Pathophysiology Quizzes

The nurse is hearing diminished breath sounds and a "grating" sound during respirations. This is consistent with excess collection of fluid in the pleural cavity. The medical term for this is: a. Pleurisy b. Pleural effusion c. Pneumothorax d. Poor lung compliance

b. Pleural effusion

While volunteering in an HIV clinic in a big city, the nurse notices a new mom and her 6-month old child in the waiting room. Upon assessing the infant for possible HIV infection, the nurse will be assessing for which clinical manifestations of HIV infection? Select all that apply. a. Weighing him to determine if he is gaining 1.5 to 2 pounds/month. b. Observing to see if he can roll over from back to stomach. c. Lack the coordination to play with toys/stuffed animals. d. History of repeated episodes of bacterial pneumonia and ear infections. e. Listlessness and poor eye contact.

a. Weighing him to determine if he is gaining 1.5 to 2 pounds/month. c. Lack the coordination to play with toys/stuffed animals. d. History of repeated episodes of bacterial pneumonia and ear infections. e. Listlessness and poor eye contact.

A client with small cell lung cancer (SCLC) has developed a paraneoplastic syndrome called Cushing syndrome. Based on this new complication, the nurse will likely assess which clinical manifestation of Cushing syndrome? a. Weight gain, moon face, buffalo hump, purple striae on abdomen. b. Bilateral edema in arms, swollen face, protruding eyes. c. Severe bone/joint pain, nausea/vomiting, polyuria d. Tetany, new onset seizure activity, emotional lability and extrapyramidal symptoms

a. Weight gain, moon face, buffalo hump, purple striae on abdomen.

A client has been suffering from fatigue and the health care provider suspects anemia. Which test results will the health care provider consult when investigating the cause of the anemia? a. Red blood cell (RBC) b. Hemoglobin c. RBC indices d. Hematocrit

c. RBC indices

Which statement most accurately captures a principle of blood flow? a. With constant pressure, a small increase in vessel radius results in an exponential increase in blood flow. b. Blood flow is primarily determined by blood viscosity and temperature. c. Blood flows most quickly in the small-diameter peripheral capillaries. d. Smaller cross-sectional vessel area is associated with lower flow velocity.

a. With constant pressure, a small increase in vessel radius results in an exponential increase in blood flow.

Which pain descriptions would lead the nurse to suspect the client is experiencing ureteral colic? a. Right upper quadrant pain that worsens with deep breaths and palpation b. Excruciating pain in the flank and upper outer quadrant of abdomen that radiates to bladder area c. Pain described as "fire poking in my side" pulsating with every heartbeat but decreases when in fetal position d. Perineal pain that increases when urinating and then lessens until time to urinate again

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

Which statement best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system? a. Adrenocorticotropic hormone (ACTH) released by the hypothalamus controls the release of cortisol. b. The pituitary gland communicates with the adrenal cortex through the release of ACTH. c. The adrenal cortex receives corticotropin-releasing hormone (CRH) and in turn releases cortisol. d. The pituitary gland causes a release of CRH from the hypothalamus which promotes hormone release from the adrenal cortex.

b. The pituitary gland communicates with the adrenal cortex through the release of ACTH.

Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which phenomena has facilitated the rapid movement of her hand in response to the painful stimulus? a. Her midbrain has rapidly responded to the nociceptive stimuli and induced arm flexion. b. The withdrawal reflex, a spinal motor reflex, has quickly mediated a quick removal of the body part away from the offending stimulus. c. The forebrain has mediated a protective spinal cord reflex. d. Her ANS has enacted a protective response received by neurons that innervate her arm muscles.

b. The withdrawal reflex, a spinal motor reflex, has quickly mediated a quick removal of the body part away from the offending stimulus.

A client with a newborn infant is also the caregiver for her 75-year-old mother, who lives with them and who has diabetes. The client requests pneumonia vaccinations for her entire household. Which vaccine is most likely to be effective for the baby? a. Since the infant's immune system is mature at birth, regular vaccine is appropriate. b. There is no effective vaccine for newborn infants. c. The 23-valent vaccine will be effective. d. No vaccine is necessary for the baby if the nursing mother is immunized.

b. There is no effective vaccine for newborn infants.

Which statement best conveys a characteristic of red blood cells? a. They lack organelles and soluble enzymes. b. They contribute to the maintenance of blood pH. c. They help maintain the body's fluid balance. d. They are self-replicating.

b. They contribute to the maintenance of blood pH.

Which statements about mesangial cells within the glomerulus are accurate? Select all that apply. a. They cover the entire amount of endothelial cells contained within the capillaries. b. They have phagocytic properties that remove macromolecular materials. c. They exhibit vasodilator properties to assist with increase blood flow in times of stress. d. They enlarge (hyperplasia) in response to glomerular diseases. e. They are coiled and drain Bowman's capsule.

b. They have phagocytic properties that remove macromolecular materials. d. They enlarge (hyperplasia) in response to glomerular diseases.

Which statement best captures an aspect of the process of fat digestion and absorption? a. Ingested triglycerides are broken down into absorbable form by gastric lipase. b. Triglycerides are digested with the aid of bile salts. c. Long-chain fatty acids are absorbed directly into the portal blood. d. Stool is not excreted until all fat is absorbed.

b. Triglycerides are digested with the aid of bile salts.

The nurse is caring for a client with sepsis who has developed disseminated intravascular coagulation (DIC). Which assessments should the nurse prioritize? Select all that apply. a. Platelet count b. Urine output c. Level of consciousness d. Weight e. Oxygen saturation

b. Urine output c. Level of consciousness e. Oxygen saturation

Which process would most likely be considered an anomaly during the cellular phase of inflammation? a. Platelet aggregation b. Vasoconstriction c. Migration of phagocytic white cells d. Macrophage activity

b. Vasoconstriction

Which procedure reduces the potential for infection primarily by addressing the portal of entry? a. Wiping down common areas with buffered bleach on a regular basis b. Wearing gloves when contact with blood or body fluids is anticipated c. Disposing of soiled clothing and bed linens in a dedicated receptacle d. Isolating clients who have antibiotic-resistant infections

b. Wearing gloves when contact with blood or body fluids is anticipated

A client with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which statement most accurately underlies the dominant regulation process of hormone levels in the body? a. A positive feedback cycle ensures that stable levels of hormones exist in the body over time. b. With input from various sensors, hormone production and release are adjusted based on existing hormone levels. c. The hypothalamus ensures that hormone levels correspond accurately to the diurnal cycle. d. The pituitary gland is genetically programmed to stimulate and inhibit hormone production and/or release based on needs at different points in the life cycle.

b. With input from various sensors, hormone production and release are adjusted based on existing hormone levels.

When counseling a male client with suspected HIV, the nurse informs him that if the enzyme-linked immunosorbent assay (ELISA) comes back positive, then: a. no further testing is required since this confirms HIV infection. b. a second test known as the Western blot assay will be ordered to confirm positive HIV status. c. he will be sent to an infectious disease physician for a tissue biopsy to confirm infection. d. if the second test, the Western blot, returns negative, he has not developed a case of full-blown AIDS.

b. a second test known as the Western blot assay will be ordered to confirm positive HIV status.

A nurse practitioner has a 30-year-old male client presenting with fever/chills, urinary frequency/urgency and pain with urination. A urine sample displays cloudy and foul-smelling urine. During digital rectal exam of the prostate, the nurse notes a thick white discharge. A likely diagnosis would be: a. urinary tract infection requiring a prescription of sulfur drugs. b. acute bacterial prostatitis requiring antimicrobial therapy. c. testicular cancer requiring appointment with an urologist. d. inflammation of the epididymis requiring scrotal elevation.

b. acute bacterial prostatitis requiring antimicrobial therapy.

A potential donor is angry at the personal nature of the questions about HIV risk factors that he is required to answer at a blood collection center, and states that simple blood testing should suffice. How can the nurse at the center best respond? a. "There are some very uncommon subtypes of the HIV virus that are not detectable by current testing methods." b. "There's a chance that persons who are asymptomatic but HIV positive can have their antibodies missed by serum testing." c. "There's a period shortly after someone is infected with HIV when blood tests might still be negative." d. "Even though blood tests are completely accurate, the high stakes of blood donation and transfusion mean that double measures are appropriate."

c. "There's a period shortly after someone is infected with HIV when blood tests might still be negative."

A 41-year-old male has presented to his family physician stating that for the last 2 years his erection "is as crooked as a dog's hind leg, and hurts too." He has subsequently been diagnosed with Peyronie disease. Which statement by his physician is most appropriate? a. "Even though it's obviously distressing, you should know that this will likely resolve on its own with time." b. "I'll refer you to a urologist who will likely want to perform a circumcision." c. "This might need surgery but it could possibly disappear over time without needing treatment." d. "There are things you can do to minimize this, such as getting more exercise, stopping smoking, and maintaining a healthy diet."

c. "This might need surgery but it could possibly disappear over time without needing treatment."

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

c. A man who has entered cardiogenic shock following a severe myocardial infarction

A middle school student is scheduled to receive booster immunizations and the father asks the nurse why the booster is necessary. What characteristic of the adaptive immune system listed below would provide the rationale for the nurse's response? a. Some antibodies require a repeat of the primary immune response. b. Some antibodies have a duration measured in months rather than years. c. A secondary response causes a sharp rise in antibody levels. d. Antigen receptors on CD4+ cells require multiple exposures separated by time.

c. A secondary response causes a sharp rise in antibody levels.

During a thyroid crisis, which medication may increase dissociation of free hormone from the binding proteins, resulting in a worsening effect on the client? a. Lisinipril, an ACE-inhibitor b. Atorvastatin, a statin drug c. Acetylsalicylic acid, a nonsteroidal anti-inflammatory drug (NSAID) d. Glucophage, a biguanide

c. Acetylsalicylic acid, a nonsteroidal anti-inflammatory drug (NSAID)

An 81-year-old female client in a subacute medical unit of a hospital has developed an oral Candida albicans infection. Which phenomena would the client's nurse suspect as a key contributing factor to her infection? a. The moist and temperature-suited oral environment of the client's mouth b. The ability of fungi to remain latent until the host reaches an immunocompromised state c. Antibiotic therapy that eliminated normal bacterial flora d. The airborne communicability of yeast and molds and subsequent inhalation

c. Antibiotic therapy that eliminated normal bacterial flora

A client is diagnosed with a stroke that affects the left hemisphere of the brain, and the health care provider has prescribed testing to assess for damage to the glottis. Which action should the nurse take prior to allowing the client to receive food/beverages from the cafeteria? a. Monitor for impaired memory and judgment b. Assess for attention deficits which will determine whether the client can feed oneself without assistance c. Assess ability to swallow and check breath sounds for signs aspiration pneumonia d. Identify whether the client can make reasonable decisions versus poor reasoning skills

c. Assess ability to swallow and check breath sounds for signs aspiration pneumonia

A 70-year-old male client presents to the emergency department reporting pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. The nurse knows that the client is likely experiencing which medical diagnosis/possible treatment plan listed below? a. Acute arterial occlusion that will be treated with angioplasty b. Raynaud disease that will require antiplatelet medications c. Atherosclerotic occlusive disease necessitating thrombolytic therapy d. Giant cell temporal arteritis that will be treated with corticosteroids

c. Atherosclerotic occlusive disease necessitating thrombolytic therapy

Staphylococcus aureus commonly found in the skin, nares, and other body sites of clients without any signs and symptoms of infection is known as which condition? a. An opportunistic infection b. A parasitic infestation c. Bacterial colonization d. A saprophytic infection

c. Bacterial colonization

When talking about the various types of granulocytes, which granule contains heparin, an anticoagulant? a. Neutrophils. b. Eosinophils. c. Basophils. d. Lymphocytes.

c. Basophils.

A client in the intensive care unit is diagnosed with hypovolemic shock based on a blood pressure of 88/53 mm Hg, heart rate of 122 beats/min, respiratory rate of 26 breaths/min. Given these vital signs, what urine output should the nurse expect? a. Maintained between 30 to 50 mL/hour with no sediment in the bag. b. Increased to 60+ mL/hr with dilute urine. c. Decreased below 30 mL/hr with decrease glomerular filtration rate (GFR). d. Client's normal amount with dark, concentrated urine.

c. Decreased below 30 mL/hr with decrease glomerular filtration rate (GFR).

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a client develops watery diarrhea attributed to the elimination of normal intestinal flora. What other phenomena are most likely accompanying the low levels of normal flora? a. Decreased mineral and nutrient absorption; decreased carbohydrate metabolism b. Decreased pH of the stomach; increased pH of the lower gastrointestinal tract c. Decreased fermentation of undigestible dietary residue; decreased vitamin absorption d. Proliferation of vitamin K; lower gastrointestinal bleeding

c. Decreased fermentation of undigestible dietary residue; decreased vitamin absorption

While intubated for surgery, a client has inadvertently had his vagus nerve stimulated. What effect would the surgical team expect to observe? a. Decreased vascular perfusion due to parasympathetic stimulation b. Decreased heart rate, contractility, and afterload c. Decreased heart rate as a result of parasympathetic innervation of the heart d. Decreased heart rate as a result of impaired acetylcholine reuptake

c. Decreased heart rate as a result of parasympathetic innervation of the heart

Your client with end-stage renal disease is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2 g/dL [82 g/L)). Twenty minutes into the first transfusion, the nurse observes the client has a flushed face, hives over upper body trunk, and is reporting pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56. What is the nurse's priority action? a. Slow the rate of the blood infusion to 50 mL/hour. b. Document the assessment as the only action. c. Discontinue the transfusion and begin an infusion of normal saline. d. Recheck the type of blood infusing with the chart documentation of client's blood type.

c. Discontinue the transfusion and begin an infusion of normal saline.

A 62-year-old female with a diagnosis of acute and chronic renal failure secondary to diabetes mellitus is receiving her weekly injection of epoetin, a supplementary form of erythropoietin. Which statement best captures the necessity of this medication? a. Erythropoietin is needed in order for stem cells to proliferate into committed erythroid precursors. b. Erythropoietin is necessary for the accurate sensation of hypoxia that stimulates erythropoiesis. c. Erythropoietin causes the erythrocyte colony-forming units to proliferate and mature. d. Erythropoietin facilitates the extrusion of the reticulocyte nucleus and the formation of true erythrocytes

c. Erythropoietin causes the erythrocyte colony-forming units to proliferate and mature.

Parents of a 20-month-old infant report that he refuses food or eats poorly and that he grimaces when he swallows. He also is irritable and cries a lot. The mother is worried that he ate something inappropriate this morning, because he vomited something that looked like coffee grounds. Which health problem would the care team first suspect? a. Rotavirus infection b. Appendicitis c. Esophagitis from gastrointestinal reflux d. Hirschsprung disease

c. Esophagitis from gastrointestinal reflux

A 38-year-old woman takes clomiphene, an infertility drug that works by competing with, and thereby blocking, cellular receptors for estrogen. Which statement is most likely to be true of this client? a. Receptors for all other steroid hormones will also be blocked. b. Up-regulation will increase the number of estrogen receptors on each target cell. c. Estrogen will continue to pass freely through the cellular membranes. d. Laboratory tests will reveal an increase in cyclic adenosine monophosphate (cAMP) levels.

c. Estrogen will continue to pass freely through the cellular membranes.

A nurse caring for a client who has undergone an antithyroid peroxidase (anti-TPO) antibody test with elevated results should be prepared to educate the client about which disease process? a. Gigantism b. Hyperparathryoidism c. Hashimoto thyroiditis d. Type 2 diabetes

c. Hashimoto thyroiditis

Which infectious agent would be a site-specific pathogen and not spread throughout the body via the circulatory system? A client diagnosed with: a. B. burgdorferi caused by a tick bite. b. Salmonella typhi related to ingestion of contaminated food or water. c. Helicobacter pylori diagnosed after an endoscopic procedure. d. N. meningitidis infection of child in a daycare setting.

c. Helicobacter pylori diagnosed after an endoscopic procedure.

A 39-year-old female with HIV has been characterized as a typical progressor by her care team, and is experiencing an increase in her manifestations and complaints as her CD4+ count declines. Which health problem would her care team most likely attribute to a cause other than her HIV? a. Her recent diagnosis of bacterial pneumonia b. Her esophagitis that has been linked to herpes simplex infection c. Her decreased bone density and recent fractures d. Her increasing confusion and disorientation

c. Her decreased bone density and recent fractures

When explaining to parents what is occurring when their child has an acute bronchial asthma attack, the nurse will emphasize that which mediator is primarily responsible for the bronchial constriction? a. Tree pollen b. Mold dust c. Histamine d. T-lymphocyte proliferation

c. Histamine

A nurse practitioner is providing care for a male client with a longstanding hiatal hernia. Which statement most accurately captures an aspect of the pathophysiology of hiatal hernias? a. Paraesophageal hiatal hernias are common and are normally not treated if the client is asymptomatic. b. The root causes of hiatal hernias are normally treatable with medication. c. If esophageal acid clearance is impaired, esophagitis can result. d. An incompetent pyloric sphincter and high fat diet are commonly implicated in the development of hiatal hernias.

c. If esophageal acid clearance is impaired, esophagitis can result.

A client has been diagnosed with possible IgA nephropathy. The nurse will educate the client about which essential diagnostic test to confirm this diagnosis? a. Urine culture and sensitivity b. Serum blood urea nitrogren (BUN) and creatinine level c. Immunofluorescence microscopy d. Voiding cystourethrogram

c. Immunofluorescence microscopy

A 66-year-old male presents to the emergency room accompanied by his wife, who claims that he has been acting confused. The man is reporting a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 102.8°F (39.3°C) and his blood work indicates his sodium level at 126 mEq/L (126 mmol/L) [normal 135-145 mEq/L // 135-145 mmol/L]. Based on this assessment, the nurse suspects the client has: a. Bronchopneumonia b. Mycoplasma pneumonia c. Legionella pneumonia d. Pneumococcal pneumonia

c. Legionella pneumonia

A client whose only diagnosis is essential hypertension is fasting for a fasting blood glucose and lipid profile test to be performed in the morning. The client's regular medications are currently on hold. What is the nurse's priority action? a. Monitor client's blood glucose level to avoid hypoglycemia overnight. b. Assess for dizziness and encourage the client to change positions slowly. c. Measure client's blood pressure and heart rate periodically. d. Remove client's water from the bedside to prevent consumption overnight.

c. Measure client's blood pressure and heart rate periodically.

A client who has a diagnosis of an autoimmune disease asks his nurse why it is that their immune system does not attack all of the cells that make up his body. Which of the following aspects of pathogen recognition in the innate immune system listed below would underlie the nurse's response? a. Normal host cells excrete inhibitory proteins that are detected by natural killer cells. b. Intraepithelial lymphocytes and natural killer cells possess specific, highly diverse receptors. c. Pattern recognition receptors (PRRs) ensure cells are correctly identified. d. Leukocytes possess pathogen associated molecular patterns (PAMPs)

c. Pattern recognition receptors (PRRs) ensure cells are correctly identified.

A child with rhinosinusitis should be monitored for complications. Which assessment finding would alert the nurse that a complication is developing? a. Purulent nasal discharge b. Temperature of 100.8°F (38.2°C) c. Periorbital edema d. Reports of headache

c. Periorbital edema

A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks' gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? a. Plasma angiotensin I and II and renin b. Urinary sodium and potassium c. Platelet count; serum creatinine; liver enzymes d. Urinary catecholamines and metabolites

c. Platelet count; serum creatinine; liver enzymes

An adult has been diagnosed with gastroesophageal reflux disease, in which the function of the lower esophageal sphincter is compromised. Which consequence of this condition is most likely? a. Decreased absorption of ingested foods and fluids. b. Impaired control of the gastric emptying rate. c. Protrusion of the stomach or regurgitation of stomach contents into the esophagus. d. Inappropriate release of gastric enzymes.

c. Protrusion of the stomach or regurgitation of stomach contents into the esophagus.

Damage to which area of a nephron would most likely result in impaired secretion and reabsorption? a. Distal tubule b. Loop of Henle c. Proximal tubule d. Collecting tubule

c. Proximal tubule

An infant is being examined for colic-like symptoms that the parent attributes to "hurting." After feeding, the infant vomits most of the feeding and then assumes a fetal position. The health care provider is associating these clinical manifestations with which childhood complication? a. Duodenal ulceration b. Constipation c. Pyloric stenosis d. Erosive esophagitis

c. Pyloric stenosis

A child is experiencing difficulty with chewing and swallowing. The nurse knows that which cells may be innervating specialized gut-related receptors that provide taste and smell? Question 8 options: a. Special somatic afferent fibers b. General somatic afferents c. Special visceral afferent cells d. General visceral afferent neurons

c. Special visceral afferent cells

A child has been diagnosed with thalassemia. Which of the following comorbidities may occur as a result of having thalassemia? a. Hypocoagulation b. Iron deficiency c. Splenomegaly d. Neutropenia

c. Splenomegaly

A 21-year-old female is suspected of having inadequate function of her hypothalamic-pituitary-thyroid system. Her care provider is planning to inject thyrotropin-releasing hormone (TRH) and then measure her levels of TSH. Which diagnostic test is being performed? a. Suppression test b. Radioimmunoassay (RIA) test c. Stimulation test d. Metabolite excretion test

c. Stimulation test

A health care provider is caring for an older adult client with a recent diagnosis of renal failure and an acid-base imbalance. The family asks, "What is the underlying cause of the renal failure?" Which phenomenon would most accurately answer the question? a. The kidneys are integral to the reabsorption of hydrogen ions and maintenance of a low pH. b. Blood buffer systems and respiratory control can compensate for inadequate renal control of pH. c. The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body. d. pH is kept at an optimal level through the renal secretion of bicarbonate ions in blood filtrate.

