Patho exam 1
The nurse is formulating a care plan that includes dietary components to reduce cancer risk. Which information should the nurse share with the client? Select all that apply.
1. Increase fiber intake 2. Increase lycopene intake 3. Increase intake of vitamins A and D 4. Increase intake of cruciferous vegetables
A nurse is teaching a class to older adults about aging and the stress-age syndrome. Which information should the nurse include in the teaching session? Select all that apply.
1. Increased cortisol levels 2. Increased coagulation of blood 3. Increased catecholamine levels
A nurse is asked by a co-worker which physiologic changes occur when epinephrine is released during the stress response. How should the nurse reply? Select all that apply.
1. Increased lipolysis 2. Increased blood glucose 3. Increased force of cardiac contraction
A nurse is teaching adults at a wellness clinic about melanoma. Which information from the adults indicates successful teaching? Select all that apply.
1. Individuals with fair skin are at risk for melanoma. 2. Melanoma may suddenly appear without warning. 3. Intermittent sun exposure is the most significant factor for developing melanoma.
Which of the following physiological responses are evident in the stress response? (Select all that apply) A. Secretion of norepinephrine B. An increased level of ACTH C. Increased release of insulin D. Vasodilation E. Increased cardiac output
A. Secretion of norepinephrine B. An increased level of ACTH E. Increased cardiac output
A patient receives the first injection in an immunotherapy desensitization treatment. He soon develops hives, coughing, and wheezing. Which of the following actions should be taken first? A. Apply oxygen B. Start an IV C. Administer epinephrine D. Administer an antihistamine
C. Administer epinephrine
A patient is being treated for cancer with chemotherapy that causes bone marrow suppression. Which of the following conditions can be attributed to bone marrow suppression? A. Pain B. Anorexia C. Anemia D. Nausea and Vomiting
C. Anemia
A patient is scheduled to begin external beam radiation to the right axilla. Which of the following instructions should be given to this patient? A. Apply a heating pad to promote circulation to the area B. Use cold compresses to relieve pain C. Do not apply deodorant to the right axilla D. Immobilize the right arm
C. Do not apply deodorant to the right axilla
Which cancer is most likely to be difficult to treat? A. Grade I, T1 N0 M0 B. Grade II, T1 N3, M0 C. Grade III, T3, N3, M1 D. Grade IV, T2, N0, M0
C. Grade III, T3, N3, M1
A patient infected with HIV has a CD4 count of 190 cells/µL. What does this indicate about the patient's condition? A. The patient is in the window period B. The patient is in the latent phase of infection C. The patient has chronic HIV infection D. The patient has AIDS
D. The patient has AIDS
Which of the following is unlikely to transmit HIV? A. Blood B. Vaginal Secretions C. Breast Milk D. Urine
D. Urine
A client is stressed and releases cortisol. Which physiologic effect of cortisol does the nurse expect to occur?
Decreased bone formation
A client states that there was a lot of drainage from the wound and it felt like "something gave way." What does the nurse expect the client is experiencing?
Dehiscence
A nurse is explaining how a leukocyte moves through inter-endothelial junctions to the site of tissue injury. Which term should the nurse use to describe this process?
Diapedesis
During the history taking of a client, a nurse discovers the client is a bidi smoker. For which cancer should the nurse teach the client precautionary information?
Digestive tract
A client has chronic stress that eventually leads to a stress-related condition. Which term should the nurse use to describe this condition?
Disease of adaptation
A client develops a stress-related disease. Which stage of the general adaptation syndrome marked the onset of this disease?
Exhaustion
A client develops melanoma from low-susceptibility genes. Which gene is affected?
Melanocortin-1
In preparing an educational presentation on hormones that influence the stress response, which information should the nurse include in the teaching session?
Melatonin is produced by the pineal gland and effects lymphocyte function.
A client's heart rate variability is evaluated. Which parameter is assessed?
Balance of the parasympathetic and sympathetic nervous systems
A client injures the left leg. When will the nurse expect substantial numbers of neutrophils to arrive at the site of injury?
Within 6 to 12 hours
A client sprains the left ankle. Before assessing the client for the classic signs of inflammation, the nurse remembers which cell type is responsible for the changes?
Mast cells.
Upon review of the findings (see chart), which data are most likely to make the nurse suspect that the client's leukemia is from benzol inhalation?
Shoemaker
Which type of tissue is best able to be regenerated into its original condition?
Oral mucosa
A client has cancer in the connective tissue. Which diagnosis will the nurse observe written on the chart?
