Patho

An example of age-related primary atrophy of skeletal tissue is:

menopausal bone loss

The nurse is caring for a client undergoing treatment for osteoporosis with teriparatide therapy. For which additional condition(s) should the nurse monitor? Select all that apply.

Dizziness Leg cramps

The nurse is assessing a client with stage 5 Alzheimer disease. Which finding(s) does the nurse anticipate? (Select all that apply.)

Exhibits major memory and cognitive deficits Requires assistance in day-to-day activities

The nurse explains risk factors for Hodgkin lymphoma (HL):

Exposure to viruses such as Epstein-Barr virus (EBV), genetic factors, and immunosuppression.

Age-related melanin deficiency leads to which one of the following manifestations?

graying hair

The nurse educates a client about myocardial infarction (heart attack). Which laboratory result does the nurse identify as a marker of inflammation?

elevated C-reactive protein (CRP)

Most common clinical manifestations of Hodgkin lymphoma include, EXCEPT:

Persistent high fever

Which of the following pathophysiological processes would a clinician most likely expect in a client with a diagnosis of dementia rather than delirium?

Plaques have developed between neurons and neurofibrillary tangles have developed within neurons.

The nurse determines that teaching has been effective when a client diagnosed with chronic stable angina (CSA) states:

"Angina may result from exertional activity or emotional stress and be relieved within minutes by rest or by nitroglycerin."

A 51-year-old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which statement by the client demonstrates a sound understanding of his new diagnosis?

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

A client who has been diagnosed with mitral valve prolapse asks the nurse if there are any dietary modifications that should be incorporated into her lifestyle. The best response would be:

"Refraining from caffeine, alcohol, and cigarettes may be sufficient to control symptoms."

When a 55-year-old client's routine blood work returns, the nurse notes that the client's C-reactive protein (CRP) is elevated. The client asks what that means. The nurse responds:

"This means you have elevated serum markers for systemic inflammation that has been associated with vascular disease."

The nurse is planning care for a client with acute lymphoblastic leukemia (ALL). Which intervention(s) will the nurse include in the plan of care? Select all that apply.

-Cluster care delivery to allow for rest periods throughout the day. -Instruct client to wear a medical mask when leaving the hospital room. -Assess the frequency and appearance of bowel movements each shift.

Which statements identify bladder function? Select all that apply.

-Control of function involves the autonomic and somatic nervous systems. -The sympathetic nervous system promotes bladder filling. -The parasympathetic nervous system promotes emptying.

The nurse is performing pulmonary function testing for an older adult client. Which age-related finding(s) should the nurse anticipate? (Select all that apply.)

-Decreased inspiratory reserve volume -Increased residual volume -Reduced ventilatory capacity -Reduced ventilation-perfusion ratio

A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the clinic reporting difficulty breathing. 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.

-Respiratory rate—32; pulse rate—122 beats/min. -"Having a hard time catching my breath." -Using accessory muscles to help him breathe.

Four clients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which client most likely experienced myocardial infarction?

80-year-old woman whose pain was not relieved by nitrates or rest; the ECG showed ST-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose

The nurse is reviewing the health histories of four clients. Select the client most at risk for developing secondary osteoporosis.

A 60-year-old female taking prednisone for asthma

The first manifestation that a client has osteoporosis is when presenting with which condition?

A bone fracture

Which client is at risk for developing acute respiratory failure?

A middle-aged male diagnosed with amyotrophic lateral sclerosis (ALS) who has pneumonia with low O2 saturation

The nurse is performing an assessment on a client diagnosed with an intestinal obstruction. Which finding(s) should the nurse anticipate? (Select all that apply.)

Abdominal distention Abdominal pain Vomiting Edema

Based solely on the inheritable condition,a child with Down syndrome is susceptible for developing which type of cancer

Acute Lymphocytic leukemia (ALL)

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen

Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the following?

Airway inflammation

A nurse is evaluating clients at risk for developing dyspnea. Which diagnoses would place a client at risk? Select all that apply.

Asthma Heart disease Emphysema Pneumonia

The nursing instructor, when teaching the students about coronary artery disease (CAD), identifies which of the following as the main cause of CAD?

Atherosclerosis

The most important information for a nurse to give a client who has been diagnosed and treated for a calcium oxalate stone would include which facts related to their diet?

Avoid spinach and peanuts

The nurse is reviewing lab results for a client with a diagnosis of a urinary obstruction. Which result(s) should the nurse anticipate? (Select all that apply.)

