Pathophysiology Practice Questions
Which type of diabetes mellitus is associated with the destruction of pancreatic beta cells, which secrete insulinbetes mellitus A. Type 1 b. Type 2 diabetes mellitus c. Gestational diabetes mellitus d. Other specific types of diabetes mellitus
A. Type 1 diabetes mellitus
Which laboratory values would be expected in the client with nephrotic syndrome? a. Low total cholesterol and LDL level b. Low triglycerides and high LDL levels c. High HDL and high LDL levels d. High total cholesterol and high LDL levels
d. High total cholesterol and high LDL levels
Which statement by a client who has a new diagnosis of non-Hodgkin lymphoma (NHL) demonstrates a sound understanding of the diagnosis and treatment of the health problem? a. "They confirmed my diagnosis with a lymph node biopsy and I'll get radiation treatment soon because it's fairly early stage." b. "They took a sample of my lymph nodes and I'll be having surgery soon that will hopefully cure my lymphoma." c. "My blood work came back positive for NHL, and I'm meeting with my oncologist to discuss chemotherapy soon." d. "Since the tests show NHL, I'm going to pursue my options for palliative care because I'm committed to dying with dignity."
a. "They confirmed my diagnosis with a lymph node biopsy and I'll get radiation treatment soon because it's fairly early stage."
In which individuals would a clinician most suspect multiple myeloma as a diagnosis? a. A 40-year-old man who has had 3 broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated. b. A 68-year-old former coal miner who has white blood cell levels exponentially higher than normal ranges. c. An 81-year-old male resident of a long-term care home who has an uncommon bacterial pneumonia and who is unable to produce a fever. d. A 70-year-old woman whose blood work reveals large numbers of immature granulocytes.
a. A 40-year-old man who has had 3 broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated.
Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"? a. A middle-aged overweight adult with a fasting plasma glucose level of 122mg/dL with follow-up Glucose Tolerance Test of 189 mg/dL b. A school-aged child who had a blood glucose level of 115mg/dL following lunch. c. A retired female registered nurse with a fasting plasma glucose level of 92 mg/dL. d. An elderly client who got "light-headed" when he skipped his lunch. Blood glucose level was 60 mg/dL at the time.
a. A middle-aged overweight adult with a fasting plasma glucose level of 122mg/dL with follow-up Glucose Tolerance Test of 189 mg/dL
A patient has a chest tube present secondary to a large left-sided pneumothorax after sustaining multiple fractured ribs in a motor vehicle accident. What does the nurse expect to find on assessment of this client? a. Absent left-sided breath sounds in the left lower lobe of the lung b. Absent right-sided breath sounds in the right lower lobe of the lung c. Normal breath sounds throughout both lungs d. Equal movement of the chest with inspiration
a. Absent left-sided breath sounds in the left lower lobe of the lung
Which of the following is the primary concept involving the pathophysiology of diabetes mellitus, which is described as insulin secretion that is too low in relation to the blood glucose level? a. Absolute insulin deficiency b. Relative insulin deficiency c. Insulin resistance d. Hyperglycemia
a. Absolute insulin deficiency
The parents of the child with a new diagnosis of Sickle Cell Disease should be aware that their child is at a significant risk for which of the following health problems? Select all that apply. a. Acute pain b. Stroke c. Increase risk for infection d. Autoimmune diseases e. Fractures
a. Acute pain b. Stroke c. Increase risk for infection
Which of the following residents of a long-term facility is exhibiting clinical manifestations of hypothyroidism? a. An 80-year-old woman who has uncharacteristically lost her appetite and often complains of feeling cold b. A 90-year-old woman with a history of atrial fibrillation whose arrhythmia has recently become more severe c. An 88-year-old man with a history of Alzheimer's disease who has become increasingly agitated and is wandering around the facility more frequently d. A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis
a. An 80-year-old woman who has uncharacteristically lost her appetite and often complains of feeling cold
Which statement most accurately conveys an aspect of lymphatic system activity? a. B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures. b. B cells and macrophages are released from the bone marrow in their completed state. c. Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis. d. Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system.
a. B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures.
A diabetic client presents to the clinic. He is concerned his lower legs are "feeling funny." Which of the following assessment findings lead the health care provider to suspect the client may have developed somatic neuropathy? Select all that apply. a. Both legs appear to be the same as far as numbness is involved. b. Bilateral cool ankles and feet. c. Inability to empty bladder after urination. d. Client complains of a severe sensation of burning on bilateral feet. e. One leg has a reddened area in the calf.
a. Both legs appear to be the same as far as numbness is involved. b. Bilateral cool ankles and feet.
In which stage of Type 2 diabetes does insulin resistance increase further, fasting plasma glucose levels may remain normal, but postprandial plasma glucose level rise? a. First stage b. Second stage c. Third stage d. None of the above
a. First stage
In which stage of Type 2 diabetes does insulin resistance increase further, fasting plasma glucose levels may remain normal, but postprandial plasma glucose level rise? a. First stage b. Second stage c. Third stage d. None of the above
a. First stage
Which glycoprotein is responsible for treating such diseases as bone marrow failure following chemotherapy and hematopoietic neoplasms such as leukemia? a. Growth factors and cytokines. b. Neutrophils and eosinophils. c. T lymphocytes and natural killer cells. d. Natural killer cells and granulocytes.
a. Growth factors and cytokines.
