Patho prep u review exam 4

What laboratory markers are most commonly used to diagnose acute pancreatitis? Amylase and cholesterol Lipase and amylase Cholesterol and triglycerides Lipase and triglycerides

Lipase and amylase

Which is the primary component of white matter? Dendrites Demyelinated lesions Cell bodies Myelinated fibers

Myelinated fibers

Which parts of the brain make up the brain stem? Pons and medulla oblongata Circle of Willis and hypothalamus Limbic and diencephalons Cerebellum and reticular system

Pons and medulla oblongata

A hospitalized older adult asks the nurse how he acquired Clostridium difficile while taking an antibiotic medication. Which is the best response by the nurse? "It is a consequence of being older and having health issues." "The administration of broad-spectrum antibiotics can disrupt the normal microbial balance and allow overgrowth of species." "All patients in the hospital are at risk for developing the problem." "It is the result of using a generic medication in place of your home medication."

"The administration of broad-spectrum antibiotics can disrupt the normal microbial balance and allow overgrowth of species."

A nurse educator is explaining basic neuroanatomy to a class of prospective nursing students. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)? CSF distributes plasma proteins throughout the superficial gray matter of the CNS. It provides physical protection for the brain and ensures leukocytes and erythrocytes are evenly distributed in the CNS. CSF cushions the brain and provides a near-water medium for diffusion of nutrients. It ensures the high metabolic and oxygenation needs of the brain are met, as well as absorbing physical shocks.

CSF cushions the brain and provides a near-water medium for diffusion of nutrients.

All diseases have risk factors. What is the most significant environmental risk factor for pancreatic cancer? Cigarette smoking Water pollution Heavy metal toxicity Air pollution

Cigarette smoking

Peripheral neuropathy occurs most commonly with which disorder? Cancer Diabetes Alcoholism AIDS

Diabetes

Pharmacologic treatment for peptic ulcers has changed over the past several decades. The nurse knows that the goal for pharmacologic treatment is focused on which of the following? Promoting special diet Increasing acid production Neutralizing blood count Eradicating Helicobacter pylori (H. pylori)

Eradicating Helicobacter pylori (H. pylori)

Which pain assessment tool is best to utilize when caring for children between the ages of 3 to 8 years old? Behavioral distress scale Word graph scale Numeric pain scale FACES pain scale

FACES pain scale

The underlying causative problem in Parkinsonism is: Genetic defect Autoimmune disorder Failure of dopamine release Viral infection

Failure of dopamine release

Bradykinesia occurring in Parkinson disease places the Parkinson's client most at risk for: Weight loss Incontinence Emotional dysfunction Falls and injury

Falls and injury

In patients with acute diarrhea, many require no treatment. However, the nurse knows the priority assessment in all patients with diarrhea is which of the following? Fluid and electrolyte status Stool specimen Skin integrity Dietary intake

Fluid and electrolyte status

A patient is admitted to the hospital for further evaluation of problems experienced with gastrointestinal digestion and absorption. The nurse anticipates the health care provider will further assess the: Small intestine Large bowel Intestinal lumen Sigmoid colon

Small intestine

A client with malabsorption syndrome is experiencing fatty, bulky, yellow-gray, and foul-smelling stools. The nurse would document this as what type of stool? Steatorrhea Flatulence Tetany B12 deficiency

Steatorrhea

Fat that is not absorbed in the intestine is excreted in the stool. Which of the following terms is used to describe fatty stools?

Steatorrhea

If a client is experiencing acute pain, which clinical manifestation will the nurse assess? Hyperthermia Bradypnea Hypotension Tachycardia

Tachycardia

The nurse is aware that some drugs may be prevented from entering the brain as a function of: the blood-brain barrier. rapid absorption in the gastric mucosa. elimination by the kidneys. detoxification by the liver.

The blood-brain barrier

Constipation is the infrequent or difficult passage of stools. True or False

True

Global or diffuse brain injury is manifested by changes in the level of consciousness. True False

True Global brain injury nearly always results in altered levels of consciousness, ranging from inattention to stupor or coma.

Which scenario would be an example of a child born with congenital insensitivity to pain? A child who: skinned knee from a bike accident but only told parents when it started burning. develops pins-and-needles sensation after jumping out of a tree. fell off a skate board and fractured ankle but did not feel any pain, just noted swelling in foot. cries every time the wind blows because it hurts his face and ears.

fell off a skate board and fractured ankle but did not feel any pain, just noted swelling in foot.

