Patho Quiz 2 Questions
Which of the following individuals is most likely to develop a form of reactive arthritis? A) A 24-year-old male who completed treatment for a chlamydial infection 1 year ago B) A 46-year-old female who has a long-standing diagnosis of systemic lupus erythematosus C) A 3-year-old girl who was born with a 20-degree congenital scoliosis D) A 79-year-old male who had a total hip replacement 2 months prior
A) A 24-year-old male who completed treatment for a chlamydial infection 1 year ago
Which of the following newborn infants demonstrates the highest risk of presenting with developmental dysplasia of the hip (DDH)? A) A girl who was born with toeing-in and who was in a breech presentation B) A twin girl who required resuscitation after delivery C) A boy who was born by caesarian section to a 44-year-old first-time mother D) A boy with Down syndrome who was exposed to cocaine in utero
A) A girl who was born with toeing-in and who was in a breech presentation
Which of the following patients who presented to a walk-in medical clinic is most likely to be diagnosed with a rhinosinusitis rather than a common cold? A) A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9F B) A woman presenting with malaise, lethargy, and copious nasal secretions C) A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9F D) A woman complaining of generalized aches and who has a hoarse voice and reddened, painful upper airways
A) A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9F
A new patient arrives at the clinic. The physician is suspecting that the patient may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and a history of pleural effusions. The nurse should anticipate which of the following diagnostic test will be a priority to facilitate with the diagnosis? A) Anti-DNA antibody test B) Routine hemoglobin C) C-reactive protein D) B-cell lymphocytes
A) Anti-DNA antibody test
The emergency department is awaiting the arrival of a spinal cordñinjured patient. Knowing the innervation of the diaphragm, a patient with which type of injury may be in need of immediate mechanical ventilation? Injury to the A) C4 area. B) C7 area. C) T1 area. D) T4 area.
A) C4 area.
A premature infant on mechanical ventilation has developed bronchopulmonary dysplasia (BPD) and is showing signs and symptoms of hypoxemia, low lung compliance, and respiratory distress. Which of the following is the most likely contributor to the infant's present health problem? A) High-inspired oxygen concentration and injury from positive-pressure ventilation B) Failure to administer corticosteroids to the infant in utero C) Insufficient surfactant production and insufficient surfactant therapy D) Insufficient supplemental oxygen therapy
A) High-inspired oxygen concentration and injury from positive-pressure ventilation
A 13-year-old girl and her father come in to the local health clinic hoping to see an orthopedic doctor about the girl's stiff and warm knee. The father reports that she hurt it sliding into base during a softball game, and the daughter concurs, but with further discussion, it becomes clear that the slide made an existing pain worse. Her knee had been stiff, warm, and shiny and had been keeping her awake at night for a week or so before the game. Which of the following might be the cause of the girl's symptoms? A) Osteosarcoma B) Osteoma C) Chondroma D) Osteochondroma
A) Osteosarcoma
A nurse is providing care for a client who has been admitted to a medical unit with a diagnosis of bronchiectasis. Which of the following signs and symptoms should the nurse expect to find during physical assessment of the client and the review of the client's history? Select all that apply. A) Recurrent chest infections B) Production of purulent sputum C) A barrel chest D) Low hemoglobin levels E) Recent surgery
A) Recurrent chest infections B) Production of purulent sputum D) Low hemoglobin levels
The mother of a 7-year-old boy who has recently been diagnosed with childhood asthma has come to the education center to learn more about her son's condition. Which of the following teaching points is most justifiable? A) Research has shown that viruses may actually be a factor in many children's asthma. B) The most reliable indicator that your child is having an asthma attack is audible wheezing. C) Steroids that your child can inhale will likely be the first line of defense. D) Your son will likely need to limit or avoid exercise and sports.
A) Research has shown that viruses may actually be a factor in many children's asthma.
A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations lead the nurse to suspect a pneumothorax? Select all that apply. A) Respiratory rate 34 B) Asymmetrical chest movements, especially on inspiration C) Diminished breath sounds over the painful chest area D) Pulse oximetry 98% E) ABG pH level of 7.38
A) Respiratory rate 34 B) Asymmetrical chest movements, especially on inspiration C) Diminished breath sounds over the painful chest area
A 16-month-old boy has a normal weight for his age but a height far below the normal range. His list of symptoms includes a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed, and he has difficulty standing. What is the child's most likely diagnosis? A) Rickets B) Rachitic rosary C) Paget disease D) Developmental dysplasia of the hip
A) Rickets
The nurse caring for a male child with respiratory problems is concerned he may be developing respiratory failure. Upon assessment, the nurse knows that which of the following are clinical manifestations of respiratory failure? Select all that apply. A) Severe accessory muscle retractions B) Nasal flaring C) Grunting on expiration D) Inspiratory wheezes heard E) Swollen glottis
A) Severe accessory muscle retractions B) Nasal flaring C) Grunting on expiration
The infant of a family that has recently immigrated to the United States from South Asia has been diagnosed with rickets. Bone density scanning would yield which of the following characterizations of the infant's bones? A) The child's bones are far softer than those of healthy children. B) The infant has bones that are brittle and susceptible to breakage. C) The child's bones lack bone matrix and prevent weight bearing. D) The child's bones are oversized due to insufficient osteoclasts.
A) The child's bones are far softer than those of healthy children.
A nurse is providing care for a patient who has been admitted with a newly diagnosed bilateral pleural effusion. Which of the following findings from the nurse's initial assessment of the patient is incongruent with the patient's diagnosis and would require further investigation? A) The client complains of sharp pain exacerbated by deep inspiration. B) The client's breath sounds are diminished on auscultation. C) Pulse oximetry indicates that the client is hypoxemic. D) The client complains of dyspnea and increased work of breathing.
A) The client complains of sharp pain exacerbated by deep inspiration.
A physician is attempting a differential diagnosis of a 30-year-old female who is suspected of having systemic lupus erythematosus (SLE). Which of the following aspects of the physician's assessment and the client's history would be considered potentially indicative of SLE? Select all that apply. A) The client has a butterfly rash on her nose and cheeks. B) She complains of intermittent joint pain. C) The woman states that she has numerous environmental allergies. D) The client has been hospitalized twice in the past for pleural effusions. E) Blood work indicates low red cells, white cells, and platelets.
A) The client has a butterfly rash on her nose and cheeks. B) She complains of intermittent joint pain. D) The client has been hospitalized twice in the past for pleural effusions. E) Blood work indicates low red cells, white cells, and platelets.
A 44-year-old woman has developed calf pain during a transatlantic flight. She is extremely short of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE) that resolved with anticoagulant therapy. Which of these statements best characterizes the underlying problem of her PE? A) Ventilation was occurring, but perfusion was inadequate causing shortness of breath. B) The combination of normal perfusion but compromised ventilation caused hypoxia. C) She developed a transient anatomic shunt resulting in impaired oxygenation. D) Impaired gas diffusion across alveolar membranes resulted in dyspnea and hypoxia.
A) Ventilation was occurring, but perfusion was inadequate causing shortness of breath.