Bacteriuria Hematuria

A client with confirmed low bone density asks the nurse if there is anything she can to decrease the risk of trauma. The best response would be:

Brisk walking three times per week on a flat surface

When asking a nursing student to identify what the large intestine reabsorbs, which answer(s) is accurate? Select all that apply.

water vitamin K B complex vitamins

A nurse is caring for a client diagnosed with chronic lymphocytic leukemia (CLL).The client's initial white blood cell (WBC) count is 120,000/mm^3 (120 x 10^9/l).The nurse prepares the client for which initial priority treatment

Chemotherapy

The nurse is preparing a client for intrathecal chemotherapy. How will the nurse explain this treatment to the client?

Chemotherapy drugs will be injected into the cerebrospinal fluid area of the spinal cord.

A nurse is assessing a client with a diagnosis of acute pericarditis. The client will most likely exhibit which clinical manifestations? Select all that apply.

Fever Chest pain Pericardial friction rub Pleuritic pain

The nurse is performing an assessment on a client who is exhibiting tachypnea. Which other finding(s) may lead to this condition? (Select all that apply.)

Fever Physical activity

A client is diagnosed with leukemia.The student nurse working with this client correctly identifies the cancer to be

Hematologic Cancer

Increased cardiac workload with left-sided heart failure can result in which change to the myocardial cells?

Hypertrophy

The nurse is reviewing the laboratory results of an older adult client with a diagnosis of water retention. Which additional condition should the nurse anticipate?

Hyponatremia

A nurse is assessing a 1-year-old child diagnosed with croup. Which manifestation would most likely be present?

Inspiratory stridor and barking cough

The family of an older adult client is concerned about injuries from falls. The nurse providing discharge teaching would best minimize this risk by encouraging the family to perform which intervention?

Keep walkways free of clutter since alteration in vision happens with aging.

A 30-year-old client arrives with these vital signs: Blood pressure 50/30 mm Hg, pulse 100 beats/min, respiratory rate 12 breaths/min, temperature 101°F (38.3°C). The nurse interprets these results as the client being in shock based on which reading?

Low blood pressure

In considering a definition of aging, a 76-year-old male would be classified into which of the following subgroups?

Middle-old

Which statement demonstrates and supports the stochastic free radical theory of aging?

Mitochondria DNA may become damaged from reactive oxygen species (ROS).

A teenaged client with cystic fibrosis 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?

Pancreatic

The nurse is caring for a client who is exhibiting Cheyne-Stokes respirations. Which component(s) of the central nervous system may be affected in this client? (Select all that apply.)

Respiratory control center Lung receptors Chemoreceptors

Cystic fibrosis (CF), the major cause of severe chronic respiratory disease in children, is characterized by which diagnostic finding?

Salt depletion

An 86-year-old female client has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to minimize urinary incontinence. The client's admitting laboratory results are suggestive of prerenal failure. The nurse should be assessing this client for which early sign of prerenal injury?

Sharp decrease in urine output

What is a common cause of spastic bladder dysfunction?

Spinal cord injury

What is the primary cause of heart failure in infants and children?

Structural heart defects

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for treatment of hypertension. What expected outcome does the nurse expect this medication will have?

Will prevent the conversion of angiotensin I to angiotensin II

A client diagnosed with stage II Non-Hodgkin lymphoma (NHL) asks the nurse about his treatment. The nurse explains:

You can be treated effectively with radiation therapy.

Common clinical manifestations of leukemias are, EXCEPT:

alopecia

The nurse is caring for a client who is diagnosed with aspiration pneumonia. The client's arterial blood gas (ABG) results from 4 hours ago indicated a paO2 of 80 mm Hg (10.64 kPa) and a paCO2 of 30 mm Hg (3.99 kPa). The nurse notes current ABG results of paO2 of 70 mm Hg (9.31 kPa) and a paCO2 of 50 mm Hg (6.66 kPa). When notifying the health care provider, which recommendations will the nurse make? Select all that apply.

blood cultures chest x-ray oxygen to maintain SaO2> 90% preparation for possible intubation

Which assessment value(s) indicates the client is experiencing ineffective perfusion? Select all that apply.

heart rate 130 beats/min, regular rhythm signs of a stroke in the medulla of the brain

A client with anxiety disorder overstimulates their sympathetic nervous system (SNS). Which manifestation is a direct result of this SNS stimulation?

heart rate 150 beats/min

Immune function is altered in aging due to:

reduced T-cell lymphocyte activity

A client is being discharged following a percutaneous transluminal coronary angioplasty (PTCA) with stent placement. The nurse explains that the acetylsalicylic acid (ASA) and clopidogrel are both prescribed to reduce the risk of which complication?

stent occlusion

A nurse is preparing to lecture on aging. One topic the nurse plans to discuss is tissue effects that occur as a result of deposits of lipofuscin. Which effect(s) will the nurse include? Select all that apply.

stiffening rigidity

Hodking lymphoma (HL)'s treatment is based on clinical staging of HL. Primary treatments are, except:

surgery

The nurse is scheduled to teach a client experiencing urinary incontinence about Kegel exercises. Which descriptor should the nurse include in this education?

