Patho-Coursepoint

A client with iron-deficiency anemia asks, "What does this low mean corpuscular volume (MCV) level mean?" Which response by the nurse is most accurate?

The MCV is one red blood cell (RBC) index that indicates your RBCs are small cells.

Which type of characteristic do thyroid and steroid hormones exert on target cells by way of nuclear receptors?

The ability to cross the cell membrane of target cells

A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students recognize the local action of hormones as:

Paracrine

Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding?

Paralysis

Female Hemoglobin (Hgb)

12-15 g/dL

Normal red blood cells live an average of about how many days?

120

Male Hemoglobin (Hgb)

14-16.5 g/dL

The nurse suspects a client has stage 2 systolic hypertension. What systolic pressure would confirm the nurse's suspicion?

140 mm Hg or higher

The practitioner is reviewing the medication list of a client with Raynaud disease. Which medication would the practitioner expect the client to be receiving?

A calcium channel-blocker

Turner Syndrome

A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted.

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?

Increased blood pressure

Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory increase in which physiologic process?

Increased erythropoiesis

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.

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

Increased heart rate

A nurse is providing care for several clients on an acute medicine unit. Which client should the nurse recognize as being at the highest risk for metabolic alkalosis?

A client on continuous nasogastric suction and whose hypertension is being treated with diuretics

Which client does the nurse determine will have the most difficulty in instituting an exercise plan?

A client who has hypercapnia

Which client most likely faces the highest risk of developing secondary pulmonary hypertension?

A client with COPD and a 35 pack-year smoking history.

Which clients are at risk for developing metabolic alkalosis? Select all that apply.

A client with chronic kidney disease taking calcium carbonate A client with gastric suction for a bowel obstruction A client with heart failure receiving furosemide

A parent brings his child to the emergency department after the child sustains a fall from a tree. The child has severe right arm pain. A radiograph shows a complete break in the humerus with multiple pieces of bone at the fracture line and the skin is not broken. This type of fracture is classified as:

A closed, comminuted fracture

Down Syndrome (Trisomy 21)

A genetic disorder caused by the presence of all or part of a third copy of chromosome 21.

complement system

A group of about 30 blood proteins that may amplify the inflammatory response, enhance phagocytosis, or directly lyse extracellular pathogens.

Erythropoietin

A hormone produced and released by the kidney that stimulates the production of red blood cells by the bone marrow.

The nurse is caring for a client with an acid-base imbalance. Which of these does the nurse recognize is correct regarding compensation?

A pH moves toward the normal range.

A client who has experienced a spinal cord injury still has use of the arms but has impaired motor and sensory function of the trunk, legs, and pelvic organs. Which term best describes how this injury is classified?

Paraplegia

What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?

Parkinson disease

Ankylosing spondylitis is a disease that typically manifests in late adolescence and early adulthood. What is the characteristic of the pain in ankylosing spondylitis?

Worse when lying down

A client returns to the doctor's office for evaluation 6 weeks after a tibial fracture. Which assessment indicates the potential for nonunion?

X-ray shows minimal calcification at the fracture.

The parents of a child diagnosed with cystic fibrosis (CF) ask about the risk of any future children having the condition. How should the nurse respond?

You have a 25% chance that your next child will have CF.

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection (UTI). Which finding should the nurse report as evidence of a UTI?

increased nitrites

autosomal dominant

inheritance pattern of a dominant allele on an autosome

autosomal recessive

inheritance pattern of a recessive allele on an autosome

Marfan Syndrome

inherited connective tissue disorder

A client has an ectopic pregnancy. Which factor(s) in the client's history could contribute to the condition? Select all that apply.

pelvic inflammatory disease (PID) smokes one pack per day

Thrombocytes

platelets

How will the nurse describe unilateral chest pain associated with respiratory movements?

pleuritic

A nurse caring for a client with a head injury is concerned that respirations are 30 breaths per minute. Which physiologic factor will affect cerebral blood flow?

Decreased carbon dioxide level

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?

Elevated atrial natriuretic hormone

The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia?

Elevated total cholesterol

A client has been diagnosed with diabetes mellitus. Which lab result would the practitioner expect?

Elevation of triglycerides

Angina pectoris is a chronic ischemic CAD that is characterized by a symptomatic paroxysmal chest pain or pressure sensation associated with transient myocardial ischemia. What precipitates an attack of angina pectoris?

Emotional stress

Excessive activity of the excitatory neurotransmitters and their receptor-mediated effects is the cause of which type of brain injury?

Excitotoxic

What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise?

Exercise can increase blood vessel growth and help to decrease symptoms.

A nurse is caring for a client with hypoparathyroidism. Which imbalance is a major concern for the client?

Hypocalcemia

A 30-year-old client who manages type 2 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. The client has come from a party at which the client drank two beers to celebrate running a half-marathon. Which is likely to be the cause of this client's?

Hypoglycemia

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

Hypoglycemia

An extremely lethargic client arrives by ambulance at the emergency department. His blood glucose level is 32 mg/dL (1.78 mmol/L). The nurse will anticipate that this client will be diagnosed with:

Hypoglycemia

Which diagnosis is most likely to require surgical correction?

Hypospadias

The client presents with a reduction in red blood cells, white blood cells, and platelets. The practitioner is unable to determine the cause of the client's condition. Which type of anemia does the client have?

Idiopathic aplastic

A client calls the clinic and informs the nurse that he has sustained an erection for 3 hours and that it is extremely painful. The client has a history of sickle cell disease and this has not happened to him in the past. Which instruction should the nurse give to the client?

If the client does not seek medical attention, impotence may result.

Which current multiple sclerosis drug treatments are designed to slow the progress of myelin degeneration?

Immunomodulators

What is the usual cause of acute pyelonephritis?

Infection

Which pathophysiologic process occurs in cases of bacterial meningitis?

Inflammation allows pathogens to cross into the cerebrospinal fluid.

The nurse is assessing a client who states he felt fine all day and then, within 5 minutes, began to feel extremely weak and tired and began having a fever. What do these symptoms indicate that the client may be experiencing?

Influenza

A client is prescribed an angiotensin-converting enzyme (ACE) inhibitor for hypertension. The nurse knows that ACE inhibitors are contraindicated by which clinical condition?

Renal artery stenosis

A client asks why his blood pressure pills seem to make him go to the bathroom to urinate frequently when they are not water pills (diuretics). Which physiologic process explains the long-term regulation of blood pressure most accurately?

Renal monitoring and adjustment of extracellular fluid volume

The nurse is caring for a client with chronic lung disease who has a history of smoking two packs of cigarettes per day for 25 years. For which blood dyscrasia should the nurse be assessing this client?

Secondary polycythemia

A child born premature does not have descended testes. The pediatrician has made a note to watch in the coming visits for testicular descension. Which consequence is the most significant concern if the testes do not descend?

Testicular torsion

Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess?

Weight gain

The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes that which altered diagnostic test is consistent with development of edema?

Decreased albumin

A client calls the health care provider's office and frantically tells the nurse his TB test is red, and he is afraid this means he has tuberculosis. The best response by the nurse would be:

"A definitive diagnosis of active pulmonary tuberculosis requires cultures or DNA amplification techniques."

A client has been given the diagnosis of diffuse glomerulonephritis. The client asks the nurse what diffuse means. The nurse responds:

"All glomeruli and all parts of the glomeruli are involved."

The nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of which chemical component?

HCO3-

The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:

"Children can be affected with almost all of the rheumatic diseases that occur in adults."

An adult client with a history of worsening respiratory symptoms has presented for care. Which assessment question will best allow the clinician to address the possibility of chronic bronchitis?

"Do you tend to have a cough even when you don't feel sick?"

A client from Texas is suspected of being infected with coccidioidomycosis and has been admitted to the hospital with fever, cough, pleuritic chest pain, and skin lesions. When performing a health history, which question would be most valuable to assist with diagnosis?

"Do you work in construction and dig soil?"

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology?

"Genetic predisposition is very likely."

A client is admitted with secondary orchitis. Which assessment question is most relevant?

"Have you ever had mumps?"

A child has been home from camp for 2 weeks and reports a sore throat, low-grade fever, and enlarged cervical lymph nodes. After testing, it is determined the child has Epstein-Barr virus (EBV)-associated infectious mononucleosis. The parent asks, "How did my child acquire this type of infection?" Which is the best response by the nurse?

"The infection is acquired primarily through contact with infected oral secretions."

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

"Insulin is destroyed by the stomach contents and has to be administered by injection."

A client in the nursing home wonders why he is having these signs and symptoms of left-sided heart failure. Which explanation will the nurse give the client?

"The left ventricle is having problems pumping blood forward, and this is causing blood to back up into your lungs."

The respiratory therapist explains respiratory acidosis to the orientee. The therapist knows the orientee understands the topic when she verbalizes which concept?

"The manifestations of respiratory acidosis often are intermixed with those of oxygen deficit."

The nurse teaches the client with end-stage kidney disease and hyperphosphatemia to take sevelamer HCl, a phosphate binder, with meals. How does the nurse explain the rationale for the timing of this medication?

"The medication should be taken at meal time to allow the binding of phosphate."

When administering a corticosteroid to a client with rheumatoid arthritis, a nurse includes which education about the medication? Select all that apply.

"These drugs are for short-term use." "Pain is relieved with use of corticosteroid medications." "Corticosteroids do not prevent joint destruction."

A 29-year-old pregnant woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia in her second trimester. What should her care provider teach her about this change in her health status?

"We don't really understand why some women get high blood pressure when they're pregnant."

The nurse determines that additional client education is needed when a client with gout makes which statement?

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

A female client with uterine leiomyomas asks the nurse about her risk of uterine cancer. Which statement best answers the question?

"Your leiomyomas may cause heavy periods but will not become cancerous."

A nurse is assessing a client who displays pale skin and nail beds. Which laboratory data should the nurse evaluate?

Hemoglobin level

A client is admitted to the emergency department with possible internal bleeding after being involved in an automobile accident. What type of isotonic intravenous (IV) solution does the nurse prepare to infuse?

0.9% NaCl

Oxygen has been prescribed for a client with chronic obstructive pulmonary disease (COPD). Which amount of oxygen is considered most appropriate for the COPD client?

1 to 2 L/min

A client is suspected to be infected with Histoplasma capsulatum. Which is the average incubation period for this infection to cause symptoms?

1 to 4 weeks

According to the Glasgow Coma Scale, opening one's eyes to only painful stimuli would receive which score?

2

Which manifestation indicates a client is at risk for developing diabetes mellitus?

