Pathophysiology Exam 4 study
One of the most important pulmonary treatments in cystic fibrosis is: A. Chest physiotherapy. B. Inhaled beta agonists. C. Oral enzymes. D. Inhaled corticosteroids.
A. Chest physiotherapy.
Virchow's triad can result in... A. Pulmonary embolus B. Bronchoconstriction C. Alveolar collapse D. Decreased pulmonary arterial pressure
A. Pulmonary embolus
An emergency room nurse is assessing a female client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client? A. A low respiratory B. Diminished breath sounds C. The presence of a barrel chest D. A sucking sound at the site of injury
B. Diminished breath sounds
In addition to nausea and severe flank pain, a female client with renal calculi has pain in the groin and bladder. What additional sign should the nurse assess? A. nephritis B. referred pain C. urine retention D. additional stone formation
B. referred pain
With which condition would you expect to see copious amounts of foul smelling sputum? A. Pulmonary edema B. Epiglottitis C. Bronchiectasis D. Emphysema
C. Bronchiectasis
Which of these is the best goal for the patient admitted with chronic bronchitis who has a nursing diagnosis of ineffective airway clearance? A. Patient denies having dyspnea. B. Patient's mental status is improved. C. Patient has a productive cough. D. Patient's 02 saturation is 90%.
C. Patient has a productive cough.
____ is the most common type of renal stone.
Calcium
Non-adherence to medication therapy is also known as
Noncompliance
Describe urge incontinence
A pattern of a strong urge to void followed by incontinence prior to accessing the bathroom
A nurse teaches a male client about the use of a respiratory inhaler. Which action by the client indicates a need for further teaching? A. Inhales the mist and quickly exhales B. Removes the cap and shakes the inhaler well before use C. Presses the canister down with the finger as he breathes in D. Waits 1 to 2 minutes between puffs if more than one puff has been prescribed
A. Inhales the mist and quickly exhales
Which diagnostic test would best determine the cause of AKI? A. Creatinine level B. GFR C. BUN or urea D. BUN; creatinine; creatinine ratio urea
D. BUN; creatinine; creatinine ratio urea
Individuals who have chronic bronchitis most often have: A. Normal lung sounds B. Barrel chest C. Substantial weight loss D. Productive cough
D. Productive cough
Presence of overdistended and non-functional alveoli is a condition called: A. Bronchitis B. Emphysema C. Empyema D. Atelectasis
B. Emphysema
The client who has a history of gout also is diagnosed with urolithiasis and the stones are determined to be of uric acid type. The nurse gives the client instructions in which foods to limit, including: A. Milk B. Liver C. Apples D. Carrots
B. Liver
During a health history, which statement by a client indicates a risk of renal calculi? A. "I've been drinking a lot of cola soft drinks latelv." B. "I've been jogging more than usual." C. "I've had more stress since we adopted a child last vear." D. "I'm a vegetarian and eat cheese two or three times each day."
D. "I'm a vegetarian and eat cheese two or three times each day."
Which nursing action would most likely be successful in reducing pleuritic chest pain in a client with pneumonia? A. Encourage the client to breathe shallowly. B. Have the client practice abdominal breathing. C. Offer the client incentive spirometry. D. Teach the client to splint the rib cage when coughing
D. Teach the client to splint the rib cage when coughing
________ is the organism responsible for the majority of urinary tract infections.
E- coli
_______ Is a systemic vascular risk factor for the development o chronic Kidney disease.
Hypertension
The client is in the oliguric phase of acute renal failure. For which risk should the nurse assess the client? A. pulmonary edema B. metabolic alkalosis C. hypotension D. hypokalemia
A. pulmonary edema
The client with acute pyelonephritis wants to know the possibility of developing chronic pyelonephritis. The nurse's response is based on knowledge of which disorder that most commonly leads to chronic pyelonephritis? A. acute pyelonephritis B. recurrent urinary tract infections C. acute renal failure D. glomerulonephritis
B. recurrent urinary tract infections
The most common type of upper urinary tract infection that results from bacteria ascending to the kidney from the lower respiratory tract is A. urethritis. B. prostatitis. C. pyelonephritis. D. cystitis.