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

A pathologist is examining histological (tissue) samples from a client with an autoimmune disease. Which characteristic of muscle samples would signal the pathologist that the samples are cardiac rather than skeletal muscle? a. The cell samples lack intercalcated disks. b. The muscle cells have small and few mitochondria. c. The muscle cells are arranged as an interconnecting lattice-work. d. The muscles are striated and composed of sarcomeres.

c. The muscle cells are arranged as an interconnecting lattice-work.

A family of five vacationed together, but only the client contracted traveler's diarrhea. The client asks the nurse, "We all ate and drank the same things. Why am I the only one with this condition?" What should the nurse offer to the client as the most likely reason for susceptibility for this condition? a. You are male and your family members are all female. b. You are taking a beta blocker for hypertension. c. You are taking a proton pump inhibitor for gastric reflux disease. d. You are the only obese member of the family.

c. You are taking a proton pump inhibitor for gastric reflux disease.

If a virus has caused inflammation resulting in endothelial dysfunction, an excessive amount of endothelins in the blood can result in: a. arterial wall weakening resulting in aneurysm formation. b. release of excess fatty plaque causing numerous pulmonary emboli. c. contraction of the underlying smooth muscles within the vessels. d. overproduction of growth factors resulting in new vessel production.

c. contraction of the underlying smooth muscles within the vessels.

Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which component of his "white matter" has most likely been damaged? a. The inner layer (archilayer) b. The middle layer (paleolayer) c. The outer layer (neolayer) d. The reticular formation

c. The outer layer (neolayer)

Analysis has shown that a client's right atrial pressure is 30 mm Hg. What is the most likely conclusion that the client's care team will draw from this piece of data? a. The result is likely normal and gravity-dependent given the lack of valves in thoracic and central veins. b. The pressure is insufficient to provide adequate stroke volume and cardiac output. c. The pressure is excessive given that the right atrium should be at atmospheric pressure. d. Pressure pulsations are likely to be undetectable given the low atrial pressure.

c. The pressure is excessive given that the right atrium should be at atmospheric pressure.

Which statement best captures an aspect of the neural control of sexual function? a. The sensory system contained in the testes communicates with the spinal cord by way of afferent pathways. b. Perineal stimulation transmits signals to the thalamus and hypothalamus. c. The spinal cord plays a central role, with the limbic system and cerebral cortex also contributing. d. Sympathetic stimulation causes the shunting of blood results in erection, while parasympathetic stimulation results in detumescence.

c. The spinal cord plays a central role, with the limbic system and cerebral cortex also contributing.

The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication? a. To regulate glucose metabolism b. To decrease appetite c. To decrease airway inflammation d. To decrease stress of illness

c. To decrease airway inflammation

A 71-year-old man diagnosed with a stage T2 prostate tumor 2 years ago has elected watchful waiting. Recently, his PSA has jumped considerably, as have his levels of serum acid phosphatase. Which course of action would be least appropriate at this stage? a. Combination treatment with an anti-androgen and a GnRH agonist b. Treatment with bisphosphonates c. Treatment with GnRH agonists alone d. Treatment with ketoconazole

c. Treatment with GnRH agonists alone

In the ICU, the nurse hears an emergency cardiac monitor go off. The nurse looks at the telemetry and notices the client has gone into ventricular tachycardia. The nurse will likely assess for signs/symptoms of: a. development of hypertension with BP 190/98. b. oxygen deprivation with O2 saturation decreasing to ~90%. c. decreasing cardiac output due to less ventricular filling time. d. increasing cardiac index by correlating the volume of blood pumped by the heart with an individual's body surface area.

c. decreasing cardiac output due to less ventricular filling time.

The spirochete Leptospira is primarily transmitted to farmers by: a. an airborne mechanism. b. exposure to spores in the environment. c. direct contact with infected animals. d. a mosquito bite.

c. direct contact with infected animals.

An autopsy is being performed on a 44-year-old female who died unexpectedly of heart failure. Which components of the pathologist's report is most suggestive of a possible history of poorly controlled blood pressure? a. "Scarring of urethra suggestive of recurrent urinary tract infections is evident." b. "Bilateral renal hypertrophy noted." c. "Vessel wall changes suggestive of venous stasis are evident." d. "Arterial sclerosis of subcortical brain regions noted."

d. "Arterial sclerosis of subcortical brain regions noted."

A medical student is familiarizing herself with recent overnight admissions to an acute medical unit of a university hospital. Which client would the student recognize as least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? a. A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident b. A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks c. A 30-year-old female with a diagnosis of left leg deep vein thrombosis and a pulmonary embolism d. A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

d. A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use

In which client would diagnostic investigations be least likely to reveal increased thrombopoietin production? a. An 81-year-old woman with diagnoses of rheumatoid arthritis and failure to thrive b. A 55-year-old man with dehydration secondary to Crohn disease c. A 66-year-old woman with a diagnosis of lung cancer with bone metastases d. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

d. A 21-year-old woman awaiting bone marrow transplant for myelogenous leukemia

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

A client with a surgical wound has developed excessive granulation tissue extending above the wound edges. Which action should the nurse take? a. Contact the health care provider to order wet-to-dry dressings to promote debridement of the tissue. b. Take no action; this overgrowth of tissue is referred to as "keloids" and is not amenable to treatment. c. Apply an occlusive dressing to increase moisture in the wound bed as excessive granulation tissue is due to dryness. d. Ask the health care provider about surgical options to remove the excess tissue and promote wound healing.

d. Ask the health care provider about surgical options to remove the excess tissue and promote wound healing.

The anatomy of the prostate gland is made up of three concentric areas surrounding the prostatic urethra, into which they open. The nurse understands that an overgrowth of the mucosal glands can cause which disorder in older men? a. Prostate cancer b. Neoplasm cells of the prostate c. Testicular cancer d. Benign prostatic hyperplasia

d. Benign prostatic hyperplasia

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. Her liver and spleen are both enlarged. c. Blood work reveals an increased white blood cell count. d. Chest auscultation reveals crackles in her lower lung fields bilaterally.

d. Chest auscultation reveals crackles in her lower lung fields bilaterally.

Due to complications, a male postoperative client has been unable to mobilize secretions for several days following surgery and develops atelectasis. Which process would his care team anticipate with relation to his health problem? a. Vasodilation in the alveolar vessels in the affected region of his lung b. Increased workload for the left side of the client's heart c. Increased blood flow to the area of atelectasis d. Directing blood flow away from the lung regions that are hypoxic

d. Directing blood flow away from the lung regions that are hypoxic

Which statement best captures an aspect of normal spermatogenesis? a. Testosterone chemically lyses each primary spermatocyte into two secondary spermatocytes with 23 chromosomes each. b. Sertoli cells differentiate into spermatids, each of which can contribute half of the chromosomes necessary for reproduction. c. Spermatogonia adjacent to the tubular wall undergo meiotic division and provide a continuous source of new germinal cells. d. Each primary spermatocyte undergoes two nuclear divisions yielding four cells with 23 chromosomes each.

d. Each primary spermatocyte undergoes two nuclear divisions yielding four cells with 23 chromosomes each.

Which statement best describes an aspect of the normal process of glucose metabolism? a. Blood glucose levels are primarily a result of the timing, quantity, and character of food intake. b. Ingested glucose that is not needed for cellular metabolism circulates in the blood until it is taken up to meet cellular needs. c. Blood glucose levels are kept in a steady state by selective excretion and reuptake by the kidneys. d. Glucose that exceeds metabolic needs is converted and stored by the liver.

d. Glucose that exceeds metabolic needs is converted and stored by the liver.

Which statement best communicates the nature of movements in the colon? a. The internal and external anal sphincters control the movement of feces into and through the colon. b. Haustrations move the colon contents along with 2- to 3-minute rest periods between movements. c. Segmentation waves are local events involving only 0.5 to 1.5 in (1.25 to 3.75 cm) of the intestine. d. Large segments of the colon contract as a unit for around 30 seconds.

d. Large segments of the colon contract as a unit for around 30 seconds.

The nurse in the emergency department knows clients exposed to Clostridium botulinum, an agent of bioterrorism, would likely be exhibiting which clinical manifestation listed below? a. Blindness and respiratory distress b. Hemorrhage from all orifices resulting in signs of shock and coma c. Frothy, odiferous diarrhea and dehydration d. Muscle weakness in extremities eventually leading to paralysis of respiratory muscles

d. Muscle weakness in extremities eventually leading to paralysis of respiratory muscles

A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment? a. To control his hypertension b. To increase the amount of oxygen distributed by his red blood cells c. To reduce the mean size of his red cells d. To reduce the viscosity of his blood

d. To reduce the viscosity of his blood

New parents are upset their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. Which factors would the pediatrician be most likely to rule out as a contributor to high bilirubin levels? a. The fact that the infant is being breast-fed b. Hypoxia c. Hepatic immaturity of the infant d. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)

d. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)

A client with a history of an endocrine disorder exhibits signs and symptoms of hormone deficiency. Which process would the client's care team most likely rule out first as a contributing factor? a. The client's target cells lack sufficient receptors for the hormone in question. b. Hormone production is sufficient, but affinity on the part of the target cells is lacking. c. The process of down-regulation has resulted in decreased hormone sensitivity. d. Up-regulation has increased the sensitivity of the body to particular hormone levels.

d. Up-regulation has increased the sensitivity of the body to particular hormone levels.

The daughter of a client with metastatic cancer is confused as to why the client is receiving radiation therapy and asks the nurse, "Why are we still treating the cancer? The plan was only for comfort care." What is the nurse's best response? a. "In this case, the radiation is being used to help alleviate the bone pain your family member is experiencing." b. "This type of radiation has no serious adverse effects so we often apply it in palliative cases as there is no harm." c. "Radiotherapy is slowing tumor growth so you can have more time with your family member, but it is not curative." d. "You will need to discuss the plan of care with your family member as I am not at liberty to discuss it with you."

a. "In this case, the radiation is being used to help alleviate the bone pain your family member is experiencing."

When talking about the lifespan of various blood components, the students should know that once a neutrophil moves into tissue, it lives approximately how long? a. 4 days. b. 12 hours. c. 24 hours. d. 2 days.

a. 4 days.

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

b. "Has your son had any sinus or ear infections in the last little while?"

If a male has a history of impaired blood flow in his vascular system, he may be prone to developing: a. Premature ejaculation b. Erectile dysfunction c. Penile engorgement d. Vascular clots in pudendal arteries

b. Erectile dysfunction

Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenal glands' production of cortisol drops. This is an example of which type of endocrine disorder? a. Primary b. Secondary c. Tertiary d. Somatic

b. Secondary

A 66-year-old female client has presented to the emergency department because of several months of intermittently bloody stool which has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which situation is most likely? a. The woman has depleted blood volume due to her ongoing blood loss. b. She will have iron-deficiency anemia due to depletion of iron stores. c. The client will be at risk for cardiovascular collapse or shock. d. She will have delayed reticulocyte release.

b. She will have iron-deficiency anemia due to depletion of iron stores.

The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to: a. move the testes into the scrotum. b. maintain testicular temperature. c. empty fluid from the seminal vesicles into the genital ducts. d. move sperm from the ampulla to the penis.

b. maintain testicular temperature.

Which teaching point would be most appropriate with a client who has a recent diagnosis of Von Willebrand disease? a. "It's important that you avoid trauma." b. "Your disease affects your platelet function rather than clot formation." c. "Make sure that you avoid taking aspirin." d. "Clotting factor VIII can help your body compensate for the difficulty in clotting."

c. "Make sure that you avoid taking aspirin."

A 35-year-old male client has started androgen therapy for hypogonadism. What symptoms should the nurse instruct the client to report? a. Increased body hair growth b. Weight gain c. Changes in urination d. Increased libido

c. Changes in urination

As a result of dehydration, a client's epithelial cells are producing insufficient amounts of mucus. Consequently, the client's mucociliary blanket is compromised. Which change would the care provider anticipate as a direct result of this change? a. Impaired function of the client's cilia b. Decreased levels of oxygen saturation c. Increased amounts of bacteria in the lungs d. Increased carbon dioxide levels

c. Increased amounts of bacteria in the lungs

During an automobile accident where the client is bleeding heavily, which vascular component is the most distensible and can store large quantities of blood that can be returned to the circulation at this time of need? a. Liver and pancreas b. Kidneys c. Veins d. Aorta

c. Veins

A young adult client has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause? a. "Do you have a history of heart failure?" b. "Have you recently had kidney stones?" c. "Have you ever been diagnosed with diabetes?" d. "Have you had any type of infection within the past 2 weeks?"

d. "Have you had any type of infection within the past 2 weeks?"

The school nurse has several children with hemophilia A. After recess, one hemophilia student comes to the school nurse complaining of pain in the knee from falling on the playground. The nurse notes there is swelling in the knee and pain on palpation. The nurse should: a. administer some NSAIDs to relieve the pain. b. wrap the knee in an ace bandage for compression. c. apply some warm compresses to the knee. d. notify parents to pick up the child and possibly administer Factor VIII.

d. notify parents to pick up the child and possibly administer Factor VIII.

A nurse who works in the office of an endocrinologist is orientating a new staff member. Which teaching point is the nurse justified in including in the orientation? Select all that apply. a. "A bodily process can be the result of the combined effect of several different hormones from different sources." b. "A single hormone can act on not only one process or organ, but often on several different locations or processes." c. "It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." d. "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions." e. "The regulation in homeostasis requires that hormones be absent from the body when their effect is not needed."

a. "A bodily process can be the result of the combined effect of several different hormones from different sources." b. "A single hormone can act on not only one process or organ, but often on several different locations or processes." c. "It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." d. "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions."

The nurse knows which statement listed below is accurate regarding the functions and nature of cytokines relative to a variety of pathologies? a. "A particular cytokine can have varied effects on different systems, a fact which limits their therapeutic use." b. "Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold." c. "Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine." d. "Cytokine actions are self-limiting, in that activation of one precludes activation of other cytokines with similar actions."

a. "A particular cytokine can have varied effects on different systems, a fact which limits their therapeutic use."

A hospital client has a large, superficial wound on her elbow that was the result of shearing action when she was moved up in her bed. The client's husband mentions that the wound looks infected and irritated since it is completely red. Which response by the nurse would be inappropriate? a. "A thin sheet of blood clotting is actually desirable and not a sign that your wife's wound is infected." b. "Even though it is red, it doesn't mean that the wound is infected." c. "The red areas show that there is enough circulation to facilitate healing." d. "Those are fresh blood vessels that are a sign of healthy healing."

a. "A thin sheet of blood clotting is actually desirable and not a sign that your wife's wound is infected."

A client is reading a brochure on atherosclerosis while in the waiting room of medical clinic. Which excerpt from the educational brochure warrants correction? a. "Because smoking causes a permanent increase in your risk of heart disease, it's best not to start." b. "All things being equal, men have a higher risk of coronary heart disease than perimenopausal women." c. "High blood pressure often accompanies, or even causes, clogging of the arteries." d. "Every bit that you can lower your cholesterol means that you'll have a lower risk of developing heart disease."

a. "Because smoking causes a permanent increase in your risk of heart disease, it's best not to start."

Two nursing students are debating the merits and demerits of infant circumcision. Which statement is most accurate? a. "Circumcised men tend to have a lower incidence of penile cancer." b. "Getting circumcised basically rules out the possibility of getting Peyronie disease later in life." c. "Circumcision reduces pressure on the deep dorsal vein and the dorsal artery, making erection easier later in life." d. "The odds of getting infant priapism fall with circumcision."

a. "Circumcised men tend to have a lower incidence of penile cancer."

The nurse is preparing a client for a radioiodine test to assess thyroid functioning. Which question is most important for the nurse to ask the client prior to preparing this client for this diagnostic test? a. "Have you had a CT scan in the past month?" b. "Are you claustrophobic or have trouble lying still?" c. "Have you had abnormal thyroid hormone levels?" d. "Will you be able to fast for 12 hours for the test?"

a. "Have you had a CT scan in the past month?"

A 72-year-old female has been told by her physician that she has a new heart murmur that requires her to go visit a cardiologist. Upon examination, the cardiologist informs the client that she has aortic stenosis. After the cardiologist has left the room, the client asks, "What caused this [aortic stenosis] to happen now?" The clinic nurse responds: a. "Heart murmurs result from tumultuous flow through a diseased heart valve that is too narrow and stiff. This flow causes a vibration called a murmur." b. "Aortic stenosis is commonly seen in older adult clients. Basically, there is a blockage in the valve that is causing blood to pool, causing decreased velocity of flow." c. "This is caused by a tear in one of the papillary muscles attached to the valve. They can do a procedure where they thread a catheter into the heart and reattach the muscle ends." d. Because of the high amount of energy it takes to push blood through the aortic valve to the body, your valve just had to work too hard and it is weakening.

a. "Heart murmurs result from tumultuous flow through a diseased heart valve that is too narrow and stiff. This flow causes a vibration called a murmur."

A family physician is performing client teaching about the influenza virus with each client who has come to the clinic to receive that year's vaccine. Which statement by the client best reflects an accurate understanding of the flu virus? a. "I could come down with viral or bacterial pneumonia as a result of a bad flu bug." b. "I know my vaccination is especially important since there aren't any drugs that can treat the flu once I get sick with it." c. "The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated and actually ineffective." d. "Like all vaccines, it is ideal if everyone in a population gets immunized against the flu."

a. "I could come down with viral or bacterial pneumonia as a result of a bad flu bug."

A 60-year-old male client with an acute viral infection is receiving interferon therapy. The nurse is teaching the client about the ways interferon differs from other anti-infective therapies. What point should the nurse include? a. "Interferon stimulates the activity of natural killer cells that attack viruses." b. "Interferon will only target the cells affected by the virus and not affect other cells." c. "Interferon helps limit macrophage activity to reduce the reaction to the infection." d. "Interferon will suppress apoptosis to prevent the death of healthy cells."

a. "Interferon stimulates the activity of natural killer cells that attack viruses."

A single mother who was raised in a traumatic environment is very protective of her child. She expresses a desire to keep her child from experiencing stressful situations in hopes of promoting healthy development. What response by the nurse is most helpful? a. "It is normal to experience stressors periodically and this can enhance healthy development." b. "You are creating more stress for yourself while protecting your child and this is not healthy." c. "I think it is admirable that you are protecting your child from negative life experiences." d. "You can never prevent all stressful situations; they are a reality of growing into adulthood."

a. "It is normal to experience stressors periodically and this can enhance healthy development."

A nurse is changing the wound dressing on a coccyx-region pressure injury of an immobilized client. The existing dressing is saturated with both watery, clear discharge and foul, grayish-colored liquid. Which entry in the client's chart most accurately documents these findings? a. "Large amounts of suppurative and serous exudates noted." b. "Purulent discharge and fibrinous exudates noted on existing dressing." c. "Abscess activity noted to coccyx wound." d. "Plasma proteins and membranous exudates present on existing dressing."

a. "Large amounts of suppurative and serous exudates noted."

A client with uncontrolled hypertension has reviewed the echocardiogram report prior to visiting the health care provider. The client asks, "What does it mean when my ejection fraction is measured as only 30%? I want to know how to get this back to normal." Which response by the provider is most accurate? a. "Most likely, your low ejection fraction is caused by your uncontrolled high blood pressure." b. "With the right combination of heart medication and diuretics, your ejection fraction should return back to normal." c. "This low ejection fraction means you have heart failure and need to go on more medication." d. "If you are feeling fine without any chest pain, there should be no need to prescribe any further medications."

a. "Most likely, your low ejection fraction is caused by your uncontrolled high blood pressure."

A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client's husband is confused as to why a disease of coagulation can result in bleeding. Which statement by the nurse best characterizes DIC? a. "So much clotting takes place that there are no available clotting components left, and bleeding ensues." b. "Massive clotting causes irritation, friction, and bleeding in the small blood vessels." c. "Excessive activation of clotting causes an overload of vital organs, resulting in bleeding." d. "These same hormones and bacteria that cause clotting also cause bleeding."

a. "So much clotting takes place that there are no available clotting components left, and bleeding ensues."

As part of preoperative teaching for clients who are about to undergo a coronary artery bypass graft, a nurse is performing an education session with a group of surgical candidates. Which teaching point best conveys an aspect of the human circulatory system? a. "The blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation." b. "Only around one-quarter of your blood is in your heart at any given time." c. "Blood pressure and blood volume roughly mimic one another at any given location in the circulatory system." d. "Left-sided and right-sided pumping action on each beat of the heart must equal each other to ensure adequate blood distribution."

a. "The blood pressure varies widely between arteries and veins, and between pulmonary and systemic circulation."

