patho-test 1
When educating a client about glargine, the nurse should explain that this medication:
has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours. p. 1210
A client is experiencing the early stages of an inflammatory process and develops leukocytosis. The nurse recognizes this as a/an:
increase in circulating neutrophils. 229
The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?
increased estradiol production causes increased follicle-stimulating hormone (FSH) production.
Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:
is morbidly obese (defined as greater than 100 pounds over ideal weight).
While the nurse is performing a skin assessment on a dark-skinned client, the nurse notes that the client has a healed wound on the leg but that the wound has an excess of scar tissue. The nurse documents this as:
keloid. p. 241-242
While reviewing the phases of wound healing, the students note that the first cells to arrive after the injury are the:
neutrophils. p. 241
Which physiologic function of the pituitary gland facilitates breast milk production?
prolactin
After many years of cigarette smoking, a client is admitted to have a "mass" removed from the lung. When explaining the surgery and recovery, the physician notes that the client is likely to have a good amount of fibrosis develop at the surgical area. After the physician leaves the room, the client asks the nurse what was meant by "fibrosis" in the lung. The nurse bases the response on the fact that tissue repair can:
result in replacement tissue in the form of connective (fibrous) tissue, which leads to scar formation or fibrosis of the lung. P.237
Following a severe automobile accident, a client is scheduled to have surgery to either repair or remove his spleen, pancreas, and stomach. The client wants the organs repaired and not removed if at all possible. However, the nursing staff understands that extensive regeneration in parenchymal organs can only occur
the residual tissue is structurally and functionally intact. p. 237
A client with environmental allergies is experiencing respiratory inflammation. Which mediator causes vasodilation during the vascular stage of the inflammatory response?
Histamine p. 232
A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?
"A single hormone can act on not only one process or organ but often on several different locations or processes."
Following surgery for appendicitis, a teenaged client notes four small "stab" wounds on the abdomen. The client is obviously worried about body appearance. The nurse explains, "Your body will heal quickly and tissue repair will allow for regeneration of any cells needed." The client asks, "What does regeneration mean?" The nurse responds that tissue repair by regeneration means:
"Any injured cells are replaced with cells of the same type. Therefore, after healing, the wound will look like your surrounding skin." p. 237
A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be:
"This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes." p. 1219
Which core body temperature is within normal range?
37.3°C (99.1°F)
After receiving change-of-shift report about the following four clients, which client should the nurse assess first?
70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.2°F (39.6°C) p. 1204
A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?
A hypermetabolic state p.1203
Which client would be considered to be exhibiting manifestations of "prediabetes"?
A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL (10.49 mmol/L).
A client presents with an oral temperature of 101.7°F (38.7°C) and painful, swollen cervical lymph nodes. Laboratory results indicate neutrophilia with a shift to the left. Which diagnosis is most likely?
A severe bacterial infection p. 236
A client with small cell carcinoma lung cancer may secrete an excess of which hormone, causing an ectopic form of Cushing syndrome due to a nonpituitary tumor?
ACTH p. 1210
Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system?
Acting as a second messenger to mediate hormone action on target cells
Paracrine action involves which characteristic?
Action locally on cells other than those that produce the hormone
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:
Anterior pituitary gland
When hormones act locally rather than being secreted into the bloodstream, their actions are termed:
Autocrine and paracrine
The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?
Beta cells
While explaining to a young child why he should be careful with a wound, the nurse reviews healing with the parent. The nurse educates the parent about how strength in the healing wound site is developed based on which substance being available?
Collagen synthesis p. 238
When caring for a client with a deeply infected wound that has been slow to heal, the nurse recognizes which of these are considered inflammatory mediators present during wound healing? Select all that apply.
Complement Tumor necrosis alpha Vascular endothelial growth factor p. 225
The nurse caring for a client with a large leg wound notes that the client's past medical history includes diabetes, chronic atrial fibrillation, asthma controlled by maintaninence medication, and neuropathy. Which one has the greatest potential to negatively impact the healing of the client's wound?
Diabetes p. 243
The nurse is reviewing assessment documentation of a client's wound and notes "purulent drainage." The nurse would interpret this as:
Exudate containing white blood cells, protein, and tissue debris p. 234
Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease?
Fine-needle aspiration biopsy
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:
Graves disease
During the acute inflammatory response, there is a period called the transient phase where there is increased vascular permeability. What is considered the principal mediator of the immediate transient phase?
Histamine p. 232
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?
Hormone stimulation
Which manifestation in a client with Addison disease results from negative feedback?
Hyperpigmentation
A client with hyperthyroidism took aspirin for a headache. Which complications could develop? Select all that apply.
Hyperthermia Tachycardia Agitation
A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?