A patient with small cell lung cancer (SCLC) has developed a paraneoplastic syndrome called Cushing syndrome. Based on this new complication, the nurse will likely assess which of the following clinical manifestations of Cushing syndrome? A) Weight gain, moon face, buffalo hump, and purple striae on the abdomen B) Bilateral edema in the arms, swollen face, and protruding eyes C) Severe bone/joint pain, nausea/vomiting, and polyuria D) Tetany, new-onset seizure activity, emotional lability, and extrapyramidal symptoms
A) Weight gain, moon face, buffalo hump, and purple striae on the abdomen
Which of the following patients would the nurse expect to find woven bone scaffolding in place to facilitate healing? Select all that apply. A) A 14-year-old patient recovering from a head injury following a diving accident B) A 22-year-old patient recovering from an auto accident where he incurred a fracture of his femur C) An 85-year-old nursing home patient who is undergoing rehabilitation therapy for the arthritis in his knee D) A 55-year-old prostate cancer patient undergoing radiation therapy for bone metastasis
B) A 22-year-old patient recovering from an auto accident where he incurred a fracture of his femur D) A 55-year-old prostate cancer patient undergoing radiation therapy for bone metastasis
Which of the following individuals is likely to have the highest risk of developing tuberculosis osteomyelitis? A) A 55-year-old female who is in renal failure secondary to poorly controlled type 1 diabetes B) A 79-year-old man who is immunocompromised following a bone marrow transplant C) A 30-year-old man who has undergone open reduction and internal fixation of his fractured tibia D) A 68-year-old woman who had a laminectomy 4 days prior for treatment of her chronic back pain
B) A 79-year-old man who is immunocompromised following a bone marrow transplant
Which of the following phenomena is most likely occurring during a child's alveolar stage of lung development? A) Terminal alveolar sacs are developing, and surfactant production is beginning. B) A single capillary network exists, and the lungs are capable of respiration. C) The conducting airways are formed, but respiration is not yet possible. D) Primitive alveoli are formed, and the bronchi and bronchioles become much larger.
B) A single capillary network exists, and the lungs are capable of respiration.
As a consequence of a long-standing lung disease, a client is in a chronic state of hypoxia. Which of the following phenomena would the client's care team be most justified in anticipating? Select all that apply. A) Metabolic alkalosis B) Increased erythropoietin production C) Pulmonary vasodilation D) Hyperventilation E) Personality changes
B) Increased erythropoietin production D) Hyperventilation E) Personality changes
A male, lifetime smoker has died because of chronic obstructive pulmonary disease. Which of the following phenomena regarding his alveoli would his care team expect in the weeks prior to his death? A) Proliferation of natural killer (NK) cells in the alveolar lumen B) Large numbers of alveolar macrophages in septal connective tissue C) The presence of tubercles in the interalveolar spaces D) Compensatory regeneration of type I alveolar cells
B) Large numbers of alveolar macrophages in septal connective tissue
Reviewing pathology for an exam on pulmonary vasculature, the nursing student states that blood enters the right side of the heart via the vena cavae, then to the right atrium, right ventricle, and then which vessel carries the deoxygenated blood into the pulmonary system? A) Pulmonary capillaries B) Pulmonary artery C) Pulmonary vein D) Ductus arteriosus
B) Pulmonary artery
A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would most likely lead clinicians to this conclusion? A) A visible hematoma is present on the anterior portion of the knee. B) The woman experiences intermittent, painful locking of her joint. C) Computed tomography indicates a complete tear of her knee ligament. D) An x-ray shows that her femoral head and tibia are no longer articulated.
B) The woman experiences intermittent, painful locking of her joint.
A client with a newborn infant is also the caregiver for her 75-year-old mother, who lives with them and who has diabetes. The client requests pneumonia vaccinations for her entire household. Which vaccine is most likely to be effective for the baby? A) Since the baby's immune system is mature at birth, regular vaccine is appropriate. B) There is no effective vaccine for newborn infants. C) The 23-valent vaccine will be effective. D) No vaccine is necessary for the baby if the nursing mother is immunized.
B) There is no effective vaccine for newborn infants.
A 51-year-old female client who is 2 days postoperative in a surgical unit of a hospital is at risk of developing atelectasis as a result of being largely immobile. Which of the following teaching points by her nurse is most appropriate? A) Being in bed increases the risk of fluid accumulating between your lungs and their lining, so it's important for you to change positions often. B) You should breathe deeply and cough to help your lungs expand as much as possible while you're in bed. C) Make sure that you stay hydrated and walk as soon as possible to avoid us having to insert a chest tube. D) I'll proscribe bronchodilator medications that will help open up your airways and allow more oxygen in.
B) You should breathe deeply and cough to help your lungs expand as much as possible while you're in bed.
A patient is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering A) a bronchodilator. B) a corticosteroid. C) aspirin. D) an albuterol inhaler.
B) a corticosteroid.
A nurse in an acute medical unit is providing care for a number of patients with a variety of diagnoses. Which of the following patients most likely exhibits risk factors for impaired coughing? A patient with A) an injury to her cerebellum. B) a nasogastric (NG) tube attached to suction. C) a diagnosis of viral pneumonia. D) diagnosis of diabetes mellitus and morbid obese.
B) a nasogastric (NG) tube attached to suction.
A male patient in his 50s has just been diagnosed with hyperuricemia. He has had multiple flare-ups of his first metatarsophalangeal joint pain and swelling. The pain is so severe that he cannot sleep with any covers/sheets over his feet at night. The nurse should anticipate that the patient will likely be prescribed: Select all that apply. A) Tylenol (acetaminophen) for the pain. B) allopurinol (Zyloprim) to decrease uric acid levels. C) calcium carbonate used to increase the intake of calcium. D) Anturane (sulfinpyrazone) to increase excretion of urate. E) sevelamer (Renagel) to reduce the absorption of phosphate.
B) allopurinol (Zyloprim) to decrease uric acid levels. D) Anturane (sulfinpyrazone) to increase excretion of urate.
While reviewing the role of the parathyroid hormone in the balance of calcium and phosphate levels, the nursing faculty will emphasize that the kidney responds to parathyroid stimulation by A) increasing reabsorption of sodium in the distal tubules. B) reducing the reabsorption of phosphate. C) stimulating production of red blood cells. D) decreasing the reabsorption of calcium.
B) reducing the reabsorption of phosphate.
Which of the following clients is most likely to have low bone density? A) A 70-year-old woman with increased numbers of osteoblasts. B) A 78-year-old female whose osteoclast function is inhibited. C) A 65-year-old male who is noted to have osteopenia. D) A 68-year-old male who takes vitamin D supplements.
C) A 65-year-old male who is noted to have osteopenia.
A 44-year-old woman who has a long-standing diagnosis of SLE has been able to control her symptoms with lifestyle modifications for several years, but has presented to her care provider due to recent exacerbation. Which of the following pharmacological treatment options is her care provider most likely to rule out first? A) Nonsteroidal anti-inflammatory drugs B) Corticosteroids C) Antiplatelet aggregators D) Immunosuppressive drugs
C) Antiplatelet aggregators
In which of the following locations would a clinician expect to find a ligament? A) At the attachment points between ribs and the sternum B) Between the radius bone of the arm and the biceps brachii muscle C) Around the capsule that forms the knee joint D) Between the individual plates of the skull
C) Around the capsule that forms the knee joint
As a result of dehydration, a client's epithelial cells are producing insufficient amounts of mucus. Consequently, the client's mucociliary blanket is compromised. Which of the following changes would the care provider anticipate as a direct result of this change? A) Impaired function of the client's cilia B) Decreased levels of oxygen saturation C) Increased amounts of bacteria in the lungs D) Increased carbon dioxide levels
C) Increased amounts of bacteria in the lungs
A 30-year-old woman has just given birth to a boy. How will the mother's bone marrow differ from that of her son? A) Her bone marrow performs additional functions for the maintenance of homeostasis that her son is not able to yet perform. B) The son will have a greater proportion of adipose tissue in his bone marrow. C) Proportionately, the infant will have more red marrow and less yellow marrow than his mother. D) The amount of yellow marrow in the son's bones will decrease as he develops.
C) Proportionately, the infant will have more red marrow and less yellow marrow than his mother.
