Patho Quiz 6 Questions

Which of the following clients would be considered to have a significant risk of developing the prerenal form of acute renal failure? Select all that apply. A) A 22-year-old male who has lost large amounts of blood following a workplace injury B) A 41-year-old female who is admitted for intravenous antibiotic treatment of pyelonephritis C) A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure D) A 20-year-old male who is admitted for treatment of an overdose of a nephrotoxic drug E) A 68-year-old male with a diagnosis of benign prostatic hyperplasia (BPH) F) An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

A) A 22-year-old male who has lost large amounts of blood following a workplace injury C) A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure F) An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-BarrÈ syndrome in his medical history. The patient asks, What is that? How should the nursing student reply? A) A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles B) Swelling of your arm where you got your flu shot, and maybe your eyes and lips had some swelling as well C) A degenerative disease where you have trouble walking without the help of a cane or walker D) Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot

A) A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles

A 4-year-old boy who has been deaf since birth and has bilateral cataracts has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the health care team's initial differential diagnosis most likely be? A) Alport syndrome B) Systemic lupus erythematosus glomerulonephritis C) Henoch-Schˆnlein purpura nephritis D) Immunoglobulin A nephropathy

A) Alport syndrome

Which of the following clients on a medical unit of a hospital is most likely to be experiencing health problems that may be attributable to kidney disease? A) An 81-year-old female client with osteoporosis and anemia B) A 77-year-old client with urinary retention due to benign prostatic hyperplasia (BPH) C) A 55-year-old woman with a recent stroke secondary to long-standing hypertension D) A 60-year-old man with a systemic fungal infection requiring intravenous antibiotics.

A) An 81-year-old female client with osteoporosis and anemia

If the nurse suspects a spinal cord injury, the patient has developed autonomic dysreflexia. Which of the following assessments would confirm this complication? Select all that apply. A) BP 180/98 B) Skin covered with macular rash C) Pulse rate 49 D) Complains of a pounding headache E) Cold, cyanotic lower legs

A) BP 180/98 C) Pulse rate 49 D) Complains of a pounding headache

Following a collision while mountain biking, the diagnostic workup of a 22-year-old male has indicated the presence of an acute subdural hematoma. Which of the following pathophysiological processes most likely underlies his diagnosis? A) Blood has accumulated between the man's dura and subarachnoid space. B) Vessels have burst between the client's skull and his dura. C) A traumatic lesion in the frontal or temporal lobe has resulted in increased ICP. D) Blood has displaced CSF in the ventricles as a consequence of his coup contrecoup injury.

A) Blood has accumulated between the man's dura and subarachnoid space.

A hospital client with a diagnosis of chronic renal failure has orders for measurement of her serum electrolyte levels three times per week. Which of the following statements best captures the relationship between renal failure and sodium regulation? A) Clients with advanced renal failure are prone to hyponatremia because of impaired tubular reabsorption. B) Renal clients often require a sodium-restricted diet to minimize the excretion load on remaining nephrons. C) Clients with renal failure often maintain high sodium levels because of decreased excretion. D) Restricting sodium intake helps to preserve nephron function and has the additional benefit of lowering blood pressure.

A) Clients with advanced renal failure are prone to hyponatremia because of impaired tubular reabsorption.

A 41-year-old woman was diagnosed with multiple sclerosis (MS) 7 years ago and is sharing her story with members of an MS support group, many of whom have been diagnosed recently. Which of the following aspects of her health problem should the woman warn others to expect at some point in the progression of the disease? Select all that apply. A) Debilitating fatigue B) Progressive loss of visual acuity C) Gradual development of a resting tremor D) Loss of mental acuity E) Shuffling gait

A) Debilitating fatigue B) Progressive loss of visual acuity D) Loss of mental acuity

A 1-year-old baby boy with renal dysplasia risks end-stage renal disease unless intervention occurs. Which of the following treatment options is his care team most likely to reject? A) Dietary restriction plus erythropoietin B) Continuous cyclic peritoneal dialysis C) Renal transplantation D) Continuous ambulatory peritoneal dialysis

A) Dietary restriction plus erythropoietin

The nurse should anticipate that a patient diagnosed with spastic bladder dysfunction may be prescribed which of the following medications that will help decrease detrusor muscle tone and increase bladder capacity? Select all that apply. A) Ditropan (Oxybutynin), an antimuscarinic drug B) Detrol LA (tolterodine tartrate), an antimuscarinic drug C) Uroxatral (alfuzosin), an a-adrenergic antagonist D) Flomax (tamsulosin), an a-blocker E) Bactrim (sulfamethoxazole and trimethoprim), antibiotics

A) Ditropan (Oxybutynin), an antimuscarinic drug B) Detrol LA (tolterodine tartrate), an antimuscarinic drug

Following the diagnosis of acute renal failure, the nurse knows that one of the earliest manifestations of residual tubular damage is which of the following lab/diagnostic results? A) Elevated blood urea nitrogen (BUN) B) Serum creatinine elevation C) Inability to concentrate urine D) Reduced glomerular filtration rate

A) Elevated blood urea nitrogen (BUN)

The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? A) Have you ever given your child any honey or honey-containing products? B) Is there any family history of neuromuscular diseases? C) Has your baby ever been directly exposed to any chemical cleaning products? D) Is there any mold in your home that you know of?

A) Have you ever given your child any honey or honey-containing products?

A 73-year-old man presents to his family physician with complaints of recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which of the following clinical consequences would his care provider expect prior to the resolution of his health problem? A) Hydroureter and pain B) Development of renal calculi and renal cysts C) Unilateral hydronephrosis and pain D) Development of glomerulonephritis or nephrotic syndrome

A) Hydroureter and pain

A 68-year-old woman with a new onset of vascular dementia has recently begun retaining urine. Which of the following physiological phenomena would her care providers most realistically expect to currently occur as a result of her urinary retention? A) Hypertrophy of the bladder muscle and increased bladder wall thickness B) Decreased urine production and nitrogenous waste excretion by the kidneys C) Decompensation, bladder stretching, and high residual urine volume D) Overflow incontinence and loss of contraction power

A) Hypertrophy of the bladder muscle and increased bladder wall thickness

A brain tumor causing clinical manifestations of headache, nausea, projectile vomiting, and mental changes is likely located in which parts of the brain? Select all that apply. A) Intra-axially B) Extra-axially C) Brain stem D) Temporal lobe E) Frontal lobe

A) Intra-axially B) Extra-axially E) Frontal lobe

When educating the patient about possible treatments following surgery for bladder cancer, the nurse might include which of the following chemotherapy options? Select all that apply. A) Intravesical chemotherapy with doxorubicin (Adriamycin) B) Intravenous chemotherapy with at least three agents C) Bacillus Calmette-GuÈrin (BCG) vaccine D) Endocan, a tumor angiogenesis inhibitor

A) Intravesical chemotherapy with doxorubicin (Adriamycin) C) Bacillus Calmette-GuÈrin (BCG) vaccine D) Endocan, a tumor angiogenesis inhibitor

To treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. What is the most likely rationale for this treatment? A) It removes water from the filtrate and returns it to the vascular compartment. B) It lessens the amount of fluid entering the glomerulus. C) It leads to the production of dilute urine. D) It causes tubular cells to lose their water permeability.