2 hour oral GTT 175 mg/dL (9.7 mmol/L)

The client reports he has been noticing small amounts of blood in his stool for the last several weeks. The provider knows the client's red cell mass may reach which value without the occurrence of signs and symptoms?

50%

Which of these clients would be at greatest risk for developing chronic osteomyelitis?

6-year-old with a compound fracture of the right wrist

What is considered the normal amount of serum bilirubin found in the blood?

<1.5 mg/dL

Hemophilia

A hereditary disease where blood does not coagulate to stop bleeding

Which client presenting to the emergency department would most likely be diagnosed with a pathologic stress fracture?

A postmenopausal female who was diagnosed with breast cancer with metastasis to bone

AIDS

A serious (often fatal) disease of the immune system transmitted through blood products especially by sexual contact or contaminated needles.

HIV

A virus that attacks and destroys the human immune system using CD4+ T Cells

Which individual likely faces the highest risk of developing chronic pancreatitis?

A woman who has 6 to 8 alcoholic beverages each evening

A client diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified?

Acquired, autoimmune secondary neutropenia

Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system?

Acting as a second messenger to mediate hormone action on target cells

ST-elevated myocardial infarction (STEMI) is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI?

Action decreases metabolic demands of the heart.

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Action of releasing hormones from hypothalamus

When trying to educate a client about the release of free radicals and the role they play in formation of atherosclerosis, which statement is most accurate?

Activated cells that release free radicals oxidize LDL, which is harmful to the lining of your blood vessels.

The nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics

The nurse is providing care for a client who has a recent history of visual disturbances, facial pain and erythema in the region of the temporal artery. Which aspect of care is most appropriate?

Administration of corticosteroids as prescribed

The nurse is caring for a client who has developed hypoxemia and tissue hypoxia. Which of these interventions does the nurse set as a priority intervention?

Administration of supplemental oxygen

A client has developed community-acquired pneumonia and is being treated at home. What does the nurse recognize are the methods in the diagnosis of community-acquired pneumonia? Select all that apply.

Age Coexisting health problems Severity of illness

Which client would the nurse recognize as needing to be assessed for orthostatic hypotension?

An 80-year-old client who has experienced two falls while attempting to ambulate to the bathroom

Which client would be considered high risk for falling and fracturing the hip?

An 81-year-old woman taking medication for osteoporosis

Which individual displays the precursors to acromegaly?

An adult with an excess of growth hormone due to an adenoma

Jaundice, bilirubin

An individual has a yellowing of both the skin and whites of the eyes. The individual most likely has _____, which is caused by high levels of _____ in the blood

Which client should most likely be assessed for orthostatic hypotension?

An older adult client who has experienced two falls since admission while attempting to ambulate to the bathroom.

Which individual should have priority for receiving a seasonal influenza vaccination?

An older adult resident of a long-term care facility

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Antidiuretic hormone (ADH) and oxytocin

What medication teaching should be done for a woman of childbearing age with a seizure disorder?

Antiseizure drugs increase the risk for congenital abnormalities.

For which health problem is stem cell transplantation likely to be of therapeutic benefit?

Aplastic anemia

A client suffers a musculoskeletal injury while participating in a sporting event. Which treatment is most appropriate initially?

Applying ice and sitting out the rest of the game

The health care provider is evaluating a client who is at risk for the development of osteonecrosis. The client is at risk for:

Aseptic necrosis of a bone segment caused by interruption of the blood supply

Which medication order should the nurse question for a client with hyperthyroidism who is experiencing signs of impending thyroid storm?

Aspirin

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

The nurse in the emergency department is assessing a toddler suspected of epiglottitis. Which intervention is considered the priority when working with this client?

Assess if airway is compromised and call for health care provider assistance with intubation to establish an airway, if needed.

A client presents with arthralgia and arthritis. Which is the priority nursing intervention?

Assessing the client's pain and history of treating it

The nurse is preparing to auscultate for a mitral valve stenosis murmur. Where is the best location to place the stethoscope?

At the apex of the heart

A client with a history of chronic obstructive pulmonary disease (COPD) has developed influenza. Which statements about possible treatments are accurate for this client? Select all that apply.

At the onset of influenza-like symptoms, antiviral medications should be initiated within the first 48 hours. The antiviral drug of choice is oral oseltamivir.

A 29-year-old client had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:

Atypical cervix cellular changes

multiple myeloma

B-Cell malignancy- common in elderly

Pernicious anemia is thought to be an autoimmune disease that destroys the gastric mucosa. This results in chronic atrophic gastritis and the production of antibodies that interfere with which vitamin's ability to bind to intrinsic factor?

B12

Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas present differently. The nurse is aware of which difference?

BPH is commonly located in the periurethral zone of the prostate, while prostate cancers are commonly located in the peripheral zones of the prostate.

Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences?

Backflow from the left ventricle to left atrium

A client diagnosed with sinusitis will express concern that which physical maneuver increases the headache?

Bending forward or coughing

The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. The nurse teaches the student that epinephrine will cause which effect on blood glucose levels?

Blood glucose will elevate.

A client was involved in an auto accident and suffered massive internal injuries that resulted in a large blood loss. Select the type of anemia the client is at greatest risk to develop.

Blood loss

In pregnancy, which diagnostic findings are characteristic for preeclampsia-eclampsia?

Blood pressure 160/100 mm Hg and platelet count 25,000/μL (25 ×109/L)

A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.

Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy

The nurse knows that coarctation of the aorta can be a secondary cause of hypertension. Which blood pressure finding can be characteristic of this condition?

Blood pressure in arms 20 mm Hg higher than in the legs

After birth, red blood cells are normally made in which location?

Bone marrow

The nurse caring for a client in the early stage of multiple myeloma would anticipate the client to report which symptom?

Bone pain

What is the first symptom of multiple myeloma that a client typically presents with on a visit to the primary care provider?

Bone pain

A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:

Brain death

An infant who was born prematurely and developed respiratory distress syndrome was placed on mechanical ventilation for several weeks. What condition should the nurse monitor the infant for related to the long-term ventilatory support?

Bronchopulmonary dysplasia

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

Dehiscence

Bursting open of a wound, especially a surgical abdominal wound

The nurse recognizes the role of the lungs in acid-base balance is regulation of which of the following?

CO2

A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?

Calcium

Serum phosphorus level has a reciprocal relationship with which serum electrolyte?

Calcium

A client presents with epigastric pain, a mild fever, nausea, and vomiting. His history shows a previous episode with similar symptoms that reverted in 24 hours. This time the pain is not subsiding. What diagnosis is the most likely?

Calculous cholecystitis

A client's initial blood pressure on admission to the outpatient clinic is 190/120 mm Hg. Which action by the clinic staff is most appropriate at this time?

Calling an ambulance to take the client to the emergency department

When caring for a client with hypomagnesemia, the nurse prioritizes assessment of which body system?

Cardiac

A client presents to the emergency room with symptoms of generalized muscle weakness, dyspnea, muscle cramps, vomiting, and diarrhea. Based on these symptoms, the nurse anticipates which type of monitoring will be required?

Cardiac monitoring

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

Which of the following is an anion?

Chloride

A client with iron-deficiency anemia reports feeling "tired all of the time." What does the nurse understand may be the cause of the fatigue that the client is experiencing?

Chronic blood loss with inadequate iron available for recycling

Clients with lung disease can develop polycythemia as a result of which condition?

Chronic hypoxia

In which conditions are Bence Jones proteins not found in the lab analysis? Select all that apply.

Chronic lymphocytic leukemia Chronic myelogenous leukemia Hodgkin lymphoma

A middle-aged client with a 30-year history of smoking was diagnosed with lung cancer. A health history revealed previous exposure to air pollution, asbestos, and radiation. Which factor most likely had the greatest impact on development of the lung cancer?

Cigarette smoke

Which risk factor is associated with erectile dysfunction (ED) and considered preventable?

Cigarette smoking

The nurse is caring for a client with cancer of the penis. The nurse recognizes which factor reduces the risk of this type of cancer?

Circumcision

Which female client is exhibiting signs of untreated polycystic ovary syndrome (PCOS)?

Client age 34, states excess body hair and menstrual cycles are irregular

The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?

Client has anuria.

Which client is most susceptible to experiencing the effects of inadequate erythropoiesis?

Client with renal failure as a result of longstanding hypertension

A client's emergency room report includes the presence of a contrecoup injury. The nurse plans care for a client with which of the following?

Closed head injury opposite the area of impact

A client presents to the emergency department following an accident where he fell off a chair. The client reports initial hip numbness followed by increasing pain and muscle cramping. Which type of injury does the triage nurse suspect?

Closed hip fracture

A nurse is teaching a client about nutritional components needed for erythropoiesis. Which vitamin/mineral is essential for DNA synthesis and nuclear maturation of a red blood cell?

Cobalamin

Which type of fracture involves healing of more than two pieces of bone?

Comminuted fracture

Which criterion about insulin would prompt a diagnosis of type 1 diabetes?

Complete failure of insulin secretion

The vulva area is especially prone to skin infections. The nurse knows that this occurs because of:

Constant exposure to secretions and moisture

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:

Constriction of the pulmonary vessels in response to hypoxemia

The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?

Cretinism

Sepsis

Dangerous infection of the blood

A client tells his health care provider that his body is changing. It used to be normal for his blood glucose to be higher during the latter part of the morning. However, now his fasting blood glucose level is elevated in the early AM (07:00). The health care provider recognizes the client may be experiencing:

Dawn phenomenon

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect?

Decreased pH below 7.35

A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH)

Which statement best describes the pathophysiology of Parkinson disease?

Degeneration of the nigrostriatal dopamine system

Which metabolic abnormalities can cause type 2 diabetes? Select all that apply.

Deranged secretion of insulin Insulin resistance Increased glucose production by the liver

When a nurse assesses a client with scleroderma (systemic sclerosis), which manifestation does the nurse recognize is part of the CREST variant syndrome rather than the systemic type of this disorder?

Dermal thickening proximal to wrists

A client arrives in the emergency department with hypovolemia related to excretion of "at least 3 gallon jugs of dilute, water-like urine in the past 24 hours." In collaboration with the physician, the nurse prepares to administer which medication?

Desmopressin acetate

A client affected by postural hypotension will likely display what symptoms?

Dizziness and pallor when moved to upright position

A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?

Dopamine

A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?

Dopamine nigrostriatal system

Which statements concerning endocrinology laboratory testing are true? Select all that apply.

Endocrine tests are generally sensitive to storage requirements. Client education regarding endocrine testing must include specific test requirements.