A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. Upon assessment of the lungs, what clinical manifestations should the nurse expect? A) Rapid, deep breaths B) Wheezing throughout lung fields C) Short, shallow breaths D) Pursed-lip breaths with slow, steady breaths
C) Short, shallow breaths
A patient asks the nurse why his hip fracture (head of the femur) bone has died (osteonecrosis). The nurse responds based on which of the following pathophysiological principles? A) All fractured bones interrupt blood supply and thereby results in death of the bone no matter where it is located. B) Most of the time when the head of the femur breaks, the entire neck region is disconnected to the rest of the bone so the blood vessels are severed. C) Since the head of the femur has only limited collateral circulation, interruption in the blood flow from the fracture causes necrosis and irreversible damage. D) When the femur head breaks, it dislocates and crushes the surrounding area causing the blood vessels to be occluded.
C) Since the head of the femur has only limited collateral circulation, interruption in the blood flow from the fracture causes necrosis and irreversible damage.
The physician is considering prescribing an anti-tumor necrosis factor (TNF) like infliximab for a rheumatoid arthritis patient. Which of the following statements is accurate about the advantages of using a TNF inhibitor? A) Since TNF inhibitors have few side effects, these drugs will fit well into your regimen. B) Your disease-modifying antirheumatic drug (DMARD) methotrexate has more cardiovascular side effects than TNF inhibitors. C) TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions. D) Not only do TNF inhibitors control your disease better but they also will interrupt the inflammatory cascade at several levels.
C) TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions.
While explaining to the parents of a 5-year-old why the child's fractured femur has so much swelling and bruising, the nurse will include which of the following statements? A) Your child fell out of the tree with so much force that the body is trying to send extra fluid to the area of the break. B) All bone fractures have lots of bruising so it's nothing to worry about. C) This bone is hollowed out, and the inside of the shaft produces marrow where red blood cells are formed. D) There are a lot of cartilage attaching to the shaft of the femur, so when you break that bone, it ruptures the cartilage and causes more swelling.
C) This bone is hollowed out, and the inside of the shaft produces marrow where red blood cells are formed.
When educating a student who lives in a crowded apartment and diagnosed with tuberculosis, the college school nurse will emphasize, A) Once your fever goes away, you can stop taking the streptomycin injection. B) If isoniazid makes you nauseous, we can substitute something milder. C) To destroy this bacterium, you must strictly adhere to a long-term drug regimen. D) You will have to wear an N95 mask while on campus at all times.
C) To destroy this bacterium, you must strictly adhere to a long-term drug regimen.
A 56-year-old male is obese and has poorly controlled type 2 diabetes mellitus. The home care nurse who changes the dressing on his chronic foot ulcer three times weekly has noted that the client's bone is now visible in the wound bed. The client has a fever and has not complained of any notable increase in pain to his foot. Which of the following statements best captures what is likely occurring? A) The client is possibly experiencing direct penetration osteomyelitis in which microorganisms have entered through his foot wound. B) Infectious microorganisms in his blood supply have proliferated in the distal portions of his skeletal system. C) Vascular insufficiency has contributed to infection in both soft tissue and now his bone. D) His immunocompromised status associated with diabetes has allowed skin flora to penetrate his foot bone via the surface wound.
C) Vascular insufficiency has contributed to infection in both soft tissue and now his bone.
In the early morning, an African American woman brings her 5-year-old son to the emergency room. The boy is wheezing, is short of breath, and has a dry cough. The mother states that he has always been very healthy. He went to bed with only a slight cold and a runny nose but woke her with his coughing shortly after 4 AM. His symptoms worsened so dramatically that she brought him to the hospital. The care team would most likely suspect that he has A) respiratory syncytial virus. B) influenza. C) asthma. D) pneumonia.
C) asthma.
While studying bones in pathophysiology class, the nursing students learn that the Haversian canals are composed of A) calcium salts. B) collagen. C) lymphatics. D) glycosaminoglycans.
C) lymphatics.
A 77-year-old lifetime smoker has been diagnosed with a tumor in his lung at the site of an old tubercle scarring site, located in a peripheral area of his bronchiolar tissue. What is this client's most likely diagnosis? A) Squamous cell carcinoma B) Small cell lung cancer C) Large cell carcinoma D) Adenocarcinoma
D) Adenocarcinoma
A female patient is requiring supplementary oxygen by face mask due to her reduced lung compliance. Which of the following pathophysiological processes is most likely a contributor to her low lung compliance? A) The woman's lungs have more recoil than a healthy person's. B) Her type II alveolar cells are producing a slight excess of surfactant. C) Turbulent airflow is taking place in the patient's large airways. D) Her thoracic cage is less flexible than when she was healthy.
D) Her thoracic cage is less flexible than when she was healthy.
While rock climbing, a 22-year-old male has endured a severe head injury. Which of the following statements best captures expected clinical manifestations and treatments for his immediate condition? A) Oxygen therapy is likely to decrease his respiratory drive and produce an increase in PCO 2 . B) Cheyne-Stokes breathing is likely but will respond to bronchodilators. C) The client is unlikely to respond to supplementary oxygen therapy due to impaired diffusion. D) Hypoventilation may exist, resulting in increased PCO 2 and hypoxemia that may require mechanical ventilation.
D) Hypoventilation may exist, resulting in increased PCO 2 and hypoxemia that may require mechanical ventilation.
While being tackled, a 20-year-old football player puts out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment? A) This strain will likely resolve itself with sufficient rest. B) You've suffered a severe sprain, and you might need a cast. C) Your wrist contusion will have to be observed for bleeding under the skin surface. D) It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks.
D) It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks.
Around 3 weeks after razing an old chicken house, a 71-year-old retired farmer has developed a fever, nausea, and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis. Which of the following processes is most likely taking place? A) Toxin production by Histoplasma capsulatum is triggering an immune response. B) Antibody production against the offending fungi is delayed by the patient's age and the virulence of the organism. C) Spore inhalation initiates an autoimmune response that produces the associated symptoms. D) Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.
D) Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.
A 56-year-old female with a diagnosis of breast cancer has developed bone metastases, which her oncologist would like to treat with radiation therapy. What is her physician's most likely primary goal in the treatment plan of the metastases? A) Thorough elimination of neoplastic cells in the bone structure B) Preservation of normal weight bearing and range of motion C) Ensuring vascular supply to the bone is not affected D) Prevention of pathologic fractures
D) Prevention of pathologic fractures
Following a progressive onset of fatigue, aching, and joint stiffness over the last 2 years, a 69-year-old male has recently been diagnosed with rheumatoid arthritis (RA). Which of the following teaching points should his primary care physician include during the office visit in which this diagnosis is communicated to the client? A) The symptoms you've been experiencing are the result of damage inside your joints, but I'll start you medications that will reverse this damage. B) It's important that you maximize your level of activity, since decreasing your mobility will worsen the disease. C) The best treatment plan is to try all other available treatments before resorting to using medications. D) Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms.
D) Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms.
An 8-year-old child has just been diagnosed with systemic lupus erythematosus (SLE). The parents wonder what the child's prognosis is going to be. Which of the following findings would be considered a good prognostic indicator of the extent/seriousness of the disease? A) Complaints of arthralgias and arthritis in joints with movement B) Ligaments and tendons hurt during passive ROM C) Has a rash on the nose and cheeks D) Swelling in the face and eyes and rust/blood-colored urine
D) Swelling in the face and eyes and rust/blood-colored urine
A 36-year-old female who has experienced diverse symptoms for several years has finally had her health problems attributed to scleroderma (systemic sclerosis) and has committed herself to learning as much about the disease as she can. Which of her following statements would her nurse want to correct or clarify? A) I'm surprised that in this day and age, they still don't know what causes scleroderma. B) I suppose this explains why I have such terrible circulation to my hands and feet. C) I'm scared by the damage that this could cause to my heart and lungs. D) The worst part of this so far has been learning that there aren't any treatments for scleroderma.