A) It removes water from the filtrate and returns it to the vascular compartment.

While living and hiking in the Rocky Mountains, a gentleman slipped and fell. He goes to an urgent care where an x-ray was done, and some blood was drawn for a CBC. The clinic informs him that he is anemic. What may contribute to this person's anemia? Select all that apply. A) Living in a high altitude B) Tissue hypoxia C) Inability to manufacture erythropoietin D) Destruction of RBCs caused by natural killer cells E) Dehydration

A) Living in a high altitude B) Tissue hypoxia C) Inability to manufacture erythropoietin

Which of the following diagnostic findings is likely to result in the most serious brain insult? A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP) B) Moderate decrease in brain tissue volume secondary to a brain tumor removal C) Increased ICP accompanied by hyperventilation D) High intracellular concentration of glutamate

A) Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

A pediatric unit will be receiving an 8-day-old infant with a suspected congenital renal disorder. Which of the following renal abnormalities could be the possible cause? Select all that apply. A) One of the infant's kidneys may have failed to develop normally. B) The kidneys may be misshapen and have cysts present. C) The upper or lower poles of the two kidneys may be fused. D) Renal cell carcinoma may be present. E) Urine-filled dilation of renal pelvis associated with atrophy of the kidney may be present.

A) One of the infant's kidneys may have failed to develop normally. B) The kidneys may be misshapen and have cysts present. C) The upper or lower poles of the two kidneys may be fused.

When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which of the following medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply. A) Penicillin B) Aspirin C) Morphine sulfate D) Potassium chloride E) Sodium chloride

A) Penicillin B) Aspirin C) Morphine sulfate

An 87-year-old male resident of an assisted living facility has been consistently continent of urine until the last several weeks. Which of the following actions by the care providers at the facility is the most likely priority? A) Performing a physical examination and history to determine the exact cause and character of the incontinence B) Providing client education focusing on the fact that occasional incontinence is a normal, age-related change C) Teaching the resident about protective pads, collection devices, and medications that may be effective D) Showing the resident the correct technique for exercises to improve bladder, sphincter, and pelvic floor tone

A) Performing a physical examination and history to determine the exact cause and character of the incontinence

Which of the following phenomena contributes to the difficulties with absorption, distribution, and elimination of drugs that are associated with kidney disease? A) Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug. B) Acute tubular necrosis is associated with impaired drug reabsorption through the tubular epithelium. C) Decreased retention by the kidneys often renders normal drug dosages ineffective. D) Dialysis removes active metabolites from circulation minimizing therapeutic effect.

A) Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.

A female client with suspected glomerular disease has been referred to a nephrologist. The nurse knows that which of the following clinical manifestations may be present with the diagnosis of acute nephritic syndrome? Select all that apply. A) Sudden onset of hematuria B) Proteinuria C) Flank pain D) Excess urine output E) Edema

A) Sudden onset of hematuria B) Proteinuria E) Edema

A badly burned firefighter has been in an induced coma for 3 weeks. When he awakens, he thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose? A) Thalamus B) Hypothalamus C) Corpus callosum D) Basal ganglia

A) Thalamus

During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that a client has a sustained damage to her vagus (CN X) nerve. Which of the following assessment findings is most likely to lead the physician to this conclusion? A) The client has difficulty swallowing and has had recent constipation and hypoactive bowel sounds. B) The client is unable to turn her head from side to side, and her tongue is flaccid. C) The client has a unilateral facial droop, dry eyes, and decreased salivary production. D) The client is unable to perform any fine motor movements of her tongue.

A) The client has difficulty swallowing and has had recent constipation and hypoactive bowel sounds.

A male newborn infant has been diagnosed with spina bifida occulta. Which of the following pathophysiological processes has most likely contributed to the infant's health problem? A) The neural groove failed to fuse and completely close across the top of the neural plate. B) The infant's spinal cord and meninges protrude through his skin. C) The child's central and peripheral nervous systems have insufficiently differentiated during embryonic development. D) The infant's soma and viscera are underdeveloped.

A) The neural groove failed to fuse and completely close across the top of the neural plate.

Which of the following substances is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms? A) Water B) Sodium C) Phosphate D) Calcium

A) Water

Which of the following clinical manifestations would lead the nurse to suspect the renal failure patient is developing uremia? Select all that apply. A) Weakness and fatigue B) Lethargy and confusion C) Extreme itching D) Blood in urine E) Urine smell in the stool

A) Weakness and fatigue B) Lethargy and confusion C) Extreme itching

A client has been diagnosed with having calcium oxalate kidney stones following intravenous pyelography. Which of the following teaching points about the treatment of the health problem are justifiable? Select all that apply. A) You may need to cut out cocoa, chocolate, and some nuts from your diet. B) It's important that you avoid high-calcium foods like milk, cheese, and yogurt. C) We will come up with a plan to safely limit your fluid intake over the next few weeks. D) Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones. E) Most likely your stones can be dissolved by medications over the next several days.î

A) You may need to cut out cocoa, chocolate, and some nuts from your diet. D) Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones.

A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate? A) Your prognosis will depend on whether we can surgically resect your tumor. B) Our treatment plan will depend on whether your tumor is malignant or benign. C) This is likely a result of a combination of heredity and lifestyle. D) The major risk that you face is metastases to your lungs, liver, or bones.

A) Your prognosis will depend on whether we can surgically resect your tumor.

Following kidney transplantation, the patient is prescribed maintenance immunosuppressive therapy consisting of prednisone, azathioprine, and cyclosporine. Educating the patient about long-term maintenance on immunosuppressive therapy should include discussion of side effects that may include: (Select all that apply). A) cardiovascular complications. B) increased risk of developing cancer. C) nephrotoxicity of a newly transplanted kidney. D) development of moon face and buffalo hump. E) ringing or buzzing of the ears.

A) cardiovascular complications. B) increased risk of developing cancer.

Which of the following clients's signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult A) has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days. B) has experienced a sudden loss of balance and slurred speech. C) has vomited and complained of a severe headache. D) states that his left arm and leg are numb, and gait is consequently unsteady.

A) has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days.

A 20-year-old has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which of the following aspects of the client's history would be considered to have contributed to his stroke? Select all that apply. The client A) is an African American male. B) takes iron supplements for the treatment of chronic anemia. C) blood pressure has historically been in the range of 150s/90s. D) was diagnosed with type 2 diabetes 8 years ago. E) takes corticosteroids for the treatment of rheumatoid arthritis.

A) is an African American male. C) blood pressure has historically been in the range of 150s/90s. D) was diagnosed with type 2 diabetes 8 years ago.

When educating a patient about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be reexcited. Within the cell, the nurse understands that A) potassium channels open while sodium channels close, causing repolarization to the resting state. B) the influx of calcium is the primary stimulus for the repolarization of cardiac tissue. C) only the electrical activity within the heart will determine when repolarization occurs. D) the cell membranes need to stay calm resulting in muscle tissue becoming refractive.