"Contract and relax the pelvic floor muscles at least 10 times every hour while awake."

The educator of a geriatric unit is orienting new staff and is teaching strategies on communicating with older adults with impaired hearing. Which teaching point is most appropriate?

"Ensure that the hearing aid is in place, turned on, and properly functioning."

A client with a history of chronic obstructive pulmonary disease (COPD) is undergoing pulmonary function testing. Which instructions should the technician provide to determine the client's forced vital capacity (FVC)?

"I'll ask you to breathe in as deeply as you can, and then blow out as much of that air as possible."

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

"Research supports a possible genetic link with an early onset."

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 explanation is most appropriate to share?

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

On the third day following an acute myocardial infarction, the client asks the nurse how the heart muscle will heal. What is the nurse's best response?

"The body will clear away the dead cells and you will be left with some scar tissue on your heart muscle."

A 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 tells the nurse he was diagnosed with a sinus infection about 7 days ago. He is now experiencing facial swelling and has also had periods of confusion. His family told him he is not remembering things. The best response by the nurse would be:

"This can be a complication of the infection; we need to let the health care provider know."

A client experienced asymptomatic UTIs while pregnant. The client asks the nurse if this places her at any risk for complications. Which would be the best response by the nurse?

"You are at risk for developing acute pyelonephritis."

A client with persistent, primary hypertension remains apathetic about high blood pressure, stating "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How could the nurse best respond to this client's statement?

"You may not sense any problems, but hypertension increases your risk of heart disease and stroke."

The spouse of a client diagnosed with Alzheimer disease asks the nurse why the client often neglects to take a shower. The spouse states that the client was always diligent with hygiene in the past; however, over the past few months that has not been the case. What is the nurse's best response?

"You should remind the client to shower."

The nurse is teaching a client with advanced chronic obstructive pulmonary disease (COPD) about the contributing factors to hypercapnia in this condition. Which information will the nurse include? Select all that apply.

-"Loss of elasticity in the airways leads to trapping of carbon dioxide in the lungs." -"Enlarged air sacs in the lungs can collapse, preventing the release of carbon dioxide."

Which clients would be considered at high risk for developing pneumonia (both community and hospital setting)? Select all that apply.

-A young adult in motorcycle accident with head injury requiring tracheostomy and mechanical ventilation -A HIV-positive client with a WBC count of 2000 who has been camping near a commercial farm raising chickens for food -A school-aged child with severe asthma controlled by steroids admitted for an exacerbation

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.

-Antiprotease production and release are not adequate to neutralize the excess protease production." -"There is α1-antitrypsin deficiency, so this enzyme can't protect the lung from damage."

Which statements most accurately describe secondary hypertension? Select all that apply.

-Can be corrected or cured by surgery or specific medical treatment -Accounts for 5% to 10% of hypertension cases -Has an independent risk factor for obstructive sleep apnea -Is most commonly caused by kidney disease

A nurse is teaching a client about the functions of the kidney. Which would be the most appropriate information for the nurse to provide? Select all that apply.

-Eliminates metabolic wastes -Regulates calcium and phosphorus conservation and elimination -Regulates blood pressure through the renin-aldosterone mechanism -Regulates pH of body fluids through reabsorption and conservation

Which client(s) will the nurse assess closely for formation of blood clots? Select all that apply.

-female client using oral contraceptives -client with chronic eosinophilic leukemia, a myeloproliferative disease -client with systemic lupus erythematosus, an autoimmune disease

The nurse is reviewing client records. Which finding(s) indicates to the nurse that the client is at risk for impaired gastrointestinal function? Select all that apply.

-recent abdominal surgery -takes opioids daily for chronic pain -hurt knee recently so no longer takes walks daily -experiences high anxiety frequently every week

The nurse knows that the main objective of the management of hypertension is to achieve a sustainable level of blood pressure below:

140/90

Which glomerular filtration rate (GFR) correlates with the client having a hydroureter?

