Patho Final Questions
Disease of the arterial system affects body function by impairing blood flow. Which term refers to an area of necrosis in an organ produced by occlusion of its arterial blood supply
Infarction
Which individual is at greatest risk for developing a venous thrombosis resulting from venous stasis
Client on bed rest
A 3 year old boy has been diagnosed with croup. The nurse anticipates the plan of care includes
Cool, humidified air to relieve airways spasms
A client who is suspected of having acute renal failure would first be assessed by which blood tests? Select all that apply
Creatinine BUN
Manifestation of barking cough
Croup
A client is beginning to recover from acute tubular necrosis. During which phase of acute kidney injury will the nurse assess an increase in urine output
Diuretic phase
Which dermatologic problem most often accompanies chronic kidney disease (CKD)
Dry skin & pruritus
Match the type of lung cancer with the characteristic "Small, round/oval cells"
Small cell carcinoma
A 35 year old client is diagnosed with acute kidney injury and is started on hemodialysis. The client is concerned with the diagnosis & 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 & often reversible if recognized early & treated appropriately"
A client who was recently diagnosed with cancer & is worried that his cancer might spread asks the nurse how cancer spreads. What would be the nurse's best response
"Cancer spreads through the lymph channels & blood vessels"
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?"
Diagnostic testing has resulted in a diagnosis of small cell lung cancer in an older adult client. When exploring the etiology of the client's disease, what assessment question is most relevant
"Have you ever been a smoker?"
A client in the nursing home wonders why he is having these signs & symptoms of left sided heart failure. Which explanation will the nurse give the client
"The left ventricle is having problems pumping blood forward & this is causing blood to back up into your lungs"
A nurse is performing client health education with a 68 year old man who has recently been diagnosed with heart failure. Which statement demonstrates an accurate understanding of his new diagnosis
"I'm trying to think of ways that I can cut down the amount of salt that I usually eat"
A client who is being screened for cancer due to a family history asks the nurse what is meant by "tumor suppressing genes"? Which statement would be the nurse's best response
"It is category associated with gene under activity which by being less active creates an environment in which cancer is promoted"
A client has come into the ED with facial droop that progressed with hemiplegia & aphasia that began the previous evening at bedtime. The client's spouse is extremely upset because the physician stated that the client cannot receive thrombolytic medication to reestablish cerebral circulation & the spouse asks why. What is the nurse's most accurate response
"Thrombolytics may cause cerebral hemorrhage if given too late"
A client diagnosed with TB asks the nurse how long the anti tubercular medication will need to be taken. What is the best response
"You can expect to take multiple drugs possibly for as long as 24 months or until all tubercle bacilli are eliminated"
A client with persistent, primary hypertension remains apathetic about high BP stating "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell" How could the nurse best respond to this client's statement
"You may not sense an problems, but HTN increases your risk of heart disease & stroke"
EMS arrives to the Ed with an 84 year old patient who was involved in a house fire. The nurse notes a burn on the left lower extremity that extends into the subcutaneous tissue, muscle & bone. It appears waxy yellow in color with a brownish center & looks hard, dry, leathery. The nurse notifies the burn center to prepare to receive a patient with what depth of burn
3rd degree, full thickness
Which HTN individual is most likely to have his or her high BP diagnosed as secondary rather than essential
A 51 year old male who has been diagnosed with kidney disease
Which client of an oncologist is likely to have the poorest prognosis
A 69 year old man who has been diagnosed with stage IV malignant melanoma
Which client is exhibiting signs of advanced COPD
A client sitting in bed resting elbows on the overbed table, expiratory wheezes notes
The nurse notes that the client is taking several OTC medications that contain a preparation known to be the drug that most commonly causes liver failure. What is this drug
Acetaminophen
The most common type of leukemia found in children is
Acute lymphocytic
Based solely on the inheritable condition, a child with Down syndrome is susceptible for developing which type of cancer
Acute lymphocytic leukemia
