Final for Patho
The nurse is teaching a group of student nurses about treatment strategies that are beneficial to a client with hyperparathyroidism. Which statement of the student nurse does the nurse correct?
"The client is prescribed BISPHOSPHONATES to stimulate osteoclast activity."
The nurse reviews the laboratory reports of a diabetic client and concludes that the client has diabetic nephropathy. Which finding supports the nurse's conclusion?
Albumin in urine
Which factors will a nurse identify to be associated with the formation of struvite stones, after comparing struvite stones with calcium stones? Select all that apply.
Anatomical abnormalities in the urinary tract. Presence of urease-producing organisms. Neurologist disorders of the bladder.
Which statement about the pathophysiology of lower urinary tract infections is true?
Any obstruction of urinary outflow decreases the bladder's resistance to bacterial infection.
A nurse is taking the history of a female client who is suspected of having urolithiasis. Which are effective questions that the nurse can ask the client in order to facilitate the diagnosis? Select all that apply.
"Do you have pain in the lower back?" "Are you taking any over-the-counter herbal supplements?" "Has anyone in your family ever had kidney stones?" "Do you have gout?"
The registered nurse is teaching a group of student nurses about managing hyperosmolar hyperglycemic syndrome (HHS) in clients. Which response of a student nurse indicates effective learning?
"Fluids should be administered BEFORE administering intravenous (IV) insulin to the client."
A student nurse is comparing treatment methods for urolithiasis and urinary incontinence. Which statement made by the student nurse indicates proper understanding of the treatment methods? Select all that apply.
"Hydrochlorothiazide is the drug of choice for treatment of calcium stone."
Which statement by the nurse to a client demonstrates an understanding of the factors responsible for the formation of different types of ureter stones?
"Prolonged use of supplements has contributed to your developing calcium stones."
Which statements made by a student nurse demonstrate an understanding of the clinical presentation for lower urinary tract infections (UTIs)? Select all that apply.
"Severe pain in the glans penis is common in case of lower UTI." "Frequency is a common symptom of UTI"
A nurse is teaching student nurses about the epidemiology of urolithiasis. Which statement made by a student nurse indicates the need for further learning?
"The incidence of urolithiasis in women peaks in the late fifties."
A nurse is teaching student nurses about the epidemiology of lower urinary tract infections (UTIs). Which statement made by a student nurse indicates a need for further learning?
"Up to 40% of men in the United States, aged 20 to 40 years, have suffered a lower UTI."
Which chromosomal genetic mutations are associated with the cause of pituitary adenoma?
11q13 (focus on 11 and 13)
How long does a typical wave of renal colic last?
20 to 60 minutes
While preparing a client for the oral glucose tolerance test (OGTT), the nurse asks the client to ingest soda which contains 80 g of carbohydrates. After 2 hours, the nurse measures the postprandial blood glucose level and concludes that the client has diabetes. Which blood glucose finding supports the nurse's conclusion?
250 mg/dL
Which value of cortisol levels would the nurse expect to find in the laboratory report of a client with Cushing's disease?
3.8 mcg/dL
How much urine can the urinary bladder usually hold?
300 to 400 mL
What is the rate of recurrence of urolithiasis within 5 years after it occurs in a client for the first time?
35%
The nurse reviews the laboratory reports of a client and concludes that the client has diabetes. Which finding helped the nurse to reach this conclusion?
A glycated hemoglobin (HbA1c) value of 7
The nurse observes sweating, dizziness, and disorientation in the client and consults the primary health-care provider while caring for a diabetic client. Which treatment option would be most beneficial to the client?
Administering 50 mL of 50% dextrose intravenously
A client tells the nurse, "I've been feeling excessively thirsty for the last 2 days." On examination, the nurse finds the client has poor skin turgor, low blood pressure, and dry skin. A computed tomography scan of the client's head shows a pituitary tumor. Which treatment does the nurse expect to be prescribed by the primary health-care provider?
Arginine vasopressin
Which is the most common cause of urinary obstruction in men older than 60 years of age?
