Patho II Exam 3 - Ch 26-31

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5. Which side effect does the nurse expect to observe in a client who is on epinephrine therapy? 1. Gastrocolic reflex 2. Injuries to the gastric epithelium 3. Suppression of the urge to defecate 4. Decreased gastrointestinal secretions

3. Suppression of the urge to defecate

18. A male client at the age of 62 years visits the health-care provider with concerns about infertility. The client states, "I am marrying a younger woman and we want to have children." Which information presented by the health-care provider is likely to be most applicable to the client? 1. Age is an important consideration affecting sperm count. 2. A history of cancer and cancer treatment affects fertility. 3. Anatomical abnormalities can prevent sexual activity. 4. Lifestyle choices and habits can prevent fertility.

1. Age is an important consideration affecting sperm count.

6. While assessing a client who has liver dysfunction, the nurse finds the client has shifting abdominal dullness. Which condition does the nurse suspect in the client? 1. Ascites 2. Splenomegaly 3. Spider angiomata 4. Esophageal varices

1. Ascites

12. A client is diagnosed with condyloma acuminata. Which test does the nurse expect to be most beneficial to detect the viral genome? 1. Biopsy 2. Papanicolaou (Pap) smear 3. Colposcopy 4. Enzyme-linked immunosorbent assay (ELISA) for IgG association

1. Biopsy

9. Upon physical examination, the nurse detects abdominal tenderness, increased bowel sounds accompanied by signs of borborygmi, abdominal distension, and tympany on percussion. Which diagnostic test distinguishes Crohn's disease from ulcerative colitis in the client? 1. Colonoscopy 2. Urinalysis 3. Complete blood count 4. Chest x-ray

1. Colonoscopy

19. The registered nurse is teaching a client with dysmenorrhea about her treatment plan. Which statement made by the client indicates the need for additional teaching? 1. "I should avoid the use of oral contraceptives." 2. "I should take ibuprofen as prescribed." 3. "I should consume a low-fat diet." 4. "I should perform regular exercise."

1. "I should avoid the use of oral contraceptives."

4. The nurse is reviewing the pathophysiology of nonalcoholic fatty liver disease (NAFLD) with staff nurses. Which statement made by an attending nurse indicates understanding? 1. "NAFLD is linked to metabolic syndrome." 2. "Exposure to vinyl chloride can cause NAFLD." 3. "Increased level of adiponectin is associated with NAFLD." 4. "NAFLD is caused by accumulation of fat in the adipose tissue."

1. "NAFLD is linked to metabolic syndrome."

14. The nurse educator is teaching a group of staff nurses about the importance of inserting a nasogastric tube in clients with large bowel obstruction. Which statement made by an attending nurse indicates effective learning? 1. "A nasogastric tube relieves pressure caused by bowel obstruction." 2. "A nasogastric tube is primarily used to deliver medications directly to the client's stomach." 3. "A nasogastric tube removes free air present under the client's diaphragm." 4. "A nasogastric tube removes the mechanical obstruction in the large intestine."

1. "A nasogastric tube relieves pressure caused by bowel obstruction."

17. The nurse is reviewing with a group of staff nurses the use of antibiotics in a client diagnosed with appendicitis. Which statement made by a nurse indicates understanding? 1. "Antibiotics are administered before an operation and continued until 48 hours after the operation." 2. "Antibiotics are not administered before diagnosis, as they interfere with the diagnostic signs." 3. "Antibiotics are to be administered after restoring the fluid and electrolyte balance." 4. "Antibiotics are used when there is no need for surgical removal of the appendix."

1. "Antibiotics are administered before an operation and continued until 48 hours

10. The nurse is reviewing the treatment plan for Crohn's disease with staff nurses. Which statement made by a nurse indicates understanding? 1. "Cholestyramine is prescribed to clients with ileal disease." 2. "Loperamide is administered in clients to reduce abdominal cramps." 3. "Propantheline dicyclomine is administered to relieve chronic diarrhea." 4. "Multivitamin supplements are contraindicated in clients with decreased absorption."

1. "Cholestyramine is prescribed to clients with ileal disease."

4. Which is the largest serous membrane in the body? 1. Peritoneal serosa 2. Submucosal layer 3. Columnar epithelium 4. Circular muscle layer

1. Peritoneal serosa

2. The nurse is teaching adolescent girls about the menstrual cycle. Which comment by an attendee expresses understanding about ovulation? 1. "The actual stimulus for ovulation comes from the brain." 2. "Another commonly used term for menstruation is menarche." 3. "The menstrual cycle consists of the number of days of menstruation." 4. "The rise in progesterone decreases if the ovum is fertilized."

1. "The actual stimulus for ovulation comes from the brain."

1. The nurse is counseling a client about high doses of NSAIDs taken to "keep aches and pains away." The nurse shares that the liver is at risk for damage. The client asks, "What does the liver do, anyway?" Which is the best answer by the nurse? 1. "The liver plays multiple important roles in digestion." 2. "Damage to the liver can cause serious illnesses." 3. "The liver can be damaged by overuse of medications." 4. "A seriously diseased liver may require a liver transplant."

1. "The liver plays multiple important roles in digestion."

17. The nurse is reviewing the functions of the liver with a group of staff nurses. Which response by one of the attending nurses indicates the need for additional review? 1. "The liver synthesizes glucagon." 2. "The liver synthesizes thrombopoietin." 3. "The liver synthesizes angiotensinogen." 4. "The liver synthesizes insulin-like growth factor 1."

1. "The liver synthesizes glucagon."