C. pyelonephritis.
The nurse is providing teaching to the family of an older adult client with a urinary tract infection (UTI). Which common early symptom that is likely to occur in older adults should the nurse stress? A. Urinary urgency B. Blood in the urine C. Urinary frequency D. Alteration in cognition
D. Alteration in cognition
The nurse is providing discharge teaching for a client diagnosed with a urinary tract infection (UTI). The client is prescribed a 3-day course of oral trimethoprim-sulfamethoxazole (TMP-SMZ). Which client statement indicates that teaching has been effective? A. "I will return within 10 days for a follow-up urine culture." B. "I will practice Kegel exercises on a daily basis." C. "I will increase my intake of fluids, especially citrus juice." D. "I will only wear 100% cotton underwear."
A. "I will return within 10 days for a follow-up urine culture."
An acute asthma attack is associated with A. Bronchoconstriction B. Bronchial mucosal edema C. Hypersecretion of mucus D. Hypoxemia E. Alveolar collapse
A. Bronchoconstriction B. Bronchial mucosal edema C. Hypersecretion of mucus D. Hypoxemia
In addition to nausea and severe flank pain, a female client with renal calculi has pain in the groin and bladder. The nurse should assess the client further for signs of: A. Nephritis. B. Referred pain. C. Urine retention. D. Additional stone formation.
B. Referred pain.
Which of the following diagnostic tests is definitive for TB? A. Chest x-ray B. Mantoux test C. Sputum culture D. Tuberculin test
C. Sputum culture
A client has urge incontinence. When obtaining the health history, the nurse should ask the client about which factors that could precipitate incontinence? A. inability to empty the bladder B. loss of urine when coughing C. involuntary urination D. frequent dribbling of urine
C. involuntary urination
Why does chronic bronchitis lead to cor pulmonale? A. Ventricular hypoxia B. Left ventricular strain C. Hypervolemia D. Increased pulmonary vascular resistance
D. Increased pulmonary vascular resistance
With which condition does air that enters the pleural space during inspiration is unable to exit during expiration A. Empyema B. Pleural effusion C. Open pneumothorax D. Tension pneumothorax
D. Tension pneumothorax
Which finding would be the best indication to the nurse that the patient having an acute asthma attack was responding to the prescribed bronchodilator therapy? A. Wheezes are more easily heard. B. The oxygen saturation is 89%. C. Vesicular breath sounds resolve. D. The respiratory effort decreases.
A. Wheezes are more easily heard.
A client with chronic renal failure has completed a hemodialysis treatment. The nurse measures which parameters at the completion of the hemodialysis procedure to monitor for hemodynamic stability and to determine effectiveness of fluid extraction? A. vital signs and blood urea nitrogen (BUN) B. vital signs and weight C. sodium and potassium levels D. BUN and creatinine levels
B. vital signs and weight
A nurse is evaluating discharge instructions to a client admitted for urolithiasis. Which of the following statements made by the client indicates to the nurse a need for further instructions? A. "I will report any changes in the amount or character of urine to my physician." B. "If I have any pain during urination, I will inform my physician." C. "I will drink at least 2000 mL of fluid per day." D. "I will report any blood in my urine.
C. "I will drink at least 2000 mL of fluid per day."
A patient is seen in the clinic with COPD. Which information given by the patient would help most in confirming a diagnosis of chronic bronchitis? A. The patient tells the nurse about a family history of bronchitis. B. The patient denies having any respiratory problems until the last 6 months. C. The patient's history indicates a 40 pack-year cigarette history. D. The patient complains about having a productive cough every winter for 2 months.
D. The patient complains about having a productive cough every winter for 2 months.
An 8-year-old client with cystic fibrosis is admitted to the hospital and will undergo a chest physiotherapy treatment. The therapy should be properly coordinated by the nurse with the respiratory therapy department so that treatments occur during: A. Between meals B. After meals C. After medication D. Around the child's play schedule
A. Between meals
What does the nurse identify as urosepsis in a patient? A. Infection spreads from the urinary tract to the bloodstream. B. Escherichia coli from the intestinal tract infects the urinary tract. C. Normal flora protection decreases following long-term antibiotic therapy. D. Decline in estrogen causes changes to the skin and mucous membranes.
A. Infection spreads from the urinary tract to the bloodstream.
A nurse is caring for a client with renal calculi. Which drug does the nurse expect the physician to order? A. Opioids analgesics B. Nonsteroidal anti-inflammatory drugs C. Muscle relaxants D. Salicvlates
A. Opioids analgesics
A nurse has provided instructions to a female client with cystitis about measures to prevent recurrence. The nurse determines that the client needs further instruction if the client verbalizes to: A. take bubble baths for more effective hygiene B. wear underwater made of cotton or with cotton panels C. drink a glass of water and void after intercourse D. avoid wearing pantyhose while wearing socks
A. take bubble baths for more effective hygiene
Which statement made by the patient indicates effective learning about tips to prevent urinary tract infections? A. "I should take a bubble bath regularly." B. "| should clean the perineum from front to back." C. "I should drink high fructose cranberry juice daily." D. "I should use spermicidal agents with intercourse."
