Patho exam 4

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

The regulation of cerebral blood flow is accomplished through both autoregulation and local regulation. This allows for the brain to meet its metabolic needs. What is the low parameter for arterial blood pressure before cerebral blood flow becomes severely compromised?

60 mm Hg

Average blood sugar level

600

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. The nurse determines further teaching is necessary when the client states:

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."

A client discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The client's spouse is extremely upset because the physician stated that the client cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. What is the nurse's most accurate response?

"Thrombolytics may cause cerebral hemorrhage."

diabetic ketoacidosis

(DKA) -because insulin levels are too low, the body cannot use sugar and uses fat as fuel instead -byproducts of fat breakdown, called ketones, build up in the body -high levels are toxic

Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"?

A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL.

A patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient?

A young female patient who has been trying to get pregnant.

disorder of the mind that is subtle memory loss but progresses

Alzheimers

When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:

Anterior pituitary gland

There are two main categories of glial tumors. One of the categories is:

Astrocytic

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 the normal self. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?

Atherosclerotic lesions in cerebral vessels

The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?

Autocrine

The nurse knows that type 1 diabetes mellitus results from destruction of the pancreatic beta cells by two mechanisms. The mechanism for type 1A diabetes is _______ destruction.

Autoimmune

A client reveals that when in bed, changes in head position cause brief periods of vertigo, usually lasting less than 1 minute. Which condition is the client most likely experiencing?

Benign paroxysmal positional vertigo

A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly but her respiratory rate is 45 breaths per minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment?

Coma

The nurse is caring for a 31-year-old trauma victim admitted to the neurologic intensive care unit. While doing the initial assessment, the nurse finds that the client is flexing the arms, wrists, and fingers. There is adduction of the upper extremities with internal rotation and plantar flexion of the lower extremities. How would the nurse describe this in the notes?

Decorticate posturing

A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which medical diagnosis listed below may be associated with these clinical manifestations?

Encephalitis

When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs?

Erythropoietin

Classic sign of Hyperthyroidism

Exophthalmos

Acronym used for stroke procedure

Face (droops) Arms (drift) Speech (attn. to how they talk) Time (get them to stroke center asap) Time within 3-4 hours of onset symptoms

Which nursing intervention is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo?

Fall precautions

When sensors detect a change in a hormone level, the hormonal response is regulated by which mechanism that will return the level to within normal range?

Feedback

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

Most common cause of hypothyroidism

Hashimoto's thyroiditis

Common pressure ulcer sights

Heels, elbows, back, hip, groin

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

Hypoglycemia

Neurons that connect sensory and motor neurons are known as which of the following?

Interneurons

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.

Stimulation tests

You can do eye to ear drops but not ear to eye drops.

True

Amblyopia, or lazy eye, occurs at a time when visual deprivation or abnormal binocular interactions occur in visual infancy. Whether amblyopia is reversible depends on which factor?

Maturity of the visual system at time of onset.

What are the hallmark signs of diabetes mellitus?

Polyuria, polydipsia, and polyphagia

Which visual deficit is a clinician justified in attributing to the normal aging process?

Presbyopia

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dl

Hormones are chemical messengers that provide which function in the body?

Regulate body functions.

Thyroid and steroid hormones, which exert their effect on target cells by way of nuclear receptors, have which of the following characteristics?

The ability to cross the cell membrane of target cells

A client has started on interferon beta for treatment of multiple sclerosis. What should the nurse include in the teaching? Select all that apply.

The medication will be given by subcutaneous injection. Interferon beta alters your immune response.

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which of these does the nurse explain to the client is the role of the thyroid gland?

The thyroid gland is responsible for increasing the metabolic rate.

Sharp muscle convulsions, lose consciousness

Tonic- CLonic

A client in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which diagnosis best captures this pathophysiology?

Vasogenic edema

Classic symptom of Meneries Disease

Vertigo

While assessing a client with suspected Ménière disease, the nurse would expect which clinical manifestation?

Vertigo

Tinea pedis

athlete's foot

Impetigo

bacterial skin infection characterized by isolated pustules that become crusted and rupture

Severe phase of Alzheimer

bedridden, require total care

shear

bends blood vessels

Clonic seizure

bilateral, symmetric, rhythmic muscle contractions

Pressure ulcers

blood flow obstructed

tinea corporis

body

AU

both ears

OU

both eyes

If your cold and clammy you need some ____

candy

Albinism

complete/partial loss of pigment more likely for sunburn

Addisons hormones all ____

decrease

Diaper dermatitis

diaper rash

Dysphagia

difficulty swallowing

Retinopathy

disease of the retina small retinal blood vessels

otic

ear

ENT doctor

ear, nose, and throat doctor

HPV

genital warts over 80 cases

Islets of Langerhans

groups of pancreatic cells secreting insulin and glucagon.

