Final study guide Patho

The nurse is teaching a client about the prescribed antiepileptic drug, phenytoin (Dilantin). The nurse determines that learning occured when the client makes which statement? Select all that apply

"I should not drive until I know how the drug affects me" "I should keep a seizure diary to chronicle changes in symptoms when doses are adjusted" "I should take medication exactly as ordered as close to the same time each day" " I should use a soft toothbrush and keep my regularly scheduled dentist appointments.

A patient who is newly diagnosed with Parkinson's disease is prescribed levodopa (Dopar). The patient asks the nurse about drugs to prevent disease progression. What will the nurse tell this patient?

"While some drugs show promise, there are no studies that have proven a neuroprotective effect."

The father of an 18 month girl noticed a small vesicle on her face several days ago. The lesion ruptured and left a straw-colored crust that remained on the girls face. The eruption of new vesicle has prompted him to bring the child to the emergency dept. in the ER, the child was diagnosed with impetigo. Which of the following is the most likely form of treatment for this infant?

An antibacterial (antibiotic)

A nurse teaches a patient at risk of developing progressive vision loss from dry age related macular degeneration (ARMD) to increase the dietary intake of which nutrients?

Antioxidants and zinc

Light-skinned races such as Caucasians have

Approximately the same number of melanocytes as races with darker skin.

When a patient has a peculiar visual sensation that immediately precedes a seizure, what term should the nurse to describe this sensation?

Aura

When the patient asks, "What is the cause of multiple sclerosis?" how should the nurse reply? The cause of MS seems to be an interaction between:

Autoimmunity and genetic suseptibility

The most common skin cancer

Basal cell carcinoma

A 24 y/o female presents to your office complaining of vaginal discharge and intense pruritits (itching). Ten days ago she was treated for bronchitis with amoxicillin. Her past medical HX is non -contributory. She is not sexually active. Gynecological exam reveals a thick cottage cheese like discharge. The most likely organism is:

Candida albicans

A type of fracture that occurs when the broken bone is exposed to the outside by an opening in the skin

Compound Fracture

A 51 y/o male is admitted to the neurological critical care unit with severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. How should the nurse chart this condition?

Decerebrate posturing

TENS is a therapeutic intervention that:

Decreases sensory stimulation at the site.

What is the pathophysiological change in Parkinson's Disease?

Degeneration of the basal nuclei with deficit of dopamine

What statement does not apply to myasthenia gravis?

Dementia develops in the later stage.

A 23 y/o female begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). What is occurring in the patients body?

Demyelination of nerve fibers in the CNS

A patient has been taking Prozac for 11 months and reports feeling cured of depression. The nurse learns that the patient is sleeping well, participates in usual activities, and feels upbeat and energetic most of the time. The patient weight has returned to normal. What will the nurse tell this patient?

Discuss gradual withdrawal of the medication with provider.

When ------ is released within the spinal cord and adheres to opiate receptors on the appropriate neuron, this will block the release of -------.

Enkephalin/Substance P

spinal anesthesia involves injecting a local anesthetic into the ----------.

Epidural space

A 15 y/o male hit a tree while skiing and suffered a traumatic brain injury. Paramedics found him conscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with medical staff. Upon arrival to the hospital, he was alert and oriented. Physical exam reveals confusion and impaired responsiveness. What is the probable nature of his brain injury?

Extradural (epidural) hematoma

A patient on Dilantin should double their dose of medication if they miss their dose? True or false

False

The nursing instructor asks a student which bacterial pathogen is most commonly found in the middle ear of children. The nursing student demonstrates understanding by giving which answer?

Haemophilus influenzae

Which auto-antibodies are associated with the destruction of acetylcholine (ACh) receptor sites in this disease process?

IgG

Drugs that are used to treat Parkinson's disease attempt to:

Increase the amount of Dopamine available to the brain

What statement applies to myasthenia gravis?

It is an autoimmune disorder. The cholinergic receptors at the neuromuscular junctions are damaged. Muscle weakness and fatigue occur in the face and neck.

Which of the following is not a typical effect of advanced Parkinson's disease?

Loss of vision

A patient whose spouse had died recently reports feeling down most of each day for the past 2 months. On further questioning, the nurse learns that the patient has quit participating in church and social activities, has difficulty falling asleep, and has lost 5 pounds. The patient reports feeling tired and confused all the time but does not have suicidal thoughts. What does the nurse suspect?

