Respiratory and Reproductive Patho Q&A's from study guide and thepoint nclex q&a

the diffuse --------? diseases are a diverse group of lung disorders that produce similar inflammatory and fibrotic changes in the interalveolar septa of the lung.

Interstitial diseases

What are people with talc lung (injected or inhaled tal powder that has been mixed with heroin, meth, or codeine as a filler) susceptible to?

Interstitial lung disease

An 18 yr old woman presents at the clinic complaining new onset breakthrough bleeding even though she is taking contraceptives. What contraceptive use, along with new onset breakthrough bleeding, has been associated with PID?

Intrauterine device

is a specific type of pleural effusion in which there is blood in the pleural cavity

hemothorax

clinical manifestations of atelectasis

tachypnea, tachycardia, dyspnea, cyanosis, signs of hypoxemia, diminished chest expansion absence of breath sounds

Fibrocystic changes in the breast are not uncommon. How is the diagnosis of fibrocystic changes made?

ultrasonography and mammography

The influenza viruses can cause three types of infections:

upper respiratory infection viral pneumonia respiratory viral infection followed by a bacterial infection

A client has developed chronic hypoxia and has developed pulmonary hypertension (HTN). The nurse recognizes that the most likely cause of pulmonary hypertension would be:

Correct Response: Constriction of the pulmonary vessels in response to hypoxemia Rationale: Pulmonary HTN occurs as a result of chronic hypoxia. In response to hypoxia, the pulmonary vessels constrict. The pulmonary vessels differ from the systemic circulation vessels, which dilate in response to hypoxia and hypercapnia. Smooth muscle hypertrophy and proliferation of the vessel intima occur in pulmonary HTN

What are the three most prominent theories of the pathogenesis of endometriosis?

- regurgitation/implantation theory, suggests that menstrual blood containing fragments of the endometrium is forced upward through the fallopian tubes into the peritoneal cavity. Retrograde menstruation is not an uncommon phenomenon, and it is unknown why endometrial cells implant and grow in some women but not in others. a second theory, the metaplastic theory, proposes that dormant, immature cellular elements spread over a wide area during embryonic development persist into adult life and then differentiate into endometrial tissue. A third theory the vascular of lymphatic theory, suggests that the endometrial tissue may metastasize through the lymphatics or vascular system. Genetic and immune factors also have been studied as contributing factors to the development of endometriosis.

Which intervention(s) is important for the nurse caring for a child admitted with bronchiolitis, using the latest evidence in the research literature? Select all that apply.

-Administer supplemental oxygen when the oxygen saturation consistently falls below 90%. -Elevate the head to facilitate respiratory movements. Rationale: The latest evidence does not recommend that health care providers administer albuterol or corticosteroids to children with a diagnosis of bronchiolitis. However, nebulized hypertonic saline may be given to hospitalized children. Treatment is supportive and includes administration of supplemental oxygen when the oxygen saturation consistently falls below 90%. Elevation of the head facilitates respiratory movements and avoids airway compression. Because the infection is viral, antibiotics are not effective and only given if a secondary bacterial infection occurs. It would be inappropriate to call a "code blue" if the child displays wheezing and appears listless, since these are manifestatins of bronchiolitis and the reason the child was admitted to the hospital in the first place.

statements regarding childhood respiratory tract infection that are true

-Each exposure to a new pathogen results in an infection. -Impaired airflow and obstructions are common outcomes of these infections. -An immature immune system is the usual trigger for such infections. -The size of the child has an impact on the seriousness of the symptoms. Rationale: Frequent infections occur because the immune system of infants and small children has not been exposed to many common pathogens. Consequently, they tend to contract infections with each new exposure. Although most of these infections are not serious, the small size of an infant's or child's airways tends to foster impaired airflow and obstruction. In children, respiratory tract infections are common, and although they are troublesome, they usually are not serious.

Which statements concerning hypoxemia are true?

-The brain is vulnerable to hypoxia. -The condition depends on the body's ability to adapt to lowered oxygen levels. -When hypoxemia occurs, metabolic acidosis is a possible outcome. -Normally, serum lactate levels are between 0.5-1 mmol/L (4.5-9.0 mg/dL) Rationale: Hypoxemia produces its effects through tissue hypoxia and the compensatory mechanisms that the body uses to adapt to the lowered oxygen level. Body tissues vary considerably in their vulnerability to hypoxia. Tissues with the greatest need are the brain, lungs, and heart. If the PO2 of the tissues falls below a critical level, aerobic metabolism ceases and anaerobic metabolism takes over, with formation and release of lactic acid, resulting in increased serum lactate levels and metabolic acidosis. The normal range of serum lactate levels is 1 - 0.5 mmol/L (9.0 - 4.5 mg/dL) in non-acutely ill people

For a woman, what is the most serious long-term outcome of an infection resulting from exposure to the N. gonorrhoeae bacteria? 1. Sterility 2. Bartholin gland abscesses 3. Postcoital bleeding 4. Dysuria

1. Sterility

The nurse should assess a client with a history of untreated chlamydia for which potential disease process? 1. Cervical cancer 2. Reiter syndrome 3. Early-onset dementia 4. HIV encephalopathy

2. Reiter syndrome Rationale: Reiter syndrome, a reactive arthritis that includes the triad of urethritis, conjunctivitis, and painless mucocutaneous lesions, is a complication of an untreated chlamydial infection. The remaining options are not related to chlamydial infection.

A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice. 1. Acyclovir 2. Ceclor 3. Azithromycin 4. Bactrim

3. Azithromycin Rationale: The CDC recommends the use of azithromycin or doxycycline in the treatment of chlamydial infection; penicillin is ineffective. Azithromycin or amoxicillin is the preferred choice in pregnancy.

What is the primary reason that the nurse urges clients to be seen by their health care provider when they have genital warts? 1. To be informed of the chance of transmitting to others 2. To have an MRI to screen for other conditions 3. To be informed of the risk of premalignant and malignant changes 4. To receive intravenous antibiotics

3. To be informed of the risk of premalignant and malignant changes Rationale: The association with premalignant and malignant changes has increased concern regarding the diagnosis and treatment of this viral infection. Intravenous antibiotics are not used to treat viruses. The client does not have to see the health care provider to be told that they have a risk of transmitting this condition to others. There are several pharmacologic treatments for symptomatic removal of visible genital warts, and cryotherapy is one of them.

The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of: 1. Genital infection 2. Pruritus 3. Urethritis 4. Blindness

4. Blindness

When is syphilis highly contagious? 1. Years 3 to 5 of its latent stage 2. After the characteristic rash disappears 3. When gummas lesions are observable 4. During its primary stage

4. During its primary stage Rationale: The infection is highly contagious during its primary stage, but because the symptoms are mild, it frequently goes unnoticed. The other options are not necessarily indicators of a highly contagious period.

The nurse is caring for four clients. Select the client at risk for the development of a pulmonary embolism. A 32-year-old male with viral pneumonia A 62-year-old male who is postoperative for repair of a fractured femur An 80-year-old female client with diabetes A 36-year-old female smoker with an intrauterine device (IUD)

A 62 year old male who is postoperative for repair of a fractured femur Rationale:A client with surgery to the lower extremities is at higher risk for the development of deep vein thrombosis that could lead to a pulmonary embolism. There is increased risk for pulmonary embolism among users of oral contraceptives, particularly in women who smoke, but not with the use of IUD.

acute respiratory distress syndrome (ARDS)

ARDS

When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. What factors contribute to hypercapnia?