Cold sores

herpes simplex

If your hot and dry your sugar is ____

high

Phenom occurs when too much circulating thyroid hormone

hyperthyroid

Aphasia

inability to speak/ understand words

Following a head injury on the football field, the medical team is concerned because the athlete is showing this earliest sign of decreased level of consciousness?

inattention

Cushings hormones all ____

increase

cellulitis

inflammation of skin cells in the dermis of subq tissue

Tumor malignant in the melanocyte

melanoma

Mineral corticoid that had major influence on adrenal gland

mineral corticoid

Signs/symptoms of Cushing's

moon face, purpura, hair , muscle weakness, hypertension

loss of cosciousness + awareness

multi-hemisphere

The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense:

muscle position

myoclonic seizure

muscles of the face, trunk, extremities contract

macular degeneration

progressive damage to the macula of the retina loss of central vision

As the nurse is performing a physical assessment of a client, the client begins to have seizure activity including loss of consciousness and limb jerking. The nurse's priority is to:

protect the client from injury.

AD

right ear

OD

right eye

tinea capitis

ringworm of the scalp

Hyperglycemic Hyperosmolar State (HHS)

same state of DKA but no ketones spilling into the bloodstream

Initial phase of Alzheimer

short term memory loss

Dysarthria

slurred speech

Ringing of the ears

tinnitus

Retinal detachment

two layers of the retina separate from each other

Tonic seizure

voluntary muscles of the legs and arms contract

Verrucae

warts

Why does a stroke reoccur?

weakened vessels, in bed with no exercise, if you have one you'll likely have another.

Cardiovascular problems that cause a stroke

Hypertension

Hormones that have major effect on your adrenal glands?

Salt, Sugar, Sex Mineral corticoid, glucco corticoid, and sex hormones

Atonic seizure

lack of normal muscle tone

AS

left ear

OS

left eye

Signs/symptoms of Addison's

lethargic, elevated potassium levels, loss of weight, hypotension

does not lose consciousness / awareness

limited to one hemisphere

Absent seizure

still conscious - tend to space out NO convulsion

Which gland is often referred to as the master gland because it secretes many hormones?

Pituitary

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells

Which components of the nervous system make up the central nervous system?

Brain and spinal cord

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which component of her nervous system contains the highest level of control of her arm and hand action?

Frontal lobe

The nursing student who is studying pathophysiology correctly identifies the condition that characteristically has an increase in the aqueous humor that fills the anterior and posterior chambers of the eye. What is this disease called?

Glaucoma

Which substance provides the majority of the fuel needs of the neurologic system?

Glucose

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:

Glycosylated hemoglobin, hemoglobin A1C (HbA1C)

When educating a patient about glargine (Lantus), the nurse should explain that this medication:

Has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours.

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?

Hyperglycemia

A diabetic client was visiting the endocrinologist for annual checkup. The client's blood work reveals an increased level of which lab result that reveals early signs of diabetic nephropathy?

Microalbuminuria

What could cause a patients skin to sheer?

Moving the sheets under them

Which is the primary component of white matter?

Myelinated Fibers

For which common manifestation of acute meningococcal meningitis should the school nurse be assessing students?

Petechiae

While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' diabetes? Select the best answer.

Promote glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids.

While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is:

Sebum, secreted by the sebaceous gland

Herpes zoster

Shingles; painful red blisters

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?

Stupor

Cradle cap

a skin condition known for yellowish, crusty patches on the scalp

A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced?

a tonic-clonic seizure

Ischemic Stroke

a type of stroke that occurs when the flow of blood to the brain is blocked (80%)

Sugar puts the body in what state?

acidic

2nd degree burns

epidermis + dermis

Moderate phase of Alzheimer

everything becomes impaired

Polyphasia

excessive hunger/ eating too much

Polydipsia

excessive thirst

polyurea

excessive urination

Hemorrhagic Stroke

occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed (15%)

Adrenal

on top of the kidneys; prepares the body for action, controls the heart rate and breathing in times of emergency.

1st degree burns

only epidermis is damaged

Inflammation of the outer ear

otitis externa

vitilligo

patches of skin without pigment; benign condition with no known cause

More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by which portion of the frontal lobe?

premotor cortex

When testing nociceptive stimuli to elicit a withdrawal reflex in the body, what stimuli are commonly used?

pressure from a sharp object

What can make a patients blood sugar spike during hospitalization

stress

Cerebral Edema

swelling of the brain

Glaucoma

a condition of increased pressure within the eyeball, causing gradual loss of sight.

The nurse is caring for a client with Guillain-Barré syndrome. Which clinical manifestations are expected with this diagnosis? Select all that apply.

Flaccid paralysis of extremities Pain Loss of tendon reflexes

optic

eye

aqueous humor

fluid in the eye, found between the cornea and the lens delivers food and oxygen to the lens and cornea

tonic-clonic seizure

generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups

otitis media

inflammation of the middle ear (cause children to have tubes placed in)

3rd degree burns

into subcutaneous tissue. damage bone, blood vessels

puritis

itching

1st sign of congenital hypothyroidism

jaundice

Staph or strep can damage

kidneys