Patho PrepU Final Exam
The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the nurse, "How long will I live?" What is an appropriate response by the nurse?
"AIDS is considered to be a chronic illness today."
Which treatment should take place immediately in a client experiencing autonomic dysreflexia?
Position the client in upright position, and correct the initiating stimulus.
When a nurse is caring for a client with gout, which diagnostic study supporting the presence of the disease does the nurse monitor?
Uric acid levels
A client who has experienced a spinal cord injury still has use of the arms but has impaired motor and sensory function of the trunk, legs, and pelvic organs. Which term best describes how this injury is classified?
paraplegia
What is the most common mode of transmission of HIV?
vaginal and anal intercourse
The nurse has just completed an assessment on a client admitted with Guillain-Barré syndrome. The nurse determines that a priority of care will be:
ventilatory assessment and support.
A client with hereditary angioneurotic edema (HAE) is experiencing an attack. Which priority intervention should the nurse be prepared to administer?
maintaining a patent airway
A nurse caring for a client in myasthenic crisis identifies a priority concern as:
maintenance of airway and respiration.
Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy?
carpal tunnel syndrome
Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)?
elevated anti-nuclear antibodies (ANA)
Typical symptoms seen in the latent period of HIV infection include which of the following?
No signs or symptoms
The nurse caring for a client with a newly diagnosed intracranial tumor anticipates that the neoplasm will be:
Astrocytic neoplasms
What statements regarding autoimmune disorders are true? Select all that apply.
Autoimmune disorders are capable of affecting almost any body tissue. Autoimmune disorders are a result of the body's inability to identify self from non-self. Self tolerance is a central concept used to explain autoimmune disorders. Autoimmune diseases are a homogeneous group of disorders.
The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the nurse, "How long will I live?" What is an appropriate response by the nurse
"AIDS is considered to be a chronic illness today."
The nurse working at a community clinic is caring for a young male client. The client asks the nurse if he could get HIV/AIDS from being sprayed in the face with breast milk. Select the best response by the nurse.
"Breast milk can contain HIV, which causes AIDS, but to be infected, the milk needs to be in contact with your mucous membranes or an open sore."
The parents of a child diagnosed with rheumatic disease are shocked by the diagnosis and tell the nurse that they did not think children could acquire the disease. The best response would be:
"Children can be affected with almost all of the rheumatic diseases that occur in adults."
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 teaching a group of college students about reducing the risk of HIV transmission during sexual relations. The nurse makes which appropriate teaching point?
"If a person has a sexually transmitted disease (STD), there is an increased risk for HIV infection."
In the context of a workshop on rheumatoid arthritis, a clinical educator is teaching a group of nurses about autoimmune diseases. Which statement by an attendee would the educator most likely want to follow up with further teaching?
"Introduction of a foreign antigen can sometimes induce a cascade of immune response that is not self-limiting."
A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?
"Losing some weight and reducing your alcohol intake will likely be beneficial."
A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make?
"More women than men are affected by lupus."
The adult child of a client with end-stage Alzheimer disease asks the nurse if Alzheimer disease can be passed on to him or her. What is the nurse's most accurate response?
"Research supports a possible genetic link with an early onset."
The nurse has just finished teaching a client newly diagnosed with rheumatoid arthritis about the disease. The nurse determines that teaching is effective when the client makes which statement?
"Rheumatoid arthritis includes joint involvement that is usually symmetric and polyarticular."
A 5-year-old child is experiencing itchy, watery eyes and an increased respiratory rate with some inspiratory wheezes. He has been outside playing in the yard and trees. The mother asks, "Why does he get like this?" The health care worker's best response is:
"This is what we call a type I hypersensitivity reaction and usually occurs a few minutes after exposure to his allergen. It is primarily caused by mast cells in his body."
The nurse determines that additional client education is needed when a client with gout makes which statement?
"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."
A client develops an immunodeficiency disorder after receiving chemotherapy for the treatment of lung cancer. The client asks the nurse if he was born with this deficiency. What is the nurse's best response?
"You have developed a secondary immunodeficiency disorder as a result of your chemotherapy."
The nurse is teaching health promotion strategies to a client who is infected with HIV and has a CD4+ cell count of 600. The nurse includes which information related to vaccination?
"You should be immunized for measles, mumps, and rubella."
The spouse of a client diagnosed with Alzheimer disease asks the nurse why the client often neglects to take a shower. The spouse states that the client was always diligent with hygiene in the past; however, over the past few months that has not been the case. What is the nurse's best response?