B. "| should clean the perineum from front to back."
A client has active TB. Which of the following symptoms will he exhibit? A. Chest and lower back pain B. Chills, fever, night sweats, and hemoptysis C. Fever of more than 104*F and nausea D. Headache and photophobia
B. Chills, fever, night sweats, and hemoptysis
Which statements by a female client would indicate that she is at high risk for a recurrence of cystitis? A. "I can go 8 to 10 hours without emptying my bladder." B. "I take a tub bath every evening." C. " I drink herbal tea with each meal." D. "I work out by lifting weights three times a week."
A. "I can go 8 to 10 hours without emptying my bladder."
A client appears dyspneic, but the oxygen saturation is 97%. What action by the nurse is best? A. Assess for other manifestations of hypoxia. B. Change the sensor on the pulse oximeter. C. Obtain a new oximeter from central supply. D. Tell the client to take slow, deep breaths.
A. Assess for other manifestations of hypoxia.
A client with acute respiratory distress syndrome (ARDS) has fine crackles at lung bases, and the respirations are shallow at a rate of 28 breaths/min. The client is restless and anxious. In addition to monitoring the arterial blood gas results, what should the nurse do? Select all that apply. A. Monitor serum creatinine and blood urea nitrogen levels. B. Administer a sedative. C. Keep the head of the bed flat. D. Administer humidified oxygen. E. Auscultate the lungs.
A. Monitor serum creatinine and blood urea nitrogen levels. D. Administer humidified oxygen. E. Auscultate the lungs.
A client is at risk for acute pyelonephritis. The nurse should instruct the client about which health promotion behaviors that will be most effective in preventing pyelonephritis? A. Wash the perineum with warm water and soap, cleaning from front to back. B. Treat fungal infections such as athlete's foot immediately. C. Have a pneumonia immunization to prevent streptococcal infection. D. Treat skin lesions with antibiotics, and cover any open lesions.
A. Wash the perineum with warm water and soap, cleaning from front to back.
Which clinical assessment findings are associated with cystic fibrosis leading to pancreatic abnormalities? SATA A. Weight has remained the same as birth B. Too much fat in the stools C. 8 to 10 liquid stools/day D. Head circumference is 13in, the same as at birth E. Appears active and engaged in surroundings
A. Weight has remained the same as birth B. Too much fat in the stools C. 8 to 10 liquid stools/day
The nurse makes a diagnosis of impaired gas exchange for a patient with COPD in acute respiratory distress, based on the assessment finding of A. a pulse oximetry reading of 86%. B. dyspnea and respiratory rate of 36. C. use of the accessory respiratory muscles D. the presence of crackles in both lungs.
A. a pulse oximetry reading of 86%.
The client with acute renal failure asks the nurse, "Will my kidneys ever function normally again?" What should the nurse tell the client?You will: A. continue to improve over a period of weeks. B. likely need dialysis. C. improve when you have a kidney transplant. D. have more kidney damage in several years.
A. continue to improve over a period of weeks
A nurse is analyzing the laboratory results of a client with chronic renal failure who is receiving epoetin alfa (Epogen). The nurse interprets that the medication is having the expected effect if the results indicate an increase in which of the following levels? A. red blood cells B. potassium C. creatinine D. phosphorus
A. red blood cells
A nurse is teaching a client to use a metered-dose inhaler (MDI) to administer bronchodilator medication. Indicate the correct order of the steps from first to last the client should take to use the MDI appropriately. All options must be used. A.Shake the inhaler immediately before use. B. Hold the breath for 10 seconds, and then exhale. C. Activate the MDI on inhalation. D. Breathe out through the mouth.
A.Shake the inhaler immediately before use. D. Breathe out through the mouth. C. Activate the MDI on inhalation. B. Hold the breath for 10 seconds, and then exhale.
The nurse educates a group of women who have had frequent urinary tract infections (UTIs) about how to avoid recurrences. Which patient statement shows a correct understanding of what the nurse has taught? A. "Urinating 1000 mL on a daily basis is a good amount for me." B. "I should be drinking at least 1.5 to 2.5 liters of fluids every day." C. "It is a good idea for me to reduce germs by taking a tub bath daily." D. "Trying to get to the bathroom to urinate every 6 hours is important for me."