Abnormalities in respiratory function, Alteration in carbon dioxide production, Disturbance in gas exchange function, Changes in neural control of respiration Rationale: Hypercapnia refers to an increase in carbon dioxide levels. In the clinical setting, four factors contribute to hypercapnia: alterations in carbon dioxide production, disturbance in the gas exchange function of the lungs, abnormalities in respiratory function of the chest wall and respiratory muscles, and changes in neural control of respiration. A decrease in carbon dioxide production does not cause hypercapnia.

Which physiologic dysfunction is the most common cause of hypercapnia?

Alterations in respiratory rate Rationale: Hypercapnia refers to an increase in carbon dioxide levels. In the clinical setting, four factors contribute to hypercapnia: alterations in carbon dioxide production, disturbance in the gas exchange function of the lungs, abnormalities in function of the chest wall and respiratory muscles, and changes in neural control of respiration. Alterations in respiratory function or the respiratory rate decrease minute volume, which is the most common cause of hypercapnia.

Leiomyomas, or intrauterine fibroids, are the most common form of pelvic tumor. Approximately half the time leiomyomas are asymptomatic. What are the symptoms of leiomyomas that are not asymptomatic?

Anemia and urinary frequency Leiomyomas are asymptomatic approximately half of the time and may be discovered during a routine pelvic examination, or they may cause menorrhagia (excessive menstrual bleeding), anemia, urinary frequency, rectal pressure/constipation, abdominal distention, and infrequently pain.

In the clinic, what type of blood is used for blood gas measurements and why?

Arterial blood is commonly used for measuring blood gases. Venous blood is not used because venous levels of oxygen and carbon dioxide reflect the metabolic demands of the tissues rather than the gas exchange.

An adult client reports to the emergency department with shortness of breath. Which additional clinical finding(s) leads the health care provider to suspect the client has a moderate-sized pulmonary embolism?

Blood tinged sputum apprehensive when asked to lay flat Rationale: Pulmonary embolism manifestations depend on the size and location of the obstruction. Clients with moderate-sized emboli often present with breathlessness accompanied by pleuritic pain, apprehension, slight fever, and cough productive blood-tinged sputum.

Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has: 1. C. trachomatis 2. C.albicans 3. T. vaginalis 4. N. gonorrhoeae

C. albicans Rationale:Candida albicans has a definitive morphology under the microscope of budding yeast filaments (hyphae) and a low pH.

Epididymitis can be sexually transmitted, or it can be caused by a variety of other reasons, including abnormalities in the genitourinary tract. What are the most common causes of epididymitis in young men without underlying genitourinary disease?

Chlamydia trachomatis and Neisseria gonorrhoeae

Describe the pathogenic mechanism of cystic firbrosis

Cystic fibrosis is caused by mutation in a single gene on the long arm of chromosome that encodes for the cystic fibrosis transmembrane regulator, which funtions as a chloride channel in epithelial cell membranes. Mutations in the CFTR gene render the epithelial membranes. Mutations in the CFTR gene render the epithelia membrane reltrively impereable toe chloride ion. The impaired transport of Cl- ultimately leads to a series of seconday events, including increased absorpition of Na+ and water from the airways into the blood. This lowers the water content of the ucociliary blanket coating the respiratory epithelium, causing it to become more viscid. The resulting dehydration of the mucous layer lead to defective mucociliary function and accumulation of vicid secretions that obstruct the airways and predisopse to recurrent pulmonaryinfections

A nurse monitors for side effects in a female client receiving endometriosis treatment with the gonadotropin-releasing hormone (GnRH) agonist leuprolide. Which adverse effect would be cause to limit duration of treatment? Decreased bone density Muscle spasms Nosebleed and cough Hot flashes and night sweats

Decreased bone density Rationale: The GnRH agonist leuprolide suppresses the release of estrogens from the ovaries. This allows endometrial tissue to shrink and reduces manifestations of endometriosis. Side effects include hot flashes, nosebleed, cough, hypocalcemia, and decreased bone density. Except for bone density, all of these side effects will stop with treatment. A rapid decrease in bone density may be cause to stop treatment because it may not be completely reversed when therapy is ended and could lead to osteoporosis.

What manifestations would the nurse expect to find when assessing a client with a right pleural effusion? .

Dyspnea on exertion Hypoxemia Diminished right breath sounds Rationale: Pleural effusion may vary according to the cause. Classic signs include diminished breath sounds over the affected area, and dyspnea as seen with increased effort or rate of breathing. Hypoxemia may occur due to reduced surface area for gas exchange.

Respiration has both automatic and voluntary components that are sent to the respiratory center of the brain from a number of sources. What physiologic forces can exert their influence on respiration through the lower brain centers?

Fever, pain, emotion

What is the only approved vaccine for cervical cancer?

Gardasil a quadrivalent vaccine to prevent infection with the HPV subtypes 16, 18, 6, and 11

When counseling a client who is 3 months' pregnant and who recently went on a vacation to South America where she received several mosquito bites, the biggest complication the provider should prepare her for is delivering a child with which type(s) of defect?

Hearing problems, Microcephaly, Eye concerns Rationale: Zika virus show few symptoms. If the woman is infected by Zika during pregnancy, severe birth defects can occur, such as microcephaly, brain defects, hearing and eye defects, and impaired growth.

What late complications of a transurethral prostatectomy (TURP) will the nurse address with the client as a part of discharge teaching?

Incontinence Rationale: Late complications of a TURP include erectile or sexual dysfunction, incontinence, and bladder neck constriction. Immediate complications of TURP include the inability to urinate, postoperative hemorrhage or clot retention, and urinary tract infection.

ARDS is commonly signaled by varying degrees of hypoxemia and hypercapnia. Respiratory acidosis develops manifested by what?

Increased cerebral blood flow

pleuritis, an inflammatory process of the pleura, is common in infectious processes that spread to the pleura. Which are the drugs of choice for treating pleural pain?

Indomethacin

The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which instructions are appropriate for the nurse to provide? Select all that apply. It prevents sexually transmitted infections. It can be given to boys and girls. It should be given before the child is sexually active. It prevents a common cause of cervical cancer. It produces short-term immunity.

It can be given to boys and girls., It should be given before the child is sexually active., It prevents a common cause of cervical cancer. Rationale: The quadrivalent human papillomavirus recombinant vaccine is given to boys and girls between the ages of 9 and 26 years before they begin sexual activity. The vaccine provides long-term immunity from HPV, which is a common cause of cervical cancer. It does not protect against other sexually transmitted diseases.

Elderly people are very susceptible to pneumonia in all its varieties. The symptoms the elderly exhibit can be very different than those of other age groups who have pneumonia. What signs and symptoms are elderly people with pneumonia less likely to experienc than people with pneumonia in other age groups?

Marked elevation in temperature Rational: Elderly persons are less likely to experience marked elevations in temperature; in these persons, the only signs of pneumonia may be a loss of appetite and deterioration in mental status

Bartholin gland obstruction of the ductal system will cause a cyst. Sometimes the cyst becomes infected and an abscess occurs. What is the surgical removal of Bartholin cyst or abscess when a wedge of vulvar skin is removed along with cyst wall?