"You should remind the client to shower."
What is the length of time from infection with HIV to seroconversion?
1-3 months
Which statement accurately reflects the typical person afflicted with multiple sclerosis (MS)?
25 yr old woman
Which client has the highest risk of contracting an opportunistic infection?
A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL
Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphagia, muscle weakness and spasticity, and dysphonia?
ALS is caused by both an upper motor neuron and lower motor neuron disturbance.
Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?
Altered level of consciousness
Which statement about HIV/AIDS is true?
Accidental stick with a needle used on an HIV-infected client carries little risk of infection.
Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated loss of which physiologic function?
Acetylcholine receptors
What is the most common cause of progressive dementia?
Alzheimer disease
A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of:
An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve
What medication teaching should be done for a woman of childbearing age with a seizure disorder?
Antiseizure drugs increase the risk for congenital abnormalities.
What is the term used to identify a person's inability to experience pleasure in things that use to result in pleasure?
Anhedonia
Which of these is an AIDS-defining condition?
CD4+ count less than 200 cells/μL
A client is experiencing pain, tingling, and numbness of the thumb and first, second, third, and half of the fourth digits of the hand. She states that she has pain in the wrist and hand, which worsens at night, and she has noticed that they have become clumsy. The nurse recognizes these manifestations as:
Carpal tunnel syndrome
A client who has chronic alcoholism has developed Wernicke-Korsakoff syndrome with associated deficiency in thiamine (vitamin B12). Which manifestation is most distinctive of this syndrome?
Confabulation
The nurse is caring for a client with a rapid degenerative form of dementia. The client has abnormalities of visual-spatial coordination and impaired memory and judgement. The nurse understands that which disorder may be the cause of these symptoms?
Creutzfeldt-Jakob disease
Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?
Ct Scan
A client affected by postural hypotension will likely display what symptoms?
Dizziness and pallor when moved to upright position
A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?
Dopamine
A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?
Encephalitis
The spouse of a client with schizophrenia asks the nurse why the client claims to "hear bad voices" when no one is around. The most accurate response is that the client is most likely undergoing which manifestation?
Experiencing auditory hallucinations
The nurse is teaching a male client who has been diagnosed as HIV positive. The client asks what precautions he should take to prevent his family members from contracting HIV. Which statement will the nurse include in teaching this client?
Family members should not come in contact with your blood.
Which statement is true regarding the development of juvenile idiopathic arthritis?
Generalized stunted growth can occur.
When caring for a client with ankylosing spondylitis, the nurse tells the client that stiffness may be relieved by which intervention?
Gentle exercise
A client with memory loss is concerned about the possibility that it may be inherited. Which disorder will the nurse teach the client is considered an inherited cause of dementia?
Huntington disease
In a newborn, which antibody crosses the placenta to provide protection from infection?
IgG
Infants are born with a passive immunity that occurs when immunoglobulin antibodies cross the placenta from the maternal circulation prior to birth. Which immunoglobulin is capable of crossing the placenta?
IgG
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
A nurse assessing an older adult client for signs and symptoms of depression would assess for which manifestations? Select all that apply.
Inability to make decisions Fatigue Feelings of worthlessness
While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels, thereby increasing cerebral blood flow to the brain?" The best student response would be:
Increased carbon dioxide level
A client who has recently been diagnosed with polymyositis asks the nurse how this problem arose. The nurse tells the client that the underlying cause of this disorder is:
Inflammation and immune mechanisms
An older adult is being evaluated for dementia. Which assessments are not considered part of normal aging? Select all that apply.
Is easily agitated when routines are not followed Is unable to explain the meaning of a proverb Needs cues to perform hygiene activities
What is understood to be the cause of Huntington disease (HD)?
It is inherited as an autosomal dominant disorder.
Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)?
Joint pain and proteinuria
A nurse is caring for a client with ankylosing spondylitis. For which associated symptom does the nurse assess?
Kyphosis
Anticonvulsive medications are used in the treatment of bipolar depression. What other drug is used to treat bipolar disorder?
Lithium
Based on assessment parameters for motor response on the Glasgow Coma Scale, to which client should the nurse assign a score of 5?
Localizes pain
A client who experienced a myocardial infarction 2 weeks ago reports awakening early, loss of appetite, difficulty sitting still or concentrating, and loss of interest in personal hobbies. What mental health disorder do these manifestations represent?