Which assessment and laboratory findings would be most closely associated with acute leukemia? a. High blast cell counts and fever b. Decreased oxygen partial pressure and weight loss c. Increased serum potassium and sodium levels d. Increased blood urea nitrogen and bone pain
a. High blast cell counts and fever
Which assessment and laboratory findings would be most closely associated with acute leukemia? a. High blast cell counts and fever b. Decreased oxygen partial pressure and weight loss c. Increased serum potassium and sodium levels d. Increased blood urea nitrogen and bone pain
a. High blast cell counts and fever
A child with asthma is walking outside and develops a bronchospasm. The school nurse knows this bronchospasm has what effects on bronchioles with a. Impaired airflow b. Exerting tension on the bronchiole walls c. Causing atelectasis in posterior lung segments d. Inhibiting the filtering of dust particles
a. Impaired airflow
The nurse is caring for a client with nephrosis and notes generalized edema. The nurse attributes this finding to which processes? Select all that apply. a. Increased permeability of glomerular capillaries b. Decreased tubular reabsorption of sodium c. Decreased serum albumin d. Increased aldosterone levels e. Increased glomerular pressures
a. Increased permeability of glomerular capillaries b. Decreased tubular reabsorption of sodium e. Increased glomerular pressures
Leukemias are classified according to the predominant cell type. The myelogenous cell type of leukemia can: a. Interfere with thrombocyte cell maturation b. Originate in marrow and infiltrate nodes c. Affect B and T stem cells in bone marrow d. Transform mature cells into immature ones
a. Interfere with thrombocyte cell maturation
Which factors contribute to diminished expiratory airflow in individuals with obstructive lung disease? Select all that apply. a. Loss of elastic recoil in small airways b. Decreased distensibility of lung tissue c. Decreased mucosal inflammation d. Increased mucus secretion e. Bronchodilation
a. Loss of elastic recoil in small airways d. Increased mucus secretion
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, atopic or allergic asthma? a. Perfume b. Cold weather c. Stress d. Respiratory tract infections
a. Perfume
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, atopic or allergic asthma? a. Pet dander b. Cold weather c. Stress d. Respiratory tract infections
a. Pet dander
A 2-week-old infant presents with persistent and increasing jaundice. Blood testing reveals that the infant's unconjugated bilirubin level is 28 mg/dL, and assessment does not reveal neurologic deficits. The infant's weight is normal, and the mother claims to have had no significant difficulty feeding the infant. The most likely treatment for this infant will be: a. Phototherapy b. Packed red blood cell transfusion c. Phlebotomy d. Intravenous antibiotics
a. Phototherapy
Which of the following are clinical manifestations of Diabetes Ketoacidosis? Select all that apply. a. Polyuria b. Weight loss c. Kussmaul respiration d. Fluid overload e. Cardiac arrhythmias
a. Polyuria b. Weight loss c. Kussmaul respiration
A client has undergone a lymph node biopsy. The nurse anticipates that the report will reveal which of the following if the client has Hodgkin's lymphoma? a. Reed-Sternberg cells b. Philadelphia chromosome c. Epstein-Barr virus d. Herpes simplex virus
a. Reed-Sternberg cells
A client has undergone a lymph node biopsy. The nurse anticipates that the report will reveal which of the following if the client has Hodgkin's lymphoma? a. Reed-Sternberg cells b. Philadelphia chromosome c. Epstein-Barr virus d. Herpes simplex virus
a. Reed-Sternberg cells
The nurse is analyzing the lab results for a client admitted with an acute gastrointestinal bleed. a. Reticulocyte b. Hemoglobin Mean Corpuscular volume (MCV) c. Mean Corpuscular Hemoglobin concentration (MCHC) d. Hemoglobin
a. Reticulocyte
The nurse is analyzing the lab results for a client admitted with an acute gastrointestinal bleed. An elevation in which lab value would indicate that there was an increase in red blood cell production? a. Reticulocyte b. Hemoglobin Mean Corpuscular volume (MCV) c. Mean Corpuscular Hemoglobin concentration (MCHC) d. Hemoglobin
a. Reticulocyte
The primary reason for airway obstruction early in an allergic asthma attack? a. Severe bronchoconstriction b. Infiltration of the bronchi with inflammatory white blood cells c. Dilation and collapse of respiratory bronchioles d. Excessive mucous secretion
a. Severe bronchoconstriction
A nurse is providing care for a client who has been admitted with a newly diagnosed bilateral pleural effusion. Which finding from the nurse's initial assessment of the client is incongruent with the client's diagnosis and would require further investigation? a. The client reports sharp pain exacerbated by deep inspiration. b. The client's breath sounds are diminished on auscultation. c. Pulse oximetry indicates that the client is hypoxemic. d. The client reports dyspnea and increased work of breathing.
a. The client reports sharp pain exacerbated by deep inspiration.