Sarcoma
A client lies on a concrete floor for 9 hours after a heroin overdose and develops a deep pressure ulcer on the sacrum. How will the nurse expect this wound to heal?
Secondary intention
A nurse is teaching about examples of granulocytes. Which cellular class should the nurse include?
Basophils
A nurse is teaching a client about the role of cigarette smoking in the development of cancer. Which information should the nurse include in the teaching session?
Cigarette smoking is the most important cause of cancer.
A nurse is caring for a client who is receiving radiation therapy for metastatic cancer. Which assessment finding does the nurse recognize as evidence of a paraneoplastic syndrome?
Serum calcium elevated
A nurse is caring for an adult who had surgery three days ago. Which assessment finding does the nurse recognize as abnormal and needing immediate attention?
Small amount of purulent exudate visible at distal end of incision
When a client is stressed, which part of the nervous system initiates the stress response?
Sympathetic
Which information indicates the nurse has a good understanding of the stress response and the immune system?
T cell growth factor interleukin-2 can up-regulate adrenocorticotropic hormone (ACTH).
Which of the following chemical mediators is involved in generating a febrile response to an infection?
TNF-α
The nurse caring for a client with poorly controlled diabetes mellitus gives priority to assessment for postoperative wound infection. What is the best rationale for the nurse's actions?
Hyperglycemia suppresses the activity of macrophages.
While assessing a client, the nurse observes a raised scar at the site of injury. What does the nurse suspect to be the cause of this scarring pattern?
Increase in collagen levels
Which process in a client with a severe viral infection supports the nurse's suspicion that the client has risk of cachexia?
Increase in tumor necrosis factor-alpha
A client is in the later stages of inflammation. The client's mast cells release leukotrienes that perform which function?
Increase vascular permeability
When a client is stressed and epinephrine is released, which clinical manifestation will the nurse observe?
Increased blood glucose
Which effect will the nurse expect to occur when a client's body releases cortisol?
Increased gastric secretions
A client that is stressed has released catecholamines. Which physiologic effect of catecholamines can the client experience?
Increased glycogenolysis
Which complication will the nurse monitor for in a client who has been prescribed long-term antibiotic therapy?
Increased risk of Candida albicans infection
A client is stressed and the posterior pituitary is activated. Which clinical manifestation will the nurse find upon assessment?
Increased water retention
The nurse is preparing information for an educational presentation on the stress-age syndrome. The nurse includes which pieces of information in the presentation? Select all that apply.
1. Free radicals will damage cells 2. Alterations in lipoproteins will occur 3. Patterns of chronic inflammation develop
Which findings will the nurse observe in a client with local inflammation of the eye? Select all that apply.
1. edema 2. redness
A nurse is teaching a health and wellness class about relaxation techniques to reduce stress. Which techniques should the nurse include? Select all that apply.
1. imagery 2. massage 3. meditation 4. biofeedback
Which order indicates the nurse has an accurate understanding of a client's defense mechanisms, from the first line of defense to the last?
1. innate immunity 2. inflammatory response 3. adaptive immunity
Which information from the staff indicates effective teaching by the nurse for the first line of defenses against disease? Select all that apply.
1. intact skin 2. mucous membranes 3. low skin temperature
A client drinks alcohol in excessive quantities. Which areas should the nurse monitor as they are most likely to develop cancer related to the alcohol consumption? Select all that apply.
1. liver 2. larynx 3. pharynx 3. oral cavity
Which cancer risks are decreased when a client eats non-starchy vegetables? Select all that apply.
1. mouth 2. larynx 3. stomach
Which body fluids and secretions contain lysozymes that protect the client from invasion of gram-positive bacteria? Select all that apply.
1. tears 2. saliva 3. perspiration
When a client is stressed, which receptors are stimulated by catecholamines? Select all that apply.
1. α-adrenergic 2. β-adrenergic
The nurse is explaining the stress response to another health professional. In which order should the nurse present the information?
1.A stressor is encountered. 2.Sympathetic nervous system responds. 3.Norepinephrine is released. 4.Neuropeptide Y is released. 5.Vasoconstriction occurs.
A nurse is asked by a coworker what an immature macrophage is called. How should the nurse respond?
A monocyte
In which stage of the General Adaptation Syndrome is the sympathetic nervous system response initiated?
Alarm
A client has an overactivation of adaptive regulatory physiologic response to stress. Which term should the nurse use to describe this condition?
Allostatic overload
A client has been caring for an ailing mother for 18 months. In addition, the client has recently lost a job and is having difficulty finding a new one. Blood pressure has recently been running higher than normal. What is the client experiencing?
