exam 4 and quiz 4 medsurge
The nurse has been educating a client newly diagnosed with MS. Which statement by the client indicates an understanding of the education?
"I will stretch daily as directed by the physical therapist."
An infant from parents of Mediterranean descent has been diagnosed with a severe form of β-thalassemia anemia. The nurse caring for this infant knows that the infant will most likely receive which medical treatment?
Transfusion therapy
Which type of lymphocyte is involved with humoral-mediated immunity?
• B lymphocytes
How could a health care professional most accurately explain an aspect of the underlying structure of DNA to a colleague who is unfamiliar with genetics?
"In the base pairs, adenine combines with thymine and guanine with cytosine.
A 41-year-old male has presented to his family physician stating that for the last 2 years his erection "is as crooked as a dog's hind leg and hurts too." He has subsequently been diagnosed with Peyronie disease. Which statement by his Is a physician most appropriate?
"This might need surgery, but it could possibly disappear over time without needing treatment.
The nurse knows that what PR interval presents a first-degree heart block?
0.24 seconds
The nurse is working on a telemetry unit, caring for a client who develops dizziness and a second-degree heart block, Mobitz Type 1. What will be the initial nursing Intervention?
Administer an IV bolus of atropine.
Which of the following medication classifications is more likely to be expected when Is the nurse caring for a client with atrial fibrillation?
Anticoagulant
A nurse is working with a 15-year-old client with sickle cell anemia. The client was started on a new pain management plan today, and the nurse is evaluating the effectiveness of the plan. Which is not appropriate to include in nursing care?
Asking only the client's parents to be present at the education session
A client's electrocardiogram (ECG) tracing reveals a atrial rate between 250 and 400, with saw-toothed P waves. The nurse correctly identifies this dysrhythmia as
Atrial flutter
The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what?
Atrial rate of 300 to 400
A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?
Bone fracture
The nurse recognizes which laboratory test is a key diagnostic indicator of heart failure?
Brain natriuretic peptide (BNP)
What can a female client with a palpable breast lump expect as the next diagnostic step if the mass does not appear on mammography?
Breast ultrasound
Which of the following is the earliest and most significant sign of increasing intracranial pressure (ICP)?
Change in level of consciousness (LOC)
The nurse is caring for a client who states that he is suddenly having severe pain at a leg fracture site. The nurse notes increased swelling in the limb and difficulty palpating a pulse. The nurse suspects that the client may have:
Compartment syndrome
A 70-year-old female client comes to the clinic with back pain. An x-ray revealed vertebral fractures, and she was diagnosed with osteoporosis. Which factor most likely contributed to her condition?
Decreased estrogen levels
A client who experienced an ST elevation myocardial infarction (STEMI) received fibrinolytic therapy with streptokinase. Which manifestation alerts the nurse to a developing complication?
Decreased level of consciousness
A client with venous insufficiency asks the nurse what they can do to decrease their risk of complications. What advice should the nurse provide to clients with venous Insufficiency?
Elevate the legs periodically for at least 15 to 20 minutes.
Which of the following laboratory test results would the nurse associate with obstructive jaundice?
Increased direct bilirubin
Some messengers, such as thyroid hormone and steroid hormones, do not bind to membrane receptors but move directly across the lipid layer of the cell membrane and are carried to the cell nucleus. What do they do at the cell nucleus?
Influence DNA activity.
A female client is at risk for developing osteoporosis. Which action will reduce the clients risk?
Initiating weight-bearing exercise routines
Which of the following is the hallmark symptom for peripheral arterial disease (PAD) in the lower extremity?
Intermittent claudication
The nurse notes a client's hemoglobin is 10.0 g/dL (100 g/L) and examines the red blood cell (RBC) indices. The nurse suspects what type of anemia based on the Findings?
Iron-deficiency anemia
A client in the intensive care unit (ICU) has a traumatic brain injury. The nurse must implement interventions to help control intracranial pressure (ICP). Which of the following are appropriate interventions to help control ICP?
Keep the clients neck in a neutral position (no flexing).
A client has sustained a right tibial fracture and has just had a cast applied. Which instruction should the nurse provide in client cast care?