Which type of diabetes mellitus is associated with the destruction of pancreatic beta cells, which secrete insulin? a. Type 1 diabetes mellitus b. Type 2 diabetes mellitus c. Gestational diabetes mellitus d. Other specific types of diabetes mellitus
a. Type 1 diabetes mellitus
An older adult man reports recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which clinical manifestations would the health care provider expect prior to the resolution of this health problem? a. Urinary frequency and urgency and pain b. Development of renal calculi and renal cysts c. Unilateral hydronephrosis and pain d. Development of glomerulonephritis or nephritic syndrome
a. Urinary frequency and urgency and pain
An older adult man reports recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which clinical manifestations would the health care provider expect prior to the resolution of this health problem? a. Urinary frequency and urgency and pain b. Development of renal calculi and renal cysts c. Unilateral hydronephrosis and pain d. Development of glomerulonephritis or nephritic syndrome
a. Urinary frequency and urgency and pain
The most damaging effects of urinary obstruction would be ongoing obstruction of urine outflow and: a. Urinary stasis b. Concentrated urine c. Kidney hyperplasia d. Renal hypertension
a. Urinary stasis
Which of the following clients is most susceptible to experiencing the effects of inadequate erythropoiesis? A client: a. Who has developed renal failure as a result of long-standing hypertension b. Who recently experienced an ischemic stroke and who remains bedridden c. Whose heavy alcohol use has culminated in a diagnosis of pancreatitis d. Whose estimated blood loss during recent surgery was 700 mL
a. Who has developed renal failure as a result of long-standing hypertension
A client with type 2 diabetes has routine lab work, which reveals elevated free fatty acids (FFA). The client asks, "Why is this significant?" The most accurate response would be: a. Your pancreas is affected by increased fat (lipotoxicity), which causes beta cell dysfunction, leading to the need for insulin b. Excess fat in the liver causes a decrease in hepatic glucose production leading to a severe hypoglycemia. c. Nonalcoholic fatty liver disease may lead to needing a liver transplant. d. Excess fatty acids may interfere with the way your body responds to an infection
a. Your pancreas is affected by increased fat (lipotoxicity), which causes beta cell dysfunction, leading to the need for insulin
A patient on a low-carbohydrate high-protein diet presents with fruity breath and ketones in the urine. The pathophysiology behind this finding is the result of a. the catabolism of fats b. the accumulation of glucose c. accumulation of carbon dioxide (CO2) d. the catabolism of polysaccharides
a. the catabolism of fats
A client's primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the following instructions should the client be given? a. "You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample." b. "The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals." c. "They'll take a blood sample and see how much sugar is attached to your red blood cells." d. "You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample."
b. "The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals."
A client has recently been diagnosed with renal calculi and asks the nurse, "What should I be eating to prevent stone formation?" What is the most appropriate response to the client'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 do not need to change your diet, but now that you have stones in one kidney, you are 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."
A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect? a. "You can expect your blood results, fatigue, and susceptibility to the infection to gradually worsen over a few years." b. "You could remain in the chronic stage of CML for several years before it accelerates and culminates in a crisis." c. "It's likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms." d. "Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don't treat it immediately."
b. "You could remain in the chronic stage of CML for several years before it accelerates and culminates in a crisis."
A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect? a. "You can expect your blood results, fatigue, and susceptibility to infection to gradually worsen over a few years." b. "You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis." c. "It's likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms." d. "Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don't treat it immediately."
b. "You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis."
A 51-year-old female client who is 2 days postoperative in a surgical unit of a hospital is at risk of developing atelectasis as a result of being largely immobile. Which teaching point by her nurse is most appropriate? a. "Being in bed increases the risk of fluid accumulating between your lungs and their lining, so it's important for you to change positions often." b. "You should breathe deeply and cough to help your lungs expand as much as possible while you're in bed." c. "Make sure that you stay hydrated and walk as soon as possible to avoid our having to insert a chest tube." d. "I'll prescribe bronchodilator medications that will help open up your airways and allow more oxygen in."
b. "You should breathe deeply and cough to help your lungs expand as much as possible while you're in bed."