45 ml/min/1.73 m2

The physician's order states, "Calculate the pulse pressure of the client's B/P." The blood pressure reading is as follows: systolic pressure of 146 mm Hg and a diastolic pressure of 82 mm Hg. The pulse pressure would be:

64 mm Hg

Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.

While looking in on a neighbor who lives alone, the nurse notes left-sided paralysis, drooping face, and aphasia. What action should the nurse perform first?

Activate the emergency response system.

In addition to regulating body fluids and electrolytes, the kidneys' endocrine function in maintaining bone calcium levels consists of what process?

Activating vitamin D

The different cells affected by leukemia are either lymphoid or myeloid types. The student identify the following wrong information about Lymphocytic leukemias:

Acute lymphocytic leukemia (ALL) is the most common cancer in adults.

A client who has a diagnose of Hodgkin Limphoma (HL) asks the nurse it is hereditary. A best answer to the client by the nurse is:

An increased incidence is found in children who have parents with a history of HL.

Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.

Baroreceptors

The nurse is performing a nutritional assessment for an older adult client. Which alteration(s) in mineral metabolism should the nurse anticipate? (Select all that apply.)

Calcium Phosphate Magnesium

The nurse is caring for a client who has just experienced an acute myocardial infarction. Which type of shock is this client likely to experience?

Cardiogenic

Hospitalized neonates are at greatest risk of developing septicemia related to which procedure?

Catheter-associated bacteriuria

A nurse is informing a client diagnosed with a neurogenic bladder about treatment options. Which options should be included in client teaching? Select all that apply.

Catheterization Bladder training Surgery Pharmacologic intervention

A 56-year-old male client has been diagnosed with hypercholesterolemia. Which laboratory result supports this diagnosis?

Cholesterol 250 mg/dL (6.47 mmol/L) and HDL 32 mg/dL (0.83 mmol/L)

Which individual is at greatest risk for developing a venous thrombosis resulting from venous stasis?

Client on bed rest

Gastrointestinal elimination in older adults is often characterized by which common symptom?

Constipation

A client with primary lung disease has developed right heart failure. The health care provider would document this as:

Cor pulmonale

A client who had a diagnosis of leukemia asked why he has frequent epistaxis. The nurse explains that:

Crowding of leukemic cells in the bone marrow can suppress platelet production, leading to bruising and bleeding problems.

A client with chronic obstructive pulmonary disease presents to the emergency department with difficulty breathing. Physical examination reveals bluish skin, nail beds, and mucous membranes. Which term correctly describes this condition?

Cyanosis

Which manifestation of left-sided heart failure can be diagnosed by examination of the lips and mucous membranes?

Cyanosis

During the admission interview the client, who is admitted with bacterial pneumonia, reveals a 20 pack per year smoking history. The nurse relates the possible cause of this pneumonia to the decreased defense of the pulmonary system caused by cigarette smoking. Smoking affects the pulmonary defense system in what way?

Damage or destruction of cilia

Which physiologic change in the elderly population contributes to urinary incontinence?

Decline in detrusor muscle function

A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will:

Decrease

What contributes to impairment in renal function in aging?

Decrease in functioning nephrons

The nurse is assessing the fluid status of an older adult client. Which age-related change(s) should the nurse consider? (Select all that apply.)

Decrease in total body water Decreased kidney function

A client's recent history of emphysema has resulted in the functional loss of many alveoli. How will this impact the physiologic function of the type II alveoli?

Decrease the production of surfactant

Which vascular changes can occur in older adults because of the increase in blood pressure during the aging process?

Decreased elasticity in arterial connective tissue

A client is immobilized following a hip injury. The client has developed lower leg discoloration with edema, pain, and tenderness in the midcalf area. How should the nurse document these clinical findings?

Deep vein thrombosis

The nurse is performing a skin assessment for an older adult client. Which age-related finding(s) should the nurse anticipate? (Select all that apply.)

Dry, wrinkled appearance Varied skin pigmentation Decreased elasticity

A client who has no previous history of respiratory disease describes a sensation of shortness of breath and the feeling of not being able to pass enough air during exercise that has just developed over the past month. The client would be documented as having:

Dyspnea

The nurse is caring for a client undergoing preventive treatment for osteoporosis with estrogen therapy. For which additional condition(s) should the nurse monitor? Select all that apply.

Endometrial hyperplasia Deep vein thrombosis Breast cancer

All of the following interventions are ordered STAT for a client stung by a bee who is experiencing severe respiratory distress and faintness. Which priority intervention will the nurse administer first?

Epinephrine

Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.

