Patho Exam 3 PREP U

A 35-year-old client is diagnosed with acute kidney injury (AKI) and is started on hemodialysis. The client is concerned with the diagnosis and wants to know what to expect in the progression of this disorder. Which statement best addresses the client's concern?

"Acute kidney injury is abrupt in onset and often reversible if recognized early and treated

A nurse suspects an elderly client is experiencing benign prostatic hyperplasia (BPH). Which of the following questions should the nurse ask this client?

"Has the force of your urinary stream decreased?"

A client who has just been diagnosed with a spastic bladder asks the nurse what that means. What would be the nurse's best response?

"It is a problem with storing urine."

What would be an ideal body mass index (BMI) for an adult?

20-24

A client asks the nurse the purpose of white fat. The best response would be:

Energy storage

Management of hyperthyroidism would include which interventions? Select all that apply.

Eradication of the gland with radioactive iodine Surgical removal of part or the entire gland Drug therapy directed toward decreasing the gland's function

Which interventions would be included in the plan of care for a client experiencing myxedematous coma? Select all that apply.

Frequent monitoring of cardiac functions Initiation of thyroid replacement therapy Oxygen therapy to support ineffective respirations Reversal of hypoglycemia

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

Mental status

In an acute adrenal crisis with Addison disease, the onset of symptoms are sudden and can be precipitated by exposure to a minor illness or stress. What are the manifestations of acute adrenal crisis? (Select all that apply.)

Muscle weakness Dehydration Altered mental status Vascular collapse

The nurse recognizes that acute renal injury is characterized by which of the following?

Rapid decline in renal function

Which of the following signs and symptoms is most suggestive of acute cholecystitis?

Upper right quadrant or epigastric pain

rhe nurse is teaching her patient with hepatobiliary disease about her diet. She tells her that she may have steatorrhea, which is the malabsorption of which dietary component?

fat

vaginal discharge of trichomias

frothy green

Release and synthesis of anterior pituitary hormones are mainly regulated by the inhibiting or releasing actions of the:

hypothalamus.

Bmi of 32.4 is considered

obese (not overweight)

A male client is diagnosed with an inguinal hernia. Which statement by the client indicates that the nurse's teaching about the hernia has been effective?

"The hernia is a loop of bowel protruding through a weak spot in my abdominal muscles."

Following several days of intermittent upper right quadrant pain, a 29 year-old obese, Native American woman has been diagnosed with cholelithiasis. The nurse at the clinic has taught the client about the pathophysiology and contributing factors to her health problem, as well as some of the likely treatment options. Which of the following statements by the client demonstrates a sound understanding of her diagnosis?

"This explains why my skin was yellow-tinged lately and why I had those pains that spread to my upper back and right shoulder."

A client experienced asymptomatic UTIs while pregnant. The client asks the nurse if this places her at any risk for complications. Which would be the best response by the nurse?

"You are at risk for developing acute pyelonephritis."

1m 27s Which of the following clients should the nurse observe most closely for the signs and symptoms of paralytic ileus? A client who is first day postoperative following gallbladder surgery A client whose acute diarrhea has necessitated the use of antidiarrheal medications An obese client who refuses to ambulate because he complains of shortness of breath A client with a long-standing diagnosis of irritable bowel syndrome

1

The nurse is assessing a client who has been diagnosed with GERD. The nurse recognizes which sign/symptom may be associated with GERD? Select all that apply. Epigastric pain Retrosternal pain Chronic cough Hoarseness Heartburn before eating Relief of discomfort with aspirin

1, 2, 3

Which of the following clients is most clearly displaying the signs and symptoms of irritable bowel disease (IBD)? A 32 year-old mother who complains of intermittent abdominal pain that is worse during her menstrual period. A 51 year-old male who states that his stomach pain is in his lower abdomen, "comes and goes" and "feels more like a cramp than a dull ache." A 44 year-old man who is works the evening shift at a factory and who states that his lower abdominal pain is much worse at night than during the day. A 24 year-old man who has a stressful job but whose diarrhea and cramping does not worsen during periods of high stress.