A 41-year-old male client has presented to the emergency department with an acute onset of increased respiratory rate and difficulty breathing. STAT chest X-ray indicates diffuse bilateral infiltrates of his lung tissue and ECG displays no cardiac dysfunction. What is this client's most likely diagnosis?? a. Cor pulmonale b. Acute lung injury /Acute Res Syndrome c. Pulmonary hypertension d. Sarcoidosis
b. Acute lung injury /Acute Res Syndrome
A 41-year-old male client has presented to the emergency department with an acute onset of increased respiratory rate and difficulty breathing. STAT chest X-ray indicates diffuse bilateral infiltrates of his lung tissue and ECG displays no cardiac dysfunction. What is this client's most likely diagnosis? a. Cor pulmonale b. Acute lung injury /Acute Respiratory Distress Syndrome c. Pulmonary hypertension d. Sarcoidosis
b. Acute lung injury /Acute Respiratory Distress Syndrome
Jaundice occurs when there is an excess of: a. White Blood Cells b. Bilirubin c. Urobilinogen d. Neutrophils
b. Bilirubin
Leukocytes consist of three categories of cells that have different roles in the inflammatory and immune responses. Which of the following leukocytes is correctly matched with its function? a. Lymphocyte—phagocytosis b. Eosinophils—allergic reactions c. Basophils—engulf antigens d. Monocytes—release heparin
b. Eosinophils—allergic reactions
Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease? a. Hypopituitarism b. Excess ACTH production by a pituitary tumor c. Autoimmune destruction of the adrenal cortex d. Malfunction of the HPA system
b. Excess ACTH production by a pituitary tumor
A middle-aged woman is admitted with acute pyelonephritis. Which assessment finding correlates with this diagnosis? a. poorly controlled hypertension b. Flank pain, dysuria, and nausea/vomiting c. systemic infection d. scarring and deformation of the renal calyces and pelvis
b. Flank pain, dysuria, and nausea/vomiting
A school nurse is working with a 16-year-old client recovering from mononucleosis. Which activities should the nurse recommend the teenager avoid while recovering? Select all that apply. a. Swimming b. Football c. Hockey d. Golfe. Tennis
b. Football c. Hockey
A school nurse is working with a 16-year-old client recovering from mononucleosis. Which activities should the nurse recommend the teenager avoid while recovering? Select all that apply. a. Swimming b. Football c. Hockey d. Golf e. Tennis
b. Football c. Hockey
Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal: a. Glaucoma b. Hemorrhages c. Dehydration d. Infections
b. Hemorrhages
Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal: a. Glaucoma b. Hemorrhages c. Dehydration d. Infections What is the
b. Hemorrhages
The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate (struvite) stones based on which of the following urinalysis results? a. Elevated uric acid levels b. High urine phosphate level c. Low bacterial count d. Presence of cystine particles
b. High urine phosphate level
Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory: a. Hypoactive bone marrow b. Increased erythropoiesis c. Iron retention in the body d. Shrinkage of the spleen
b. Increased erythropoiesis
As a consequence of long-standing lung disease, a client is in a chronic state of hypoxia. Which phenomena would the client's care team be most justified in anticipating? Select all that apply. a. Metabolic alkalosis b. Increased erythropoietin production c. Pulmonary vasodilation d. Hyperventilation e. Personality changes
b. Increased erythropoietin production d. Hyperventilation e. Personality changes
As a consequence of long-standing lung disease, a client is in a chronic state of hypoxia. Which phenomena would the client's care team be most justified in anticipating? Select all that apply. a. Metabolic alkalosis b. Increased erythropoietin production c. Pulmonary vasodilation d. Hyperventilation e. Personality changes
b. Increased erythropoietin production d. Hyperventilation e. Personality changes
A client visited his health care provider after finding an enlarged lymph node along the mediastinal border. The health care provider may be alerted to a possible diagnosis of Hodgkin lymphoma (HL) based on the client having which other clinical manifestations? Select all that apply. a. Yeast infection in the mouth b. Night sweats c. Unexplained pruritus d. Joint swelling e. Sore throat with pustules on tonsils.
b. Night sweats c. Unexplained pruritus d. Joint swelling
Which of the following is not a factor that results in Type 1 diabetes? a. Genetics b. Obesity c. Environment d. Autoimmunity
b. Obesity
Which of the following is not a factor that results in Type 1 diabetes? a. Genetics b. Obesity c. Environment d. Autoimmunity
b. Obesity
A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis? a. Auscultating the client's lungs b. Palpating the client's lymph nodes c. Assessing the client's cranial nerve reflexes d. Assessing the client for bone pain
b. Palpating the client's lymph nodes
A teenaged cystic fibrosis client presents to the clinic. The health care provider (HCP) knows that cystic fibrosis (CF) causes severe chronic respiratory disease in children. In addition, the HCP should also focus his or her assessment on which of the other body systems affected by CF? a. Renal b. Pancreatic c. Cardiac d. Central nervous system
b. Pancreatic
A client with a history of emphysema from long-term cigarette smoking has lost many alveoli. Which of the following physiologic function of the type II alveoli, is affected a. Facilitation of bronchial circulation b. Production of surfactant c. Gas exchanged. d. Production of macrophages
b. Production of surfactant
A client with a history of emphysema from long-term cigarette smoking has lost of many alveoli. Which of the following physiologic function of the type II alveoli, is affected a. Facilitation of bronchial circulation b. Production of surfactant c. Gas exchange d. Production of macrophages
b. Production of surfactant
The health care provider diagnosed the patient with pyuria. The patient asks you what does that mean. You explain as follow: a. Blood in the urine b. Pus in the urine c. Pain when urinating d. A healthy urine
b. Pus in the urine
A 32-year-old woman presents at her health clinic complaining of weakness, feeling of abdominal fullness, 6-month history of fatigue and night sweats. She added a multivitamin with iron and some extra meat and leafy greens to her diet but has not experienced an increase in energy. Upon assessment, her spleen was noted to be enlarged. Which diagnosis is most likely associated with her manifestations? a. Accelerated chronic myelogenous leukemia b. Stage A Hodgkin disease c. Infectious mononucleosis d. Chronic lymphocytic leukemia
b. Stage A Hodgkin disease
A young adult with a history of intermittent flank pain, repeated urinary tract infections (UTIs), and hematuria is diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which pathophysiologic abnormality most likely has contributed to the development of ADPKD? a. UTIs coupled with an impaired immune response have caused the ADPKD. b. The client has inherited a tendency for epithelial cells in the tubules to proliferate inappropriately. c. Severe hypertension and portal hypertension are likely precursors. d. The client has inherited undersized kidneys that are prone to calculi formation
b. The client has inherited a tendency for epithelial cells in the tubules to proliferate
A young adult with a history of intermittent flank pain, repeated urinary tract infections (UTIs), and hematuria is diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which pathophysiologic abnormality most likely has contributed to the development of ADPKD? a. UTIs coupled with an impaired immune response have caused the ADPKD. b. The client has inherited a tendency for epithelial cells in the tubules to proliferate inappropriately. c. Severe hypertension and portal hypertension are likely precursors. d. The client has inherited undersized kidneys that are prone to calculi formation.
