Patho Exam 2

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis?

Hyperventilation

The health care provider is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which assessment finding is congruent with the client's diagnosis? Spasticity Hypotonia Tetany Rigidity

Hypotonia

What is ocular muscle imbalance resulting in "lazy eye" called?

Amblyopia

A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of:

An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve

A 26-year-old client who has recently traveled by airplane complains of pain in his right ear. The nurse suspects which condition?

Barotrauma

Chapter 20

Ch 20

How is the organism causing Legionnaire disease, a form of bronchopneumonia, usually transmitted?

Warm, standing water becomes aerosolized and inhaled

. Fasting causes

metabolic acidosis.

A first episode of depression that occurs after what age can be a precursor to dementia? 45 75 55 65

65

Normal Anion gap (AG)

8-16

The nurse has just received the laboratory results of a client's calcium level. The nurse identifies a normal calcium level as:

8.5 to 10.5 mg/dl (2.25 mmol/l to 2.6 mmol/l)

ICP range

0 to 15 mm Hg

Oxygen has been prescribed for a client with chronic obstructive pulmonary disease (COPD). Which amount of oxygen is considered most appropriate for the COPD client?

1 to 2 L/min

The nurse is assigned to care for four clients on a medical floor. Which client is most at risk for viral pneumonia after influenza?

A 76-year-old client with cardiopulmonary disease

What is the major cause of sensorineural hearing loss in children?

Genetic cause

The nurse is caring for a client with myasthenia gravis on the acute care unit. Which order from the physician for the treatment of pneumonia should the nurse question for administration in this client? Azithromycin Ciprofloxacin Gentamicin Ceftriaxone

Gentamicin

When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate?

Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels.

Which intervention is the priority for the medical management of a client with a dissecting aortic aneurysm?

Administration of sodium nitroprusside and beta-adrenergic blocking medications (beta-blockers)

The nurse is teaching a client about the treatment of open-angle glaucoma. The most appropriate information for the nurse to give the client would be:

Administration of topical beta-adrenergic antagonists to lower the pressure.

REVIEW

All Chapters

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

A client is rushed to the emergency department with assessment findings of urticaria, wheezing, chest tightness, and difficulty breathing. The client is most likely experiencing which type of shock?

Anaphylactic

What can trigger myocardial ischemia even when there is adequate coronary oxygen supply?

Anemia Carbon monoxide poisoning Hypoxia

An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to acting normally. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode? Diffuse cerebral electrical malfunctions Minor residual deficits Atherosclerotic lesions in cerebral vessels Aneurysm leakage

Atherosclerotic lesions in cerebral vessels

A client presents with copious amounts of yellow-green drainage, conjunctival redness, and chemosis to the right eye. A culture of the eye drainage reveals S. pneumoniae. The client most likely developed: Viral conjunctivitis Chronic conjunctivitis Bacterial conjunctivitis Allergic conjunctivitis

Bacterial

Which cardinal assessment finding would lead the nurse to suspect a client has developed Parkinson disease?

Bradykinesia

Adult strabismus is almost always of the paralytic variety. What is a cause of adult strabismus? Addison disease Graves disease Parkinson disease Huntington

Graves

Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy?

Carpal tunnel syndrome

What does the destructive nature of tuberculosis cause in a previously unexposed immunocompetent person? Caseating necrosis and purulent pulmonary lesions Cavitation and rapidly progressing pulmonary lesions Caseating necrosis and cavitation Rapidly progressing lesions and purulent necrosis

Caseating necrosis and cavitation

Chapter 30

Ch 30

Chapter 31

Ch 31

Chapter 8

Ch 8

A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged, resulting in a pulmonary embolism. Which type of shock is this client at risk of experiencing? Obstructive shock Cardiogenic shock Hypovolemic shock

Obstructive shock

What are the common clinical manifestations of acute angle-closure glaucoma? Select all that apply.

Ocular pain Blurred vision

The nurse is educating a client diagnosed with Meniere disease on lifestyle modifications to reduce the frequency and/or intensity of exacerbations. Which should the nurse include?