Marsupialization surgical treatment of a Bartholin cyst that has abscessed or blocks the introitus is called marsupialization, a procedure that involves removal of a wedge of vulvar skin and the cyst wall.

Polycystic ovary syndrome is an endocrine disorder and a common cause of chronic anovulation. In addition to the clinical manifestations of PCOS, long term health problems including cardiovascular disease and diabetes have been linked to PCOS. What drug has emerged as an important part of PCOS treatment?

Metformin Metformin, an insulin sensitizing drug, used with or without ovulation inducing medications, is emerging as an important component of PCOS treatment.

The primary function of the respiratory system is to remove appropriate amount of CO2 from the blood entering the pulmonary circulation and to add adequate amounts of ? ......... to the blood leaving the pulmonary circulation.

O2

What are the effect of pulmonary embolism on lung tissue?

Obstruction of pulmonary blood flow causes reflex bronchoconstriction in the affected area of the lung, wasted ventilation and impaired gas exchange, and loss of alveolar surfactant pulmonary hypertension and right heart failure may develop when there is massive vasoconstriction because of large embolus

A nurse is caring for a client in whom genital herpes is being ruled out. Which information helps to confirm the diagnosis? Select all that apply. Pain on urination Pustules Painful lesions Itching Positive urine culture

Pain on urination, Pustules, Painful lesions, Itching Rationale: Symptoms of primary genital herpes infection include pain on urination, pustules, painful lesions, and itching. Tingling and pain in the genital area are also possible with urinary retention. Positive urine cultures do not help to diagnose this condition.

Describe the disease producing changes of ARDS

Pathologic lung changes include diffuse epithelial cell injury with increased permeability of the alveolar capillary membrane, which permits fluid, plasma proteins, and blood cells to move out of the vascular compartment into the interstitum and alveoli of the lung. Diffuse alveolar cell damage leads to accumulation of fluid, surfactant inactivation, and formation of a hyaline membrane. The work of breathing becomes greatly increased as the lung stiffens and becomes more difficult to inflate. There is increased intrapulmonary shunting of blood, impaired gas exchange, and hypoxemia despite high supplemental oxygen therapy. Gas exchange is further compromised by alveolar collapse resulting from abnormalities in surfactant production. When injury to the alveolar epithelium is severe, disorganized epithelial repair may lead to fibrosis

What type of pressure drives breathing?

Pressure in the pleural cavity

Which statements regarding prostate cancer are true?

Prognosis has improved because of PSA diagnostic screenings., Black males are at highest risk for developing the disease., Age is a risk factor of this cancer. Rationale: A recent increase in diagnosed cases is thought to reflect earlier diagnosis because of widespread use of PSA testing. The incidence of prostate cancer increases with age and is greater in black men of all ages. Prostate cancer is third to lung cancer and colorectal cancer as a cause of cancer-related death in men. The American Cancer Society suggests that every man 50 years of age or older should have a digital rectal examination and PSA test done as part of his annual physical examination.

Alveolar oxygen levels directly impact the blood vessels in the pulmonary circulation. In a person with lung disease, there is vasoconstriction throughout the lung, causing a generalized hypoxia. What can prolonged hypoxia lead to?

Pulmonary hypertension and increased workload on the right heart.

The public health nurse is presenting a program on the prevalence of STIs. Which information should be included in the presentation? Select all that apply. STIs may be asymptomatic. STIs are only bacterial. Condoms do not prevent the spread of STIs. Drugs can manage infections but do not control the spread. Partners of infected persons are easy to find and treat.

STIs may be asymptomatic., Drugs can manage infections but do not control the spread. Rationale: Many factors contribute to the increased prevalence and the continued spread of STIs. STIs are frequently asymptomati. Partners of infected persons are often difficult to notify and treat. Condoms could prevent the spread of many STIs, but they often are not used or are used improperly. In addition, there currently are no cures for viral STIs; although there are drugs available that may help to manage the infections, they do not entirely control the spread. Also, drug-resistant microorganisms are rapidly emerging, making treatment of many STIs more difficult.

A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in

Secondary Rationale: Manifestations of secondary syphilis include symptoms of a rash (especially on the palms and soles), fever, sore throat, stomatitis, nausea, loss of appetite, and inflamed eyes, which may come and go for a year but usually last for 3 to 6 months. Secondary manifestations may include alopecia and genital lesions called condylomata lata.

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?

Staphylococcus aureus

The nurse develops a plan to prevent atelectasis in a postsurgical client. Which intervention will be effective?

Supervision of hourly deep-breathing exercises Rationale: Ambulation, deep-breathing exercises and changing body positions help to prevent postoperative atelectasis.

How does BPH cause obstruction of the urethra?

The anatomic location of the prostate at the bladder neck contributes to the pathophysiology and symptomatology of benign prostatic hyperplasia BPH. There are two prostatic components to the obstructive properties of BPH and development of lower urinary tract symptoms: dynamic and static. The static component of BPH is related to an increase in prostatic size, and gives rise to symptoms such as weak urinary stream, postvoid dribbling, frequency of urination, and nocturia The dynamic component of BPH is related to prostatic smooth muscle tone a1 adrenergic receptors are the main receptors for the smooth muscle component of the prostate

A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women? Chancroid Herpes simplex Genital warts Trichomoniasis

Trichomoniasis Rationale: Trichomoniasis increases the risk of infertility in women because the trichomonads serve as vectors for the spread of pathogens into the fallopian tubes. In men it contributes to decreased mobility and viability of sperm. The others do not have the same risks for infertility.

What involves the movement of fresh atmospheric air to the alveoli for delivery provision of O2 and removal of CO2.

Ventilation

Cancer of the breast is the most common cancer in women. Many breast cancers are found by women themselves while doing breast self examination. When should postmenopausal women do breast self examination?

any day of the month postmenopausal women and women who have had a hysterectomy can perform the examination any day

an autosomal recessive disorder involving fluid secretion in the exocrine glands in the epithelial lining of the respiratory, gastrointestinal, and reproductive tracts

cystic fibrosis

------- occurs when a fertilized ovum implants outside the uterine cavity the most common site being the fallopian tube

ectopic pregnancy

infection in the pleural cavity

empyema

the condition in which functional endometrial tissue is found in ectopic sites outside the uterus

endometriosis

increase in the carbon dioxide content of the arterial blood

hypercapnia

The term Pneumonia describes

inflammation of parenchymal structures of the lung, such as the alveoli and the bronchioles

Primary atelectasis of the newborn implies that the lung has never been

inflated

refers to an abnormal collection of fluid in the pleural cavity

pleural effusion

The body compensates for chronic hypoxemia by increased ventilation pulmonary vasoconstriction, and increased production of

red blood cells

lobar pneumonia

refers to consolidation fo part or all of a lung lobe

elevated levels of Pco2 produce a decrease in PH and

respiratory acidosis

bronchopenumonia

signifies a patchy consolidation involving more than one lobe

the level of PSA correlates with

the volume and stage of prostate cancer

Describe a colposcopy

A colposcopy is the examination of the vagina and cervix with an optical magnifying instrument. It is usually done after a Pap smear shows abnormal cells

Uterine prolapse is a disorder of pelvic support and uterine position. It can range in severity from a slight descent of the uterus into the vagina, all the way to the entire uterus protruding through the vaginal opening. In women who want to have children, or in older women who are at significant risk if surgery is performed, what device is inserted to hold the uterus in place?