A) potassium channels open while sodium channels close, causing repolarization to the resting state.

A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the patient that the venous blood supply to the penis is controlled by A) sacral parasympathetic fibers. B) the hypothalamus. C) the vagus nerve. D) postganglionic sympathetic neurons.

A) sacral parasympathetic fibers.

Which of the following patients scheduled for an interventional radiology procedure requiring administration of radiocontrast dye would be considered at high risk for nephrotoxicity? Select all that apply. A) A 14-year-old with severe abdominal pain B) A 25-year-old with a history of glomerular nephritis who is complaining of severe flank pain C) A 67-year-old diabetic undergoing diagnostic testing for new-onset proteinuria D) A 45-year-old with elevated liver enzymes possibly due to fatty liver cirrhosis E) A 53-year-old male undergoing biopsy for a suspicious ìspotî on his chest x-ray

B) A 25-year-old with a history of glomerular nephritis who is complaining of severe flank pain C) A 67-year-old diabetic undergoing diagnostic testing for new-onset proteinuria

A nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which of the following individuals are at risk of developing urinary obstructions? Select all that apply. A) A 43-year-old male with an acid base imbalance secondary to malnutrition B) A 29-year-old female, pregnant for the first time C) A 69-year-old female with anemia secondary to insufficient erythropoietin production D) A 70-year-old male with benign prostatic hyperplasia (BPH) E) A 58-year-old male with renal calculi F) A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

B) A 29-year-old female, pregnant for the first time D) A 70-year-old male with benign prostatic hyperplasia (BPH) E) A 58-year-old male with renal calculi F) A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

Which of the following individuals are likely to display identified risk factors for the development of lower urinary tract obstruction? Select all that apply. A) A 32-year-old woman who had a healthy delivery of her third child 4 months ago B) A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) C) A 55-year-old man with diabetes who is receiving diuretic medications for the treatment of hypertension D) A 30-year-old woman who has been diagnosed with gonorrhea E) A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation F) A 20-year-old man who has spina bifida and consequent impaired mobility.

B) A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) D) A 30-year-old woman who has been diagnosed with gonorrhea E) A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation F) A 20-year-old man who has spina bifida and consequent impaired mobility.

Which of the following clinical findings among older adults is most unlikely to warrant further investigation and possible treatment? A) An 81-year-old male's serum creatinine level has increased sharply since his last blood work. B) A 78-year-old female's GFR has been steadily declining over several years. C) A 90-year-old female's blood urea nitrogen (BUN) is rising. D) An 80-year-old male whose urine dipstick reveals protein is present.

B) A 78-year-old female's GFR has been steadily declining over several years.

Which of the following clients diagnostic blood work is most suggestive of chronic kidney disease (CKD)? A) A client with high pH; low levels of calcium; and low levels of phosphate B) A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels C) A client with low bone density; low levels of calcium; and low levels of phosphate D) A client with low potassium levels; low calcitriol levels; and increased PTH levels

B) A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels

A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem? A) Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids B) A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins C) Cerebellar lesions; surgical and immunosuppressive treatment D) Excess acetylcholinesterase production; treatment with thymectomy

B) A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins

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

B) A tonic clonic seizure

Which of the following patients on a geriatric medical unit is most likely to require slow-release potassium supplements on a regular basis? A) A 90-year-old female who is taking an aldosterone antagonist to treat pulmonary edema B) An 81-year-old male who takes a thiazide diuretic to control his hypertension C) A 79-year-old male with heart failure who is receiving a loop diuretic D) An 83-year-old female who is taking an osmotic diuretic to address severe peripheral edema

B) An 81-year-old male who takes a thiazide diuretic to control his hypertension

Following an automobile accident where the patient had a traumatic amputation of his lower leg and lost greater than 40% of his blood volume, he is currently not producing any urine output. The nurse bases this phenomena on which of the following humoral substances responsible for causing severe vasoconstriction of the renal vessels? A) Aquaproin-2 channels B) Angiotensin II and ADH C) Renin and potassium ions D) Albumin and norepinephrine

B) Angiotensin II and ADH

A dialysis technician is providing care for a client with chronic renal failure. The technician would recognize which of the following characteristics of healthy kidneys? Select all that apply. A) The kidneys are contained within the peritoneal cavity. B) Blood vessels, nerves, and ureters all connect with the kidney at the hilus. C) The medulla of the kidney contains the glomeruli. D) Each kidney consists of lobes, with each lobe comprised of nephrons. E) Each nephron contains several hundred glomeruli that perform filtration.

B) Blood vessels, nerves, and ureters all connect with the kidney at the hilus. D) Each kidney consists of lobes, with each lobe comprised of nephrons.

At which of the following locations in the nephron would a health care professional first expect blood to be largely free of plasma proteins? A) Proximal convoluted tubule B) Bowman space C) Loop of Henle D) Afferent arteriole

B) Bowman space

Which of the following statements best conveys an aspect of the role of cerebrospinal fluid (CSF)? A) It provides physical protection for the brain and ensures that leukocytes and erythrocytes are evenly distributed in the CNS. B) CSF cushions the brain and provides a near-water medium for diffusion of nutrients. C) CSF distributes plasma proteins throughout the superficial gray matter of the CNS. D) It ensures that the high metabolic and oxygenation needs of the brain are met, as well as absorbing physical shocks.

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

Which of the following medications would the nurse anticipate being prescribed for the renal failure patient who has hyperphosphatemia? A) Vitamin D (calcitriol) B) Calcium carbonate C) Levothyroxine (Synthroid) D) Sensipar (Cinacalcet)

B) Calcium carbonate

A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly, but her respiratory rate is 45 breaths/minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment? A) Delirium B) Coma C) Brain death D) Vegetative state

B) Coma

Which of the following pain descriptions would lead the nurse to suspect the client is experiencing ureteral colic? A) Right upper quadrant pain that worsens with deep breaths and palpation B) Excruciating pain in the flank and upper outer quadrant of the abdomen that radiates to the bladder area C) Pain described as fire poking in their side, pulsating with every heart beat but decreases when in fetal position D) Perineal pain that increases when urinating and then lessens until the time to urinate again

B) Excruciating pain in the flank and upper outer quadrant of the abdomen that radiates to the bladder area

A nurse in an acute medical unit of a hospital has admitted a 62-year-old female from the emergency department who has been diagnosed with acute pyelonephritis. Which of the following statements most accurately conveys an aspect of the knowledge base that the nurse needs to perform adequate care and teaching? A) Most cases of acute pyelonephritis are attributable to poorly controlled hypertension. B) Flank pain, dysuria, and nausea and vomiting are likely assessment findings. C) The infection in the kidney is most likely a manifestation of a systemic infection. D) Imaging tests are likely to reveal scarring and deformation of the renal calices and pelvis.

B) Flank pain, dysuria, and nausea and vomiting are likely assessment findings.