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?

Endometriosis

Which of the following are examples of amines? Select all that apply.

Epinephrine Norepinephrine

Endemic Burkitt lymphoma occurs in regions of Africa where what other infections are common?

Epstein-Barr and malaria

The microbiology technician explains to the student that which blood cell is the most common?

Erythrocyte

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

Escherichia coli

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?

Eye health and visual acuity

The nurse is assessing a female client with a hemoglobin of 6.8 g/dL (68 g/L). Which symptoms would the nurse expect to find? Select all that apply.

Faintness Headache Dyspnea

Diabetic ketoacidosis (DKA) in a client with type 1 diabetes occurs when the lack of insulin leads to the release of which physiologic product?

Fatty acids

The nurse notes that a client is experiencing a triad of splenomegaly, recurrent pulmonary infections, and neutropenia. During the handoff report, the nurse should report the client is exhibiting which disease associated with antineutrophil antibodies?

Felty syndrome

The practitioner is examining a client who is fatigued and has a hemoglobin of 8.7 g/dL (87 g/L). Before ordering treatment, which lab will the practitioner order?

Ferritin

The nurse assesses a client in an ambulatory care facility. Which manifestation(s) leads the nurse to advocate for investigation of possible acute pyelonephritis? Select all that apply.

Flank pain in the back Abrupt onset of fever and chills Urinary urgency and frequency

The nurse is caring for a client with a tumor obstructing the lymphatic system. For which consequence does the nurse assess?

Fluid accumulating in the interstitial spaces distal to the tumor

A client is admitted after losing 44 lb (20 kg) over the past 3 months, largely due to frequent vomiting. What intervention should the nurse anticipate in the treatment of the client's resulting acid-base imbalance?

Fluid replacement with an intravenous solution containing electrolytes as prescribed

The nurse's plan of care for a client with multiple myeloma should include interventions to prevent:

Fractures

When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention?

Gentle exercise

The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond?

Glucose is unused without insulin, so body fats are used for energy.

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:

Glycosylated hemoglobin, hemoglobin A1C (HbA1C)

The nurse is teaching a class on reduction of cardiovascular disease. Which action/activity demonstrates an intervention that is cognizant of the modifiable risk factors for hyperlipidemia?

Going for a brisk walk with a friend and talking to him about continuing to exercise regularly

The community health nurse is developing a program to decrease the amount of pulmonary tuberculosis that has recently risen in her area. Which populations at risk will the nurse target? Select all that apply.

HIV-infected people Foreign-born people from countries with a high incidence of tuberculosis Residents of high-risk congregate settings

A client with malignant hypertension is at risk for a hypertensive crisis, including the cerebral vascular system often causing cerebral edema. The nurse would assess this client for which signs and symptoms?

Headache and confusion

What is the most important factor in myocardial oxygen demand?

Heart rate

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which high-risk factor with the development of this cancer?

Heavy smoking

A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?

Helping the client make meaningful changes to his diet and activity level.

The client develops osteomyelitis that has originated from infectious organisms that reach the bone through the bloodstream. This is known as which type of osteomyelitis?

Hematogenous

What formation must occur at the fracture site to initiate the cellular events essential to bone healing?

Hematoma

When an Rh-negative mother gives birth to an Rh-positive infant, the mother usually produces antibodies that will attack any subsequent pregnancies in which the fetus is Rh positive. When subsequent babies are Rh positive, erythroblastosis fetalis occurs. What is another name for erythroblastosis fetalis?

Hemolytic disease of the newborn

A client tells the nurse that he is concerned about developing hepatitis after being exposed to contaminated feces, saliva, and food. The nurse is aware that the client is at risk for:

Hepatitis A

A 38-year-old woman with proliferative breast changes of papilloma asks the nurse about her risk for breast cancer. Which statement of risk is correct?

Higher because of your papilloma

Which intervention by the client will decrease overall cardiovascular risk?

Higher levels of fitness and exercise

Anaphylactic shock causes severe hypoxia very quickly because of which reason?

Histamine release causes massive vasodilation.

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

History of cigarette smoking and elevated blood pressure

Which physiologic process allows hormones to exert influence upon some cells and not others?

Hormone receptors

The health care provider has completed the assessment on a client with jaundice. The provider determines that which pathophysiologic abnormality could cause the jaundice?

Impaired uptake of bilirubin by the liver

A client has developed priapism. For which outcome is this client at risk?

Impotence

During assessment of a recently admitted client with right-sided heart failure, the nurse notes that the liver is enlarged and verifies by palpation and percussion. A student asks the nurse to explain how the liver and heart failure are related. Which is the nurse's best response?

In right-sided heart failure, there is high pressure in the inferior vena cava that backlogs blood into the liver.

The nurse is caring for a client with ketoacidosis who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which phenomenon is most likely occurring?

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids.

When will the nurse plan to assess a client's blood pressure to confirm the possible diagnosis of orthostatic hypotension?

In the morning before arising from bed

A female client with blocked fallopian tubes seeks assistance at a fertility clinic. Which assisted reproductive technology will bring the greatest chance for conception?

In vitro fertilization (IVF)

A client with ethylene glycol toxicity is restless, and stating he has flank pain. What intervention should the nurse perform to minimize complications?

Increase IV fluids

The nurse is caring for a client with alcoholism who now presents with gastrointestinal bleeding. What alteration does the nurse anticipate related to the bleeding?

Increase in ammonia level

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?

Increase in appetite

An adult client is scheduled for testing of a suspected growth hormone (GH)-secreting tumor. Which result from the glucose suppression test would confirm the condition?

Increased GH secretion

A client is experiencing fatigue and laboratory results reveal: Hct 40% (0.40); Hgb 8 g/dL (80 g/L); WBC 8000 (8 x 109/L); and platelets 175,000/ µL (175 ×109/L). The nurse would interpret these results as indicative of which diagnosis?

Low hemoglobin/anemia

The practitioner is examining a client and notes that he has small, punctate skin hemorrhages on his abdomen and chest. This finding is suggestive of which lab result?

Low platelets

Which lipoprotein is the main carrier of cholesterol?

Low-density lipoprotein (LDL)

The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find?

Lower back pain

A client is diagnosed with vulvar carcinoma, which appears as an inconspicuous thickening of the skin resembling eczema or dermatitis and may produce few symptoms other than pruritus, local discomfort, and exudation. The nurse understands that the cancer metastasizes readily through which mode?

Multiple lymph channels

An adult client's blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man's most likely diagnosis?

Multiple myeloma

A client presents with joint pain and suspected rheumatoid arthritis (RA). Which intervention is appropriate for the nurse to implement?

Muscle-strengthening exercises to support joints

A student nurse is taking microbiology and reviewing various types of cells. From which cell type are granulocytes derived?

Myeloid stem cells

The granulocyte cell lines are derived from:

Myeloid stem cells

Shortly after a closed fracture has occurred, what localized early manifestation occurs?

Numbness

When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease?

Obesity

A parent has brought her 2-week-old infant to the emergency department due to the infant's persistent and increasing jaundice. Laboratory testing reveals indirect bilirubin level is 28 mg/dL (479 µmol/L), but otherwise a normal physical assessment. Which intervention will most likely be prescribed for this infant?

Phototherapy

Which structure controls the functions of the greatest number of target glands and cells?

Pituitary gland

A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client?

Raynaud disease

The renal control mechanism of restoring the acid-base balance is accomplished through which process?

Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms.

A nurse is performing a genital examination on a male client who develops an erection. Which action is the nurse's most appropriate intervention?

Reassure the client that this is a normal response and continue with the examination

A client with a diagnosis of myasthenia gravis underwent a mastectomy. The surgery was a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which priority measure should the care team initiate immediately?

Respiratory support and protection of the client's airway

- D antigen

Rh negative

D antigen

Rh positive

The nurse is performing a physical assessment of the gastrointestinal tract. In which area does the nurse place the hands for palpation of the liver?

Right upper quadrant

When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult?

Risk for falls

The health care provider is assessing a client with a history of ankylosing spondylitis to note progression of the disease. On which area of the body will the provider focus the assessment?

Spine

The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which organ?

Spleen

When red blood cells age, which organ is responsible for their destruction?

Spleen

A client's blood pressure is persistently in the range of 130 to 135 mm Hg systolic and 85 to 88 mm Hg diastolic. How will the nurse classify this client's blood pressure?

Stage 1 hypertension

Chronic lymphocytic leukemia (CLL) commonly causes hypogammaglobulinemia. This makes clients with CLL more susceptible to infection. What is the most common infectious organism that attacks clients with CLL?

Staphylococcus aureus

Drug-related nephropathies involve functional and/or structural changes to the kidney after exposure to a drug. What does the tolerance to drugs depend on?

State of hydration

A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?

Stimulation testing

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with:

Subarachnoid hemorrhage

A client with cystic fibrosis reports recent weight loss without fever or cough. What interventions will the nurse implement to promote health for the client? Select all that apply.

Supplemental vitamin/minerals Increase pancreatic enzymes

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

Supplementary oxygen therapy

A social worker is counseling the family of an 85-year-old woman who has just been diagnosed with non-small cell lung cancer. What concerns should she convey to the family regarding the unintended effects of treating the disease?

Surgical treatment may have the consequence of weakening the client.

Which assessment findings may indicate that the client with acute rhinosinusitis is experiencing a complication? Select all that apply.

Swelling below the eyes Abnormal extraocular movements Changes in mental status

Which substance helps maintain a smooth surface in joint cartilage?

Synovial fluid

A nurse is caring for a client admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which disease process?

Systemic lupus erythematosus (SLE)

The student is studying the body's lymphatic system. Which of the following is true of this system?

T lymphocytes travel to the thymus to complete the differentiation process.

The nurse is explaining to a client's family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be:

The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will I get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?

The brain relies on blood glucose as its main energy source.

The nurse is assessing a client with abnormal blood gas values. Which of these interpretations does the nurse make regarding the client's physiologic status?

The client has abnormalities in his buffer system.

A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.

The client is achieving normal glycemic control.

A client has developed a tendency to have a back-and-forth tremor in his fingers as he reaches for an object. The client and his wife deny any changes to his cognition. Which signs/symptoms and diagnostic testing should primarily be the focus of the assessment?

The client's cerebellar function

A nurse observes that a client's urine is cola colored and considers which factor as a possible reason?

The client's urine contains material from the degradation of red blood cells.

Evisceration

The displacement of organs outside of the body.

Which complication is associated with prostatic hyperplasia?