Nutrition students are studying the nervous system, which has a high rate of metabolism. What is its major fuel source? Ketones Protein Glucose Electrolyes

glucose

The most common cause of ischemic stroke is: cryptogenesis. vasospasms. thrombosis. arterial vasculitis.

thrombosis. Ischemic stroke includes those caused by large artery thrombosis (20%), small artery thrombosis (25%), cardiogenic embolism (20%) and cryptogenic (undetermined cause)(30%), making thrombosis the most common cause (45%).

Malabsorption syndrome results in loss of fat in the stool and failure to absorb fat-soluble vitamins. True False

true

The nurse is caring for a female client with cholelithiasis. When teaching the client about the disease, the nurse includes which of these points? "You are unable to store bile in your gallbladder, which inhibits digestion of the foods you eat." "Stones in the gallbladder are most common in men. Your case is unusual." "You have an inflammation of your gallbladder caused by an autoimmune process." "Gallstones have developed, which are typically composed of cholesterol."

"Gallstones have developed, which are typically composed of cholesterol."

A client is diagnosed with pernicious anemia and asks, "Whyis my body is not able to absorb vitamin B12?" Which response by the nurse is most accurate? "More than likely, you were born with deficient vitamin B12 stores." "Your stomach is not secreting a substance known as intrinsic factor which is needed to absorb vitamin B12." "You have too many ulcers in your stomach." "Your daily intake of high saturated fats is interfering with the stomachs ability to absorb the nutrients that it needs, especially vitamin B12."

"Your stomach is not secreting a substance known as intrinsic factor which is needed to absorb vitamin B12."

A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced? An absence seizure A myoclonic seizure A tonic-clonic seizure A complex partial seizure

A tonic-clonic seizure. A tonic-clonic seizure often begins with tonic contraction of the muscles with extension of the extremities and immediate loss of consciousness. Incontinence of bladder and bowel is common. Cyanosis may occur from contraction of airway and respiratory muscles. The tonic phase is followed by the clonic phase, which involves rhythmic bilateral contraction and relaxation of the extremities. -A myoclonic seizure involves bilateral jerking of muscles, generalized or confined to the face, trunk, or one or more extremities. -Absence seizures are nonconvulsive and -complex partial seizures are accompanied by automatisms (aimless and apparently undirected behavior that is not under conscious control and is performed without conscious knowledge).

A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to: administer analgesics for the relief of pain. prepare the client for emergency surgery. monitor vital signs closely for improvement. administer IV tissue plasminogen activator (tPA).

Administer IV tissue-type plasmin activator (tPA) tPA administration is the treatment of choice for an ischemic stroke after confirmation that it is not a hemorrhagic stroke. Monitor vital signs and provide pain relief to prevent complications

The nurse is caring for a client who has returned from surgery after having a colon resection. What is the best method for the nurse to use when administering an opioid for pain in order to optimize pain control? Administer the opioid preemptively and before pain becomes extreme. Administer the opioid each time the client asks for it. If the client is asleep, wait until she awakens to administer an opioid, because sleeping clients are not in pain. Administer the opioid if the client is becoming restless.

Administer the opioid preemptively and before pain becomes extreme.

A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding antiepileptic medications? All antiepileptic medications should be taken with food. Pregnant women should reduce the dose of medication or discontinue until after delivery. Antiepileptic medications should never be discontinued abruptly. Children can build up a tolerance to the medication quickly.

Antiepileptic medications should never be discontinued abruptly. Consistency in taking seizure medications is essential to obtaining and maintaining therapeutic blood levels of the medication. Abrupt withdrawal can cause seizure recurrence. Monitoring and assessment of drug levels are important. Each prescribed drug will provide information regarding administration to provide client safety.

When conducting a health assessment that focuses on the pain experienced by an older client diagnosed with early dementia, the nurse will pay particular attention to which of the following? The client's comfort level regarding the discussion of pain The client's verbal perception of pain Behavioral signs of pain demonstrated by the client Cultural beliefs held by the client regarding the cause of pain

Behavioral signs of pain demonstrated by the client

A nurse is concerned about a patient's continual use of nonsteroidal anti-inflammatory drugs (NSAIDs). Which of the following is the nurse concerned about? Damage to the gastric mucosa Increase in gastrin secretion Decrease in the production of intrinsic factor Increase in the proton pump

Damage to the gastric mucosa

The nurse measures a blood glucose level of 40 mg/dL (2.22 mmol/L) for a client with type 1 diabetes. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client? It is not necessary for glucose to be replaced immediately because the client will have enough stored to function for a while. The nurse should administer a food source of protein in order to increase the glucose level for improved cardiac function. Small amounts of glucose may be stored in the brain for a short period of time but are rapidly metabolized. Glucose is not stored in the brain and is a major fuel source for brain function.