2

A patient informs the nurse that he or she would like to begin a healthier dietary intake and would like to limit carbohydrate consumption. Understanding that the patient must have carbohydrates to avoid tissue wasting and ketosis, Which of the following forms of carbohydrate should the nurse suggest? Select all that apply. Ground beef Vegetables Fruits Whole grains Eggs

2,3,4

When trying to explain to a newly diagnosed irritable bowel syndrome (IBS) client how the nervous system affects gastrointestinal (GI) disorders, the nurse mentions which of the following in regard to IBS? Increase in smooth muscle tone Enhancement of sphincter function Decrease in gastrointestinal motility Increase in enteric nervous system activity

4

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.20 F

Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis?

A 79-year-old hospital client who is being treated with broad-spectrum antibiotics

Which of the following patients is likely at the greatest risk of developing a urinary tract infection?

A 79-year-old patient with an indwelling catheter

The nurse is evaluating client risk for the development of overactive bladder/urge incontinence and determines that which client is at highest risk is for this condition?

A client with diabetes mellitus

The nurse recognizes hepatic encephalopathy may be aggravated by which of these situations?

A high protein meal

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

A hypermetabolic state

One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and which of the following?

ACTH

Which of the following factors is most strongly associated with the pathogenesis of gallstones?

Abnormalities or stasis of bile

A patient is being evaluated for kidney stones. The nurse anticipates the patient will manifest:

Acute onset of colicky or dull and achy intermittent flank pain

To maintain hematocrit levels in people with kidney failure, the nurse should be prepared to:

Administer a subcutaneous injection of recombinant human erythropoietin (rhEPO).

A male client seeks treatment for erectile dysfunction. What factors contribute to this condition? Select all that apply.

Age 65 years Cardiovascular disease Antihypertensive medications

Which of the following residents of a long-term facility is exhibiting clinical manifestations of hypothyroidism?

An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold

An elderly male patient is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the patient may have a problem with:

An enlarged prostate gland.

Which of the following types of pharmacological therapy does the nurse anticipate administering to a patient for treatment of a spastic bladder in order to decrease bladder hyperactivity?

Anticholinergic medications

A patient with diabetes mellitus type 1 has bladder atony with dysfunction. Which of the following assessments indicates a primary concern for this patient?

Ascending urinary tract infection

The nurse is caring for a patient with a spinal cord injury at C-4 and assesses a blood pressure of 180/120 mm Hg, a heart rate of 42, and profuse diaphoresis. Which of the following priority actions should the nurse take?

Assess the patient for a kinked indwelling catheter.

The nurse is caring for a patient who has had acute blood loss from ruptured esophageal varices. Which of the following does the nurse recognize is an early sign of prerenal failure?

Baseline urine output of 50 mL/hr that is now 10 mL/hr

An elderly client has just been admitted for urinary tract obstruction and retention. Which clinical manifestations should the nurse expect this client to demonstrate? Select all that apply.

Bladder distention Hesitancy Small stream Overflow incontinence

The nurse is caring for a client with a sacral cord injury that resulted in loss of the perception of bladder fullness and loss of voluntary urination. When planning care for the client, the nurse should include which nursing interventions?

Bladder retraining

A nurse is caring for a patient with systemic lupus erythematosis (SLE). The patient asks why a urinalysis is necessary. The best answer is that a urinalysis would determine whether which of the following factors was present in the urine?

Blood or protein

An adult client presents to the emergency department with manifestations of acute cystitis. For which would the nurse assess the client? Select all that apply.

Burning on urination Back discomfort Cloudy urine

Which body systems are most commonly affected by chronic kidney disease (CKD) in the elderly?

Cardiovascular and cerebrovascular systems

Hospitalized patients are at the greatest risk of developing septicemia related to which procedure?

Catheter-associated bacteriuria

A nurse correctly identifies which approved treatments for a client who is admitted with a diagnosis of neurogenic bladder? Select all that apply.

Catheterization Bladder training Meds to manipulate bladder function Surgery

When caring for the client with pancreatic cancer, for which of these signs and symptoms does the nurse assess Fever, chills and weight loss Central abdominal pain, jaundice and weight loss Abdominal and back pain which lessen when lying flat A large abdominal mass, left upper quadrant pain and vomiting

Central abdominal pain, jaundice and weight loss

When caring for the client with pancreatic cancer, for which of these signs and symptoms does the nurse assess?