Decrease dietary intake of sodium Explanation: A lifestyle change that would be recommended for a client with Meniere disease is to consume a low sodium diet, related to the medication treatment (diuretics). The other modifications are not relevant to Meniere disease

A client who experienced an ST elevation myocardial infarction (STEMI) received fibrinolytic therapy with streptokinase. Which manifestation alerts the nurse to a developing complication

Decreased LOC

The diagnosis of dementia is based on assessment of the presenting problem. The American Academy of Neurology practice parameters recommend screening for which disorder when assessing a client for dementia? High pressure hydrocephalus Hyperthyroidism Depression Vitamin D deficiency

Depression

The psychiatrist recommends electroconvulsive therapy (ECT) for an older adult client. The nurse understands that this therapy is effective for which disorder?

Depression

An expectant mother is 23 weeks into her pregnancy when she goes into labor. Regarding fetal lung development, what is of greatest concern to the attending medical team?

Development of type II alveolar cells Explanation: Type II alveolar cells begin to develop at approximately 24 weeks and produce surfactant, a substance capable of lowering the surface tension of the air-alveoli interface. By 28 to 30 weeks, sufficient amounts of surfactant are available to prevent alveolar collapse when breathing begins. The respiratory musculature, alveoli, and bronchial tree are all developed by the 23rd week.

The nurse developing a plan of care for a client with a cerebral cortex injury should include assessment for which of the following?

Difficulty concentrating

Which diagnosis places a child at the greatest risk for airway obstruction?

Epiglottitis

Diagnostic testing has resulted in a diagnosis of small cell lung cancer (SCLC) in an older adult client. When exploring the etiology of the client's disease, what assessment question is mostrelevant?

Have you ever been a smoker

For which type of hearing loss should the nurse assess in a child who has had recurrent otitis media since birth?

Hearing loss that is associated with recurrent otitis media is conductive loss.

A client has these arterial blood gas values: anion gap 20 mEq/L (20 mmol/L), pH 7.29, PCO2 37 mm Hg (4.92 mmol/L), HCO3- 11 mEq/L (11 mmol/L), base excess -6 mEq/L (-6 mmol/L). With what condition do these values correspond?

Lactic acidosis Explanation: Anion gap (AG) is the difference between the plasma concentration of sodium ions and the sum of the measured anions (chloride and bicarbonate). Normally, the AG value should be between 8 and 16 mEq/L. AG will rise above normal for conditions that commonly cause acidosis such as lactic acidosis and ketoacidosis.

The nurse reading a client's lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted? Increased glucose Large number of polymorphonuclear neutrophils Clear cerebrospinal fluid Decreased protein count

Large number of polymorphonuclear neutrophils Explanation: Lumbar puncture findings, which are necessary for accurate diagnosis, include a cloudy and purulent CSF under increased pressure. The CSF typically contains large numbers of polymorphonuclear neutrophils (up to 90,000/mm3), increased protein content, and reduced sugar content.

What is the task of the prefrontal area of the brain?

Manage information

A client comes to the emergency department complaining of dizziness, rapid breathing, sweating, palpitations, and a feeling of dying. The client has normal laboratory values and has had a cardiac workup. The symptoms persist for 30 minutes and then subside. Which condition is the client exhibiting?

Panic disorder

Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding? Hypotonia Involuntary movements Paralysis Muscle rigidity

Paralysis

Many people have experienced some kind of traumatic event in their lives. While response to trauma varies with individuals, what is a generalized response in those who have experienced severe trauma in childhood?

Response later in adulthood that manifests itself in medical and mental issues

Which diagnostic test results indicate a client has a vestibular disturbance? Dix-Hallpike maneuver did not elicit vertigo or nystagmus. Caloric stimulation test shows slow nystagmus toward the irrigated side for 2 to 3 minutes. Electronystagmography shows no nystagmus with focused gaze. Romberg test response shows increased swaying with arm drift to one side.

Romberg test response shows increased swaying with arm drift to one side

An immunocompromised host is open to pneumonia from all types of organisms. There is, however, a correlation between specific types of immunologic deficits and specific invading organisms. What organism is most likely to cause pneumonia in an immunocompromised host with neutropenia and impaired granulocyte function?