Match the type of lung cancer with the characteristic "Occurs in the bronchioles & alveoli"
Adenocarcinoma
The process which allows tumors to develop new blood vessels and is triggered & regulated by tumor - secretions is called
Angiogenesis
The nurse is caring for inmates in a correctional facility. Which is the mode of transmission for the recent outbreak of TB
Airborne droplets
The nurse is caring for inmates in a correctional facility. Which is the mode of transmission for the recent outbreak of tuberculosis
Airborne droplets
Acute onset bronchial asthma causes wheezing and breathlessness as a result of
Airway inflammation
What description is characteristic of the pathology of chronic bronchitis
Airways are obstructed by mucus, causing hypoxemia
The nurse is conducting a staff inservice on increased ICP. The nurse determines that the participants are understanding the information when they identify that blood pressure increases in increased ICP because of which pathophysiologic response
An attempt to increase cerebral perfusion
A client admitted for cardiac embolic stroke. Which therapy to best prevent recurrence of embolic stroke should the nurse monitor for effectiveness
Anticoagulation therapy
A client who has recently attended a talk on healthy tips for preventing cancer identifies which food/compound to be carcinogenic in humans
Asbestos
Manifestation of expiratory wheezing
Asthma
The nursing instructor when teaching the students about coronary artery disease identifies which of the following as the main cause of CAD
Atherosclerosis
The nursing instructor, when teaching the students about coronary artery disease identifies which of the following as the main cause of CAD
Atherosclerosis
This type of skin cancer involves the sub layer of epidermis & rarely metastasis. It is the most common type of skin cancer. Scab, reddened
Basal cell
Following a collision while mountain biking, the diagnostic work up for a 22 year old male has indicated the presence of an acute subdural hematoma. Which pathophysiologic process most likely underlies his diagnosis
Blood has accumulated between the man's dura & subarachnoid layer of meninges
The nurse has just come on duty in the AM & is assessing a patient admitted the previous night with shortness of breath. The assessment reveals diminished breath sounds bilaterally, a prolonged expiratory phase, and an increased respiratory rate. The patient is thin appearing. The nurse suspects the following diagnosis
COPD
Which condition does the nurse know can lead to right sided heart failure
COPD
The nurse working in an ER is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's order will include
CT scan
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 ED
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 obstructive bronchitis & emphysema
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 smoking
A client's recent history of emphysema has resulted in the functional loss of many alveoli. How will this impact physiologic function of the alveoli
Decrease the production of surfactant
The nursing student caring for a patient diagnosed with active TB who has been admitted for non - compliance with antimicrobial therapy. The instructor explains to the students that the destructive nature of TB is due to the following mechanism
Delayed type of hypersensitivity reaction
Which changes associated with aging contribute to heart failure development in older adults
Elevated diastolic BP
The CT scan report identified that a client with a skull fracture has developed a hematoma that resulted from a torn artery. The report would be interpreted as
Epidural hematoma
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
Epstein - Barr virus (EBV)
Which risk factor for the development of primary HTN is nonmodifiable
Ethnicity
The nurse will monitor the client for which possible respiratory manifestations of heart failure. Select all that apply
Exertional dyspnea Orthopnea
Which body response to an acute inflammation will the nurse assess if the client is experiencing a systemic response
Fever & tachycardia
The client undergoes a cardiac catheterization to evaluate symptoms of chest pain & shortness of breath. The test shows lesions in the coronary arteries that have begun to reduce the size of the vessel lumen. This type of lesion is known as
Fibrous atheromatous plaque
A client comes in with a mild sunburn. Which term best describes the sunburn
First degree burn
A nurse will be providing care for a female patient who has a diagnosis of heart failure that has been characterized as being primarily right-sided. Which of the following statements best describes the presentation that the nurse should anticipate? The client
Has pitting edema to the ankles & feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain
The ED nurse is caring for a client who fell & has a head injury. Which assessment would be noted during the early stage of increased ICP