Urine retention

A young woman presents with signs and symptoms of urinary tract infection (UTI). The nurse notes that this is the fifth UTI in as many months. What would this information lead the nurse to believe?

There is possible obstruction in the urinary tract.

A normally healthy client is diagnosed with polycythemia vera. The nurse should prioritize assessments aimed at the early identification of which complication associated with this diagnosis?

Thromboembolism

A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color, and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which complication?

Thrombosis in the right leg

What is the reason why bed rest and analgesics are expected treatments for infectious mononucleosis?

To relieve fever, headache, and sore throat

Thalassemia can be classed as major or minor. If therapy for thalassemia major is not started in infants who present with this disease, severe growth retardation will occur. At 6 months of age, which therapy must be started?

Transfusion

An infant from parents of Mediterranean decent 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 serum biomarker is highly specific for myocardial tissue?

Troponin

Which blood vessel layer is composed primarily of smooth muscle cells?

Tunica media

While discussing the elimination of hormones from the body to prevent overaccumulation, which hormones are eliminated in bile? Select all that apply.

Unbound adrenal hormones Gonadal steroid hormones Thyroid hormones

The nurse is providing education for a client diagnosed with essential hypertension. The nurse will state that the cause of this disorder is:

Unknown

Which type of blood vessel cells in the tunica media layer produce vasoconstriction and/or dilation of blood vessels?

Vascular smooth muscle cells (SMCs)

Levels of endothelins may be increased in clients with heart failure. Which of the following is the primary action of endothelins?

Vasoconstriction

A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect?

Vasodilating effects reducing preload and afterload

The nurse is assessing blood gas results for a client with diabetes and ketoacidosis and notes a pH level of 7.15. Which arrhythmias should the nurse closely monitor while treating this client?

Ventricular tachycardia

A newly admitted client's health record states that the client's health history includes tubercular osteomyelitis. Where is the most likely anatomical site of this infection?

Vertebrae

The nurse recognizes which intervention is essential to reduce the pain of acute pancreatitis?

Withholding food and fluid

dysplasia

abnormal growth

The nurse is developing a plan of care for a postsurgical client. A major goal is to prevent the formation of deep vein thrombosis (DVT). Which nursing intervention should the nurse implement?

apply sequential pneumatic compression devices to lower extremities

Non-Hodgkin's Lymphoma

arise from lymphocytes in B-Cell T-cell NK-Cell

The nurse is caring for a client experiencing a seizure. During the seizure the nurse notes that the client repetitively rubs his/her clothing. When contacting the client's physician, the nurse notes that the client exhibited:

automatisms.

Unconjugated bilirubin

breakdown product of heme, lipid soluble, never in urine

Disseminated Intravascular Coagulation (DIC) s/s

bruising purpura of skin blood tests may be normal initially

Leukemia

cancer of white blood cells

A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increased risks associated with exercise, the health care provider should encourage the client to:

carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia.

red blood cells

carry oxygen

apoptosis/necrosis

cell death

aplastic anemia

characterized by an absence of all formed blood elements caused by the failure of blood cell production in the bone marrow

white blood cells

fight infection

innate immunity

first line of defense

neutropenia cause

genetic/congenital factors drug induced autoimmune

A client suffering global cerebral ischemia a week after a suicide attempt by hanging is in the intensive care unit receiving treatment. The parent asks the nurse why it is necessary to keep the client paralyzed with medications and on the ventilator. The most appropriate response would be that these therapies:

decrease metabolic needs and increase oxygenation.

An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension?

decreased elasticity of the aorta and large arteries

sickle cell anemia

hereditary disorder of abnormal hemoglobin producing sickle-shaped erythrocytes and hemolysis

A client who has just completed running a marathon reports muscle weakness, cramping, and general fatigue despite drinking adequate amounts of water. The nurse suspects which type of hypotonic hyponatremia?

hypovolemic

A client has just returned from his surgical procedure. During initial vital sign measurements, the nurse notes that the client's heart rate is 111 beats/minute and the BP is 100/78 (borderline low). In this early postoperative period, the nurse should be diligently monitoring the client for the development of:

hypovolemic shock due to acute intravascular volume loss.

The nurse in the urology unit is teaching about medication to treat erectile dysfunction. The mechanism of action of most of these medications is that the medication:

promotes increase in blood flow to the corpora cavernosa.

A preventive measure to decrease the risk of developing rheumatic heart disease includes:

prompt diagnosis of streptococcal infections with a throat culture.

As the nurse is performing a physical assessment of a client, the client begins to have seizure activity including loss of consciousness and limb jerking. The nurse's priority is to:

protect the client from injury.

The nurse is reviewing the lab results of a client with suspected nephrotic syndrome. The nurse anticipates the results to include:

protein in the urine.

Erythrocytes

red blood cells

hemolytic anemia

reduction in red cells due to excessive destruction

metaplasia

reversible change in cell type

Assessment of an older adult client reveals bilateral pitting edema of the client's feet and ankles; difficult to palpate pedal pulses; breath sounds clear on auscultation; oxygen saturation level of 93% (0.93); and vital signs normal. What is this client's most likely health problem?

right-sided heart failure

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet.

A client who is experiencing angina at rest that has been increasing in intensity should be instructed to:

see the doctor for evaluation immediately.

Turner Syndrome s/s

short stature delayed puberty infertility heart defects

Atrophy

smaller size

graft

transplantation

thrombocytosis

an abnormal increase in the number of platelets in the circulating blood

iron deficiency anemia

anemia resulting when there is not enough iron to build hemoglobin for red blood cells

Blood loss anemia

anemia with abnormal blood loss

Down Syndrome s/s

delayed development slurred speech/speech delay short stature lazy eye

The nurse is caring for a client with advanced liver disease who has ascites. Which treatment will the nurse anticipate being used for the daily management of ascites?

diuretics

Marfan Syndrome s/s

tall/thin stature long limbs blurred vision mitral valve murmur

The provider notes that the client's hemoglobin is 8.2 g/dL (82 g/L). Which supplement will the provider recommend to the client?

Ferrous sulfate

In assessing a client with a fibroadenoma of the breast, what will the nurse find?

Firm, rubbery masses

The nurse is teaching a client with a diagnosis of hypertrophic cardiomyopathy and aortic valve stenosis. Which statement by the client shows that the client understands this condition?

"I should report episodes of dizziness or fainting."

Which substance, when deficient, results in a diagnosis of anemia?

Hemoglobin

anemia s/s

SOB Fatigue pallor tachycardia

Platelets

blood clotting

example of active immunity

natural- exposed acquired- vaccination

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?

"A single hormone can act on not only one process or organ but often on several different locations or processes."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:

"Because the skull sutures are not fused there may be no brain damage."

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Negative feedback loop

While teaching a family member about the development of hepatic encephalopathy, which cause is likely to be mentioned?

Neurotoxin accumulation

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 can't shake this feeling like I've received a death sentence."

Antibody testing has confirmed that a client is positive for hepatitis A virus (HAV). Which statement suggests the client understands the new diagnosis?

"I don't know why I didn't bother to get vaccinated against this."

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

"I should have my LDL monitored."

A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

"I will have to take my medication for the rest of my life."

The nurse has taught a 30-year-old female client to perform breast self-evaluation (BSE). Which statement by the client indicates correct understanding?

"I will palpate my breasts for lumps a few days after my period."

The nurse is teaching an older adult about adapting to age-related physiologic changes. Which statement by the client prompts the nurse to provide additional teaching?

"I will reduce my total daily fluid intake."

Which report by a middle-aged woman should prompt a care provider to assess for the possibility of ovarian cancer?

"I'm having a lot of indigestion and bloating, which I've never had before."

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."

The client asks, "What is reduction?" How will the nurse respond?

"It refers to realigning the bone."

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make?

"More women than men are affected by lupus."

A nurse is teaching the parent of a child with a diagnosis of Legg-Calve¨-Perthes disease about the prescribed treatment. Which statement by the parent indicates adequate understanding?

"My child will need to use crutches until the hip heals."

An older adult client who was recently diagnosed with emphysema asks the nurse what caused the disease. Which statement is the best response?

"One of the causes of emphysema is a history of cigarette smoking that causes damage to the lungs. Have you ever smoked?"

The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement?

"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."

A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which explanation is most appropriate to share?

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

The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that additional teaching is needed?

"So I can stop my insulin if I start an exercise program."

The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate?

"The circumcision will not be done now; the foreskin is needed for surgical repair."

A client's primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which instruction should the client be given?

"The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals."

A month after surgical repair of a rotator cuff tear of the shoulder, a client tells the nurse, "This is not getting any better. I still have a lot of pain and limited motion." Which response by the nurse is most accurate?

"The shoulder joint is complex and can take up to 6 months to heal depending on the injury."

A client asks the purpose of an exercise stress test. What is the nurse's best response?

"The test is used to measure functional status during stress."

While lecturing on COPD, the instructor mentions emphysema. The instructor asks the students, "If the client is a smoker, explain the physiology behind cellular changes occurring in the lung which allow destruction of the alveoli." Which students have an accurate response? Select all that apply.

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

A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be:

"This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."

A client discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The client's spouse is extremely upset because the physician stated that the client cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. What is the nurse's most accurate response?

"Thrombolytics may cause cerebral hemorrhage."

platelet count

150,000-450,000

female red blood cell count

3.6-6

Which client will likely experience difficulty maintaining lipoprotein synthesis, resulting in elevated LDL levels?

35-year-old client with history of hepatitis C and B with end-stage liver disease.

Female Hematocrit (Hct)

37%-47%

white blood cell count

4,300-10,800

Male red blood cell count

4.2-5.4

Male Hematocrit (Hct)

40-50%

At an influenza vaccination clinic, a nurse is screening clients who are requesting the vaccine. The nurse determines that which client is unable to receive the vaccine?

A 20-year-old healthy female reporting an allergy to eggs

A nurse who works in a fertility clinic is conducting a program on options for various fertility issues. The nurse judges that the participants understand the education when they identify that donor eggs are the best option for which woman?

A 42-year-old

Which sexually active woman most likely faces the highest risk of developing an ectopic pregnancy?

A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed

The nurse is caring for four clients. Select the client at risk for the development of a pulmonary embolism.

A 62-year-old male who is postoperative for repair of a fractured femur

Which client is at greatest risk for orthostatic hypotension?

A 66-year-old postoperative client on bed rest

Which individual is likely to have the highest risk of developing tuberculosis osteomyelitis?

A 79-year-old man who is immunocompromised following a bone marrow transplant.