Central abdominal pain, jaundice and weight loss

A client with a history of chronic pancreatitis is concerned about developing long-term complications. The best response by the nurse would be: Clients can develop signs of diabetes and malabsorption. Chronic pancreatitis can lead to liver failure and cirrhosis. Long-term effects are similar to those seen in cholelithiasis. Clients with chronic pancreatitis develop portal hypertension.

Clients can develop signs of diabetes and malabsorption.

Incontinence can be transient. What are the possible causes of transient urinary incontinence? (Select all that apply.)

Confusional states Stool impaction Recurrent urinary tract infections

The nurse encourages a female patient with recurrent urinary tract infections (UTIs) to drink which of the following on a daily basis?

Cranberry juice

Which disorder is a result of excess cortisol?

Cushing syndrome

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

Decreased albumin

The nurse is instructing a patient with advanced kidney disease (AKD) about a dietary regimen. Which of the following restrictions should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?

Dietary protein

Which of the following integumentary problems most often accompanies chronic kidney disease?

Dry skin and pruritus

Which laboratory findings should you expect to see in a patient diagnosed with nephritic syndrome?

Elevated urine protein and hypoalbuminemia

A 60-year-old man comes to the clinic and has been found to have a history of type 2 diabetes mellitus and cardiovascular disease. The manifestations of these diseases will warrant the nurse to assess the patient for which of the following problems?

Erectile dysfunction

The physician has just completed an assessment on a client diagnosed with cirrhosis. The client asks if she is at risk for any serious complications. Which would be the best response?

Esophageal varices

The physician has just completed an assessment on a client diagnosed with cirrhosis. The client asks if she is at risk for any serious complications. Which would be the best response? Esophageal varices Duodenal ulcers Biliary colic Dehydration

Esophageal varices

A client has just been diagnosed with a neurogenic disorder of the bladder. The nurse caring for him understands that this means that this client could demonstrate which of the following? Select all that apply.

Failure to store urine Failure to empty urine

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.

The health care provider is reviewing lab results of a client. Select the test that is the best measurement of overall kidney function?

Glomerular filtration rate (GFR)

Digested dietary carbohydrates are primarily converted to:

Glucose

A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:

Graves disease

A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?

Hypertension

The physician is assessing a client with a preliminary diagnosis of endocrine disorder. Further assessment findings identify abnormalities with emotion, pain, body temperature, and neural input. The physician determines the need to further assess the:

Hypothalamus

A nurse is assessing an elderly woman diagnosed with chronic hypothyroidism who has developed myxedematous coma. The nurse will likely assess which lab and clinical manifestations in this client? Select all that apply.

Hypoventilation Hyponatremia Hypoglycemia Lactic acidosis

Which of the following assessments indicates to the nurse that a patient may have a spastic bladder dysfunction?

Incontinence

The nurse is planning care for a patient with a urinary tract obstruction. The nurse includes assessment for which of the following possible complications?

Increased blood pressure

Which of the following data would a clinician consider as most indicative of acute renal failure?

Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR).

A patient is to receive a radiocontrast media as part of a diagnostic scan. Which of the following is intended to reduce the nephrotoxic effects of the radiocontrast media?

Increasing the normal saline intravenous infusion rate to 125 mL/hour

Which one of the following is the usual cause of acute pyelonephritis?

Infection

What is true regarding the process of absorption? Select all that apply.

It is the process by which nutrients are moved through the GI tract. The process involves active transport. The process involves diffusion.

The acute care unit has had an increase in Gram-negative septicemia over the last 6 months. Which of the following would the infection care nurse know might require clinical focus of the most common cause of these types of infections?

Knowledge of aseptic technique when inserting urethral catheters

A client is diagnosed with renal failure. The nurse must monitor for failure of which of the following functions? Select all that apply.

Maintenance of body water Electrolyte balance Acid-base balance Removal of metabolic waste from blood

The prostate gland functions in the elimination of urine. The nurse knows that the prostate gland if enlarged can cause which dysfunction of the urinary system?

Obstruction

Surgical stone removal is indicated for which of the following instances?