12. Which artery provides engorgement of the glans during erection? 1. Dorsal 2. Cavernous 3. Bulbourethral 4. Thoracic

1. Dorsal

9. Which gastrointestinal disorder occurs after bariatric surgery involving removal of part of the stomach? 1. Dumping syndrome 2. Mallory-Weiss syndrome 3. Zollinger-Ellison syndrome 4. Plummer-Vinson syndrome

1. Dumping syndrome

17. A client is exposed to the Neisseria gonorrhoeae organism and becomes infected. Which symptom is noted in the client immediately after the infection? 1. Dysuria 2. Abdominal pain 3. Copious discharge 4. Chancre formation

1. Dysuria

3. While assessing a female client at 7 years of age, the health-care provider finds the client has enlargement of the breasts, erection of the nipples, and pubic hair. Which hormonal levels are found to be high in the client? 1. Estrogen 2. Progesterone 3. Pitocin 4. Graafian

1. Estrogen

5. A female client is diagnosed with infertility due to the production of antibodies against the ovarian tissue. Which treatment does the nurse expect for the client? 1. Estrogen replacement therapy 2. Oral contraceptive therapy 3. Clomiphene citrate 4. Dilatation and curettage surgery

1. Estrogen replacement therapy

21. The nurse is caring for a neonate immediately after birth. The mother has genital warts. Which intervention by the nurse is initiated? 1. Examine the pharynx of the neonate 2. Instruct the mother to breastfeed the neonate 3. Encourage the mother to give kangaroo care to the neonate 4. Administer vitamin D and iron supplements to the neonate

1. Examine the pharynx of the neonate

3. Which part of the gastrointestinal (GI) tract is involved in the production of protective mucus? 1. Goblet cells 2. Submucosal layer 3. Circular muscle layer 4. Columnar epithelial cells

1. Goblet cells

1. The registered nurse is teaching a group of adolescents about sexually transmitted diseases and makes the following statement, "This disease spreads through close skin contact and cannot be prevented by using condoms." Which sexually transmitted disease is the nurse referring to in the teaching? 1. Herpes simplex virus (HSV) 2. HIV 3. Hepatitis B 4. Chlamydia

1. Herpes simplex virus (HSV)

1. The nurse is preparing a client for a laparoscopic fundoplication. Reports on previously performed endoscopy and barium tests are not yet available. On reviewing the medical history, the nurse notes the client complains of dysphagia, substernal burning, and belching. Which condition does the nurse expect to be identified in the client? 1. Hiatal hernia 2. Gastritis 3. Stomach cancer 4. Schatzki ring

1. Hiatal hernia

22. Upon reviewing a female client's laboratory reports, the nurse finds that the client tested positive for a sexually transmitted infection. With which infection is the client likely to remain fertile? 1. Human papillomavirus (HPV) infection 2. Chlamydia infection 3. Gonorrheal infection 4. Pelvic inflammatory disease

1. Human papillomavirus (HPV) infection

10. While assessing a male client, a nurse observes swelling in the scrotum due to the collection of serous fluid. Which condition does the nurse suspect in the client? 1. Hydrocele 2. Epispadias 3. Hematocele 4. Hypospadias

1. Hydrocele

1. A female client tells a nurse, "I have excessive bleeding that lasts for more than 7 days every time I menstruate." Which menstrual disorder does the nurse suspect in the client? 1. Menorrhagia 2. Metrorrhagia 3. Oligomenorrhea 4. Secondary amenorrhea

1. Menorrhagia

8. A client diagnosed with dysmenorrhea is prescribed ibuprofen and hormonal contraceptives. Which outcome in the client indicates the effectiveness of the therapy? 1. No painful experience during the first 2 days of the menstrual period 2. No behavioral change during the luteal phase of the menstrual cycle 3. No formation of multiple regions of unreleased egg on the ovarian surface 4. No increase in the laboratory test levels of prostaglandin F

1. No painful experience during the first 2 days of the menstrual period

8. The nurse is providing care for an older adult client who presents with abdominal cramping, abdominal distention, and the inability to have a bowel movement. An abdominal x-ray reveals a distended colon, with loops of dilated bowel superior to an obstruction. Which treatment does the nurse expect to be prescribed? 1. Placement of a nasogastric tube 2. Laxatives to stimulate peristalsis 3. Pureed, bland diet as tolerated 4. Enemas until return is clear

1. Placement of a nasogastric tube

23. The health-care provider asks a client to lie down facing upwards and flex the right thigh at the hip. The client says, "I cannot do this. This position is hurting my abdomen." Which sign of appendicitis does the nurse recognize in this client? 1. Psoas sign 2. Rovsing sign 3. Obturator sign 4. Rebound tenderness

1. Psoas sign

10. The nurse is providing care for a client with renal disease and notices a slight yellowish color of the skin. The client reports recent symptoms of the flu. Which contributing factor does the nurse identify as increasing the client's possibility of hepatitis B? 1. Renal disease is treated with hemodialysis 2. Ethnic background identified as Caucasian 3. Recent travel to Central and Southeast Asia 4. Ingestion of raw or undercooked shellfish

1. Renal disease is treated with hemodialysis

2. A client tells a nurse, "My new medication has helped with my erectile dysfunction." Which medication prescribed for the client is likely responsible? 1. Sildenafil 2. Finasteride 3. Tamsulosin 4. Pyridoxine

1. Sildenafil

5. The nurse suspects hepatic encephalopathy in a client with severe liver dysfunction. Which symptom supports the nurse's suspicion? 1. Stupor 2. Ascites 3. Hematemesis 4. Spider angiomata

1. Stupor

3. The nurse is reviewing laboratory results on a client that indicates the presence of the spirochete bacterium Treponema pallidum. Which infection does the nurse associate with the laboratory report? 1. Syphilis 2. Chancroid 3. Granuloma inguinale 4. Lymphogranuloma venereum

1. Syphilis

16. A client with premenstrual syndrome (PMS) is prescribed selective serotonin receptor inhibitors (SSRIs) and nutritional supplements. Which symptom in the client indicates the effectiveness of the therapy? 1. The client has decreased irritability and mood swings. 2. The client no longer experiences painful menstruation. 3. The client's blood report shows no serum beta human chorionic gonadotropin (b-HCG). 4. The client has elevated levels of progesterone.