Benign prostate hyperplasia
Which factor does the nurse identify to be responsible for potentially lower urinary tract infections (UTIs) in young men?
Both A and B (Lack of circumcision Anal intercourse)
Which observation is associated with the nonulcerative type of interstitial cystitis (IC)?
Both A and B (Thinning of the bladder mucosa Hemorrhages on the bladder wall when the bladder is distended)
Which statement is true regarding the bacteria that frequently cause lower urinary tract infections (UTIs)? Select all that apply.
Both A and D (Proteus mirabilus causes 70% to 95% of upper and lower urinary tract infections. Urease-producing bacterium enhance formation of the struvite staghorn calculi in the kidneys.)
A nurse is caring for an older adult with a urinary tract infection (UTI). A spinal injury has necessitated the long-term use of an indwelling urinary catheter in this client. Which is the most likely complication that the nurse would anticipate in this client?
Both B and D (Urosepsis Bladder cancer)
Which situation makes an individual susceptible to developing a lower urinary tract infection (UTI)?
Both C and D (Vesicoureteral reflux Urease-secreting bacterium)
Which medication does the primary health-care provider prescribe for the treatment of prolactinoma in a client with hyperpituitarism?
Bromocriptine
Which diagnostic test helps in detecting the natural insulin secretion from the pancreas?
C-peptide test
The nurse is caring for four clients in a health-care setting diagnosed with different endocrine disorders. Which client requires treatment by placement of a ventriculo-peritoneal shunt?
Client 1 Pineal tumor
The nurse is reviewing the medical records of different clients. Which client does the nurse expect to have metabolic syndrome?
Client 2. Female, 37 inches, 130 mg/dL
The nurse is assessing the medical records of different clients with diabetes. Which client has a reduced risk of cardiovascular disease?
Client 3
Four clients are diagnosed with different endocrine disorders as given below. Which client would be prescribed a magnetic resonance imaging (MRI) scan of the abdomen to visualize the adrenal gland?
Client 3 Pheochromocytoma
The nurse observes the final diagnosis of four clients in their case reports as given below. In which client does the nurse notice the presence of Chvostek sign and Trousseau sign?
Client 4 HypoPARAthyroidism
Which congenital condition occurs due to thyroid hormone deficiency during embryonic development and early neonatal life?
Cretinism
Which condition exhibits "moon facies" as a characteristic symptom?
Cushing's syndrome
Which disorder is caused by an increase in the hormones that are secreted from the adrenal gland?
Cushing's syndrome
Which type of renal calculi is caused by a genetic disorder associated with the faulty metabolism of an amino acid?
Cystine stones
Arrange in order the events associated with the obstruction of the urinary tract that eventually leads to renal failure (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
D. The intraluminal ureteral pressure becomes elevated. C. Ureteral peristalsis is overcome by the pressure. G. Increased hydrostatic pressures are transmitted directly to the nephron tubules. A. Glomerular filtration rate (GFR) decreases E. Depressed GFR is maintained if complete obstruction is not relieved after 12 to 24 hours. F. Renal blood flow progressively falls. B. Ischemia and incremental nephron loss take place.
Which complication is suspected in a client whose blood sugar is less than 30 mg/dL?
Seizure
Arrange in order the steps that depict how untreated urolithiasis can lead to kidney failure (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
D. Urine gets supersaturated with stone-forming salts. B. Urine flow pushes the stone down the ureter. A. Bleeding occurs when ureteral mucosa is sheared off. F. Intense pain is caused by buildup of pressure and spasms within the ureter. C. Backward accumulation of pressure occurs into the renal pelvis. G. Swelling of the renal pelvis is seen. E. Toxicity occurs in nephrons.
Which is the most common complication expected in clients with type 1 diabetes?