A nurse educator is orientating new nurses to a renal unit of the hospital. Which of the following teaching points should the nurse include as part of a review of normal glomerular function? A) Nephrons are delicate structures that cannot endure the high pressure that exists in capillary beds elsewhere in the body. B) Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation. C) Dilation of the afferent arteriole allows more blood into the nephron and increases the glomerular filtration rate. D) The glomerulus is located between an arteriole and a venule that work together to regulate blood flow.

B) Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation.

A 9-year-old boy has been brought to the emergency department by his father who is concerned by his son's recent fever, stiff neck, pain, and nausea. Examination reveals a petechial rash. Which of the following assessment questions by the emergency room physician is most appropriate? A) Is your son currently taking any medications? B) Has your son had any sinus or ear infections in the last little while? C) Does your son have a history of cancer? D) Was your son born with any problems that affect his bone marrow or blood?

B) Has your son had any sinus or ear infections in the last little while?

Which of the following lab results would be associated with abnormalities in kidney function? Select all that apply. A) An absence of protein in a urine sample B) Increased creatinine levels C) Urine gravity of 1.038 and normal serum creatinine levels D) Decreased blood urea nitrogen (BUN) level E) Detectable levels of glucose in a urine sample F) Elevated cystatin-C level.

B) Increased creatinine levels E) Detectable levels of glucose in a urine sample F) Elevated cystatin-C level.

Which of the following data would a clinician consider as most indicative of acute renal failure? A) Alterations in blood pH; peripheral edema B) Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR) C) Decreased serum creatinine and blood urea nitrogen (BUN); decreased potassium and calcium levels D) Decreased urine output; hematuria; increased GFR

B) Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR)

The nurse knows which of the following phenomena listed below is an accurate statement about axonal transport? A) Anterograde and retrograde axonal transport allow for the communication of nerve impulses between the neuron and the central nervous system (CNS). B) Materials can be transported to the nerve terminal by either a fast or slow component. C) The unidirectional nature of the axonal transport system protects the CNS against potential pathogens. D) Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

B) Materials can be transported to the nerve terminal by either a fast or slow component.

A 55-year-old man has made an appointment to see his family physician because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day. What is the man's most likely diagnosis and possible underlying pathophysiological problem? A) Stress incontinence due to damage to CNS inhibitory pathways B) Overactive bladder that may result from both neurogenic and myogenic sources C) Overactive bladder due to intravesical pressure exceeding urethral pressure D) Overflow incontinence that can result from displacement of the angle between the bladder and the posterior proximal urethra

B) Overactive bladder that may result from both neurogenic and myogenic sources

Following an injury where a child hit his head from a fall, the CT scan reveals a contusion that the doctor classifies as a moderate brain injury. Which of the following manifestations will the nurse more than likely assess on this child that support this diagnosis? Select all that apply. A) Coma with total paralysis B) Periods of unconsciousness C) Aphasia at times D) Nuchal rigidity E) Weakness or slight paralysis affecting one side of the body

B) Periods of unconsciousness C) Aphasia at times E) Weakness or slight paralysis affecting one side of the body

A 22-year-old female with a history of intermittent flank pain, repeated UTIs, and hematuria has been diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which of the following phenomena has most likely contributed to the development of this diagnosis? A) UTIs coupled with an impaired immune response have caused her ADPKD. B) She has inherited a tendency for epithelial cells in her tubules to proliferate inappropriately. C) Severe hypertension and portal hypertension are likely precursors. D) She has inherited undersized kidneys that are prone to calculi formation.

B) She has inherited a tendency for epithelial cells in her tubules to proliferate inappropriately.

A 51-year-old woman diagnosed with a cerebrovascular accident (CVA) 5 months prior is distressed that she has had several recent episodes of urinary incontinence. She has asked her nurse practitioner why this is the case. Which of the following statements best captures the fact that would underlie the nurse's response to the client? A) Neurological diseases like MS often result in flaccid bladder dysfunction. B) She may be unable to sense her bladder filling as a result of her MS. C) Lesions to the basal ganglia or extrapyramidal tract associated with MS inhibit detrusor contraction. D) Pathological reductions in bladder volume brought on my MS necessitate frequent micturition.

B) She may be unable to sense her bladder filling as a result of her MS.

A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? A) The client has decreased deep tendon reflexes. B) The client displays increased muscle tone. C) The client's muscles appear atrophied. D) The client displays weakness in the distal portions of his limbs.

B) The client displays increased muscle tone.

During male ejaculation, which of the following statements addresses why sperm is not normally seen inside the bladder? A) The parasympathetic nervous system keeps the seminal fluid inside the urethra. B) The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time. C) With ejaculation, the male expels some urine along with the seminal fluid to wash any extra sperm out of the bladder. D) The detrusor muscle relaxes allowing for the closing of the sphincter at the base of the bladder.

B) The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time.

Following a motor vehicle accident 3 months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? A) Your daughter has lost all her cognitive functions as well as all her basic reflexes. B) Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change. C) If you or the care team notices any spontaneous eye opening, then we will change our treatment plan. D) Your daughter's condition is an unfortunate combination with total loss of consciousness but continuation of all other normal brain functions.

B) Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.

An 82-year-old resident of a long-term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which of the following actions by the care team is most appropriate? A) Uroflowmetry to determine the rate of the client's urine flow B) Ultrasound bladder scanning to determine the residual volume of urine after voiding C) Renal ultrasound aimed at identifying acute or chronic kidney disease D) Urinalysis focusing on the presence of or absence of microorganisms, blood, or white cells in the man's urine

B) Ultrasound bladder scanning to determine the residual volume of urine after voiding

A nurse is collecting a urine specimen prior to measuring the albumin level in a clients urine. A colleague questions the rationale for the test, stating, I thought albumin was related to liver function, not kidney function. How can the nurse best respond to this statement? A) Urine should normally be free of any proteins, and albumin is one of the more common proteins to be excreted in chronic renal failure. B) Urine albumin levels are useful for diagnosing diabetic kidney disease. C) A urine dipstick test will tell us exactly how much albumin is being spilled by the client's kidneys. D) A urine test for albumin allows us to estimate the client's GFR quite accurately.

B) Urine albumin levels are useful for diagnosing diabetic kidney disease.

A 60-year-old man has been diagnosed with renal calculi after repeated episodes of excruciating flank pain in recent weeks. The man states that, I don't know how this could happen to me, since I'm so careful about eating a healthy diet. What is the most appropriate response to the man's statement? A) Your diet may have played a part in this, but in fact, genetics are likely primarily to blame. B) What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved. C) You likely don't need to change your diet, but now that you have stones in one kidney, you're at very high risk of growing them in the other kidney. D) Your diet might be normally healthy, but high intake of normally beneficial minerals like calcium and magnesium can lead to stones.

B) What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved.

During a family picnic, a relative of a nurse asks what he should do if there is blood in his urine and some pain in his lower abdomen. The best advice the nurse could give this family member would be for him to A) go to the emergency room right away. B) get an appointment with his family doctor. C) wait and see if it goes away without treatment. D) increase his intake of cranberry juice and other fluids.

B) get an appointment with his family doctor.