S. Aureus

Which cause or mechanism in older adults displaying late-life psychoses like delusions has been recently researched?

Sensory Deprivation

Heart failure and circulatory shock are both conditions of circulatory system failure. Which statement regarding these conditions is correct? They have the same compensatory mechanisms. They have the same remediation. They have the same pathogenesis. They have the same etiology

They have the same compensatory mechanisms.

A 2-year-old child who has had otitis media (OM) for 4 months and been treated with several courses of antibiotics now appears to have some hearing loss. The nurse anticipates that the most appropriate treatment for the child would be:

Tympanostomy tube insertion

A client with asthma comes to the emergency department very anxious due to increasing shortness of breath. Physical assessment reveals tachypnea, and an arterial blood gas shows decreased carbon dioxide levels and hypoxemia. What is the most likely cause?

hypeventilation

The nurse is explaining to the parent of a 5-year-old that the child has otitis media with effusion (OME), noted by otoscopic exam, following an upper respiratory infection. Unlike acute otitis media (AOM), OME does not require treatment with antibiotics because it is usually: asymptomatic and often self-limiting. symptomatic and the tympanic membrane is blue. asymptomatic and requires the administration of antivirals. very symptomatic and requires immediate intervention.

asymptomatic and often self-limiting.

A young child has been diagnosed with amblyopia. The parents ask the nurse when treatment should be considered. At what age should treatment of children with the potential for development of amblyopia be instituted?

before 6 years

A child is experiencing an acute exacerbation of asthma. Which quick-acting treatment is most appropriate for this client?

beta-adrenergic agonists

As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased: intracellular albumin. sodium/phosphate anion absorption. bicarbonate/carbonic acid regulation. hydrogen/potassium binding.

bicarbonate/carbonic acid regulation

A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which factor mostlikely had the greatest impact on development of the lung cancer?

cigarette smoking

A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that:

cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

A client's chart documents the finding of cholesteatoma. The nurse interprets this to mean that the client has:

cystlike mass in the middle ear. Cholesteatoma is a cystlike mass of the middle ear that often extends to involve the temporal bone.

Which statement best describes the pathophysiology of Parkinson disease?

degeneration of the nigrostriatal dopamine system

A client with Alzheimer disease (AD) is forgetful and has started to lose interest in social activities. Which treatment routine would be beneficial for the client?

donepezil

For which acid-base imbalance will the nurse monitor for a client taking large doses of loop diuretics?

metabolic alkalosis

. Severe potassium deficits causes

metabolic alkalosis.

Which factor is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?

pet dander

Which risk factor has been associated with the diagnosis of schizophrenia? childhood vaccinations viruses obesity poverty

poverty

Respiratory acidosis:

represents a decreased pH and an increased PCO2

Metabolic alkalosis:

represents an increased pH and a increased

HCO3-Respiratory alkalosis:

represents an increased pH and decreased PCO2

Extreme obesity causes

respiratory acidosis

The term chronic obstructive pulmonary disease (COPD) can be a combination of two types of obstructive airway diseases. Which disease processes have been identified as being part of COPD?

Chronic bronchitis and emphysema

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.

Chemotherapy, Surgery to remove tumor, Radiation therapy.

The family of an older adult reports increasing inability to perform basic activities of daily living. After evaluation, the client is diagnosed with Alzheimer's disease. What intervention will be implemented to slow cognitive decline?

Cholinesterase inhibitors

Ch 16

Chapter 16

After surviving an ischemic stroke, a client has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings and exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which brain structure?

Client's limbic system

A nurse on a neurology unit is assessing a client with a brain injury. The client is unresponsive to speech, with dilated pupils that do not react to light. The client is breathing regularly with a respiratory rate is 45 breaths per minute. In response to a noxious stimulus, the client's arms and legs extend rigidly. What is the client's level of impairment?

Coma

What intervention is appropriate for a client with sarcoidosis? Lymph node radiation Antifungal agents Corticosteroids Antihistamines

Corticosteroids Explanation: Sarcoidosis treatment is directed at interrupting the inflammatory process with corticosteroid medications. Sarcoidosis is overgrowth of granulomas and does not have a fungal or allergy component.