Obstruction of urine flow

Which manifestations regarding hypothyroidism are accurate ? Select all that apply.

Onset of symptoms is gradual Weight gain Anorexia

A patient who has suffered a spinal cord injury at C4 is experiencing a sudden change in condition. Their BP is 186/101; heart rate 45; profusely sweating and complaining of "not feeling right." The nurse should:

Palpate their bladder for overdistention.

A newly diagnosed paraplegic client who suffered an automobile accident appears to have control of bladder emptying. The health care provider explains this process to the client/family stating, "This function is allowing the motor component of the neural reflex to assist with bladder emptying and is primarily controlled by the:

Parasympathetic division of the ANS."

A patient has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which of the following types of renal failure should the nurse closely monitor for?

Postrenal failure

An 86-year-old female patient is admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to prevent urinary incontinence. The patient's most recent laboratory results are suggestive of acute renal failure. The nurse recognizes that this patient has which type of failure?

Prerenal

A patient in renal failure has marked decrease in renal blood flow caused by hypovolemia, caused by gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which of the following forms of acute renal injury does this patient have?

Prerenal failure

The nurse is caring for a client with viral hepatitis who has general malaise, easy fatigability, arthralgia, and anorexia. These manifestations correspond with what stage of the disease?

Prodromal period

After several months of persistent heartburn, a 57 year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem?

Proton pump inhibitors; avoiding large meals; remaining upright after meals

Phosphate excretion is impaired in chronic kidney disease (CKD), resulting in high serum phosphate levels and the development of phosphate crystals. Which manifestation of hyperphosphatemia should the nurse assess for?

Pruritus

A nurse is working in an eating disorder inpatient clinic. Which of the following does the nurse recognize as one of the most challenging aspects of treatment of anorexia nervosa?

Recognizing that there is a problem

A client diagnosed with chronic kidney disease (CKD) is experiencing nausea and vomiting. Which would be the best instruction for the nurse to provide?

Restrict intake of dietary protein

Several neurotransmitters have been identified with nausea and vomiting. In this capacity, they act as neuromediators. What neuromediator is thought to be involved in the nausea and vomiting that accompanies chemotherapy?

Seratonin

A 51 year-old woman diagnosed with a cerebrovascular accident (CVA) five months prior is distressed that she has had several recent episodes of urinary incontinence. She has asked her nurse practitioner why this is the case. Which of the following statements best captures the facts that would underlie the nurse's response to the client?

She may be unable to sense her bladder filling as a result of her MS.

The nurse is caring for a client diagnosed with hyperthyroidism. Which clinical manifestations are most likely to be seen in this client? Select all that apply.

Shortness of breath Tachycardia Weight loss Fine muscle tremor

A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?

T4 and TSH

A client with chronic kidney disease (CKD) is anemic. The nurse will attempt to alleviate the anemia in order to prevent which of the following? Select all that apply.

Tachycardia Fatigue Decreased myocardial oxygen

A client has experienced severe hemorrhage and is in prerenal failure. The nurse anticipates the laboratory results of the client's BUN and serum creatinine to identify:

The BUN-to-creatinine ratio is 20:1.

Which clients would the nurse assess for possible urinary retention? Select all that apply.

The client receiving an antihistamine The client taking over-the-counter medication for a cold or flu The client with depression taking an antidepressant The client with psychosis taking antipsychotic medicine daily

A patient has a spastic bladder. Which of the following is of most concern to the nurse?

The patient has an elevated temperature."

A client who had been utilizing pharmacologic management for BPH is now experiencing severe signs of obstruction. The client would most likely require:

Transurethral prostatectomy

An 82 year-old resident of a long term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which of the following actions by the care team is most appropriate?

Ultrasound bladder scanning to determine the residual volume of urine after voiding.

The nurse understands that medications although very beneficial to clients can also have harmful effects. When working with elderly clients the nurse should recognize which of the following is a common result of potent, fast-acting diuretics?

Urge incontinence

Clients with which medical history will have an increased risk for developing urinary tract infections? Select all that apply.

Urinary obstruction Neurogenic disorders Elderly Prostate disease

Which of the following are risk factors for developing a UTI? (Select all that apply.)