A female client with a new diagnosis of systemic lupus erythematosus (SLE) has been told that this is an autoimmune disease whereby the immune system is attacking the body's cells and tissue. She knows that she has inflammation and tissue damage. She asks her nurse to explain "What cells in the body are triggering this inflammation?" The nurse responds: a. "The lymphocytes that migrate to the brain where they secrete cytokines, which trigger inflammation." b. "Mainly the adrenocorticoids like cortisone are responsible for all your inflammation." c. "Mineralocorticoids like aldosterone usually begin the process of inflammation." d. "Primarily, this acute stress reaction is associated with stimulation of the autonomic nervous system, which causes stiffness in the joints."

a. "The lymphocytes that migrate to the brain where they secrete cytokines, which trigger inflammation."

A 3-year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes? a. "The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin." b. "It's not known exactly why your daughter has completely stopped making insulin, and treatment will consist of your rigidly controlling her diet." c. "This tendency to produce insufficient amounts of insulin is likely something that she inherited." d. "Environmental and lifestyle factors are known to play a part in the fact that her pancreas secretes and withholds insulin at the wrong times."

a. "The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin."

A male client has just been diagnosed with esophageal cancer. He knew he was losing weight and fatigued most days, but he just attributed it to aging and working. The physician recommends chemotherapy and irradiation. However, the cancer has already metastasized. The client asks the nurse what he can expect if he agrees to the treatments. The nurse responds: a. "The therapies may shrink the cancer in an effort to increase survival of the cancer." b. "The doctor is prescribing treatment measures to help you swallow better." c. "These therapies will most likely cure your cancer." d. "You need to talk with your physician some more. I will page him for you."

a. "The therapies may shrink the cancer in an effort to increase survival of the cancer."

A female client presented to her primary care physician with classic signs/symptoms of Cushing syndrome. Upon testing, it was discovered that the client had vaginal small cell carcinoma. How can the health care providers explain the Cushing syndrome signs/symptoms to this client? a. "The tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs/symptoms." b. "We are going to have to run some more tests. We think you might have a problem with your pituitary gland." c. "There is no connection between the Cushing syndrome and the vaginal carcinoma. You have two very distinct problems occurring at the same time." d. "We need to check your thyroid. Your Cushing syndrome may be caused by hypofunction of this gland."