Allostatic overload
An individual has been suffering from sleep deprivation secondary to worrying about an impending divorce. This individual begins to suffer from an increased evening appetite, which eventually leads to increased caloric intake. What is this individual experiencing?
Allostatic overload
The nurse is evaluating the education provided to a client about the effects of psychological stress and heart disease. Which information from the client indicates the nurse needs to follow up?
"I will eventually adapt to long-term psychological stress without any health problems."
An older adult client had a myocardial infarction yesterday. The client asks, "I understand that part of my heart muscle is dead, but will it grow back?" What is the best response by the nurse?
"No, but it will heal by forming a scar where the heart muscle died."
A client is experiencing multiple stressors simultaneously. The stress continues and the client experiences allostatic overload and sleep deprivation. Which clinical manifestations may the nurse observe upon assessment? Select all that apply.
1. Eczema 2. Weight gain 3. Tension headaches 4. increased insulin
Which information from the staff indicates successful teaching by the nurse regarding caretaker genes? Select all that apply.
1. Caretaker genes are guardians of the genome 2. Loss of function of caretaker genes results in increased mutation rates 3. Loss of function of caretaker genes can cause increased rates of specific cancers 4. Caretaker genes encode proteins that repair damaged deoxyribonucleic acid (DNA)
A nurse is teaching about typical characteristics of cancer cells. Which concepts should the nurse include in the teaching session? Select all that apply.
1. Autocrine stimulation 2. Development of immortality 3. Insensitivity to antigrowth signals 4. Loss of cellular self-destruct mechanisms
Which information indicates the nurse has a correct understanding of bradykinin? Select all that apply.
1. Bradykinin can induce pain. 2. Bradykinin increases vascular permeability. 3. Bradykinin causes smooth muscle cell contraction.
A nurse is teaching a client the difference between normal cells and cancer cells. Which information should the nurse include? Select all that apply.
1. Cancer cells induce angiogenesis 2. Cancer cells evade growth suppressors 3. Cancer cells have sustaining proliferative signaling
A nurse is teaching the staff about neoplasms associated with the human immunodeficiency virus type 1 (HIV-1). Which neoplasms should the nurse include? Select all that apply.
1. Kaposi sarcoma 2. Non-Hodgkin lymphoma
A nurse is teaching about xenobiotics. Which information should the nurse include? Select all that apply.
1. Lipid membranes can be penetrated by xenobiotics 2. Most xenobiotics are transported in the blood by lipoproteins 3. The term includes toxic, mutagenic, and carcinogenic chemicals
A woman has recently gained weight and now has a body mass index (BMI) of 30.1 kg/m2. Which information should the nurse share with this client regarding BMI and cancer? Select all that apply.
1. Lowering the degree of obesity will lower cancer risks 2. Sex hormones are one of the major factors in obesity and cancer 3. Possible mechanisms explaining obesity's correlation to increased cancer incidence include insulin-insulin-like growth factor1 axis
When a client is stressed and glucocorticoids are released, what do glucocorticoids regulate? Select all that apply.
1. Mood 2. Sleep 3. Memory 4. Cognition
A 62-year-old building contractor presents to the public health clinic with persistent cough, shortness of breath, and fatigue. A chest radiograph finds multiple tumors in the lungs, which are subsequently diagnosed as lung cancer. The client states that he has never used tobacco products. Which environmental factors may have contributed to the lung cancer? Select all that apply.
1. Occupational exposure to paints 2. Occupational exposure to asbestos
Which assessment findings are classic for a client with inflammation of the knee? Select all that apply.
1. Painful knee 2. Warmth of the knee 3. Swelling of the knee 4. Loss of knee movement
The client is a postmenopausal woman who has recently divorced and has confided to the nurse that she has recently signed up for an online dating service and is worried about being sexually active with new partners. Which information will be helpful for the nurse to share with the client regarding protection against human papillomavirus (HPV)-induced cancers? Select all that apply.
1. Postmenopausal women have been found to experience a second peak prevalence in high-risk HPV. 2. Proper oral hygiene will decrease the risk of HPV-associated cancers. 3. Smoking has been implicated as a risk factor for acquiring high-risk HPV cancers. 4. Persistent infection with high-risk HPV is required for the development of invasive cervical cancer.
During tissue injury and inflammation, the client's clotting system is activated. While planning care, the nurse chooses interventions based on which functions of the clotting system? Select all that apply.