Major depression
A health care provider has diagnosed a client with Wernicke-Korsakoff syndrome based on the client's discrete memory impairment and confabulation. Which assessment finding by the nurse would correspond with the confabulation finding?
Making up information the client can't remember to fill in gaps in the conversation
What is the task of the prefrontal area of the brain?
Manage information
The nurse is caring for a client with newly diagnosed systemic lupus erythematosus (SLE). Which over-the-counter medication does the nurse recognize is useful in treating inflammation, arthritis, and pleuritis?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:
Multiple sclerosis (MS)
Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category?
Myasthenia gravis
Thought and memory pass across synapses in the brain. What are the neural circuits transmitted by new or reactivated pathways called?
Neuronal networks
Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding?
Paralysis
A client states, "I am the most famous rock star in the country and all the other stars are trying to kill me." What type of distorted thinking is the client likely experiencing?
Paranoid
What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?
Parkinson's disease
The nurse plans care for a client with Alzheimer's disease. Which treatment has shown great success in decreasing agitated behavior in this population of clients?
Personalized music playlists
The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate?
Physical examination and x-ray studies
A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?
Placement of a shunt
A nurse is caring for a client with rheumatoid arthritis (RA) who states she "caught" this from her mother. Which statement is the correct explanation of how this type of arthritis develops?
RA has an autoimmune and genetic predisposition.
A client has started having uncontrolled seizures that are not responding to usual medications. Nurses working with the client must pay special attention to which priority aspects of this client's care? Assessment of:
Respiratory status and oxygen saturation
The transmission of impulses at the neuromuscular junction is mediated by which action?
Release of neurotransmitter acetylcholine from autonomic nerve endings
The nursing assistant reports to the registered nurse that a client with a brain tumor has a blood pressure of 180/100 mm Hg and a pulse of 50 bpm. Which action is the correct nursing intervention?
Report to physician the client's signs of increased intracranial pressure.
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
When teaching a group of nursing students about rheumatic disorders, a nurse emphasizes which important differences when caring for the older adult?
Risk for falls
What instruction will the nurse provide to a client with a new diagnosis of anaphylactic reaction to peanuts?
Routinely wear medical alert identification.
Although no definite genetic links for specific psychiatric disorders have been identified, which disorder is thought to be heritable?
Schizophrenia
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 abnormality in the client's gait?
Slow to start walking and has difficulty when asked to "stop" suddenly
Which statement does the nurse know is true concerning substance use disorder in adolescence?
Substance use disorder in teenagers can change the development of the brain.
Which substance helps maintain a smooth surface in joint cartilage?
Synovial fluid
A nurse is caring for a client admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which disease process?
Systemic lupus erythematosus (SLE)
A nurse at a long-term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the client's TIAs?
TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.
A client comes to the clinic and informs the nurse that he believes he is suffering from Parkinson disease. What objective data assessed by the nurse would correlate with the client's concern? Select all that apply.
Tachycardia Tremor Rigidity Bradykinesia
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:
The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.
A nurse is caring for a child diagnosed with DiGeorge syndrome with thymic hypoplasia. Which immune response would the nurse anticipate in this child?
The child with thymic hypoplasia will be at increased risk of infection.
An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?
The client's blood pressure has historically been in the range of 150/90 to 160/100 mm Hg.
After surviving an ischemic stroke, a client has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings and exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which brain structure?
The components of the client's limbic system
A nurse is providing education to a client newly diagnosed with Guillain-Barré syndrome. Which statement reflects accurate information about the course of the disease?
The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.
The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include?
The injections will be given only 3 to 4 times per year because they can increase joint destruction.
The nurse is presenting information about various causes of dementia to a group of clients in a senior facility. What will the nurse include as the major cause of Wernicke-Korsakoff syndrome?
This form of progressive dementia commonly results from chronic alcoholism.
A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing:
Transient ischemic attack (TIA)
The type of hypersensitivity reaction that is mediated by IgG or IgM antibodies directed against target antigens on specific host cell surfaces or tissues is also known as which type of hypersensitivity reaction?
Type 11
A client with a long history of cigarette smoking and poorly controlled hypertension is experiencing psychomotor deficits due to hemorrhagic brain damage. Which diagnosis is likely for the onset of progressive dementia?
Vascular dementia
A 67-year-old client diagnosed with myasthenia gravis will likely display which clinical manifestations as a result of autoantibodies ultimately blocking the action of acetylcholine, resulting in destruction of the receptors?