Escherichia coli

Disorders that affect cortical bone typically result in:

Fractures of long bones

Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

Hematuria

Which factor contributes to the development of polycystic kidney disease?

Hereditary mutations in polycystin I and II

The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be

History of cigarette smoking and elevated blood pressure

A pneumonia that occurs 48 hours or more after admission to the hospital is considered:

Hospital-acquired pneumonia

The nurse is caring for a client with sequelae of an untreated urinary obstruction. Which additional condition(s) does the nurse anticipate? (Select all that apply.)

Hydronephrosis Renal failure Infection Hypertension

Common results of acute respiratory failure are hypoxemia and:

Hypercapnia

While rock climbing, a 22-year-old male has endured a severe head injury. Which statement best captures expected clinical manifestations and treatments for his immediate condition?

Hypoventilation may exist, resulting in increased PCO2 and hypoxemia that may require mechanical ventilation.

A 20-year-old college student has a pelvic fracture and a severed leg from a motorcycle accident. She lost several units of blood. When the student arrived in the emergency department, her blood pressure was very low, her pulse was high, and her skin was pale. The nurse knows that this client has developed which type of shock?

Hypovolemic

A client diagnosed with congestive heart failure has an arterial blood oxygen level (PaO2) of 89%. Which term should the nurse use to document a reduced oxygenation of arterial blood?

Hypoxemia

The nurse is reviewing the laboratory work of several medical clients. Which laboratory result is most suggestive of abnormalities in kidney function?

Increased creatinine and blood urea nitrogen (BUN) levels

A client has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which measures should the client integrate into his or her lifestyle to reduce the risk of recurrence?

Increased fluid intake and dietary changes

A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which physiologic phenomenon will occur as a consequence of hypoxemia?

Increased heart rate

The practitioner is counseling an 80-year-old client who has recently lost his spouse. The practitioner is aware that the client is at risk for which of the following?

Increased incidence of depression

The nurse is assessing a client with secondary osteoporosis due to corticosteroid therapy. Which findings are related to the etiology of the client's secondary osteoporosis? Select all that apply.

Increased parathyroid activity Decreased calcium absorption

The nurse is caring for a client with secondary osteoporosis due to hyperparathyroidism. Which additional finding(s) does the nurse expect? Select all that apply.

Increased parathyroid hormone Hypercalcemia Polyuria Renal calculi

The nurse is caring for a postoperative older adult client recovering from an appendectomy. What should the nurse anticipate about the client's recovery? (Select all that apply.)

Increased risk for infection Impaired wound healing

The nurse is caring for a client with ineffective airway clearance. Which processes may contribute to this condition? (Select all that apply.)

Inflammation Edema Exudate Foreign body

A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor?

Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction

A client treating for ALL is receiving intrathecal chemotherapy. The nursing student knows that:

Intrathecal chemotherapy involves administering the cancer-fighting drugs into the subarachnoid space.

A client who has suffered a myocardial infarction is being treated in the emergency room. His pain remains severe even though he was given nitrates and oxygen. The physician now orders morphine for the pain. What method should the nurse use to administer the morphine?

Intravenous

While working in the newborn ICU, the nurses receive a call that an infant, gestational age 23 weeks, is being air-flighted to their level three trauma nursery. The priority intervention for this infant would be:

Intubation and mechanical ventilation.

The nurse is assessing a client with secondary osteoporosis due to hyperthyroidism. Which additional finding(s) does the nurse expect? (Select all that apply.)

Irritability Palpitations Diaphoresis Weight loss

To help diagnose problems in cognitive function, many nursing facilities utilize the Mini-Mental State Examination (MMSE) tool. Which of the following statements accurately describes this tool?

It is a brief, objective tool that will assess memory, orientation and attention.

A female client asks the nurse if there is any noninvasive treatment to help with the involuntary loss of urine that occurs when she coughs or sneezes. Which is the best response by the nurse?

Kegel exercises

Which lipid results on four clients will the nurse recognize as having the greatest risk for cardiovascular disease?

LDL cholesterol 205 mg/dL (5.31 mmol/L), HDL 40 mg/dL (1.04 mmol/L), and triglyceride level 150 mg/dL (1.69 mmol/L)

A nursing student is studying the respiratory airways in the lungs, in particular the alveoli. A fellow student asks which cells are most instrumental in the destruction of foreign substances that may enter the alveoli with inspired air. The most accurate response would be:

Macrophages

The nurse is caring for a client exhibiting findings consistent with a severed cervical nerve. Which action should the nurse anticipate first?