D) The worst part of this so far has been learning that there aren't any treatments for scleroderma.
While reviewing the bones in anatomy class, the instructor discusses this type of bone that protects the underlying structures. A good example of a flat bone is: A) metatarsal bones. B) vertebrae. C) femur. D) skull.
D) skull.
While speaking to a senior citizen club about osteoarthritis (OA), which of the following facts are accurate to share? Select all that apply. A) By the time you are in your 70s, about 85% of adults will have some form of OA B) Men usually get OA in their hands, whereas women get OA primarily in their hips C) Obesity in women has been correlated to having OA in the knees D) Heredity does not play a significant role in the development of OA
A) By the time you are in your 70s, about 85% of adults will have some form of OA C) Obesity in women has been correlated to having OA in the knees
Which of the following endocrine functions are responsible for increased resorption of bone that results in a reduction of the number and function of osteoclasts? Select all that apply. A) Calcitonin secretion B) Decrease in estrogen levels C) Stimulation of excess thyroid hormone D) Release of catecholamines E) Increase movement of calcium and phosphate from bone into the extracellular fluid
A) Calcitonin secretion B) Decrease in estrogen levels
The parents of an active 9-year-old are leaving the emergency department (ED) following cast placement for their son's lower extremity as a result of a fall in soccer. The nurse should emphasize that assessment of the cast is important and that they should bring their son back to the ED if they note which of the following signs and symptoms? Select all that apply. A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg. C) Swelling in the lower leg has remained the same since they left the ED 12 hours ago. D) Pulses are palpable below the level of the cast. E) Bruising noted in the lower foot and toes.
A) Cold, pale toes on the side with the cast. B) Patient complaining of tingling and numbness in the casted leg.
A patient has been admitted with a fractured pelvis that occurred in an auto accident just a few hours ago. The nurse notices a slight change in behavior. Which of the following clinical manifestations would lead the nurse to suspect that the patient has fat emboli that has migrated? Select all that apply. A) Complaints of substernal chest pain B) Complaints of pain in the lower abdomen and back C) Pulse rate 120 with temperature of 99.7∞F D) Profuse diaphoresis with pallor noted E) Urine output of 30 mL/hour
A) Complaints of substernal chest pain ) Pulse rate 120 with temperature of 99.7F D) Profuse diaphoresis with pallor noted
A 71-year-old woman is dependent on oxygen therapy and bronchodilators due to her diagnosis of emphysema. Which of the following pathological processes occur as a result of her emphysema? Select all that apply. A) Decreased elastic recoil due to alveolar damage B) Decreased residual lung volume due to impaired alveolar ventilation C) Increased anatomical dead space due to reduced tidal volume D) Increased alveolar dead space due to incorrect intrapleural pressure
A) Decreased elastic recoil due to alveolar damage C) Increased anatomical dead space due to reduced tidal volume D) Increased alveolar dead space due to incorrect intrapleural pressure
A 22-year-old woman has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the woman expect over the course of recovery? Select all that apply. A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity D) Presence of infectious microorganisms in the synovial capsule E) Rapid restoration of the cartilage cells in the meniscus
A) Decreased lubrication in the knee joint B) Decreased stability of the knee C) Reduced shock absorption capacity
An 80-year-old female with a diagnosis of osteoporosis receives daily supplements of calcitonin in the form of a nasal spray that she instills each morning. Which of the following phenomenon would her care providers expect to result from her supplementation? A) Decreased serum calcium levels B) Increased bone resorption C) Acceleration of osteoclast action D) An increase in bone formation
A) Decreased serum calcium levels
When educating the patient with ankylosing spondylitis, the nurse should emphasize which of the following treatment interventions? Select all that apply. A) Encourage sleeping supine on an extra firm mattress if possible. B) Prop self up in bed with extra pillows if having respiratory congestion. C) Try using the heating pad prior to exercise to help stretching and improve movement. D) Wear a knee immobilizer while biking to facilitate ability to exercise for longer periods. E) Modify diet to include more protein from red meats and green vegetables for vitamin K.
A) Encourage sleeping supine on an extra firm mattress if possible. C) Try using the heating pad prior to exercise to help stretching and improve movement.
When a 4-year-old boy stands erect with his medial malleoli touching, the distance between his knees is 2 inches. What is the child's most likely diagnosis and treatment? A) Genu varum, which can be treated by bracing B) Flatfoot, which will require orthopedic shoes C) Genu valgum necessitating a series of surgeries D) Femoral torsion, which will spontaneously resolve before puberty
A) Genu varum, which can be treated by bracing
A 21-year-old male client has suffered a head injury during a crash on his motorcycle, and a deficit that assessments have revealed is an impaired swallowing mechanism. He has also developed aspiration pneumonia. Which of the following statements most accurately captures an aspect of his condition? A) His vocal folds are likely not performing their normal function. B) His epiglottis is covering his larynx. C) His vocal folds have been compromised. D) His tracheobronchial tree is intermittently obstructed.
A) His vocal folds are likely not performing their normal function.
A family physician is performing patient teaching about the influenza virus with each patient who has come to the clinic to receive that year's vaccine. Which of the following statements by the patient best reflects an accurate understanding of the flu virus? A) I could come down with viral or bacterial pneumonia as a result of a bad flu bug. B) I know my vaccination is especially important since there aren't any drugs that can treat the flu once I get sick with it. C) The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated and actually ineffective. D) Like all vaccines, it is ideal if everyone in a population gets immunized against the flu.
A) I could come down with viral or bacterial pneumonia as a result of a bad flu bug.
A female tennis player has suffered an injury to her shoulder that has affected her bursae in the joint. Which of the following consequences would be most expected from this aspect of her injury? A) Increased friction on the tendons of the shoulder joint B) Direct contact between the humerus and scapula bones C) Loss of connection between the humerus bone and biceps muscle. D) Fusing of the head of the humerus with the glenoid capsule of the scapula.
A) Increased friction on the tendons of the shoulder joint
Which of the following characteristics most accurately applies to compact (cortical) bone? A) It is found along lines of stress in the body. B) The bone is arranged in an interwoven, lattice-like pattern. C) It is relatively light but still strong. D) The surface of the bone is lined with osteogenic cells.
A) It is found along lines of stress in the body.
Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis? A) Loss of motion in the spinal column and eventual kyphosis B) A progressive loss of range of motion in the knee and hip joints C) A facial ìbutterfly rashî and multiorgan involvement D) Decreased bone density in long bones
A) Loss of motion in the spinal column and eventual kyphosis
A 51-year-old male with a history of hypertension has received a kidney transplant. The client's physician is explaining some of the consequences of the procedure, including the fact that he will need to be on long-term steroid therapy. Which of the following teaching points should the physician emphasize? A) One of the risks that these steroids bring is the possibility that part of a bone might die. B) Steroids will help your body to not reject your new kidney, but they bring a risk of bone infection. C) You're going to have to avoid contact sports because the steroids will make your bones very susceptible to breakage. D) If you notice sudden limb pain after taking your steroid pills, it could be an increase in pressure in the compartment around your muscles.
A) One of the risks that these steroids bring is the possibility that part of a bone might die.