The nurse is caring for a client who has been diagnosed with presbycusis. The nurse understands that with this disorder, the client experiences which of the following?

Difficulty hearing high-pitched frequencies

The nurse is caring for a client who receives hemodialysis. The nurse knows that hemodialysis involves movement of charged or uncharged particles along a concentration gradient. Which function best describes this process?

Diffusion

Which chemical in the body is associated with the need to continue to abuse addictive substances? Glucose Dopamine Adrenaline Serotonin

Dopamine

What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise?

Exercise can increase blood vessel growth and help to decrease symptoms.

A group of student nurses is reviewing the anatomy of the eye for an upcoming exam. One of the student nurses asks where the tarsal plate is located. What is the response? Ciliary body Eyelid Lens Retina

Eyelid

A group of student nurses is reviewing the anatomy of the eye for an upcoming exam. One of the student nurses asks where the tarsal plate is located. Where is it located?

Eyelid

Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by: Increased collateral circulation Intermittent vessel vasospasms Excessive endothelial relaxing factors Fixed coronary obstruction

Fixed coronary obstruction

Vitreous humor occupies the posterior of the eyeball. When liquefacation of the gel occurs, as in aging, what can be seen during head movement? Red spots Blind spots Meshlike structures Floaters

Floaters

The nurse is caring for a client with a tumor obstructing the lymphatic system. For which consequence does the nurse assess?

Fluid accumulating in the interstitial spaces distal to the tumor

Which conditions increase client risk for developing pulmonary arterial hypertension (PAH)? Select all that apply.

HIV infection, Scleroderma, and Family history

The nurse reading a client's lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted?

Large number of polymorphonulcear neutrophils

Following a head injury, if the brain tissue is moving upward from the infratentorial compartment and causing blockage of the aqueduct of Sylvius, which manifestations will the nurse observe?

Hydrocephalus and coma

What causes drop in Anion gap

Hyperkalemia, lithium toxicity, hypercalcemia, hypermagnesemia, and multiple myeloma

Which current multiple sclerosis drug treatments are designed to slow the progress of myelin degeneration?

Immunomodulators

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications? Encourage ambulation Reduce dietary calcium Increase IV fluids Give aspirin for pain

Increase IV fluids

Following a head injury, a client is diagnosed with intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. What additional clinical manifestations correlate with this diagnosis? Diffuse venous bleeding from the nose Ipsilateral pupil dilation Increased head circumference with hydrocephalus Ipsilateral hemiparesis

Ipsilateral pupil dilation

A client's history documents the presence of the homonymous hemianopia. What assessment finding would the nurse anticipate this client to display? Loss of different half fields in the two eyes Bilateral loss of peripheral vision Loss of the same side of the visual field in each eye Equal loss of central vision in each eye

Loss of the same side of the visual field in each eye

A child accidentally consumes a container of wood alcohol. The ED physician knows that the child is at risk of developing which of the following?

Metabolic acidosis

Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is their response?

Pulmonary vessels constrict Explanation: Continued exposure of the pulmonary vessels to hypoxemia is a common cause of pulmonary hypertension. Unlike blood vessels in the systemic circulation, most of which dilate in response to hypoxemia and hypercapnia, the pulmonary vessels constrict.

Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work?

Parathyroid hormone Explanation: The small, but vital, amount of ECF calcium, phosphate, and magnesium is directly or indirectly regulated by vitamin D and parathyroid hormone.

An 8-year-old child develops pneumonia with physical exam revealing intercostal retractions and difficulty breathing. The nurse anticipates the need for prompt treatment based on which facts about pneumonia?

Pneumonia is the leading cause of death among children in the world.

Guillain-Barré syndrome is characterized by which form of neuron damage? Transneuropathy Peripheral neuropathy Polyneuropathy Mononeuropathy

Polyneuropathy

Multiple sclerosis is characterized by what type of neuron damage? Aneuropathy Polyneuropathy Transneuropathy Mononeuropathy

Polyneuropathy

Cortical blindness is the bilateral loss of the primary visual cortex. What is retained in cortical blindness?

