Patho practice test 4
A client sustains a musculoskeletal injury of the left hip. In addition to pain, which manifestations would the nurse expect to accompany a dislocation? Select all that apply.
-shortened left leg -limited movement
A nurse is teaching a client diagnosed with osteoarthritis about the joint capsule. Which statement made by the client indicates that teaching was successful?
"The synovial fluid in my joint capsule acts as a lubricant and helps the movement of the joint's articulating surfaces."
A sixth-grade science teacher asks the students to explain the role of cilia in the lower respiratory tract. Which student response is best?
"These little hairs move germs trapped in mucus toward the throat so the body can cough them out."
Which situation can best be characterized as an example of passive immunity?
- 6 week old infant Reeves antibodies from his motors breast milk
Which symptoms support a diagnosis of acute HIV infection?
- night sweats -mouth lcers -swollen lymph nodes -headache
The nurse is creating a plan for a client with osteoarthritis (OA) of the basal joints in both hands. Which intervention(s) does the nurse include? Select all that apply.
-teach the client to avoid activities that place stress on the thumb joints -apply cold or warm packs to joints based on client preference -review side effects of non steroidal anti-inflammatory drugs - consult with an occupational therapist for devices to support joints
A client has 60% full-thickness (third-degree) burns to the body. Which descriptor(s) is characteristic of full-thickness (third-degree) burns? Select all that apply.
-thrombosed vessels seen under the burned skin -hard,dry, and leathery to tough -deep red to black color
Which of these clients would be at greatest risk for developing chronic osteomyelitis?
6-year-old with a compound fracture of the right wrist
Which client is at the greatest risk for developing an intracellular pathogen infection?
A client with AIDS who has a decreased CD4+ TH1 count
A client experiences an allergic reaction. Select the immunoglobulin that would bind to mast cells and release histamine.
IgE
A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At the annual physical, the client asks whether to get the hepatitis A "shot." How will the nurse respond, based on the concepts of adaptive immunity?
No, because having an active case, you have already developed antibodies against hepatitis A."
The nurse is conducting a health promotion class on osteoarthritis (OA). Which statement should the nurse include?
Obesity is a strong risk factor for developing OA.
The first physical line of defense in innate immunity is:
Skin and mucous membranes
Which client would be considered high risk for falling and fracturing the hip?
an 81-year-old woman taking medications for osteoporosis
Substances foreign to the host that can stimulate an immune response are known as:
antigens
The nurse is caring for clients with autoimmune conditions. Which client will the nurse assess first?
client with systemic lupus erythematous reporting chest pain
The older adult client tells the nurse that she believes she is getting shorter. The nurse explains to the client that height loss is caused by which occurrence with aging?
compression of the vertebral column
A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology?
genetic predisposition is very likely
The nurse is caring for a client who has developed facial swelling related to a hypersensitivity reaction to a medication. Which of these substances does the nurse recognize is implicated in causing this type of reaction?
histamine
The nurse is assessing a female client's risk for osteoporosis. Which factor places this client at greatest risk?
menopause
A 75-year-old female has been admitted to the hospital with a hip fracture. She states, "All I did was fall into my chair, not even very hard." Upon diagnostic testing, the client's bones shows loss of trabeculae from cancellous bone and thinning of the cortex. Which diagnosis is most likely?
osteoporosis
During assessment of a client with systemic lupus erythematosus (SLE), the nurse hears a friction rub when the stethoscope is placed over the heart. Which complication of SLE will the nurse document in the medical records and report to the health care provider?
pericarditis
The nurse is caring for a client who has experienced pathologic fractures. For which condition will the nurse advocate assessing the client, because the condition is the most likely to contribute to bone weakening?
primary or secondary hyperparathyroidism leading to elevated parathyroid hormone
Which client needs screening for osteoporosis?
the client who seems to have shrunk in height
Which teaching points about acute tubular necrosis (ATN) should the renal nurse educator include in the orientation session of new nurses?
trauma, burns and major surgeries are common precursors to ATN
A nurse is teaching a wellness group among a group of older adult women. One of the women has asked for advice about preventing osteoporosis, which affects many of her friends. What is the nurse's best response to the woman's query?
weight-bearing exercise is helpful, as are calcium supplements
A nurse is caring for a client who has systemic lupus erythematosus (SLE). Which of the following causes the disease?