1. The client has decreased irritability and mood swings.

13. In a client diagnosed with large bowel obstruction, an abdominal x-ray is performed, which shows the presence of free air under the diaphragm. After the diagnosis, the nurse initiates prophylactic antibiotic therapy and fluid replacement therapy per the prescriptions of the health-care provider. Which outcome in the client indicates the effectiveness of the therapy? 1. The client has normal levels of serum amylase. 2. The client has a normal count of red blood cells. 3. The client no longer experiences abdominal cramps. 4. The client no longer experiences chronic diarrhea.

1. The client has normal levels of serum amylase.

19. Which client does the nurse instruct to avoid eating or drinking food items that are hot or spicy? 1. The client with esophagitis 2. The client with esophageal cancer 3. The client with dumping syndrome 4. The client with upper gastrointestinal bleed (UGIB)

1. The client with esophagitis

11. For a client diagnosed with terminal ileal disease, the health-care provider prescribes sulfasalazine. Which outcome in the client indicates the effectiveness of the therapy? 1. The client's gastrointestinal wall is normalized. 2. The client's hematocrit percentage is normal. 3. The client is able to absorb bile acids. 4. The client's urinalysis results show normal values.

1. The client's gastrointestinal wall is normalized.

6. A nurse is caring for a female client at 19 years of age who never had a menstrual cycle. Physical assessment reveals a webbed neck; short stature; and a broad, shieldlike chest. Which is the most probable cause of the client's condition? 1. Turner syndrome 2. Sheehan's syndrome 3. Asherman's syndrome 4. Mayer-Rokitansky-Hauser syndrome

1. Turner syndrome

21. Which disorder of the large intestine may require laparoscopic surgery to unwind the intestine? 1. Volvulus 2. Appendicitis 3. Hemorrhoids 4. Diverticular disease

1. Volvulus

5. The registered nurse is teaching about medications for benign prostatic hyperplasia (BPH) to a group of staff nurses. Which statement made by a nurse indicates the need for additional teaching? 1. "Alpha-blockers improve urine flow." 2. "Alpha-blockers reduce the size of the prostate." 3. "Tamsulosin is a typical example of an alpha-blocker." 4. "Alpha-blockers relax the smooth muscles in the prostate."

2. "Alpha-blockers reduce the size of the prostate."

15. While assessing a young female client for reproductive disorders, the nurse understands the client has amenorrhea. Which specific question does the nurse ask the client? 1. "Do you have frequent vaginal infections?" 2. "Do you have any thyroid gland disorders?" 3. "Do you have diabetes mellitus?" 4. "Do you have continuous or intermittent pelvic pain?"

2. "Do you have any thyroid gland disorders?"

14. The nurse counsels a male client about healthy spermatogenesis. During a follow-up visit, the nurse learns the client is still experiencing diminished sperm production. Which statement by the client indicates a need for additional teaching? 1. "I am trying to limit fluid intake." 2. "I sit in the hot tub daily after exercising." 3. "I am medicating to stop cigarette smoking." 4. "I have replaced all my underwear with boxers."

2. "I sit in the hot tub daily after exercising."

14. The nurse is reviewing the causes and manifestations of perimenopause with a group of staff nurses. Which comment by an attending staff nurse indicates understanding of the difference between perimenopause and menopause? 1. "A normal level of estrogen continues after menopause." 2. "Perimenopause is confirmed by high levels of follicle-stimulating hormone (FSH)." 3. "Menstruation will occur occasionally after menopause." 4. "Perimenopause brings a permanent stage of infertility."

2. "Perimenopause is confirmed by high levels of follicle-stimulating hormone (FSH)."

22. The nursing instructor is discussing the physical assessment findings for hemorrhoids. Which statement made by the student nurse indicates effective learning? 1. "Presence of anal fistulas is observed." 2. "Presence of blood in stools may be observed." 3. "McBurney's point indicates tenderness." 4. "Auscultation indicates high-pitched bowel sounds."

2. "Presence of blood in stools may be observed."

16. The nurse is providing care for a client with suspected gallbladder disease. Assessment by the nurse reveals jaundice, dark-colored urine, and upper right quadrant abdominal pain. Based on the assessment findings, which is the most likely cause of the client's condition? 1. A gallstone lodged in the cystic duct 2. A gallstone lodged in the common bile duct 3. Multiple gallstones located in the gallbladder 4. Gallstones in the liver from a ruptured gallbladder

2. A gallstone lodged in the common bile duct

20. For which reason does the nurse identify the change of urine color in a client with liver disease? 1. Failure of bilirubin to reach the intestine 2. Accumulation of bilirubin in the bloodstream 3. Accumulation of bile salts in the bloodstream 4. Infiltration of the liver with fat

2. Accumulation of bilirubin in the bloodstream

2. The nurse concludes that an obese client is manifesting symptoms from a rare type of hernia. Which finding confirms the condition? 1. Belching 2. Acute chest pain 3. Substernal burning 4. Epigastric discomfort

2. Acute chest pain

18. The nurse is preparing to present information about sexually transmitted infections (STIs) to a multicultural group of various ages. Which information does the nurse include to best engage all attendees? 1. Men who have sex with men (MSM) have the highest incidence of STIs. 2. Approximately 19 million new cases are diagnosed annually in the United States. 3. African Americans make up 67% of new cases of gonorrhea in the United States. 4. Clinicians are urged to screen young adults for STIs when possible.