A frantic mother brings her young child into the emergency department. She states that during the evening bath, she noticed a large mass in her child's abdomen. After diagnostic testing, the pediatrician tells the parents that their child has Wilms tumor, stage IV. After the doctor leaves the room, the parents ask the nurse, What does this mean? The nurse will respond, Your child's A) has cancer in his stomach. B) has cancer in the kidney that has spread most likely to his lungs. C) will need to undergo surgery to remove both kidneys and then go on dialysis. D) tumor can be easily treated with chemotherapy. We will start this soon.

B) has cancer in the kidney that has spread most likely to his lungs.

Which of the following statements about mesangial cells within the glomerulus is accurate? Select all that apply. Mesangial cells A) cover the entire amount of endothelial cells contained within the capillaries. B) have phagocytic properties that remove macromolecular materials. C) exhibit vasodilator properties to assist with increase in blood flow in times of stress. D) enlarge (hyperplasia) in response to glomerular diseases. E) are coiled and drain Bowman capsule.

B) have phagocytic properties that remove macromolecular materials. D) enlarge (hyperplasia) in response to glomerular diseases.

As you are walking in the park, a huge black Labrador (dog) runs up to you and places his paws on your shoulders. Immediately your heart starts racing, you feel palpations and anxiety, and your hands become a little shaky. The nurse knows that this response is primarily caused by A) fear of dogs that make you feel like your chest is being tightened and that you have lost control of the situation. B) increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level. C) response of the cholinergic muscarinic receptors on innervational targets of postganglionic fibers. D) stimulation of the release of β 2 -adrenergic receptors, which will open the airway and increase oxygenation.

B) increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level.

When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is A) positively charged. B) inhibitory. C) overstimulated. D) dormant.

B) inhibitory.

While assessing a critically ill patient in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the patient became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is A) metabolic acidosis that occurs spontaneously following any dysrhythmias. B) interruption of the blood/oxygen supply to the brain. C) massive cerebrovascular accident (CVA) resulting from increased perfusion. D) a blood clot coming from the heart and occluding the carotid arteries.

B) interruption of the blood/oxygen supply to the brain.

While assessing a patient with urosepsis, the ICU nurse notes the patient's BP is 80/54; HR 132; RR 24; and pulse oximetry 89% on 6 lpm O 2 . Over the last hour, the patient's urine output is 15 mL. When explaining to a new graduate nurse, the nurse will emphasize that the patient's status may relate to that A) the infection is deep inside the kidney, and it will take a long time for the antibiotics to kill the bacteria. B) the patients sympathetic nervous system has been stimulated that has resulted in vasoconstriction of the afferent arteriole, which causes a decrease in renal blood flow. C) the glomerular filtration system gets overwhelmed in times of stress (like infections) and can become clogged with waste material from the bacteria. D) the ability to transport substances from the tubular fluid into the peritubular capillaries becomes impaired, which results in fluid being forced out of capillaries into the glomerulus.

B) the patients sympathetic nervous system has been stimulated that has resulted in vasoconstriction of the afferent arteriole, which causes a decrease in renal blood flow.

A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him asleep and could not get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the roommates in the fraternity, the nurse begins by explaining that alcohol is A) water-soluble compound that is easily absorbed by the gastric lining of the stomach. B) very lipid soluble and rapidly crosses the blood brain barrier. C) able to reverse the transport of some substances to remove them from the brain. D) very likely to cause sedation, and therefore the patient just needs to sleep it off.

B) very lipid soluble and rapidly crosses the blood brain barrier.

Because the associated nephropathy is an important cause of end-stage renal failure in children and adolescents, a toddler who has had an uncomplicated bout of urinary tract infection (UTI) should still be evaluated for A) urethrovesical reflux. B) vesicoureteral reflux. C) neurogenic bladder. D) detrusor muscle instability.

B) vesicoureteral reflux.

Which of the following clients may be experiencing a sensory focal seizure that has sent an abnormal cortical discharge to the autonomic nervous system (ANS)? A) A 44-year old patient complaining of constant movement and pain in the legs that gets worse when he tries to sleep B) An 85-year-old patient experiencing drooping of the right side of the face and numbness in the right arm and leg C) A 56-year-old complaining of tingling sensations and has both an elevated pulse and BP D) A 22-year-old complaining of a stiff neck and achiness, along with some nausea and vomiting

C) A 56-year-old complaining of tingling sensations and has both an elevated pulse and BP

Which of the following individuals would most likely experience global ischemia to his or her brain? A) A male client who has just had an ischemic stroke confirmed by CT of his head B) A woman who has been admitted to the emergency department with a suspected intracranial bleed C) A man who has entered cardiogenic shock following a severe myocardial infarction D) A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater

C) A man who has entered cardiogenic shock following a severe myocardial infarction

A 24-year-old man is currently in a rehabilitation facility following a spinal cord injury at level T2. He is discussing his long-term options for continence management. Which of the following statements by the client demonstrates he has a clear understanding of the issue? A) Self-catheterization can limit the recovery of my neural pathways that control my voiding if I do it too often. B) It's critical that intermittent catheterization be performed using sterile technique. C) An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications. D) An indwelling urethral catheter is the option that best minimizes my chance of a urinary tract infection.

C) An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications.

A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care? A) Assessment and documentation of cognitive changes, including confusion and restlessness B) Regular pain assessment and administration of opioid analgesics as needed C) Assessment of swallowing ability and respiratory status D) Cardiac monitoring and administration of inotropic medications

C) Assessment of swallowing ability and respiratory status

A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations? A) Rocky Mountain spotted fever B) Lyme disease C) Encephalitis D) Spinal infection

C) Encephalitis

A 62-year-old woman with high blood pressure is to begin long-term treatment with a thiazide diuretic that she thinks she will need to take for some time. What should the nurse expect to happen to her potassium and calcium levels? A) Her potassium and calcium levels will not change. B) Her potassium and calcium levels will both go down. C) Her potassium level will drop, but her calcium level may rise. D) Her potassium level will rise, but her calcium level may drop.

C) Her potassium level will drop, but her calcium level may rise.

A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts is likely responsible for his symptoms? A) Increased tissue perfusion at the site of the malformation B) Hydrocephalus and protein in the cerebral spinal fluid C) High pressure and local hemorrhage of the venous system D) Localized ischemia with areas of necrosis noted on CT angiography

C) High pressure and local hemorrhage of the venous system

A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a patient having problems in his hand/wrist. In order to test Tinel sign, the nurse should give the patient which of the following directions? A) Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose. B) Hold your wrist in complete flexion; keep it in this position for 60 seconds; how does your hand feel after placing it in a neutral position? C) I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else? D) I'm going to tap this tuning fork and place it on the side of your thumb; then tell me what you are feeling in your hand and wrist.

C) I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?