A client with small cell carcinoma lung cancer may secrete an excess of which hormone, causing an ectopic form of Cushing syndrome due to a nonpituitary tumor?

ACTH

The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.

ACTH peaks in the morning and declines throughout the day.

Which anatomical site would the nurse expect to monitor when caring for an adult client who has just had a bone marrow aspiration performed?

Posterior iliac crest

A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first?

Administer epinephrine (adrenaline).

A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a client suspected of having a lymphoma. The nurse interprets the report as indicating:

Hodgkin lymphoma

Fluid shifts in isotonic fluid volume deficit are seen as which type of fluid shift?

Absent

The nurse evaluating a client's blood work determines that a client has an increased risk for infection based on which lab result?

Absolute neutrophil count of 800/μL (0.80 x 109/L)

The nurse is caring for a client with chronic myelogenous leukemia (CML) and notes that the client has splenomegaly and an increased basophil count as well as night sweats, bone pain, and a low grade fever. The nurse interprets the symptoms as indicating that the client is in which phase of the clinical course of CML?

Accelerated

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which factor has most likely resulted in the client's increased blood pressure?

Activation of the renin-angiotensin-aldosterone mechanism

Which client is displaying manifestations of having a kidney stone?

Acute onset of colicky flank pain radiating to lower abdomen

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:

Acute postinfectious glomerulonephritis

A 34-year-old woman presents with an abrupt onset of shaking chills, moderate to high fever, and a constant ache in her lower back. She is also experiencing dysuria, urinary frequency, and a feeling of urgency. Her partner states that she has been very tired the last few days and that she looked like she may have the flu. What is the most likely diagnosis?

Acute pyelonephritis

An adolescent male comes to the urgent care clinic. Upon assessment, the following is noted: history of circumcision, erythema of the glans, and prepuce with a malodorous discharge. Based on symptoms, the probable diagnosis would be:

Acute superficial balanoposthitis

Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication?

Acute tubular necrosis

What is a primary intervention for the nurse to implement for a client with pelvic inflammatory disease ?

Administer antibiotic therapy.

A client sustained a puncture injury to the chest resulting in development of a tension pneumothorax. What is the pathogenesis behind a tension pneumothorax?

Air is permitted to enter but not leave the pleural space, causing lung collapse.

What description is characteristic of the pathology of chronic bronchitis?

Airways are obstructed by mucus, causing hypoxemia.

Hypoglycemia has a sudden onset with a progression of symptoms. What are the signs and symptoms of hypoglycemia?

Altered cerebral function and headache

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

Select the category of hormones that include norepinephrine and epinephrine.

Amines and amino acids

The nurse is caring for a client with hepatic encephalopathy who is receiving neomycin. Which of these does the nurse monitor to determine if a positive outcome to the medication has resulted?

Ammonia level

A client taking an antihypertensive drug for several months comes to the physician's office with a dry, persistent cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?

Angiotensin-converting enzyme (ACE) inhibitors

The nurse knows that which groups of drugs influence the renin-angiotensin-aldosterone system (RAAS) for the treatment of hypertension? Select all that apply.

Angiotensin-receptor blockers ACE inhibitors Beta-adrenergic blockers (beta-blockers)

When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:

Anterior pituitary gland

When caring for the client with acute bacterial prostatitis, the nurse plans for which intervention?

Antibiotics

The nurse assesses a 65-year-old female client who reported to the emergency department with exacerbation of asthma during her daughter's wedding reception. Select all of the triggers that may have precipitated the attack.

Aspirin Dancing Emotional stress

The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?

Autocrine

A nurse is caring for a client who has systemic lupus erythematosus (SLE). Which of the following causes the disease?

Autoimmune process

What is the most common cause of hypothyroidism?

Autoimmune thyroiditis

Most primary glomerular disease is caused by which pathophysiologic disorder?

Autoimmunity

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as:

Autosomal recessive

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Autosomal recessive polycystic kidney disease (ARPKD)

A school nurse is teaching a group of fourth-grade girls about personal hygiene. Important teaching points aimed at reducing the incidence of urinary tract infection (UTI) include which of the following? Select all that apply.

Avoiding bubble baths Wiping from front to back after a bowel movement Careful hand washing

A nurse is preparing her client for a blood transfusion. She knows that a client with type A blood is said to have which type of antibodies?

B

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

Barrel chest

A client is to have a serum thyroxine and thyroid stimulating laboratory test performed to assess the baseline status of the hypothalamic-pituitary target cell hormones. When educating the client about the laboratory tests, when would the nurse inform him the test should be obtained?

Before 0800

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells

Which clinical manifestations would you expect to see in an infant diagnosed with autosomal recessive polycystic kidney disease (ARPKD)?

Bilateral flank masses and impaired lung development

The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which flowing lab value?

Bilirubin 15 mg/dL (256.56 µmol/L) (high)

Which interventions for a client with metastatic bone disease can help prevent pathologic fractures? Select all that apply.

Bisphosphonates Radiation therapy

Based on the group that statistically has the greatest risk, the health care provider should assess which ethnic group for prostate cancer?

Black

A nurse is participating in a health fair and is addressing many of the varied factors that can contribute to hypertension. The nurse should be cognizant of the higher incidence and prevalence of hypertension in which groups?

Black and South Asian people

The nurse knows that which statements regarding blood pressure in the black population are correct? Select all that apply.

Black clients often experience greater renal damage from hypertension. Hypertension is more severe among black persons compared to people from other ethnic groups. Hypertension in black clients is often treated less aggressively.

The role of inflammation in the etiology of atherosclerosis has emerged over the last few years. Which lab test is a marker for systemic inflammation?

C-reactive protein

The nurse caring for a client with respiratory acidosis examines arterial blood gas (ABG) results. Which change from the initial value indicates the client's respiratory acidosis is improving?

CO2 has decreased

Which assessment should be prioritized in the care of a client who is being treated for a serum potassium level of 2.7 mEq/L (2.7 mmol/L)?

Cardiac monitoring looking for prolonged PR interval and flattening of the T wave

When caring for a client with hyperkalemia, the nurse prioritizes assessment of which body system?

Cardiovascular

A client complains of not being able to experience satisfactory sexual intercourse. The nurse knows that erectile dysfunction is now recognized as a marker for:

Cardiovascular disease

An older adult client arrives with garbled speech, unilateral facial drooping, and weakness and unfortunately dies. Laboratory work reveals hematocrit of 54% (0.54). Which complication of polycythemia could most likely be associated with this client's death?

Cerebral thrombosis

A nurse is caring for an older adult client with a urinary tract infection (UTI). The nurse understands which information about UTI's in the older adult population? Select all that apply.

Client may have no symptoms. The UTI may be reflected in a change in the client's mental state. UTI is relatively common in older adults.

When assessing the nutritional intake of a client with generalized pancreatic cancer, which statement by the client is consistent with the disease and food intake?

Client states pain becomes worse with food intake.

The nurse anticipates that which client would be considered a good candidate for coronary artery bypass grafting (CABG)?

Client who failed a percutaneous coronary intervention (PCI) and has a history of myocardial infarction (MI) experiencing new-onset pain and ST elevation

When caring for a group of clients, the nurse recognizes which of these individuals has increased risk for balanitis?

Client with a sexually transmitted infection

Which of the following describes surgical correction of tetralogy of Fallot?

Closure of the ventricular-septal defect and relief of the right ventricular outflow obstruction

A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply.

Consume a diet rich in fruits, vegetables, and low-fat dairy products. Stop smoking. Reduce dietary sodium intake. Limit alcohol consumption.

infection

Contamination or invasion of body tissue by pathogenic organisms

A client with long-term diabetes mellitus reports a "pins and needles" feeling in the feet. What interventions can help reduce this symptom? Select all that apply.

Control blood glucose Gabapentin Lidocaine patch

A 3-year-old boy has been diagnosed with croup (acute laryngotracheobronchitis). The nurse anticipates the plan of care to include:

Cool, humidified air to relieve airway spasms

What intervention is appropriate for a client with sarcoidosis?

Corticosteroids

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

Cortisol, a glucocorticoid

A client consistently has an elevated systolic BP greater than 150 mm Hg but a diastolic pressure in the 80s. The health care provider should be assessing for which complication?

Crackles in bilateral lung bases caused by left-sided heart failure

The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers?

Sensory neuropathy

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

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which disorder was the player's most likely cause of death?

Hypertrophic cardiomyopathy (HCM)

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

Deviated trachea

A client presented to the emergency department with a sudden onset of unilateral weakness and gait disturbances. The client has undergone rapid assessment and diagnostic testing and the nurse has just received an order for STAT administration of tissue-type plasminogen activator (tPA). What conclusion can the nurse draw from this medication order?

Diagnostic testing has ruled out the presence of a hemorrhagic stroke.

When blood pressure is measured, pressure rises during ventricular contraction, then falls during relaxation. As the pressure falls, there is a brief rise as the aortic valve closes. This rise is known by which terminology?

Dicrotic notch

Which assessment is most likely to reveal a potential exacerbation in a 70-year-old client's diagnosis of benign prostatic hyperplasia (BPH)?

Digital rectal examination

When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which diagnostic test?

Dual-energy x-ray absorptiometry (DXA)

A nurse assesses a client with normal biomarkers who reports angina. Which additional manifestations are late signs of aortic stenosis? Select all that apply.

Dyspnea Peripheral cyanosis Syncope

The nurse is conducting a staff in-service program on non-Hodgkin lymphomas. The nurse should include that essentially all people with Burkitt lymphoma have evidence of infection with:

EBV

The client has been diagnosed with an acute leukemia. Which signs and symptoms would the practitioner expect to assess in this client? Select all that apply.

Ecchymosis Epistaxis Fatigue

When teaching a community education class on osteoarthritis (OA), the nurse should include which demographic in discussing which individuals are at risk for this problem? Select all that apply.

Elderly individuals Older women Obese people

An adult client with good overall health has reported headaches and dizziness in recent weeks. The nurse's assessment reveals blood pressure of 158/99 mm Hg, which is unprecedented for the client. On observation, the client's skin appears reddened, though he denies feeling warm. The nurse should anticipate what further diagnostic finding?

Elevated RBC, hemoglobin, and hematocrit.

Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?

Excess ACTH production by a pituitary tumor

Raynaud disease or phenomenon is a functional disorder caused by intense vasospasm of the arteries and arterioles in the:

Fingers

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

A nurse admitting a client to the emergency department with a suspected fracture notes a deep abrasion with bruising. The client reports receiving a hard tackle during a football game. Which grade of tissue damage accompanies this fracture?