Mechanical ventilation

A nurse is assessing an older adult with reports of constipation, for which the client often takes over-the-counter medications. What assessment should the nurse perform to address the etiology of the client's problem?

Medication regimen for drugs like anticholinergic agents or calcium

The nurse is caring for a client with Alzheimer disease undergoing treatment with a cholinesterase inhibitor. For which condition should the nurse monitor?

Nausea

A client is admitted to the hospital following smoke inhalation. The nurse would anticipate the need for cellular metabolism and that the client would need supplemental:

O2

A teenager is diagnosed with hypertension. The nurse knows that risk factors for hypertension in children and adolescents include which of these? Select all that apply.

Obesity High salt consumption Inactive lifestyle

A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experienced any relief. The client is most likely experiencing:

Onset of STEMI

Which statement correctly describes osteogenesis imperfecta, or brittle bone disease?

Osteogenesis imperfecta is caused by deficiencies in the synthesis of type I collagen.

An older adult client is admitted for the treatment of pneumonia. The nurse notes the home medications include nasal calcitonin, vitamin D, and calcium chloride. Which disease process is this client likely treating with these medications?

Osteoporosis

The nurse is caring for an older adult client with an unexplained fracture. For which condition should the nurse anticipate treatment?

Osteoporosis

A physiotherapist (PT) at an assisted living facility for older adults is leading an exercise class for the residents. Part of the PT's introductory class is an explanation of the health problems that can be mitigated by physical activity and those which are considered inevitabilities of the aging process. Which of the following phenomena would the PT most justifiably characterize as modifiable?

Overall reduction in muscle strength.

The nurse is caring for a client with a diagnosis of detrusor underactivity who is experiencing urinary incontinence. For which type of incontinence should the nurse anticipate treatment?

Overflow

A client is brought to the emergency department with symptoms of acute coronary syndrome (ACS). Select the most important interventions that should be implemented. Select all that apply.

Oxygen Morphine Nitrates ECG monitoring β-adrenergic blocking agents

COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population?

PO2 level of 50 mm Hg

A client presents with fatigue and a temperature of 101.3°F (38.5°C). The client also has several bruises at varying degrees of healing and reports 10 lb (4.5 kg) unintentional weight loss in the past 2 months. Which assessments will the nurse perform to help identify the possible cause of these symptoms? Select all that apply.

Palpate lymph nodes. Draw blood for compete blood count (CBC). Ask about recent history of infections.

The nurse is assessing a client with a brain abscess that has affected the client's respiratory pattern. Which finding(s) should the nurse anticipate? (Select all that apply.)

Periodic apnea Unpredictable breathing pattern Shallow, slow respirations Kussmaul respirations

While assessing a peritoneal dialysis client in the home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as:

Peritonitis

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?

Plasma proteins

The nurse is hearing diminished breath sounds and a "grating" sound during respirations. This is consistent with excess collection of fluid in the pleural cavity. The medical term for this is:

Pleural effusion

Factors that affect cardiac performance include:

Preload, afterload, and myocardial contractility (all of these)

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?

Prepare for mechanical ventilation.

The anemia that occurs with end-stage kidney disease is often caused by the kidneys themselves. What loss of function in the kidney results in anemia of end-stage kidney disease?

Produce erythropoietin

The nurse would be most concerned when the glomerular filtrate contains:

Protein

As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to which complication?

Pulmonary hypertension

An older adult client has been hospitalized for the treatment of acute pyelonephritis. Which characteristic of the client is most likely implicated in the etiology of this current health problem?

Recently had a urinary tract infection

Renal function impairment in aging is related to:

Reduced nephron number

The nurse is caring for a client undergoing treatment for osteoporosis with calcitonin therapy. For which additional conditions should the nurse monitor? Select all that apply.

Rhinorrhea Hypocalcemia

The nurse is assessing a client with no previous diagnosis of respiratory dysfunction who has presented with acute dyspnea. Which assessments should the nurse prioritize related to acute onset dyspnea? Select all that apply.

SaO2 level breath sounds presence of pain

The nurse is assessing an older adult client at risk for age-related changes in neurological function. For which finding(s) should the nurse monitor? (Select all that apply.)

Sensory deficits Motor dysfunction Sleep disturbances Impaired memory and cognition

The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?

Smoking cessation program

The results of a client's 24-hour stool specimen indicate 20 g or more of fat. The nurse would interpret this as:

Steatorrhea

A 6-month-old infant has been hospitalized with acute bronchiolitis. Which treatment should be prioritized in the infant's care?