Hypoglycemia p. 1224-1225
An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?
Hypothyroidism
Which complications could occur when an adult client has an anterior hypophysectomy? Select all that apply.
Hypothyroidism Addison disease
Which metabolic abnormality can lead to the development of type 2 diabetes?
Insulin resistance p. 1217
The nurse is caring for a client with an accumulation of 2.5 cm of darkened tissue scar over the area of a 3-mm injury. How does the nurse correctly document this finding in the medical record?
Keloid p. 241-242
The nurse is evaluating the bloodwork results of a client with an infected leg ulcer. The white blood cell count is 18,000 cells/uL. The nurse interprets this as:
Leukocytosis p. 236
What is the most common mechanism of hormone control?
Negative feedback
A student arrives at the health clinic anxious and afraid. The student found an enlarged lymph node in the groin area that is extremely painful to touch and "knows" it is cancer. What information should the health care provider relay to this student about lymphadenitis?
Not all swollen lymph nodes are due to cancer. It could be caused by an infection in the genital region. p. 236-237
Which structure controls the functions of the greatest number of target glands and cells?
Pituitary Glands
The nurse caring for a postoperative client documents that the surgical incision is healing by:
Primary intention p. 240-241
The nurse is assessing the wound of a postoperative client. The client has a 6-inch abdominal wound that is well approximated and closed with surgical suture. The wound does not display any redness or drainage. The nurse would document the healing process as:
Primary intention p. 240-241
Select the most accurate statement regarding measurements of urinary hormone.
Provide a better measure of hormone levels during a designated period.
A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for:
Redness p. 226
Hormones are chemical messengers that provide which function in the body?
Regulate body functions
A client who had an implantable cardioverter-defibrillator (ICD) returns the next week with a fever, chills, and elevated WBC. The physician suspects the wound is infected. If this wound does not respond to antibiotic therapy, the nurse can anticipate the client will undergo:
Removal of device p. 243
A nurse is assessing a client for the classic signs of acute inflammation. The nurse would assess the client for:
Rubor, swelling, and pain p. 225
The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers?
Sensory neuropathy p. 1226
A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?
Stimulation testing
The nurse cares for a client with severe chronic obstructive pulmonary disease who has been taking oral steroids for several years. Which response in the client's endocrine control will the nurse expect?
Suppression of the client's hypothalamic-pituitary-target cell system
A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?
T4 and TSH
Which responsibility of the extracellular matrix (ECM) is most accurate?
The ECM provides the scaffolding for tissue renewal. p. 238
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?
The thyroid gland is responsible for increasing the metabolic rate.
The nurse is assessing a client with diabetes and notes an area on the client's right foot as inflamed, necrotic, and eroded. The client states he accidentally slammed his foot in a door 2 weeks ago. The nurse would document this finding as a(n):
Ulceration p. 234
A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?
Using an insulin infusion pump p. 1219
A client comes into the emergency room with an animal bite to the hand. Which intervention should the nurse anticipate?
Wound irrigation p. 243
The nurse is selecting a dressing for a vascular wound that has a dry wound surface. The most appropriate dressing for this wound is one that:
adds moisture to wound bed. p.241
An oncology client is about to begin chemotherapy. During the education, the nurse mentions that continuously dividing cells will be most affected by the chemotherapy. The client asks, "What are continuously dividing cells?" The nurse responds, "These are cells that continue to divide and replicate like: Select all that apply.
cells on the surface of your skin." cells in your mouth." cells lining your GI tract." p. 237
Following a severe automobile accident, a client is scheduled to have surgery to either repair or remove his spleen, pancreas, and stomach. The client wants the organs repaired and not removed if at all possible. However, the nursing staff understands that extensive regeneration in parenchymal organs can only occur if:
the residual tissue is structurally and functionally intact. p. 237
In major athletic competition, athletes are required to submit to liquid chromatography testing looking for:
use of performance-enhancing agents to increase the chances of winning.
The nurse is caring for a client diagnosed with systemic inflammatory response syndrome. Which illness is likely responsible for this diagnosis?
Sepsis p.236
A client has presented to the emergency department after he twisted his ankle while playing soccer. Which assessment findings are cardinal signs that the client is experiencing inflammation? Select all that apply.
The client is experiencing pain The ankle is warmer than the unaffected ankle The client's ankle is visibly red The ankle appears to be swollen p. 225
The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?
The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.
The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?
The client should be strongly urged not to smoke.
A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?
The hypothalamic-pituitary-target cell system
A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant taking thyroid hormone supplement, what should be included in the education?
The infant will have dosage levels adjusted as he grows.
When educating a client about glargine, the nurse should explain that this medication:
has a prolonged absorption rate and provides a relatively constant concentration for 12-24