2. Approximately 19 million new cases are diagnosed annually in the United States.

5. A female client presents at a community clinic with pelvic pain, chills, and a fever of 102.2°F (39°C). A urine test indicates pregnancy, and the client reports missing two periods. Which action does the nurse take immediately? 1. Consult a health-care provider for antibiotics 2. Arrange for hospitalization and treatment 3. Administer medication to reduce the fever 4. Perform an ultrasound to confirm pregnancy

2. Arrange for hospitalization and treatment

7. While assessing a male client for reproductive disorders, the health-care provider wants to verify whether the client has prostate cancer or benign prostatic hyperplasia (BPH). Which diagnostic test does the health-care provider prescribe to rule out cancer? 1. Ultrasound 2. Biopsy 3. Digital rectal examination (DRE) 4. Blood test for the level of prostate-specific antigen (PSA)

2. Biopsy

16. A client tells the nurse, "I have intense stomach pain for 3 hours after eating." On assessment the nurse finds abdominal pain and tenderness. The nurse suspects the client has peptic ulcers. Which diagnostic procedure does the nurse expect the health-care provider to prescribe? 1. Ultrasound of the abdomen 2. Blood test for Helicobacter pylori antibodies 3. Fecal occult blood test 4. Computerized tomography (CT) scan

2. Blood test for Helicobacter pylori antibodies

2. The nurse is reviewing the medical records of a client who is pregnant and finds the client has a Chlamydia infection. Which complication is the nurse aware of in the newborn if the client is not treated? 1. Meningitis 2. Conjunctivitis 3. Hearing disorders 4. Aortic valve deformity

2. Conjunctivitis

19. Which is a characteristic feature of ulcerative colitis? 1. Presence of cobblestone appearance 2. Continuous areas of inflammation in the large intestine 3. Healthy tissues interrupted by areas of diseased tissue 4. Presence of anal fissure and anal fistula formations

2. Continuous areas of inflammation in the large intestine

10. A female client is admitted to the emergency department with severe lower abdominal pain. Physical assessment reveals adnexal tenderness, and an ectopic pregnancy is suspected. Which test is performed to specifically determine if a tubal rupture has occurred? 1. Abdominal x-ray 2. Culdocentesis 3. Human chorionic gonadotropin (HCG) levels 4. Pelvic ultrasound

2. Culdocentesis

14. Which characteristic feature of dumping syndrome does the nurse recognize in a client after bariatric surgery? 1. Steatorrhea 2. Diaphoresis 3. Colicky cramping 4. Hematemesis

2. Diaphoresis

4. Which part of the stomach most commonly harbors Helicobacter pylori? 1. Body 2. Fundus 3. Pylorus 4. Duodenum

2. Fundus

2. Which virus helper function is needed for the replication of hepatitis D virus? 1. Hepatitis A virus (HAV) 2. Hepatitis B virus (HBV) 3. Hepatitis C virus (HCV) 4. Hepatitis E virus (HEV)

2. Hepatitis B virus (HBV)

3. A nurse observes that a newborn has an abnormally positioned urethral orifice of the penis. Which disorder does the nurse suspect in the newborn? 1. Orchitis 2. Hypospadias 3. Cryptorchidism 4. Testicular torsion

2. Hypospadias

11. After assessing a client with biliary cirrhosis, the nurse identifies the presence of xanthelasmas. Which laboratory test supports the nurse's assessment finding? 1. Endoscopy 2. Lipid levels 3. Bilirubin levels 4. Prothrombin time

2. Lipid levels

17. While assessing a female client for anomalies of the genital tract, the health-care professional observes that the uterus is absent and the vagina is foreshortened. However, the client's breast is normal in shape and contour. Which menstrual disorder would the nurse suspect in the client? 1. Dysmenorrhea 2. Mayer-Rokitansky-Hauser syndrome 3. Premenstrual syndrome 4. Menorrhea

2. Mayer-Rokitansky-Hauser syndrome

13. The nurse is aware of multiple methods of testing to identify microorganisms causing sexually transmitted infections (STIs). Which laboratory test is used in order to detect microorganisms in sample of tissue, blood, or body fluid? 1. Cultures grown on a specific agar 2. Polymerase chain reaction (PCR) 3. Nucleic acid amplification test (NAAT) 4. Viral RNA levels

2. Polymerase chain reaction (PCR)

13. After examining an older adult client's penis, the nurse finds the presence of scar tissue in the corpora cavernosum. On further assessment, the nurse confirms Peyronie's disease in the client. Which finding supports the nurse's confirmation? 1. Small intrascrotal testes 2. Presence of a curved penis 3. Dilatation of the veins within the scrotum 4. Excessive growth of the prostate gland

2. Presence of a curved penis

19. While assessing a male client, a nurse observes that the client has a small penis and testicles, long legs, short trunk, enlarged breast tissue, and a history of sexual dysfunction. Which condition does the nurse suspect? 1. Effects of mumps infection 2. Presence of an extra X chromosome 3. Prolonged administration of antihypertensive agents 4. Increased cellular growth and size of the prostate gland