Pupillary reflexes

Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD?

Rapid and shallow breathing and chest retractions

The nurse is caring for a client who has been diagnosed with Meniere disease. The nurse expects which medication will be prescribed to manage the symptoms?

Promethazine. Pharmacologic management includes suppressant drugs such as promethazine.

Which attribute is correct about Creutzfeldt-Jakob disease (CJD)? Hereditary disorder Rare, rapidly progressive form of dementia Atrophy of the frontal and temporal lobes Results most often from chronic alcoholism

Rare, rapidly progressive form of dementia CJD is an extremely rare, rapidly progressive form of dementia. In the United States, there are approximately 200 cases per year. CJD causes degeneration of the pyramidal and extrapyramidal systems; affected people usually are demented within 6 months of onset.

The adult child of a client with end-stage Alzheimer disease asks the nurse at the physician's office if Alzheimer's can be passed on to her. What is the nurse's most accurate response?

Research supports a possible genetic link with an early onset

The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?

Septic Shock

Which type of blood vessel cells in the tunica media layer produce vasoconstriction and/or dilation of blood vessels?

Smooth muscle

The nurse discusses Botox injections as a treatment of which eye disorder? -Ptosis -Strabismus -Amblyopia -Eye tremor

Strabismus

A client has developed bacterial pneumonia and is admitted to the hospital. The nurse obtains sputum cultures upon admission. What bacteria does the nurse anticipate finding when the results are complete?

Streptococcus pneumoniae

A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head?

Temporal

A client diagnosed with giant cell arteritis will likely experience pain located in which region of the head? Ophthalmic Temporal Vertebral Carotid

Temporal

Which lobe of the brain houses the cerebral cortical structure responsible for language comprehension?

Temporal

A client has been recovering from a stroke for several weeks and has been reluctant to participate in physical therapy. As a result, the client has experienced disuse atrophy. The nurse should recognize that the client is experiencing the consequences of which physiologic process?

The diameter of the client's muscle cells has decreased

The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system?

The kidneys

A client with a long history of cigarette smoking and poorly controlled hypertension is experiencing psychomotor deficits due to hemorrhagic brain damage. Which diagnosis is likely for the onset of progressive dementia?

Vascular dementia

An older adult client asks the nurse why so many older people develop heart failure. The bestresponse would be increased: Cardiac tone and compliance Myocardial metabolism Response to beta-adrenergic stimulation Vascular stiffness

Vascular stiffness

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Vasospasms and hypertension

The nurse is preparing a client for a surgical procedure to create an endolymphatic shunt. The nurse understands that this procedure aims to relieve which symptom?

Vertigo

Mechanical ventilation causes

respiratory alkalosis

A nurse is caring for a client experiencing muscle fasiculations. Fasiculations appear as:

spontaneous contractions of muscle fibers presenting as twitching.

The nurse understands that movement of otoliths may result in

vertigo and nystagmus

The parents of a child diagnosed with cystic fibrosis (CF) ask about the risk of any future children having the condition. How should the nurse respond?

you have a 25% chance that your next child will have CF

A client is suspected to be infected with Histoplasma capsulatum. Which is the average incubation period for this infection to cause symptoms? 24 to 48 hours 4 to 5 days 1 to 4 weeks 5 to 10 weeks

1 to 4 weeks

What is the term used to identify a person's inability to experience pleasure in things that use to result in pleasure? Avolition Anhedonia Affective flattening Alogia

Anhedonia

Ch 19

Chapter 19

Ch 26

Chapter 26

Ch 27

Chapter 27

A 3-year-old child has been admitted to the pediatric unit for the treatment of croup. The nurse should include which action in the child's plan of care?