a. "The tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs/symptoms."

```A nurse is conducting an immunization clinic when a 14-year-old client asks, "Does this vaccine make me immune to the disease?" What is the nurse's best response? a. "The vaccine imitates a disease without causing illness, resulting in the creation of antibodies to the disease." b. "The vaccine introduces substances that replicate and can kill the microorganisms if you are exposed." c. "The vaccine contains medicines that are designed to combat the microorganisms that cause this disease." d. "The vaccine will not make you immune but will improve your chances of surviving an infection."

a. "The vaccine imitates a disease without causing illness, resulting in the creation of antibodies to the disease."`

After assessment, the nurse asks how long the client has had red, pinpoint hemorrhages on the lower legs. The client responds, "This is the first time I have noticed this. What is wrong with me that is causing these small hemorrhages?" Which response by the nurse is most accurate? a. "These hemorrhages are called petechiae and occur when platelets are deficit." b. "More than likely, you bumped something and these are a result of trauma to the vessel." c. "Your platelets are developing a deformity as they are being produced by the bone marrow." d. "You might have a pooling of all your platelets in the spleen. I will assess for that next."

a. "These hemorrhages are called petechiae and occur when platelets are deficit."

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."

The nurse is preparing to administer rasburicase to a client undergoing chemotherapy. How should the nurse explain the purpose of this medication to the client? a. "This drug helps reduce uric acid levels and protect your kidneys." b. "Rasburicase is a unique antiemetic that will reduce your nausea." c. "Chemotherapy causes high phosphate and this medication reduces this." d. "This medication protects your bladder from the toxic effects of chemotherapy."

a. "This drug helps reduce uric acid levels and protect your kidneys."

The nurse is caring for a client who has just been diagnosed with shingles. The client states, "I have not been around anyone with this condition. How could I have caught it?" What is the nurse's best response? a. "This is a latent virus that you likely were exposed to as a child and it has now become active in the form of shingles." b. "This virus has a long prodromal stage so you could have been exposed over a month ago and not been aware." c. "Shingles is caused by recent exposure to someone who has active herpes zoster virus or has just been vaccinated." d. "This virus is the same one that causes cold sores and is manifesting in a different way this time, so it is very common."

a. "This is a latent virus that you likely were exposed to as a child and it has now become active in the form of shingles."

A child with leukemia hears the health care provider tell the parents that the child has "pancytopenia." This child asks the nurse, "What does 'pancy' mean? Am I going to die?" Which response by the nurse is most appropriate for this 10-year-old child? a. "This means the chemotherapy has lowered your blood counts including red blood cells, white blood cells and platelets. You are very sick, but we are working hard to make you healthy again." b. "This means the chemotherapy is attacking your bone marrow and your body has to find a way to fight back. No, you are not going to die." c. "This is very serious and could possibly lead to death if you start bleeding badly." d. "This is just a way of saying that you are sick and need to rest more.Your medicine is fighting your cancer cells so that you will not die."

a. "This means the chemotherapy has lowered your blood counts including red blood cells, white blood cells and platelets. You are very sick, but we are working hard to make you healthy again."

The nurse is reviewing the treatment plan with parents of a 6-month-old diagnosed with severe β-thalassemia. Which statements by the parents demonstrate they understand the treatment plan? Select all that apply. a. "Transfusions are needed to prevent skeletal abnormalities from developing." b. "We will need to feed our child a diet high in iron to promote red blood cell production." c. "A stem cell transplant may be used as part of the treatment plan." d. "Transfusions will need to begin once our child reaches 2 years of age." e. Oxygen therapy should be used to prevent organ damage from chronic hypoxia.

a. "Transfusions are needed to prevent skeletal abnormalities from developing." c. "A stem cell transplant may be used as part of the treatment plan."

A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistula (EA/TEF). Which explanation should the care team provide to the infant's parents? a. "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally." b. "This problem will require respiratory therapy and supplementary feeding but it will likely resolve itself over time." c. "The biggest risk that will face your daughter until this is fixed is the danger of malnutrition and dehydration." d. "The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs."

a. "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally."

A 21-year-old college football player has acknowledged to a nurse at a campus clinic that he has been injecting androgens in an effort to increase the size of his musculature and enhance his on-field performance. Which teaching point should the nurse include in a conversation with the player? a. "You run a real risk of developing acne and developing breasts by doing this." b. "You will indeed be able to increase your muscles, but they will rebound by shrinking smaller than they ever were within a few months." c. "Most of the people who do this cause themselves to be permanently sterile." d. "A reduction in the size of your penis and the production of mutated sperm can be an effect of steroid use."

a. "You run a real risk of developing acne and developing breasts by doing this."

A health care professional has recommended biofeedback to a client as a method of dealing with the high levels of stress. Which explanation should the nurse offer the client to explain biofeedback treatment? a. "You will be taught how to gain control over skeletal muscle contractions." b. "You might be asked to use an electrocardiogram as part of the therapy." c. "The goal is to reduce the amount of daily stress to which you are exposed." d. "You will become aware of the increased skin temperature that accompanies anxiety."

a. "You will be taught how to gain control over skeletal muscle contractions."

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

a. "Your prognosis will depend on whether we can surgically resect your tumor."

The nurse is caring for a client who is suspected to have multiple myeloma. What findings will the nurse use as evidence the client has multiple myeloma? Select all that apply. a. 20% plasma cells in bone marrow biopsy b. X-rays demonstrate bone loss c. Bence Jones proteins in urine d. Erythrocytosis e. Hyperkalemia

a. 20% plasma cells in bone marrow biopsy b. X-rays demonstrate bone loss c. Bence Jones proteins in urine

A fifth-grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has: a. 5 to 6 liters of blood throughout the body b. 2 to 4 cups of blood in the body c. 3 pints of blood total d. 3 to 4 quarts of blood in the body

a. 5 to 6 liters of blood throughout the body

Which scenario would put a client at risk for experiencing a thyroid problem due to a decrease in thyroxine-binding globulin (TBG)? Select all that apply. a. 55-year-old male with cirrhosis due to alcohol abuse b. 47-year-old female experiencing hot flashes and excess diaphoresis related to menopause c. 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) d. 18-year-old female client with anorexia nervosa weighing 78 pounds who has consumed no protein for the past 3 years.

a. 55-year-old male with cirrhosis due to alcohol abuse c. 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) d. 18-year-old female client with anorexia nervosa weighing 78 pounds who has consumed no protein for the past 3 years.

Which client Is most likely experiencing health problems that may be attributable to kidney disease? a. 81-year-old client with osteoporosis and anemia b. 77-year-old client with urinary retention due to benign prostatic hyperplagia (BPH) c. 55-year-old client with a recent stroke secondary to longstanding hypertension d. 60-year-old client with a systemic fungal infection requiring intravenous antibiotics

a. 81-year-old client with osteoporosis and anemia

The nurse is planning care for a group of clients. Which client should the nurse assess first? a. A 25-year-old client with an absolute neutrophil count of 300/mm3 (0.30 x 109/L) b. An 82-year-old client with a hemoglobin of 9.0 g/dL (90 g/L) c. A 65-year-old client with a white blood cell count of 15,200/μL (15.2 x 109/L) d. A 45-year-old client with a platelet count of 100,000/mm3 (100 x 109/L)

a. A 25-year-old client with an absolute neutrophil count of 300/mm3 (0.30 x 109/L)

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.

The nurse is caring for a group of postoperative clients. Who should the nurse prioritize as having the greatest risk for infection at the surgical site? a. A 45-year-old with external fixation of a fractured tibia b. A 15-year-old 1 day post-tonsillectomy c. A 65-year-old awaiting pacemaker insertion d. A 22-year-old 2 days post-appendectomy

a. A 45-year-old with external fixation of a fractured tibia

A nurse is developing a program to help clients reduce the impact of chronic stress on their health. Which clients should the nurse prioritize as being able to most benefit from the program? Select all that apply. a. A 45-year-old with inflammatory bowel disease b. A 30-year-old with substance use c. A 22-year-old with an eating disorder d. A 15-year-old with mononucleosis e. A 75-year-old with pneumonia

a. A 45-year-old with inflammatory bowel disease b. A 30-year-old with substance use c. A 22-year-old with an eating disorder

Which individual is most likely to be experiencing vasodilation? a. A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin-angiotensin-aldosterone system b. A 9-year-old boy who has been given an injection of epinephrine to preclude an anaphylactic reaction to a bee sting c. A 30-year-old woman who takes antihistamines to treat her seasonal allergies d. A 32-year-old man who takes a selective serotonin reuptake inhibitor for treatment of depression

a. A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin-angiotensin-aldosterone system

Which situation can best be characterized as an example of passive immunity? a. A 6-week-old infant receives antibodies from his mother's breast milk. b. A 6-month-old infant receives his scheduled immunization against measles, mumps, and rubella. c. A 9-year-old boy is immune to chickenpox after enduring the infection 1 year previous. d. An 8-year-old girl recovers from a respiratory infection after intravenous antibiotic treatment.

a. A 6-week-old infant receives antibodies from his mother's breast milk.

A physician is providing care for several clients on a medical unit of a hospital. In which situation would the physician be most likely to rule out hypertension as a contributing factor? a. A 61-year-old man who has a heart valve infection and recurrent fever b. An 81-year-old woman who has had an ischemic stroke and has consequent one-sided weakness c. A 44-year-old man awaiting a kidney transplant who requires hemodialysis three times per week d. A 66-year-old woman with poorly controlled angina and consequent limited activity tolerance

a. A 61-year-old man who has a heart valve infection and recurrent fever

The nurse is caring for several clients. Given the typical treatments for each of the listed client conditions, which client should the nurse prioritize as most at risk for acute gastrointestinal bleeding? a. A 65-year-old client being treated for atrial fibrillation and coronary artery disease b. A 45-year-old with hypertension and type 2 diabetes being treated for a foot ulcer c. A 70-year-old with rheumatoid arthritis being treated for pneumonia d. An 85-year-old with failure to thrive who is confused and receiving intravenous fluids

a. A 65-year-old client being treated for atrial fibrillation and coronary artery disease

Which client would be most likely to be experiencing an increase in renal erythropoietin production? a. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD) b. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic c. A 68-year-old man with a long-standing diagnosis of polycythemia vera d. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior

a. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD)

Which individual situation listed below best exemplifies the processes of innate immunity? a. A child who has experienced heat and swelling of his skinned knuckle b. An adult who complains of itching and is sneezing because he is allergic to pollen c. A client whose blood work indicates increased antibody titers during an acute illness d. A client who has experienced rejection of a donor liver after transplantation

a. A child who has experienced heat and swelling of his skinned knuckle

Which scenario best describes an example of infection originating with a fomite? a. A client who contracted hepatitis C through sharing a contaminated syringe with an infected person b. A nurse with a positive tuberculin screening test (PPD) after admitting a client diagnosed with tuberculosis (TB) c. A woman who contracted Lyme disease after a tick bite d. A man who has been diagnosed with trichinosis after eating undercooked pork

a. A client who contracted hepatitis C through sharing a contaminated syringe with an infected person

A client with a diagnosis of atrophic gastritis and consequent pernicious anemia is receiving high oral doses of vitamin B12. Following completion of his treatment, which lab finding demonstrates improvement in this condition? a. A decrease in mean corpuscular volume b. Increased serum bilirubin c. Increased folic acid levels d. Decreased free heme levels

a. A decrease in mean corpuscular volume

Which client who presented to a walk-in medical clinic is most likely to be diagnosed with rhinosinusitis rather than a common cold? a. A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F (38.2°C) b. A woman presenting with malaise, lethargy, and copious nasal secretions c. A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9°F (37.1°C) d. A woman complaining of generalized aches and who has a hoarse voice and reddened, painful upper airways

a. A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F (38.2°C)

A parent brings a 12-year-old to the emergency room with multiple bite wounds to the arms and hands from a stray cat. Which interventions should the nurse be prepared to apply? Select all that apply. a. A review of the client's immunization record b. Administration of corticosteroids c. Rabies prophylaxis d. Suturing of the wounds e. Irrigation of the wounds f. Administration of prophylactic antibiotics

a. A review of the client's immunization record c. Rabies prophylaxis e. Irrigation of the wounds f. Administration of prophylactic antibiotics

An 80-year-old client has a stage 3 decubitus ulcer on the left ischial tuberosity which has not shown much improvement despite optimal local wound treatment. What other interventions should the nurse recommend to promote wound healing? Select all that apply. a. A review of the client's medications b. Positioning the client in a chair three times a day c. Placing the client on an alternating pressure mattress d. Administering corticosteroids e. Nutritional supplements

a. A review of the client's medications c. Placing the client on an alternating pressure mattress e. Nutritional supplements

A client has suffered damage to the anterior pituitary gland, reducing the ability to respond to increases in plasma osmolality. The nurse should monitor for what expected assessment findings? Select all that apply. a. A urine specific gravity of 1.000 b. A urine to serum osmolality of 1.5:1 c. An increase in body weight d. Increased thirst and fluid consumption e. Decreased urine output

a. A urine specific gravity of 1.000 b. A urine to serum osmolality of 1.5:1 d. Increased thirst and fluid consumption

The nurse suspects the client may have developed partial bilateral ureter obstruction. What evidence assessment findings support this suspicion? Select all that apply. a. A urine specific gravity of 1.001 b. An increase in urine output c. Low blood pressure d. Weak urine stream e. Bladder distension

a. A urine specific gravity of 1.001 b. An increase in urine output

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

a. Accelerated chronic myelogenous leukemia

The nurse is caring for a client with thrombotic thrombocytopenic purpura (TTP) and notices a yellow discoloration of the client's sclera. Which are likely possible causes of this finding? Select all that apply. a. Accelerated intravascular hemolysis b. Hypoperfusion of the liver c. Elevated levels of nitrogenous wastes (uremia) d. Side effect of hepatotoxic medication e. Viral hepatitis

a. Accelerated intravascular hemolysis b. Hypoperfusion of the liver

A client, admitted after an automobile accident in which their head and chest hit the steering wheel, has a combination of biomarker testing (SP-D, neutrophil chemotractor factor, and interleukin-8). The family asks, "Why are there so many blood tests?" The response by the nurse reveals these test results will confirm the client has developed which condition(s)? Select all that apply. a. Acute lung injury b. Pulmonary embolism c. Pulmonary hypertension d. Acute respiratory distress syndrome (ARDS) e. Pneumothorax

a. Acute lung injury d. Acute respiratory distress syndrome (ARDS)

Which nursing interventions would be considered priority when managing a client with life-threatening myxedema coma? Select all that apply. a. Administer 3% sodium IV solution to increase sodium levels. b. Administer 50% dextrose to raise glucose levels. c. Place on oxygen therapy to encourage deep breathing. d. Place on a warming bed to raise body temperature. e. Administer sedatives frequently to prevent seizures.

a. Administer 3% sodium IV solution to increase sodium levels. b. Administer 50% dextrose to raise glucose levels. c. Place on oxygen therapy to encourage deep breathing.

A client is suspected of having bacterial meningitis. Which action should the nurse complete first? a. Administer antibiotics b. Prepare for lumbar puncture c. Administer antipyretics d. Complete neurological assessment

a. Administer antibiotics

The nurse is caring for a 67-year-old client who has been diagnosed with pneumonia. The vital signs are temperature 101.7°F (38.7°C), blood pressure 155/95, respiratory rate 26, and heart rate 88. Which interventions should the nurse incorporate into the client's plan of care? Select all that apply. a. Administer antipyretics as ordered. b. Administer antitussives as ordered. c. Encourage deep breathing and coughing. d. Elevate the client's legs periodically. e. Encourage fluid intake.

a. Administer antipyretics as ordered. c. Encourage deep breathing and coughing. e. Encourage fluid intake.

The nurse is planning care for a client with acute epididymitis. Which interventions should the nurse be sure to perform? Select all that apply. a. Administer nonsteroidal anti-inflammatory medications. b. Apply a supportive device to elevate the scrotum. c. Encourage frequent ambulation. d. Assess temperature four times daily.

a. Administer nonsteroidal anti-inflammatory medications. b. Apply a supportive device to elevate the scrotum. d. Assess temperature four times daily.

The nurse is caring for a client who meets the physical assessment criteria for sepsis, but the specimen cultures are negative for a causative organism. What action should the nurse take next? a. Administer the prescribed antibiotics. b. Recollect specimen cultures. c. Contact the health care provider. d. Continue to monitor signs and symptoms.

a. Administer the prescribed antibiotics.

The nurse is planning care for a client with damage to the vestibular area of the vestibulocochlear nerve. What should the nurse include in the plan of care? Select all that apply. a. Administering medications for motion sickness b. Speaking clearly while facing the client c. Providing nonverbal communication tools d. Asking client to call for assistance prior to ambulation e. Teaching the client to change positions slowly

a. Administering medications for motion sickness d. Asking client to call for assistance prior to ambulation e. Teaching the client to change positions slowly

A 60 year-old man has long managed his type 1 diabetes effectively with a combination of vigilant blood sugar monitoring, subcutaneous insulin administration, and conscientious eating habits. This morning, however, his wife has noted that he appears pale and clammy and appears to be in a stupor, though he is responsive. She suspects that he has made an error in his insulin administration and that he is experiencing a hypoglycemic episode. Which action should be the wife's first choice? a. Administration of 15 to 20 g of glucose in a concentrated carbohydrate source. b. Administration of subcutaneous glucagon. c. IV infusion of 50% dextrose and water solution. d. Careful monitoring for level of consciousness and resolution of hypoglycemia.

a. Administration of 15 to 20 g of glucose in a concentrated carbohydrate source.

A 72-year-old client being treated for rheumatoid arthritis is admitted with suspected ehrlichiosis. What should the nurse implement as a treatment priority? a. Administration of empirically chosen antibiotics b. Isotonic intravenous fluids at a minimum rate of 200 mL/hr c. Collection of appropriate blood and fluid cultures d. Isolation of the client using contact precautions

a. Administration of empirically chosen antibiotics

The nurse is creating a care plan for a premature infant with respiratory distress syndrome. Which aspects of care should the nurse include in the plan? Select all that apply. a. Administration of synthetic surfactant b. Delivery of oxygen under positive pressure c. Monitoring blood glucose d. Frequent stimulation e. Keeping infant in incubator

a. Administration of synthetic surfactant b. Delivery of oxygen under positive pressure c. Monitoring blood glucose e. Keeping infant in incubator

A 45-year-old woman with a diagnosis of shingles is experiencing an acute onset of severe neuropathic pain. Which stage of Selye's characterization of stress response is the woman most likely experiencing at the moment? a. Alarm b. General Adaptation Syndrome (GAS) c. Exhaustion d. Resistance

a. Alarm

A young boy who is deaf and has bilateral cataracts is brought to the clinic. The parent found blood in the toilet after the boy voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the health care team's initial differential diagnosis most likely be? a. Alport syndrome b. Systemic lupus erythematosus glomerulonephritis c. Henoch-Schonlein purpura nephritis d. Immunoglobulin A nephropathy

a. Alport syndrome

A widow who lost her husband a few weeks ago is having trouble with insomnia. When visiting with her health care provider, the provider suggests a prescription to help her regain a normal circadian pattern. This is based on the fact that interruption of sleep-wake cycles can cause which problems? Select all that apply. a. Alterations in immune function that can result in an infection b. An increased risk in accidents when sleep deprived, similar to those under the influence of alcohol c. Hallucinations that may result in harm to the individual d. Excess of non-rapid eye movement (NREM) sleep, which affects the creativity process e. Restless leg syndrome due to inability to find a comfortable sleeping position

a. Alterations in immune function that can result in an infection b. An increased risk in accidents when sleep deprived, similar to those under the influence of alcohol

The nurse is preparing a client for bone marrow transplant. The client asks, "How long will it take for the new marrow to make the blood cells?" What is the nurse's best response? a. Although it can vary, we will administer medication that will stimulate the bone marrow to create the cells. b. The stem cells that are injected will take the normal amount of time to create the cells as if it were your own marrow. c. The new marrow will not be creating blood cells until it has homed to the appropriate areas and matured. d. Because we place the donated marrow directly into your iliac crest, the marrow will start making cells right away.

a. Although it can vary, we will administer medication that will stimulate the bone marrow to create the cells.

The nurse knows that if which hormones listed below are not available during embryonic development, a male embryo with an XY chromosomal pattern may develop female external genitalia? Select all that apply. a. Anti-müllerian hormone (AMH) b. Testosterone c. Dihydrotestosterone (DHT) d. Acrosome e. Follicle-stimulating hormone (FSH)

a. Anti-müllerian hormone (AMH) b. Testosterone c. Dihydrotestosterone (DHT)

A client is admitted for cardioembolic stroke. Which therapy to best prevent recurrence of embolic stroke should the nurse monitor for effectiveness? a. Anticoagulation therapy b. Blood pressure management c. Correction of dyslipidemia d. Antiarrhythmic therapy

a. Anticoagulation therapy

A student asks the faculty member, "I just do not get how a hormone can be produced within a neuron and then travel via the blood to affect target cells. Can you give me a couple of examples of this phenomenon?" Which faculty response(s) answers this student's question? Select all that apply. a. Antidiuretic hormone b. Parathyroid hormone c. Testerostone d. Insulin e. Epinephrine

a. Antidiuretic hormone e. Epinephrine

An older adult client has a history of ischemic heart disease, MI, unstable angina controlled by transdermal nitroglycerin patch, chronic smoking requiring use of nebulized bronchodilators, and hypertension treated with a potassium-sparing diuretic and a beta-adrenergic blocking medication. The man states that he has been unable to maintain his erection. Which aspects of the man's health problems/treatments would the nurse identify as contributing to his erectile difficulty (ED)? Select all that apply. a. Antihypertensive medications b. Use of bronchodilators c. Hypertension d. Diuretic use e. Smoking history f. Age

a. Antihypertensive medications c. Hypertension e. Smoking history f. Age

A nurse is teaching a group of older adults about the value of including foods containing antioxidants in their diet. Which statement best captures the rationale underlying the nurse's advice? a. Antioxidants inhibit the actions of reactive oxygen species. b. Antioxidants prevent the formation of superoxide dismutase. c. Antioxidants react nonspecifically with molecules. d. Antioxidants prevent the occurrence of cell dysplasia.

a. Antioxidants inhibit the actions of reactive oxygen species.

The nurse is caring for a 45-year-old client undergoing radiotherapy of the mediastinal nodes due to lymphoma. Which interventions should the nurse prioritize? Select all that apply. a. Assessing for fatigue b. Avoiding invasive procedures c. Performing respiratory assessment d. Performing neurologic assessment e. Assessing for urinary retention

a. Assessing for fatigue b. Avoiding invasive procedures c. Performing respiratory assessment

The nurse is caring for a client hospitalized yesterday with acute coronary syndrome. The client also has difficulty dealing with life stressors. On what should the nurse focus as the priority of care? a. Assessing heart rate and blood pressure and interviewing the client about chest pain b. Counseling the client on how to reduce life stressors to decrease the impact on overall health c. Teaching the client stress management techniques such as guided imagery and journaling d. Encouraging physical activity along with a healthy diet to slow the progression of heart disease

a. Assessing heart rate and blood pressure and interviewing the client about chest pain

The nurse notes eosinophilia on the client's laboratory results. The nurse should interview the client about a history of which conditions? Select all that apply. a. Asthma b. Exposure to parasites c. Allergic reactions d. Viral infection e. Bacterial infection

a. Asthma b. Exposure to parasites c. Allergic reactions

The nurse is caring for a client with an astrocytoma. The client asks, "What do astrocytes do in the brain?" What is the nurse's best response? a. Astrocytes have a protective and regulatory function in the grey matter of your brain. b. These are the cells that produce the myelin needed by axons in your central nervous system. c. Astrocytes are phagocytic and clear away substances that should not be present in the brain. d. These cells are responsible for producing synapses that result in thought and behavior.

a. Astrocytes have a protective and regulatory function in the grey matter of your brain.

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.

Following a bone marrow biopsy, which assessment would indicate the client is experiencing a complication as a result of this diagnostic procedure? a. BP 90/60, heart rate 132, excess bleeding, and hematoma noted at insertion site. b. BP 130/80, oxygen saturation 95%, crackles heard on inspiration. c. Respiratory rate 24, complaining of pain at insertion site. d. Heart rate regular 64 bpm, temperature 99.6°F (37.5°C) orally.

a. BP 90/60, heart rate 132, excess bleeding, and hematoma noted at insertion site.

Which type of pneumonia is best characterized by an infective agent that produces sputum samples with a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet? a. Bacterial b. Chlamydial c. Viral d. Mycoplasmal

a. Bacterial

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which treatment would the nurse most likely anticipate providing for the client? a. Beta-adrenergic blocking medications (beta-blockers) to reduce sympathetic nervous stimulation b. Administration of levothyroxine to supplement thyroid function c. Calcium channel blocking medications to reduce heart rate and cardiac risks d. Administration of somatostatin analogs to inhibit GH production