2. Presence of an extra X chromosome

15. A female client is admitted to the hospital with abdominal pain that originates in the umbilical region and radiates to the right lower quadrant. The health-care provider prescribes a urinalysis. In which manner does this help the health-care provider diagnose the client's condition? 1. Rules out the possibility of calcium stones within the appendix 2. Rules out the possibility of a kidney stone or pyelonephritis 3. Rules out the possibility of ectopic pregnancy 4. Rules out the possibility of a gynecological disorder

2. Rules out the possibility of a kidney stone or pyelonephritis

13. A client reports fatigue and arthralgia to the nurse. On physical assessment, the nurse finds that the client has hyperpigmentation of the skin. Which laboratory test does the nurse suggest for safe and effective care of the client? 1. Bilirubin levels 2. Serum ferritin levels 3. Ceruloplasmin levels 4. Immunoglobulins level

2. Serum ferritin levels

17. Which client does the nurse expect to be prescribed a tissue biopsy test for confirmation of the disease? 1. The client with peritonitis 2. The client with celiac disease 3. The client with gastroenteritis 4. The client with Zollinger-Ellison syndrome

2. The client with celiac disease

11. The nurse is attending a client 3 days postoperative for removal of a section of small bowel because of injury from a strangulated hernia. The nurse is aware the client is now diagnosed with short-bowel syndrome. Which initial postoperative teaching is most important for the nurse to provide? 1. The client will need 12 to 18 months for the body to adapt to the change. 2. The first 3 months will require careful monitoring and nutrition supplements. 3. The body will gradually adapt to the change and eventually function as normal. 4. An extensive regimen of medication therapy requires lifelong compliance.

2. The first 3 months will require careful monitoring and nutrition supplements.

18. The nurse teaches a group of staff nurses about the diagnosis of irritable bowel syndrome. After the teaching session, an attending nurse is asked to determine the presence of lactose intolerance in a client with irritable bowel syndrome. Which intervention by the nurse indicates effective learning? 1. The nurse performs a complete blood analysis of the client. 2. The nurse performs a hydrogen breath test on the client. 3. The nurse performs a blood draw for culture and sensitivity. 4. The nurse performs testing on a stool sample for occult blood.

2. The nurse performs a hydrogen breath test on the client.

6. The nurse is preparing information for a client newly diagnosed with ulcerative colitis. Which information is more likely associated with Crohn's disease than with ulcerative colitis? 1. Only the large intestine is affected. 2. The patient is prone to anal fistula and fissure formation. 3. It predisposes the client to colon cancer. 4. The disease affects only the mucosa and submucosa layers.

2. The patient is prone to anal fistula and fissure formation.

15. The client with alcoholic liver disease is experiencing bruising, nosebleed, and hematemesis. Which treatment option does the nurse suspect to be effective in this client? 1. Diuretics 2. Vitamin K 3. Band ligation 4. Phototherapy

2. Vitamin K

11. A female client reports the presence of tenderness and cystic distention that are most prominent during the progesterone-dominant phase of the menstrual cycle. Needle aspiration reveals the diagnosis of fibrocystic breast disease. Which client teaching by the nurse is accurate? 1. "Taking the prescribed danazol will cure the condition." 2. "You need to have any new cysts aspirated immediately." 3. "You need to be aware of foods that are high in methylxanthines." 4. "This condition is not connected with the possibility of cancer."

3. "You need to be aware of foods that are high in methylxanthines."

4. A female client at 14 years of age is identified with constitutional growth delay. The client tells a nurse, "I am not getting any taller! I am the same height I was last year!" In which manner does the nurse respond? 1. "I will refer you to an endocrinologist." 2. "You should start taking growth supplements." 3. "You will reach full height by adulthood." 4. "I am afraid you will not grow any taller."

3. "You will reach full height by adulthood."

8. While assessing an adolescent male client, the nurse finds erythema, swelling, and tenderness of the scrotum. The client also reports the presence of pain. Which disorder does the nurse suspect in the client? 1. Epispadias 2. Cryptorchidism 3. Testicular torsion 4. Benign prostatic hyperplasia

3. Testicular torsion

1. The nurse is providing care for a client in the emergency room with an initial presence of pain in the abdomen. Assessment elicits the presence of rebound pain at McBurney's point, an ultrasound is positive for an inflamed appendix, and white blood cells (WBCs) are moderately elevated. Which prescription does the nurse anticipate from the health-care provider? 1. Initiate nothing by mouth (NPO) status and start an IV infusion 2. Medicate the client with opioids for pain above a level 5 3. Administer oral antibiotics and explain continued use at home 4. Present information regarding the risk for developing peritonitis

3. Administer oral antibiotics and explain continued use at home

20. A nurse is caring for a client who was newly diagnosed with a herpes simplex viral infection and who has been prescribed acyclovir (Zovirax). Which would be the accurate nursing intervention for the client? 1. Administering the medication once a day before dinner 2. Administering the medication with some water once a day 3. Administering the medication three times daily for 7 to 10 days 4. Administering the medication three times daily for 15 to 20 days

3. Administering the medication three times daily for 7 to 10 days

18. The nurse reviews a client's medical record and learns the endometrial lining is absent in a client who underwent a dilation and curettage (D&C) abortion. Which syndrome does the nurse recognize in the client? 1. Turner syndrome 2. Sheehan's syndrome 3. Asherman's syndrome 4. Mayer-Rokitansky-Hauser syndrome

3. Asherman's syndrome

20. Which gland secretes a lubricating fluid that coats the urethra during sexual arousal? 1. Bartholin gland 2. Prostate gland 3. Bulbourethral gland 4. Sertoli gland