A pessary a pessary may be inserted to hold the uterus in place and may stave off surgical intervention in women who want to have children or in older women for whom the surgery may pose a significant health risk.

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

A school-aged child with severe asthma controlled by steroids admitted for an exacerbation 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

After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which statement by the client indicates the need for further teaching? "I really hope the cancer hasn't spread anywhere, because I've read that it's a possibility." "I can't shake this feeling like I've received a death sentence." "I have to admit that the prospect of losing a testicle is a bit overwhelming." "I guess there's some solace in the fact that this cancer wasn't a result of an unhealthy lifestyle."

"I can't shake this feeling like I've received a death sentence." Rationale: Testicular cancer has the potential for metastasis, but outcomes are positive for most clients and survival rates are high. With appropriate treatment, the prognosis for men with testicular cancer is excellent. Orchiectomy remains the standard treatment, and the pathogenesis of testicular cancer is not thought to be related to lifestyle factors.

While working with a client with a fairly recent spinal cord injury, the partner asks about the couple's ability to maintain a sexual relationship. Which response by the nurse is most accurate? "If the parasympathetic impulses can pass from the sacral segments of spinal cord through pelvic nerves, an erection should be possible." "It takes all components, neural, vascular, and chemical pathways to produce a satisfactory erection." "It is highly doubtful since the majority of nerves in the lower back must function in order to obtain an erection and for ejaculation." "As long as you can stimulate each other in a meaningful way, then this will fulfill your need for sex."

"If the parasympathetic impulses can pass from the sacral segments of spinal cord through pelvic nerves, an erection should be possible." Rationale: Erection is mediated by parasympathetic nervous system (PSNS) impulses that pass from the sacral segments of the spinal cord through the pelvic nerves to the penis. PSNS stimulation results in release of the neurotransmitter nitric oxide, which causes relaxation of trabecular smooth muscle of the corpora cavernose. This relaxation permits inflow of blood into the sinuses. Therefore, PSNS innervation must be intact and nitric oxide synthesis must be active for erection to occur.

While the cause of BPH is unknown, we do know that the incidence of BPH increases with age. What ethnic group is BPH highest in?

African American

a 40 yr old man presents at the clinic complaining of painful urination and rectal pain. His vital signs are; temp 101.7, bp 105/74, pulse 98, resp 22. While taking a history the nurse notes the client has had chills, malaise, and myalgia. What would the nurse suspect as a diagnosis?

Acute bacterial prostatitis

What are the central nervous symptoms associated with tertiary stage syphilis?

Blindness, Dementia, Ataxia Rationale: Central nervous system lesions can produce dementia, blindness, or injury to the spinal cord, with ataxia and sensory loss

Which symptoms are believed to have a strong association with ovarian cancer? Select all that apply. Increased intestinal gas Bloating Abdominal or pelvic pain Increased appetite Difficulty eating

Bloating, Abdominal or pelvic pain, Difficulty eating Rationale: Symptoms that are believed to have a strong correlation to ovarian cancer include abdominal or pelvic pain, increased abdominal size or bloating, and difficulty eating or feeling full quickly after ingesting food. Increased intestinal gas and an increased appetite are not highly correlated with ovarian cancer.

When there is mismatching of ventilation and perfusion within the lung itself, insufficient ventilation occurs. There is a lack of enough oxygen to adequately oxygenate the blood flowing through the alveolar capillaries, creating a physiologic shunt. What causes a physiologic right to left shunting of blood in the respiratory system

Destructive lung disease or heart failure Rationale: Physiologic shunting of blood usually results from destructive lung disease that impairs ventilation or from heart failure that interferes with movement of blood through sections of the lungs.

A diagnosis of tension pneumothorax would be suspected in which physical assessment finding?

Deviated trachea Rationale: Physical assessment findings of a deviated trachea and neck vein distention would indicate a tension pneumothorax. Asymmetry of the chest during inspiration would suggest a spontaneous pneumothorax. Both would need to be confirmed by radiology.

Describe the alterations in a normal period and give the hormone that thought to be responsible

Dysfunctional menstrual cycles are related to alterations in the hormones that support normal cyclic endometrial changes. Estrogen deprivation causes retrogression of a previously built-up endometrium and bleeding. Such bleeding often is irregular in amount and duration, with the flow varying with the time and degree of estrogen stimulation and with the degree of estrogen withdrawal. A lack of progesterone can cause abnormal menstrual bleeding; in its absence, estrogen induces development of a much thicker endometrial layer with a richer blood supply. The absence of progesterone results from the failure of any of the developing ovarian follicles to mature to the point of ovulation, with the subsequent formation of the corpus luteum and production and secretion of progesterone.

Our ability to oxygenate the tissues and organs of our bodies demands on our ability to ventilate, or exchange, gases in our respiratory system. The resultant distribution of ventilation or the areas of the body open to the exchange of gases in our respiratory system depends on what?

Effects of gravity and body position Rationale: The distribution of ventilation between the apex and base of the lung varies with body position and the effects of gravity on the intrapleural pressure. Intrapleural pressure impacts the distribution of ventilation.

assessment findings concern the presence of respiratory distress in an infant?

Grunting Central cyanosis sternal retraction Respiratory rate of 95 breaths/min Rationale: Infants with respiratory distress syndrome (RDS) present with multiple signs of respiratory distress, usually within the first 24 hours of birth. Central cyanosis is a prominent sign. Breathing becomes more difficult, and retractions occur as the infant's soft chest wall is pulled in as the diaphragm descends. Grunting sounds accompany expiration. As the tidal volume drops because of atelectasis, the respiration rate increases (usually to 60 to 120 beaths/min) in an effort to maintain normal minute ventilation. Fatigue may develop rapidly because of the increased work of breathing. The stiff lungs of infants with RDS also increase the resistance to blood flow in the pulmonary circulation. As a result, a hemodynamically significant patent ductus arteriosus may develop in infants with RDS.

There are two types of vulvar cancer. One type is found in older women, and one type is found in younger women, generally less than 40years of age. What is the type found in younger women thought to be caused by?

Human papillomavirus One third to one half of vulvar intraepithelial neoplasia (VIN) cases appear to be caused by the cancer-promoting potential of certain strains of HPV (subtypes 16 and 18) that are sexually transmitted and are associated with the type of vulvar cancer found in younger women.

The mother of a 5 year old boy brings him in to the clinic bc theres a firm feeling swelling around one of his testes. What would the suspected diagnosis be?

Hydrocele

Which chronic health issues increase a man's risk for developing erectile dysfunction? Select all that apply. Hypertension Diabetes mellitus Hyperlipidemia Crohn disease Asthma

Hypertension, Diabetes mellitus, Hyperlipidemia Rationale: Common risk factors for generalized penile arterial insufficiency (erectile dysfunction) include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation. Asthma and Crohn disease are not associated with erectile dysfunction.

Which clinical manifestations would the nurse expect to observe in a female with pelvic inflammatory disease (PID)? Select all that apply. Temperature of 100°F (37.8°C) Lower abdominal pain Elevated C-reactive protein White blood cell (WBC) count of 7500 cells/mL Purulent cervical discharge

Lower abdominal pain, Elevated C-reactive protein, Purulent cervical discharge Rationale: Manifestations of PID include lower abdominal pain, dyspareunia, purulent cervical discharge, cervix pain with manual examination, temperature greater than 100°F (37.8°C), a WBC greater than 10,000 cells/mL, and elevated C-reactive protein.