a. Beta-adrenergic blocking medications (beta-blockers) to reduce sympathetic nervous stimulation

A client is admitted to a rehabilitation center after hospital treatment for an ischemic stroke. What aspects of the client's history are risk factors for ischemic stroke? Select all that apply. a. Black male b. Takes iron supplements for the treatment of chronic anemia c.Blood pressure historically in the range of 150/90 to 160/100 mm Hg d. Diagnosed with type 2 diabetes 8 years ago e. Takes corticosteroids for the treatment of rheumatoid arthritis

a. Black male c.Blood pressure historically in the range of 150/90 to 160/100 mm Hg d. Diagnosed with type 2 diabetes 8 years ago

The nurse is caring for a client who has a tumor that results in excess levels of catecholamines being released. Which assessments will the nurse prioritize in this client's plan of care? Select all that apply. a. Blood glucose b. Blood pressure c. Heart rate and rhythm d. Oxygen saturation e. Level of consciousness

a. Blood glucose b. Blood pressure c. Heart rate and rhythm

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

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

A client has recently been diagnosed with large cell carcinoma, and the nurse is preparing the client for diagnostic testing to identify distal metastases. Which sites should the nurse explain to the client as the primary focus for the investigation? Select all that apply. Select 3 correct answer(s) a. Bone b. Colon c. Brain d. Liver e. Mediastinal lymph nodes

a. Bone c. Brain d. Liver

A client who is on several medications has noticed an increase in gastrointestinal infections. What type of medication should the nurse advise the client to discuss with the health care provider as a possible cause for increased gastrointestinal infections? a. Broad-spectrum antibiotics b. Beta-1 selective adrenergic blocker c. H1 receptor blocker d. Enteric-coated aspirin

a. Broad-spectrum antibiotics

The emergency department is awaiting the arrival of a client with a spinal cord injury. Knowing the innervation of the diaphragm, a client with which type of injury may be in need of immediate mechanical ventilation? Injury to the: a. C4 area. b. C7 area. c. T1 area. d. T4 area.

a. C4 area.

A client with kidney cancer who underwent exploratory surgery has returned to the postoperative unit with a report of severe burning and indigestion in the epigastric region. Which intervention by the nurse would be priority for this client? a. Call the surgeon for a prescription for a proton pump inhibitor (PPI) to prevent stress ulcer development. b. Sit the client up in a high-Fowler position and give ice chips to suck on. c. Call the dietary team to bring some milk products to the floor to counter excess gastric acid. d. Administer prescribed pain medications and dim the lights in the room.

a. Call the surgeon for a prescription for a proton pump inhibitor (PPI) to prevent stress ulcer development.

A client arrives with symptoms of stroke. What should the nurse assess first? a. Capillary blood glucose b. Serum creatinine and urea c. Serum potassium d. Coagulation tests

a. Capillary blood glucose

The nurse is creating a plan of care for a 45-year-old male client who has lived with untreated hypogonadism for the past 20 years. The nurse should prioritize screening the client for which health conditions related to his hypogonadism? Select all that apply. a. Cardiovascular disease b. Colon cancer c. Depression d. Prostate cancer e. Osteoporosis

a. Cardiovascular disease c. Depression e. Osteoporosis

The nurse will most likely assess which clinical manifestation in a client diagnosed with Creutzfeldt-Jakob disease? a. Change in behavior and memory, loss of coordination leading to encephalopathy b. Gastrointestinal problems like vomiting and diarrhea c. Muscle inflammation and edema, making movements very painful d. Projectile vomiting, hypertension, and drowsiness caused by elevated ICP

a. Change in behavior and memory, loss of coordination leading to encephalopathy

Which clients would be at risk for developing nonthrombocytopenic purpura? Select all that apply. a. Child adopted from India and displaying malaise, lethargy, and petechiae all over the body associated with suspected scurvy. b. 73-year-old client admitted with concussion that resulted from a fall c. 55-year-old client diagnosed with Cushing disease displaying bruises, weight gain with a buffalo hump, and "moon" face d. 15-year-old with insulin-dependent diabetes who has hypoglycemia and is displaying irritability with headaches and tachycardia e. Pregnant mother experiencing headaches and proteinuria

a. Child adopted from India and displaying malaise, lethargy, and petechiae all over the body associated with suspected scurvy. c. 55-year-old client diagnosed with Cushing disease displaying bruises, weight gain with a buffalo hump, and "moon" face

A client with a history of chronic nausea and vomiting but an insatiable appetite has the symptoms attributed to an enzyme deficiency. Which enzyme deficiency is primarily responsible for the large appetite and lack of control of food intake? a. Cholecystokinin b. Ghrelin c. Gastrin d. Secretin

a. Cholecystokinin

A 78-year-old male client has undergone a total knee replacement. He just doesn't feel like getting out of bed and moving around. After 3 days of staying in bed, the physical therapist encourages him to get out of bed to the chair for meals. He starts to complain of dizziness and lightheadedness. These symptoms are primarily caused by which pathophysiologic principle? Select all that apply. a. Client is experiencing a reduction in plasma volume. b. Peripheral vasoconstriction mechanism has failed. c. Client is so stressed that he is releasing too many endorphins. d. Client is still bleeding from the surgical procedure. e. Client has loss all of his muscle tone.

a. Client is experiencing a reduction in plasma volume. b. Peripheral vasoconstriction mechanism has failed.

Which client, when faced with acute stressful situations, would be considered highest risk for becoming noncompliant with his/her medication regimen? a. Client with end-stage renal failure experiencing electrolyte imbalances related to having trouble sticking to the prescribed diet b. Teenager whose period is late by 2 weeks and afraid to tell her parents c. Paraplegic client who forgot his pressure control device and has a small decubitus on the coccyx d. New mother who is breast-feeding every 2 to 3 hours throughout the day and night

a. Client with end-stage renal failure experiencing electrolyte imbalances related to having trouble sticking to the prescribed diet

Two years after chemotherapy and radiation therapy for lung cancer, a 72-year-old client reports being extremely tired all the time. The physician suspects the client may have developed aplastic anemia. The nurse assessing the client will likely find which clinical manifestation of aplastic anemia? Select all that apply. a. Complaints of weakness and fatigue b. Small spots of skin hemorrhages over entire body c. Excess bleeding from gums and nose d. Spoon-shaped deformity of the fingernails e. Hemolysis from renal dialysis treatments

a. Complaints of weakness and fatigue b. Small spots of skin hemorrhages over entire body c. Excess bleeding from gums and nose

The nurse is caring for a client with an altered level of consciousness and needs to assess the withdrawal reflex. Which action should the nurse perform? a. Creating a painful stimulus to the client's extremities b. Asking the client to flex a limb while applying resistance c. Stroking the plantar aspect of the client's foot d. Producing a loud noise near the client's ear

a. Creating a painful stimulus to the client's extremities

A 28-year-old man presents with reports of diarrhea, fecal urgency, and weight loss. His stool is light-colored and malodorous, and it tends to float and be difficult to flush. He has also noted tender, red bumps on his shins and reports pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which diagnosis would his care team first suspect? a. Crohn disease b. Ulcerative colitis c. Diverticulitis d. Colon cancer

a. Crohn disease

A 79-year-old female resident of an assisted living facility receives care from a community nurse on a regular basis for treatment of a chronic venous leg ulcer. Which factor would the nurse be most justified in ruling out as a contributing factor to the client's impaired wound healing? a. Decreased antibody levels b. A lower skin collagen content than in younger adults c. Decreased fibroblast synthesis d. Slow re-epithelialization

a. Decreased antibody levels

A 71-year-old woman is dependent on oxygen therapy and bronchodilators due to her diagnosis of emphysema. Which pathological processes occur as a result of her emphysema? Select all that apply. a. Decreased elastic recoil due to alveolar damage. b. Decreased residual lung volume due to impaired alveolar ventilation. c. Increased anatomical dead space due to reduced tidal volume. d. Increased alveolar dead space due to incorrect intrapleural pressure.

a. Decreased elastic recoil due to alveolar damage. c. Increased anatomical dead space due to reduced tidal volume. d. Increased alveolar dead space due to incorrect intrapleural pressure.

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal react in which way? a. Decreasing amplitude of the slow waves, which control the spontaneous oscillations in membrane potentials. b. Increasing the peristaltic motion of the gastrointestinal tract, thereby causing explosive diarrhea. c. Increasing the amount of secretions being entered into each segment of the intestinal tract. d. Signaling the vagus nerve to slow down motility and increase absorption of water from the large intestines.

a. Decreasing amplitude of the slow waves, which control the spontaneous oscillations in membrane potentials.

The nurse is planning care for a client in the acute recovery phase after an ischemic stroke. What interventions will the nurse prioritize when planning care? Select all that apply. a. Deep vein prophylaxis b. Falls prevention c. Swallowing precautions d. Reorientation exercises e. Stroke prevention education

a. Deep vein prophylaxis b. Falls prevention c. Swallowing precautions

A client with pancreatitis is admitted with weight loss, nausea, and vomiting. To maintain nutrition, the physician orders parenteral nutrition to be started. Knowing that a major side effect of parenteral nutrition is a hyperosmolar hyperglycemic state, the nurse should assess the client for which clinical manifestations? a. Dry lips, excess urine output, and seizures. b. Facial tics, shuffling gait, stiff joints. c. Fever, chills, elevated BP of 170/101. d. Irritability, bradycardia, wheezing noted on inspiration.

a. Dry lips, excess urine output, and seizures.

The nurse practitioner is working in an overnight sleep lab assessing and diagnosing clients with sleep apnea. During this diagnostic procedure, the nurse notes that a client's blood pressure is 162/97 mm Hg. The nurse explains this connection to the client based on which pathophysiologic principle? a. During apneic periods the client experiences hypoxemia, which stimulates chemoreceptors to induce vasoconstriction. b. When the client starts to snore, the epiglottis is closed over the trachea. c. Specialized cells are located in the back of the throat that signal when the airway is obstructed; this sends signals to the kidney to increase the pulse rate. d. When airways are obstructed, the body will retain extracellular fluid so that this fluid can be shifted to intravascular space to increase volume.

a. During apneic periods the client experiences hypoxemia, which stimulates chemoreceptors to induce vasoconstriction.

The nurse is assessing a client. What findings should the nurse apply as evidence of iron deficiency anemia? Select all that apply. a. Dyspnea on exertion b. Oral lesions c. Concave fingernails (koilonychia) d. Jaundice e. Paresthesia of the feet and fingers

a. Dyspnea on exertion b. Oral lesions c. Concave fingernails (koilonychia)

A client reports having diarrhea that has lasted days. Which intervention would the nurse recommend to decrease the diarrhea? a. Electrolyte drink containing sodium and glucose b. Diet soda c. Water d. Drink with caffeine

a. Electrolyte drink containing sodium and glucose

An adult client with a possible growth hormone (GH)-secreting tumor is undergoning testing. If a glucose load is given, which response by the body would confirm the client has a GH-secreting tumor? a. Elevated GH level after a glucose load b. No change in blood level after the glucose load c. Suppression of the GH level d. Development of gigantism

a. Elevated GH level after a glucose load

Tumor necrosis factor-α and IL-1 are major cytokines that mediate inflammation. If the client is developing a systemic response to an infection, the nurse will likely assess which clinical manifestations? Select all that apply. a. Elevated temperature b. Tachycardia c. Anorexia d. Hypertension e. Decrease in urine output

a. Elevated temperature b. Tachycardia c. Anorexia

The nurse is caring for a client with jaundice. What evidence will the nurse use to determine if the cause of the jaundice is due to a hemolytic condition? a. Elevated unconjugated bilirubin b. Decreased hemoglobin c. Liver function tests d. Decreased conjugated bilirubin

a. Elevated unconjugated bilirubin

The nurse is caring for a client with a diabetic foot ulcer who has difficulty adhering to dietary restrictions. This has resulted in elevated blood glucose levels. What information is most important for the nurse to share with the client? a. Elevations in blood glucose make it more difficult for your white blood cells to fight the infection. b. We can have the registered dietitian come to speak to you about the importance of following your diet. c. High blood glucose levels damage your arteries and reduce the blood flow to your wound. d. When you do not comply with your diet, it makes it more difficult for us to help you get well.

a. Elevations in blood glucose make it more difficult for your white blood cells to fight the infection.

A nurse is providing care for a client who is immunocompromised following chemotherapy. The nurse knows that which characterization of the adaptive immune system is responsible for the client's disruption in normal immune function? a. Epitopes on antigens are recognized by immunoglobulin receptors following presentation by accessory cells. b. Haptens combine to form epitopes that stimulate the response of regulatory and effector cells. c. Effector cells orchestrate the immune response of regulatory cells toward an antigen. d. Accessory cells such as macrophages are engulfed by regulatory cells, stimulating effector cells.

a. Epitopes on antigens are recognized by immunoglobulin receptors following presentation by accessory cells.

Which phenomena best accounts for the increased presence of leukocytes at the site of inflammation? a. Existing leukocytes stick to the epithelial cells and move along blood vessel walls. b. Increased numbers of leukocytes are released into circulation via cytokine stimulation. c. Leukocytes are osmotically drawn from circulation into the interstitial space as a result of swelling. d. Epithelium expresses leukocyte stimulation factors in response to cell injury.

a. Existing leukocytes stick to the epithelial cells and move along blood vessel walls.

The nurse is assessing a female neonate on the neonate's first clinic appointment after leaving the hospital. Which manifestations leads the nurse to suspect the neonate has developed a urinary tract infection? Select all that apply. a. Fever higher than 101°F (38.3°C) b. Poor skin perfusion with ashen color c. Abdominal distention d. Irritability e. Parent reports enuresis. f. Parent reports crying when infant is urinating.

a. Fever higher than 101°F (38.3°C) b. Poor skin perfusion with ashen color c. Abdominal distention d. Irritability

During science class, a student asks, "What is the difference between plasma and serum in the blood?" The nurse responds that the primary difference between plasma and serum is that plasma contains: a. Fibrinogen b. Heparin c. White blood cells d. Hydrogen ions

a. Fibrinogen

Of the following list of medications, which would likely be prescribed to a client with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate? a. Finasteride, a 5-alpha-reductase inhibitor b. Isosorbide mononitrate, a vasodilator c. Birth control pills containing both estrogen and progestin d. Leuprolide, a gonadotropin-releasing hormone analog

a. Finasteride, a 5-alpha-reductase inhibitor

The blood work of a 44-year-old male client with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which phenomenon would a clinician be most justified in anticipating? a. Fluid imbalances b. Impaired immune function c. Acid-base imbalances d. Impaired thermoregulation

a. Fluid imbalances

The nurse is caring for a client with left-sided heart failure causing chronic activation of the renin-angiotensin-aldosterone system (RAAS). What is the nurse's priority assessment? a. Fluid volume excess b. Decreased blood pressure when standing c. Hyperkalemia d. Increased urine output

a. Fluid volume excess

The nurse is caring for a male client who has been diagnosed as having hypogonadism, and the health care provider is now investigating the cause of the condition. What diagnostic test should the nurse anticipate being ordered? a. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels b. Genetic testing c. Testosterone levels d. A biopsy of the prostate gland

a. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels

The nurse is caring for a client with a disorder that prevents the pyloric valve from closing properly. For which priority complication should the nurse assess? a. Gastrointestinal bleeding b. Pancreatitis c. Intestinal obstruction d. Jaundice

a. Gastrointestinal bleeding

After several months on a waiting list, a 44-year-old male received a liver transplant 5 days ago. In the last 36 hours, he has developed a rash beginning on his palms and soles, along with abdominal pain and nausea. It has been determined by his care team that the immune response that is causing his symptoms originates not with his own compromised immune components but with those introduced with his new organ. This man's most likely medical diagnosis is: a. Graft-versus-host-disease (GVHD) b. Acute transplant rejection c. Hyperacute organ rejection d. T-cell mediated graft rejection

a. Graft-versus-host-disease (GVHD)

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.

During a period of stress, the nurse asks the client to close his eyes and think of a calm, relaxing place where he can feel the wind blowing on his cheek and smell the salty air from the ocean. This is an example of utilizing which type treatment for stress reduction? a. Guided imagery b. Hypnosis c. Yoga d. Biofeedback

a. Guided imagery

A 19 year-old intravenous drug user was exposed to the HIV virus 3 weeks ago and is experiencing a rapid proliferation in viral load. Which statement best captures an aspect of the process of HIV replication that underlies this proliferation? a. HIV is able to change its RNA into DNA to allow for replication by CD4+ cells. b. Free HIV RNA is able to attach to the cell coat of CD4+ cells. c. The cytoplasm of CD4+ cells provides a protected environment for the replication of RNA by HIV. d. Expression of reverse transcriptase by CD4+ cells allows replication of HIV cells rather than new lymphocytes.

a. HIV is able to change its RNA into DNA to allow for replication by CD4+ cells.

The nurse is assessing heart sounds on a client and detects a previously undocumented murmur. What diagnostic test should the nurse prioritize requesting an order for related to this finding? a. Hemoglobin b. Potassium c. Troponin d. Calcium

a. Hemoglobin

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 premature infant on mechanical ventilation has developed bronchopulmonary dysplasia (BPD) and is showing manifestations of hypoxemia, low lung compliance, and respiratory distress. Which factors are the most likely contributors to the infant's present health problem? a. High inspired oxygen concentration and injury from positive-pressure ventilation b. Failure to administer corticosteroids to the infant in utero c. Insufficient surfactant production and insufficient surfactant therapy d. Insufficient supplemental oxygen therapy

a. High inspired oxygen concentration and injury from positive-pressure ventilation

A client has suffered a head injury during a motorcycle accident resulting in impaired swallowing and aspiration pneumonia. Which statement most accurately captures an aspect of his condition? a. His vocal folds of the larynx are not performing their normal function. b. His epiglottis is covering his larynx c. His trachea has been compromised. d. His tracheobronchial tree is intermittently obstructed.

a. His vocal folds of the larynx are not performing their normal function.

A deficiency in which of these would result in an inhibition of the inflammatory response? a. Histamine b. Helper T cells c. B cells d. Vitamin K

a. Histamine

A client arrives at the emergency department with symptoms of stroke. What evidence should the nurse gather to determine if the client is a candidate for thrombolytic therapy? Select all that apply. a. History of stroke b. Age c. Blood pressure d. Heart rate e. Time of symptom onset

a. History of stroke c. Blood pressure e. Time of symptom onset

When explaining the final stages of the inflammatory response to pathogens, the nurse should include which educational topics? a. How the body can kill the pathogen by generating toxic oxygen and nitrogen products, producing such things as nitric oxide and hydrogen peroxide b. Margination, which is a process whereby white cells (leukocytes) stick to the endothelium and accumulate along the blood vessel c. The increase in vascular permeability, which lets fluids leak into the extravascular tissues d. The promotion of tissue regeneration, whereby monocytes and macrophages produce potent prostaglandins and leukotrienes

a. How the body can kill the pathogen by generating toxic oxygen and nitrogen products, producing such things as nitric oxide and hydrogen peroxide

The health care provider is ordering a complete blood count (CBC). What information should the nurse expect to be able to gather from the results? Select all that apply. a. If the client has anemia b. The presence of leukocytosis c. If the client is deficient in clotting factors d. If there are common vitamin deficiencies e. Presence of thrombocytopenia

a. If the client has anemia b. The presence of leukocytosis e. Presence of thrombocytopenia

When educating a client with a wound that is not healing, the nurse should stress which dietary modifications to ward off some of the negative manifestations that can occur with inflammation? a. Increase your intake of oily fish and fish oil so that you will increase absorption of omega-3 polyunsaturated fatty acids. b. Increase the amount of calcium in the diet, especially drinking milk and eating cheese. c. This is the one time whereby you should eat more fat (both polyunsaturated and saturated) so you can absorb more fat-soluble vitamins. d. Since there is a loss of plasma proteins, you should increase your intake of organ meats like liver.

a. Increase your intake of oily fish and fish oil so that you will increase absorption of omega-3 polyunsaturated fatty acids.

A client who has been awaiting the results of a bone marrow biopsy for several days is experiencing stress as a result of uncertainty and the possibility that abnormal cell growth may be detected. A physical examination and blood work would most likely yield which result? a. Increased blood pressure and heart rate; increased antidiuretic hormone (ADH). b. Increased respiratory rate; increased levels of testosterone c. Pupil dilation; increased somatomedin C d. Increased gastrointestinal motility; decreased thyroid-stimulating hormone

a. Increased blood pressure and heart rate; increased antidiuretic hormone (ADH).

A nurse is teaching a student about nephrotic syndrome. Which statement(s) about the pathogenesis of nephrotic syndrome is accurate and should be included in the education? Select all that apply. a. Increased glomerular membrane permeability allow proteins to escape from the plasma into glomerular filtrate. b. Massive proteinuria is a result of the increased permeability. c. Loss of colloidal osmotic pressure causes generalized edema. d. The presence of glomerular immunoglobulin A immune complex deposits occur. e. There is an insidious onset beginning with hematuria and mild hypertension.

a. Increased glomerular membrane permeability allow proteins to escape from the plasma into glomerular filtrate. b. Massive proteinuria is a result of the increased permeability. c. Loss of colloidal osmotic pressure causes generalized edema.

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 c. Decreased serum albumin d. Increased aldosterone levels

Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was performed. Which result is most likely to be considered unexpected by the health care team? a. Increased thrombopoietin levels b. Decreased platelet count c. Normal vitamin K levels d. Normal leukocyte levels

a. Increased thrombopoietin levels

Which effect of the sympathetic nervous system is most responsible for the development of duodenal ulcers due to anxiety and stress? a. Inhibition of the actions of Brunner glands b. Overstimulation of the oxyntic glands c. Suppression cholecystokinin d. Inflammation of the parotid glands

a. Inhibition of the actions of Brunner glands

A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which phenomenon best captures the rationale for allergy desensitization therapy? a. Injections of allergens simulate production of IgG, combining with the antigens to prevent activation of IgE antibodies. b. Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response. c. Allergens in large, regular quantities overwhelm the IgE antibodies that mediate the allergic response. d. Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response.

a. Injections of allergens simulate production of IgG, combining with the antigens to prevent activation of IgE antibodies.

Which statement most accurately conveys an aspect of cell injury due to impaired calcium homeostasis? a. Injured cells tend to accumulate calcium. b. Normal intracellular calcium ion levels are higher than extracellular levels. c. Ischemia and certain toxins cause a decrease in cytosolic calcium. d. Low calcium levels cause an activation of damaging enzymes.

a. Injured cells tend to accumulate calcium.

A 61-year-old client with a 40 pack-year history of cigarette smoking and chronic obstructive pulmonary disease (COPD) is experiencing an increase in arterial levels of CO2. This change stimulates the inspiratory center in the medulla oblongata, which in turn causes the diaphragm to contract more forcefully and increase respiratory rate. Which term best describes the role of the inspiratory center? a. Integrator b. Sensor c. Effector d. Feedback system

a. Integrator

A brain tumor causing clinical manifestations of headache, nausea, projectile vomiting, and mental changes is likely located in which part of the brain? Select all that apply. a. Intra-axial b. Extra-axial c. Brain stem d. Temporal lobe e. Frontal lobe.

a. Intra-axial b. Extra-axial e. Frontal lobe.

A Tae Kwon Do (TKD) master is applying downward pressure just above the elbow joint on an attacker who immediately collapses to the ground. The TKD master knows the elbow joint can bend inwards towards the body, but not in the opposite direction. Which reflex is applicable to this example? a. Inverse myotatic b. Knife-clasp c. Withdrawal d. Myotatic

a. Inverse myotatic

Misinterpreting her physician's instructions, a 69-year-old woman with a history of peripheral artery disease has been taking two 325 mg tablets of aspirin daily. How has this most likely affected her hemostatic status? a. Irreversible acetylation of platelet cyclooxygenase activity has occurred. b. The client's prostaglandin TXA2 levels are abnormally high. c. She is at risk of developing secondary immune thrombocytopenic purpura (ITP). d. The binding of an antibody to platelet factor 4 produces immune complexes.

a. Irreversible acetylation of platelet cyclooxygenase activity has occurred.

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

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

A client presents to their health care provider with excruciating back pain progressively getting worse, decreased sensation in his lower extremities, urinary incontinence, and problems completely emptying his bladder. He is diagnosed with advanced prostate cancer with spinal cord compression and admitted to the hospital. The nurse should anticipate administering which medications to this client? Select all that apply. a. Ketoconazole, a fungicide to lower serum testosterone levels b. Bisphosphonates, such as pamidronate, to inhibit bone loss c. Phosphate binding agents such as aluminum hydroxide d. Sulfonamides with trimethoprim to treat the urinary tract infection (UTI) e. Calcium carbonate to prevent osteoporosis

a. Ketoconazole, a fungicide to lower serum testosterone levels b. Bisphosphonates, such as pamidronate, to inhibit bone loss

The nurse is caring for neonates undergoing treatment for hyperbilirubinemia. Which assessment findings should the nurse prioritize? Select all that apply. a. Lethargy b. Rigidity c. Jaundice d. Increase in urine output e. Reduction in feeding

a. Lethargy b. Rigidity e. Reduction in feeding

A student is attempting to trace the feedback cycle involved in the stress response. Which neural structure is thought to be the central integrating site for the stress response? a. Locus caeruleus b. Hypothalamus c. Cerebral cortex d. Reticular formation

a. Locus caeruleus

A person who has been diagnosed with HIV infection 12 years ago and still has a CD4+ cell count of 800 cells/μL and a low viral load is considered to be in which clinical group? a. Long-term nonprogressor b. Rapid progressor c. Typical progressor d. Delayed progressor

a. Long-term nonprogressor