3. Bulbourethral gland

7. When reviewing a pathology report, the nurse associates an identified pathogen with a certain condition. Which microorganism does the nurse associate with inclusion conjunctivitis? 1. Treponema pallidum 2. Neisseria gonorrhoeae 3. Chlamydia trachomatis 4. Klebsiella granulomatis

3. Chlamydia trachomatis

10. The nurse is assessing a client in the emergency department. The client states, "I have been really sick with an infection and now I have this awful diarrhea." Which type of gastroenteritis does the nurse suspect? 1. Campylobacter 2. Escherichia coli 3. Clostridium difficile 4. Helicobacter pylori

3. Clostridium difficile

7. The nurse reviews the colonoscopy report on a client. The nurse concludes that which disorder is diagnosed by the presence of a "cobblestoning" appearance? 1. Volvulus 2. Appendicitis 3. Crohn's disease 4. Ulcerative colitis

3. Crohn's disease

8. While reviewing the medical file of a client with cirrhosis, the nurse finds that the client has steatorrhea. Which reason does the nurse identify for this condition in the client? 1. Hyperbilirubinemia 2. Activation of stellate cells 3. Diminished synthesis of bile 4. Nitrogenous waste accumulation in the blood

3. Diminished synthesis of bile

12. For which reason is a health-care provider most likely to recommend genetic testing for a female client? 1. Estrogen levels are lower than normal 2. Presence of early menopause manifestations 3. First-degree relative with breast cancer 4. Infertility that is unresponsive to treatment

3. First-degree relative with breast cancer

15. After assessing a client who has Chlamydia trachomatis infection, the nurse finds fibrotic adhesions around the liver and a tender abdomen. Which condition does the nurse identify in the client? 1. Salpingitis 2. Condyloma acuminata 3. Fitz-Hugh-Curtis syndrome 4. Reiter's syndrome

3. Fitz-Hugh-Curtis syndrome

17. A male client reports to a community clinic and asks to be checked for a sexually transmitted infection (STI). Upon examination the client is noted to have wartlike lesions on the penis. Which testing is prescribed? 1. Hormonal analysis 2. Alpha-fetoprotein levels 3. HIV testing 4. Semen analysis

3. HIV testing

6. Which infection would be detected by testing the swab samples of lesions on a Tzanck smear? 1. Neisseria gonorrhoeae 2. Treponema pallidum 3. Human papillomavirus (HPV) 4. Haemophilus influenzae

3. Human papillomavirus (HPV)

7. A female client reports missed menstrual periods after discontinuing hormonal contraceptives. Which reason does the nurse recognize as the cause for the missed menstrual periods? 1. Obstruction in the cervix 2. Damage to the fallopian tube 3. Hypothalamic-pituitary-ovarian dysfunction 4. Extra growth of uterine tissue

3. Hypothalamic-pituitary-ovarian dysfunction

16. Which hormone stimulates the Leydig cells of the testes to secrete testosterone? 1. Prolactin 2. Thyroid hormone 3. Luteinizing hormone 4. Follicle-stimulating hormone

3. Luteinizing hormone

15. During an assessment, the nurse observes the signs of diminished secondary sexual characteristics in an adult male client. Which is the appropriate nursing action? 1. Perform a digital rectal examination 2. Check the prostate-specific antigen levels 3. Measure the morning serum testosterone levels 4. Perform a computerized tomography (CT) scan

3. Measure the morning serum testosterone levels

19. A nurse is caring for a neonate born to a mother with a herpes simplex 2 viral infection. Which action by the nurse is most beneficial to the neonate? 1. Encourage the mother to breastfeed the neonate 2. Obtain the electrocardiogram results of the neonate 3. Obtain magnetic resonance imaging studies in the neonate 4. Educate the mother in preventing hypothermia in the neonate

3. Obtain magnetic resonance imaging studies in the neonate

19. The nurse in an intensive care unit (ICU) is providing care for a client diagnosed with encephalopathy due to severe liver disease. Which nonpharmacological treatment is most important for the nurse to initiate? 1. Frequently reorient the client to person, time, and place 2. Monitor routinely for an increase in jaundice 3. Pad side rails and protect from physical injury 4. Encourage frequent, nutritional dietary intake

3. Pad side rails and protect from physical injury

20. A client visits the gynecologist because of pelvic pain and the inability to conceive after trying for 1 year. After reading the results of a pelvic ultrasound, the gynecologist suspects endometriosis. Which prescribed treatment will both confirm and treat the client's condition? 1. Prescribed oral contraceptives 2. Administration of danazol 3. Performance of laparoscopy 4. Continuous progestogen

3. Performance of laparoscopy

13. The nurse is providing care for a client admitted with abdominal pain, abdominal rigidity, and rebound tenderness. The health-care provider suspects appendicitis and prescribes tests to validate the diagnosis. Which test result indicates a more serious diagnosis? 1. A sudden decrease in the amount of client-reported pain 2. White blood cell (WBCs) count of 10,000 cells/mcL with a high neutrophil count 3. Peritoneal fluid with a neutrophil count of 700 cells/mcL 4. Blood pressure (BP) 130/78 mm Hg, respirations 20/min, pulse 82/min

3. Peritoneal fluid with a neutrophil count of 700 cells/mcL

10. The public health nurse is aware that sexually transmitted infections (STIs) are occurring in greater numbers within the adolescent and young adult populations. Which action does the nurse initiate to positively affect the numbers of incidence? 1. Arrange for free STI screening 2. Hand out condoms to those at risk 3. Provide multimedia education 4. Campaign for sexual abstinence