Supplementary oxygen therapy

A client demonstrates understanding about Lymphomas and Leukemias, EXCEPT when saying:

Surgery is the first treatment option for both lymphomas and leukemias.

The nurse recognizes the following similarities between Hodgkin lymphomas and Non-Hodgkin lymphomas, EXCEPT:

The Reed-Sternberg cell has been identified as the neoplastic origin.

The postoperative client has a catheter in his brachial artery for continuous blood pressure monitoring. Which assessment would be a concern for the nurse?

The client states his hand is numb.

The health care provider is reviewing lab results of a client diagnosed with heart failure. The provider notes that the client's ANP and BNP levels have been increasing and remain significantly elevated. These results would be interpreted as:

The condition is getting progressively worse.

Which function of the kidneys helps to maintain the pH balance in the body?

The kidneys conserve base bicarbonate and eliminate hydrogen ions.

The nurse is caring for a client whose chest x-ray showed a right pleural effusion. Which procedure should the nurse anticipate?

Thoracentesis

The nurse is caring for a client with polycystic kidney disease and end stage renal failure. Which treatment(s) does the nurse anticipate? (Select all that apply.)

Transplantation Dialysis

Which serum biomarker is highly specific for myocardial tissue?

Troponin

A client with a suspected MI is brought to the emergency department by ambulance. The nurse caring for this client would expect to receive an order for which laboratory test to confirm a diagnosis of MI?

Troponin level

The nurse is caring for a client undergoing treatment for osteoporosis with risedronate therapy. For which additional condition(s) should the nurse monitor? Select all that apply.

Upper GI distress Arthralgias

The nurse is caring for a client undergoing treatment for osteoporosis with alendronate therapy. For which other condition(s) should the nurse monitor? Select all that apply.

Upper GI distress Myalgias Arthralgias

A client tells the nurse that he is experiencing involuntary loss of urine associated with a strong desire to void (urgency). The nurse would recognize this as:

Urge incontinence

A client is diagnosed with gout in the right foot and a kidney stone in the left ureter. The nurse recognizes these conditions may have resulted from accumulation of which chemical in the body?

Uric acid

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones?

Uric acid stones

The nurse is caring for a client exhibiting bacteriuria on a recent urinalysis. For which condition should the nurse anticipate treatment?

Urinary tract infection

A nurse educates a client about Lymphomas. The client demonstrates understanding, EXCEPT when saying:

Vaccination against hepatitis B virus should decrease the incidence of Lymphomas.

Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes what response in the pulmonary circulation?

Vasoconstriction

The nurse is caring for a client who has decreased mucosal secretions in the respiratory system. Which function of protection is affected?

Warming and humidifying the air

The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:

a loss of over half the client's normal kidney function.

Once the ambulance arrives, what medication(s) should the nurse anticipate being prescribed to a client experiencing chest pain? Select all that apply.

acetylsalicylic acid nitroglycerin sublingual morphine sulfate oxygen

A 20-year-old male client is experiencing a severe immunologically mediated reaction in which histamines have been released into the blood. Which type of reaction is most likely occurring with this client?

anaphylactic shock

Following the birth of a healthy newborn weighing 3860 grams, the client reports dizziness and lightheadedness. The nurse assesses a large quantity of lochia, bleeding around the IV site, and bleeding from the nose and mucous membranes. Which treatment option(s) does the nurse anticipate to treat this obstetrical complication known as disseminated intravascular coagulation (DIC)? Select all that apply.

anticoagulants exogenous clotting factors

The nurse recognizes as possible manifestations of Non-Hodgkin lymphoma, EXCEPT:

arrythmias

The nurse is reviewing laboratory results for a client with pulmonary fibrosis. Which finding(s) should the nurse anticipate? Select all that apply.

arterial pH of 7.2 partial pressure of carbon dioxide of 50 mm Hg

A client with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior-posterior chest diameter. Which term should the nurse use to document this finding?

barrel chest

The nurse is caring for a client newly diagnosed with acute myeloid leukemia (AML). When reviewing the client's medical record, the nurse notes which finding(s) is evidence of a favorable prognosis for the client? Select all that apply.

being 30 years of age at the time of diagnosis having a lower number of immature while blood cells being asymptomatic at the time of diagnosis

J.S. had a diagnosis of Leukemia. He asked what could result in DNA changes in the blood cells. The nurse explained that all of the following, EXCEPT:

beta blockers

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

cholinesterase inhibitors

Which client(s) is at risk for obstruction to the bowel and thus should be assessed accordingly? Select all that apply.

client who is experiencing constipation client who explains having 3 to 4 "watery stools" client who states the color of stool is "silver"