Cool, humidified air to relieve airway spasms Providing cool, moist air for the child to breathe

To diagnose a vestibular disorder, which test would be used that assesses the eye movements in response to vestibular, visual, and positional stimulation? Audiogram Electronystagmography Caloric stimulation Romberg test

Electronystagmography

A child is brought to the emergency department an hour after ingesting ethylene glycol. What intervention will minimize toxicity? Acetylcysteine Syrup of ipecac Gastric lavage Fomepizole

Fomepizole

The registered nurse reads in the electronic medical record that the primary care provider notices "silver wire" or "copper wire" changes in the retinal arteries of a client. Which disease is associated with this change? Diabetic retinopathy Glaucoma Detached retina Hypertensive retinopathy

Hypertensive Retinopathy

A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?

Hypertrophic cardiomyopathy

A child has developed respiratory stridor and is displaying a crowing sound. The parents ask the nurse what is causing this sound. The best response would be: The collapse of intrathoracic airways because of air trapping Pulling in of the soft tissue surrounding the cartilaginous and bony thorax Increased turbulence of air moving through the obstructed airways Nasal obstruction and inhalation occurring through the mouth rather than the nares

Increased turbulence of air moving through the obstructed airways

The nurse is conducting a community education class on amblyopia. The nurse determines that the participants understand the concepts when they identify which time period as the time when amblyopia is generally diagnosed?

Infancy

The nurse is assessing a client who states he felt fine all day and then, within 5 minutes, began to feel extremely weak and tired and began having a fever. What do these symptoms indicate that the client may be experiencing? Common cold Reye syndrome Viral pneumonia Influenza

Influenza one distinguishing feature of an influenza viral infection is the rapid onset, sometimes in as little as 1 to 2 minutes, of profound malaise. Viral pneumonia is a complication of influenza. Reye syndrome is a complication of influenza that is extremely rare and is found mostly in children after being give aspirin as an antipyretic. The common cold has more of a slow onset.

A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that which of the following is the most likely cause of this infection?

Nosocomial hospital-acquired infection

The nurse observes nystagmus in a client sitting quietly without head movement. The nurse interprets this finding in which way? This is a common finding in older adult clients. This is an emergency finding that requires immediate intervention. This is a pathological finding. This is a normal variation in all people.

Patho

Which treatment should take place immediately in a client experiencing autonomic dysreflexia?

Position the client in upright position, and correct the initiating stimulus.

The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent:

Pulmonary embolism

The nurse is explaining to a client's family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be:

The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

young, male child is born with severe respiratory failure. Over the course of months, the parents note his body looks swollen. They ask, "Are our baby's kidneys not working right? Why is he so swollen?" The nurse bases the reply on which physiologic principles?

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.

A client diagnosis with tuberculosis asks the nurse how long the antitubercular medication will need to be taken. What is the best response?

You can expect to take multiple drugs possibly for as long as 24 months or until all tubercle bacilli are eliminated.

A client who has just completed running a marathon reports muscle weakness, cramping, and general fatigue despite drinking adequate amounts of water. The nurse suspects which type of hypotonic hyponatremia? normovolemic hypovolemic hypervolemic euvolemic

hypovolemic Explanation: Hypovolemic hypotonic hyponatremia develops when both water and sodium have been lost (as in sweating) but only water, rather than electrolyte-containing liquids, is used to replace fluids lost. This may also be caused by gastrointestinal sodium loss caused by frequent irrigation with distilled water as well as by adrenal insufficiency. Hypervolemic hyponatremia is caused when excess water is retained compared to sodium, resulting in a dilutional hyponatremia. Because the intravascular sodium is low, there is less osmotic pressure, and the water often ends up moving into the interstitial spaces due to osmosis resulting in edema or ascites. This is why it is termed hypervolemic even if the intravascular volume is low. The terms "euvolemic" and "normovolemic" are synonymous and occur when hyponatremia is present in a client with a normal total body water balance.

Death caused by muscular dystrophy in early adulthood is usually due to: malnutrition. severe long bone fractures. severe skeletal muscle weakness. respiratory and cardiac muscle involvement.

respiratory and cardiac muscle involvement.

The nurse is caring for a client diagnosed with labyrinthitis. The nurse explains that manifestations of this disorder are generally expected: to resolve in a few hours. to resolve in 6 weeks. to be permanent. to resolve in 10 to 14 days.

to resolve in 10 to 14 days.