b. The client has inherited a tendency for epithelial cells in the tubules to proliferate inappropriately.
A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which aspect of her condition would help to rule out Hodgkin lymphoma? a. Her neoplasm originates in secondary lymphoid structures. b. The lymph nodes involved are located in a large number of locations in the lymphatic system. c. The presence of Reed-Sternberg cells has been confirmed. d. The woman complains of recent debilitating fatigue.
b. The lymph nodes involved are located in a large number of locations in the
A 14-year-old boy has been diagnosed with infectious mononucleosis. Which pathophysiologic phenomenon is most responsible for his symptoms? a. The Epstein-Barr virus (EBV) is lysing many of the boy's neutrophils. b. Viruses are killing some of his B cells and becoming incorporated into the genome of others. c. EBV inhibits the maturation of white cells within his peripheral lymph nodes. d. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.
b. Viruses are killing some of his B cells and becoming incorporated into the genome of others.
Which of the following are clinical manifestations of Diabetes Ketoacidosis? Select all that apply. a. Polyuria b. Weight loss c. Kussmaul respiration d. Fluid overload e. Cardiac arrhythmias
b. Weight loss c. Kussmaul respiration
A client is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering: a. a bronchodilator. b. a corticosteroid. c. aspirin. d. an albuterol inhaler.
b. a corticosteroid.
When caring for a client with any type of anemia, the nurse knows that most of the manifestations assessed are caused by a. tissue hypoxemia b. the irregular shape of the red blood cells c. retention of carbon dioxide d. malnutrition
b. the irregular shape of the red blood cells
When caring for a client with any type of anemia, the nurse knows that most of the manifestations assessed are caused by a. tissue hypoxemia b. the irregular shape of the red blood cells c. retention of carbon dioxide d. malnutrition
b. the irregular shape of the red blood cells
Which of the following factors is most strongly associated with the pathogenesis of gallstones? a. Excess serum ammonia and urea levels b. Portal hypertension c. Abnormalities or stasis of bile d. High-cholesterol diet
c. Abnormalities or stasis of bile
Which long-term care resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)? a. A 79-year-old lifetime smoker who reports shortness of breath and pain on deep inspiration. b. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells. c. An 81-year-old male who has a productive cough and recurrent respiratory infections. d. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke.
c. An 81-year-old male who has a productive cough and recurrent respiratory infections.
Which long-term care resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)? a. A 79-year-old lifetime smoker who reports shortness of breath and pain on deep inspiration. b. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells. c. An 81-year-old male who has a productive cough and recurrent respiratory infections. d. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke.
c. An 81-year-old male who has a productive cough and recurrent respiratory infections.
A pregnant woman tells the nurse that she has a family history of sickle cell disease and is afraid her baby will be born with the disease. The nurse would provide which information during a discussion with the client? a. Sickle cell anemia is a male disease and would be passed on through the man's family. b. Genetic testing will be needed to determine if her fetus is affected. c. Both mother and father must carry the defective gene for the child to have sickle cell disease. d. The child only needs one parent to be a carrier in order for the child to be affected.
c. Both mother and father must carry the defective gene for the child to have sickle cell disease.
Conditions that predispose to sickling of hemoglobin in persons with sickle cell anemia include: a. Impaired red blood cell maturation b. Increased iron content of blood c. Decreased oxygen saturation d. Increased intravascular volume
c. Decreased oxygen saturation
Conditions that predispose to sickling of hemoglobin in persons with sickle cell anemia include: a. Impaired red blood cell maturation b. Increased iron content of blood c. Decreased oxygen saturation d. Increased intravascular volume
c. Decreased oxygen saturation
Which clinical finding would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease (COPD)? a. Audible wheezing on expiration b. Reduced expiratory flow rates c. Decreased tidal volume d. Normal forced expiratory volume
c. Decreased tidal volume
Which clinical finding would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease (COPD)? a. Audible wheezing on expiration b. Reduced expiratory flow rates c. Decreased tidal volume d. Normal forced expiratory volume
c. Decreased tidal volume
A client has just been admitted to the postsurgical unit following a below-the-knee amputation. Which of the following measures should her care team prioritize to prevent atelectasis during the client's immediate recovery? a. Bedrest and supplementary oxygen by nasal cannula b. Administration of bronchodilators by nebulizer c. Deep-breathing exercises and early mobilization d. Adequate hydration and a high-humidity environment
c. Deep-breathing exercises and early mobilization
Which condition is described as visual impairment caused by excessive vascular occlusion or vascular permeability? a. Retinal detachment b. Retinopathy c. Glaucoma d. Cataract
c. Glaucoma
A 62-year-old Caucasian male with a past medical history of renal calculi is seen in the office with complaints of mild right-sided flank pain that started suddenly today and nausea without vomiting. The nurse knows that the acute management in the clinic involves: a. Scheduling a CT scan. b. Scheduling an ultrasound or plain x-rays films. c. Having the client drink fluids, take pain medication and strain the urine. d. Sending the client to the emergency room.