Headache
A highshool student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome & ask them to watch for & report which manifestations of its presence
Headaches & poor concentration
A client is diagnosed with leukemia. The student nurse working with this client correctly identifies this type of cancer to be
Hematologic cancer
A college student has been experiencing frequent headaches that he described as throbbing. He is reporting difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which pathophysiologic concepts is likely responsible for his symptoms
High pressure & local hemorrhage of the venous system
The presence of Reed - Sternberg cells on a laboratory exam confirms the diagnosis of what type of cancer
Hodgkin lymphoma
What is the major risk factor for developing atherosclerosis
Hypercholesterolemia
Which manifestation typically accompanies an asthmatic attack
Hyperinflation of the lungs
Following an MI, the nurse should be assessing the client for which possible complications. Select all that apply
Hypotension Ventricular dysrhythmias Cardiogenic shock
A 16 year old boy with sickle cell disease presents to the ED with chest pain. His mother reports he was doing well until he came down with a respiratory tract infection. She said he insisted on playing basketball even though he wasn't feeling well. The nurse anticipated what treatments to be ordered. Select all that apply
IV hydration Oxygen Pain medication
The nurse is caring for a client with sickle cell disease. The most important treatment for the nurse to provide would be
IV hydration & morphine
A client reports to the nurse recent episodes of headaches nausea & blurred vision and has been scheduled for a CT scan of the brain. The nurse understand that the symptoms of a brain neoplasm are often related to
Increased ICP
Which assessment findings would the health care provider consider as most indicative of acute renal failure
Increased nitrogenous waste levels Deceased GFR
The nurse is assessing a teenage client diagnosed with sickle cell disease. Which factors would contribute to sickling of the red blood cells. Select all that apply.
Increased stress due to final exams Prolonged exposure to cold while waiting for the school bus Recent diagnosis of an upper respiratory infection
Which physiologic response results from hyperinflation of the lungs that is seen in emphysema
Increased total lung capacity
The oncology nurse explains to her nursing oriented that the three stages of carcinogenesis include
Initiation, promotion, progression
A nurse is assessing a 1 year old with croup. Which manifestation would most likely be present
Inspiratory stridor & barking cough
A 70 year old male patient is receiving thrombolytic therapy (Activase) for an ischemic stroke. The nurse is alert for what serious complication after administering the medication
Intracranial bleeding
A client sustained acute tubular injury 2 hours ago. Which cause of acute kidney injury would the nurse suspect the client is experiencing
Intrarenal
A client asks the nurse how malignant tumors differ from benign tumors. The best response would be that malignant tumors
Invade surrounding tissues
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
While discussing the heart, the nursing instructor teaches about pericarditis. Which statement does the instructor state best defines this disease
It is an inflammatory process
A client with chronic kidney disease has developed asterisks. The nurse knows that asterisks is
Jerking movements of the hands
Match the type of lung cancer with the characteristic "Polygonal cells, highly anaplastic"
Large cell carcinoma
Match the sign or symptoms with left or right sided heart failure Blood tinged sputum
Left
Match the sign or symptoms with left or right sided heart failure Crackles heard in lung bases
Left
Match the sign or symptoms with left or right sided heart failure Orthopnea
Left
Match the sign or symptoms with left or right sided heart failure Pulmonary congestion
Left
A nurse educator is explaining to a group of students the differences between leukemias & lymphomas. Which respect to classification of these disease, which explanation is most accurate
Leukemia arises from precursor cells in marrow & lymphomas originate in peripheral lymphoid structures
Several steps characterize the development of atherosclerosis. Which is the correct order in which atheromas develop
Lipoprotein oxidation, foam cells produced, fibrous plaques develop, a thrombus forms
Which description sums up the basic pathophysiology of heart failure that the nurse would include when educating a client
Low cardiac output due to reduced pumping ability
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
This type of skin cancer has a high mortality & can rapidly progress & spread to other areas of the body Dark, irregular borders
Malignant melanoma