B. "I should be drinking at least 1.5 to 2.5 liters of fluids every day."
The nurse teaches a female client who has cystitis methods to relieve her discomfort until the antibiotic takes effect. Which response by the client would indicate that she understands the nurse's instructions? A. "I will place ice packs on my perineum." B. "I will take warm tub baths." C. "I will drink a cup of warm tea every hour." D. "I will void every 5 to 6 hours."
B. "I will take warm tub baths."
A client with chronic obstructive pulmonary disease (COPD) is experiencing dyspnea and has a low Pa02 level. The nurse plans to administer oxygen as prescribed. Which statement is true concerning oxygen administration to a client with COPD? A. High oxygen concentrations will cause coughing and dyspnea. B. High oxygen concentrations may inhibit the hypoxic stimulus to breathe. C. Increased oxygen use will cause the client to become dependent on the oxygen. D. Administration of oxygen is contraindicated in clients who are using bronchodilators.
B. High oxygen concentrations may inhibit the hypoxic stimulus to breathe.
A client who has been diagnosed with tuberculosis has been placed on drug therapy. The medication regimen includes rifampin. Which instruction should the nurse give the client about potential adverse effects of rifampin? Select all that apply. A. Have eye examinations every 6 months. B. Maintain follow-up monitoring of liver enzymes. C. Decrease protein intake in the diet. D. Avoid alcohol intake. E. The urine may have an orange color.
B. Maintain follow-up monitoring of liver enzymes. D. Avoid alcohol intake. E. The urine may have an orange color.
A client who is 70 years of age and lives alone has stress incontinence. What should the nurse teach the client to do to prevent incontinence? Select all that apply. A. Ask someone else to lift heavy objects. B. Refrain from drinking coffee or alcohol. C. Perform perineal muscle exercises (i.e., Kegel exercises). D. Apply estrogen cream to the urinary meatus after voiding. E. Avoid jumping up and down.
B. Refrain from drinking coffee or alcohol. C. Perform perineal muscle exercises (i.e., Kegel exercises). E. Avoid jumping up and down.
When teaching a patient with chronic obstructive pulmonary disease (COPD) about reasons to quit smoking, the nurse will explain that long-term exposure to tobacco smoke leads to a A. weakening of the smooth muscle lining the airways. B. decrease in the area available for oxygen absorption. C. lesser number of red blood cells for oxygen delivery. D.. decreased production of protective respiratory secretions.
B. decrease in the area available for oxygen absorption.
A client newly diagnosed with tuberculosis (TB is being admitted with the prescription for "isolation precautions for tuberculosis." The nurse should assign the client to which type of room? A. a room at the end of the hall for privacy B. private room to implement airborne precautions C. a room near the nurses station to ensure confidentiality D. a room with windows to allow sunlight
B. private room to implement airborne precautions
Which information should the nurse include in a teaching plan for the client newly diagnosed with chronic obstructive pulmonary disease (COPD)? Select all that apply. A. Pulmonary rehabilitation programs offer very little benefit. B. Pneumococcal vaccination is contraindicated for clients with lung disease. C. High humidity increases the effort of breathing. D. A bronchodilator with metered-dose inhaler should be readily available. E. Smoking cessation is important to slow or stop disease progression.
C. High humidity increases the effort of breathing. D. A bronchodilator with metered-dose inhaler should be readily available. E. Smoking cessation is important to slow or stop disease progression.
A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the clients oxygen saturation has not significantly improved. What response by the nurse is best? A. Breathing so rapidly interferes with oxygenation. B. Maybe the client has respiratory distress syndrome. C. The blood clot interferes with perfusion in the lungs. D. The client needs immediate intubation and mechanical ventilation.
C. The blood clot interferes with perfusion in the lungs.
During assessment of a patient with a history of asthma, the nurse notes wheezing and dyspnea. The nurse will anticipate giving medications to reduce A. laryngospasm. B. pulmonary edema. C. airway narrowing. D. alveolar distention.
C. airway narrowing.
A client is admitted to the hospital with a diagnosis of renal calculi. The client is experiencing severe flank pain and nausea; the temperature is 100.6°F (38.1°C). Which outcome is a priority for this client? A. prevention of urinary tract complications B. alleviation of nausea C. alleviation of pain D. maintenance of fluid and electrolyte balance
C. alleviation of pain
A patient with a history of asthma is admitted to the hospital in acute respiratory distress. During assessment of the patient, the nurse would notify the health care provider immediately about A. a pulse oximetry reading of 90%. B. a peak expiratory flow rate of 240 ml/min. C. decreased breath sounds and wheezing. D. a respiratory rate of 26 breaths/min.