c. Having the client drink fluids, take pain medication and strain the urine.
While explaining the physiology of type 2 diabetes to a group of nursing students, the clinical instructor reviews which of the following accurate information? a. The destruction of beta cells and absolute lack of insulin in people with type 2 diabetes means that they are particularly prone to the development of diabetic complication. b. Because of the loss of insulin response, all people with type 2 diabetes require exogenous insulin replacement to control blood glucose levels c. In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance. d. They have increased predisposition to other autoimmune disorders such as Graves disease, rheumatoid arthritis, and Addison disease.
c. In skeletal muscle, insulin resistance prompts decreased uptake of glucose. Following meals (postprandial), glucose levels are higher due to diminished efficiency of glucose clearance.
A 44-year-old hospitalized client with a diagnosis of end-stage acquired immunodeficiency syndrome (AIDS) has been placed on neutropenic precautions that limit his interaction with visitors, staff, and other clients. What is the underlying rationale for these precautions? a. His antibody-mediated immunity is compromised by his low production of neutrophils. b. Neutropenia limits the ability of his CD4+ helper cells to present antigens c. Insufficient levels of neutrophils make him particularly susceptible to infections. d. Cyclic neutropenia limits his body's ability to fight various infections.
c. Insufficient levels of neutrophils make him particularly susceptible to infections
A 72-year-old woman with complaints of increasing fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this client's gastrointestinal bleed? a. Hemolytic anemia b. Aplastic anemia c. Iron deficiency anemia d. Megaloblastic anemia
c. Iron deficiency anemia
A 72-year-old woman with complaints of increasing fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this client's gastrointestinal bleed? a. Hemolytic anemia b. Aplastic anemia c. Iron deficiency anemia d. Megaloblastic anemia
c. Iron deficiency anemia
Sue is fatigued, and some blood tests are done. Her results include Hct 40%; Hgb 8g/dL; WBC 8000 and platelets 175,000. The nurse should interpret Sue's blood work as indicative of: a. High platelets/thrombocytosis b. Low WBC count/granulocytopenia c. Low hemoglobin/anemia d. High hematocrit /polycythemia
c. Low hemoglobin/anemia
The nurse is caring for a client who develops sudden onset dyspnea. Which assessment should the nurse prioritize to best identify if the cause may be a pulmonary embolism? a. Respiratory rate b. Chest auscultation c. Lower limb appearance d. Chest excursion
c. Lower limb appearance
One of the most important strategies in helping clients with sickle cell disease (SCD) is to prevent episodes of crisis is to remind them to: a. Decrease the fluid intake b. Eat more green leafy vegetables c. Maintain adequate hydration d. Exercise daily vigorously for one -hour everyday
c. Maintain adequate hydration
One of the most important strategies in helping clients with sickle cell disease (SCD) is to prevent episodes of crisis is to remind them to: a. Decrease the fluid intake b. Eat more green leafy vegetables c. Maintain adequate hydration d. Exercise daily vigorously for one -hour everyday.
c. Maintain adequate hydration
The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which of the following signs/symptoms? a. Complaints of muscle fatigue b. Facial myxedema with puffy eyelids c. Ophthalmopathy d. Pulse rate of 64 beats/minute
c. Ophthalmopathy
A short, nonsmoking 44-year-old male presents to the emergency room with left-sided chest pain and a cough. He states the pain started abruptly and worsens with deep breathing and coughing. He denies recent injury. Assessment includes shallow respirations with a rate of 36, normal breath sounds, no cyanosis. Which condition is most likely causing his symptoms? a. Myocardial infarction b. Spontaneous pneumothorax c. Pleuritis related to infection d. Obstructive atelectasis
c. Pleuritis related to infection
A client with a diagnosis of type 1 diabetes who is being evaluated by his medical provider has administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin? a. Initiation of fat breakdown b. Promotion of gluconeogenesis c. Promotion of glucose uptake by target cells. d. Promotion of glycogenolysis
c. Promotion of glucose uptake by target cells
An elderly female client has been hospitalized for the treatment of acute pyelonephritis. Which of the following characteristics of the client is most likely implicated in the etiology of her current health problem? a. Has been diagnosed with type 2 diabetes several years earlier b. Takes a diuretic and an ACE inhibitor each day for the treatment of hypertension c. Recently had a urinary tract infection d. Has peripheral vascular disease
c. Recently had a urinary tract infection
A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which aspect of her condition would help to rule out Hodgkin lymphoma? a. Her neoplasm originates in secondary lymphoid structures. b. The lymph nodes involved are located in a large number of locations in the lymphatic system. c. The presence of Reed-Sternberg cells has been confirmed. d. The woman complains of recent debilitating fatigue.
c. The presence of Reed-Sternberg cells has been confirmed.