Glucose is not stored in the brain and is a major fuel source for brain function.

A client arrives in the clinic and informs the nurse that he is having pain in the left knee that has lasted for several weeks. The physician orders an x-ray of the left hip and knee. The client tells the nurse that the pain is in the knee, not the hip. What is the best response by the nurse? "The physician must have misunderstood what you were saying. We will change the order." "The pain you are having may be referred pain, which can cause the pain in the knee resulting from a hip problem." "The pain you are having is most likely caused by a disturbance in your nerve transmission." "You only think that the pain is in the knee when it really is in your hip."

"The pain you are having may be referred pain, which can cause the pain in the knee resulting from a hip problem."

A patient has experienced a stroke affecting the reticular formation of the medulla and lower pons. The nurse tells the patient's wife that care must be taken with eating to prevent which of the following? Aspiration pneumonia Duodenal ulcers Gastric atony Steatorrhea

Aspiration pneumonia

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first? Document the finding as it is an expected symptom. Assess for signs/symptoms of cerebrovascular accident (stroke). Assess for other signs/symptoms of increased intracranial pressure. Contact physician for anti-nausea medication orders.

Assess for other signs/symptoms of increased intracranial pressure The tumor may be causing increased intracranial pressure. Vomiting, with or without nausea, is a common symptom of increased intracranial pressure and/or brain stem compression. The nurse's first action is to assess for other signs/symptoms of increased intracranial pressure. Once the assessment is completed, the nurse should contact the physician if indicated by the findings.

Which of the meninges provides the major protection for the brain and spinal cord? Dura mater Tentorium cerebelli Arachnoid membrane Pia mater

Dura mater

A nurse is teaching a client about the difference between digestion and absorption. Which action should the nurse describe as absorption? Hydrolysis of compounds to make them into smaller molecules Emulsification of fats to make them water soluble Moving nutrients from the external environment of the GI tract into the internal environment Cleavage of proteins into peptides and amino acids

Moving nutrients from the external environment of the GI tract into the internal environment

The parent of a toddler with Duchenne muscular dystrophy reports that the child has an increase in muscle size but a decrease in strength. The nurse documents this using which medical term? Fasciculations Pseudohypertrophy Chorea Dysdiadochokinesia

Pseudohypertrophy

A client is admitted to the acute care facility with severe pain in the abdomen related to inflammatory bowel disease. What type of pain will the nurse be administering medication to relieve? Cutaneous pain Referred pain Visceral pain Somatic pain

Visceral pain

A nurse providing dietary guidance to a patient with celiac disease tells the patient that which of the following foods should be avoided? Wheat bread Homogenized milk Pork products Watermelon

Wheat bread

Nonopioids, such as acetaminophen (Tylenol), are the first line of therapy for managing mild to moderate pain in the elderly because they are safe. true or false

true

A client with a history of cancer that metastasized to the liver has arrived at the outpatient clinic to have a paracentesis performed. The physician anticipates that the client will have more than 5 L of fluid removed. The physician has prescribed intravenous albumin following the procedure. The client asks why she needs "more fluids in my vein?" The nurse responds: "Albumin will stay in your blood vessels a long time so that you will not seep out more fluid in your belly for at least a few weeks." "Albumin is a volume expander. Since a lot of fluid was removed, you have a decrease in your vascular volume, so without this albumin, your kidneys will try to reabsorb and hold onto water." "After the albumin, your potassium level will stay steady and you should keep excess water weight off for several weeks." "Albumin works like your diuretics to help you get rid of excess fluid thru your kidneys, it's just more potent than your home water pills."

"Albumin is a volume expander. Since a lot of fluid was removed, you have a decrease in your vascular volume, so without this albumin, your kidneys will try to reabsorb and hold onto water."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be: "Infants never have symptoms from hydrocephalus." "Unfortunately, there usually is significant brain dysfunction." "Because the skull sutures are not fused there may be no brain damage." "The cranial sutures are fused and decrease brain damage."

"Because the skull sutures are not fused there may be no brain damage."

A client has developed global ischemia of the brain. The nurse determines this is: inadequate perfusion to the dominant side of the brain. inadequate to meet the metabolic needs of the entire brain. inadequate perfusion of the right side of the brain. inadequate perfusion of the nondominant side of the brain.

Inadequate to meet the metabolic needs of the entire brain Global ischemia occurs when blood flow is inadequate to meet the metabolic needs of the entire brain. The result is a spectrum of neurologic disorders reflecting diffuse brain dysfunction.