Following a motorcycle accident that resulted in bilateral femoral fractures, a 42-year-old male has been receiving skeletal traction for the past 8 days. His care providers would recognize that which of the following risks is paramount? A) Risk of thromboemboli B) Risk of compartment syndrome C) Risk of permanent muscle atrophy D) Risk of decreased bone density and increased future fracture risk
A) Risk of thromboemboli
A COPD patient asks the nurse what medications are prescribed to help his breathing. The nurse, looking at the list of medications, will educate the patient about which of the following medications to help his COPD in the long term? Select all that apply. A) Salmeterol (Serevent), a bronchodilator B) Tiotropium (Spiriva), anticholinergic C) Alprazolam (Xanax), a benzodiazepine D) Sildenafil (Viagra), a vasodilator E) Ketorolac (Toradol), an NSAID
A) Salmeterol (Serevent), a bronchodilator B) Tiotropium (Spiriva), anticholinergic
A patient with pulmonary hypertension may display which of the following clinical manifestations? Select all that apply. A) Shortness of breath B) Decreased exercise tolerance C) Nasal flaring D) Grunting on expiration E) Swelling (edema) of the legs and feet
A) Shortness of breath B) Decreased exercise tolerance E) Swelling (edema) of the legs and feet
A 71-year-old male with a suspected diagnosis of osteoarthritis is being scheduled for a knee aspiration. The client is surprised to learn that his knee joint contains fluid and asks the physician ordering the procedure what the main role of the fluid is. Which of the following statements best underlies the explanation that the physician will provide? A) Synovial fluid allows for joint movement by minimizing friction. B) Fluid in the synovial cavities is essential for its role in immunity, and deficits indicate autoimmune etiologies. C) Synovial fluid allows for the diffusion of gases and nutrients to cartilage that lacks blood supply. D) The fluid inhibits clot formation in bone surfaces that are in constant contact.
A) Synovial fluid allows for joint movement by minimizing friction.
Following bone density scanning and diagnostic imaging, a 4-year-old boy has been diagnosed with Legg-CalvÈ-Perthes disease. Which of the following findings, signs, and symptoms would lead clinicians to this conclusion? Select all that apply. A) The boy has significant difficulty in walking. B) The boy's feet toe-in when standing upright. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic. E) There are numerous microfractures where his patellar tendon and tibia articulate.
A) The boy has significant difficulty in walking. C) The child has limited abduction of the affected hip. D) His femoral head region is noted to be necrotic.
A public health nurse has learned that a colleague has been screening for scoliosis during visits made to schools even though such screening is not mandated. How should the nurse best respond to the colleague? A) The potentially harmful outcomes of screening have been shown to outweigh the benefits. B) Screening for scoliosis has been proven to be inaccurate. C) Screening is unnecessary now that we know scoliosis is a benign condition. D) The low prevalence and incidence of scoliosis have made screening unnecessary.
A) The potentially harmful outcomes of screening have been shown to outweigh the benefits.
A 74-year-old female has been diagnosed with osteoporosis after her bone density scan indicated osteopenia. Which of the following factors would her care team be most likely to rule out as contributors to her health problem? A) The woman is an African American and was exposed to asbestos in her work. B) She has been a heavy drinker for her whole adult life and has diabetes mellitus. C) The client takes corticosteroids for treatment of her long-standing osteoarthritis. D) The woman has an estrogen deficiency and has never undergone hormone therapy.
A) The woman is an African American and was exposed to asbestos in her work.
The parents of a newborn who has been diagnosed with developmental dysplasia of the hip ask the nurse about the reason this harness has to be on their child. The nurse responds, A) This harness allows your baby some mobility as it slowly brings the leg back into abduction. B) The harness is meant to help the baby be moved without increasing his pain. C) The harness will keep the leg immobile and force the femoral head back into the cup-shaped socket of the hip bone. D) Infants with dysplasia of the hip need to keep the leg still, and this harness will provide the immobility needed for healing postsurgery.
A) This harness allows your baby some mobility as it slowly brings the leg back into abduction.
The osteoporosis patient asks the nurse to explain what a bisphosphonate medication does. The nurse will respond, A) This medication helps prevent bone resorption, which will help prevent fractures. B) These drugs increase your phosphorus levels and thereby help with your calcium levels as well. C) This medication stimulates your parathyroid gland to increase osteoclastic activity. D) This medication plays an important role in bone remodeling.
A) This medication helps prevent bone resorption, which will help prevent fractures.
Following a winter power outage, a client who had been using a home gasoline generator began to experience dizziness and headaches and was diagnosed with carbon monoxide poisoning. What is the goal of hyperbaric oxygen treatment for carbon monoxide poisoning? A) To increase the amount of oxygen carried in the dissolved state B) To increase the production of unbound hemoglobin C) To stimulate the release of oxygen at the capillaries D) To remove bound CO from hemoglobin
A) To increase the amount of oxygen carried in the dissolved state
A 60-year-old male hospital patient with a diagnosis of chronic obstructive pulmonary disease (COPD) is undergoing lung function tests to gauge the progression of his disease. Which of the following aspects of the lung volumes will the respiratory therapist be most justified in using to guide interpretation of the test results? A) Vital capacity will equal the patient's combined inspiratory reserve, expiratory reserve, and tidal volume. B) Vital capacity will equal the total lung capacity. C) Resting tidal volume will exceed that of tidal volume during activity. D) Expiratory reserve will equal residual lung volume.
A) Vital capacity will equal the patient's combined inspiratory reserve, expiratory reserve, and tidal volume.
Which of the following clients are displaying known risk factors for the development of pulmonary emboli? Select all that apply. A client who is: A) immobilized following orthopedic surgery. B) experiencing impaired Cl ñ and Na + regulation. C) taking amiodarone for the treatment of premature ventricular contractions. D) a smoker and who takes oral contraceptives. E) undergoing radiation therapy for the treatment of breast cancer.
A) immobilized following orthopedic surgery. D) a smoker and who takes oral contraceptives.
Child/parents are coming into the physician's office to get the results of some diagnostic testing relating to his knee pain and unusual stiffness and fatigue. The physician suspects the child may have slipped capital femoral epiphysis. The nurse should anticipate that the treatment will involve: Select all that apply. A) no weight bearing on the femur. B) bed rest. C) traction. D) injection of steroids into the joint. E) high dose of calcium supplements.
A) no weight bearing on the femur. B) bed rest. C) traction.
A patient who has been on a high-protein diet comes to the emergency department with respiratory symptoms. Upon analysis of arterial blood gases (ABGs), the patient is diagnosed with hypercapnia. The nurse will note the ABG results that confirm this diagnosis include: Select all that apply. A) pH 7.31 (normal 7.35 to 7.45). B) PO 2 of 97%. C) PCO 2 of 58 mm Hg (normal 38 to 42). D) Serum HCO 3 of ñ33 mEq/L (normal 22 to 28). E) Serum K + (potassium)of 3.6 mmol/L (normal 3.5 to 5.0).
A) pH 7.31 (normal 7.35 to 7.45). C) PCO 2 of 58 mm Hg (normal 38 to 42). D) Serum HCO 3 of ñ33 mEq/L (normal 22 to 28).
Upon admission to the ICU, a patient with a history of cor pulmonale will likely be exhibiting which of the following clinical manifestations of right heart failure? Select all that apply. A) Fine crackles throughout both lung fields B) +4 pitting edema in lower extremities C) Expectorating copious amounts of frothy, pink sputum D) Jugular vein distension E) Altered level of consciousness
B) +4 pitting edema in lower extremities D) Jugular vein distension E) Altered level of consciousness
Which of the following individuals demonstrates a health problem with his or her axial skeleton? A) A 21-year-old male who fractured his humerus while snowboarding. B) A 40-year-old man who has a contusion to the left temporal bone of his skull following a motor vehicle accident. C) A 79-year-old female who has undergone hemiarthroplasty (hip replacement surgery). D) A 30-year-old pregnant woman who has a separated pubic symphysis.
B) A 40-year-old man who has a contusion to the left temporal bone of his skull following a motor vehicle accident.
