Patho (Quiz 4-6)

A neighbor is complaining to a friend (who happens to be a nurse) about several changes in their body. Which of the following complaints raises a "red flag" because it could be a sign of epithelial cell bladder cancer? A. "I noticed my urine is pinkish red, but I'm not having any pain when I pee." B. "Sometimes I get a sharp pain in my side while exercising." C. "Every now and then, I have urine leak when I cough." D. "Seems like I'm holding onto more water these days."

A. "I noticed my urine is pinkish red, but I'm not having any pain when I pee."

In anatomy class, the instructor asks, "Explain how urine is expelled from the bladder during voiding." The student with the most accurate response would be: A. "The detrusor muscle contract down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder." B. "The beginning of micturition occurs when neurons send messages down to the pudendal nerve." C. "It's really the external sphincter muscle that controls urination. The somatic nervous system innervates the muscles of the external sphincter and the pelvic floor muscles that together control the outflow of urine." D. "The urothelium acts as a barrier to prevent urine from seeping into capillaries."

A. "The detrusor muscle contract down on the urine and the ureteral orifices are forced shut. The external sphincter relaxes as urine moves out of the bladder."

Which of the following clients is at risk for developing a preventable disorder related to prolonged immobility? A. A postsurgical client who is refusing to get out of bed and walk and will not wear those "uncomfortable elastic stocking" B. A young adult female diagnosed with sarcoidosis requiring corticosteroids to return her to remission C. A middle-aged adult male diagnosed with bronchitis related to chronic smoking D. A sleep apnea client related to a history of smoking who utilizes a C-PAP machine every night at bedtime to maintain airway

A. A postsurgical client who is refusing to get out of bed and walk and will not wear those "uncomfortable elastic stocking"

A child is recovering from a bout with group A β-hemolytic Streptococcus infection. They return to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed: A. Acute postinfectious glomerulonephritis B. Adult-onset medullary cystic disease C. Acute nephritic syndrome D. Autosomal recessive polycystic kidney disease

A. Acute postinfectious glomerulonephritis

A client is admitted with dilated cardiomyopathy with left ventricular dysfunction. The nurse should assess for which of the following clinical manifestations? Select all that apply. A. Dyspnea B. Extreme fatigue with activity C. Fainting D. Orthopnea E. Excess abdominal fluid

A. Dyspnea B. Extreme fatigue with activity D. Orthopnea

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. Hypocalcemia B. Hypophosphatemia C. Hypokalemia D. Elevation in vitamin D levels

A. Hypocalcemia

Which of the following assessment findings would lead the nurse to suspect the client has nephrotic syndrome? A. Proteinuria and generalized edema B. Renal colic and increased serum sodium C. Hematuria and anemia D. Increased creatinine with normal blood urea nitrogen

A. Proteinuria and generalized edema

A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because: A. Trapped, inspired air collapses the lung. B. Blebs on the lung surface rupture. C. The opposite lung hyperinflates. D. Expired air exits the bleeding wound.

A. Trapped, inspired air collapses the lung.

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. "I think that I probably could have prevented this if I had got in the habit of exercising more when I was younger." B. "If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis." C. "I read on the Internet that I might have got bronchitis because I was born with an enzyme deficiency." D. "I'm pretty sure that I first caught bronchitis from the person who has the cubicle next to mine at work."

B. "If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis."

A father experienced the onset of chest pain and dies suddenly. The family asks, "What caused him to die so suddenly?" The health care provider's reply that is most appropriate would be, "There's a high probability that your loved one developed an acute heart attack and experienced: A. High troponin levels." B. Acute ventricular arrhythmia." C. Hypertrophic cardiomyopathy." D. Acute myocarditis."