Major depression

Identify classic signs and symptoms associated with Parkinson Disease

Mask-like facise, rigidity, stopped posture, and tremor.

A 4 y/o boy presents to your office for evaluation of toe walking and frequent falling since about 2 years of age. Parents have also noticed that he gets up from the floor in an unusual pattern. Mother's brother died in his early 20's from a similar problem. Examination shows pelvic girdle muscle weakness, hyporeflexia, and prominent calves. The most likely diagnosis is:

Muscular dsytrophy

The patient reports generalized muscle weakness. The health care provider orders administration of the medication edrophonium chloride (Tensilon). this medication is used in the diagnosis of:

Myasthenia gravis

Which statement by a patient indicates was successful regarding myasthesia gravis?

Myasthenia gravis results from autoimmune injury at the neuromuscular junction.

A 25 y/o male was in a MVA. At impact, his forehead struck the windshield. In this situation, a nurse recalls the contrecoup injury would occur in the -----region.

Occipital

Which of the following is characteristic of multiple sclerosis?

Remissions and exacerbations

A 16 month-old boy has a normal weight for his age but a height far below the normal range. His list of symptoms include a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed, and he has difficulty standing. What is the child's most likely diagnosis?

Rickets

Which is not considered endorphin?

Synorphins

This is not associated with skin function

Synthesis of vitamin B

Leprosy

The armadillo serves as a vector to human transmission, caused by the bactria Mycobacterium leprae, also known as Hansens disease, social stigma associated with it persists resulting in barrier to self-reporting and early treatment.

Which of the following are considered afferent fibers that conduct pain impulses?

The general visceral afferent fibers (GVA) conduct sensory impulses from the viscera, glands, and blood vessels to the central nervous system.

Which of the following characteristics of generalized seizures?

The uncontrolled discharge of neurons in both hemispheres

Patients with myasthenia gravis often have tumors or pathologic changes in the:

Thymus

A patient taking a monoamine oxidase inhibitor (MAOI) is seen in the clinic with a blood pressure of 170/96 mm Hg. What will the nurse ask this patient?

To list all the foods eaten that day

A 20 year old male was at the supermarket when he fell to the ground. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed several times. He is most likely was experiencing a (n):

Tonic-clonic seizure

Which vitamin begins its synthesis in the skin exposed to ultraviolet?

Vitamin D

endorphins. endorphins, neurotransmitters found in the brain that have pain-relieving properties similar to morphine. There are three major types of endorphins:

beta endorpins, found primarily in the pituitary gland; and enkephalins and dynorphin, both distributed throughout the nervous system

Foods to be avoided include tyramine- containing substances such as:

chocolate. aged cheese, beer, and red wine.

A nurse screening at a clinic for primary open-angle glaucoma (POAG) is aware that which major risk factors are not associated with the disease?

hypotension

A 25 y/o male was admitted to the ER following a MVA. On initial examination, he was noted to have bilateral femur fracture. The patient was immobilized, and taken to the operating room for debridment and an ORIF ( open reduction and internal fixation). Post-operatively, he was placed on skeletal traction. On post-op day #8, the patient complains that he "a little winded" What is the most likely diagnosis?

muscle atrophy

An age related skeletal disease that is characterized by loss of bone mineral density and increased bone fragility is:

osteoporosis

Visceral pain travels by way of:

parasympathetic fibers

A patient has been diagnosed with multiple sclerosis (MS) for 10 years and has a history of 3 periods of neurologic dysfunction lasting several weeks separated by long periods of full recovery. In the past 6 months, the patient has had prolonged neurological dysfunction without remission. The nurse understands that the patient may have which MS Type?

secondary progressive MS

All of the following are functions associated with skin

sensory function, protection of underlying structures, excretions of salts, organic wastes and water.

A nurse is caring for a patient who has myasthenia gravis. The prescriber has ordered neostigmine (Prostigmin). An important initial action before administration of the medication includes:

swallowing ability

The first step in healing a fracture is

the formation of a fracture hematoma

Which are the following are the effects of advanced Parkinson's disease?

urinary retention, orthostatic hypotension, and difficulty chewing and swallowing.

A patient is diagnosed with major depression with severe symptoms and begins taking antidepressant medication. Three weeks after beginning therapy, the patient tells the nurse that the drug is not working. The nurse will counsel the patient to ask the provider about:

using non-drug therapies to augment the medication.