When caring for the client with hepatic failure, the nurse recognizes which of these problems places the client at increased risk for bleeding? Decreased red blood cells Increased vitamin K Increased platelet count Increased prothrombin time

Increased prothrombin time

Colonic microorganisms play a role in the synthesis of which of the following vitamins? E C D K

K

A patient tells the nurse that he experiences diarrhea after eating ice cream or cheese. The nurse tells the patient he may have a deficiency of which of the following? Lactase Amylase Trypsin Pepsin

Lactase

When caring for the client with portal hypertension and ascites, which of these dietary interventions does the nurse suggest to prevent the progression of fluid accumulation? Consume foods high in potassium. Avoid dairy products. Reduce protein intake. Limit intake of sodium.

Limit intake of sodium.

The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be: CT of the head Sputum culture Blood cultures Lumbar puncture

Lumbar puncture The diagnosis of bacterial meningitis is confirmed with abnormal CSF findings. Lumbar puncture findings, which are necessary for accurate diagnosis, include a cloudy and purulent CSF under increased pressure. The other options do not confirm the diagnosis.

A client has been diagnosed with Guillain-Barré syndrome and is being treated in the intensive care unit. The client is experiencing rapidly ascending paralysis. What is the nurse's priority intervention when caring for this client? Inserting a Foley catheter Assessing distal peripheral pulses Restarting the IV when it infiltrates Maintenance of the client's airway

Maintenance of the client's airway

The nurse is aware that the primary function of the sympathetic nervous system is: conservation of energy and resource replenishment. suppression of responses during threatened periods. maintenance of vital functions and responding when there is a critical threat to the integrity of the individual. maintenance of organ function during periods of minimal activity.

Maintenance of vital functions and responding when there is a critical threat to the integrity of the individual

After being thrown off the back of a bull, a bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is referred to as: Paraplegia Quadriplegia Tetraplegia Anterior cord syndrome

Paraplegia

The nurse is providing client education to a client newly diagnosed with Parkinson disease. The nurse most accurately describes the disease progression as: Parkinson's is a chronic condition and treatment aims to manage symptoms. Parkinson's has no known effective treatment. Parkinson's disease, while chronic, will likely improve over time. Parkinson's is an acute disorder that can be surgically corrected.

Parkinson's is a chronic condition and treatment aims to manage symptoms.

A adult has been diagnosed with a gastroesophageal reflux disease, in which the function of his lower esophageal sphincter is compromised. Which consequence of this condition is most likely? Inappropriate release of gastric enzymes. Impaired control of the gastric emptying rate. Protrusion of the stomach or regurgitation of stomach contents into the esophagus. Decreased absorption of ingested foods and fluids.

Protrusion of the stomach or regurgitation of stomach contents into the esophagus.

A nurse is completing an abdominal assessment on a patient suspected to have appendicitis. When the nurse applies and then releases pressure in the patient's right lower quadrant, the patient experiences tenderness. The nurse is documenting the presence of which of the following? Peforated appendix Periumbilical tenderness Referred tenderness Rebound tenderness

Rebound tenderness

The nurse is explaining to a client's family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be: There is a decrease in the amount of fluid volume in the brain. There is an increase in the production of cerebrospinal fluid volume. Normal physiologic circumstances result in decreased adsorption of CSF. The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid. Vasogenic brain edema occurs with conditions that impair the function of the blood-brain barrier and allow the transfer of water and protein from the vascular space into the interstitial space. Increased production of CSF and decreased absorption result in hydrocephalus. It occurs in conditions such as hemorrhage, brain injury, and infectious processes.

A client has been diagnosed with alcohol-induced liver disease. He admits to the nurse, "I know what the lungs do, and I know what the heart does, but honestly, I have no idea what the liver does in the body." The nurse should tell the client that the liver: maintains a balanced level of electrolytes and pH in the body and stores glucose, minerals, and vitamins. is responsible for the absorption of most dietary nutrients, as well as the production of growth hormones. metabolizes most components of food and also cleans the blood of bacteria and drugs. contributes to the metabolism of ingested food and provides the fluids that the GI tract requires.

The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.

The community health nurse is teaching about prevention of hepatitis A. Which of these groups does the nurse suggest will benefit from this vaccine? Those traveling to third world countries Those working for the Centers for Disease Control and Prevention Homosexual women Those who have been recently exposed to hepatitis A

Those traveling to third world countries

A nurse caring for a client in myasthenic crisis identifies a priority concern as: monitoring for ptosis. ongoing physical therapy to maintain strength. monitoring for difficulty chewing. maintenance of airway and respiration.

maintenance of airway and respiration.