throughout the brain unless blood flow is restored. C) Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored. D) Unless blood flow is restored, the client faces the risk of progressing to hemorrhagic stroke.
c
As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to: A) Breakdown of elastin B) Left-sided heart failure C) Pulmonary hypertension D) Expiratory airway collapse
c
The client has a traumatic complete spinal cord transection at the C5 level. Based on this injury, the health care worker can expect the client to have control of which body function/part? A) Bladder B) Finger flexion C) Diaphragm D) Trunk muscle
c
The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this client's diagnosis? A) Elevation in vitamin D levels B) Hypophosphatemia C) Hypocalcemia D) Hypokalemia
c
Which of the following clients is at risk for developing a preventable disorder related to prolonged immobility? A) A middle-aged adult male diagnosed with bronchitis related to chronic smoking B) A young adult female diagnosed with sarcoidosis requiring corticosteroids to return her to remission C) A postsurgical client who is refusing to get out of bed and walk and will not wear those "uncomfortable elastic stocking" D) A sleep apnea client related to a history of smoking who utilizes a C-PAP machine every night at bedtime to maintain airway
c
Which of the following individuals has the highest chance of having a medulloblastoma? A) An 88-year-old man who has begun displaying signs and symptoms of increased ICP B) A 60-year-old woman who is soon to begin radiation therapy for the treatment of breast cancer C) A 4-year-old child who has become uncoordinated in recent months D) A 68-year-old man who is a smoker and has a family history of cancer
c
Which of the following phenomena is thought to underlie the decreased reported incidence of some sexually transmitted infections (STIs)? A) Increased knowledge of the correct use of condoms B) Increased public funding for health promotion activities C) Decreased reporting of cases of certain STIs D) Decreased numbers of sexual partners among young adults
c
Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male client? A) Presence of purulent, whitish discharge from the penis B) Emergence of hard, painless nodules on the shaft of the penis C) Itching, pain, and the emergence of pustules on the penis D) Production of cloudy, foul-smelling urine
c
vWhich of the following has not been implicated in the development of asthma? A.Allergens B.Respiratory tract infections C.Diet D.Drugs and chemicals E.Hormonal changes and emotional upsets F.Airborne pollutants Gastroesophageal reflux
c
A car accident client is admitted with a chest tube following pneumothorax. He also has an elevated blood alcohol level. When the nurse enters his room, she notes the client is dyspneic, short of breath, and holding his chest tube in his hand. When the nurse pulls the linens back, she finds a "sucking" chest wound. After calling a "code blue," the next priority intervention would be to: A) Place the client's meal napkin over the wound B) Observe and wait for the code blue team to bring equipment C) Try to calm the patient down by maintaining therapeutic communication D) Apply a Vaseline gauze (airtight) dressing over the insertion site
d
A client has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems? A) Take a sputum sample for culture and sensitivity. B) Compare the client's oral, tympanic, and axillary temperatures and order a white blood cell count. C) Palpate the client's lymph nodes and inspect the ears with an otoscope. D) Perform transillumination and ask the client if bending forward exacerbates the headache.
d
A client has started having uncontrolled seizures that are not responding to usual medications. Nursing working with the client must pay special attention to which of the following priority aspects of this clients care? Assessment of: A) ECG for arrhythmias B) Urine output and continence C) Ability to grasp hands and squeeze on command D) Respiratory status and oxygen saturation
d
A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is: A) Characterized by an inability to comprehend the speech of others or to comprehend written material B) Nearly normal speech except for difficulty with finding singular words C) Manifested as impaired repetition and speech riddled with letter substitutions, despite good comprehension and fluency D) Characterized by an inability to easily communicate spontaneously or translate thoughts or ideas into meaningful speech or writing
d
A client who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? A) Cerebellar dystaxia B) Cerebellar tremor C) A lower motor neuron lesion D) A vestibulocerebellar disorder
d
A client with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the client appears confused but is oriented to person and place but not time. What type of seizure did this client most likely experience? A) Tonic-clonic seizure B) Atonic seizure C) Myoclonic seizure D) Focal seizure with impairment to consciousness
d
A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which of the following physiologic phenomena will occur as a consequence of hypoxemia? A) Peripheral vasodilation B) Necrosis C) Hypoventilation D) Increased heart rate
d
A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for: A) Aneurysm leakage B) Cause of minor residual deficits C) Diffuse cerebral electrical malfunctions D) Atherosclerotic lesions in cerebral vessels
d
A late indicator of increased intracranial pressure is: A) Tachycardia B) Right-sided heart failure C) Narrow pulse pressure D) High mean arterial pressure
d
A newly admitted critical head injury client presents to the neuro-ICU. The client is unresponsive to painful stimuli but able to breathe on his own. As the shift progresses, the nurses note a decrease in the client's respiratory effort. The client cannot maintain his O2 saturation above 70%. The nurses should anticipate assisting in beginning what type of pulmonary support? A) Increase oxygen level to 10 L/min. B) Begin Bi-PAP. C) Call respiratory therapy to suction the client. D) Prepare for mechanical ventilation.
