Pathophysiology
Which individual displays the precursor to acromegaly?
An adult with an excess of growth hormone due to adenoma
A nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by a participant should the nurse follow up first?
"I've had a little sore on the sole of my foot for a few days, but im sure it will eventually heal."
A diabetic client presents to a clinic for a routine visit. Blood work reveals a HbA1c of 11.0% (high). Which response by the client may account for this abnormal lab result?
"my meter broke so i have not been checking my blood glucose levels for a while"
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 degrees fahrenheit or 39.6 degrees celsius
Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS) including dysphagia, muscle weakness and spasticity, and dysphonia? -ALS is caused by disruption to the cerebellum -ALS is caused by lack of dopamine in the body -ALS is caused by muscular necrosis -ALS is caused by both an upper motor neuron and lower motor neuron disturbance
ALS is caused by both an upper motor neuron and lower motor neuron disturbance
A client with a new diagnosis of diabetes mellitus receives education about the diabetic diet plan. which menu selection indicates the client understood the instruction?
Baked chicken breast, coleslaw, and milk
A 14 year old girl has been thrown from the back of a pick up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column? - can not breathe on own needs ventilator assistance - partial or full diaphragmatic functions: ventilation is diminished because of the loss of intercostal muscle function, resulting in shallow breaths and a weak cough - intercostal and abdominal musculature is affected; the ability to take a deep breath and cough is less impaired - needs maintenance therapy to strengthen existing muscles for endurance and mobilization of secretions
Cannot breath on own, needs ventilator assistance
Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy? - guillain barre syndrome - carpal tunnel syndrome - myasthenia gravis - phalen maneuver
Carpal tunnel syndrome
An older adult has had a recent decrease in coordination with gait being described as wide based unsteady and lacking in fluidity although the clients muscle tone appears normal. This client requires further assessment for which condition that is involved with coordination of movement? -muscle atrophy -cerebellar disorder -impaired spinal reflexes -lower motor neuron lesions
Cerebellar disorder
A client had an arm cast fitted after suffering a right humeral fracture in a hockey game. The client reported a loss of sensation in the right hand but sensation returned upon removal of the cast. Which was the most likely cause of the clients loss of sensation? -compression lesion of the musculocutaneous nerve -severing of the musculocutaneous nerve followed by regeneration -inflammation of the musculocutaneous nerve -inhibition of the musculocutaneous nerve to protect the humerus
Compression lesion of the musculocutaneous nerve
Regarding the pathophysiology of Parkinson's disease, which statement is true? -degeneration of the nigostriatal dopamine neurons occur -the dopamine receptors increase from an alteration in neuronal basal ganglia -failure of the cerebral cortex interferes with the use of acetylcholine -acetylcholine levels rise and inhibit voluntary movement
Degeneration of the nigostriatal dopamine neurons occur
A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food? - dairy products - unrefrigerated meat - home-grown and canned vegetables - fresh fish
Home grown and canned vegetables
Increased cardiac workload with left heart failure can result in which of the following change to the myocardial cells? Hyperplasia Metaplasia Hypertrophy Atrophy
Hypertrophy
Assessment of an older adult client reveals bilateral pitting edema of the client's feet and ankles; difficult to palpate pedal pulses; breath sounds clear on auscultation. What is this client's most likely health problem? Cor pulmonale Left sided heart failure Right sided heart failure Cardiogenic shock
Right sided heart failure
A client has been diagnosed with Guillain-Barré syndrome and is being treated in ICU. the client is experiencing rapidly ascending paralysis. What is the nurses priority intervention when caring for this client? -inserting a Foley catheter -assessing distal peripheral pulses -restarting the IV when it infiltrates -maintenance of the clients airway
Maintenance of the clients airway
Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category? -multiple sclerosis - duchenne muscular dystrophy - Becker muscular dystrophy - myasthenia gravis
Myasthenia gravis
Which peripheral nerve injury will likely result in cellular death with little chance of regeneration? - nerve fibers destroyed close to the neuronal cell body - crushing injury where the nerve is traumatized but not severed - cutting injury where slow regeneration axonal branches are located - incomplete amputation where tubular implants are used to fill in the gaps of nerves
Nerve fibers destroyed close to the neuronal cell body
A client is scheduled for dual energy x-ray absorptiometry DEXA testing. The client asked the nurse what is the reason for this test? The nurse bases the answer on the understanding that the client is most likely being evaluated for what? - Intravertebral disc disease - arthritis - bone tumors - osteoporosis
Osteoporosis
What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia? - Parkinson's disease - Huntington disease - guillain barre syndrome - myasthenia gravis
Parkinson's disease
A client with a closed reduction of a wrist fracture has a plaster cast applied. Which nursing intervention is the highest priority immediately after the procedure? Elevating the extremity on a pillow Performing a peripheral circulation assessment Immobilizing the arm in a sling Handling the cast with the palms of the hands
Performing a peripheral circulation assessment
Which treatment should take place immediately in a client experiencing autonomic dysreflexia? -position the client in upright position and correct the initiating stimulus -increase the clients blood pressure to allow for adequate perfusion -place the client in a supine position and increase intravenous fluids -apply binders and support hose to shunt the blood to the main organs
Position the client in upright position and correct the initiating stimulus
The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will i get headache, disturbed behavior, coma and seizures if its my pancreas that's impaired?" Which response is the best explanation?
The brain relies on blood glucose as its main energy source
Which serum biomarker is highly specific for myocardial tissue? Troponin assays C-reactive protein (crp) White bloood cells Red blood cells
Troponin assays
A client diagnosed with early multiple sclerosis (MS) will likely demonstrate which manifestations? Select all that apply -visual clouding -parasthesia -bladder dysfunction -fatigue -anxiety
Visual clouding Parasthesia Bladder dysfunction Fatigue
When educating a client about type 1 diabetes the nurse will mention that this type is caused by which mechanism?
autoimmune destruction of pancreatic beta cells
Which manifestation of left sided heart failure can be diagnosed by examination of the lips and mucous membranes? Cyanosis tamponade atrial fibrillation valvular insufficiency
cyanosis
A nurse on a medical unit is providing care for a 37 year old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?
eye health and visual acuity
During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time what can occur?
hyperglycemia
A 30 year old man who manages his type 1 diabetes with glyburide presents to the ER reporting headache, confusion, and tachycardia. He came from a party where he drank 2 beers to celebrate running his first half marathon. Which phenomenon is likely to be the cause of his symptoms?
hypoglycemia
A client arrives at the doctor's office complaining of severe indigestion that has been intermittent but the pain is new constant and feels like someone is squeezing their chest. Based on the above ECG the nurse recognizes that the situation is possibly emergent as the ECG indicates the patient may be experiencing: myocardial infarction decreased intracranial pressure advanced hypokalemia benign late repolarization
myocardial infarction
A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self- administrator of a dose of insulin in anticipation of eating lunch at noon. What type of insulin does he most likely inject?
short acting
A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:
teach the client about the safe and effective use of synthetic thyroid hormones
A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?
thyroid storm
An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics?
weight loss, glucose monitoring, and oral antihyperglycemic medications