Urinary obstruction Postmenopausal status Prostate disease Neurogenic bladder

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include:

Urine retention

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

Withholding food and fluid

The nurse recognizes which of these interventions is essential to reduce the pain of acute pancreatitis? Administering medication for pain Withholding food and fluid Providing intravenous fluids and electrolytes Administration of antiemetics

Withholding food and fluid Withholding food and fluid prevents premature activation of pancreatic enzymes and autodigestion. Pain medication will mask pain, but not treat the underlying problem of preventing autodigestion, as will intravenous fluids.

Which of these substances should the nurse teach the client with pancreatitis is essential to avoid? Narcotic analgesics Fatty foods Alcohol Concentrated sweets

alcohol

The client also states that the emesis has often contained frank blood in the hours prior to admission Which of the following potential contributing factors would the health care team suspect first?

alcohol consumption

A 61 year-old woman who has had an upper respiratory infection for several weeks has presented to her family physician with complaints of a recent onset of urinary retention. She reveals to her physician that she has been taking non-prescription cold medications over and above the suggested dose for the past two weeks. Which of the following phenomena will her physician most likely suspect is contributing to her urinary retention?

he anticholinergic effects of the medication are impairing normal bladder function.

A patient with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which of the following problems? Perforation Obstruction Penetration Obtrusion

obstruction

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to:

plasma proteins.

When explaining absorption to a client, the nurse mentions that a number of substances require a specific carrier or transport system. An example the nurse could use relates to the transport of amino acids and glucose, which requires the presence of which of the following for absorption to occur?

sodium

majority of body energy is stored as

triglycerides

Which manifestations is considered a major complication of persistent gastroesophageal reflux? Strictures Heartburn Chest pain Hoarseness

1

A diabetes education nurse is teaching a group of recently diagnosed diabetics about the potential genitourinary complications of diabetes and the consequent importance of vigilant blood glucose control. Which of the following teaching points best conveys an aspect of bladder dysfunction and diabetes mellitus?

"It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying."

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

Increase in ammonia level

The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process? Select all that apply.

24-hour urine secretion of cortisol Dexamethasone suppression test Plasma levels of ACTH

Which of the following factors is most strongly associated with the pathogenesis of gallstones? Excess serum ammonia and urea levels Portal hypertension Abnormalities or stasis of bile High-cholesterol diet

Abnormalities in stasis of bile

A decrease in the serum level of which of the following substances is suggestive of liver injury?

Albumin

Which of these substances should the nurse teach the client with pancreatitis is essential to avoid?

Alcohol

The nurse is teaching a group of nursing students about hepatitis. Which of these does the nurse include in teaching about the causes of hepatitis? Select all that apply.

Alcohol consumption Viruses Autoimmune disorders

The nurse is teaching a group of nursing students about hepatitis. Which of these does the nurse include in teaching about the causes of hepatitis? Select all that apply. Unrefrigerated foods Alcohol consumption Diabetes Viruses Autoimmune disorders

Alcohol consumption Viruses Autoimmune disorders

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 is admitted with the diagnosis of obstructive jaundice. Which assessment findings would the nurse expect to see in this client? Select all that apply.

Clay-colored stools. Dark urine. Elevated conjugated bilirubin levels. Severe itching.

A nurse is caring for an elderly client with a urinary tract infection (UTI). The nurse understands which information about UTI's in the elderly 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 the elderly.

A client with a history of chronic pancreatitis is concerned about developing long-term complications. The best response by the nurse would be:

Clients can develop signs of diabetes and malabsorption.

The nurse is caring for a client with hepatic disease whose skin has a yellowish discoloration. When documenting in the medical record, which of these is a proper entry for this assessment finding?

Icteric skin

Which stresses can cause injury to the kidney glomerulus? Select all that apply.

Immunologic Nonimmunologic Heredity Diabetes

The nurse is caring for a client alcoholism who now presents with gastrointestinal bleeding. What alteration does the nurse anticipate related to the bleeding? Increase in ammonia level Decreased glucose synthesis Decreased prothrombin time Increased triglycerides

Increase in ammonia level

A male client reports sudden pain and a bulging in the scrotal sac after lifting a heavy object. The swelling does not reduce when the client is supine and he begins to sweat profusely. What condition is the likely cause of these manifestations?

