Patho Final - Quizzes 5-7

A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for:

Atherosclerotic lesions in cerebral vessels

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

Intravaginal testicular torsion

A child has been hospitalized for the treatment of hematogenous osteomyelitis. The defining characteristic of this type of osteomyelitis is:

Introduction of microorganisms from the bloodstream

Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes? A client who:

Is morbidly obese defined as greater than 100 pounds over ideal weight

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

Urine retention

While discussing hormonal control of bone formation, one should note that which hormone lowers blood calcium levels and decreases bone resorption?

Calcitonin

When sensors detect a change in a hormone level, the hormonal response is regulated by which of the following mechanisms that will return the level to within normal range.

Feedback

The condition that contributes to the pathology of all metabolic bone diseases is:

Osteopenia

Which of the following complaints by middle-aged women should prompt a care provider to assess for the possibility of ovarian cancer?

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

A 21-year-old college student has sought care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which of the clinician's assessment questions is most likely to apply to a diagnosis of vaginitis?

"Have you ever had a sexually transmitted infection?"

Following a fracture, the nurse is educating the client and his family about bone healing. The nurse begins by stating:

"In order to initiate the cellular events essential to bone healing, within a day or so, your body will develop a blood clot at the fracture site."

A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize?

"It would be helpful for you to take control of your diet, sleep schedule, and stress levels."

A client with a family history of breast cancer has just learned that she carries the BRCA1 and BRCA2 mutation. When educating this client about follow-up care, which of the following statements would be most appropriate?

"You should have more frequent breast evaluations using an MRI rather than standard mammography."

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

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

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

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that:

A large percentage (70%) of those infected experience no symptoms of the disease.

Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis?

A woman who has six to eight alcoholic beverages each evening

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

ACTH

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

Abnormalities or stasis of bile

Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics?

Acne vulgaris

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

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

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

Albumin

Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with:

Alcohol intake

A client with a history of osteoarthritis in his hip, which he refers to as "bad hip," is also complaining of knee pain. The physiological principle behind this would include the fact that:

All joints of an extremity are innervated by the same peripheral nerves as they travel down the limb.

When drinking alcohol, driving ability decreases. The rationale for poor performance in driving as the amount of alcohol intake increased includes, "The blood-brain barrier ________________________."

Allows alcohol, a very lipid-soluble molecule to rapidly enter the brain."

Which of the following individuals displays the precursors to acromegaly?

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

A client with a history of diabetes presents to the emergency department following several days of polyuria and polydipsia with nausea/vomiting. On admission, the client labs show a blood glucose level of 480 mg/dL and bicarbonate level of 7.8 mEq/dL. The nurse suspects the client has diabetic ketoacidosis (DKA). The priority intervention should include:

Begin a loading dose of IV regular insulin followed by a continuous insulin infusion.

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which of the following pathophysiologic processes underlies the client's new diagnosis?

Beta cell exhaustion due to long-standing insulin resistance

Which of the following statements about bone mass and the elderly is accurate?

Bone resorption and formation are no longer perfectly coupled, and bone mass is lost.

A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?

Brain contusions and hematomas

While breaking in a new pair of shoes, a client develops a large (1.0 cm) blister filled with clear fluid. The dermatologist diagnoses this as:

Bullae

A female athlete has been diagnosed with amenorrhea due to intense training for a spot on the Olympic swimming team. As a health care provider, which of the following should be implemented to prevent premature osteoporosis?

Calcium/vitamin D supplements to support BMD.

While explaining to the parents of a child diagnosed with postural scoliosis, the nurse will emphasize which of the following concepts? This form of scoliosis:

Can be corrected with bending and active/passive exercises

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

Carry a snack with carbs to prevent profound hypoglycemia

A female receives a PAP smear result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse will emphasize the need for continued follow-up since HPV is directly associated with:

Cervical dysplasia

An increase in the level of RANKL would result in:

Changes in the rate of bone remodeling

A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is:

Chlamydia

A couple presents to an infertility clinic. The health care provider will focus testing on which of the following sexually transmitted infections (STIs) that is very damaging to the reproductive system but rarely exhibits symptoms of infection?

Chlamydial infection

Impaired and delayed healing in a person with diabetes is caused by long-term complications that include:

Chronic neuropathies

A client complains to the health care provider that he keeps getting hard skin on the sides of the great and little toes when he wears certain pairs of shoes. This is probably caused by ill-fitting shoes putting pressure on certain areas of the foot and would be called a:

Corn

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

Digital rectal examination

Complex regional pain syndrome is characterized by:

Disproportionate pain with mobility

Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer?