Keep your right leg elevated above heart level
The nurse performs a breast exam on a client and finds a firm, non-moveable lump in the upper outer quadrant of the right breast that the client reports was not there 3 weeks ago. What does this finding suggest?
Malignant tumor
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived?
Medications
The nurse is discussing spinal cord injury (SCI) at a health fair at a local high school. The nurse relays that the most common cause of SCI is
Motor vehicle crashes
A pregnant woman has undergone prenatal screening that has revealed evidence of congenital heart defect in the fetus. The nurse interprets this finding as indicative of which type of inheritance?
Multifactorial
Crossing-over of chromatid segments during meiosis division 1 results in:
New gene combinations
Which is the leading cause of disability and pain in the elderly?
Osteoarthritis (OA)
What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?
Parkinson disease
A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms?
Parkinsons disease
A 75-year-old man presents at the clinic complaining of pain during intercourse and an upward bowing of his penis during erection. The client's history mentions an inflammation of the penis that was treated 3 months ago. The physician's physical examination of the client notes beads of scar tissue along the dorsal midline of the penile shaft. What would be the suspected diagnosis of this client?
Peyronie disease
A client with a diagnosis of small cell lung carcinoma has developed bone metastases, a finding that has prompted a series of new interventions. What are the primary goals of the treatment regimen for this client's bone cancer?
Prevention of pathologic fractures and survival with maximum functioning
The nurse practitioner is able to correlate a patient's neurologic deficits with the location in the brain affected by ischemia or hemorrhage. For a patient with a left hemispheric stroke, the nurse would expect to see:
Right-sided paralysis.
A client presents at a clinic reporting back pain that goes all the way down the back of the leg to the foot. The nurse should document the presence of what type of Pain
Sciatica
A patient is exhibiting classic signs of a hemorrhagic stroke. What complaint from the patient would be an indicator of this type of stroke?
Severe headache
The nurse is caring for a client immediately following a spinal cord injury (SCI). Which is an acute complication of SCI?
Spinal shock
A client is diagnosed with acute leukemia. Which treatment therapy can be used to correct bone marrow failure and treat malignancies?
Stem cell transplant
Which enzyme listed below is responsible for cancer cells' ability to resist aging and contributes to cellular immortality so characteristic of this disease Process?
Telomerase
A child is diagnosed with Turner syndrome. When describing this genetic condition to the parents, which of the following would the nurse include?
The child will have fertility problems.
A nurse and physician are preparing to visit a hospitalized client with peripheral arterial disease. As you approach the clients room, the physician asks if the client has reported any intermittent claudication. The client has reported this symptom. The nurse explains to the physician which of the following details?
The client can walk about 50 feet before getting pain in the right lower leg.
A client recently experienced a stroke with accompanying left-sided paralysis. His family voices concerns about how to best interact with him. They report the client doesn't seem aware of their presence when they approach him on his left side. What advice should the nurse give the family?
The client is unaware of his left side. You should approach him on the right side
A client has a health problem attributable to alterations in the normal endocytosis process. What outcome of these alterations should the nurse most likely identify?
The client's cells lack the necessary nutrients to sustain cellular activity
The pathophysiology student is studying erythropoiesis. Which statement demonstrates understanding of this process?
The reticulocyte count serves as an index of erythropoietic activity of the bone marrow
A nurse educator is explaining male reproductive physiology during grand rounds and is referring to the process of spermatogenesis. Where does spermatogenesis occur?
The seminiferous tubules
A 52-year-old male client is being treated for Parkinsons disease. The nurse is aware that Parkinson's disease results in several physical manifestations. What occurs in the neurons that cause these symptoms?
There is an imbalance between dopamine and acetylcholine.
A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment?
To reduce the viscosity of his blood
A child is to receive an oral corticosteroid as part of the treatment regimen for leukemia. After teaching the child and family about this drug, the nurse determines the need for additional teaching when they state:
We should administer the drug on an empty stomach.
The nurse is caring for a 22-year-old client at high risk of developing cervical cancer. The client asks the nurse how to best be screened for cervical cancer. Whichresponse by the nurse is best?