Mary's husband, John has a diagnosis of type-2 diabetes. He is status post emergency surgery. He is surprised at his high blood sugar readings post surgery. Which of the following factors may have contributed to the client's excessive elevated blood glucose levels a. The tissue trauma of surgery resulted in gluconeogenesis. b. Illness inhibited the release and uptake of glucagon c. The stress of the event caused the release of cortisol. d. Sleep disruption in the hospital precipitated the dawn effect.
c. The stress of the event caused the release of cortisol.
Mary's husband, John has a diagnosis of type-2 diabetes. He is status post emergency surgery. He is surprised at his high blood sugar readings post-surgery. Which of the following factors may have contributed to the client's excessively elevated blood glucose levels a. The tissue trauma of surgery resulted in gluconeogenesis. b. Illness inhibited the release and uptake of glucagon c. The stress of the event caused the release of cortisol. d. Sleep disruption in the hospital precipitated the dawn effect.
c. The stress of the event caused the release of cortisol.
An obese, male client with a history of gout and a sedentary lifestyle has been advised by his primary care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which of the following types of kidney stones a. Calcium stones b. Magnesium ammonium phosphate stones c. Uric acid stones d. Cystine stones
c. Uric acid stones
An obese, male client with a history of gout and a sedentary lifestyle has been advised by his primary care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the client's susceptibility to which of the following types of kidney stones a. Calcium stones b. Magnesium ammonium phosphate stones c. Uric acid stones d. Cystine stones
c. Uric acid stones
A diabetic client presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high)? Which response by the patient may account for this abnormal lab result? a. "I've had more periods of hypoglycemia than usual over the past few months." b. "I've been doing great. I haven't needed much insulin coverage before meals." c. "To tell you the truth, my blood glucose levels have been pretty normal for me." d. "My meter broke so I have not been checking my blood glucose levels for a while."
d. "My meter broke so I have not been checking my blood glucose levels for a while."
Which individual 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
Which individuals would most likely possess normal plasma cell synthesis and fully differentiated myeloid and lymphoid cells? a. A 7-year-old boy with a diagnosis of acute lymphocytic leukemia (ALL). b. A 70-year-old male who has acute myelogenous leukemia (AML) c. A 58-year-old female with HIV and multiple myeloma d. A 78-year-old male who has been diagnosed with chronic lymphocytic leukemia (CLL).
d. A 78-year-old male who has been diagnosed with chronic lymphocytic leukemia (CLL).
A client has been given the diagnosis of diffuse glomerulonephritis. They ask the nurse what diffuse means. The nurse responds: a. Only some of the glomeruli are affected. b. Only one segment of each glomerulus is involved. c. The mesangial cells are being affected d. All glomeruli and all parts of the glomeruli are involved
d. All glomeruli and all parts of the glomeruli are involved
Mr. Jones is being worked up for AML (acute myeloid leukemia), you expect him to complain of which of the following? a. Complaints of bone pain b. Complaints of fatigue c. Anemia d. All of the above
d. All of the above
The client who has a long history of type 1 diabetes is being treated for bronchitis and sinusitis. The nurse observes deep, rapid unlabored respirations, fruity odor on the client's breath and clothes, and dry skin. Which of the following actions should the nurse do next? a. Assess breath sounds for additional signs of response to treatment of the infection. b. Assess blood glucose level for signs of hypoglycemia. c. Encourage the client to rest frequently and to drink 8 to 10 glasses of fluids daily. d. Assess blood glucose level for hyperglycemia and check urine for ketones.
d. Assess blood glucose level for hyperglycemia and check urine for ketones.
A client is admitted to the hospital in Addisonian crisis 1 month after a diagnosis of Addison disease. The nurse knows which clinical manifestation would support this diagnosis? a. Hyperactive deep tendon reflexes and slow, shallow breathing b. Cerebral spinal fluid leakage and impaired swallowing c. Irregular heart rate and decreased temperature d. Change in level of consciousness and profound hypotension
d. Change in level of consciousness and profound hypotension
A 16-year-old female has been brought to her primary care physician by her mother due to the girl's persistent sore throat and malaise. Which fact revealed in the girl's history and examination would lead the physician to rule out infectious mononucleosis? a. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. b. Blood work reveals an increased white blood cell count. c. Her liver and spleen are both enlarged. d. Chest auscultation reveals crackles in her lower lung fields bilaterall
d. Chest auscultation reveals crackles in her lower lung fields bilaterall
A 16-year-old female has been brought to her primary care physician by her mother due to the girl's persistent sore throat and malaise. Which fact revealed in the girl's history and examination would lead the physician to rule out infectious mononucleosis? a. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. b. Blood work reveals an increased white blood cell count. c. Her liver and spleen are both enlarged. d. Chest auscultation reveals crackles in her lower lung fields bilaterally.
d. Chest auscultation reveals crackles in her lower lung fields bilaterally.