The endocervix is covered with large-branched mucus secreting glands. During the menstrual cycle, they undergo functional changes, and the amount and properties of the mucus that they secret vary as to the stage of the cycle. When one of these glands is blocked what kind of cyst forms within the cervix?

Nabothian cysts Blockage of the mucosal glands results results in trapping of mucus in the deeper glands leading to the formation of dilated cysts within the cervix, called nabothian cysts. The other answers are incorrect

Mastitis is an inflammation of the breast that can occur at any time. what is the txm?

Nonsteroidal anti inflammatory drugs application of heat or cold

When assessing the client with chronic inflammatory bacterial prostatitis, the nurse recognizes which findings are typically present?

Painful urination, Frequency of urination, Low back pain, Bacteriuria Rationale: Men with chronic bacterial prostatitis have urinary tract infections with the same strain of pathogenic bacteria in prostatic fluid and urine. Other symptoms include frequent and urgent urination, dysuria, perineal discomfort, and low back pain. Men with nonbacterial prostatitis often have inflammation of the prostate with an elevated leukocyte count and abnormal inflammatory cells in their prostatic secretions without presence of pathogens in the urine.

A 29-year-old female client has been diagnosed with fibrocystic breasts. The nurse should assess the client for which symptoms associated with fibrotic changes? Select all that apply. Breast engorgement Palpable breast masses that change during the menstrual cycle Breast pain or discomfort Purulent nipple discharge that is whitish or yellowish in color Erythema on skin regions within 1 to 2 cm of the areolae

Palpable breast masses that change during the menstrual cycle, Breast pain or discomfort Rationale: Fibrocystic changes include nodular granular breast masses that are more prominent and painful during the luteal or progesterone-dominant portion of the menstrual cycle. Discomfort ranges from heaviness to exquisite tenderness, depending on the degree of vascular engorgement and cystic distention. Engorgement, erythema, and discharge are atypical.

A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain and increased respiratory rate. What is a classic sign of pulmonary infarction?

Pleuritic pain

Name a few disease states that are characterized by dyspnea?

Pneumonia Emphysema Myasthenia Gravis

A 40-year-old male presents to the emergency department reporting chest pain and shortness of breath. The health care provider suspects a pulmonary embolism and orders several diagnostic tests. Select the test that would require further follow-up

Positive D-dimer Rationale: The D-dimer test is a good indicator that a clotting disorder has occurred. A positive result indicates a need to be further investigated for possible pulmonary embolism given the client's symptoms. The elevated CPK-MB and EKG may indicate cardiac abnormalities.

Cystic fibrosis is an autosomal recessive disorder involving the secretion of fluids in specific exocrine glands. The genetic defect in CF inclines a person to chronic respiratory infections fro a small group of organisms. Which organisms create chronic infection in a child with cystic fibrosis?

Pseudomonas aeruginosa and Staphylococcus aureus

What is the result of the absence of surfactant in premature infants?

Pulmonary immaturity, together with surfactant deficiency, lead to alveolar collapse. The type 2 alveolar cells that produce surfactant do not begin to mature until approximately the 25th to 28th weeks of gestation; consequently, many premature infants are born with poorly functioning type 2 alveolar cells and have difficulty producing sufficient amounts of surfactant. Without surfactant, the large alveoli remain inflated, wheras the small alveoli become difficult to inflate, resulting in respiratory distress syndrome

What is the function of pulmonary surfactant?

Pulmonary surfactant forms a monolayer with its hydrophilic surface binding to liquid film on the surface of the alveoli and its hydrophobic surface facing outward toward the gases in the alveolar air. This monolayer interrupts the surface tension that develops at the air-liquid interface in the alveoli, keeping them from collapsing and allowing equal inflation.

Which diagnosis puts a client at risk for developing an immunologic form of interstitial lung disease?

Rheumatoid Arthritis Rationale: Rheumatoid arthritis is a risk factor for the development of immunologic lung disease. Cancer is a risk for therapeutic agent-related interstitial lung disease when certain chemo drugs are used as treatment. Asbestosis is a risk for occupational /environmental inhalant interstitial lung disease. Septicemia increases the risk of acute respiratory distress syndrome

The nurse is teaching the client about risk factors for cervical cancer. What will be included in the plan of care? Select all that apply. Alcohol consumption Smoking Multiple sexual partners Diabetes First intercourse at an early age History of sexually transmitted infections

Smoking, Multiple sexual partners, First intercourse at an early age, History of sexually transmitted infections Rationale: Risk factors for cervical cancer include early age at first intercourse, multiple sexual partners, smoking, and a history of STIs. Diabetes and alcohol consumption are not risk factors.

Describe the Leep procedure

The LEEP uses a thin, rigid wire loop that is attached to a generator. It blends high frequency low voltage current for cutting with a higher voltage current for coagulation. The wire loop allows the physician to remove the entire transformation zone of the cervix. This removes the entire lesion while providing a specimen for further histologic evaluation. The procedure is done under local anesthesia in the physician's office at a lower cost than a cone biopsy, which is done in the hospital or outpatient surgery

Which clients would the nurse determine are at increased risk of infection with gonorrhea? Select all that apply. The client who married late in life The client who has constant urinary tract pain The client who is younger than 25 years of age The client who does not use condoms The client with multiple sexual partners

The client who is younger than 25 years of age, The client who does not use condoms, The client with multiple sexual partners Rationale: Clients who are identified as being at increased risk of infection include those who are 25 and under, have multiple sexual partners, and do not use condoms. Clients who marry late in life or have constant urinary tract pain are not documented to be at increased risk.

A client arrives in the clinic with a cough, fever, and chest discomfort and is diagnosed with community-acquired pneumonia. What education does the nurse anticipate providing prior to discharging the client from the clinic?

The use of antibiotics Rationale: Treatment for community-acquired pneumonia involves the use of appropriate antibiotic therapy. Empiric antibiotic therapy, based on knowledge regarding an antibiotic's spectrum of action and ability to penetrate bronchopulmonary secretions, often is used for people with community-acquired pneumonia who do not require hospitalization.

Describe the functional anatomy of normal pelvic support

The uterus and the pelvic structures are maintained in proper position by the uterosacral ligaments, round ligaments, broad ligament, and cardinal ligaments. The two cardinal ligaments maintain the cervix in its normal position. The uterosacral ligaments hold the uterus in a forward position and the broad ligaments suspend the uterus, fallopian tubes, and ovaries in the pelvis. The vagina is encased in the semirigid structure of the strong supporting fascia. The muscular floor of the pelvis is a strong , sling like structure tat supports the uterus, vagina, urinary bladder, and rectum.

Why should you be concerned about the future of your patient with PCOS?

There is also concern that women with PCOS who are anovulatory do not produce significant amounts of progesterone. This may, in turn, subject the uterine lining to an unopposed estrogen environment, which is a significant risk factor for development of endometrial cancer. Although there is also reported association with breast cancer and ovarian cancer, PCOS has not been conclusively shown to be an independent risk factor for either malignancy

Bronchial blood vessels have several functions they warm and humidify incoming air as well as distribute blood to the conducting airways and the supporting structures of the lung. What is it that makes bronchial blood vessels unique in the body?