1. Stops bleeding 2. Prevents the spread of infection 3. Provides a framework for future healing
A client has experienced chronic stress, which has adversely affected immunity. When explaining this to the client, in which order should the nurse present the components of the hypothalamic-pituitary-adrenal (HPA) axis?
1. Stressor is experienced 2. Hypothalamus secretes corticotropin-releasing hormone (CRH) 3. Pituitary gland produces adrenocorticotropic hormone (ACTH) 4. Adrenal glands are stimulated 5. Cortisol is released
A client has been diagnosed with a squamous cell carcinoma. Which information should the nurse remember when planning care? Select all that apply.
1. The lesion is likely caused by ultraviolet sunlight 2. The lesion is most likely found on the nose or hands
A nurse teaches the staff about typical characteristics of benign tumors. Which information from the staff indicates successful teaching? Select all that apply.
1. The tumor has few mitotic cells 2. Benign tumors often are surrounded by a capsule
While planning care for a client with inflammation, the nurse recalls that vasodilation and increased vascular permeability include which benefits? Select all that apply.
1. They dilute bacterial toxins. 2. They transport neutrophils to the area of injury. 3. They bring macrophage cells to the area of injury.
A nurse is teaching a health class about the effects of tobacco smoking. Which information should the nurse include in the teaching session? Select all that apply.
1. This activity is carcinogenic 2. It is more common among men than women 3. Smokers die 13 to 14 years earlier than nonsmokers
A nurse observes warmth and redness of the client's skin during inflammation. Which processes causes these changes? Select all that apply.
1. Vasodilation 2. Increased vascular permeability
Which information from the client indicates successful teaching by the nurse for the stages of the general adaptation syndrome? Select all that apply.
1. alarm 2. resistance 3. adaptation 4. exhaustion
A client is stressed and the general adaptation syndrome is activated. In which sequence will the client experience the following stages?
1. alarm 2. resistance 3. exhaustion
A nurse is teaching a health class about dietary factors that can increase the risk of colorectal cancer. Which information from the class indicates successful teaching? Select all that apply.
1. alcohol use 2. processed meats
A client is experiencing multiple stressors simultaneously. In which order does the chain of events occur during the alarm reaction when this client is stressed?
1.A stressor is sensed and the hypothalamus triggers corticotropin-releasing hormone 2.Anterior and posterior pituitary as well as the sympathetic nervous system are stimulated to release hormones 3.Norepinephrine, epinephrine, antidiuretic hormone, and adrenocorticotropic hormone are released 4.Norepinephrine increases blood pressure, and epinephrine causes bronchodilation and increased glycogenolysis 5.Blood glucose increases
When a client is stressed, which glands produce the nonspecific physiologic responses of the general adaptation syndrome? Select all that apply.
1.Pituitary gland 2. Hypothalamus 3. Adrenal glands
Which nursing assessment data increase the client's risk for wound dehiscence?
5'3" tall with weight 189 lb
Which of the following wounds would heal by secondary intention?
A Stage III Pressure Ulcer
A client has cancer of the blood-forming cells. The nurse is caring for which client?
A client with leukemia
Which older adult is most predisposed to mortality with the spouse's hospitalization or death?
A wife within 1 month after her husband's death
The nurse anticipates that the client with which injury will be most at risk for developing chronic inflammation?
A wood splinter
The nurse is taking a history on a combat veteran. All of the following client statements would support a diagnosis of PTSD EXCEPT: A. "I have been anxious for the past two weeks" B. "I feel disconnected from my wife" C. "I have recurrent nightmares about being shot at" D. "I can't finish reading a book chapter without getting distracted"
A. "I have been anxious for the past two weeks"
Which of the following classes of HIV medications prevents the formation of viral RNA into DNA? A. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) B. Protease Inhibitors C. Fusion/Entry Inhibitors D. Integrase Inhibitors
A. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Which of the following genetic alteration can result in the development of cancer? A. Proto-oncogenes are activated to oncogenes B. Oncogenes are activated to Proto-oncogenes C. Tumor Suppressor genes are activated D. An absence of the Familial Adenomatous Polyposis gene
A. Proto-oncogenes are activated to oncogenes
Which response from the client indicates to the nurse that allostasis occurred?
Adaptive physiologic response
A client with cancer has a hemoglobin level of 8 g/dl. Which prescribed treatment will the nurse provide?
Administration of erythropoietin
During which stage of the general adaptation syndrome is fight-or-flight first exhibited in a client?
Alarm
Which term should the nurse use to describe a microorganism that does not infect people who have intact immune systems but does infect people who are immunosuppressed?