A 25-year-old Asian American man arrives in the emergency room in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine. What disease has likely caused of his hematuria and how should it be treated? A) Goodpasture syndrome and will be treated with plasmapheresis and immunosuppressive therapy B) Membranous glomerulonephritis and should be treated with corticosteroids C) Immunoglobulin A nephropathy and may be advised to use omega-3 fatty acids to delay progression of disease D) Kimmelstiel-Wilson syndrome and should be treated with medication to control high blood pressure

C) Immunoglobulin A nephropathy and may be advised to use omega-3 fatty acids to delay progression of disease

A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. The nurse knows which of the following aspects of the nervous system listed below would her health care providers focus their diagnostic efforts on? A) Her afferent and efferent cranial nerve function B) Possible damage to her pons and medulla C) Impaired function of her hypothalamus D) Potential damage to the girl's cerebellum

C) Impaired function of her hypothalamus

The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client's medication regimen. What is the most likely focus of the pharmacologic treatment of the man's health problem? A) Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions B) Preventing demyelination of the efferent cerebellar pathways C) Increasing the functional ability of the underactive dopaminergic system D) Preventing axonal degradation of motor neurons

C) Increasing the functional ability of the underactive dopaminergic system

The nurse should anticipate she will need to teach the newly diagnosed multiple sclerosis patient how to give injections if he is prescribed which medication to modify the course of the disease by reducing exacerbations? A) Corticosteroids B) Plasmapheresis C) Interferon beta D) Mitoxantrone

C) Interferon beta

A 63-year-old woman has visited a physician because she has been intermittently passing blood-tinged urine over the last several weeks, and cytology has confirmed a diagnosis of invasive bladder cancer. Which of the following statements by the physician is most accurate? A) There are new and highly effective chemotherapy regimens that we will investigate. B) Fortunately, bladder cancer has a very low mortality rate, and successful treatment is nearly always possible. C) It's likely that you'll need surgery, possibly a procedure called a cystectomy. D) Unfortunately, there are nearly no treatment options for this type of cancer, but we will focus on addressing your symptoms.

C) It's likely that you'll need surgery, possibly a procedure called a cystectomy.

The nurse assessing a renal failure patient for encephalopathy caused by high uremic levels may observe which of the following clinical manifestations? A) Severe chest pain with pericardial friction rub on auscultation B) Stiff immobile joints and contractures C) Loss of recent memory and inattention D) Pruritus with yellow hue to skin tone

C) Loss of recent memory and inattention

A 24-year-old college student has presented to the campus medical clinic with complaints of frequent, burning urination and has, subsequent to urinalysis, been diagnosed with an acute lower urinary tract infection (UTI) caused by E. coli. What teaching will the clinician most likely provide to the student? A) This should likely resolve itself if you drink a lot of water and especially cranberry or blueberry juice. B) Unfortunately, the bacteria causing your infection is no longer responsive to antibiotics, but there are alternative treatments that we can use. C) Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe. D) This likely shows that you have some sort of obstruction in your urinary system, so when that is treated your UTI will likely resolve as well.

C) Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe.

A nurse educator is performing client education with a 51-year-old man who has been recently diagnosed with chronic kidney disease. Which of the following statements by the client would the nurse most likely want to correct or clarify? A) I'll be prone to anemia, since I'm not producing as much of the hormone that causes my bones to produce red blood cells. B) My heart rate might go up because of my kidney disease, and my blood might be a lot thinner than it should be. C) My kidney problems increase my chance of developing high blood pressure or diabetes. D) I'll have a risk of either bleeding too easily or possibly clotting too quickly, though dialysis can help minimize these effects.

C) My kidney problems increase my chance of developing high blood pressure or diabetes.

A 35-year-old female ultramarathon runner is admitted to the hospital following a day- long, 50-mile race because her urinary volume is drastically decreased and her urine is dark red. Tests indicate that she is in the initiating phase of acute tubular necrosis. Why is her urine red? A) Hematuria B) Hemoglobinuria C) Myoglobinuria D) Kidney bleeding

C) Myoglobinuria

A patient is asked to stand with feet together, eyes open, and hands by the sides. Then the patient is asked to close his eyes while the nurse observes for a full minute. What assessment is the nurse performing? A) Segmental reflex B) Posture C) Proprioception D) Crossed-extensor reflex

C) Proprioception

Damage to which of the following areas of a nephron would most likely result in impaired secretion and reabsorption? A) Distal tubule B) Loop of Henle C) Proximal tubule D) Collecting tubule

C) Proximal tubule

Following a car accident of a male teenager who did not have his seatbelt on, he arrived in the emergency department with a traumatic brain injury. He has severe cerebral edema following emergent craniotomy. Throughout the night, the nurse has been monitoring and reporting changes in his assessment. Which of the following assessments correspond to a supratentorial herniation that has progressed to include midbrain involvement? Select all that apply. A) Clouding of consciousness B) Decorticate posturing with painful stimulation C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

C) Pupils fixed at approximately 5 mm in diameter D) Respiration rate of 40 breaths/minute E) Decerebrate posturing following painful stimulation of the sternum

A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell? A) Special somatic afferent fibers B) General somatic afferents C) Special visceral afferent cells D) General visceral afferent neurons

C) Special visceral afferent cells

A 61-year-old woman who has had an upper respiratory infection for several weeks has presented to her family physician with complaints of a recent onset of urinary retention. She reveals to her physician that she has been taking nonprescription cold medications over and above the suggested dose for the past 2 weeks. Which of the following phenomena will her physician most likely suspect is contributing to her urinary retention? A) Cholinergic actions of the cold medicine are triggering internal and external sphincter contraction. B) Antihistamine effects inhibit communication between the pons and the thoracolumbar cord. C) The anticholinergic effects of the medication are impairing normal bladder function. D) Over-the-counter medications such as cold medicine stimulate the parasympathetic nervous system and inhibit bladder emptying.

C) The anticholinergic effects of the medication are impairing normal bladder function.

A physician who is providing care for a 71-year-old male client with a recent diagnosis of renal failure and an acid base imbalance is explaining some of the underlying etiology of the man's diagnoses to him and his family. Which of the following phenomena would most accurately underlie the teaching that the physician provides? A) The kidneys are integral to the reabsorption of hydrogen ions and maintenance of a low pH. B) Blood buffer systems and respiratory control can compensate for inadequate renal control of pH. C) The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body. D) pH is kept at an optimal level through the renal secretion of bicarbonate ions in blood filtrate.

C) The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body.

Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his fingers and thumb but is still able to perform gross motor movements of his hand and arm. Which of the following components of his white matter has most likely been damaged? A) The inner layer (archilayer) B) The middle layer (paleolayer) C) The outer layer (neolayer) D) The reticular formation

C) The outer layer (neolayer)

A toddler is displaying signs and symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The patient's family asks how he got this. The nurse will respond A) This could result from playing in soil and then ingesting bacteria that are now attacking his motor neurons. B) No one really knows how this disease is formed. We just know that in time, he may grow out of it. C) This is a degenerative disorder that tends to be inherited as an autosomal recessive trait. D) This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.

C) This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.

The clinical nurse educator on a nephrology unit of a large, urban hospital is orientating recent nursing graduates to the unit. Which of the following teaching points about acute tubular necrosis (ATN) should the educator include in the orientation session? A) The cardinal signs of ATN are oliguria and retention of potassium, creatinine, and sulfates. B) Ureteral and bladder outlet obstructions are often contributors to ATN. C) Trauma, burns, and major surgery are common precursors to ATN. D) Tubular epithelial cells are sensitive to ischemia and toxins, and damage is irreversible.