They undergo angiogenesis Rationale: the bronchial blood vessels are the only ones that can undergo angiogenesis and develop collateral circulation when vessels in the pulmonary circulation are obstructed, as in pulmonary embolism. The development of new blood vessels helps to keep lung tissue alive until the pulmonary circulation can be restored. The blood in the bronchiole blood vessels is unoxygenated, so they neither carry oxygen rich blood to the lung tissues nor participate in gas exchange. Bronchial blood vessels drain blood into the bronchial veins.

What is the genetic component of breast cancer?

Two breast cancer susceptibility genes- BRCA1 on chromosome 17 and BRCA2 on chromosome 13 may account for most inherited forms of breast cancer. BRCA1 is known to be involved in tumor suppression. A woman with known mutations in BRCA1 has a lifetime risk of 60% to 85% for breast cancer and an increased risk of ovarian cancer. BRCA2 is another susceptibility gene that carries and elevated cancer risk similar to that of BRCA1

Ectopic pregnancies are true gynecologic emergencies and are considered the leading cause of maternal death in the first trimester. What diagnostic test would you expect to have ordered for a suspected ectopic pregnancy?

Ultrasonography followed by serial hCG tests

Blood transports both oxygen and carbon dioxide in a physically dissolved form to the tissues and organs of the body. It is the measurements of the components of the gases in the blood that are used as indicators of the body's status by health care workers. Why is it commonly the blood in the arteries that is measured rather than the blood in the veins?

Venous blood measures the metabolic demands of the tissues rather than the gas exchange function of the lungs.

Viral infections can damage ---------? epithelium that would normally clean the incoming air, --------? airways making it harder to move gasses, and lead to secondary ----? infections due to the static mucus providing a route for infection.

Viral infections can damage Bronchial epithelium that would normally clean the incoming air, obstruct airways making it harder to move gasses and lead to secondary bacterial infections due to the static mucus providing a route for infection

The most frequent cause of respiratory tract infections?

Viruses

the manifestations of acute bacterial prostatitis include:

fever and chills malaise myalgia arthralgia frequent and urgent urination dysuria urethral discharge

The nurse performs a complete physical assessment on a client with polycystic ovary syndrome (PCOS). Which assessment findings support this diagnosis? Select all that apply. a. Elevated blood glucose b. Obesity c. Dysmenorrhea d. Decreased luteinizing hormone (LH) level e. Increased dark facial hair

a. Elevated blood glucose, b. Obesity, e. Increased dark facial hair Rationale: PCOS is an endocrine disorder affecting between 5% and 10% of women of childbearing age. Common manifestations include irregular infrequent menstrual periods, signs of hyperandrogenism such as acne and excess body hair, elevated testosterone levels, obesity, insulin resistance, and polycystic ovaries. Also characteristic of the disorder is an imbalance between LH and FSH (follicle-stimulating hormone) where the LH levels are higher in proportion to FSH. This leads to anovulation and infertility.

A school nurse is providing an informational session about the prevention of cervical cancer in young girls and women. The most important information for the nurse to present would be: a. HPV vaccine before becoming sexually active b. Use of latex condom with each and every sexual encounter c. Use of low-dose estrogen oral contraceptive pills or patches d. Abstinence of sexual activity until in a monogamous relationship

a. HPV vaccine before becoming sexually active Rationale: Two types of HPV vaccines are currently available to prevent HPV infection: a quadrivalent vaccine to prevent infection by HPV subtypes 16, 18, 6, and 11 and a bivalent vaccine to prevent infection by subtypes 16 and 18. The quadrivalent vaccine has been approved for females and males between the ages of 9 and 26 years, optimally before initiation of sexual activity. Abstinence and condoms may help, but the vaccine is recommended.

characterized by severe dyspnea of rapid onset, hypoxemia, and pulmonary infiltrates

acute respiratory distress syndrome

BPH

an age related nonmalignant enlargement of the prostate gland

A teenage female client who is being seen in the family medicine clinic for an annual physical exam reports being sexually active. What should the nurse plan to teach the client? Select all that apply. Information on immunization for herpes simplex a.Problems with infertility associated with human papillomavirus (HPV) b. Importance of being tested for chlamydia infection c. The importance of annual PAP smears for early detection of cervical cancer d. The development of vaccines to protect against specific human papillomavirus (HPV) strains

b. Importance of being tested for chlamydia infection, c. The importance of annual PAP smears for early detection of cervical cancer, d. The development of vaccines to protect against specific human papillomavirus (HPV) strains Rationale: The rates of many STIs are highest among adolescents. According to CDC estimates, chlamydial infections reported from each of the 50 states and the District of Columbia equaled approximately 1.3 million new cases in 2010, predominantly among people younger than 25 years of age. The CDC estimates about twice the reported number of people are actually infected with chlamydia. Testing for chlamydia is recommended for all sexually active females under age 25 by the Centers for Disease Control and Prevention. Human papillomavirus (HPV) can increase risk of cervical cancer, and PAP smears should be performed annually for early detection. There is no vaccine available for herpes simplex, and herpes simplex infection does not cause cervical cancer.

lung tissue destruction resulting from a vicious cycle of infection and inflammation

bronchiectasis

A older female client has developed some central nervous system symptoms not usually common in her family history. After months of no improvement, the provider ordered blood panels that returned as positive for syphilis. Having been married for decades, the provider suspects tertiary syphilis based on which finding(s)? Select all that apply. a. Kidney stone development b. Enlarged cervical lymph nodes c. Lack of voluntary coordination resulting in gait abnormality d. Slowly progressing dementia e. Gradual loss of sight

c. Lack of voluntary coordination resulting in gait abnormality, d. Slowly progressing dementia, e. Gradual loss of sight Rationale: Symptoms of central nervous system lesions of teritary syphilis include dementia, blindness, or injury to the spinal cord with ataxia (lack of voluntary coordination of muscle movements that can include gait abnormality) and sensory loss. It is not associated with kidney stone development or cervical lymph node enlargement.

left untreated may extend to include the development of pelvic cellulitis, low back pain, dyspareunia, cervical stenosis, dysmenorrhea, and ascending infection of the uterus or fallopian tubes

cervicitis

The interstitial lung disorders exert their effects on the ------? and -----? connective tissue found between the delicate interstitium of the alveolar walls.

collagen and elastic connective tissue

Sexually transmitted infections can selectively infect the --------? tissues of the external genitalia-primarily cause vaginitis in women-or they can produce both genitourinary and systemic effects.

mucocutaneous

Palliative care for clients diagnosed with terminal prostate cancer includes focal irradiation of symptomatic bone disease and:

pain control Rationale:Palliative care includes adequate pain control and focal irradiation of symptomatic or unstable bone disease. Treatment therapies are not generally included in palliative care. If depression exists it will be treated, but it is not considered a focus

Endometriosis is the condition in which endometrial tissue is found growing outside the uterus in the pelvic cavity. What are risk factors for endometriosis?

periods longer than 7 days and increased menstrual pain Risk factors may include: -early menarche -regular periods with shorter cycles (less than 27 days) -heavirer flow -increased menstrual pain -other first degree relatives with the conidtion

caused by the inhalation of inorganic dusts and particulate matter

pneumo-conioses

the most common lesions of the cervix

polyps

vaginal infections can occur in young girls prior to menarche. These infections generally have nonspecific causes. What are some of the causes of vaginal infections in premenarchal girls?

presence of foreign bodies intestinal parasites poor hygiene

What type of pneumonia results from inhalation or aspiration of nasopharyngeal secretions during sleep?