Grade 2

graft vs host disease

Grafted Immunocompetent T cells proliferate in the irradiated immunocompromised host and reject cells with 'foreign' proteins, resulting in severe organ dysfunction. RASH, Jaundice, Diarreha, Hepatosplenomegaly.

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Graves disease

The nurse is caring for a client with lichen simplex chronicus. What assessment finding does the nurse expect?

Gray-white plaques with an irregular surface

An individual affected by a basal-ganglia associated movement disorder is affected by dyskinesias. Which assessment correlates with dyskinesia?

Grimacing and lip pursing

Loss of pituitary function can result in deficiencies (or loss) of secretions of which hormones? Select all that apply.

Growth hormone Luteinizing hormone Follicle stimulating hormone Prolactin

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

Hematuria

The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which complete blood count (CBC) result is characteristic of this type of anemia?

Hemoglobin 7.8 g/dL (78 g/L)

The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education?

Hemoglobin A1C level is 8.7%.

A client is suspected of having lymphoma and is having diagnostic tests performed to determine the type of lymphoma. Which form of lymphoma does the nurse recognize has the classic symptoms of pruritus and intermittent fevers associated with night sweats?

Hodgkin lymphoma (HL)

Which statement best explains the function of hormone receptors?

Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.

When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?

Hormone stimulation

Common results of acute respiratory failure are hypoxemia and:

Hypercapnia

When caring for the client with acute pancreatitis, which alterations does the nurse recognize is consistent with the disease?

Hyperglycemia

Which manifestation typically accompanies an asthmatic attack?

Hyperinflation of the lungs

A client has developed atherosclerosis. The nurse knows that a major cause for this disorder is:

Hypertension

Which statements regarding hypertension are correct? Select all that apply.

Hypertension is more frequent among younger men than in younger women. Hypertension is a major risk factor for cardiovascular disease. Hypertension is one of the most common health problems for adults.

A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?

Hypertrophic cardiomyopathy

A young college football player was bought to the emergency room after collapsing on the football field during practice. When arriving he was unconscious and his ECG was abnormal. Subsequently he died after arresting in the emergency room. What does the physician suspect is the likely cause of this?

Hypertrophic cardiomyopathy

A 9-year-old child has been diagnosed with the nephrotic syndrome. Place the following stages in the development of this health problem in ascending order. Use all the options.

Hypoalbuminemia Increased glomerular membrane permeability Proteins escape from plasma to glomerular filtrate Decreased colloidal osmotic pressure Accumulation of fluid in interstitial tissue (edema).

The nurse is performing a newborn assessment on a 2-day-old male infant. Assessment reveals the presence of the urethral opening on the ventral side of the penis. The nurse would document this finding as being:

Hypospadias

A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?

Hypothalamus

An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?

Hypothyroidism

The nurse is caring for a client diagnosed with pneumonia. The client's arterial blood gas results identify decreased level oxygen and other laboratory work reveals an increase in lactic levels. How will the nurse interpret these findings?

Hypoxemia

A nurse is monitoring a client with anemia and low oxygen levels. The nurse knows that which condition stimulates the secretion of erythropoietin?

Hypoxia

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

The nurse is caring for the client with hepatocellular carcinoma. What does the nurse recognize is a cause of this disease?

Illness with hepatitis B or C

A nurse is assessing a client who is experiencing hypoglycemia caused by an insulin reaction. The client is conscious and can follow directions. Which intervention is most appropriate at this time?

Immediately administer a rapidly absorbed form of glucose (preferably via oral route if the client is alert enough to swallow).

In addition to direct invasion of the vascular wall by an infectious agent, what pathogenic mechanism is a common cause of vasculitis?

Immune-mediated inflammation

What is the underlying cause of respiratory failure in a child with bronchiolitis?

Impaired gas exchange

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the client's temperature is 102°F (38.9°C). Which other clinical manifestations may lead to the diagnosis of encephalitis?

Impaired neck flexion resulting from muscle spasm

An 86-year-old client is disappointed to learn that he or she has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which age-related change predisposes older adults to the development of heart failure?

Increased vascular stiffness

A client asks the nurse if it is possible to contract influenza by being exposed to wound secretions. On what knowledge should the nurse base her response to the client?

Influenza transmission occurs by inhalation of droplet nuclei.

A 22-year-old man is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. Which immediate treatments are likely to most benefit the man?

Infusion of normal saline or Ringer's lactate to maintain the vascular space.

Which situations would result in an increased intestinal production of ammonia in a client? Select all that apply.

Ingested a high-protein lunch. Was admitted with a gastrointestinal (GI) bleed.

A client with a blood glucose reading of 673 mg/dL (37.4 mmol/L) is diagnosed with diabetic ketoacidosis (DKA). Blood gas results are as follows: serum pH 7.29; HCO3− level 19 mEq/dL (19 mmol/L); PCO2 level 32 mm Hg. The nurse should prepare for which initial treatment orders?

Initiating an insulin IV infusion along with fluid replacement

The diagnosis of type 1 diabetes would be confirmed by which principle?

Insulin is not available for use by the body.

Which metabolic abnormality can lead to the development of type 2 diabetes?

Insulin resistance

The nurse knows that metabolic abnormalities that lead to type 2 diabetes include which physiologic problems? Select all that apply.

Insulin resistance Beta cell failure Hepatic glycogenolysis

Lymph fluid arises directly from which space?

Interstitial

Which disorder of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

Intravaginal testicular torsion

The rate at which hemoglobin is synthesized depends on availability of which substance?

Iron

A newborn is diagnosed with Tetralogy of Fallot. Prior to surgery, which abnormality should be corrected to prevent a stroke?

Iron deficiency anemia

A client reporting low abdominal pain, purulent cervical discharge, and painful intercourse is diagnosed with pelvic inflammatory disease (PID). The provider educates the client about this disease mentioning which statement?

Is a polymicrobial infection of the upper reproductive tract

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

Ischemic stroke

The nurse is performing an assessment for a client who is experiencing shortness of breath. The nurse notes a full and bounding pulse, crackles in the lung fields, and jugular vein distention. The nurse recognizes symptoms of which problem?

Isotonic fluid volume excess

A client who has just been diagnosed with mitral valve stenosis tells the nurse that he has heard of the disease but he does not know anything about it. What would be the nurse's best response?

It is a defect of the mitral valve which causes obstruction of blood flow.

The nurse is evaluating a client's blood gases. The client has a pH of 7.35. How does the nurse interpret this value?

It is within a normal range.

In general, how are children affected by a rheumatic disease such as juvenile idiopathic arthritis (JIA)?

It's characterized by synovitis and can influence epiphyseal growth, resulting in stunted growth.

Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)?

Joint pain and proteinuria

Following a lengthy series of diagnostic tests, a client's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this client most likely to require?

Joint replacement surgery

A client has been ill for several days and has not had anything to eat, consuming only about 6 oz of water per day. The client has been vomiting and having diarrhea. Which condition is the nurse most concerned about the client developing?

Ketoacidosis

Athletic injuries fall into two types: acute or overuse injuries. Where do overuse injuries commonly occur?

Knee

The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?

Kupffer cells

A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess?

Kyphosis

A client develops hypocalcemia after thyroid surgery. Which hormonal imbalance caused this complication?

Lack of parathyroid hormone

A client with a longstanding diagnosis of short bowel syndrome is brought to the emergency room due to disorientation and slurring of words. The client did not have any alcohol within the last 24 hours. Which condition might be the cause of her symptoms?

Lactic acidosis

The health care provider suspects a diagnosis of endometriosis. Which procedure provides a definitive diagnosis?

Laparoscopy

Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis?

Laryngeal edema

A 6-year-old child has developed idiopathic osteonecrotic disease of the proximal (capital) femoral epiphysis. The health care provider would document this finding as which diagnosis?

Legg-Calvé-Perthes disease

A client's bone marrow study report reveals the findings of blast cells in the bone marrow. What does the nurse interpret this as indicating?

Leukemia

The pediatrician knows that the most common cause of cancer in children is:

Leukemia

A nurse educator is explaining to a group of students the differences between leukemias and lymphomas. With respect to classification of these diseases, which explanation is most accurate?

Leukemia arises from precursors in marrow, and lymphomas originate in peripheral lymphoid structures.

Which factor differentiates chronic leukemias from acute leukemias?

Leukemic cells are more fully differentiated in chronic than in acute leukemias.

When caring for the client with portal hypertension and ascites, which dietary intervention does the nurse suggest to prevent the progression of fluid accumulation?

Limit intake of sodium.

What laboratory markers are most commonly used to diagnose acute pancreatitis?

Lipase and amylase

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct?

Local

If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?

Lower extremities

The nurse is conducting education for a client who is scheduled to undergo diagnostic testing for non-Hodgkin lymphoma (NHL). The nurse includes information on:

Lymph node biopsy

A client has been admitted to a medical unit of a hospital for the treatment of pneumonia that is attributable to S. pneumonia. Which consideration is the priority in this client's treatment?

Maintaining the client's ventilation

A woman reports to the primary healthcare provider that she experiences monthly changes before her menstrual cycle. Which statement demonstrates understanding of premenstrual disorders?

Many women report premenstrual emotional or physical changes.

Which factor contributes to an infant developing macrosomia (large body size)?

Maternal diabetes

Which maternal factor contributes to an infant having macrosomia, hypoglycemia, and hyperbilirubinemia?

Maternal diabetes

The ovaries have a dual function. The nurse is able to explain to the client that any problems with the ovaries frequently cause which problem?

Menstrual and fertility problems

The nurse is caring for a client with asterixis. Which assessment should the nurse make to help a diagnosis of hepatic encephalopathy?

Mental status

A child accidentally consumes a container of wood alcohol. The ED physician knows that the child is at risk of developing which of the following?

Metabolic acidosis

A client admitted to the hospital with severe diarrhea has a K+ level of 6.7 mEq/L (6.7 mmol/L), symptoms of paresthesia, restlessness, and dyspnea. What could have caused his condition?

Metabolic acidosis

The nurse is caring for a client who has excessive diarrhea. Which acid-base disturbance does the nurse anticipate uncovering during evaluation of the arterial blood gas?

Metabolic acidosis

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

The nurse is monitoring the renal health of a client with diabetes mellitus. What assessment is the earliest warning sign of diabetic nephropathy?

Microalbuminuria

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminuria is a predictor of future nephropathies.

During chronic blood loss, iron deficiency anemia occurs. Most clients are asymptomatic until their hemoglobin falls below 8 g/dL (80 g/L). The red blood cells that the body does produce have too little hemoglobin. What is the term for the resulting anemia?