d
A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to: A) Check the mouth/throat for pustules and redness B) Check the jugular vein for distention C) Assess calves of legs for redness, warmth, or edema D) Scan his bladder to make sure it is empty
d
A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is: A) Chancroid B) Candidiasis C) Trichomonas vaginalis D) Chlamydia
d
Following a head injury on the football field, the medical team is assessing the player for injury. One of the earliest signs of decreased level of consciousness to assess for would be: A) Stupor B) Lethargy C) Delirium D) Inattention
d
Impaired skin integrity and skin manifestations are common in persons with chronic kidney disease. Pale skin and subcutaneous bruising are often present as a result of: A) Thrombocytopenia B) Anticoagulant therapy C) Decreased vascular volume D) Impaired platelet function
d
Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? A) Human papillomavirus (HPV) infection B) Herpes simplex virus type 2 (HSV-2) infection C) Candidiasis D) Lymphogranuloma venereum (LGV)
d
The intracranial volume that is most capable of compensating for increasing intracranial pressure is the: A) Brain cell tissue B) Intravascular blood C) Surface sulci fluid D) Cerebrospinal fluid
d
The pathogenic capacity of the tubercle bacillus is related to: A) Formation of a Ghon focus lesion B) Its inherent destructive capabilities C) Rapid viral replication in host cells D) The initiation of a cell-mediated immune response
d
Which of the following clients would be considered high risk for falling and fracturing a hip? A) A 54-year-old male with obesity and short stature B) A 36-year-old female whose diet consists of excessive sugar intake C) A 77-year-old male with hearing impairment and corrective eye lenses D) An 81-year-old female taking medication for chronic osteoporosis
d
Which of the following events is associated with the primary stage of syphilis? A) Development of gummas B) Development of central nervous system lesions C) Palmar rash D) Genital chancres
d
Which of the following individuals is most clearly in need of diagnostic testing for lung cancer? A) A client who has required hospitalization with a fever and the production of copious lung secretions B) A client with a history of secondary tuberculosis who failed to complete his prescribed course of antibiotics C) A woman who complains of recurrent lower respiratory infections and who has sought care for increasing shortness of breath D) A man who demonstrates wasting of the pelvic and shoulder muscles combined with signs of hypercalcemia
d
Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease? A) A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage B) A client whose diagnosis of thyroid cancer necessitated a thyroidectomy C) A client who experienced a hemorrhagic stroke and now has sensory and motor deficits D) A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet
d
Which of the following manifestations typically accompanies an asthmatic attack? A) Decreased residual volume B) Decreased pulmonary arterial pressure C) Prolonged inspiration D) Hyperinflation of the lungs
d
Which of the following pathophysiologic processes occurs in cases of bacterial meningitis? A) Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia. B) Trauma introduces skin-borne pathogens to the cerebrospinal fluid. C) Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits. D) Inflammation allows pathogens to cross into the cerebrospinal fluid.
d
Which type of stroke is the result of a ruptured blood vessel? A.Ischemic B.TIA C.Arteriovenous malformation D.Hemorrhagic
d
While in its dormant state, herpes simplex virus resides and replicates in the: A) Local lymph nodes B) Subcutaneous tissue C) Mucous membrane D) Dorsal root ganglia
d
While teaching a class of nursing students about spinal cord injury, the instructor mentions that male SCI clients will be able to have a sexual response if their injury is at which level on the spinal column? A) T12 B) S1 C) L2 D) S4
d
With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiological principle behind this respiratory distress is related to: A) Increases in left atrial pressure causing thickening of the lining of the pulmonary arteries B) The elevation of pulmonary venous pressure C) Structural abnormalities of pulmonary vessels with proliferation of the vessel intima D) The stiffening of the lung, making it more difficult to inflate
d
True or false: A medical condition typically affecting young men, characterized by arthritis, conjunctivitis, and urethritis, and caused by an unknown pathogen, possibly a chlamydia.
false