An opportunistic microorganism
A nurse is explaining to a client how a malignant tumor encourages the delivery of oxygen and nutrients to itself so it can continue to grow. Which process is the nurse describing?
Angiogenesis
A client has activated the complement system during an inflammatory response to an injury. When planning care, which information should the nurse remember about which substance activates complement?
Antibodies
A client reports feeling short of breath and nervous while waiting to be called in for a diagnostic test. Which type of response is the client experiencing?
Anticipatory response
Which of the following pathology reports would be associated with the highest grade of malignancy? A. Highly differentiated with a mitotic index of 7% B. Undifferentiated with a mitotic index of 80% C. Poorly differentiated with a mitotic index of 80% D. Moderately differentiated with a mitotic index of 50%
B. Undifferentiated with a mitotic index of 80%
A PPD is administered to a client. Which of the following are true about the test? A. A positive test indicates that the client has active tuberculosis B. A positive test indicates that the client has been exposed to tuberculosis C. A PPD excludes possible exposure to tuberculosis D. The test can be read 24 hours after it is placed
B. A positive test indicates that the client has been exposed to tuberculosis
Protein markers that stimulate an immune response are called which of the following? A. Leukocyte B. Antigen C. B cell D. T cell
B. Antigen
Which of the following is NOT a characteristic of cancer cells? A. Loss of cell cycle control B. Apoptosis C. Loss of contact inhibition D. Activation of Telomerase
B. Apoptosis
When cortisol levels increase what is the effect on the hypothalamus and pituitary? A. Increased secretion of CRH and ACTH B. Decreased secretion of CRH and ACTH C. Increased secretion of CRH and decreased secretion of ACTH D. Decreased secretion of CRH and increased secretion of ACTH
B. Decreased secretion of CRH and ACTH
Stimulation of the renin-angiotensin aldosterone system has which of the following physiological effects? A. Vasodilation B. Decreased serum potassium C. Decreased blood pressure D. Fluid excretion
B. Decreased serum potassium
Stimulation of the parasympathetic nervous system would have which of the following effects? A. Decreased salivation B. Increased intestinal motility C. Increased heart rate D. Bronchodilation
B. Increased intestinal motility
Which of the following clinical manifestations are consistent with the common cold? A. Temperature of 38.6 degrees Celsius (flu, maybe pneumonia) B. Nasal congestion C. Facial pain when bending forward (sinusitis) D. Pleuritic Chest Pain (pneumonia)
B. Nasal congestion
Antibiotics are appropriate to treat which of the following respiratory infections? (Select all that apply) A. The Common Cold B. Sinusitis C. Influenza (viral) D. Pneumonia E. Tuberculosis
B. Sinusitis D. Pneumonia E. Tuberculosis
Which organism is the most common cause of community acquired pneumonia? A. Haemophilus Influenza B. Streptococcus Pneumoniae C. Mycoplasma Pneumoniae D. Chlamydia Pneumoniae
B. Streptococcus Pneumoniae
Which of the following factors is most important in determining the degree of dysfunction caused by a benign neoplasm? A. The duration of abnormal cell growth B. The location of the tumor C. The agent responsible for the alteration in growth D. Hereditary factors
B. The location of the tumor
Which of the following results confirm infection with the HIV virus? A. The Elisa (EIA) antibody test is positive B. The western Blot antibody test is positive C. The viral RNA level in undetectable D. The CD4 count is 600 cells/µL
B. The western Blot antibody test is positive
Which of the following conditions is likely to result in chronic inflammation? (Select all that apply) A. A surgical wound B. Tuberculosis C. A laceration D. An Abscess E. An Abrasion
B. Tuberculosis D. An Abscess
A client has a high risk for ovarian cancer. Which gene alteration did the nurse observe on the client's chart?
BRCA1
Which carcinogenic agent is used in the production of rubber and paint?
Benzidine
A client with cancer has a rapid pulse rate, blood pressure of 170/110 mm Hg, sweating, and tremors. Which tumor marker will help diagnose the client's condition?
Blood catecholamine
A female client received radiation from sources placed into the cervix. The nurse will report the client had which type of treatment?
Brachytherapy
A fetus in utero is exposed to undernutrition. Which cancer could develop decades later?