A 41-year-old male client has presented to the emergency department with an acute onset of increased respiratory rate and difficulty breathing. STAT chest x-ray indicates diffuse bilateral infiltrates of his lung tissue, and ECG displays no cardiac dysfunction. What is this client's most likely diagnosis? A) Cor pulmonale B) Acute lung injury C) Pulmonary hypertension D) Sarcoidosis
B) Acute lung injury
Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture? A) A 20-year-old football player who had an opposing player fall laterally on his leg B) An 8-year-old boy who fell out of a tree and on to his arm C) An 81-year-old woman with a history of osteoporosis who stumbled and fell on her hip D) A 32-year-old woman who fell awkwardly on her arm while skiing
B) An 8-year-old boy who fell out of a tree and on to his arm
The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture? A) A 77-year-old male who runs marathons and maintains a BMI of 25. B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom. C) A 64-year-old male with uncontrolled diabetes and chronic kidney disease on dialysis. D) A 73-year-old nursing home patient with long-term continence issues but able to walk the hallways for exercise.
B) An 82-year-old female with macular degeneration and uses a walker to go to the bathroom.
During pathophysiology class, a nursing student asks the faculty what purpose do the osteoprogenitor cells serve. From the following list, identify the purpose of these cells. Select all that apply. A) Formation of red blood cells B) Growth and remodeling of bone C) Anchorage point for blood vessels D) Repair of bone E) Supply nerves to the bone matrix
B) Growth and remodeling of bone D) Repair of bone
A 17-year-old male has been diagnosed with osteosarcoma of the upper tibia following several months of leg pain. Which of the following statements by the client demonstrates that he has an accurate understanding of his diagnosis? A) I guess it's good that at least my tumor's a benign type. B) I'm really nervous about having to get surgery and chemo. C) I'm gaining hope from the fact that it's really rare for someone to die from this. D) It still feels surreal that I'm going to have to get my leg amputated.
B) I'm really nervous about having to get surgery and chemo.
Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which of the following phenomena most likely underlies the woman's situation? A) Inappropriate T-cell mediated immune responses have resulted in articular cartilage degeneration. B) Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself. C) Excessive collagen deposits have accumulated in the woman's synovial joints. D) Bone overgrowth in synovial joints has resulted in fusing of adjacent bones that normally articulate.
B) Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.
While an infant is in the supine position with both knees flexed, the clinician applies gentle downward pressure to both knees, and the knee and thigh are abducted as an upward and medial pressure is applied to the proximal thigh. This examination technique, used to screen for a reducible dislocation, is called A) Galeazzi test. B) Ortolani maneuver. C) clubfoot test. D) Trendelenburg test.
B) Ortolani maneuver.
A 3-year-old boy has developed croup following a winter cold. His care provider would recognize that which of the following microorganisms and treatments is most likely to be effective? A) Respiratory syncytial virus treated with intubation B) Parainfluenza virus treated with a mist tent and oxygen therapy C) Haemophilus influenza treated with appropriate antibiotics D) Staphylococcus aureus treated with bronchodilators and mist tent
B) Parainfluenza virus treated with a mist tent and oxygen therapy
Which of the following is the best example of a diarthrodial joint? A) The interface between the body of the femur and the epiphyseal plates at the ends of the bone B) The interphalangeal joint between the proximal and middle phalanges of the fingers C) The suture between the frontal and parietal bones of the skull D) The syndesmoses between the two sides of the pelvis
B) The interphalangeal joint between the proximal and middle phalanges of the fingers
A nurse is providing care for an older, previously healthy adult male who has been diagnosed today with pneumococcal pneumonia. Which of the following signs and symptoms is the nurse most likely to encounter? A) The man will be hypotensive and febrile and may manifest cognitive changes. B) The patient will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles. C) The patient will have copious bloody sputum and diffuse chest pain and may lose his cough reflex. D) The patient will lack lung consolidation and will have little, if any, sputum production.
B) The patient will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles.
Although the client's primary care provider has downplayed the symptoms, a geriatrician suspects that an 82-year-old female has polymyalgia rheumatica. Which characteristic symptomatology would most likely have led the specialist to suspect this health problem? A) Extended periods of walking cause pain that extends from her ankles, knees, and sciatic nerve. B) The woman complains of aching and morning stiffness in her neck, shoulder, and pelvis. C) Range of motion in the woman's wrists and ankles is greatest in the morning and decreases over the course of a day. D) The woman's metatarsal joints are inflamed and sensitive to touch.
B) The woman complains of aching and morning stiffness in her neck, shoulder, and pelvis.
A 62-year-old female smoker is distraught at her recent diagnosis of small cell lung cancer (SCLC). How can her physician most appropriately respond to her? A) I'm sure this is very hard news to hear, but be aware that with aggressive treatment, your chances of beating this are quite good. B) This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens. C) I'm very sorry to have to give you this news; I'd like to talk to you about surgical options, however. D) This is a difficult diagnosis to receive, but there is a chance that the cancer may go into remission.
B) This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens.
Which of the following situations is most likely to result in an increased binding affinity of hemoglobin for oxygen? A) A client is in respiratory acidosis, with a low pH. B) Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen. C) A client's body temperature is elevated as a result of an infectious process. D) An increase in 2,3-diphosphoglycerate enhances the loading of oxygen.
B) Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen.
A 70-year-old womanís family physician has recommended a vitamin D supplement. The woman states that she tries hard to take as few pills as possible and questions her physician on the rationale and necessity of the hormone. How can the physician most accurately reply to the client's concerns? A) Vitamin D can prevent osteoporosis by increasing the density of your bones. B) Vitamin D is important in order for your body to absorb the calcium that you consume in your diet. C) When your liver is unable to produce enough on its own, it's important to take vitamin D supplements to promote bone strength. D) Vitamin D slows down the rate that your body breaks down your bones.
B) Vitamin D is important in order for your body to absorb the calcium that you consume in your diet.
A female toddler has been diagnosed with toeing-in (metatarsus adductus). What teaching should the pediatrician provide to the parents of the child about her diagnosis? A) She will likely walk later than most children, but it will resolve itself with time. B) We'll likely need to start putting the first of a series of casts on her legs quite soon. C) The best time to perform the surgery that's needed will be at age 3 or 4. D) While there's no effective treatment for her toeing-in, most children learn to accommodate the problem and walk independently.
B) We'll likely need to start putting the first of a series of casts on her legs quite soon.
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? A) Osteoporosis has been shown to have a strong genetic basis, so there is little you can do to prevent it. B) Weight-bearing exercise is helpful, as are calcium supplements. C) If possible, scaling back your hormone replacement therapy will reduce your osteoporosis risk. D) There are drugs called glucocorticoids that both prevent osteoporosis and treat it if you do develop it.
B) Weight-bearing exercise is helpful, as are calcium supplements.
A pneumonia that occurs 48 hours or more after admission to the hospital is considered A) community-acquired pneumonia. B) hospital-acquired pneumonia. C) viral pneumonia. D) immunocompromised pneumonia.
B) hospital-acquired pneumonia.
While working in the newborn ICU, the nurses receive a call that an infant, gestational age of 23 weeks, is being air flighted to the level 3 trauma nursery. The priority intervention for this infant would be A) insertion of an umbilical line for fluids. B) intubation and mechanical ventilation. C) insertion of a feeding tube. D) insertion of an intraventricular catheter.
B) intubation and mechanical ventilation.
When explaining to a class of nursing students the effects of dysregulation of the RANKL/RANK/OPG pathway, the instructor emphasizes that this plays a prominent role in the pathogenesis of: Select all that apply. A) osteomalacia. B) neoplasia of the bone. C) osteoporosis. D) genu varum. E) bone necrosis.