Inguinal hernia

The nurse recognizes that which of these individuals are at risk for hepatitis B? Select all that apply.

Injection drug users Those having unprotected sex

The nurse recognizes that which of these individuals are at risk for hepatitis B? Select all that apply. Those with cirrhosis Injection drug users Blood donors Those who eat sushi Those having unprotected sex

Injection drug users Those having unprotected sex

The client in the GI clinic tells the nurse she is concerned she has something wrong with her gallbladder like what her friend with gallstones and inflammation had. Which of these complaints does the nurse recognize that supports the client's concern?

Intolerance to greasy food; burping

The nurse is caring for a client with viral hepatitis who has general malaise, easy fatigability, arthralgia, and anorexia. These manifestations correspond with what stage of the disease? Prodromal period Icterus phase Convalescent phase Chronic period

Prodromal period Acute symptomatic viral hepatitis can be divided into three phases: the prodromal period, icterus phase, and the convalescent phase. The prodromal period includes general malaise, myalgia, arthralgia, easy fatigability, and severe anorexia. There may also be nausea, vomiting, and diarrhea with mild right-sided abdominal pain. The icterus phase usually follows the first phase by 5 to 10 days. Jaundice may accompany a temporary worsening of the initial symptoms. In the convalescent phase the client begins to feel better, regains the appetite, and jaundice subsides. The acute illness subsides gradually over 2 to 3 weeks.

An example of a single hormone that can exert effects in different tissues, erythropoietin, made in the kidney stimulates the bone marrow to produce:

Red blood cells.

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

Reduced production of erythropoietin

granulomatous lesions are shaped like

cobblestones

The primary care provider for a newly admitted hospital patient has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The patient's GFR will be extrapolated from serum levels of:

creatinine.

A patient presents with gonorrhea. Which of the following is a primary nursing action?

report to CDC

For which cancers is a patient infected with human papillomavirus (HPV) at increased risk? Select all that apply.

vulvar cervical vaginal

Which of the following female patients is at risk for amenorrhea? 18-year-old with anorexia nervosa 25-year-old with peptic ulcer disease 32-year-old with hypertension 45-year-old with myocardial infarction

1

Which metabolic effects are caused by the action of estrogen? Select all that apply. Decrease bone resorption Increase production of thyroid globulins Increase low-density lipoproteins Decrease high-density lipoproteins

1,2

A client has been admitted to the hospital with an exacerbation of peptic ulcer disease. The nurse is aware the client is at risk for: Select all that apply. Perforation Hemorrhage Obstruction Weight gain Increased urinary output

1,2,3

A nurse is teaching a client diagnosed with Crohn disease about potential complications. The most appropriate information for the nurse to include would be: Fistula formation Chronic constipation Excessive weight gain Difficulty swallowing

1

A nurse is working in an eating disorder inpatient clinic. Which of the following does the nurse recognize as one of the most challenging aspects of treatment of anorexia nervosa? Recognizing that there is a problem Overcoming depression Socializing with other clients Gaining weight

1

A stroke patient is having difficulty swallowing food and beverages. The patient complains that it feels like "the food is sticking to the back of their throat." Given this information, the priority nursing interventions would be to: Make the patient "nothing per os" (NPO) and call the physician. Feed the patient while they are sitting in an upright position. Add a thickening agent to all of the patient's beverages. No action is warranted since this is a normal occurrence after a stroke.

1

An elderly patient presents with loose mucousy stools. The nurse suspects the patient has Clostridium difficile. What is a priority assessment for the nurse? Ask the patient about his or her antibiotic use. Ask the patient about his or her normal bowel pattern. Ask the patient about his or her fluid intake. Ask the patient about the foods he or she has consumed.