Impaired and delayed healing in a person with diabetes is caused by long-term complications that include: a. Ketoacidosis b. Somogyi effect c. Fluid imbalances d. Chronic neuropathies
d. Chronic neuropathies
What is the most likely appearance of pleural fluid removed by thoracentesis in the client with a pleural effusion secondary to lung cancer? a. Clear b. Dark yellow color c. Blood-tinged d. Cloudy
d. Cloudy
What is the mechanism in fuel metabolism that involves formation of glucose or glycogen from non-CHO sources? a. Lipolysis b. Glycogenesis c. Ketogenesis d. Gluconeogenesis
d. Gluconeogenesis
Which laboratory values would be expected in the client with nephrotic syndrome? a. Low total cholesterol and LDL level b. Low triglycerides and high LDL levels c. High HDL and high LDL levels d. High total cholesterol and high LDL levels
d. High total cholesterol and high LDL levels
Following the diagnosis of nephrotic syndrome, the nurse knows the clinical manifestations occur as a result of a decreased plasma colloidal osmotic pressure. Therefore, the nurse should assess the client for: a. Both lung fields clear on auscultation b. Liver enlargement c. Kidneys palpable to deep palpation d. Increased circumference in the abdomen related to fluid excess
d. Increased circumference in the abdomen related to fluid excess
A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which of the following physiologic phenomena will occur as a consequence of hypoxemia? a. Peripheral vasodilation b. Necrosis c. Hypoventilation d. Increased heart rate
d. Increased heart rate
A client has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that most likely originated in which of the following sites? a. Thymus b. Spleen c. Bone marrow d. Lymph nodes
d. Lymph nodes
The nurse is caring for a group of clients and is reviewing the arterial blood gas results for each. Which client should the nurse assess first? The client with: a. morphine infusion and a PaO2 of 80 mm Hg (10.64 kPa) and a PaCO2 of 50 mm Hg (6.65 kPa) b. Chronic obstructive pulmonary disease and a PaO2 of 75 mm Hg (9.98 kPa) and a PaCO2 of 55 mm Hg (7.32 kPa) c. Tuberculosis and a PaO2 of 85 mm Hg (11.30 kPa) and a PaCO2 of 50 mm Hg (6.65 kPa) d. Pneumonia and a PaO2 of 60 mm Hg (7.98 kPa) and PaCO2 of 40 mm Hg (5.32 kPa)
d. Pneumonia and a PaO2 of 60 mm Hg (7.98 kPa) and PaCO2 of 40 mm Hg (5.32 kPa)
A newly admitted critical head injury client presents to the ICU. The client is unresponsive to painful stimuli but able to breathe on his own. The nurse observes a decrease in the client's respiratory effort. The client cannot maintain his O2 saturation above 70%. The nurses should anticipate assisting in beginning what type of pulmonary support? a. Increase oxygen level to 10 L/min. b. Begin Bi-PAP. c. Call respiratory therapy to suction the client d. Prepare for mechanical ventilation.
d. Prepare for mechanical ventilation
A newly admitted critical head injury client presents to the ICU. The client is unresponsive to painful stimuli but able to breathe on his own. The nurse observes a decrease in the client's respiratory effort. The client cannot maintain his O2 saturation above 70%. The nurses should anticipate assisting in beginning what type of pulmonary support? a. Increase oxygen level to 10 L/min. b. Begin Bi-PAP. c. Call respiratory therapy to suction the client d. Prepare for mechanical ventilation.
d. Prepare for mechanical ventilation.
A 48-year-old male client, who normally enjoys good health, has been admitted to the hospital for the treatment of polycythemia vera. The nurse who is providing care for the client should prioritize assessments aimed at the early identification of which of the following health problems? a. Orthostatic hypotension b. Hyperventilation c. Vasculitis d. Thromboembolism
d. Thromboembolism
Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal lung volume instead of low lung volumes, which result in a. Airway constriction of the main bronchus b. Release of epinephrine, a catecholamine, which causes airway dilation c. An increase in the physiological dead space in alveoli that are perfused but not ventilated d. Trapping of large amounts of air that cannot participate in gas exchange
d. Trapping of large amounts of air that cannot participate in gas exchange
Which of the following individuals is experiencing the effects of a primary endocrine disorder? A client: a. With adrenal cortical insufficiency due to pituitary hyposecretion of ACTH b. Who has hypothyroidism as a result of low TSH production c. Whose dysfunctional hypothalamus has resulted in endocrine imbalances d. Who has low calcium levels because of the loss of his parathyroid gland
d. Who has low calcium levels because of the loss of his parathyroid gland
Which of the following individuals is experiencing the effects of a primary endocrine disorder? A client: a. With adrenal cortical insufficiency due to pituitary hyposecretion of ACTH b. Who has hypothyroidism as a result of low TSH production c. Whose dysfunctional hypothalamus has resulted in endocrine imbalances d. Who has low calcium levels because of the loss of his parathyroid gland
d. Who has low calcium levels because of the loss of his parathyroid gland