ALL and AML are two distinct disorders with similar presenting clinical features. What clinical feature do ALL and AML share
Night sweats
A client is brought to the ED with symptoms of acute coronary syndrome. Select the most important interventions that should be implemented. Select all that apply
Nitrates Morphine Oxygen ECG monitoring
A client is diagnosed with hypertension. The nurse knows that modifiable risk factors for HTN include which of these. Select all that apply
Obesity Inactive lifestyle Smoking
a 84 year old male client presents to the ED complaining of pain in the right lower extremity. He states that he hit his leg on the car door 2 days ago & it has become more painful & caused him difficulty walking. Upon inspection, the leg appears reddened and swollen. The nurse assess for other signs of inflammation which may include the following. Select all that apply
Pain Warmth Loss of function
Which factor is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma
Pet dander
A client has an obstructive urine outflow related to benign prostatic hyperplasia. Due to the inability to excrete adequate amounts of urine, which type of renal failure should the nurse closely monitor for
Postrenal failure
A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have
Prerenal failure
Following peripheral blood testing and a bone marrow biopsy, a patient has been diagnosed with chronic myelogenous leukemia. Which of the following is most likely to have preceded the patient's diagnosis
Presence of a Philadelphia chromosome
The nurse is preparing to auscultate a client's BP. Which information obtained form the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading
The client just smoked a cigarette
Which target of both chemotherapy and radiation treatment accounts for adverse as well as therapeutic effects
Rapidly proliferating cells
A 63 year old male patient has been diagnosed with a MI. Based on physician orders, the nurse has administered oxygen, morphine, and anti platelet medications in preparation for the patient to go to the cardiac catheterization lab. The nurse explains to the patient that the primary goal for immediate treatment is to
Re - establish perfusion to the affected area of the myocardium
A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for
Redness
The nurse reads in the medical record that a clients surgical wound in ruborous. When assessing the client the nurse anticipated the characteristics of the wound will reflect which of these
Redness
A diabetic client has injured his foot while walking barefoot on the lawn. On admission, which assessment finding would be considered a localized cardinal sign of acute inflammation
Redness & edema at the injured site
Match the sign or symptoms with left or right sided heart failure Ascites
Right
Match the sign or symptoms with left or right sided heart failure Bilateral ankle & leg edema
Right
Match the sign or symptoms with left or right sided heart failure Distended jugular veins
Right
Match the sign or symptoms with left or right sided heart failure Enlarged liver & spleen
Right
A 68 year old patient presented to the ED in the middle of the night with complaints of SOB with execration & at night & inability to sleep lying down. Upon assessment of the patient, the nurses notes bilateral lower extremity swelling, abdominal distention & an enlarged liver. The nurses know these findings indicate what type of heart failure
Right & left
In examining the ECG of a patient experiencing an MI, the nurse knows that which abnormal finding on the ECG indicated damage is occurring to the myocardial muscle
ST segment elevation
Nurses understand the importance of early detection for cancer. The best way to diagnose cancer in clients at its earliest stage is through which procedure
Screening
A child struggling to breathe is brought to the ER with a prolonged bronchospasm & severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, & tachycardia. What is the most likely diagnosis
Severe asthma attack
A child struggling to breathe is brought to the emergency department with a prolonged bronchospasm and severe hypoxemia. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. What is the most likely diagnosis
Severe asthma attack
The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner knows the client has what type of anemia
Sickle cell
Which type of bronchogenic carcinoma has the greatest association with tobacco smoking & tends to metastasize to the brain
Small cell
When talking to a group of homeless women living in a shelter, the nurse should educate about risk for developing tuberculosis. The nurse should emphasize which lab/diagnostic test as considered to be the "gold" standard for diagnosing tuberculosis
Sputum or bronchial cultures
This type of skin cancer involves the outer layer of epidermis. It is the second most common type of skin cancer.