Dysphagia in an individual with no history of neurologic disease

Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease?

Excess ACTH production by a pituitary tumor

In comparison to children with acute otitis media (AOM), those with otitis media with effusion (OME) have:

Excess middle ear fluid

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation?

Fallopian tube damage

A client presents to a STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI?

Gonorrhea

A 44-year-old man has been brought to the emergency department with severe electrical burns resulting from a workplace accident. The most immediate threat to this client's survival at this time is:

Hemodynamic instability

Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal:

Hemorrhages

An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?

Immunologically mediated joint inflammation

Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the client with psoriasis, a disorder that results from:

Increased epidermal cell turnover

Dysplastic nevi are precursors of malignant melanoma that are:

Larger than other nevi

In third-world countries, many children experience uncontrolled itching and scratching, which may develop into:

Lichenification

The nurse caring for a client with diverticulitis should assess for which of the following clinical manifestations?

Lower left quadrant pain

A diabetic client was visiting the endocrinologist for annual checkup. The client's blood work reveals an increased level of which lab result that reveals early signs of diabetic nephropathy?

Microalbuminuria

A child with a diagnosis of Legg-Calvé-Perthes disease will exhibit:

Necrosis of the proximal femoral head

Nociceptors are sensory receptors that are activated by:

Noxious stimuli

An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis?

Obstruction of the intestinal lumen

The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which of the following signs/symptoms?

Ophthalmopathy

A female client presents to the orthopedic clinic for evaluation. The primary care provider told her she has a "spur" on her joint. She asks, "Why did this happen?" The nurse recognizes this to be osteoarthritis (OA) culminating in:

Osteophyte formation and erosion of cartilage

A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the client notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the client's medication administration record. The nurse should conclude that this client likely has a history of:

Osteoporosis

A client presents to a health care clinic reporting sudden onset of deep, localized pain and swelling in her proximal femur. The client is currently undergoing diagnostic workup for suspected lung cancer. The nurse suspects the client may have developed which of the following neoplasms of the skeletal system?

Osteosarcoma

How are the oxygenation needs of the articulating areas in a synovial joint met?

Oxygen is provided to the articulating areas indirectly by synovial fluid.

A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of:

Pannus tissue

Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include:

Petechiae

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

Placement of a shunt

A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience?

Prehepatic

Which of the following vision deficits is a clinician justified in attributing to the normal aging process?

Presbyopia

A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which of the following manifestations related to the necrosis of liver cells?

Rapid onset of jaundice

A client's clavicular fracture has healed in the weeks following a bicycle accident. Which of the following events takes place in the remodeling stage of bone healing?

Reduction in the size of the callus

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client?

Respiratory ventilation assessment and prevention of aspiration pneumonia

Psoriasis is a skin disorder characterized by:

Scaling plaques

A 14-year-old presents to the dermatologist clinic with a severe case of acne. The nurse explains that this acne is a result of inflamed

Sebaceous glands

While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is:

Sebum, secreted by the sebaceous gland

Primary adrenal insufficiency is manifested by:

Serum sodium level of 120 mmol/L (low) and blood glucose level of 48 mg/dL (low)

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which of the following abnormalities in the client's gait?

Slow to start walking and has difficulty when asked to "stop" suddenly

When a person is stung on the index finger by a bee, the thalamus interprets the pain as:

Somewhere on the hand

A client who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive?

Stopping the drug suddenly may cause acute adrenal insufficiency

A client has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which of the following treatment modalities is most likely to benefit this client?

Synthetic preparations of T3 or T4

An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms?

Tertiary syphilis

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

Which of the following physiologic processes best exemplifies a positive feedback mechanism?

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

Which of the following clinical manifestations would lead the health care provider to diagnose the sunburn as severe?

There is blistering of the skin and associated fever and chills.

During accommodation, you are able to maintain focus because of:

Thickening the lens

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has:

Trichomoniasis

A college student goes to the campus health office complaining of diarrhea, lower right abdominal pain, and weight loss. Suspecting Crohn disease, the nurse will assess for which complication associated with this diagnosis?

Urine that has the look and smell of feces

A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile, but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect?

Varicella

Both prehepatic and posthepatic causes of portal hypertension include the formation of:

Venous thrombosis

A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous small blisters on the shaft of his penis. On examination, the clinician notes that the lesions are between 2 and 4 mm in diameter and are filled with serous fluid. The clinician would document the presence of:

Vesicles

Which of the following characteristics differentiates a migraine with aura from a migraine without aura?

Visual symptoms that precede the headache