Breast
The nurse is teaching a patient who is diagnosed as being HIV+. Which of the following points should the nurse include in the teaching? (Select all that apply) A. The HIV virus can be eliminated from the body if the patient adheres to their HAART regimen B. The HIV virus uses the patient's red blood cells to replicate C. HIV can be effectively managed with medications D. The patient can still pass the infection to others E. The patient is unlikely to contract opportunistic infections if the CD4 count is above 500
C. HIV can be effectively managed with medications D. The patient can still pass the infection to others E. The patient is unlikely to contract opportunistic infections if the CD4 count is above 500
The most common immunoglobulin (antibody) is which of the following? A. IgA B. IgE C. IgG D. IgM
C. IgG
Which one of the following characteristics of the immune system distinguishes antibody-mediated from cell-mediated immunity? A. The cells are called leukocytes B. The responses are specific to foreign invaders C. The long-term immunity can be transferred from person to person D. The cells arise from pluripotent stem cells
C. The long-term immunity can be transferred from person to person
Which of the following best describes an autoimmune disorder? A. The person has an inadequate number of immune cells B. The person cannot produce antibodies to foreign antigens C. The person forms antibodies against their own tissues D. The person does not have HLA coding for proteins on their cells.
C. The person forms antibodies against their own tissues
A client has a severe inflammatory response. Which complement factor is considered a potent anaphylatoxin?
C3a
A client with cancer has weight loss with inflammation affecting adipose tissue. Which term should a nurse use to describe this condition at change-of-shift report?
Cachexia
Which information indicates the nurse has an accurate understanding of distant metastasis in clients?
Cells must gain access to blood and lymphatic vessels.
A client is experiencing multiple stressors simultaneously. What are potential behavioral responses that may occur during this initial period of stress?
Changes in dietary intake, smoking, drinking, and sleep disturbances
Which information indicates the nurse has a good understanding of chronic inflammation?
Chronic inflammation causes differentiation of macrophages into epithelioid and giant cells.
A nurse is educating a health class about stress-related diseases and conditions like cardiovascular disease, osteoporosis, and type 2 diabetes mellitus. Which pathophysiologic process that is common to all these diseases will the nurse include in the teaching session?
Chronic inflammatory processes play a critical role.
The home health nurse is visiting a female client with a chronic ventricular dysrhythmia for a health check. The client states that she has received news this morning that the company she worked for has filed for bankruptcy and she will no longer be receiving a pension or health insurance. What is the nurse's greatest concern?
Client will be at increased risk for sudden cardiac death.
A nurse is explaining how a client's cancer cells accumulate faster than the client's normal neighboring cells. Which process is the nurse describing?
Clonal expansion
Which information from the staff indicates effective teaching by the nurse for substances that act as opsonins?
Complement proteins
Which physiologic response will a stressed client experience when norepinephrine is released?
Constricted arteriole smooth muscles
The nurse is working with a hospitalized client who just received news that the client's home was burglarized and a significant amount of cash was stolen. The nurse asks about how the client is handling the news. The client states, "Money can always be replaced, and no one was hurt. I'm glad I was here." What is the client demonstrating?
Coping
A client is experiencing physiologic stress. The nurse monitors the client for increased blood glucose levels. What is the rationale for the nurse's action?
Cortisol is released.
Which of the following is NOT a physiological response to stress? A. An increase in cortisol levels B. An increase in catecholamines (epinephrine and norepinephrine) C. An increase in blood pressure D. A decrease in inflammatory response
D. A decrease in inflammatory response
An influenza vaccine is indicated for which of the following clients? A. A healthcare worker B. A 55 year old with chronic lung disease C. A healthy 70 year old D. All of the above
D. All of the above
A person who is bitten by an animal with suspected rabies will be initially given an injection of antibodies against the rabies virus. This is an example of which type of immunity?
D. Artificial Passive Immunity
A client is at risk for cardiovascular disease from chronic psychosocial stress. When planning care for this client, which primary pathophysiologic mechanism should the nurse remember?
Dysregulation of the circadian rhythm
The nurse is assessing the coping strategies of a client as part of risk factor management for the client's high blood pressure. Which assessment finding should the nurse identify as a maladaptive coping strategy?
Eating twice a day rather than three times
A nurse is discussing antimicrobial peptides, defensins, collectins, and mannose-binding lectin. What is the nurse describing?
Epithelial cell-derived chemicals
What is a client's first line of defense against infection?
Epithelial cell-derived chemicals
A nurse is providing wound care and observes that the client is healing normally and is in the proliferative phase of wound healing. What will the nurse observe?
Epithelialization
A nurse is asked which hormone is known to exert a calming effect during stressful situations. How should the nurse reply?
Estrogen
Which assessment finding indicates to the nurse that the client is exhibiting the most frequently reported symptom of cancer?
Fatigue
A client is in phase II of wound healing. Which cells produce collagen during tissue healing?