B. Acute ventricular arrhythmia

Which of the following clients should most likely be assessed for orthostatic hypotension? A. A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-the-counter analgesics B. An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom C. A 42-year-old client who has a history of poorly controlled type 1 diabetes D. A 65-year-old client whose vision has become much less acute in recent months and who has noticed swelling in her ankles

B. An 80-year-old elderly client who has experienced two falls since admission while attempting to ambulate to the bathroom

Glomerulonephritis is usually caused by: A. Vesicoureteral reflux B. Antigen-antibody complexes C. Catheter-induced infection D. Glomerular membrane viruses

B. Antigen-antibody complexes

Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following consequences? A. Inhibition of the SA node's normal action potential B. Backflow from the left ventricle to the left atrium C. Backup of blood from the right atrium into the superior vena cava D. Backflow from the right ventricle to the right atrium during systole

B. Backflow from the left ventricle to the left atrium

If a CKD client is developing uremic encephalopathy, the earliest manifestations may include: Select all that apply. A. New-onset seizures B. Decreased alertness C. Diminished awareness D. Delirium and hallucinations

B. Decreased alertness C. Diminished awareness

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. Bronchiolitis B. Epiglottitis C. Croup D. Asthma

B. Epiglottitis

The most recent assessment of a client with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk? A. Hematuria B. Microalbuminuria C. Orthostatic hypotension D. Diabetic retinopathy

B. Microalbuminuria

A child with asthma is walking outside and develops a bronchospasm. The school nurse knows this bronchospasm has what effects on bronchioles with airflow? Select all that apply. A. Causes atelectasis in posterior lung segments B. Narrowing of bronchioles C. Impairs airflow D. Exerts tension on the bronchiole walls E. Inhibits the filtering of dust particles

B. Narrowing of bronchioles C. Impairs airflow

A client with a history of emphysema from long-term cigarette smoking has loss of many alveoli. When comparing the type I alveolar cell physiologic function with the primary role of type II alveoli, the nurse would be aware that the type II alveoli are responsible for: A. Production of macrophages B. Production of surfactant C. Facilitation of bronchial circulation D. Gas exchange

B. Production of surfactant

If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern? A. Heart rate 150 beats/minute, labeled as supraventricular tachycardia B. Slowing of heart rate to below 60 beats/minute C. Complete cardiac standstill D. Disorganized ventricular fibrillation

B. Slowing of heart rate to below 60 beats/minute

The most important complication of atherosclerosis that may cause occlusion of small heart vessels is: A. Fibrous plaque B. Thrombosis C. Fatty streaks D. Ulceration

B. Thrombosis

A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute: A. Prerenal inflammation B. Tubular necrosis C. Intrarenal nephrotoxicity D. Bladder outlet obstruction

B. Tubular necrosis

An adult client has been diagnosed with polycystic kidney disease. Which of the client's following statements demonstrates an accurate understanding of this diagnosis? A. "I suppose I really should have paid more attention to my blood pressure." B. "I've always been prone to getting UTIs, and now I know why." C. "I suppose I should be tested to see if my children might inherit this." D. "I had a feeling that I was taking too many medications, and now I know the damage they can do."

C. "I suppose I should be tested to see if my children might inherit this."

A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which of the following explanations is most appropriate to share? A. "Since your heart function is impaired, the lungs are not able to oxygenate the blood and your kidneys are wearing out." B. "You must be drinking way too many liquids. Your kidneys cannot filter all that you are drinking during the day." C. "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water." D. "Your heart muscle is overstretched, so it's not able to pump all the blood out. The prescribed 'water pills' help by decreasing your weight."

C. "Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."

Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, midclavicular line. The client asks, "What does that mean?" The nurse will base her answer on which of the following physiologic principles? A. "Your heart has enlarged, so naturally your valves had to enlarge as well." B. "You heart has been pumping your blood so hard, that the pressure has damaged your valves." C. "You have a heart valve that is diseased." D. "You have been exposed to an infection that went into your blood stream."

C. "You have a heart valve that is diseased."

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease? A. A client who experienced a hemorrhagic stroke and now has sensory and motor deficits B. A client whose diagnosis of thyroid cancer necessitated a thyroidectomy C. A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet D. A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage

C. A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

The most common causes of left-sided heart failure include: A. Impaired renal blood flow B. Chronic pulmonary disease C. Acute myocardial infarction D. Tricuspid valve regurgitation

C. Acute myocardial infarction

A client has been given the diagnosis of diffuse glomerulonephritis. They ask the nurse what diffuse means. The nurse responds: A. Only one segment of each glomerulus is involved. B. Only some of the glomeruli are affected. C. All glomeruli and all parts of the glomeruli are involved. D. That the mesangial cells are being affected.