3. Provide multimedia education

3. The nurse is assessing a client who reports nausea, vomiting, abdominal pain, and discomfort. The nurse finds that the abdomen is firm and peristalsis is visible. The laboratory reports show electrolyte imbalances. Which condition does the nurse anticipate in the client? 1. Hiatal hernia 2. Acute gastritis 3. Pyloric stenosis 4. Peptic ulcer disease

3. Pyloric stenosis

12. A client tells the nurse, "I have had abdominal pain, bloating, visual disturbances, and bone pain for the last 3 to 6 months." On assessment, the nurse finds excessive weight loss and suspects an autoimmune hypersensitivity disorder. Which diagnostic test does the health-care provider recommend for further confirmation? 1. Abdominal computerized tomography (CT) scan 2. Ultrasound abdomen 3. Serology celiac panel 4. Barium contrast x-ray series

3. Serology celiac panel

5. The nurse finds a note stating, "Reduction of 15% to 20% from the original stomach size" while reviewing the medical record of an obese client. Which surgical procedure does the nurse expect for this client? 1. Gastric bypass 2. Gastric banding 3. Sleeve gastrectomy 4. Biliopancreatic diversion with duodenal switch

3. Sleeve gastrectomy

8. The nurse is providing care for a neonate immediately after a spontaneous vaginal birth to a mother who tested positive for gonorrhea. Which prescription does the nurse anticipate to be most beneficial to the neonate? 1. Vitamin K1 (Mephyton, Aquamephyton) 2. Vitamin D and iron supplements 3. Tetracycline ophthalmic ointment (Ocudox) 4. Hepatitis B (Recombivax HB) vaccine

3. Tetracycline ophthalmic ointment (Ocudox)

4. The nurse is reviewing the medical records of a client that indicates the presence of multiple clusters of fleshy growths on the vagina. Which conclusion does the nurse interpret from these findings? 1. The client has chancroid. 2. The client has granuloma inguinale. 3. The client has condyloma acuminata. 4. The client has trichomoniasis.

3. The client has condyloma acuminata.

3. The nurse is caring for multiple clients in an acute care setting. Which client does the nurse identify as being at risk for nonalcoholic fatty liver disease (NAFLD)? 1. The client being treated for hepatitis B 2. The client with exposure to isoniazid 3. The client who is a strict vegetarian 4. The client with cell-mediated immunity

3. The client who is a strict vegetarian

18. The health-care provider suggests the hepatitis C virus (HCV) genotyping test to a client with liver disease. Which is the most likely rationale for this testing? 1. To predict prognosis 2. To determine the severity of the disease 3. To predict the likelihood of response and the duration of treatment 4. To detect the presence of antibodies against two or more antigens

3. To predict the likelihood of response and the duration of treatment

8. The health-care provider prescribes a fasting serum gastrin level test and a magnetic resonance imaging (MRI) scan for symptoms of peptic ulcer. On reviewing the test reports, the nurse finds a diagnosis of hypergastrinemia and a tumor. The nurse administers the prescribed proton pump inhibitors. Which condition does the nurse identify? 1. Dumping syndrome 2. Mallory-Weiss syndrome 3. Zollinger-Ellison syndrome 4. Plummer-Vinson syndrome

3. Zollinger-Ellison syndrome

9. A client is attending an appointment with a new gynecologist. Medical history reveals surgery for uterine fibroids and a family history of ovarian cancer. Which specific test is prescribed for the client? 1. Papanicolaou smear 2. Magnetic resonance imaging (MRI) of the pituitary gland 3. Estrogen and progesterone levels 4. Carcinoembryonic antigen 125 (CA-125)

4. Carcinoembryonic antigen 125 (CA-125)

12. The nurse finds ursodiol in a client's prescription. Which condition does the nurse suspect in the client? 1. Gilbert's syndrome 2. Alcoholic liver disease 3. Crigler-Najjar syndrome 4. Primary biliary cirrhosis

4. Primary biliary cirrhosis

20. A health-care provider suspects the presence of hemorrhoids in a client. Which diagnostic test does the health-care provider prescribe to support the suspected diagnosis? 1. Biopsy 2. Chest x-ray 3. Colonoscopy 4. Sigmoidoscopy

4. Sigmoidoscopy

13. A client who is scheduled for a hysteroscopy asks the nurse about the procedure. Which statement made by the nurse promotes client understanding? 1. "A radiopaque dye is used during a hysteroscopy." 2. "A scope is inserted into the uterus to take a small amount of tissue." 3. "A scope is inserted through a small surgical incision in the abdomen." 4. "A thin telescopic-type device is inserted via the vagina into the uterus."

4. "A thin telescopic-type device is inserted via the vagina into the uterus."

7. The nurse is reviewing portal hypertension with a group of staff nurses. Which statement by an attending nurse indicates the need for further review? 1. "Caput medusa is a sign of portal hypertension." 2. "Portal hypertension can cause hematemesis." 3. "Ascites is associated with portal hypertension." 4. "Portal hypertension causes coagulation abnormalities."

4. "Portal hypertension causes coagulation abnormalities."

2. The staff nurses are reviewing precautions to be taken while caring for a client with suspected need of surgery for appendicitis. Which statement made by a nurse indicates understanding? 1. "The client will not require IV fluids." 2. "The client will not be prescribed ampicillin." 3. "The client is given a laxative before surgery." 4. "The client is not given prediagnosis pain medications."

4. "The client is not given prediagnosis pain medications."