B) neoplasia of the bone. C) osteoporosis.
The nurse is hearing diminished breath sounds and a ìgratingî sound during respirations. This is consistent with excess collection of fluid in the pleural cavity. The medical term for this is A) pleurisy. B) pleural effusion. C) pneumothorax. D) poor lung compliance.
B) pleural effusion.
The neonatal ICU nurse is aware that type II alveolar cells produce surfactant, and they usually develop at how many weeks of gestation? A) 17 to 18 weeks B) 19 to 20 weeks C) 24 to 28 weeks D) 34 to 38 weeks
C) 24 to 28 weeks
Which of the following neurological patients is most likely to have abnormalities in breathing regulation? A) A 23-year-old male who has an injury to his frontal lobe following a sports injury B) A 45-year-old female with a spinal cord injury at C7 following a motor vehicle accident C) A 34-year-old male with damage to his upper and lower pons following a blow to the back of the head D) A 66-year-old male with temporal lobe infarcts secondary to a stroke
C) A 34-year-old male with damage to his upper and lower pons following a blow to the back of the head
A health educator is performing a health promotion workshop with the staff of a large, urban homeless shelter, and a component of the teaching centers around tuberculosis. One of the staff members comments, Anyone who's had contact with tuberculosis in the past can give it to any of the other residents of the shelter, even if they didn't get sick themselves. How could the educator best respond to this comment? A) Many people do manage to fight off the infection, but you're right: they can still spread it by coughing or sneezing. B) If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease. C) Actually, people who have the latent form of the disease won't be sick and can't spread it either. D) There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past.
C) Actually, people who have the latent form of the disease won't be sick and can't spread it either.
Which of the following residents of a long-term care facility is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)? A) A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration B) An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells C) An 81-year-old male who has a productive cough and recurrent respiratory infections D) An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke
C) An 81-year-old male who has a productive cough and recurrent respiratory infections
Bone is connective tissue, in which the intercellular matrix has been impregnated with inorganic calcium salts, that has great tensile and compressible strength but is light enough to be moved by coordinate muscle contractions. One third of the dry weight of bone is composed of which of the following? A) Bone cells, inorganic salts, and blood vessels B) Hydroxyapatite, calcium carbonate, and calcium fluoride C) Bone cells, blood vessels, and nerves D) Organic matter and inorganic salts
C) Bone cells, blood vessels, and nerves
A patient is suspected to have osteomalacia based on his clinical manifestations and lab/diagnostic workup (low calcium levels, transverse lines on x-ray). The nurse would expect the patient to have which of the following clinical manifestations? Select all that apply. A) Nerve palsy in upper extremities. B) Calcification of aortic valve. C) Bone pain. D) Muscle weakness. E) Cold limb with absent pulses.
C) Bone pain. D) Muscle weakness.
Which of the following is an aspect of the bone growth and development that occurs during the first two decades of life? A) Most bone abnormalities can be traced to anomalies in the embryonic stage of development. B) The physiological effects of in utero positioning normally remain into late adolescence. C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells. D) Bone length increases through childhood, while bone diameter remains static.
C) Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells.
Which of the following clinical findings would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease (COPD)? A) Audible wheezing on expiration B) Reduced expiratory flow rates C) Decreased tidal volume D) Normal forced expiratory volume
C) Decreased tidal volume
A nurse in a respiratory unit of a hospital is providing care for a client with end-stage lung disease. Consequently, measurement of the client's arterial blood gases indicates increased PCO 2 . Which of the following associated consequences would the nurse anticipate? A) A shift to the left of the oxygenñhemoglobin dissociation curve B) Lower than normal production of HCO 3 C) Higher than normal production of H + D) An absence of carbaminohemoglobin
C) Higher than normal production of H +
A 16-year-old boy has been diagnosed with ankylosing spondylitis. Which of the following etiologies is responsible for his health problem? A) Infection B) Friction between bones C) Immune response D) Inappropriate bone remodeling
C) Immune response
A 66-year-old male presents to the emergency room accompanied by his wife who claims that he has been acting confused. The man is complaining of a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 102.8F, and his blood work indicates his sodium level at 126 mEq/L (normal 135 to 145 mEq/L). Based on this assessment, the nurse suspects the patient has A) bronchopneumonia. B) Mycoplasma pneumonia. C) Legionella pneumonia. D) pneumococcal pneumonia.
C) Legionella pneumonia.
A public health nurse is conducting a health promotion teaching session at a seniors' drop-in center. Which of the following teaching points about hip fractures in older adults is most justified? A) Current treatment options for hip fractures in older adults mean that surgery is no longer a common necessity. B) Because of their generally higher body mass, men are particularly susceptible to breaking a hip in a fall. C) Most hip fractures are actually a break at the very top of the thigh bone. D) Because bone density is largely determined by your genes, there's little you can do to prevent hip fractures other than avoiding falls.
C) Most hip fractures are actually a break at the very top of the thigh bone.
While measuring the height of a 12-year-old girl during an office visit, the primary care physician noted a deviation of the girl's spine. This was subsequently quantified as being a right curve scoliosis of approximately 10-degree deviation. Which of the following treatment options is most clearly indicated? A) Use of a Milwaukee brace during waking hours B) Surgical correction of the girl's spine C) Observation and no active treatment D) Use of external rods to correct the deviation
C) Observation and no active treatment
Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace and that the man will regain full function after healing and rehabilitation. Which of the following cells is most responsible for restoring the integrity of the man's broken bone? A) Osteocyte B) Osteoclast C) Osteoblast D) Osteoma
C) Osteoblast
A child with rhinosinusitis should be monitored for complications. Which of the following assessment findings would alert the nurse that a complication is developing? A) Purulent nasal discharge B) Temperature of 100.8F C) Periorbital edema D) Complaints of headache
C) Periorbital edema
A short, nonsmoking 44-year-old male presents to the emergency room with left-sided chest pain and a cough. He states that the pain started abruptly and worsens with deep breathing and coughing. He denies recent injury. Assessment includes shallow respirations with a rate of 36, normal breath sounds, and no cyanosis. Which condition is most likely causing his symptoms? A) Myocardial infarction B) Spontaneous pneumothorax C) Pleuritis related to infection D) Obstructive atelectasis
C) Pleuritis related to infection
A 7-year-old boy has been diagnosed with juvenile idiopathic arthritis (JIA), and his parents are anxious to know how his health problem will affect his short-term and longer-term future. What can his health care provider most accurately tell the family? A) Because JIA is an autoimmune disease, the long-term prognosis is quite poor and his mobility is likely to decline over time. B) The earlier that we can schedule joint replacement surgeries, the better his prognosis will be. C) With appropriate use of anti-inflammatory drugs along with lifestyle modifications, your son stands a good chance of leading a normal life. D) We can relieve many of the symptoms or JIA and ensure his mobility, but there is a risk he'll develop a systemic immune response beyond his joints.
C) With appropriate use of anti-inflammatory drugs along with lifestyle modifications, your son stands a good chance of leading a normal life.
Following prosthetic joint replacement of the knee, the patient continues to complain of pain and discomfort above what would be expected. There is poor incisional healing. The clinic nurse is concerned when she sees that the incision is still draining after 3 weeks post-op. The nurse suspects a prosthetic joint infection. The nurse should anticipate the physician will prescribe A) complete bed rest with immobilization of the knee. B) high doses of nonsteroidal anti-inflammatory drugs. C) antimicrobial treatment depending on the microbe. D) wound irrigations with hydrogen peroxide twice daily.
C) antimicrobial treatment depending on the microbe.