Microcytic hypochromic

Which treatment regimen is most likely to result in stable blood glucose levels for a client with a diagnosis of type 1 diabetes?

Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed

The nurse working in the emergency room triages a client who comes in reporting chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myocardial infarction. The client is given a nitrate, which does nothing for his pain. Which medication should the nurse suspect the doctor will order next for the pain?

Morphine

The nurse caring for a client with metabolic alkalosis should anticipate which laboratory results to confirm the diagnosis?

pH of 7.45 and HCO3 of 24 mEq/L (24 mmol/L)

The nurse is developing a plan of care for a client diagnosed with stable angina. Select the most important goal for this client.

Myocardial infarction prevention

A client who developed a deep vein thrombosis during a prolonged period of bed rest has deteriorated as the clot has dislodged, resulting in a pulmonary embolism. Which type of shock is this client at risk of experiencing?

Obstructive shock

A client with a history of alcohol abuse presents to the emergency department vomiting large amounts of bright red blood that the health care provider suspects is due to esophageal varices. Which drug that reduces splanchnic and hepatic blood flow should the nurse anticipate being prescribed?

Octreotide, a long-acting synthetic analog of somatostatin

Select the manifestations of renal cell carcinoma. Select all that apply.

Often silent in the early stages Hematuria Palpable flank mass

Hypothalamic sensory neurons that promote thirst when stimulated are called:

Osmoreceptors

When assessing a client with acute cholecystitis, the nurse anticipates the client's report of pain will be consistent with which description?

Pain in the right upper quadrant referred to the same shoulder

Which of the following are characteristic signs of acute arterial embolism?

Pallor, pulselessness, and pain

The nurse is teaching clients with diabetes about the increased risk for erectile dysfunction (ED). What factors related to diabetes does the nurse link to increased risk for ED? Select all that apply.

Peripheral artery disease Peripheral neuropathy

Which body systems work with the endocrine system to regulate body functions? Select all that apply.

Peripheral nervous system Immune system Central nervous system

While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which physiologic process?

Peripheral vascular resistance

The nurse is caring for a client with metabolic alkalosis. Which of these arterial blood gas results supports this diagnosis?

pH of 7.50 and HCO3 of 45 mEq/L (45 mmol/L)

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

When a 3-day-old full-term infant has an elevated bilirubin level of 18 mg/dL (307.87 μmol/L), the nurse will expect to support which intervention?

Phototherapy

Shoulder and rotator cuff injuries usually occur from trauma or overuse. What may be prescribed for conservative treatment of an injured shoulder? Select all that apply.

Physical therapy Corticosteroid injections Anti-inflammatory agents

A child is brought to the emergency department with a respiratory infection. The child is struggling to breathe and is very anxious. The health care providers suspect epiglottitis. Which intervention would be a priority?

Place the child upright in bed and begin preparing for a tracheostomy placement.

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

A client diagnosed with Goodpasture syndrome would require which therapy to remove proteins and autoantibodies from the system?

Plasmapheresis

The nurse is performing an admission assessment on a client with the diagnosis of primary polycythemia. The nurse anticipates which clinical findings? Select all that apply.

Plethoric appearance of the lips Hypertension Itching Pain in fingers

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

Pain is an expected assessment finding in clients who have which lung disease?

Pleuritis

Which disorder of the female genitourinary system is most likely to result from a disruption in normal endocrine function?

Polycystic ovary syndrome (PCOS)

Select the most common symptoms of diabetes. Select all that apply.

Polydipsia Polyuria Polyphagia

Guillain-Barré syndrome is characterized by which form of neuron damage?

Polyneuropathy

A client is diagnosed with diabetic ketoacidosis (DKA) in the emergency department. Which clinical manifestations will the client likely exhibit?

Polyuria, polydipsia, vomiting, and fatigue

The nurse is preparing a client with suspected leukemia for a bone marrow and biopsy. What preferred site will the nurse be sure is accessible for the physician?

Posterior iliac crest

leukocytes

white blood cells

A client experiencing increasing fatigue in recent months has an echocardiogram that reveals the client's end-diastolic volume is insufficient. Which other parameter of cardiac performance will directly decrease as a result?

Preload

A client has been diagnosed with endometriosis. What assessment finding does the nurse expect? Select all that apply.

Premenstrual pain Back pain Pelvic pain

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

Following peripheral blood testing and a bone marrow biopsy, a client has been diagnosed with chronic myelogenous leukemia. Which abnormality is most likely to have preceded the client's diagnosis?

Presence of a Philadelphia chromosome

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?

Prevent accumulation

The nurse is assessing a client who has experienced a seizure. The client describes having a feeling or warning that the seizure would occur. Which term does the nurse use when documenting about this perceived warning?

Prodrome

A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?

Prolactin

A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be:

Prompt diagnosis and treatment of streptococcal infections

The nurse is caring for a client who has a positive tuberculin test. The client has close contact with family members who have active tuberculosis (TB), but the client does not have active TB (per negative x-ray). Which treatment is most appropriate for the client?

Prophylactic treatment with isoniazid

Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?

Proteins

A 3-year-old child has been admitted to the pediatric unit for the treatment of croup. The nurse should include which action in the child's plan of care?

Providing cool, moist air for the child to breathe

A client is suspected of having Hodgkin lymphoma. Which classic assessment findings would confirm Hodgkin lymphoma?

Pruritus and night fevers

The parent of a toddler with Duchenne muscular dystrophy reports that the child has an increase in muscle size but a decrease in strength. The nurse documents this using which medical term?

Pseudohypertrophy

A client with schizophrenia is admitted to the behavioral health department and is observed drinking copious amounts of water and voiding large amounts of dilute urine. The nurse recognizes this behavior is consistent with which problem?

Psychogenic polydipsia

A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?

Psychological manifestation due to involvement of white matter of cerebral cortex

The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent:

Pulmonary embolism

Three days following surgical repair of a hip fracture a client becomes anxious and complains of sudden shortness of breath. What disorder is the client most likely experiencing?

Pulmonary embolism

The nurse reviews the lab results for a client who has advanced autosomal dominant polycystic kidney disease (ADPKD). The client 's hemoglobin is 8.8 g/dL (88 g/L). The nurse suspects this lab value is related to which cause?

Reduced production of erythropoietin

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

Pulmonary hypertension

Which situation related to transition from fetal-to-perinatal circulation would be most likely to necessitate medical intervention?

Pulmonary vascular resistance, related to muscle regression in the pulmonary arteries, rises over the course of the infant's first week.

Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is their response?

Pulmonary vessels constrict

A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Which action by the new RN indicates a need for more education?

Raising the head of the bed to a high Fowler's position

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?

Rank below 10% on the growth chart

Premature infants who are treated with mechanical ventilation, mostly for respiratory distress syndrome, are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. What are the signs and symptoms of BPD?

Rapid and shallow breathing and chest retractions

A client diagnosed with the common cold has been taking an over-the-counter antihistamine for the control of symptoms. What should the client be aware may occur if the drugs are used too frequently over too many days?

Rebound symptoms

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

Recently had a urinary tract infection

What of these would be tested by a complete blood count (CBC)?

Red blood cells and platelets

A client with a compound fracture of the femur is in balanced skeletal traction. Which assessment data must be reported immediately?

Redness and heat at fracture site

The nurse is caring for a client diagnosed with sickle cell disease. For which factor should the nurse assess to prevent the cells from sickling?

Reduced oxygen tension while the client sleeps

The nurse is caring for a client who is receiving exogenous corticosteroids for rheumatoid arthritis. Recognizing that hormone levels are regulated by negative feedback, which laboratory test result does the nurse anticipate uncovering when reviewing the medical record?

Reduction in ACTH

The nurse is educating the client with a cold about the use of over-the-counter (OTC) decongestants. What expected outcome does the nurse anticipate with the use of this medication?

Reduction of nasal swelling

The transmission of impulses at the neuromuscular junction is mediated by which action?

Release of neurotransmitter acetylcholine from autonomic nerve endings

The nurse is caring for a client who complains of headache and blurred vision. The nurse recognizes that these symptoms, accompanied by increased plasma partial pressure carbon dioxide (PCO2) level and decreased pH level, are consistent with which diagnosis?

Respiratory acidosis

A client has started having uncontrolled seizures that are not responding to usual medications. Nurses working with the client must pay special attention to which priority aspects of this client's care? Assessment of:

Respiratory status and oxygen saturation

Which organism is a common cause of bacterial pneumonia in both community and hospital settings?

S. aureus

The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects which physiologic principle?

Salt and water tubular reabsorption

A 20-year-old college student being treated for a kidney infection developed a temperature of 104ºF (40°C) in spite of treatment with antibiotics. Her pulse was high, her blood pressure was low, and her skin was hot, dry, and flushed. The nurse knows that this client most likely is experiencing which type of shock?

Septic

The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?

Septic shock

A 26-year-old client has an absolute neutrophil count of less than 500 cells/mm3 (0.50 x 109/L) Which interpretation of this lab value is accurate?

Severe neutropenia

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?

Short acting

A child is brought to the emergency department with an asthma attack. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which drug will the nurse anticipate administering first?

Short-acting beta 2-adrenergic agonists such as albuterol (SABA)

Which description of symptoms would the nurse expect to obtain from a client with exacerbation of sarcoidosis?

Shortness of breath, non-productive cough, and chest pain

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Significant genital enlargement

Which complication of spinal cord injury is the most preventable in a paraplegic client?

Skin breakdown

A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma?

Slow-growing

A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. About which topics should the nurse educate the client? Select all that apply.

Smoking cessation Dietary measures to reduce LDL levels Weight reduction if overweight

A client asks, "What caused my acute prostatitis?" Which response by the nurse explains the most common cause of acute prostatitis?

Urethral infection with Escherichia coli

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

Smoking cessation program

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

Somogyi effect

The nurse practitioner determines that the client receiving chemotherapy has mild neutropenia. Which signs and symptoms would the practitioner expect to see in this client? Select all that apply.

Stomatitis Diarrhea

A client has developed bacterial pneumonia and is admitted to the hospital. The nurse obtains sputum cultures upon admission. What bacteria does the nurse anticipate finding when the results are complete?

Streptococcus pneumoniae

A nurse at a long-term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the client's TIAs?

TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? Select all that apply.

Tachycardia Delirium Very high fever

What is the most important discharge instruction for a female client with pelvic inflammatory disease (PID)?