C) Trauma, burns, and major surgery are common precursors to ATN.

An adult male has a new diagnosis of Guillain-BarrÈ syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)? A) The destruction of myelin causes fewer Schwann cells to be produced in the client's PNS. B) The axonal transport system is compromised by the lack of myelin surrounding nerve cells. C) Unless remyelination occurs, the axon will eventually die. D) A deficit of myelin predisposes the client to infection by potential pathogens.

C) Unless remyelination occurs, the axon will eventually die.

A family physician is providing care for a 61-year-old obese male who has a history of diabetes and hypertension. Blood work has indicated that the man has a GFR of 51 mL/minute with elevated serum creatinine levels. Which of the following statements will the physician most likely provide the client in light of these results? A) We will regularly monitor your kidney function, but most likely your kidneys will be able to compensate on their own and intervention is not required. B) You likely have chronic kidney disease, and there may be urine in your blood until it is controlled. C) Your chronic kidney disease has likely been caused by your diabetes and high blood pressure. D) You're in kidney failure, and I'll be starting dialysis treatment immediately.

C) Your chronic kidney disease has likely been caused by your diabetes and high blood pressure.

A 34-year-old man has been taking up to 2400 mg of ibuprofen per day following a motor vehicle accident several months ago and consequent chronic pain. He has recently been diagnosed with chronic analgesic nephritis as a result of his high analgesic intake. The man is surprised at the diagnosis stating, I thought that taking too many drugs hurts your liver if anything, not your kidneys. What is the most appropriate response to the man's statement? A) Your liver does perform most of the detoxification in your body, but your kidneys can perform this role if the liver is unable to. B) High drug intake can cause your kidneys to be very vulnerable to infections, which is likely what happened in your case. C) Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs. D) It is very rare for someone as young as yourself to have kidney damage like this; usually only older people are vulnerable to kidney damage from drugs.

C) Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs.

A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a coup injury. How will the nurse explain this to the family so they can understand? A) It's like squeezing an orange so tight that the juice runs out of the top. B) Your son has a huge laceration inside his brain where the bat hit his skull. C) Your son has a contusion of the brain at the site where the bat hit his head. D) When the bat hit his head, his neck jerked backward causing injury to the spine.

C) Your son has a contusion of the brain at the site where the bat hit his head.

The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents? A) Your son's muscular dystrophy is a result of faulty connections between muscles and the nerves that normally control them. B) He'll require intensive physical therapy as he grows up, and there's a good chance that he will outgrow this problem as he develops. C) Your son will be prone to heart problems and decreased lung function because of this. D) His muscles will weaken and will visibly decrease in size relative to his body size throughout his childhood.

C) Your son will be prone to heart problems and decreased lung function because of this.

When explaining to a class of nursing students enrolled in pathophysiology, the instructor states, the majority of energy used by the kidney is for A) filtration of drugs out of the body. B) secretion of erythropoietin for production of RBCs. C) active sodium transport mechanisms. D) removal of excess glucose from the blood.

C) active sodium transport mechanisms.

To maintain hematocrit levels in people with kidney failure, the nurse should be prepared to A) arrange for frequent blood transfusions in an outpatient clinic. B) administer iron dextran intravenously. C) administer a subcutaneous injection of recombinant human erythropoietin (rhEPO). D) administer prenatal vitamins twice a day.

C) administer a subcutaneous injection of recombinant human erythropoietin (rhEPO).

A patient in the ICU has been diagnosed with hypovolemic shock. His BP is 88/53, heart rate 122, and respiratory rate 26. Given these vital signs, the nurse should expect the urine output to be A) maintained between 30 and 50 mL/hour with no sediment in the bag. B) increased to 60+ mL/hour with dilute urine. C) decreased below 30 mL/hour with decreased GFR. D) the patient's normal amount with dark, concentrated urine.

C) decreased below 30 mL/hour with decreased GFR.

When explaining about the passage of urine to a group of nursing students, the clinic nurse asks them which muscle is primarily responsible for micturition? Their correct reply is the A) urinary vesicle. B) trigone. C) detrusor. D) external sphincter.

C) detrusor.

When teaching a community education class about the seven warning signs of cancer, the nurse will note that the most common sign of bladder cancer is A) inability to empty the bladder fully. B) colic spasms of the ureters. C) painless bloody urine. D) passage of large clots after voiding.

C) painless bloody urine.

A patient who has suffered a spinal cord injury at C4 is experiencing a sudden change in condition. His BP is 186/101; heart rate is 45; and he is profusely sweating and complaining of not feeling right. The nurse should A) call a Code Blue. B) page physician stat. and ask for an antihypertensive medication. C) palpate his bladder for overdistention. D) place his bed flat and elevate the foot of the bed.

C) palpate his bladder for overdistention.

After being thrown off the back of a bull, the bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is usually referred to as A) tetraplegia. B) quadriplegia. C) paraplegia. D) anterior cord syndrome.

C) paraplegia.

A nurse at a long-term care facility provides care for an 85-year-old man who has had recent transient ischemic attacks (TIAs). Which of the following statements best identifies future complications associated with TIAs? TIAs A) are an accumulation of small deficits that may eventually equal the effects of a full CVA. B) are a relatively benign sign that necessitates monitoring but not treatment. C) resolve rapidly but may place the client at an increased risk for stroke. D) are caused by small bleeds that can be a warning sign of an impending stroke.

C) resolve rapidly but may place the client at an increased risk for stroke.

Because they strengthen the pelvic floor muscles, Kegel exercises are most likely to help A) overflow incontinence. B) urge incontinence. C) stress incontinence. D) mixed incontinence.

C) stress incontinence.

The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state that A) it takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells. B) there is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane. C) the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable. D) the neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.

C) the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.

One of the most reliable predictors for worsening autosomal dominant polycystic kidney disease is A) serum creatinine levels. B) blood urea nitrogen (BUN) level. C) urine albumin excretion (UAE). D) urine specific gravity.

C) urine albumin excretion (UAE).

Which of the following individuals is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult A) who developed rhabdomyolysis and ischemic injury after a tourniquet application. B) who suffered a bone-depth laceration to the shoulder during a knife attack. C) who had his forearm partially crushed by gears during an industrial accident. D) who had nerves transected during surgery to remove a tumor from the mandible.

C) who had his forearm partially crushed by gears during an industrial accident.

When explaining a cystometry test to measure bladder pressure during filling and voiding in a normal adult, the nurse informs the nursing students that the normal capacity when adults have a desire to void is A) 100 to 150 mL. B) 200 to 250 mL. C) 300 to 399 mL. D) 400 to 500 mL.

D) 400 to 500 mL.