The nurse is caring for a client in emergent fluid overload requiring rapid diuresis. Which diuretic should the nurse be prepared to administer? a. Loop b. Potassium sparing c. Thiazide d. Osmotic

a. Loop

A 16-year-old girl has broken her arm while snowboarding and is shocked at the amount of swelling at the injury site. Which statement best explains the physiologic rationale for her swelling? a. Loss of plasma proteins causes an increase in interstitial osmotic pressure. b. Migration and proliferation of mast cells, neutrophils, and platelets to the injury site occupy an increased volume of tissue. c. Potent vasodilation increases the total volume of vascular space at the site of inflammation. d. Osmotic flow of plasma into the intravascular space causes increased blood volume and interstitial fluid.

a. Loss of plasma proteins causes an increase in interstitial osmotic pressure.

A 53-year-old female hospital client has received a kidney transplant following renal failure secondary to hypertension. The teaching prior to transplant made her aware that she would need to take anti-rejection drugs for the rest of her life. Which aspect of the immune system underlies this necessity? a. MHC molecules will never develop in the cells of the donor organ and effector cells will be continually stimulated. b. The lack of identifiable major histocompatibility complex (MHC) molecules will stimulate the innate immune response. c. Donor organ antibodies will be identified as foreign and stimulate an immune response. d. Anti-rejection drugs will stimulate the production of familiar MHC molecules.

a. MHC molecules will never develop in the cells of the donor organ and effector cells will be continually stimulated.

The nurse knows that a client with diabetes admitted for a lower limb infection likely is experiencing which pathophysiologic principle listed below? Select all that apply. a. Many clients with diabetes have sensory deficits and ignore minor trauma just because they can't feel it in their feet. b. Clients with chronic diabetes may have vascular problems that impair circulation and therefore cells needed for adequate inflammatory response can't reach the site. c. Hyperglycemia may provide an environment that enhances the growth of microorganisms. d. Infections happen to all age-groups and people and the client with diabetes has the same risk for developing an infection as other clients without diabetes. e. Any exercise that creates diaphoresis in their feet can cause a fungal infection in clients with diabetes.

a. Many clients with diabetes have sensory deficits and ignore minor trauma just because they can't feel it in their feet. b. Clients with chronic diabetes may have vascular problems that impair circulation and therefore cells needed for adequate inflammatory response can't reach the site. c. Hyperglycemia may provide an environment that enhances the growth of microorganisms.

A client presents with sudden, violent diarrhea and vomiting after consuming chicken and potato salad 8 hours prior at the beach on a hot day. The nurse knows which statement best matches the phase of the infectious process of food poisoning? a. Maximum impact of infectious process b. Insidious prodromal phase c. Sudden incubation of active replication d. Subacute prodromal phase

a. Maximum impact of infectious process

Which diagnostic finding is likely to result in the most serious brain insult? a. Mean arterial pressure (MAP) that equals intracranial pressure (ICP) b. Moderate decrease in brain tissue volume secondary to a brain tumor removal c. Increased ICP accompanied by hyperventilation d. High intracellular concentration of glutamate

a. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)

A client with type 2 diabetes has just screened positive for microalbuminuria. What should the nurse discuss with the client as most likely to be included in the treatment plan? Select all that apply. a. Measuring HgbA1C level b. Beta-blockers to control hypertension c. Fluid restriction d. Smoking cessation e. Referral to dietitian

a. Measuring HgbA1C level b. Beta-blockers to control hypertension d. Smoking cessation e. Referral to dietitian

The nurse is caring for a client with multiple myeloma. What aspects of care should the nurse prioritize? Select all that apply. a. Monitor urine output b. Position in high Fowler's c. Assist for ambulation d. Encourage increased fluid intake e. Restrict to a soft diet

a. Monitor urine output c. Assist for ambulation d. Encourage increased fluid intake

An adult female, newly diagnosed with possible leukemia, arrives for a bone marrow biopsy. The admission laboratory work includes: red blood cell count (RBC): 3.4 ×106/μL (3.4 ×1012/L); white blood cell count (WBC): 2,500/μL (2.5 ×109/L); platelet count of 80 ×103/μL (80 ×109/L); all below normal values. What assessment is the highest priority for this client? a. Monitoring for any type of bleeding. b. Forcing fluids to maintain renal function. c. Checking breath sounds twice a day for signs of pneumonia. d. Assessing heart sounds for any new murmurs.

a. Monitoring for any type of bleeding.

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

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

An 81-year-old male client who has a diagnosis of orthostatic hypotension is experiencing an episode of particularly low blood pressure. The man's body has responded by increasing levels of angiotensin II in the bloodstream, a hormone which decreases glomerular filtration rate in the kidneys and contributes to an increase in blood pressure. Which phenomena best describes what has occurred? a. Negative feedback b. Positive feedback c. Adaptation d. Homeostasis

a. Negative feedback

Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the: a. Neutrophils b. Erythrocytes c. Albumin d.Basophils

a. Neutrophils

The nurse is caring for a client with leukemia and a blast count of 100,000 cells/μL (100 x 109/L). What client reports should prompt the nurse to take immediate action? Select all that apply. a. New onset dyspnea b. Increased urine output c. Headache d. Lethargy e. Bleeding from gums

a. New onset dyspnea c. Headache d. Lethargy

Which assessment finding(s) correlatea with the health care providers preliminary diagnosis of a more aggressive form of non-Hodgkin lymphoma (NHL)? Select all that apply. a. Night sweats b. Elevated temperature c. Peripheral edema d. Weight loss e. Enlarged pancreas f. Reed-Sternberg cells in lymph node tissue

a. Night sweats b. Elevated temperature d. Weight loss

The nurse is caring for a client on several new medications and is experiencing diarrhea. What medication should the nurse associate with an increased risk for diarrhea? a. Non-selective adrenergic blocker b. Anticholinergic c. Opioid analgesic d. Calcium channel blocker

a. Non-selective adrenergic blocker

During a routine physical exam for a client diagnosed with hypertension, the nurse practitioner will be most concerned if which assessment is found? a. Noted hemorrhages and microaneurysms during evaluation of internal eye. b. Unable to feel vibrations when tuning fork placed on skull. c. Inability to locate kidneys with deep palpation to abdomen. d. Slight increase in number of varicose veins noted bilaterally.

a. Noted hemorrhages and microaneurysms during evaluation of internal eye.

The nurse is caring for a client suspected of having contracted C. difficile. Assessment reveals abdominal distension and new onset fever. What is the nurse's best action? a. Notify the health care provider immediately of the findings. b. Administer the client's dose of metronidazole. c. Administer an antipyretic and assist client into side-lying position. d. Prepare to administer vancomycin via enema.

a. Notify the health care provider immediately of the findings.

A client is taking methotrexate, an antimetabolite, for cancer known to interfere with cellular DNA synthesis. Which assessments should the nurse prioritize based on the expected gastrointestinal (GI) side effects of this medication? Select all that apply. a. Oral mucosa b. Bowel movements c. Nausea d. Level of consciousness e. Oxygen saturation

a. Oral mucosa b. Bowel movements c. Nausea

The nurse is caring for a client who is suffering from high levels of chronic stress. On what should the nurse focus, as a negative effect on the client's health due to chronically elevated levels of cortisol? a. Osteoblast activity and protein synthesis are suppressed to refocus energy. b. Blood glucose levels are decreased due to excessive energy expenditure. c. The immune system is bolstered in response to an impending threat. d. Attention, arousal and respiratory rate are increased to prepare for a response.

a. Osteoblast activity and protein synthesis are suppressed to refocus energy.

A 40-year-old black client is at increased risk of developing prostate cancer, because his father was diagnosed with the disease at age 60 and his brother at age 56. What diagnostic measures should be undertaken? a. PSA and DRE starting before the age of 50 b. Transrectal ultrasonography starting immediately c. PSA and DRE starting at age 50 d. Transrectal MRI starting at age 45

a. PSA and DRE starting before the age of 50

An 80-year-old woman is slated for total hip replacement the following day, and is experiencing a large amount of stress around her potential surgical outcomes. Which is most likely to be uninvolved in the physiologic response to her stress? a. Parathyroid b. Hypothalamus c. Adrenal cortex d. Pituitary gland

a. Parathyroid

A 68-year-old male has visited his family physician because the size of his scrotum has increased exponentially in recent months. He has subsequently been diagnosed with an inguinal hernia. Which statement best captures the nature of his health problem? a. Part of his intestine and parietal peritoneum are protruding through the inguinal opening. b. Rupture of the tunica vaginalis has allowed a part of his small bowel to protrude into the intrascrotal space. c. Incomplete closure of the inguinal opening during his development has contributed to testicular hypertrophy and hyperplasia. d. Occlusion of the efferent ductules and epididymis cause massive dilation of the testes.

a. Part of his intestine and parietal peritoneum are protruding through the inguinal opening.

When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply. a. Penicillin b. Aspirin c. Morphine sulfate d. Potassium chloride e. Sodium chloride

a. Penicillin b. Aspirin c. Morphine sulfate

A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons? a. Pharyngeal efferent neurons b. General visceral efferent neurons c. Preganglionic neurons d. Parasympathetic postganglionic neurons

a. Pharyngeal efferent neurons

When discussing the sequence of clot dissolution, the science instructor will talk about which item that begins the process? a. Plasminogen b. Dabigatran c. Platelets d. α2-plasmin inhibitor

a. Plasminogen

A 71-year-old male client with a history of myocardial infarction (MI) and peripheral vascular disease (PVD) has been advised by his family physician to begin taking 81 mg aspirin once daily. Which statement best captures an aspect of the underlying rationale for the physician's suggestion? a. Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin. b. Aspirin helps to inhibit ADP action and minimizes platelet plug formation. c. Aspirin can reduce unwanted platelet adhesion by inhibiting TXA2 synthesis. d. Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.

a. Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.

A 29-year-old construction worker got a sliver under his fingernail 4 days ago. The affected finger is now reddened, painful, swollen, and warm to the touch. Which of the following hematologic processes is most likely occurring in the bone marrow in response to the infection? a. Proliferation of immature neutrophils b. High circulatory levels of myeloblasts c. Increased segmented neutrophil production d. Phagocytosis by myelocytes

a. Proliferation of immature neutrophils

A couple has been trying to get pregnant for over 2 years. After infertility testing, the physician has informed the male that he has a low sperm count. The nurse knows which causes of low sperm count may lead to impaired spermatogenesis? Select all that apply. a. Prolonged fever. b. Wearing tight briefs rather than boxers. c. Undescended testes. d. Swimming in cold-water lakes. e. Vacationing in a tropical location.

a. Prolonged fever. b. Wearing tight briefs rather than boxers. c. Undescended testes.

The nurse is caring for a client with peripheral edema. When elevating the client's legs to the level of the heart, what will the nurse expect to occur? Select all that apply. a. Reduction in the venous hydrostatic pressures of the legs b. Increase in urine output c. Reduction in the venous colloid capillary pressures d. Increase in blood pressure e. Increase in arterial perfusion of the feet

a. Reduction in the venous hydrostatic pressures of the legs b. Increase in urine output d. Increase in blood pressure

A newly diagnosed HIV-positive adolescent has blood work drawn that includes a CD8+ T-cell count. The nurse knows that which functions of CD8+ T cells listed below will assist the adolescent's immune system in fighting off the viral attack? Select all that apply. a. Release of destructive enzymes b. Trigger intracellular programmed death c. Cause allergens to surround the virus d. Booster antigen-antibody response e. Removal of foreign material from lymph before it enters the blood

a. Release of destructive enzymes b. Trigger intracellular programmed death

The nurse must insert an indwelling urinary catheter in an uncircumcised male client. What action should the nurse take to prevent paraphimosis? a. Replace the foreskin over the glans after catheter is in place. b. Retract the foreskin and perform hygiene every shift while catheter is in place. c. Apply generous amounts of lubricant into the meatus prior to catheterizing. d. Use the smallest catheter size possible.

a. Replace the foreskin over the glans after catheter is in place.

The nurse is caring for a client with hypertension and diabetes who has been diagnosed with balanoposthitis secondary to Candida albicans. What actions should the nurse make sure are in the client's plan of care? Select all that apply. a. Retract foreskin and clean all surfaces of the penis twice daily. b. Optimize glycemic control. c. Keep hypertension well-controlled. d. Apply topical corticosteroid as ordered. e. Apply topical antifungal as ordered. f. Monitor urine output.

a. Retract foreskin and clean all surfaces of the penis twice daily. b. Optimize glycemic control. e. Apply topical antifungal as ordered. f. Monitor urine output.

An older adult client is admitted with a stroke and has developed pneumonia. While auscultating the right lateral thorax, the nurse hears abnormal breath sounds. Which lobe of the lung is likely effected due to obstruction by thick secretions? a. Right middle lobe b. Right lower lobe c. Right upper lobe d. Left lower lobe

a. Right middle lobe

A science teacher is talking to a group of fifth graders about the role of "spit." During the course of the discussion, the teacher informs students about which functions of saliva? Select all that apply. a. Saliva provides good protection for oral mucosa. b. People will have more saliva production when anxious, such as right before a test. c. Saliva has antibacterial action to help keep the mouth clean. d. Saliva secretes acid to chemically break down starches. e. Saliva secretes the enzyme pepsin.

a. Saliva provides good protection for oral mucosa. c. Saliva has antibacterial action to help keep the mouth clean. d. Saliva secretes acid to chemically break down starches.

Which statement best captures the essence of a second messenger in the mechanisms of the endocrine system? a. Second messengers act as the intracellular signal that responds to the presence of a hormone. b. Endocrine-producing cells must release both a hormone and a second messenger in order to exert a distant effect. c. Second messengers act to supplement hormone effects on cell receptors when the desired hormonal effect must be either increased. d. Second messengers provide an alternative pathway for endocrine effects on a cell that bypasses the normal receptor pathways.

a. Second messengers act as the intracellular signal that responds to the presence of a hormone.

While explaining the function of the first mucosal layer of the lower two-thirds (2/3) of the esophagus, the pathophysiology instructor mentions which type of functions? Select all that apply. a. Secretion of mucus to lubricate and protect the inner surface of alimentary canal. b. Smooth muscle cells that facilitate movement of contents of the gastrointestinal tract. c. Hold the organs in place and storage for fats. d. Barrier to prevent the entry of pathogenic organisms. e. A cushioning to protect against injury from sports or car accidents.

a. Secretion of mucus to lubricate and protect the inner surface of alimentary canal. d. Barrier to prevent the entry of pathogenic organisms.

A 34-year-old male has been diagnosed with testicular cancer after he visited his family physician reporting an enlarged, painful testicle. Biopsy has indicated that his tumor is malignant, and his oncologist believes the tumor arose in the seminiferous epithelium and is producing a uniform population of cells. What is the client's most likely specific diagnosis? a. Seminoma b. Choriocarcinoma c. Germ cell tumor d. Nonseminoma

a. Seminoma

The nurse caring for a child with respiratory problems is concerned he may be developing respiratory failure. Upon assessment, which findings correlate to impending respiratory failure? Select all that apply. a. Severe accessory muscle retractions b. Nasal flaring c. Grunting on expiration d. Inspiratory wheezes heard e. Swollen glottis

a. Severe accessory muscle retractions b. Nasal flaring c. Grunting on expiration

Which medication will likely be prescribed for a client with elevated LDL and triglyceride levels? a. Simvastatin, an HMG-CoA reductase inhibitor or 'statin' b. Cholestyramine, a bile acid sequestrant c. Nicotinic acid, a B vitamin d. Fenofibrate, a fibric acid.

a. Simvastatin, an HMG-CoA reductase inhibitor or 'statin'

A nurse is caring for a client with posttraumatic stress distress disorder (PTSD). Which behaviors would the nurse expect the client to manifest? Select all that apply. a. Sleep disturbance with vivid nightmares b. Reluctance to participate in group discussions c. Difficulty concentrating on tasks d. Disregard for personal safety e. Inability to recall the traumatic events

a. Sleep disturbance with vivid nightmares b. Reluctance to participate in group discussions c. Difficulty concentrating on tasks

Which statement best captures an aspect of the role of hormones in the body? a. Some chemical substances can function as hormones or be integrated with central/peripheral nervous systems. b. Hormones directly initiate many of the processes that contribute to homeostasis. c. Control of body processes is ensured by the fact that a single hormone can only exert one effect on one specific system or tissue. d. Each hormone that exists in the body is produced by only one specific endocrine gland.

a. Some chemical substances can function as hormones or be integrated with central/peripheral nervous systems.

The nurse knows that which clinical manifestations may be present with the diagnosis of acute nephritic syndrome? Select all that apply. a. Sudden onset of hematuria b. Proteinuria c. Flank pain d. Excess urine output e. Edema

a. Sudden onset of hematuria b. Proteinuria e. Edema

A 12-year-old client who experienced trauma is now having trouble dealing with many forms of conflict in the home and becomes distraught. What is the best approach for the nurse to recommend to the parents? a. Talk about the past trauma often and encourage the child to think positively about the future. b. Avoid having disagreements in the home until the child is well enough to cope with the discord. c. Request a mild sedative that the parents can administer to the child if becoming distraught. d. Place the child in a quiet space away from any disruptions when there are disagreements.

a. Talk about the past trauma often and encourage the child to think positively about the future.

Which enzyme listed below is responsible for the ability of cancer cells to resist aging and contributes to cellular immortality that is so characteristic of this disease process? a. Telomerase b. Oxidoreductase c. Hydrolase d. Isomerase

a. Telomerase

Parents have brought their child to the emergency department with abdominal pain. Which clinical manifestations would lead the health care team to suspect the child has appendicitis? Select all that apply. a. Tenderness in right lower quadrant with palpation. b. Rebound tenderness in inguinal areas upon palpation. c. Redness and warmth over right lower quadrant. d. Bloating and flatulence noticeable. e. Urine has the smell of stool with brown coloring.

a. Tenderness in right lower quadrant with palpation. b. Rebound tenderness in inguinal areas upon palpation.

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

a. Thalamus

An occupational health nurse working with police officers wishes to apply Selye's general adaptation syndrome theory in practice. Which concept should the nurse apply? a. The alarm stage involves the release of cortisol and catecholamines. b. The nature of a stress response is determined by the objective severity of the stressor. c. Systemic illnesses can sometimes result from the resistance stage of stress response. d. Periods of stress are developmentally negative for the person experiencing them.

a. The alarm stage involves the release of cortisol and catecholamines.

A woman with a diagnosis of type 2 diabetes has been ordered a hemoglobin A1C test for the first time by her primary care provider. The woman states, "I don't see why you want to test my blood cells when it's sugar that's the problem." What aspect of physiology will underlie the care provider's response to the client? a. The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell. b. Hemoglobin synthesis by the bone marrow is inversely proportionate to blood glucose levels, with low A1C indicating hyperglycemia. c. The high metabolic needs of red cells and their affinity for free glucose indicate the amount of glucose that has been available over 6 to 12 weeks. d. Insulin is a glucose receptor agonist on the hemoglobin molecule and high glucose suggests low insulin levels.

a. The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell.

A hospital laboratory technician performing routine blood analysis as part of an inpatient's assessment is examining the sample in a test tube following processing in a centrifuge and the addition of an anticoagulant. Which observation would the technician most likely interpret as an anomaly? a. The bottom layer of blood in the tube accounts for around 40% to 45% of the total volume. b. The middle layer of cells appears white to grey in color. c. The top layer of cells is too thin to visualize without microscopy. d. The yellowish fluid on the top of the sample appears to constitute around one-quarter of the total volume.

a. The bottom layer of blood in the tube accounts for around 40% to 45% of the total volume.

A 2-year-old girl has had repeated ear and upper respiratory infections since she was born. A pediatrician has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiologic origin of the child's recurrent infections? a. The child's immune system is unable to synthesize adequate immunoglobulin on its own. b. The child had a congenital absence of IgG antibodies, which her body is only slowly beginning to produce independently. c. The child was born with IgA and IgM antibodies, suggesting intrauterine infection. d. The child lacks the antigen presenting cells integral to normal B cell antibody production.

a. The child's immune system is unable to synthesize adequate immunoglobulin on its own.

A counseling psychologist is working with a 30-year-old female client who is experiencing the symptoms of posttraumatic stress disorder (PTSD) following a house fire several months prior. Which of the client's diagnostic results could most likely be interpreted as a manifestation of PTSD? a. The client has decreased levels of cortisol. b. The client has decreased levels of norepinephrine. c. The client has decreased levels of angiotensin II. d. The client has increased levels of growth hormones.

a. The client has decreased levels of cortisol.

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

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

A client with severe dermatitis from poison ivy has been prescribed prednisone, a corticosteroid, for the treatment of his skin condition. The client has been informed to gradually taper off rather than abruptly stop the prednisone. What is the most accurate rationale for this dosing protocol? a. The client's hypothalamic-pituitary-adrenal (HPA) system will require recovery time before normal adrenal function is restored. b. Steroids can induce a dependency that is best addressed with a gradual withdrawal. c. HPA function is heightened during steroid administration and must return to normal levels before the drug is completely stopped. d. Abrupt cessation of the drug can contribute to symptoms similar to Cushing syndrome.

a. The client's hypothalamic-pituitary-adrenal (HPA) system will require recovery time before normal adrenal function is restored.

When explaining to a client admitted for stress-induced supraventricular tachycardia, the nurse will incorporate which statement about what happens in the body as a result of excess stress? a. The corticotrophin-releasing factor stimulates the release of norepinephrine, which is responsible for "fight-or-flight" reaction to stress. b. The primary role of the parasympathetic nervous system is to stimulate the vagus nerve. c. Endorphins are released from the brain every time we experience stress. d. The pituitary gland is ultimately responsible for growth, metabolism, and maturation, all of which are important when the body is stressed.

a. The corticotrophin-releasing factor stimulates the release of norepinephrine, which is responsible for "fight-or-flight" reaction to stress.

An electrician who has been working 14- to 16-hour days for several weeks to ensure the financial survival of his business presents to his family physician with a report of persistent headaches and insomnia. His family physician attributes the physical symptoms to the ongoing stress likely caused by which component of the stress response? a. The fact that he has previously had difficulty coping with stress b. The fact that he is not physically active on a regular basis c. The fact that his company is heavily in debt d. The fact that he takes diuretic medication for his hypertension

a. The fact that he has previously had difficulty coping with stress

A physician is explaining to a group of medical students the concept of Virchow's triad as it applies to venous thrombosis. Which clinical observation of a 50-year-old male client is most likely unrelated to a component of Virchow's triad? a. The man has decreased cardiac output and an ejection fraction of 30%. b. The man's prothrombin time and international normalized ratio (INR) are both low. c. The man has a previous history of a dissecting aneurysm. d. There is bilateral, brown pigmentation of his lower legs.

a. The man has decreased cardiac output and an ejection fraction of 30%.

The nurse is reviewing the various factors that could impact male fertility with a client, including the underproduction of prostaglandins in the seminal vesicles. What should the nurse tell the client is the consequence of underproduction of prostaglandin in semen? a. The partner's cervix will be less receptive to the semen. b. The sperm will be sluggish and lacking motility. c. The force of ejaculation will be diminished. d. The consistency of the semen will be less viscous.

a. The partner's cervix will be less receptive to the semen.

Which physiologic process would be considered a positive feedback mechanism? a. The platelet-aggregation mechanism activating clot formation b. The release of anti-diuretic hormone (ADH) from the posterior pituitary gland c. Shivering in response to low environmental temperature d. Increased production of white blood cells (WBC) in response to a microorganism

a. The platelet-aggregation mechanism activating clot formation

A number of clients on a geriatric subacute medical floor of a hospital have developed foul-smelling diarrhea over the last several days, and subsequent culture of stool samples has confirmed the presence of Clostridium difficile in each case. The care team on the unit would recognize that which factor likely contributed to the health problem and would anticipate which treatment? a. The use of broad spectrum antibiotics likely played a role in the developments of the infections, and most clients would likely receive metronidazole as a treatment. b. Genetic predisposition and the presence of the bacterium in client's normal flora likely contributed, and treatment would consist of broad-spectrum antibiotics. c. Poor hand washing practice on the part of care providers led to the outbreak, and treatment will consist of hydration and nutritional support. d. Ingestion of contaminated food probably contributed to the infections, and corticosteroids will be needed to treat them.

a. The use of broad spectrum antibiotics likely played a role in the developments of the infections, and most clients would likely receive metronidazole as a treatment.

A male client is being investigated for infertility and has been told he has a sperm count of 20 million in his sample. He shares with the nurse that he read that you need > 50 million sperm in a sample to be considered fertile. What is the nurse's best response? a. There are several factors that determine fertility and medical advances mean this definition is being updated often. b. Actually the number is 15 million, so you should have no trouble conceiving and do not meet the current definition of infertile. c. Your sperm count is fine, so as long as your motility is also good you will not meet the definition of infertile. d. There are many options for conception even for men whose sperm count meets the definition for infertility.