Squamous cell
Match the type of lung cancer with the characteristic "Starts in the central bronchi"
Squamous cell carcinoma
A 75 year old patient with a history of CAD is being seen at his cardiologist. In preparation for the visit, the nurse is updating the patients history. The patient states chest pain occurs when exercising strenuously but relieved with rest. The nurse documents what type of condition
Stable angina
A client is being discharged following a percutaneous transluminal coronary angioplasty with stent placement. The nurse explains that the acetylsalicylic acid & clopidogrel here both prescribed to reduce the risk of which complication
Stent occlusion
The MRA scan of a client with a suspect stroke reports ruptured berry aneurysm. The nurse plans care for a client with
Subarachnoid hemorrhage
A client with newly diagnosed squamous cell carcinoma of the lung asks, "so how do we treat this cancer?" Which response from the health care provider is most accurate
Surgery, chemotherapy, radiation
A client with chronic kidney disease will be managed with peritoneal dialysis. Which description of this type of dialysis is most accurate
Treatment involves the introduction into the peritoneum of a sterile dialyzing solution which is drained after a specified time
A nurse at a long term care facility provides care for a client who has had recent transient ischemic attacks. What significance should the nurse attach to the TIAs
TIAs, by definition, resolve rapidly, but they constitute an increased risk of stroke
A 55 year old man present to the ED reporting chest pain for the last 2 hours. He describes the pain as crushing, like a huge weight is on his chest. He also states that the pain goes up into his neck & down his left arm. An acute MI is diagnosed. When taking his history, the following things were notes. Which things would be most likely to contribute to the diagnosis of MI
The client recently stopped taking his medication for HTN and hyperlipidemia due to lack of funds
While educating a smoking cessation class, a client asks the nurse, "If I can still get lung cancer, what should I be looking for?" Which response by the nurse is best
The earliest symptoms relate to a chronic cough & shortness of breath
A nurse is working with an 8 year old client diagnosed with AML. The nurse plans the client's care in the knowledge that thrombocytopenia & associated bleeding are risks because
The undifferentiated leukemic blast cells accumulate in the bone marrow, suppressing the remaining progenitor cells
A 65 year old male patient is 4 days post operative from knee surgery. He has been on bedrest due to respiratory complications. The nurse knows that the combination of orthopedic surgery & prolonged bedrest contributes to hyper coagulability & puts the patient at risk for
Thrombosis
The most common cause of ischemic stroke is
Thrombosis
Which most important complication of atherosclerosis can result in occlusion of small heart vessels
Thrombosis
When educating a college student who lives in a crowded apartment & was recently diagnosed with TB, the school nurse will emphasize which treatment plan
To destroy this bacterium, you must strictly adhere to a long term drug regimen of several medications
A client who is being been in the outpatient clinic reports a single episode of unilateral arm & leg weakness & blurred vision that lasted approximately 20 minutes. The client is most likely experiencing
Transient ischemic attack (TIA)
A 35 year old client presents to the urgent care clinic with sudden onset of fever, chills, malaise, muscle aches, headache, watery nasal drainage. They also complain of a sore throat & an occasional dry cough. Nursing assessment reveals clear lung sounds & a temperature of 99. They report being at work recently where several individuals had similar symptoms. The nurse explains to the client that the treatment goals for this condition would be
Treat symptoms & limit the infection to the upper respiratory tract
The nursing student studying about cancer says the following "A neoplasm, benign or malignant, represents a new growth". This statement is considered to be which of the following
True
A patient presents to the ED complaining of chest pain at rest which is relieved by taking sublingual nitroglycerin. The patient has a history of coronary artery disease. The nurse explains that one of his coronary arteries may be partially blocked by plaque disruption and this is called
Unstable angina
Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential
a 51 year old male who has been diagnosed with kidney disease