C. decreased breath sounds and wheezing.
The nurse is instructing a client with acute asthma who is taking short-term corticosteroid therapy. The nurse should tell the client that steroids will have which expected outcome? Steroids will: A. promote bronchodilation. B. act as an expectorant. C. have an anti-inflammatory effect. D. prevent development of respiratory infections.
C. have an anti-inflammatory effect.
Which mental status change may occur when a client with pneumonia is first experiencing hypoxia? A. coma B. apathy C. irritability D. depression
C. irritability
Clients who have had active tuberculosis are at risk for recurrence. Which condition increases that risk? A. cool and damp weather B. active exercise and exertion C. physical and emotional stress D. rest and inactivity
C. physical and emotional stress
Which question best helps the nurse establish a common cause of recurrent urinary tract infections (UTIs) in a preadolescent female client? A. "When was your last UTI?" B. "How often do you shower?" C. "Do you have a family history of urinary problems?" D. "In what direction do you wipe after a bowel movement?"
D. "In what direction do you wipe after a bowel movement?"
A community health nurse is conducting an educational session with community members regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with tuberculosis is: A. Dyspnea B. Chest pain C. A bloody, productive cough D. A cough with the expectoration of mucoid sputum
D. A cough with the expectoration of mucoid sputum
Which statement best describes the progression of AKI requiring hemodialysis? A. Once the condition improves you can be placed on peritoneal dialysis for the rest of your life B. You will need to have a renal transplant C. This condition will progress to chronic renal failure eventually D. AKI is abrupt in onset and often reversible If recognized early and treated appropriately
D. AKI is abrupt in onset and often reversible If recognized early and treated appropriately
A client with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/min, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. What should the nurse do first? A. Initiate oxygen therapy as prescribed, and reassess the client in 10 minutes. B. Draw blood for an arterial blood gas. C. Encourage the client to relax and breathe slowly through the mouth. D. Administer bronchodilators as prescribed.
D. Administer bronchodilators as prescribed.
Which nursing intervention or practice is most effective in helping to prevent urinary tract infection (UTI) in hospitalized patients? A. Encouraging them to drink fluids B. Irrigating all catheters daily with sterile saline C. Recommending that catheters be placed in all patients D. Periodically reevaluating the need for indwelling catheters
D. Periodically reevaluating the need for indwelling catheters
Kegel exercises are most likely to help with which type of incontinence? A. Overflow B. Urge C. Mixed D. Stress
D. Stress
Which antibody is associated with allergic (EXTRINSIC) asthma?
IgE (Immunoglobulin)
Describe a pneumothorax
Air in the pleural space
Spilling of protein in the urine is associated with what renal condition?
Glomerulonephritis
________ can lead to bladder stone formation
Infection
A severe asthma attack unresponsive to routine therapy that can be life threatening if not reversed is known as
Status asthmaticus
Describe a pleural effusion
fluid in the pleural space
What is hospital acquired pna (pneumonia) ? Select all that apply A. PNA caused by a virus B. PNA that occurs 48 hours or more after admission to a hospital C. PNA diagnosed within 48 hours after admission a hospital D. Bacterial PNA
B. PNA that occurs 48 hours or more after admission to a hospital D. Bacterial PNA
Glomerular filtration rate (GFR) refers to the: A. filtration of urine in the glomeruli of Bowman's capsule B. filtration of plasma per unit of time in the glomeruli C. amount of potassium filtered in the glomeruli D. amount of urine leaving the loop of Henle in the glomeruli
B. filtration of plasma per unit of time in the glomeruli
The most common type of renal stone is A. Uric acid B. Struvite C. Calcium D. Cysteine
C. Calcium
Orthopnea is seen in patients with: A. Asthma B. PNA C. Heart failure D. Sleep apnea
C. Heart failure
Cystic fibrosis is associated with... A. Emphysema B. Chronic bronchitis C. Asthma D. Bronchiectasis
D. Bronchiectasis
What is the most common sign of renal calculi? A. Vomiting B. Hematuria C. Pain D. Oliguria
C. Pain
Pleural effusion is the accumulation of fluid in the ______ space
Pleural
_____ would cause a patient to present with a deviated trachea and respiratory distress.
Pneumothorax
Strong urge to void followed by an episode of incontinence Is _________ incontinence
Urge incontinence