a. There are several factors that determine fertility and medical advances mean this definition is being updated often.

A postoperative client asks, "Why do I have to take all these deep breathing and coughing exercises every hour?" What response by the nurse is the most accurate rationale for this client? a. These exercises enhance the spread of surfactant and prevent atelectasis. b. Everyone has to do these exercises to keep their lung muscles strong. c. All clients get instructed on coughing and deep breathing exercises so they can go home sooner. d. Coughing and deep breathing exercises are very therapeutic and make you feel better.

a. These exercises enhance the spread of surfactant and prevent atelectasis.

The nurse is caring for a 30-year-old woman who is diagnosed with iron deficiency anemia. The client is confused how this condition developed because she ate many foods high in iron. How should the nurse respond? a. This iron deficiency anemia was most likely the result of chronic blood loss over a period of time. b. Some people have a condition that impairs the ability to use the iron they take in effectively. c. Diet deficiencies are the most common reason, so it is likely the intake was not sufficient. d. Iron deficiency anemia is actually more likely linked to deficits of vitamin B12 and folate in the diet.

a. This iron deficiency anemia was most likely the result of chronic blood loss over a period of time.

The nurse is caring for a client with small cell lung cancer who has developed a syndrome associated with hyperglycemia, hypokalemia, and sodium and water retention. The client asks the nurse why this occurring. How should the nurse respond? a. This is the result of tumor cells releasing the adrenal hormones, such as cortisol, in excessive amounts. b. These effects are known as a neoplastic syndrome, where too much antidiuretic hormone is being released. c. This is a side-effect of radiotherapy and reflects the body's stress response to high rate of tumor cell death. d. People experience these effects when tumor cells are destroyed and release their contents into the blood.

a. This is the result of tumor cells releasing the adrenal hormones, such as cortisol, in excessive amounts.

Following a winter power outage, a client who had been using a home gasoline generator began to experience dizziness and headaches and was diagnosed with carbon monoxide poisoning. What is the goal of hyperbaric oxygen treatment for carbon monoxide poisoning? a. To increase the amount of oxygen carried in the dissolved state b. To increase the production of unbound hemoglobin c. To stimulate the release of oxygen at the capillaries d. To remove bound CO from hemoglobin

a. To increase the amount of oxygen carried in the dissolved state

A client with leukemia begins hemorrhaging from every orifice. The physician is concerned that the client has developed disseminated intravascular coagulation (DIC). The nurse should anticipate which order to be prescribed for this client? Select all that apply. a. Transfuse 2 units of platelets. b. Transfuse fresh frozen plasma. c. Give aspirin twice/day. d. Administer IV ketorolac STAT. e. Place in reverse isolation.

a. Transfuse 2 units of platelets. b. Transfuse fresh frozen plasma.

A 1-year-old child who has experienced low platelet counts and bacterial susceptibility has been admitted to a pediatric medical unit of a hospital for treatment of Wiskott-Aldrich syndrome. The nurse who has admitted the child to the unit would anticipate which short-term and longer-term treatment plans? a. Treatment of eczema; management of bleeding; bone marrow transplant b. Transfusion of clotting factors XII and XIII and serum albumin; splenectomy c. Neutropenic precautions; fresh frozen plasma transfusions; treatment of gastrointestinal symptoms. d. Intravenous immunoglobulin (IVIg) treatment; thyroidectomy

a. Treatment of eczema; management of bleeding; bone marrow transplant

A nurse finds a client unconscious and not responding to stimuli, lying in a supine position, and snoring loudly. What should the nurse do immediately? a. Turn the client to a side-lying position. b. Assess the client's vital signs. c. Apply supplemental oxygen via mask. d. Begin cardiopulmonary resuscitation.

a. Turn the client to a side-lying position.

A 48-year-old woman has been found to have nodules on her thyroid that must be biopsied to determine whether or not they are malignant. Which imaging technique will be most helpful to the surgeon in visualization of the nodes for fine needle aspiration? a. Ultrasound b. Magnetic resonance imaging c. Radioactive scanning using radioiodine d. Radioactive scanning using sestamibi

a. Ultrasound

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

A client in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which diagnosis best captures this pathophysiology? a. Vasogenic edema b. Focal hypoxia c. Cytotoxic edema d. Hydrocephalus

a. Vasogenic edema

A 44-year-old woman has developed calf pain during a transatlantic flight. She is extremely short of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE) that resolved with anticoagulant therapy. Which statement best characterizes the underlying problem of her PE? a. Ventilation was occurring but perfusion was inadequate, causing shortness of breath. b. The combination of normal perfusion but compromised ventilation caused hypoxia. c. She developed a transient anatomic shunt resulting in impaired oxygenation. d. Impaired gas diffusion across alveolar membranes resulted in dyspnea and hypoxia.

a. Ventilation was occurring but perfusion was inadequate, causing shortness of breath.

A 60-year-old male hospital client with a diagnosis of chronic obstructive pulmonary disease (COPD) is undergoing lung function tests to gauge the progression of his disease. Which aspect of the lung volume will the respiratory therapist be most justified in using to guide interpretation of the test results? a. Vital capacity will equal the client's combined inspiratory reserve, expiratory reserve, and tidal volume. b. Vital capacity will equal total lung capacity. c. Resting tidal volume will exceed that of tidal volume during activity. d. Expiratory reserve will equal residual lung volume.

a. Vital capacity will equal the client's combined inspiratory reserve, expiratory reserve, and tidal volume.

Which substance is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms? a. Water b. Sodium c. Phosphate d. Calcium

a. Water

A female client arrives at the clinic reporting fatigue that is exhausting, bruising on the skin, and bleeding from the gums. Which diagnostic result(s) or history finding(s) correlates with a diagnosis of aplastic anemia? Select all that apply. a. White blood cell (WBC) count <1,000/μL (1 ×109/L) b. Platelet count 50 ×103/μL (50 ×109/L) c. Hemoglobin level of 12.5 g/dL (125 g/L) d. Recent bout with mononucleosis viral infection e. Completed chemotherapy for leukemia in the past year

a. White blood cell (WBC) count <1,000/μL (1 ×109/L) b. Platelet count 50 ×103/μL (50 ×109/L) d. Recent bout with mononucleosis viral infection e. Completed chemotherapy for leukemia in the past year

A client with a large decubitus ulcer asks the nurse, "How it is possible for a wound this deep to ever fully heal?" What is the nurse's best response? a. With adequate resources, the body is capable of regenerating tissue and blood flow to the area over time. b. Deep wounds like this require surgical intervention and skin grafting before they will be healed. c. It will be difficult, but you have many experts planning your care so the chances of healing are good. d. Once the first layer of new granulation tissue is formed, the speed of the repair will increase greatly.

a. With adequate resources, the body is capable of regenerating tissue and blood flow to the area over time.

The nurse is performing passive range-of-motion exercises with a client who suffered an ischemic stroke 2 weeks ago and has hemiparesis. The client says, "What is the point of doing these exercises if I will never be able to use that arm again?" What should the nurse include when responding to the client? Select all that apply. a. You may still regain use of this arm, and these exercises may help with this recovery. b. These exercises help to prevent painful shoulder complications after a stroke. c. Doing these exercises helps to prevent blood clots from forming in the arteries of your arm. d. It is important for you to keep a positive outlook as it will help with your recovery. e. We want to ensure your shoulder joint remains flexible while you recover.

a. You may still regain use of this arm, and these exercises may help with this recovery. b. These exercises help to prevent painful shoulder complications after a stroke e. We want to ensure your shoulder joint remains flexible while you recover.

A client has been diagnosed with rheumatoid arthritis and asks the nurse what causes this condition. What is the nurse's best response? a. Your immune system is attacking your own tissues as if they were harmful organisms. b. Your white blood cells are failing to respond to the increased inflammation in your joints. c. This is a condition where chronic inflammation causes the loss of bone and joint tissues. d. Your joint tissues are releasing foreign chemicals, triggering your immune system to attack the joint.

a. Your immune system is attacking your own tissues as if they were harmful organisms.

A client arrives at the ED complaining of numbness in left lower leg. Upon assessment, the nurse finds the lower left leg to be cold to touch, pedal and posterior tibial pulses non-palpable, and a sharp line of paralysis/paresthesia. The nurse's next action is based on the fact that: a. acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow. b. submersion in a whirlpool with warm water will improve the venous blood flow and restore pulses. c. the immediate infusion of tissue plasminogen activator (tPA) will not correct the problem and should only be used for CVAs. d. administration of an aspirin and sublingual nitroglycerin will vasodilate the artery to restore perfusion.

a. acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow.

Which clients are at increased risk for developing secondary hypogammaglobulinemia, a secondary humoral immunodeficiency? Select all that apply. a. cleint with burns covering more than 45% of the body b. malnourished child who only drinks cow's milk c. client with a history of anxiety and depression d. child allergic to furs, grass, and trees e. client with a a history of seizures controlled by an antiepileptic

a. cleint with burns covering more than 45% of the body b. malnourished child who only drinks cow's milk e. client with a a history of seizures controlled by an antiepileptic

A client with multiple sclerosis (MS) is frustrated by tremors associated with the disease. How should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS: a. communication being sent through neurons is slowed. b. basal ganglia are not sending organized signals to your body. c. nerve damage results in no signals making it to certain muscles. d. nerve impulses are arriving to your muscles too quickly.

a. communication being sent through neurons is slowed.

The nurse knows high incidences of infectious illnesses among the older adults who reside in a long-term care facility are most likely to have diminished immune capacity because of: a. decreased numbers and responsiveness of T lymphocytes. b. decreased antigen recognition by B lymphocytes. c. over-expression of cytokines and receptors. d. altered function in peripheral lymphocytes.

a. decreased numbers and responsiveness of T lymphocytes

A client diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be: a. dexamethasone, a corticosteroid. b. cisplatin, a chemotherapeutic. c. vincristine, a vinca alkaloid. d. doxorubicin, a cytotoxic antibiotic.

a. dexamethasone, a corticosteroid.

When teaching a group of middle-aged males about changes with aging, which manifestation(s) of benign prostate hyperplasia will the nurse share with the class? Select all that apply. a. dribbling after urination b. foul-smelling urine c. cloudy urine with white particles d. having a sensation of having to urinate frequently e. decrease in testicular size

a. dribbling after urination d. having a sensation of having to urinate frequently

A client with Parkinson disease has challenged himself to maintain mobility for longer than the physician predicts. He strives every day to walk 5 to 10 steps farther than the day before. This phenomenon, being researched by social psychologists, is known as: a. hardiness. b. stubbornness. c. assertiveness. d. positivism.

a. hardiness.

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

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

A 10 year old child with strep throat asks the nurse, "Why are there large bumps [lymph nodes] on my neck when my throat gets sore?" The nurse replies that lymph nodes: a. help your body fight off infections by allowing special cells [lymphocytes and macrophages] to move through the lymph chain and engulf and destroy germs. b. bring in cells into the lymph node [your bump] to stop the germs from going anywhere else in the body. c. bring all kind of good cells to your throat so that they can wall the strep off and keep the germs from getting any food or water. d. help your tonsils get bigger with cells that will bring immune cells into your throat to prevent any other infections.

a. help your body fight off infections by allowing special cells [lymphocytes and macrophages] to move through the lymph chain and engulf and destroy germs.

A school-age child with a history of asthma has brought a note home from school stating there has been one case of meningitis (Neisseria meningitidis) in the school. Since the mother is a nurse, she is very concerned since she knows the portal of entry of this pathogen is: a. inhalation via the respiratory tract such as through breathing or yawning. b. direct contact with a contaminated object such as a pencil. c. ingestion such as when children share their drink with their friends. d. through a cut or abrasion that may occur on the playground.

a. inhalation via the respiratory tract such as through breathing or yawning.

The nurse is collecting a blood sample for an ordered CBC. The required tube contains EDTA so the nurse will: a. invert the tube several times to prevent the blood from coagulating. b. place the tube immediately on ice to preserve the action of the EDTA on the sample. c. Invert the tube several times to promote clotting so serum can be fully separated. d. Avoid inverting the tube to prevent hemolysis, which could affect the accuracy of the results.

a. invert the tube several times to prevent the blood from coagulating.

A client who suffered a stroke is having difficulty swallowing food and beverages. The client complains that it feels like "the food is sticking to the back of my throat." Given this information, the priority nursing interventions would be to: a. make the client "nothing per os" (NPO) and call the physician. b. feed the client while he or she is sitting in an upright position. c. add a thickening agent to all of the client's beverages. d. do nothing; no action is warranted since this is a normal occurrence after a stroke.

a. make the client "nothing per os" (NPO) and call the physician.

Which of the following best describes the half-life of a highly protein-bound drug such as thyroxine (99% protein bound)? The half-life would be: a. much longer to reduce the concentration of the hormone by one half. b. shorter because only a little of the hormone has to be used up to reduce the concentration. c. dependent on which drugs were in the blood system holding on to the hormone. d. dependent on the liver to carry the hormone to its designated target organ.

a. much longer to reduce the concentration of the hormone by one half.

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

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

A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the client that the venous blood supply to the penis is controlled by: a. sacral parasympathetic fibers. b. the hypothalamus. c. the vagus nerve. d. the postganglionic sympathetic neurons.

a. sacral parasympathetic fibers.

A geriatrician is following a number of clients on a subacute geriatric medical unit, some of whom require diagnostic blood work. Which client would be most likely to have an erythrocyte sedimentation rate (ESR) screening test ordered? An adult with: a. systemic lupus erythematosus. b. a diagnosis of Alzheimer disease and depression. c. orthostatic hypotension and syncopal episodes. d. congestive heart failure.

a. systemic lupus erythematosus.

The nurse knows a drug in a category identified as a colony-stimulating factor (CSF) helps: a. to stimulate bone marrow to produce large numbers of mature cells such as platelets and erythrocytes. b. cells engulf and digest microbes that want to attach to cell membranes and destroy normal cell function. c. produce cells that will be the first responder cells to protect against cancer formation. d. stimulate the person's immune system so that they can kill their own cancer cells.

a. to stimulate bone marrow to produce large numbers of mature cells such as platelets and erythrocytes.

The nurse is caring for a client with small veins. The nurse can improve the chance of successfully drawing a blood sample by applying the principle of critical closing pressure and: a. using minimal negative pressure when drawing the sample into the syringe. b. using a small syringe and drawing the sample quickly. c. having the client raise the limb being used to draw the sample. d. flushing the vein with saline immediately before withdrawing the sample.

a. using minimal negative pressure when drawing the sample into the syringe.

When advising a morbidly obese client about the benefits of weight reduction, which statement would be most accurate to share? a. "All you need to do is stop drinking sodas and sugary drinks." b. "A 10-pound loss of weight can produce a decrease in blood pressure." c. "An increased waist-to-hip" ratio can lead to too much pressure on the liver and intestines." d. "If your leptin [hormone] level is too low, you are at increased risk for developing high BP."

b. "A 10-pound loss of weight can produce a decrease in blood pressure."

The nurse is discussing the diagnostic workup with a client suspected of having metastatic thyroid cancer. How should the nurse explain the purpose of a scan involving a combination of positron emission tomography (PET) and computed tomography (CT)? a. "The PET is used to visualize sites of metastases while the CT scan focuses on the primary tumor." b. "A PET scan focuses on tissue functioning while the CT is best for looking at tissue structure." c. "Both scans are used because it is possible to miss small tumors with only one type of scan." d."The PET is used as a diagnostic procedure while the radiation from the CT is therapeutic."

b. "A PET scan focuses on tissue functioning while the CT is best for looking at tissue structure."

A frantic parent reports a large mass in the child's abdomen; after diagnostic testing, the health care provider diagnoses a Wilms tumor, stage IV. After the provider leaves the room, the parents ask the nurse, "What does this mean?" Which response by the nurse is most accurate? a. "This is cancer in the stomach. I am surprised your child did not have earlier symptoms." b. "A cancer of the kidney has most likely spread to the lungs." c. "Your child will need to undergo surgery to remove both kidneys and then go on dialysis." d. "This type of tumor can be easily treated with chemotherapy. We will start this soon."

b. "A cancer of the kidney has most likely spread to the lungs."

An adult male who is 6'11" tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which explanation demonstrates a sound understanding of his health problem? a. "My pituitary gland produced a much higher than normal amount of growth hormone when I was a child." b. "A tumor in my brain threw off my hormone levels after I finished adolescence." c. "My liver is malfunctioning and produces too many of the hormones that ultimately cause growth." d. "The high sugar levels that go along with my diabetes made my pituitary gland overproduce the hormones that cause you to grow."

b. "A tumor in my brain threw off my hormone levels after I finished adolescence."

A student makes the statement to a colleague, "Blood plasma is essentially just a carrier for the formed cells like red blood cells and white blood cells." What would be the most accurate response to this statement? a. "That's not really true. Plasma is crucial in the immune and inflammatory responses." b. "Actually, plasma plays a significant role in nutrient and waste transport." c. "Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis." d. "Actually, plasma is integral to the proper function of the liver and maintenance of acid-base balance."

b. "Actually, plasma plays a significant role in nutrient and waste transport."

A community health nurse is conducting an education session with a group of pregnant women. One of the clients states, "I am not feeling right about getting a flu vaccine while pregnant." What is the nurse's best response? a. "The influenza vaccine is shown to be safe and will reduce the risk for you getting the flu." b. "By getting vaccinated, you reduce the risk of you and your baby getting influenza." c. "The choice is yours, but none of the substances in the vaccine will harm you or your baby." d. "Vaccines are a personal choice and you should decide what is right for you and your baby."

b. "By getting vaccinated, you reduce the risk of you and your baby getting influenza."

The family of an older adult client is wondering why his "blood counts" are not rising after his last GI bleed. They state, "He has always bounced back after one of these episodes, but this time it isn't happening. Do you know why?" The nurse will respond based on which pathophysiologic principle? a. "Everything slows down when you get older. You just have to wait and see what happens." b. "Due to stress, the red blood cells of older adults are not replaced as promptly as younger people." c. "The doctor may start looking for another cause of his anemia, maybe cancer of the bone." d. "Don't worry about it. We can always give him more blood."

b. "Due to stress, the red blood cells of older adults are not replaced as promptly as younger people."

As part of his diagnostic workup, a 77-year-old male is having his ferritin level analyzed. Which explanation by the health care provider regarding the significance and rationale for this test is most accurate? a. "Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen." b. "Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills." c. "Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet." d. "Ferritin is the form of iron that is transported in your blood plasma to red blood cells that need it."

b. "Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills."

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

b. "Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation."

A medical student is assessing a 22-year-old male who has come to the emergency department because of pain and swelling in his scrotum over the past 36 hours. The attending physician has told the student that she suspects epididymitis. Which of the medical student's following questions is most likely to be useful in the differential diagnosis of epididymitis? a. "Do you know if your vaccinations for mumps are up to date?" b. "Have you had unprotected sex in the past?" c. "Do you have a sensation of heaviness in the left side of your scrotum?" d. "Has it been painful when you get an erection lately?"

b. "Have you had unprotected sex in the past?"

A student states, "It seems like helper T cells do a lot more than just 'help' the cellular immunity process". Which response listed below best conveys an aspect of the role of CD4+ helper T cells in immunity? a. "Without helper T cells, no antigens would be presented." b. "Helper T cells play a major role in stimulating and regulating the whole process." c. "Without helper T cells, the wrong antibodies would end up being produced." d. "Helper T cells are key to the hematopoiesis that produces all the components of the immune system."

b. "Helper T cells play a major role in stimulating and regulating the whole process."

An emergency department client arrives after two days of "chest pressure" and "tightness" that was unrelieved with antacids. Following angioplasty for a massive myocardial infarction (MI), the client asks why so much muscle was damaged if only the left circumflex vessel was blocked. Which response by the nurse is most accurate? a. "With any blockage in the heart, muscle damage always occurs." b. "If a major artery like the circumflex is occluded, the smaller vessels supplied by that vessel cannot restore the blood flow." c. "Since the circumflex artery supplies oxygenated blood flow to the posterior surface of the left ventricle, any amount of blockage will result in vital muscle tissue being lost." d. "When it comes to arteries in the heart, all vessels are equal and any blockage causes massive amount of damage that will not be restored."

b. "If a major artery like the circumflex is occluded, the smaller vessels supplied by that vessel cannot restore the blood flow."

As part of her prenatal education, a 29-year-old woman who is pregnant with her first child is receiving teaching from her primary care provider. Which statement by the woman reflects an accurate understanding of HIV transmission? a. "I know my baby is safe from HIV while in the womb, but the delivery will place him or her at real risk." b. "It's discouraging to know that my breast milk can pass on HIV to my baby." c. "I know it's possible, but it's comforting that the chances of my child contracting my HIV are actually very low." d. "I'm relieved to learn that a caesarean delivery will protect my baby from being born HIV positive."

b. "It's discouraging to know that my breast milk can pass on HIV to my baby."

A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of websites. Which statement that he has read is most plausible? a. "Testicular cancer is a leading cause of death among males who should be in the prime of their life." b. "Men with cryptorchidism — the term for an undescended testicle — are known to have a higher risk of developing testicular cancer." c. "For most men with testicular cancer, bloody urine is their first sign that something is wrong." d. "Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed."

b. "Men with cryptorchidism — the term for an undescended testicle — are known to have a higher risk of developing testicular cancer."

An 8-week-old boy has been recently diagnosed with a severe combined immunodeficiency (SCID). His parents have performed a significant amount of research on the Internet and have brought a large amount of material to discuss with their care provider. Which statement best reflects an accurate understanding of their son's health situation? a. "We read that gene therapy could cure our son; we'd like you to look into that option." b. "Our son likely has a deficiency of B-lymphocytes and can't produce antibodies." c. "We feel guilty, because dietary and environmental factors have been shown to contribute to SCID" d. "The antibodies that our son produces are mismatched to the infections that he was born with, and encounters."

b. "Our son likely has a deficiency of B-lymphocytes and can't produce antibodies."

A gastroenterologist is teaching a group of students about the enteric nervous system in preparation for a consult with a client who has experienced a spinal cord injury. Which teaching point is most accurate? a. "The myenteric plexus is responsible for controlling the function of each segment of the intestinal tract." b. "The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the gastrointestinal (GI) tract." c. "Sympathetic innervation of much of the gastrointestinal (GI) tract occurs by way of the vagus nerve." d. "Parasympathetic stimulation blocks the release of the excitatory neuromediators and inhibits gastrointestinal (GI) motility."

b. "The enteric nervous system is made up of the myenteric and submucosal plexuses; these are located in the wall of the gastrointestinal (GI) tract."

A 62-year-old female smoker is distraught at her recent diagnosis of small cell lung cancer (SCLC). How can her physician most appropriately respond to her? a. "I'm sure this is very hard news to hear, but be aware that with aggressive treatment your chances of beating this are quite good." b. "This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens." c. "I'm very sorry to have to give you this news; I'd like to talk to you about surgical options, however." d. "This is a difficult diagnosis to receive, but there is a chance that the cancer may go into remission."

b. "This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens."

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

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

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 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 client who is recovering from burn injuries is discussing his prognosis with a physician. Which teaching point about expectations for healing should the physician offer? a. "Once your healing is complete, your skin will be just as strong as before your accident." b. "You may find that the scar is a bit smaller than the area of the wound." c. "You'll find that your new tissue is more elastic and fragile than the rest of your skin d. "The final remodeling phase of healing may last up to 3 months in your case."

b. "You may find that the scar is a bit smaller than the area of the wound."

Which client would be considered to be in the latent period of HIV infection? a. 16-year-old prostitute who has open sores on her labia that drain purulent secretions. b. 33-year-old heroin drug abuser who has numerous enlarged lymph nodes in his axilla and cervical neck region for the past 4 months. c. 45-year-old alcohol abuser who is reporting excessive vomiting of blood that started 2 weeks ago. d. 24-year-old college student who has developed a chronic cough that will not go away, even after taking two courses of antibiotics.