Autoimmune process
Which individuals would be considered to be at risk for the development of edema? Select all that apply.
- a client with right-sided heart failure and hypothyroidism - client who suffered extensive burns in a job--related accident -a client with hypoalbuminemia secondary to malnutrition and anorexia nervosa
A client who has sustained partial-thickness (second-degree) burns to 70% of total body surface area is arriving via ambulance to the emergency department. What aspect(s) of care will the nurse perform as part of the immediate treatment protocol? Select all that apply.
- blood pressure support -infection control -pain management
An active 9-year old is being discharged from the emergency department (ED) following cast placement for a sports injury. The nurse should emphasize that the parents should bring their child back to the ED if they note which post-cast assessment findings? Select all that apply.
- cold, pale toes on the side with the cast -client complaining of tingling and numbness in the casted leg
A client experienced full-thickness (third-degree) burns 2 days ago to the lower limbs after a fire at the workplace. For which systemic complication(s) should the nurse regularly assess? Select all that apply.
- decreased peristalsis of bowel -respiratory dysfunction -hypermetabolic response -sepsis
Electrical burns over a large surface area of a client's body have resulted in hypovolemic shock. Following physical assessment, which findings lead the nurse to believe the client's body is compensating for this fluid loss? Select all that apply.
- increased heart rate -complaining of extreme thirst -deep rapid respirations
A nurse in the emergency department is preparing a presentation about acute respiratory distress syndrome (ARDS) for new nurses. What are common causes of ARDS that should be included in this presentation? Select all that apply.
- radiation -smoke inhalation -fat embolism
Acute tubular necrosis (ATN) is the most common cause of intrinsic kidney disease. What are the most common cause(s) of ischemic ATN? Select all that apply.
- severe hypovolemia -burns -overwhelming sepsis
A client sustains a musculoskeletal injury of the right foot. In addition to pain, which manifestations would accompany a fracture? Select all that apply.
- swelling deformity of the affected part - abnormal mobility -loss of function
Which event(s) in a client's history increases risk of developing osteoarthritis? Select all that apply.
- torn meniscus in left knee at 19 -loose body in knee joint at age 40 -hip dislocation at age 35
A 30-year-old male knows that he contracted HIV a month ago. Place the following steps in the order of the progression of the disease, starting with what he could expect first if he does not receive treatment.
-There is a rapid increase in viral replication, which leads to very high viral loads. -Viral symptoms such as fatigue, lymphadenopathy, headaches, and gastrointestinal disturbances and the CD4+ T-cell count begins to fall. -There is a period (up to 10 years) of being symptom-free as CD4+ T cells decrease. -CD4+ T-cell count is 200 cells/μL, confirming the diagnosis of AIDS. -The risk of opportunist infection is highest. -Death
A client who sustained a fractured femur and multiple internal injuries during an accident is placed in balanced skeletal traction. Which goals are achieved with this type of traction? Select all that apply.
-allowing the bone to heal -reducing muscle spasms
How would the nurse describe an embolus to a client with a fractured hip?
-fat that spreads to the lungs from a broken bone
The nurse is caring for a client experiencing a systemic anaphylactic reaction. Which assessment findings correlate with this diagnosis? Select all that apply.
-hypotension -bronchospasm and respiratory distress -vomiting and abdominal cramps -laryngeal edema and obstruction
An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?
-immunologically mediated joint inflammation
Which statements are true regarding bone remodeling? Select all that apply.
-osteoclasts gradually remove dead bone -mineralized bone is present along the lines of the injury