Diabetic ketoacidosis
Arrange in order the events associated with the micturition reflex, when voiding is not appropriate (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
E. The bladder wall stretches to accommodate the increasing volume of urine. C. The parasympathetic nerves stimulate the detrusor muscle. B. Contraction of the bladder wall takes place. G. Simultaneously, the spinal cord sends nerve impulses up to the cerebral cortex. D. The individual then makes a conscious decision about whether it is appropriate to void. A. The cerebral cortex initiates impulses that travel back down the spinal cord to inhibit the reflex arc. F. The external urinary sphincter stays contracted.
Which antidiabetic medication is a sulfonylurea?
Glipizide (Glucotrol)
Which endocrine disorder involves treatment using antithyroid hormone medication such as propylthiouracil (PTU)?
Grave's disease
After reviewing the medical records of a 35-year-old female client, the nurse concludes that the client has metabolic syndrome. Which findings helped the nurse to reach this conclusion?
HIGH-DENSITY LIPOPROTEIN (HDL) cholesterol of 40 mg/dL, blood pressure of 138/90 mm Hg, and fasting blood glucose level of 130 mg/dL
The nurse observes a diabetic client who has a wound that has not healed for a long time. Which condition does the nurse suspect in the client?
Immunosuppression
The mother of an adolescent diabetic client tells the nurse, "My daughter is skipping insulin doses frequently because she is concerned about weight gain." Which condition does the nurse document for this client?
Insulin purging
Which diagnostic procedures are used for the detection of interstitial cystitis (IC) in females? Select all that apply.
Laparoscopy Urodynamic studies Hysteroscopy
Which symptom is associated with hyperosmolar hyperglycemic syndrome?
None of the above
Which diagnostic test would be beneficial to rule out ectopic ACTH-secreting tumors in the body?
Octreotide scintigraphy
Which disorder is described as the complete loss of all of the pituitary hormones?
Panhypopituitarism
Which diagnostic test is useful for detecting hyperactivity of the thyroid gland during an evaluation of a thyroid disorder?
Radioactive iodine scan
The nurse finds that the symptoms of thyroid dysfunction in a client are due to abnormal pituitary activity. The client's laboratory report shows a low TSH level, which supports the nurse's finding. What type of endocrine disorder is likely present in the client?
Secondary HYPOthyroidism
The nurse is assessing the blood glucose levels of a client at regular intervals. The nurse finds 55 mg/dL of blood glucose at 2 am and150 mg/dL at 7 am. Which mechanism does the nurse suspect behind the change in the glucose levels in the client?
Somogyi effect
Which type of calculi in the ureter is found most often in clients with spinal cord injuries?
Struvite
Which type of stone in the case of urolithiasis is associated with indwelling catheters?
Struvite
A client who underwent laryngotomy presented with depression, increased sensitivity to cold, and constipation. On assessment, the nurse finds a puffy face and periorbital edema. The blood report shows a high TSH level. What does the nurse interpret from the findings?
The client has HYPOthyroidism
The nurse observes hyperpigmented, velvety macular lesions on the neck during the assessment of a diabetic client. What does the nurse infer from this observation?
The client has acanthosis nigricans
The nurse is caring for a client with immune mediated type 1 diabetes. What would the nurse expect to be the cause for this condition in the client?
The client has destruction of beta cells.
The laboratory report of a client shows arterial blood pH of 7.6, blood glucose level of 650 mg/dL, and serum bicarbonate level of 17 mEq/L. What does the nurse infer from these laboratory findings?
The client has hyperosmolar hyperglycemic syndrome.
The nurse is caring for a client with seizures, severely elevated blood pressure, and impaired mentation. The primary health-care provider suspects the client's condition is an endocrine disorder. A 24-hour urinalysis report shows an excess amount of catecholamine metabolites. What might be the diagnosis of the client?
The client has pheochromocytoma
Which endocrine gland is called the master gland?
The pituitary gland
Why does the nurse use the C-peptide test for a type 1 diabetic client?
To ELEVATE residual pancreatic function
Which is a risk factor for both bacterial and fungal urinary tract infections (UTIs)?
Urinary catheters
A client is diagnosed with multiple endocrine neoplasia. Which sign or symptom observed in the client indicates the presence of pituitary tumors?
Visual disturbances