Bacterial pneumonia The lung below the main bronchi is normally sterile, despite frequent entry of microorganisms into the air passages by inhalation during ventilation or aspiration of nasopharyngeal secretions. Bacterial pneumonia results due to loss of the cough reflex, damage to the ciliated endothelium that lines the respiratory tract, or impaired immune defenses. Bacterial adherence also plays a role in colonization of the lower airways. The epithelial cells of critically and chronically ill persons are more receptive to binding microorganisms that cause pneumonia. Other clinical risk factors favoring colonization of the tracheobronchial tree include antibiotic therapy that alters the normal bacterial flora, diabetes, smoking, chronic bronchitis, and viral infection

The nurse is assessing a 24-year-old client who states that she has infrequent menstrual periods that are approximately 40 to 42 days apart. She also states, "My periods are really light. It's almost like I hardly even need to use a pad sometimes." The nurse should document which medical terms associated with this client's menstruation? Select all that apply. Polymenorrhea Menometrorrhagia Amenorrhea Hypomenorrhea Oligomenorrhea

Hypomenorrhea, Oligomenorrhea Rationale: Dysfunctional cycles may take the form of amenorrhea (absence of menstruation), hypomenorrhea (scanty menstruation), oligomenorrhea (infrequent menstruation, periods more than 35 days apart), polymenorrhea (frequent menstruation, periods less than 21 days apart), menorrhagia (excessive menstruation), or metrorrhagia (bleeding between periods). Menometrorrhagia is heavy bleeding during and between menstrual periods. This client exhibits hypomenorrhea and oligomenorrhea.

Which statements are true regarding priapism? Select all that apply. It can result in ischemia of the erectile tissue of the penis. It is not always related to sexual stimulation. It involves an erection that lasts longer than 2 hours. It is rarely observed in men younger than 20 years of age. It can be triggered by sickle cell disease.

It can result in ischemia of the erectile tissue of the penis., It is not always related to sexual stimulation., It can be triggered by sickle cell disease. Rationale: Priapism is an involuntary, prolonged (>4 hours), abnormal and painful erection that continues beyond, or is unrelated to, sexual stimulation. Priapism is a true urologic emergency because the prolonged erection can result in ischemia and fibrosis of the erectile tissue. Priapism can occur at any age. Sickle cell disease or neoplasms are the most common cause in boys between 5 and 10 years of age.

Community acquired pneumonia can be categorized according to several indexes. What are these indexes?

Radiologic findings Age presence of coexisting disease Community acquired pneumonia may be further categorized according to risk of mortality and need for hospitalization based on age, presence of coexisting disease, and severity of illness using physical examination findings and laboratory and radiologic findings.

Uterine leiomyomas

are benign neoplasms of smooth muscle origin

is a chronic disorder of the airways that causes airway obstruction, bronchial hyperresponsiveness, and airway inflammation that are usually reversible

asthma

The nurse working in a fertility clinic is assessing a client's risk for fallopian tube obstruction. Which disorder places the woman at greatest risk for fallopian tube obstruction? a. Vaginitis b. Dysmenorrhea c. Uterine prolapse d. Endometriosis

d. Endometriosis Rationale: Tubal patency is required for fertilization and can be disrupted secondary to PID, ectopic pregnancy, large myomas, endometriosis, pelvic adhesions, and previous tubal ligation. The remaining options do not relate to the fallopian tubes.

Obstructive airway disorders are caused by disorders that limit

expiratory airflow

Genital warts typically present as soft, raised fleshy lesions on the -------? including the penis, vulva, scrotum, perineum, and perianal skin.

external genitalia

------? are caused by the HPV

genital warts

The community health nurse is providing men's health education on prostate cancer. Which risk factors for prostate cancer should the nurse include in the discussion? Select all that apply. Father-in-law treated for prostate cancer High fat diet from processed meat Native American/First Nations descent Consuming high fat dairy items High intake of green tea

High fat diet from processed meat, Consuming high fat dairy items Rationale: While the precise cause of prostate cancer is unclear, the incidence of prostate cancer appears to be higher in relatives of men with prostate cancer. Men who have an affected first degree relative (e.g., father, brother) and an affected second-degree relative (e.g., grandfather, uncle) have an increase in risk. It has been suggested that increased intake of dietary fats may alter increase the risk of prostate cancer.

Which condition is associated with domelike lesions on both the inner thighs and vaginal area that produce a curdlike exudate? 1. Genital warts 2. Genital herpes 3. Molluscum contagiosum 4. Chancroid

3. Molluscum contagiosum Rationale: The lesions described with the curdlike exudate fits the description of molluscum contagiosum lesions. None of the remaining options present with a curdlike exudate.

Select the treatment of choice for syphilis. 1. Oral amoxicillin for 10 days 2. Topical clotrimazole cream 3. UV radiation to the genital area 4. Long-acting penicillin in a single injection

4. Long-acting penicillin in a single injection Rationale: The treatment of choice for syphilis is penicillin. Because of the spirochetes' long generation time, effective tissue levels of penicillin must be maintained for several weeks. Long-acting injectable forms of penicillin are used.

what is the normal method of detecting/diagnosing cervical cancer?

Diagnosis of cervical cancer requires pathologic confirmation. Pap smear results deomonstrating a squamous intraepithelial lesion often require further evaluation by colposcopy, during which a biopsy sample may be obtained from suspect areas examined microscopically

Ovarian cancer once though to be asymptomatic, has now been shown to produce nonspecific symptoms which make the diagnosis of ovarian cancer difficult. What symptoms are believed to have a strong association with ovarian cancer?

Difficulty eating Bloating Abdominal or pelvic pain

What is a common complication of influenza (usually of the elderly or those with cardiopulmonary disease)?

Viral pneumonia viral pneumonia occurs as a complication of influenza. It typically develops within 1 day after onset of influenza and is characterized by rapid progression of fever, tachypnea, tachycardia, cyanosis, and hypotension. The clinical course of influenza pneumonia progresses rapidly. It can cause hypoxemia and death withinva few days of onset. Survivors often develop diffuse pulmonary fibrosis.

A client has been diagnosed with endometriosis. What assessment finding does the nurse expect? Select all that apply. Increased fertility a. Back pain b. Pelvic pain c. Referred chest pain d. Premenstrual pain

a. Back pain, b. Pelvic pain, d. Premenstrual pain Rationale: Endometriosis symptoms present with pelvic pain and back pain, and most pain occurs premenstrually, subsiding after cessation of menstruation. There is decreased fertility with this condition. Chest pain is not a reported symptom.

Which disorder of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment? a. Intravaginal testicular torsion b. Benign prostatic hyperplasia (BPH) c. Spermatocele d. Erectile dysfunction

a. Intravaginal testicular torsion Rationale: Although all of the noted health problems warrant monitoring and possible treatment, intravaginal testicular torsion is an emergency that requires prompt surgery to save the torsed testicle.