You should consult with your health care provider on how often to have a Papanicolaou (Pap) test
A 70-year-old male with a 40 pack-year history of smoking and longstanding non- insulin dependent diabetes has been diagnosed with pancreatic cancer. Which teaching points should the physician provide?
You will likely be facing surgery in the near future, but know that this is very unlikely to eliminate your cancer.
A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the philadelphia chromosome. This client is likely to experience:
a prolonged chronic phase of leukemia.
The proper use of the principles of body mechanics:
acts to prevent injury to the client and/or nurse
A client asks, "What do these basophils and mast cells do in the body?" The health care provider responds that they:
are involved when you have an allergic reaction.
A 16-year-old adolescent suffered a fracture of the ulna. The fracture does not protrude through the skin and there are several pieces of broken bone evident on the x-ray. Which term should the nurse use to describe this fracture?
closed comminuted fracture
The nurse is teaching a client about atherosclerosis. The client asks the nurse what the substance causing atherosclerosis is made of. How does the nurse best responds?
fatty deposits in the lumen of arteries
The nurse is developing a presentation for a local women's health center about breast cancer. Which cancer would the nurse include as being the most common type of breast cancer?
invasive ductal carcinoma
A client has been diagnosed with in situ breast carcinoma. The nurse explains that this means:
it is noninvasive and has not extended beyond the point of origin.
The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client
places the load close to the body.
A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute with a regular interval between 0.12 and 0.20 seconds. What type of dysrhythmia does the client have?
sinus bradycardia
The nurse is caring for a 6-year-old girl with leukemia who is having an oncologic emergency. Which signs and symptoms would indicate hyperleukocytosis?
tachycardia and respiratory distress
The nurse is discussing the diagnostic workup with a client suspected of having metastatic thyroid cancer. How should the nurse explain the purpose of a scan involving a combination of positron emission tomography (PET) and computed tomography (CT)?
• "A PET scan focuses on tissue functioning while the CT is best for looking at tissue structure."
A client has a plaster cast applied to the left leg. Which comment by the client following the procedure should the nurse address first?
• "My toes are stiff."
The physician tells a client You are lucky. This episode of chest pain is a warning sign. How can the nurse explain to the client what the physician means?
• A decrease in blood supply to the heart causes stress to cells through the perception of pain.
A patient diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen (Lioresal). What should the nurse identify as an expected outcome of this treatment
• Decreased muscle spasms in the lower extremities
A nurse on a postsurgical unit is aware of the high incidence of pulmonary embolism (PE) among hospitalized patients. What nursing action has the greatest potential to prevent PE among hospital patients?
• Early ambulation and the use of compression stockings
Which is an appropriate nursing intervention in the care of the client with Osteoarthritis?
• Encourage weight loss and an increase in aerobic activity
Which gene for the hematopoietic growth factors has been cloned and its recombinant protein is now used to treat anemia of kidney failure and cancer?
• Epoetin alfa (EPO)
A 67-year-old retired textile worker has developed bladder cancer. His history shows that he smoked for 25 years and is 30.8 lb (14 kg) overweight. What conclusion can the nurse best draw about the etiology and pathophysiology of his bladder cancer?
• It is caused by carcinogens that are excreted in the urine and stored in the Bladder
A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 - S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurologic symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period?
• Logroll the client from side to side.
A 37-year-old woman is admitted to the unit with a differential diagnosis of rule out pheochromocytoma. What are the most common symptoms the nurse would expect this client to exhibit?
• Periodic severe headache and marked variability in blood pressure
The daughter of a patient with Huntington disease has requested that she be tested for the disease, even though she has no symptoms. What type of test does the nurse anticipate the physician will order?
• Presymptomatic testing
A client with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. Which cell is most likely responsible for the rejection of the client's transplanted organ?
• T cells
A 10-year-old child is hospitalized for treatment of acute osteomyelitis. After assessing swelling and tenderness of the left tibia, the nurse initiates antibiotic therapy as prescribed. The child's left leg is immobilized in a splint. What is an appropriate goal at this time for this child?
• The child will change position every 2 hours while awake.