C. All glomeruli and all parts of the glomeruli are involved.

Which of the following lab results strongly suggest an immunologic response in the client with possible rheumatic heart disease? A. Elevated white blood cell count B. Elevated erythrocyte sedimentation rate (ESR) C. Group A (β-hemolytic) streptococcal antibodies D. High C-reactive protein levels

C. Group A (β-hemolytic) streptococcal antibodies

Which of the following manifestations typically accompanies an asthmatic attack? A. Decreased pulmonary arterial pressure B. Prolonged inspiration C. Hyperinflation of the lungs D. Decreased residual volume

C. Hyperinflation of the lungs

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which of the following disorders was the player's most likely cause of death? A. Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) B. Takotsubo cardiomyopathy C. Hypertrophic cardiomyopathy (HCM) D. Dilated cardiomyopathy (DCM)

C. Hypertrophic cardiomyopathy (HCM)

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. Central nervous system B. Renal C. Pancreatic D. Cardiac

C. Pancreatic

Following surgery, a client had a chest x-ray that reported some opacities in the lung bases likely due to atelectasis. Which of the following pathophysiologic processes will result from this condition? A. Dead air space B. Ventilation without perfusion C. Perfusion without ventilation D. Compensatory vasoconstriction

C. Perfusion without ventilation

As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to: A. Expiratory airway collapse B. Left-sided heart failure C. Pulmonary hypertension D. Breakdown of elastin

C. Pulmonary hypertension

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. Productive cough with white secretions B. Faint wheezes noted in the posterior lung base C. Substernal retractions becoming more pronounced D. Increased respiratory rate to 44 breaths/minute E. New-onset expiratory grunting

C. Substernal retractions becoming more pronounced D. Increased respiratory rate to 44 breaths/minute E. New-onset expiratory grunting

When lecturing to a group of students about the pathophysiological principles behind heart failure, the instructor explains that cardiac output represents: A. Strength of the right ventricular pump to move blood B. The amount of blood pumped out of the heart with each beat C. The amount of blood the heart pumps each minute D. The volume of blood stretching the heart muscle at the end of diastole

C. The amount of blood the heart pumps each minute

A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happened. The nurse states, "For unknown reasons, you lose intrapleural negative pressure. A. You must have experienced a forced expiration against a closed glottis to cause the lung to deflate." B. You must have coughed too forcibly and your air sacs burst." C. This means your lungs collapsed and expelled its air when you lose negative pressure." D. You must have a genetic anomaly causing weakened alveolar sacs to rupture."

C. This means your lungs collapsed and expelled its air when you lose negative pressure."

Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by: A. Myocardial inflammation B. Left ventricle hypertrophy C. Vegetative valve destruction D. Chronic atrial fibrillation

C. Vegetative valve destruction

A male client with a history of angina has presented to the emergency department with uncharacteristic chest pain, and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle? A. Ventricular depolarization B. Depolarization of the AV node C. Ventricular repolarization D. Atrial depolarization

C. Ventricular repolarization

A female client asks, "Why do I leak urine every time I cough or sneeze?" The health care worker's response is based on which physiologic principle? A. A decrease in bladder distensibility B. Involuntary bladder continence during filling C. When intravesical pressure exceeds maximal urethral closure pressure D. A pressure difference between the urethra and bladder

C. When intravesical pressure exceeds maximal urethral closure pressure

A female teenager has experienced three uncomplicated urinary tract infections in the last 3 months. Knowing the anatomical location of the urethra, the nurse should educate this teenager about: A. Washing hands prior to inserting a tampon to minimize the risk of group B Streptococcus B. Wearing gloves when wiping perineum after defecation to prevent Staphylococcus aureus infection C. Wiping from front to back to prevent Escherichia coli contamination of the urethra D. Proper handwashing to decrease amount of Pseudomonas growing on the hands

C. Wiping from front to back to prevent Escherichia coli contamination of the urethra

Which of the following is a nonmodifiable risk factor for the development of primary hypertension? A. Smoking B. Obesity C. High salt intake D. African American race

D. African American race

A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants' following statements demonstrates an accurate understanding of the risk factors for bladder cancer? A. "I think I should be okay because there's no history of bladder cancer in my family that I'm aware of." B. "I can see that preventing bladder cancer is one more benefit of a healthy diet." C. "I suppose I should listen to my doctor and drink more cranberry juice." D. "More than ever, I guess it would worthwhile for me to quit smoking."