A female client is being evaluated for abdominal pain and unusual menstrual bleeding. What factors in her history will the nurse identify as increasing the risk for endometrial cancer? Select all that apply. a. Polycystic ovary syndrome b. Trichomonas infection c. Estrogen therapy d. Diabetes mellitus e. Obesity

a. Polycystic ovary syndrome, c. Estrogen therapy, d. Diabetes mellitus, e. Obesity Rationale: Unopposed estrogen stimulates endometrial hyperplasia, which can lead to cell abnormalities developing into cancers. Obesity, diabetes mellitus, polycystic ovary syndrome, and hormone replacement therapy with unopposed estrogen are all factors that produce a situation with increased estrogen levels that increase risk of endometrial cancer. Sexually transmitted infections such as trichomonas do not change estrogen levels.

The causes of infertility can be in either the male or the female. Male tests for infertility require a specimen of ejaculate that is collected when?

after 3 days of abstinence

Atelectasis is the term used to designate and incomplete expansion of a portion of the lung. Depending on the size of the collapsed area and the type of atelectasis occurring, you may see a shift of the mediastinum and trachea. Which way does the mediastinum and trachea shift in compression atelectasis?

away from the affected lung

The nurse is reviewing the laboratory results of a client who has non-inflammatory prostatitis. The nurse would expect the results to include: a. Increased PSA level b Normal leukocyte count c. Positive urine culture for bacteria d. Pain radiating down the inner thighs

b. Normal leukocyte count Rationale: Men with non-inflammatory prostatitis have symptoms resembling those of nonbacterial prostatitis but have negative urine culture results and no evidence of prostatic inflammation (i.e., normal leukocyte count). A normal leukocyte count indicates no evidence of prostatic inflammation and is a key factor to consider when making a non-inflammatory prostatitis diagnosis. PSA and bacterial culture are not used in considering either of these diagnoses.

A 69-year-old client presents with urinary urgency and nocturia. After testing he has been diagnosed with benign prostatic hyperplasia (BPH). When describing the etiology and prognosis of BPH, what should the nurse explain to the client? a. The etiology of BPH can usually be traced to long-term overdistention of the bladder. b. Surgery can often be avoided if pharmacologic interventions are successful. c. BPH is an independent risk factor for the development of prostate cancer. d. BPH results from a combination of risk factors, most of which are modifiable.

b. Surgery can often be avoided if pharmacologic interventions are successful. Rationale: BPH often necessitates surgery, but this can be avoided if drug therapy is effective. Bladder distention is a result of BPH, not a cause. Many risk factors are nonmodifiable and it does not cause prostate cancer.

Select the factor that would increase a male's risk for the development of testicular cancer. a. Improper hygiene practices b. History of cryptorchidism c. Exposure to ultraviolet A radiation d. Occupational exposure to soot

b. history of cryptorchidism Rationale: History of cryptorchidism is the greatest risk for developing testicular cancer. Additional predisposing factors include genetic factors and disorders of testicular development. The remaining options are risk factors for scrotum cancer.

A 45-year-old client reports "needing to bear down with urination," frequency, and occasional loss of urine when coughing. Based on symptoms, which diagnosis is most appropriate for this client? a. Spermatocele b. Rectocele c. Cystocele d. Enterocele

c. Cystocele Rationale: The symptoms described are commonly found with cystocele, which is the herniation of the bladder into the vagina resulting in urinary symptoms. The bear-down sensation is common in this disorder and not found in the other disorders. Rectocele is the herniation of the rectum into the vagina. Enterocele can be asymptomatic or cause a dull, dragging sensation and occasionally low backache. Spermatocele is a male disorder.

The nurse in the ER is caring for a client with lower abdominal pain that is greater on the right side and who has light vaginal spotting. When the client's human chorionic gonadroptropin (hCG) level is lower than normal, the nurse plans care for a client with: a. Cervical cancer b. Premenstrual syndrome c. Ectopic pregnancy d. Appendicitis

c. Ectopic pregnancy Rationale: The symptoms described, and the positive but low hCG, would be most indicative of an ectopic pregnancy. Appendicitis could be suspected with right lower abdominal pain, but would not have a positive hCG and spotting. Neither PMS nor cervical cancer would present with all the above symptomology.

What is the term for the condition that involves dyspareunia and widespread vaginal burning in the absence of bacterial presence? a. Vaginitis b. Localized vulvodynia c. Generalized vulvodynia d. Bartholin gland abscess

c. Generalized vulvodynia Rationale:The type of vulvodynia that is described is generalized vulvodynia, as opposed to localized, which is not as widespread. Vaginitis would have bacterial involvement. These are not the symptoms associated with a Bartholin gland abscess.

A client who has a history of untreated cervicitis tells the nurse that she is concerned about the risk of experiencing problems with fertility. The nurse explains that problems may result from: a. development of low back pain. b. acute urinary tract infection. c. ascending infection of the fallopian tubes. d. severe abdominal peritonitis.

c. ascending infection of the fallopian tubes Rationale: Untreated cervicitis may extend to include the development of pelvic cellulitis, low back pain, dyspareunia, cervical stenosis, dysmenorrhea, and ascending infection of the uterus or fallopian tubes. The other conditions would not contribute to the problem.

A client is experiencing oligomenorrhea. The nurse interprets this as: a. heavy bleeding between and during menstrual cycles. b. frequent menstruation with periods less than 21 days apart. c. bleeding that occurs between menstrual cycles. d. infrequent menstruation with periods more than 35 days apart.

d. infrequent menstruation with periods more than 35 days apart. Rationale: Oligomenorrhea is infrequent menstruation, periods more than 35 days apart; polymenorrhea is frequent menstruation, periods less than 21 days apart; menorrhagia is excessive menstruation; metrorrhagia is bleeding between periods; amenorrhea is absence of menstruation; hypomenorrhea is scanty menstruation.

What are the pathophysiologic stages of pneumococcal pneumonia infection?

pneumococcal pneumonia During the first stage, alveoli become filled with protein rich edema fluid containing numerous organisms. Marked capillary congestion follows leading to massive outpouring of polymorphonnuclear leukocytes and red blood cells. Because the first consistency of the affected lung resembles that of the liver, this stage is referred to as the red hepatization stage. The next stage involves the arrival of macrophages that phagocytose the fragmented polymorphonocunclear cells, red blood cells, and other cellular debris. During this stage, which is termed the gray hepatization stage, the congestion has diminished but the lung is still firm. The alveolar exudate is then removed, and the lung returns to normal.

The lungs are the working structures of the respiratory system and they have several functions. What are the functions of the lungs?

produce heparin convert angiotensin 1 to angiotensin 2

Emphysema is thought to result from the breakdown of elastin and other alveolar wall components by enzymes, called ====== that digest proteins.

proteases that digest proteins

chest pain, dyspnea, and increased respiratory rate are the most frequent signs and symptoms of

pulmonary embolism

develops when a blood borne substance lodges in a branch of the pulmonary artery and obstructs the flow, almost all of which are thrombi that arise from deep vein thrombosis

pulmonary embolism

Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for devloping bronchopulmonary dyplasia, a chronic lung disease. What are the signs and symptoms?

rapid and shallow breathing and chest refractions Rationale: The infant with BPD often demonstrates a barrel chest, tachycardia, rapid and shallow breathing, chest retractions, cough, and poor weight gain.

Acute lung injury/acute respiratory distress syndrome is distinguishable between the two by the extent of hypoxemia involved. What is the clinical presentation of ARDS?

rapid onset increase in respiratory rate hypoxemia refractory to treatment