11. The nurse is performing an assessment on a male client with a known diagnosis of HIV. Which information does the nurse give to the client regarding testicular cancer? 1. "Once you reach the age of 40 you have no risk for testicular cancer." 2. "If your sexual partner contracts testicular cancer, so will you." 3. "More men die of testicular cancer in the United States than of other cancers." 4. "You need to immediately report a mass lesion on one testicle."

4. "You need to immediately report a mass lesion on one testicle."

9. While assessing a client with liver cirrhosis, the nurse examines the client for indication of encephalopathy. Which manifestation indicates the development of encephalopathy? 1. Spider angiomata 2. Abdominal ascites 3. Coagulopathy 4. Asterixis

4. Asterixis

18. On assessing a client with a gastrointestinal disorder, the nurse finds steatorrhea, abdominal distension, and muscle wasting. The health-care provider prescribes corticosteroid therapy for the client. Which instruction does the nurse provide to effectively manage the condition? 1. Reduce alcohol ingestion 2. Reduce coffee consumption 3. Avoid fiber-containing foods 4. Avoid gluten-containing foods

4. Avoid gluten-containing foods

16. The medical records of a client indicate the client has Reiter's syndrome. Which microorganism is most likely to cause this infection? 1. Treponema pallidum 2. Neisseria gonorrhoeae 3. Human papillomavirus (HPV) 4. Chlamydia trachomatis

4. Chlamydia trachomatis

16. Which diagnostic test does the health-care provider order to get the most accurate information related to appendicitis? 1. Urinalysis 2. Abdominal x-ray 3. Abdominal ultrasound 4. Computerized tomography scan

4. Computerized tomography scan

15. A client is admitted into the emergency room with hematemesis; dark urine; and black, tarry feces. On examination, the nurse finds that the client has weight loss and a distended abdomen. Which condition does the nurse suspect in the client? 1. Hiatal hernia 2. Acute gastritis 3. Pyloric stenosis 4. Esophageal varices

4. Esophageal varices

9. A digital rectal examination (DRE) in a client reveals the enlargement of the prostate gland that is firm, painless, and generalized. Which medication does the nurse anticipate the health-care provider will prescribe? 1. Anticoagulants 2. Alpha-adrenergic blockers 3. Phosphodiesterase inhibitors 4. Extracts of saw palmetto

4. Extracts of saw palmetto

7. The nurse is providing care for a client diagnosed with Helicobacter pylori. Which diagnostic test result is the nurse least likely to expect? 1. Urea breath test 2. Stool antigen test 3. Blood test for antibodies 4. Fasting serum gastrin level

4. Fasting serum gastrin level

6. In the male client, which hormone stimulates Sertoli cells to synthesize spermatozoa? 1. Inhibin 2. Testosterone 3. Luteinizing hormone (LH) 4. Follicle-stimulating hormone (FSH)

4. Follicle-stimulating hormone (FSH)

11. The nurse in a community clinic is assessing a client who reports wartlike lesions in the genital area. The client tells the nurse, "I had syphilis a few years ago." Which test finding confirms the client has latent asymptomatic syphilis? 1. Presence of a nonpruritic rash on the hands and feet 2. Loss of appetite, aching joints, and vision changes 3. Granulomatous lesions in the neurological system 4. Formation of granulomas (gummas) in the organs

4. Formation of granulomas (gummas) in the organs

9. After reviewing the laboratory reports for a client, the nurse finds the client has chronic pelvic inflammatory disorder (PID). Which condition does the nurse recognize as a risk to the client? 1. Meningitis 2. Condyloma acuminata 3. Mild salpingitis 4. Inflammation of the fallopian tubes

4. Inflammation of the fallopian tubes

12. The nurse is providing care for a client with a recent spinal cord injury resulting in paralysis from the midthoracic region downward. The client is unable to initiate or control bowel function, but states to the nurse, "I am going to get bowel training later." Which factor does the nurse consider in response to the client? 1. Ability to control the sphincter muscles may return 2. Strong abdominal muscles can replace peristalsis 3. Bowel stimulants will aid in self-management 4. Neural control of the large intestine is likely lost

4. Neural control of the large intestine is likely lost

6. A client with sudden, excruciating abdominal pain; pale skin; and hematemesis is admitted to the emergency room. On assessment, the client acknowledges an overdose of NSAIDs and a history of substance abuse. The health-care provider instructs the nurse to prepare the client for a gastrojejunostomy procedure. Which condition does the nurse anticipate in the client? 1. Hiatal hernia 2. Acute gastritis 3. Pyloric stenosis 4. Peptic ulcer disease

4. Peptic ulcer disease

4. Which physical finding in a client will lead a nurse to suspect paraphimosis? 1. Inflammation of the testes 2. Enlargement of the prostate gland 3. Abnormal prolonged erection of the penis 4. Permanent retraction of the foreskin behind the tip of the penis

4. Permanent retraction of the foreskin behind the tip of the penis

1. While performing the genital assessment of a male client, the nurse observes that the client has a curvature of the penis. Which condition does the nurse suspect in the client? 1. Orchitis 2. Phimosis 3. Hypospadias 4. Peyronie's disease

4. Peyronie's disease

14. After reviewing the medical records of a client, the nurse finds that the client was previously diagnosed with mild salpingitis and later had tubal dysfunction. The nurse also finds strains of Chlamydia in the client's blood specimen. Which does the nurse interpret from these findings? 1. The client is infected with syphilis. 2. The client has condyloma acuminata. 3. The client is infected with the human papillomavirus (HPV). 4. The client has silent pelvic inflammatory disease.

4. The client has silent pelvic inflammatory disease.


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