D. "More than ever, I guess it would worthwhile for me to quit smoking."

A heart failure client has an echocardiogram performed revealing an ejection fraction (EF) of 40%. The nurse knows this EF is below normal and explains to the client: A. "Your ventricular muscle is getting too stiff to beat normally." B. "This means you have a lot of pressure built-up inside your heart." C. "You need to increase the amount of exercise you do to get your heart muscle back in shape." D. "This means your heart is not pumping as much blood out of the heart with each beat."

D. "This means your heart is not pumping as much blood out of the heart with each beat."

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. An infant whose routine screening is suggestive of cystic fibrosis B. An elderly, lifelong smoker who has been admitted to hospital with emphysema exacerbation C. A 16-year-old girl who must limit her physical activity to prevent the onset of acute asthmatic attacks D. A 30-year-old African American man who has been diagnosed with sarcoidosis

D. A 30-year-old African American man who has been diagnosed with sarcoidosis

Which of the following clients would be at high risk for developing primary varicose veins? Select all that apply. A. A Marathon runner who has completed three marathons in the past 3 months B. A new peritoneal dialysis client who has been utilizing a home machine and performing dialysis every evening beginning at 8 PM C. A 56-year-old male who has been immobile due to back surgery and has developed a deep vein thrombosis D. A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week E. A 47-year-old waitress who works 12-hour shifts three or four times/week

D. A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week E. A 47-year-old waitress who works 12-hour shifts three or four times/week

The client is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the midcalf area. He has many of the manifestations of: A. Arterial insufficiency B. Stasis ulcerations C. Primary varicose veins D. Deep vein thrombosis

D. Deep vein thrombosis

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. Proteinuria B. Edema C. Hypokalemia D. Diuresis

D. Diuresis

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which of the following high-risk factors with the development of this cancer? A. Anorexia/bulimia disorder B. Adrenal medulla tumors C. Inherited renal disease D. Heavy smoking

D. Heavy smoking

A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the client integrate into his lifestyle to reduce the risk of recurrence? A. Regular random blood glucose testing B. Weight loss and blood pressure control C. Increased physical activity and use of over-the-counter diuretics D. Increased fluid intake and dietary changes

D. Increased fluid intake and dietary changes

One of the principal mechanisms by which the heart compensates for increased workload is: A. Ventricular wall tension increase B. Sodium and water retention C. Endothelin vasoconstrictors D. Myocardial hypertrophy

D. Myocardial hypertrophy

A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows this can: A. Be cured by administering an anticoagulant immediately B. Cause the kidney to develop renal stones due to stasis C. Cause compartment syndrome in the lower extremities D. Obstruct the renal tubules with myoglobin and damage tubular cells

D. Obstruct the renal tubules with myoglobin and damage tubular cells

COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population? A. PCO2 level of 65 mm Hg B. Pulse oximeter reading of 96% saturation C. Arterial blood gas pH of 7.35 D. PO2 level of 50 mm Hg

D. PO2 level of 50 mm Hg

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which of the following physiologic processes? A. Rigidity of the ventricular walls B. Electrical impulses in the heart C. Release of stress hormones D. Peripheral vascular resistance

D. Peripheral vascular resistance

Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma? A. Cold weather B. Respiratory tract infections C. Stress D. Pet dander

D. Pet dander

The pathogenic capacity of the tubercle bacillus is related to: A. Rapid viral replication in host cells B. Formation of a Ghon focus lesion C. Its inherent destructive capabilities D. The initiation of a cell-mediated immune response

D. The initiation of a cell-mediated immune response

Many factors contribute to the incontinence that is common among the elderly. A major factor is increased: A. Detrusor muscle function B. Intake of liquids and water C. Urethral closing pressure D. Use of multiple medications

D. Use of multiple medications

Blue Bloaters is an acronym for patients with emphysema. True False

False

Shortness of breath when lying down is apnea True False

False

Difficulty breathing is dyspnea True False

True

The respiratory drive in patients with chronic obstructive pulmonary disease can be diminished when administering oxygen to them. True False

True