Fibroblasts
A client's levels of glucocorticoids and catecholamines are elevated from prolonged stress. Which type of condition indicates the client has decreased innate immunity?
Fungal infection
A client has chronic Helicobacter pylori infection and is at most risk for which type of cancer?
Gastric
Which term should the nurse use to describe a client's nonspecific response to noxious stimuli?
General adaptation syndrome
A nurse is talking about the specific cell type that allows transmission between generations. Which cell is the nurse describing?
Germ
A client has a chronic infection of Listeria that the body cannot fight. Which pathophysiologic process should the nurse monitor for in this client?
Granuloma
A client has cervical cancer. Upon review of the laboratory results, which subtype of the human papillomavirus (HPV) will the nurse most likely observe?
HPV-16
A client is receiving chemotherapy. Which complication should the nurse closely monitor for because it is the most deadly?
Infection
A client breaks the first line of defense against infection. The next response the nurse should consider involves which mechanism?
Inflammation
The nurse is inspecting a client's abdominal incision the day after surgery. What does the nurse expect to observe?
Inflammation
Which cytokine deficiency does the nurse suspect is causing delayed wound healing in a client?
Interleukin 6
Which information indicates the nurse has a correct understanding of a cytokine that has some anti-inflammatory effects?
Interleukin-10 (IL-10)
How should the nurse describe the role of chemotaxis in inflammation to a coworker?
It causes migration of leukocytes to the site of injury.
A nurse is asked about the primary function of plasmin in the body. What is the nurse's best response?
It degrades blood clots.
A nurse is teaching about neuropeptide Y (NPY). Which information should the nurse include in the teaching session?
It is implicated in atherosclerosis.
The nurse is asked to explain the concept of psychoneuroimmunology. What is the nurse's best response?
It is the study of how the consciousness, the brain and spinal cord, and the immune system interact.
A coworker asks the nurse why genistein should be increased in the diet. How should the nurse respond?
It prevents proliferation of cancer cells.
A nurse is asked what the purpose of the TNM classification system is. How should the nurse respond?
It provides a common standardization scheme for staging.
Which effect will the nurse expect to observe when a client is stressed and epinephrine is released?
It results in increased bronchodilation.
Which information from the client indicates successful teaching by the nurse about the parasympathetic system?
It slows the heart rate.
Upon review of a child's history, a nurse discovers the child had many diagnostic radiography test performed in utero. Which cancer should the nurse monitor for in this child?
Leukemia
Which laboratory test result will the nurse expect to find in a client with acute inflammation?
Leukocytosis
A nurse is teaching a health class about primary factors responsible for the majority of cancers. Which information should the nurse include?
Lifestyle/environmental factors
A client has chronic active hepatitis B infection. The nurse will monitor this client for the development of which type of cancer?
Liver
A nurse is teaching a health class about the various cancer rates. Which information should the nurse include in the teaching session?
Liver cancer in women has risen
A woman is admitted for suspected melanoma. Which area should the nurse assess first?
Lower legs
A client has an infection. Which cells provide long-term phagocytosis against infectious agents?
Macrophages
A client with a malignant tumor says, "The primary healthcare provider said my tumor is growing really quickly. Why does it grow so fast?" Which principle is the basis for the response that a nurse should provide?
Malignant cells lack contact inhibition.
Several days before abdominal surgery, the client experiences nausea and vomiting and is unable to eat any food. The nurse closely monitors this client's wound healing after surgery. What is the rationale for the nurse's actions?
Malnutrition causes reduced tensile strength.
A nurse is asked what the difference is between monocytes and macrophages. How should the nurse respond?
Monocytes circulate in the blood, macrophages are found in tissues.
A client is having pain in an injured area. The nurse administers a nonsteroidal anti-inflammatory drug (NSAID). What is the rationale for the nurse's action?
NSAIDs block the synthesis of prostaglandins.
Which of the following white blood cells is the primary responder to bacterial infection?
Neutrophil
Which dietary condition shows consistent evidence for increasing the risk of colorectal cancer in clients?
Obesity
A nurse is teaching at a wellness clinic about obesity and cancer. Which information should the nurse include?
Obesity can increase certain cancer risks.
Which client will the nurse teach to avoid beta-carotene supplements?
One with risk for lung cancer from smoking
A nurse is teaching about the role of C3b. Which information should the nurse include?
Opsonin
Which process should the nurse include when teaching about how antibodies promote phagocytosis?
Opsonization
Which term should the nurse use to describe the process of "gluing" bacteria with antibodies to promote phagocytosis of the microorganisms?