1

The health care provider needs to assess a client for protein-calorie malnutrition. The best diagnostic measure would be: Prealbumin Body circumference Skinfold thickness Serum potassium level

1

Which client has the greatest caloric needs? Breast-feeding mother who delivered 1 month ago Eight-week gestation pregnant client Diabetic client who is 82 years old Female client

1

A client, diagnosed with acute gastritis, is having bloody emesis and pain.Which possible causes of acute gastritis should the nurse assess the client for? Select all that apply. Aspirin NSAIDs Alcohol consumption Acid reflux Clostridium difficile

1,2,3

Long-term effects of estrogen deprivation include which of the following? (Select all that apply.) Osteoporosis Increased risk for cardiovascular disease Bone resorption at a faster rate than bone formation Improved cognitive function and decreased demetia

1,2,3

The nurse is teaching the client about risk factors for cervical cancer. What will be included in the plan of care? Select all that apply. First intercourse at an early age Multiple sexual partners Smoking Diabetes History of sexually transmitted infections Alcohol consumption

1,2,3,5

Which clinical manifestations would lead the nurse to suspect the post-op client has developed a mechanical bowel obstruction? Select all that apply. High-pitched bowel sounds Increased abdominal distention Severe, colicky pain Rectal bleeding Extreme restlessness

1,2,3,5

When comparing the symptomology of Crohn disease with that of ulcerative colitis, which symptoms are generally characteristic of only Crohn disease? Select all that apply. Fistulas. Toxic megacolon. Perianal ulcers. Bloddy diarrhea. Risk for cancer of the colon.

1,3

Which of the following statements about types of obesity is most accurate? Upper body obesity is often referred to as being shaped like a "pear". A waist-hip ratio greater than 1.0 in men can be interpreted to mean upper body obesity. Waist circumference is a measurement of subcutaneous abdominal adipose tissue but not intra-abdominal adipose tissue. A waist circumference of 40 inches or less in women is considered normal and therefore not associated with increased health risk.

2

Following yearly routine physical examination by the health care provider, a client has been diagnosed with upper body obesity along with central fat distribution. The client is at greater risk for developing which of the following disease processes? Osteoporosis Renal disease Cardiometabolic disorders Chronic anemia

3

Similarities between girls or women with anorexia nervosa and bulimia nervosa include: Periodontal disease Low estrogen level Electrolyte imbalances Enlarged parotid gland

3

Which of the following physiologic changes results in menopause? Changes in anterior pituitary function that alter ovarian hormone production Gradual resistance of ovarian target cells to LH and FSH stimulation Cessation of ovarian function and decreased estrogen levels Decreased levels of gonadotropin-releasing hormone (GnRH)

3

12s A client presents with a perforated peptic ulcer. Which complication would be a priority for the nurse to assess for? Blood pressure of 120/80 mmHg Flatulence with bouts of diarrhea Complaint of burning pain on an empty stomach Assessment of a rigid, boardlike abdomen

4

A transient inflammation of the gastric mucosa, acute gastritis, is most commonly associated with which cause? Undercooked meat Food allergies Gastric reflux Alcohol intake

4

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

A client who is prescribed amiodarone for frequent dysrhythmias A client who has precancerous thyroid lesions who underwent ablation with radiation A female experiencing an autoimmune disorder called thyroiditis A bipolar client prescribed lithium carbonate

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease?

A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or

A client has begun to display manifestations of hepatic encephalopathy. The family is concerned and asks the nurse what caused this condition to develop. Which is the best response by the nurse?

Accumulation of ammonia in the blood

While on tour, a 32 year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8°C (101.8°F), blood pressure 89/48 mmHg and heart rate 116 beats per minute. Blood work indicates that his serum levels of C-reactive protein, amylase and lipase are all elevated. Which of the following diagnoses would the care team suspect first?

Acute pancreatitis

While on tour, a 32 year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8°C (101.8°F), blood pressure 89/48 mmHg and heart rate 116 beats per minute. Blood work indicates that his serum levels of C-reactive protein, amylase and lipase are all elevated. Which of the following diagnoses would the care team suspect first? Hepatitis C Cholecystitis Liver cirrhosis Acute pancreatitis

Acute pancreatitis

The client in the GI clinic tells the nurse she is concerned she has something wrong with her gallbladder like what her friend with gallstones and inflammation had. Which of these complaints does the nurse recognize that supports the client's concern? Abrupt onset of right lower quadrant pain and chills Intolerance to greasy food; burping Fluid retention and edema of the hands and feet Craving for carbohydrates

Intolerance to greasy food; burping