Weakness of the eye muscles, difficulty in swallowing and slurred speech, impaired gait.
An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects?
Weight and nutritional status
The nurse is educating a group of clients at a senior residence about memory. Which will she include as an example of immediate memory?
Writing down a telephone number someone has just recited
The client tells a nurse that "many voices in his head are telling him what he should do." The nurse thinks he may be experiencing:
a hallucination.
Reflex activity involves which neurons?
all of the above
A client will be receiving a bone graft from an unrelated individual. Which type of graft does the nurse inform the client that he or she will be receiving?
allograft
A diagnosis of acquired immunodeficiency syndrome (AIDS) is identified when the CD4+ T cell count reaches which level?
below 200 cells/ul
A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:
brain death
Which intracranial volume is most capable of compensating for increasing intracranial pressure?
cerebrospinal fluid
A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:
characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.
The family of an older adult reports increasing inability to perform basic activities of daily living. After evaluation, the client is diagnosed with Alzheimer disease. What intervention will be implemented to slow cognitive decline?
cholinesterase inhibitors
Which client would be diagnosed with wasting syndrome?
client with AIDS, fever, diarrhea, and significant involuntary weight loss
The nurse is caring for clients with autoimmune conditions. Which client will the nurse assess first?
client with systemic lupus erythematosus reporting chest pain
The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced:
generalized seizure
A client is suffering from the effects of the opportunistic infection, Cryptosporidium parvum. An important nursing intervention would be to encourage which action?
hydration
Which result is an expected outcome when unipolar and bipolar disorders are treated with an selective serotonin reuptake inhibitor (SSRI) antidepressant?
inhibiting the reuptake of serotonin
Reflexes are basically "hard-wired" into the CNS. Anatomically, the basis of a reflex is an afferent neuron that synapses directly with an effector neuron to cause muscle movement. Sometimes the afferent neuron synapses with what intermediary between the afferent and effector neurons?
interneuron
A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?
ischemic stroke
The nurse is caring for a client who has AIDS and suffers from wasting syndrome. What is the priority nursing consideration for this client?
nutrition
The nurse is preparing a client for oculovestibular reflex assessment (cold caloric test). The nurse explains that the test is used to elicit which of the following?
nystagmus
When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease?
obesity
While there is no laboratory test that is diagnostic for multiple sclerosis, some clients have alterations in their cerebrospinal fluid (CSF) that can be seen when a portion of the CSF is removed during a spinal tap. What finding in CSF is suggestive of multiple sclerosis?
oligoclonal patterns
A 21-year-old client was diagnosed with HIV 4 years ago, which progressed to AIDS 1 year ago. Now, the client presents with cytomegalovirus. The nurse explains to the client that the infection is caused by a common organism that normally does not cause infection in someone with a healthy immune system. This type of infection is called what?
opportunistic infection
What is the priority intervention for a nurse caring for a client with wasting syndrome from AIDS?
promote nutritional intake
Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?
reading
The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:
rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet.
Despite differences in onset, involvement, and symptomatology, all of the spondyloarthropathies involve which pathogenesis etiology?
sacroiliitis
An older adult client is diagnosed with depression. Which medication category will the nurse anticipate will be prescribed for this client?
selective serotonin reuptake inhibitor (SSRI)
Which complication of spinal cord injury is the most preventable in a paraplegic client?
skin breakdown
The nurse is assessing a client with a motor function disorder. Which assessment(s) will the nurse perform to gather data specific to motor function? Select all that apply.
spinal reflexes muscle tone posture and gait muscle size
A nurse is caring for a client experiencing muscle fasciculations. Fasciculations appear as:
spontaneous contractions of muscle fibers presenting as twitching.
The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?
stupor
A nurse has just learned that her child has a life-threatening complement disorder known as hereditary angioneurotic edema (HAE). Due to deficiency in C1-INH, the nurse needs to be prepared for which possible life-threatening clinical manifestation?
swelling of the airway
A nurse educator is explaining how the HIV virus is responsible for AIDS and AIDS syndromes. The educator should explain that replication involves the killing of:
the CD4+ T cell and the release of HIV copies into the bloodstream.
A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?
thrombolysis
The most common cause of an ischemic stroke is which of the following?
thrombosis
The most common cause of ischemic stroke is:
thrombosis
Global or diffuse brain injury is manifested by changes in the level of consciousness.
true