The nurse documents that the client underwent "percutaneous transluminal coronary angioplasty." Which description best describes why this procedure was performed?

compressing fatty deposits in coronary arteries against the vessel wall

Which of the following may indicate the development of typical age-related changes in thyroid function?

decreased TSH levels

Which of the following vascular changes results in increased cardiac afterload and hypertension in the elderly?

decreased elasticity in arterial connective tissue

Obstruction in the renal tubules leads to:

dilation of structures proximal to the obstruction

A client has been diagnosed with an uncomplicated urinary tract infection (UTI) for the second time in a year. Which teaching will the nurse include to prevent the most common cause of recurrent uncomplicated UTIs?

hygiene practices to reduce exposing the urethral meatus to Escherichia coli

Alterations in temperature regulation in the elderly may occur due to:

impaired responsiveness to catecholamine-induced vasoconstriction

The nurse is caring for an older adult client diagnosed with pneumonia. Despite a normal fluid intake and output balance, the nurse notes physical signs of dehydration. The nurse reports which as the most likely cause of excess fluid losses when reporting the findings to the health care provider?

increased respiratory rate and diaphoresis

When caring for a client in septic shock in the intensive care unit, which medication category(ies) will the nurse question regarding its relevance in this client's treatment plan? Select all that apply.

inotropic medication blood products corticosteroids

A daughter is concerned because her elderly parent has been diagnosed with osteomalacia. The daughter asks the nurse why this happened. The best response would be that:

intestinal absorption slows as natural aging occurs.

Which is an adverse effect of emboli on pulmonary circulation and airways?

local vasoconstriction

Which medication's actions decrease peripheral vascular resistance and decrease fluid volume, resulting in overall reduction of cardiac output?

losartan, an angiotensin II receptor blocker (ARB)

A client reports severe indigestion that has been intermittent; however, the pain is now constant and feels like a vise. The nurse does an ECG and recognizes that the situation is possibly emergent due to ST-segment elevation, which could indicate:

myocardial infarction.

Blood in stool that cannot be seen with the naked eye is known as:

occult

The nurse is caring for a postoperative client who is ordered to have oxygen saturation monitored. The method used to monitor the saturation of oxygen in the blood is:

pulse oximetry.

The nurse is caring for a client diagnosed with stage II indolent non-Hodgkin lymphoma (NHL). The nurse teaches the client about which form of therapy indicated for this condition?

radiotherapy

Which of the following is a potential metabolic alteration leading to osteoporosis in older adults?

reduced vitamin D activation

Which of the following early signs could alert you to the presence of hypoxia, particularly in children?

restlessness

The condition characterized by decreased size and number of skeletal muscle fibers is known as:

sarcopenia

A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to:

saturation of urine with calcium salts.

The nurse administered an incorrect medication to a client who is allergic to the administered medication. Which sign or symptom signifies to the nurse the client is experiencing an anaphylactic reaction?

severe hypotension

In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find:

significant decrease in urine output due to decrease in renal blood flow.

A female client reports leakage of urine every time they cough or sneeze. How should the nurse document this in the medical record?

stress incontinence

The nurse is assessing a client who presented with enlarged lymph nodes suspected of having Hodgkin lymphoma (HL). Which additional assessment data will the nurse collect related to the manifestations of HL? Select all that apply.

temperature weight exercise tolerance

An oncology nurse is caring for a client with newly diagnosed B-cell lymphoma. Extensive blood work has been drawn and sent to the lab. Results reveal an elevated antiapoptotic protein BCL-2 level. The client/family asks, "What does this mean?" The health care provider bases his or her response on the fact that:

this means the cancer cells have found a way to survive and grow even with damaged DNA.

A client who is scheduled to have a tissue specimen removed for microscopic study will undergo which test

tissue biopsy

Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal lung volumes instead of low lung volumes. This results in:

trapping of large amounts of air that cannot participate in gas exchange.

Which urine laboratory results lead the nurse to suspect the client has a urinary problem? Select all that apply.

urine bacteria level of 200,000 per ml 3.5 mmol/L urine ketones 5 to 10 WBC/hpf with leukocyte esterase 30 mg/dl urine glucose

The nurse is caring for an infant admitted to the emergency department diagnosed with bronchiolitis. The nurse would assess the client for:

wheezy cough and dyspnea.

Which manifestation(s) is associated with obstruction of the ampulla of Vater, causing pancreatic and biliary secretion blockage into the intestines? Select all that apply.

yellowing of skin and sclera light-colored "silver" stools