Opsonization
Which phrase should the nurse use to describe the abscopal effect?
Out-of-field
Which information indicates the nurse has a good understanding of pathogen-associated molecular patterns (PAMPs)?
PAMPs are molecules that are expressed by infectious agents, either found on their surface or released as soluble molecules.
A nurse is teaching a health class about cancers primarily associated with smokeless tobacco use. Which response by the class indicates successful teaching?
Pancreatic
A client has an infection and the neutrophil level is elevated. Which function are the neutrophils providing for the client?
Phagocytosis
A client has a diagnostic test in which an intravenous needle is inserted into the right arm. Which type of stressor did the client experience?
Physiologic stressor
A nurse is asked which structure plays a major role in controlling growth and development in utero. How should the nurse respond?
Placenta
Which activity by the pregnant client will cause the nurse to intervene?
Places cell phone to abdomen so family can talk to the baby
A client had surgery two days ago. As part of the postoperative discharge education, the nurse teaches the client about prescribed activity limitations for the next few weeks. The client lets the nurse know that going back to work quickly is essential. Which principle should underlie the nurse's response?
Proliferation and remodeling stages are necessary for a healing wound to be strong.
A woman presents with diminished colonization of Lactobacillus, which the primary healthcare provider diagnoses as vaginosis. Which finding will be typical when the nurse takes the history?
Prolonged antibiotic treatment
A client has leukopenia from cancer chemotherapy. Which goal becomes the priority?
Protect from infection
A client has a physiologic response derived from psychologic stressors. Which term should the nurse use to describe this process?
Reactive response
When a client's body continues to mobilize and react to the actions of cortisol, norepinephrine, and epinephrine, which stage of the general adaptation syndrome is the client experiencing?
Resistance
Upon review of a client's chart, the nurse finds the client has a BRCA1 mutation. How should the nurse interpret this finding?
The client is at increased risk for breast cancer.
A client asks what it means when the primary healthcare provider refers to the complement system in regard to infection. What is the nurse's best response?
The complement system is a set of proteins in the blood that help activate the body's inflammatory and immune response to infection.
A nurse is teaching about the clotting system. Which information should the nurse include?
The extrinsic pathway is activated by tissue factor.
A client has a low pH of urine and stomach contents. How should the nurse interpret these findings?
The first line of defense is working.
A nurse is caring for a newborn. Which age-related factor will the nurse consider that affect innate immunity?
The inflammatory responses is transiently depressed.
A client has cancer not from just a single gene but from an entire intracellular signalling networks being affected. Which pathophysiologic process can cause this cancer?
The miRs have changed.
Which immune change should the nurse consider when planning care for a client with chronic stress?
There are decreased natural killer cells.
A client is experiencing acute inflammation and releases interleukin-1 (IL-1). Which piece of equipment should the nurse obtain to determine the effects of IL-1?
Thermometer
To help a client's wound heal, the nurse suggests eating foods high in vitamins A and C. What is the rationale for the nurse's action?
These vitamins are required for collagen synthesis.
A nurse is teaching a client about catecholamines. Which information should the nurse include in the teaching session?
They are synthesized in the brain.
Which information from the staff indicates successful teaching by the nurse for cytokines?
They include interleukins and interferons.
A nurse is teaching the staff about genes that normally inhibit cellular proliferation in the normal state of the cell. Which type of gene is the nurse describing?
Tumor-suppressor genes
Which information should the nurse include when teaching adults in a wellness clinic about ultraviolet (UV) light?
UV light causes basal cell carcinoma and squamous cell carcinoma.
A client uses a cell phone every day and is asking about the health risks associated with electromagnetic radiation sources and cancer. How should the nurse reply?
Use of cell phones for over 7 years has been linked to a small increased risk of some tumors
A client has an inflammatory response. Upon assessment, the nurse finds edema in the client's foot. What caused the edema?
Vascular permeability
A client's immune system activates interferons. Which type of organism should the nurse suspect is causing this reaction?
Viruses
When should the nurse document that the client has hemorrhagic exudate?
When reddish exudate, containing numerous red blood cells, occurs
When should the nurse chart that the client has fibrinous exudate?
When thick, clotted exudate, from severe inflammation, occurs
When should the nurse chart that the client has serous exudate?
When watery exudate, containing few cells and not much protein occurs
A client states, "I have a sore throat, and it's red." When the client asks why it is red, how should the nurse respond?
Your blood vessels in the area have relaxed to allow more blood into the area to promote healing.
Cortisol has an anabolic effect on protein in which area of a client's body?
the connective tissues