Take all of the antibiotic

A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:

Tearing or ripping-type pain in the chest or back

A parent of a toddler is concerned about possible side effects of influenza immunizations. What will the nurse teach the parent regarding the influenza vaccine?

The Centers for Disease Control and Prevention recommends that all people 6 months of age and older should receive the annual influenza vaccine.

A client is diagnosed with choledocholithiasis and acute suppurative cholangitis and is being rushed to surgery to prevent which possible complication?

The accumulation of purulent bile, which can cause sepsis.

The client has been diagnosed with Raynaud disease. Which treatment measure will the nurse teach the client?

The client must protect the entire body from cold, not just the extremities.

The nurse is providing education to a client with Addison disease who has been treated for hyponatremia and hypoglycemia related to the disease. The nurse inform the client that which action should be taken to ensure control of these conditions?

The client should eat and exercise on a regular schedule.

The nurse is providing education for a client diagnosed with hypothyroidism. What information about diet should the nurse be sure to include in this information?

The client should maintain a low cholesterol diet.

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

The client states his hand is numb.

A client had a tuberculin skin test (TST) performed as part of the immigration process and is surprised that the results are positive. How should the nurse best interpret this result?

The client was exposed to the tubercle bacillus at an indefinite point in the past.

The nurse is caring for the following clients. Select the client at highest risk for the development of atelectasis.

The client who is postoperative after a total knee replacement and receiving patient-controlled analgesia

A nurse is providing education to a client newly diagnosed with Guillain-Barré syndrome. Which statement reflects accurate information about the course of the disease?

The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.

A client suffering from chronic hypertension is beginning to show the symptoms of glomerular disease. This client's kidney damage is due to what phenomenon?

The higher pressures force protein and cells through the glomerular membrane, resulting in glomerular inflammation.

When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism?

The hypothalamic-pituitary-target cell system

Which physiologic process best exemplifies a positive feedback mechanism?

The increase in prolactin secretion that occurs with more frequent breast-feeding

The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include?

The injections will be given only 3 to 4 times per year because they can increase joint destruction.

The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system?

The kidneys

A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborne Mycobacterium tuberculosis (TB) and has subsequently developed latent tuberculosis infection. Which statement is accurate regarding this nurse?

The nurse is likely asymptomatic.

When it is determined that a client's red blood cells (RBCs) have a biconcave shape, what will be the nurse's reaction?

The nurse will be pleased, as that shape allows for increased oxygen diffusion.

A client has been diagnosed with pneumococcal infection. The nurse shares with the client which statement about the spread of the disease?

The spread of this bacteria, especially the antibiotic-resistant strain, is largely by healthy, colonized individuals.

The parents of a child with cystic fibrosis ask the nurse to explain the sweat test performed on their newborn. How should the nurse respond?

The sweat test measures the concentration of salt in the infant's sweat.

A neonate is born with a congenital heart defect. The nurse realizes this defect most likely originated during which week of development?

The third week of development

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

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?

Uric acid

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

Uric acid stones

The nurse is providing education to a client recently diagnosed with multiple sclerosis. The nurse instructs the client regarding which symptoms commonly occurring with multiple sclerosis? Select all that apply.

Visual loss or blurring Paresthesias of extremities Difficulty swallowing

The nurse is caring for a client who is a strict vegetarian; the client is at greatest risk for the development of:

Vitamin B12 deficiency anemia

A 45-year-old client is undergoing exercise stress testing. At which point will the test be halted and not allowed to continue?

When the client experiences chest pain

A cytotechnologist is performing genetic testing on a series of tissues. One tissue comes back with the WT1 mutation, and it's mapped to chromosome 11. What disease will the client most likely develop?

Wilms tumor

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which risk factor in the teaching?

Woman with a family history of diabetes

A client is diagnosed with pneumoconiosis. Which aspect of the client's history is most likely the cause of this diagnosis?

Worked in a coal mine for 20 years

megaloblastic anemia

a blood disorder characterized by anemia in which the red blood cells are larger than normal

inflammation

a localized response to an injury or to the destruction of tissues

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.

Disseminated Intravascular Coagulation (DIC)

abnormal blood clotting in small vessels throughout the body that cuts off the supply of oxygen to distal tissues, resulting in damage to body organs

Hodgkin Lymphoma (HL)

abnormal reed-sternberg cells

When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize that the pathogenesis begins with an inflammatory process whereby:

activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.

The nursing caring for a 62-year-old client with diffuse large B-cell lymphoma plans care based on the knowledge that this client's lymphoma is:

aggressive.

The use of oxygen at a rate above 2 L/minute is inappropriate for a client with:

chronic obstructive pulmonary disease (COPD), sitting in bed with cyanosis and pulse oximeter reading 57%.

A child is experiencing an acute exacerbation of asthma. Which quick-acting treatment is most appropriate for this client?

beta-adrenergic agonists

Mitral valve prolapse occurs frequently in the population at large. Its treatment is aimed at relieving the symptoms and preventing complications of the disorder. Which drug is used in the treatment of mitral valve prolapse to relieve symptoms and aid in preventing complications?

beta-adrenergic blocking drugs (beta-blockers)

As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased:

bicarbonate/carbonic acid regulation.

active immunity

body has developed antibodies from previous exposure

An adult client reports persistent vaginal irritation and recurrent infections. In her history the physician notices that she recently has been prescribed antibiotics for a respiratory infection and concludes that it has affected her normal flora by:

causing the vaginal environment to be more alkaline than normal.

The nurse is conducting a community education program on concussions. The nurse will include that the brain is protected from external physical forces by which part of the nervous system?

cerebrospinal fluid

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.

The term chronic obstructive pulmonary disease (COPD) can be a combination of two types of obstructive airway diseases. Which disease processes have been identified as being part of COPD?

chronic bronchitis and emphysema

hyperplasia

increase in number of cells

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 pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output.

compensatory mechanisms

A client is prescribed the recumbent granulocyte colony-stimulating factor (CSF) filgrastim. The nurse evaluates the effectiveness by monitoring which laboratory value?

complete blood count (CBC)/differential

Disseminated Intravascular Coagulation (DIC) cause

complication from other conditions structurally weak vessels damage to vessels

A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that:

cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

risk factors of thrombocytosis

deep vein thrombosis pulmonary embolism

panocytopenia

deficiency of all cells

neutropenia

deficiency of neutrophils

Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?

elevated anti-nuclear antibodies (ANA)

A client has been diagnosed with breast cancer following a suspicious mammogram followed by biopsy. The nurse who is planning this client's care should recognize that her prognosis is primarily dependent on the:

extent to which lymph nodes are involved.

neutropenia s/s

fever, sore throat, increased vulnerability to infection

adaptive immunity

immunity or resistance to a specific pathogen; slower to respond, has memory component

What is used during transplantation to reduce risk of rejection?

immunosuppressive drugs

A client with osteoarthritis states that every morning "it gets harder and harder to loosen up". The client's main therapy to this point is the use of over-the-counter nonsteroidal anti-inflammatories (NSAIDs). These drugs reduce the client's pain by:

inhibiting prostaglandin synthesis.

A client is brought to the emergency department and immediately diagnosed with a tension pneumothorax. The priority intervention would be:

insertion of a large-bore needle or chest tube.

pernicious anemia

lack of mature erythrocytes caused by inability to absorb vitamin B12 into the bloodstream

hypoxia/hypoxemia

lack of oxygen

Hemophilia s/s

large deep bruising joint pain internal bleeding

hypertrophy

larger size

plasma

liquid w/ plasma proteins

Thrombocytopenia

low platelet count

Which unit of measure best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?

mEq/L

lymphoma

malignant tumor of lymph nodes and lymph tissue

A middle-aged female client has been diagnosed with a thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases the answer on the knowledge that thyroid hormones:

may take days for the full effect to occur, based on the mechanism of action.

example of passive immunity

natural- mom to fetus acquired- injection after exposure

How does innate immunity work?

neutrophils and macrophages digest pathogen

The nurse is teaching a client with systemic lupus erythematosus (SLE) about the typical treatment course with this condition. Place in order the typical classes of medication used from earliest stages to the latest stages of the disease. Use all options.

nonsteroidal anti-inflammatory drugs (NSAIDs) antimalarial drug (hydroxychloroquine) systemic corticosteroid drugs immunosuppressive medications

cause of thrombocytopenia

not enough vitamin k excessive destruction excessive production

A client with severe hypoglycemia is unconscious. Which method of providing glucose should not be used for this client?

orange juice orally

Bilirubin

orange-yellow pigment in bile; formed by the breakdown of hemoglobin when red blood cells are destroyed

Water movement from the side of the membrane having a lesser number of particles and greater concentration of water to the side having a greater number of particles and lesser concentration of water is termed:

osmosis

A client with chronic obstructive pulmonary disease (COPD) receives oxygen in the emergency department at a rate of 4 L/min for acute respiratory distress. Later, the nurse finds the client unresponsive with a respiratory rate of 8 breaths/minute. What arterial blood gas (ABG) values would the nurse expect to obtain?

pH 7.29, PCO2 67 mm Hg (8.91 kPa), HCO3- 26 mEq/L (26 mmol/L), PO2 64 mm Hg (8.51 kPa)

When caring for the client with hyperkalemia, the nurse recognizes the body should respond in which of these ways?

secrete potassium in the distal tubules for excretion

The nurse is caring for a client who is experiencing an increased level of aldosterone secretion. The nurse anticipates that the client may develop:

sodium and water retention.

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:

sperm production.

Which treatment intervention is recommended for infants who have a severe case of hypospadias?

surgical repair

passive immnunity

the body is given antibodies

A client who is being treated for small-cell lung cancer has been placed in protective isolation due to neutropenia. The most likely cause of this client's neutropenia is:

the effects of chemotherapy on white blood cell development.

metastasize

the process by which cancer spreads from one place to another

A client reporting bone pain has sought care. Diagnostic testing reveals that the client has developed osteonecrosis. When addressing the most likely cause of this complication, the nurse should focus on:

the quality and quantity of blood flow to the site.

Which event(s) in a client's history increases risk of developing osteoarthritis? Select all that apply.

torn meniscus in left knee at age 19 loose body in knee joint at age 40 hip dislocation at age 35

autograft

transplantation of healthy tissue from one site to another site in the same individual

conjugated bilirubin

water soluble; never normal in urine

Which clinical manifestations lead the health care worker to suspect the client is at the end-stage expression of hypothyroidism? A client:

who takes analgesics for chronic pain and goes into a coma brought to the emergency department with hypothermia who presents with low serum sodium levels