When trying to explain to a patient diagnosed with a benign bone tumor, the nurse should emphasize the fact that benign tumors primarily A) grow rapidly and can spread to the surrounding tissue. B) cause growth of other tumors as they spread their cancer cells into the bloodstream. C) tend to grow very slowly without destroying the supporting tissue. D) occur as a result of tumors in other areas of the body metastasizing into the bone.
C) tend to grow very slowly without destroying the supporting tissue.
Which of the following individuals who has recently presented to a hospital emergency department is displaying an injury that involves his or her fibrocartilage? A) A 7-year-old girl whose ear has been lacerated during a dog attack B) A 24-year-old male who has had his trachea crushed in a workplace accident C) A 15-year-old boy who has suffered a knee injury during a football game D) A 78-year-old man who has fallen and is suspected of having a slipped disc in his back
D) A 78-year-old man who has fallen and is suspected of having a slipped disc in his back
Which of the following situations would be most deserving of a pediatrician's attention? A) The mother of an infant 2 days postpartum notes that her baby has intermittent periods of hyperventilation followed by slow respirations or even brief periods of apnea. B) A volunteer in the nursery notes that one of the infants, aged 2 weeks, appears unable to breathe through his mouth, even when his nose is congested. C) A neonate is visibly flaring her nostrils on inspiration. D) A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting.
D) A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting.
When working with a patient with diffuse scleroderma who is exhibiting a stone face expression, the nurse should consider which of the following to be a priority nursing diagnosis for this patient? A) Ineffective tissue perfusion related to tightening of the facial skin B) Activity intolerance related to muscle tightening in lower extremities C) Oral mucous membrane, impaired due to restricted motion of the mouth D) Aspiration, risk related to swallowing impairments
D) Aspiration, risk related to swallowing impairments
A nurse is providing care for a client who has had a cast applied to her fractured arm 6 hours prior. The client is now complaining of severe pain that she describes as even worse than when I broke my arm. What would be the nurse's best course of action? A) Administration of analgesics and teaching the client about the normal course of pain after a fracture B) Teaching the client simple range of motion exercises to promote circulation and perfusion C) Taking the client's temperature due to the possibility of infection D) Assessment of motor and sensory function with the goal of identifying compartment syndrome
D) Assessment of motor and sensory function with the goal of identifying compartment syndrome
Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma? A) IgG production is heightened as a consequence of exposure to an allergen. B) Airway remodeling results in airflow limitations. C) Epithelial injury and edema occur along with changes in mucociliary function. D) Chemical mediators are released from presensitized mast cells.
D) Chemical mediators are released from presensitized mast cells.
Due to complications, a male postoperative patient has been unable to mobilize secretions for several days following surgery and develops atelectasis. Which of the following processes would his care team anticipate with relation to his health problem? A) Vasodilation in the alveolar vessels in the affected region of his lung B) Increased workload for the left side of the patient's heart C) Increased blood flow to the area of atelectasis D) Directing blood flow away from the lung regions that are hypoxic
D) Directing blood flow away from the lung regions that are hypoxic
Laparoscopic knee surgery in a 22-year-old basketball player has necessitated entry into the synovial cavity. The surgeon performing the procedure would be aware of which of the following relevant characteristics of synovial tissue? A) Synovial tissue has a slow rate of healing compared to muscle tissue. B) Damage to synovial tissue is known to be excruciatingly painful. C) The synovial membrane lacks direct blood supply, precluding bleeding into the joint. D) Few pain receptors are located in the synovial membrane.
D) Few pain receptors are located in the synovial membrane.
A 64-year-old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. The client and his physician are discussing the effects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. Which of the following statements by the client would necessitate further teaching? A) I'm really trying to lose weight, and I've been able to lose 15 lb this year so far. B) I've been doing muscle-strengthening exercises twice a week at the community center near my house. C) Even though I don't like it, I've been using my walker to take some of the weight off my knees. D) I've been avoiding painkillers because I know they can mask damage that I might be inflicting on my knees.
D) I've been avoiding painkillers because I know they can mask damage that I might be inflicting on my knees.
A patient comes into the orthopedic clinic complaining of severe pain in his hip that was not caused by a fall. On inspection, the femur and tibia are bowed. There is also a reduced angle of the femoral neck, which gives the patient a waddling gait appearance. The doctor suspects Paget disease. The patient asks how he got that. The nurse will respond, A) It's because you don't eat enough calcium-rich foods in your diet. B) When you were a child you probably broke you hip, and since it wasn't displaced, you continued to walk on it. C) It might be related to a thyroid condition. We will need to run some more blood work. D) It's most likely a genetic predisposition. Do you know if anyone else in your family has this problem?
D) It's most likely a genetic predisposition. Do you know if anyone else in your family has this problem?
Which of the following statements best conveys an aspect of the respiratory pressures that govern ventilation? A) Intrapleural pressure slightly exceeds that of the inflated lung. B) The chest wall exerts positive pressure on the lungs that contributes to expiration. C) The lungs are prevented from collapsing by constant positive intrapulmonary pressure. D) Negative intrapleural pressure holds the lungs against the chest wall.
D) Negative intrapleural pressure holds the lungs against the chest wall.
A 35-year-old woman who has been in recovery from alcoholism for 2 years presents at her primary care physician's office with chronic hip pain. She reports that as part of her commitment to her recovery, she began exercising regularly about a year earlier. After a month or two, her hip began to hurt when she ran on the treadmill. She stretches, has had a physical trainer check her form to ensure that it is correct, and rests adequately between each workout. Six months ago, the pain began waking her at night, and now it is constant. She is not aware of any injury to her hip and has no other outward symptoms. Which of the following is most likely to be the cause of her pain? A) Hematogenous osteomyelitis B) Osteomyelitis with vascular insufficiency C) Tuberculosis of the bone D) Osteonecrosis
D) Osteonecrosis
As part of a public health initiative, a nurse is teaching a group of older adults about ways to promote and maintain their health. Recognizing that the common cold is a frequent source of ailment, the nurse is addressing this health problem. Which of the following teaching points about the common cold is most accurate? A) You shouldn't be taking antibiotics for a cold until your doctor has confirmed exactly which bug is causing your cold. B) It's important to both cover your mouth when you cough or sneeze and encourage others to do so, since most colds are spread by inhaling the germs. C) Scientists don't yet know exactly what virus causes the cold, and there is not likely to be a vaccine until this is known. D) Use caution when choosing over-the-counter drugs for your cold; most people do best with rest and antifever medications.
D) Use caution when choosing over-the-counter drugs for your cold; most people do best with rest and antifever medications.
Following genetic testing and a thorough history from the child's mother and father, a 5- month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father? A) His skeleton is prone to breakage, and we'll begin hormone therapy to treat this. B) His hips are extremely susceptible to dislocation, so rough play is out of the question. C) You'll need to commit to calcium supplementation for the duration of his development. D) You'll need to be very careful to avoid causing fractures to his fragile bones.
D) You'll need to be very careful to avoid causing fractures to his fragile bones.
The physician mentions the patient has developed alveolar dead space. The nurse recognizes that this means A) air that is moved in and out of the lungs with each breath. B) air that cannot participate in gas exchange and remains in the main bronchus. C) air is trapped in the conducting airways. D) alveoli are ventilated but not perfused.
D) alveoli are ventilated but not perfused.
While reviewing the following diagnostic findings on a group of patients with joint complaints, which finding would be a priority for further investigation and possible medical intervention? A) A male client has elevated levels of serum uric acid but lacks symptoms. B) Synovial fluid aspiration indicates the presence of monosodium urate crystals. C) A man reveals that he eats organ meat two to three times weekly. D) A 55-year-old male reveals that it takes a day or two for oral colchicines to relive his attacks of gout.
Synovial fluid aspiration indicates the presence of monosodium urate crystals.