Which of the following individuals is at the highest risk of developing a urinary tract infection (UTI)? A) A 60-year-old man with a history of cardiovascular disease who is recovering in hospital from a coronary artery bypass graft B) A 66-year-old man undergoing dialysis for the treatment of chronic renal failure secondary to hypertension C) A 38-year-old man with high urine output due to antidiuretic hormone insufficiency D) A 30-year-old woman with poorly controlled diabetes mellitus

D) A 30-year-old woman with poorly controlled diabetes mellitus

A middle-aged man with diabetes reports that he must strain to urinate and that his urine stream is weak and dribbling. He also reports feeling that his bladder never really empties. The nurse knows that all of his complaints are likely caused by which of the following medical diagnoses? A) Detrusor muscle areflexia B) Detrusorñsphincter dyssynergia C) Uninhibited neurogenic bladder D) Bladder atony with dysfunction

D) Bladder atony with dysfunction

A middle-aged woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady; her speech is slurred; and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which of the following health problems most likely underlies her present state? A) Multiple sclerosis B) Guillain-BarrÈ syndrome C) Myasthenia crisis D) Cerebellar damage caused by a cerebrovascular accident

D) Cerebellar damage caused by a cerebrovascular accident

Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced? A) Anterior cord syndrome B) Brown-SÈquard syndrome C) Central cord syndrome D) Conus medullaris syndrome

D) Conus medullaris syndrome

The nurse knows that which of the following treatment plans listed below is most likely to be prescribed after a computed tomography (CT) scan of the head reveals a new-onset aneurysmal subarachnoid hemorrhage? A) Stat administration of tissue plasminogen activator (tPA) B) Administration of a diuretic such as mannitol to reduce cerebral edema and ICP C) Monitoring in the ICU for signs and symptoms of cerebral insult D) Craniotomy and clipping of the affected vessel

D) Craniotomy and clipping of the affected vessel

During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action? A) Cerebellum B) Thalamus C) Basal ganglia D) Frontal lobe

D) Frontal lobe

A patient has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause? A) Do you have a history of heart failure? B) Have you recently had kidney stones? C) Have you ever been diagnosed with diabetes? D) Have you had any type of infection within the last 2 weeks?

D) Have you had any type of infection within the last 2 weeks?

Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which of the following phenomena has facilitated the rapid movement of her hand in response to the painful stimulus? A) Her midbrain has rapidly responded to the nociceptive stimuli and induced arm flexion. B) The withdrawal reflex of her peripheral nervous system has quickly mediated between afferent and effector neurons. C) The forebrain has mediated a protective spinal cord reflex. D) Her CNS has enacted a protective response received by neurons that innervate her arm muscles.

D) Her CNS has enacted a protective response received by neurons that innervate her arm muscles.

A 60-year-old male office worker presents to a clinic complaining of new onset of lower back pain that has been worsening over the last 6 weeks. The nurse knows which of the following components of his physical assessment and history is most indicative of a serious pathological process (like aortic aneurysm or cancer)? A) His pain is relieved by extended bed rest. B) When supine, passive rising of his leg to 90 degrees results in hamstring pain. C) He has needed regular nonsteroidal anti inflammatory drugs to control the pain in recent weeks. D) His onset of pain has been gradual, and he has no prior history of lower back problems.

D) His onset of pain has been gradual, and he has no prior history of lower back problems.

A 42-year-old male has been diagnosed with renal failure secondary to diabetes mellitus and is scheduled to begin dialysis soon. Which of the following statements by the client reflects an accurate understanding of the process of hemodialysis? A) It's stressful knowing that committing to dialysis means I can't qualify for a kidney transplant. B) I know I'll have to go to a hospital or dialysis center for treatment. C) Changing my schedule to accommodate 3 or 4 hours of hemodialysis each day will be difficult. D) I won't be able to go about my normal routine during treatment.

D) I won't be able to go about my normal routine during treatment.

Which of the following statements most accurately captures the function of the ascending loop of Henle? A) Urine is concentrated by the selective absorption of free water in the ascending limb. B) Sodium and water are reabsorbed in equal amounts, reducing filtrate quantity but maintaining osmolality. C) The majority of solute and water reabsorption occurs in the ascending loop of Henle. D) Impermeability to water and absorption of solutes yields a highly dilute filtrate.

D) Impermeability to water and absorption of solutes yields a highly dilute filtrate.

A Tae Kwon Do (TKD) master is applying downward pressure just above the elbow joint on an attacker who immediately collapses to the ground. The TKD master knows the elbow joint can bend inward toward the body but not in the opposite direction. Which of the following reflexes is applicable to this example? A) Knife clasp B) Withdrawal C) Myotatic D) Inverse myotatic

D) Inverse myotatic

A diabetes education nurse is teaching a group of recently diagnosed diabetics about the potential genitourinary complications of diabetes and the consequent importance of vigilant blood glucose control. Which of the following teaching points best conveys an aspect of bladder dysfunction and diabetes mellitus? A) People with diabetes are highly susceptible to urethral obstructions, and these can heal more slowly and cause more damage than in people without diabetes. B) High blood sugar results in a high glucose level in your urine, and this can make your bladder muscle less able to fully empty the bladder. C) Many people with diabetes find it necessary to live with an indwelling catheter to ensure their bladders do not become too full. D) It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying.

D) It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying.

A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse? A) Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses. B) Communication between a neuron and the single neuron it is connected with will be facilitated. C) The neurotransmitter will cross gap junctions more readily. D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

A patient in a hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine collection test. He asks the nurse why the test is necessary since he provided a single urine sample 2 days ago. How could the nurse best respond to the patient's question? A) A single urine sample lets your care team determine if there are bacteria in your urine, but other tests of urine chemistry need a longer-term view. B) Current lab tests aren't able to detect the small quantities of most substances contained in a single urine sample. C) Only a longer-term test is able to show whether your kidneys are letting sugar spill out into your urine. D) Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine.

D) Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine.

A nursing student having trouble moving his head from side to side is likely experiencing a problem with which type of neurons? A) General visceral efferent neurons B) Preganglionic neurons C) Parasympathetic postganglionic neurons D) Pharyngeal efferent neurons

D) Pharyngeal efferent neurons

A 70-year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult? A) Flaccid loss of muscle tone B) Difficulty in starting movement, stopping movement, and maintaining rhythmic movements. C) Tremor, rigidity, and bradykinesia D) Unsteady gait and difficulty in speaking and swallowing

D) Unsteady gait and difficulty in speaking and swallowing

A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood brain barrier and been transferred from the vascular space into the client's interstitial space. Which of the following diagnoses best captures this pathophysiology? A) Focal hypoxia B) Cytotoxic edema C) Hydrocephalus D) Vasogenic edema

D) Vasogenic edema

A patient asks the nurse what it means when the doctor said that he had adenocarcinoma of the bladder. Reviewing the pathophysiologic principles behind this type of cancer, the nurse knows A) it is a low-grade tumor that is readily cured with bladder surgery. B) after resection of the cancer, the prognosis is excellent with this type of cancer cell. C) that these types of cancer cells are very invasive to the tissue; therefore, the entire bladder must be removed. D) this is a rare but highly metastatic tumor that has a very poor prognosis.

D) this is a rare but highly metastatic tumor that has a very poor prognosis.