b. 33-year-old heroin drug abuser who has numerous enlarged lymph nodes in his axilla and cervical neck region for the past 4 months.

Which client has an absolute neutrophil count (ANC) that is critically low and the standard of care would recommend placement on neutropenic precautions? a. Client on long-term steroids for rheumatoid arthritis with WBC of 7000/μL (7 x 109/L). b. 37-year-old client with leukemia being treated with chemotherapy with ANC of 400 (0.40 x 109/L). c. 65-year-old client with prostate cancer receiving radiation therapy with neutrophil count of 2,000/μL (2.0 x 109/L). d. 75-year-old client with renal failure receiving epogen for anemia with hemoglobin level of 9.7 g/dL (97 g/L).

b. 37-year-old client with leukemia being treated with chemotherapy with ANC of 400 (0.40 x 109/L).

Which client would have a very poor response related to tissue regeneration of his or her injured area? a. 21-day-old infant undergoing a diaphragmatic hernia repair b. 54-year-old male who had a massive MI 4 days ago and came to the ED today for treatment. c. 73-year-old female who is undergoing lithotripsy for kidney stones. d. 33-year-old athlete undergoing surgery to repair a torn MCL in the right knee

b. 54-year-old male who had a massive MI 4 days ago and came to the ED today for treatment.

Which individuals are at risk for developing urinary obstructions? Select all that apply. a. A 43-year-old male with an acid-base imbalance secondary to malnutrition b. A 29-year-old female, pregnant for the first time c. A 69-year-old female with anemia secondary to insufficient erythropoietin production d. A 70-year-old male with benign prostatic hyperplasia (BPH) e. A 58-year-old male with renal calculi f. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

b. A 29-year-old female, pregnant for the first time d. A 70-year-old male with benign prostatic hyperplasia (BPH) e. A 58-year-old male with renal calculi f. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury

Which client is most clearly displaying the signs and symptoms of irritable bowel disease (IBD)? a. A 32-year-old mother who reports intermittent abdominal pain that is worse during her menstrual period. b. A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes" and "feels more like a cramp than a dull ache." c. A 44-year-old man who works the evening shift at a factory and who states that his lower abdominal pain is much worse at night than during the day. d. A 24-year-old man who has a stressful job but whose diarrhea and cramping does not worsen during periods of high stress.

b. A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes" and "feels more like a cramp than a dull ache."

Which client is most likely to be a candidate for a thymus transplant as the treatment of choice to reconstitute T-cell immunity? a. A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use b. A 7-year-old boy with diagnosis of thymic aplasia whose blood work indicates absence of T cells c. A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells d. A 9-year-old girl who has developed secondary cell-mediated immunodeficiency following a viral infection

b. A 7-year-old boy with diagnosis of thymic aplasia whose blood work indicates absence of T cells

While working triage in the emergency department, which client report should alert the nurse to imminent danger and, thus, that client should be seen first? a. A client reporting painful urination and experiencing fever and chills. b. A client holding the abdomen and reporting a tearing and ripping feeling inside. c. Athletic client reporting the kneecap popping in and out of socket. d. A client with a history of chronic obstructive pulmonary disease (COPD) experiencing a productive cough with green sputum.

b. A client holding the abdomen and reporting a tearing and ripping feeling inside.

A parent reports that the child comes home with a stomachache and then a bout of diarrhea every time she has ice cream out with friends. Which conclusion by the nurse is likely most accurate for this child? a. Anxiety about eating too many calories b. A deficiency of lactase c. Gallbladder disease d. Premature peptic ulcer formation

b. A deficiency of lactase

A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has: a. A mild parasitic infection b. A severe bacterial infection c. A mild viral infection d. A severe fungal infection

b. A severe bacterial infection

Which phenomenon is most likely occurring during a child's alveolar stage of lung development? a. Terminal alveolar sacs are developing and surfactant production is beginning. b. A single-capillary network exists and the lungs are capable of respiration. c. The conducting airways are formed, but respiration is not yet possible. d. Primitive alveoli are formed and the bronchi and bronchioles become much larger.

b. A single-capillary network exists and the lungs are capable of respiration.

A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced? a. A myoclonic seizure b. A tonic-clonic seizure c. An absence seizure d. A complex partial seizure

b. A tonic-clonic seizure

The nurse is caring for a client with angina. If wanting to reduce the Frank-Starling effect on myocardial oxygen consumption, what type of medication would the nurse expect to be prescribed? a. A positive inotrope b. A venous vasodilator c. An arterial vasodilator d. An anticoagulant

b. A venous vasodilator

An older adult client has been diagnosed with pernicious anemia as a result of the aging process. Which nursing intervention is appropriate to treat pernicious anemia? a. Increasing green, leafy vegetables in the diet b. Administering an intramuscular injection of cobalamin, a form of B12. c. Discussing ways to give liquid forms of iron supplement d. Greatly reducing intake of antacids and laxatives

b. Administering an intramuscular injection of cobalamin, a form of B12.

A 43-year-old male client has presented to the emergency department with vomiting that he claims is of a sudden onset. The client also states that the emesis has often contained frank blood in the hours prior to admission. His vital signs are stable with temperature 98.3°F (36.8°C), pulse 88, BP 140/87, and respiratory rate 18. Which potential contributing factor would the health care team suspect first? a. Overuse of antacids b. Alcohol consumption c. Staphylococcal enterotoxins d. Effects of Helicobacter pylori

b. Alcohol consumption

A client is undergoing testing for testicular cancer. Which tumor markers should the nurse include in the teaching plan for this client? Select all that apply. a. Prostate specific antigen b. Alpha-fetoprotein c. Beta-human chorionic gonadotropin d. Gonadotropin-releasing hormone e. Dihydrotestosterone

b. Alpha-fetoprotein c. Beta-human chorionic gonadotropin

The mother of a 19-week-old infant has brought her baby in for assessment to a pediatrician because of the baby's persistent weight loss and diarrhea. An intestinal biopsy has confirmed a diagnosis of celiac disease, and the child's mother is anxious to know what caused the disease. What aspect of the etiology of celiac disease would underlie the explanation that the physician provides? a. Bacterial or chemical invasion of the peritoneum leads to decreased nutrient absorption and transport. b. An inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response. c. Neurogenic or muscular inhibition of peristalsis results in inappropriate motility of ingested food in the lower small intestine and the colon. d. Inability to process or absorb the fat content of breast milk results in malnutrition and deficiency of fat-soluble vitamins.

b. An inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response.

A clinic nurse is reviewing laboratory results for several clients with appointments this day. The nurse notes that several of the clients have elevated creatinine levels. Which client(s) would the nurse be most concerned about and highlight the results for the health care provider to review? Select all that apply. a. A client in his early 30s who is training for a triathlon race b. An older adult client whose creatinine level is 4.5 mg/dL (397.80 μmol/L) c. Adolescent athlete and weight lifter with creatinine level of 2.3 mg/dL (203.32 μmol/L) d. Client with a history of uncontrolled diabetes with creatinine level of 2.7 mg/dL (238.68 μmol/L) e. Client trying to lose weight by increasing the protein level intake by eating meats

b. An older adult client whose creatinine level is 4.5 mg/dL (397.80 μmol/L) d. Client with a history of uncontrolled diabetes with creatinine level of 2.7 mg/dL (238.68 μmol/L)

A client with a traumatic amputation of the lower leg has lost >40% of blood volume and is currently not producing any urine output. The nurse bases this phenomena on which humoral substance that is responsible for causing severe vasoconstriction of the renal vessels? a. Aquaporin-2 channels b. Angiotensin II and antidiuretic hormone c. Renin and potassium ions d. Albumin and norepinephrine

b. Angiotensin II and antidiuretic hormone

Following a long history of intermittent back pain and urinary urgency, a 50-year-old client has been diagnosed with chronic bacterial prostatitis. Which factor is most likely to influence his health care provider's choice of treatment? a. The diagnosis is thought to have an autoimmune etiology with limited response to steroid treatments. b. Antibacterial drugs penetrate poorly into the chronically inflamed prostate. c. Urethral catheterization provides symptom relief and contributes to resolution of the underlying infection. d. There are no proven treatments for chronic prostatitis that address the infectious process.

b. Antibacterial drugs penetrate poorly into the chronically inflamed prostate.

Following a spider bite she received while camping, a 20-year-old female presented to the emergency department with rash, edema, and fever and was subsequently diagnosed with serum sickness. Which statement best conveys the physiologic rationale for the broad systemic effects of this event? a. The woman is experiencing diffuse tissue necrosis as a consequence of an Arthus reaction. b. Antigen-antibody complexes have been deposited in a variety of locations throughout the body. c. Antibody binding to specific target cell receptors is bringing about a change in cell function. d. Deposited antibodies are activating her complement system.

b. Antigen-antibody complexes have been deposited in a variety of locations throughout the body.

An 81-year-old female client of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the client has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the client's condition? a. Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest. b. Blood backs up into the jugular vein because there are no valves at the point of entry into the heart. c. Peripheral dilation is associated with decreased stroke volume and ejection fraction. d. Heart valves are not capable of preventing backflow in cases of atrial congestion.

b. Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

A dialysis technician is reviewing a textbook on kidney function. The technician would recognize which statements as characteristic of healthy kidneys? Select all that apply. a. The kidneys are contained within the peritoneal cavity. b. Blood vessels, nerves and, ureters all connect with the kidney at the hilus. c. The medulla of the kidney contains the glomeruli. d. Each kidney consists of lobes, with each lobe comprised of nephrons. e. Each nephron contains several hundred glomeruli that perform filtration.

b. Blood vessels, nerves and, ureters all connect with the kidney at the hilus. c. The medulla of the kidney contains the glomeruli.

At which location in the nephron would a health care professional first expect filtrate to be largely free of plasma proteins? a. Proximal convoluted tubule b. Bowman's space c. Loop of Henle d. Afferent arteriole

b. Bowman's space

The nurse is assessing a client with suspected dysphagia. Which cranial nerves (CN) should the nurse assess? Select all that apply. a. CN I b. CN V c. CN IX d. CN X e. CN XI f. CN XII

b. CN V c. CN IX d. CN X f. CN XII

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

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

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

b. Coma

A client calls the nurse at an urgent care center about ongoing symptoms of acute epididymitis. The client began antibiotic therapy 3 days ago but pain, swelling, and fever are still present. What is the best direction for the nurse to offer the client? a. Take nonsteroidal anti-inflammatory (NSAID) medication for the pain and fever. b. Come into the urgent care center for reevaluation as soon as possible. c. Maintain bed rest and elevate the scrotum to reduce swelling. d. Call the primary physician's office to make an appointment for follow-up.

b. Come into the urgent care center for reevaluation as soon as possible.

The nurse collects a urine sample but forgets the sample in the client's room for several hours. What is the nurse's best action? a. Place the sample in the fridge immediately. b. Discard the sample and recollect in the morning. c. Label with the time collected and send immediately. d. Contact the laboratory to ask for guidance.

b. Discard the sample and recollect in the morning.

When a Rh-negative mother becomes pregnant by a partner who is Rh-positive, which advanced treatment modality will decrease the risk of the fetus developing hemolytic disease? a. Give mother gamma globuline-containing Rh antibody in the first trimester of pregnancy. b. Discuss an intrauterine transfusion to the affected fetus. c. Discuss options to prevent any further pregnancy. d. Perform aminocentesis to draw unconjugated bilirubin and immediate delivery if levels are high.

b. Discuss an intrauterine transfusion to the affected fetus.

A nurse is teaching parents of a child who is being discharged after treatment for a streptococcal infection. For what symptoms should the nurse teach the parents to observe, because they are related to the risk for poststreptococcal glomerulonephritis? Select all that apply. a. Pale, dilute urine b. Edema c. Decreased urine output d. Pain in the flank area e. Increased thirst

b. Edema c. Decreased urine output

A blood sample is ordered to be collected in a plasma-separator tube, but the nurse can only find serum-separator tubes available. The nurse should be most concerned about the accuracy of which results if the serum-separator tube is used? a. Albumin and total protein levels b. Fibrinogen and clotting factor levels c. Immunoglobulin analysis d. Electrolyte measurements

b. Fibrinogen and clotting factor levels

A client at risk for febrile neutropenia related to chemotherapy treatments has been prescribed medication to prevent this reaction. Which medication should the nurse be prepared to administer? a. Prednisone, a corticosteroid b. Filgrastim, a granulocyte-colony stimulating factor (G-CSF) c. Epoetin alfa, an erythropoiesis-stimulating agents (ESAs) d. Immunoglobulin M (IgM) antibody

b. Filgrastim, a granulocyte-colony stimulating factor (G-CSF)

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

During the study of hormones related to sexual functioning, the instructor mentions negative feedback systems. Which is an example pertaining to a negative feedback loop in the male genitourinary stystem? a. High levels of testerone suppress the secretion of sperm. b. Follicle stimulating hormone (FSH) stimulates inhibin and inhibin supresses FSH. c. Lack of anterior pituitary secretion due to low levels of follicle stimulating hormone (FSH). d. Low androgens and sperm counts due to high levels of gonadotropins.

b. Follicle stimulating hormone (FSH) stimulates inhibin and inhibin supresses FSH.

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. Driving a vehicle e. Tennis

b. Football c. Hockey

A 40-year-old man who is morbidly obese and leads a sedentary lifestyle has recently been diagnosed with type 2 diabetes. Which aspects of the man's obesity likely contributed to his new health problem? a. The low metabolic needs of adipose tissue mimic a hypoglycemic state and suppress insulin secretion. b. Free fatty acids contribute to problems such as beta cell dysfunction and insulin resistance. c. Fat tissue initiates glycogenolysis and reliance on glycogen release rather than metabolism of free glucose. d. Triglyceride deposits in the pancreas result in damage to beta cells.

b. Free fatty acids contribute to problems such as beta cell dysfunction and insulin resistance.

A nursing student studying obstetrics asks the faculty, "How does the sperm get so much energy to swim up the fallopian tubes?" The instructor responds based on which pathophysiologic principle? a. Usually the ejaculation is so powerful that it propels the sperm far up into the fallopian tubes. b. Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm. c. The seminal vesicles secrete fluid for the semen and they can secrete catecholamines that energize the sperm. d. Estrogen that is being secreted when the ova are ripe and ready for penetration assists by attracting the sperm in the right direction.

b. Fructose is secreted by the seminal vesicles and provides energy for motility of the sperm.

Question 1 (1 point) While teaching about HIV/AIDS to a group of high school seniors, the school health nurse will begin by explaining the basic facts. Which information will this likely include? a. Like all viruses, HIV is a genetic material made from DNA with long molecules that carry genetic information. b. HIV is different from other viruses since it is a retrovirus that selectively attacks the body's immune cells. c. There are two types of HIV, but the one that is endemic to the U.S. is HIV type 2. d. HIV type 1 for some reason rarely develops into full-blown AIDS.

b. HIV is different from other viruses since it is a retrovirus that selectively attacks the body's immune cells.

The nurse is caring for a client with achalasia. Which interventions should the nurse prioritize in the plan of care? Select all that apply. a. Allow client to consume thickened fluids only. b. Have oropharyngeal suctioning equipment at bedside. c. Position client with head of bed elevated. d. Arrange for small, frequent meals. e. Administer antiemetics before meals.

b. Have oropharyngeal suctioning equipment at bedside. c. Position client with head of bed elevated. d. Arrange for small, frequent meals.

A nurse is interviewing a client with fever, myalgia, headache, and lethargy. Which question is most important for the nurse to ask related to identifying the cause of these symptoms and the possible need for quarantining the client? a. Are these symptoms similar to an illness you have had in the past? b. Have you or any family members traveled outside the country recently? c. Did you receive an influenza vaccine this season? d. Have you been exposed to anyone who has not been vaccinated recently?

b. Have you or any family members traveled outside the country recently?

A 48-year-old man who has been HIV positive for 6 years has just learned that he has been diagnosed with Kaposi sarcoma (KS). Which fact most accurately conveys an aspect of his diagnosis? a. An opportunistic Epstein-Barr virus underlies the man's KS. b. He is likely to have lesions on his skin, mouth, or GI tract. c. Intense pain was probably his first manifestation of KS d. Heterosexual contact most likely underlies his HIV and subsequent KS.

b. He is likely to have lesions on his skin, mouth, or GI tract.

A client is experiencing impaired circulation secondary to increased systemic arterial pressure. Which statement is the most relevant phenomenon? a. Increased preload due to vascular resistance b. High afterload because of backpressure against the left ventricle c. Impaired contractility due to aortic resistance d. Systolic impairment because of arterial stenosis

b. High afterload because of backpressure against the left ventricle

A pneumonia that occurs 48 hours or more after admission to the hospital is considered: a. Community-acquired pneumonia b. Hospital-acquired pneumonia c. Viral pneumonia d. Immunocompromised pneumonia

b. Hospital-acquired pneumonia

The parent of a child with allergies has been told the child will have a blood test done for immunoglobulin measurement. The nurse should tell the parent that which immunoglobulin will be tested? a. IgG b. IgE c. IgA d. IgM

b. IgE

Three days ago, a mother delivered her full-term infant who had been identified as having an in utero infection. The infant is receiving antibiotic and phototherapy, and the mother is breast-feeding. Which types of immunoglobulins could most reasonably be expected to predominate in the infant's immune system? a. IgA, IgM, IgD b. IgG, IgA, IgM c. IgE, IgG, IgD d. IgM, IgD, Igm

b. IgG, IgA, IgM

While being on subcutaneous heparin injections for deep vein thrombosis during the third trimester of her pregnancy, a client begins to experience major side effects. Her OB physician has called in a specialist who thinks the client is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which order? a. Order to decrease the dose of heparin from 5000 units bid to 3000 units bid. b. Immediately discontinue the heparin therapy. c. A switch to warfarin 2.5 mg once/day. d. Infusion of FFP stat.

b. Immediately discontinue the heparin therapy.

Following the identification of low blood levels of cortisol and low 24-hour urinary free cortisol, a 51-year-old female client has been diagnosed with a primary adrenal cortical insufficiency. Which health consequence would be attributable to her low levels of cortisol? a. Visible exophthalmos b. Impaired immunologic and inflammatory response c. Diminished secondary sex characteristics d. Insufficient regulation of serum potassium and sodium levels

b. Impaired immunologic and inflammatory response

An infant born with congenital hypothyroidism who does not receive care from any health care provider is likely to develop which complications? Select all that apply. a. Deformed joints and bone spurs b. Impaired physical growth c. Intellectual disability d. Loss of fine motor control and arthritis e. Down's syndrome

b. Impaired physical growth c. Intellectual disability

Which client's laboratory result would be associated with abnormalities in kidney function? Select all that apply. a. An absence of protein in a urine sample b. Increased creatinine levels c. Urine gravity of 1.038 and normal serum creatinine levels d. Decreased blood urea nitrogen level (BUN) e. Detectable levels of glucose in a urine sample f. Elevated cystatin C level

b. Increased creatinine levels e. Detectable levels of glucose in a urine sample f. Elevated cystatin C level

Health care team members know recently an increased incidence of infections such as West Nile virus and SARS do not match previously established patterns. Which phenomenon constitutes the most significant contributor to the spread of new diseases in the United States? a. Drug resistance by bacterial and protozoal infections b. Increased ease and speed of travel for individuals and groups c. Genetic variation and mutation by microorganisms d. Decreased living standards and public health standards in urban areas

b. Increased ease and speed of travel for individuals and groups

Which aspect of a client's site of inflammation would help the care provider rule out chronic inflammation? a. High levels of macrophages b. Increased neutrophils c. Proliferation of fibroblasts d. Infiltration of lymphocytes

b. Increased neutrophils

A 14-year-old female has been experiencing severe internal cramps in the region of the pelvis along with weight loss. She has been admitted with rectal bleeding. The physician has diagnosed her with inflammatory bowel disease (IBD). She asks the nurse what causes this disease. Which pathophysiologic basis will guide the nurse's response to this adolescent? a. Oversecretion of insulin from the beta cells in the pancreas b. Infiltration of the gastrointestinal track by bacterial toxins c. Endoplasmic reticulum stress in the gastrointestinal system d. Liver involvement in faulty glycogen stores

b. Infiltration of the gastrointestinal track by bacterial toxins

A 22 year-old student has developed a fever and diarrhea while on a backpacking trip in Southeast Asia. His oral temperature is 101.4°F (38.6°C). The diarrhea is bloody, frequent, and small in volume. These clinical manifestations are distressing enough that he is visiting a local medical clinic in the area. Which diagnosis best characterizes this health problem? a. Non-inflammatory diarrhea b. Inflammatory diarrhea c. Factitious diarrhea d. Secretory diarrhea

b. Inflammatory diarrhea

An adolescent client with a high cervical neck injury from diving into shallow water is in the intensive care unit (ICU) on a ventilator. The family asks, "When can they remove the breathing machine and move the client out of the ICU?" The nurse's response is based on which fact? a. The client's lungs have likely become stiff from the loss of elastin fibers. b. Injury above C3 causes loss of function of the diaphragm, which requires mechanical ventilation. c. The surface tension has to recover and return to the lungs. d. The client's lung field is only able to perform shallow breathing, because surfactant levels are low.

b. Injury above C3 causes loss of function of the diaphragm, which requires mechanical ventilation.

The nurse is caring for a client who has been on an oral corticosteroid for several years for an autoimmune condition. The nurse notes several bruises of different stages of resolution on the client. What is the nurse's best response to this finding? a. Request an order for vitamin K to prevent life-threatening hemorrhage. b. Interview the client regarding side effects of corticosteroid therapy. c. Obtain a STAT order for repeat platelet count and international normalized ratio (INR). d. Complete a thorough pain assessment related to the bruising.

b. Interview the client regarding side effects of corticosteroid therapy.

A male, lifetime smoker has died as a result of chronic obstructive pulmonary disease. Which phenomenon regarding his alveoli would his care team have expected in the weeks prior to his death? a. Proliferation of natural killer (NK) cells in the alveolar lumen b. Large numbers of alveolar macrophages in septal connective tissue c. The presence of tubercles in the interalveolar spaces d. Compensatory regeneration of type I alveolar cells

b. Large numbers of alveolar macrophages in septal connective tissue

A client arrives for a scheduled bone marrow aspiration and biopsy. The nurse explains to the client that which position(s) is best for accessing the posterior iliac crest for aspiration? Select all that apply. a. Supine b. Lateral decubitus c. Prone d. Trendelenburg e. Legs extended

b. Lateral decubitus c. Prone e. Legs extended

A client with severe anemia asks, "What happens if my bone marrow cannot produce sufficient numbers of red blood cells due to my bleeding?" Which response(s) by the nurse correctly identifies the organs that can resume hematopoiesis? Select all that apply. a. Kidneys b. Liver c. Pancreas d. Spleen e. Gall bladder

b. Liver d. Spleen

The nurse is caring for a teenager with sickle cell anemia. When comparing new laboratory results with the client's baseline, which results should the nurse prioritize as requiring intervention? Select all that apply. a. Elevated serum bilirubin b. Low pH on an arterial blood gas c. Elevated serum osmolality d. Decreased hemoglobin e. Elevated white blood cell count

b. Low pH on an arterial blood gas c. Elevated serum osmolality e. Elevated white blood cell count * The nurse's priority is avoiding sickling episodes. Factors that promote sickling are infections, which will be reflected by the elevated while blood cell count; acidosis, reflected by the low pH; and dehydration, reflected by elevated osmolality. Both elevated bilirubin (from increased RBC destruction) and a low hemoglobin are expected baseline findings that will fluctuate in the client with sickle cell anemia.

The nurse is creating a plan of care for a client with autosomal dominant polycystic kidney disease (ADPKD). What should the nurse include in the plan of care? Select all that apply. a. Fluid restriction of 1.5 liters per 24 hours b. Low sodium diet c. Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) d. Administration of antihypertensives e. Inspection of urine output

b. Low sodium diet d. Administration of antihypertensives e. Inspection of urine output

The nurse knows which component is needed for long-lasting immunity in a client with a diagnosis of sepsis without the causative agent identified? a. Neutrophils b. Lymphocytes c. Colony-stimulating factors d. Natural killer cells

b. Lymphocytes

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

b. Materials can be transported to the nerve terminal by either fast or slow components.

Which laboratory value result correlates to the development of diabetic glomerulosclerosis? a. Urine glucose positive b. Microalbuminuria c. High uric acid level d. Hematuria

b. Microalbuminuria

From the current health histories, which client(s) is at risk for developing secondary forms of immune thrombocytopenic purpura (ITP)? Select all that apply. a. Female client in the first trimester reporting abdominal cramping b. Middle-aged client scheduled for gastroscopy to confirm Helicobactor pylori c. Former IV drug user recently diagnosed with hepatitis C virus d. Older adult female undergoing testing for cause of joint discomfort e. Adolescent admitted for facial burns when the "vape" (cigarette) exploded in the mouth

b. Middle-aged client scheduled for gastroscopy to confirm Helicobactor pylori c. Former IV drug user recently diagnosed with hepatitis C virus

A 30 year-old male's blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man's most likely diagnosis? a. Acute myelogenous leukemia b. Multiple myeloma c. Acute lymphocytic leukemia d. Hodgkin lymphoma

b. Multiple myeloma

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

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? a. The student is correct. A warning sign of cancer is a lump or bump that should not be there. b. Not all swollen lymph nodes are due to cancer. It could be caused by an infection in the genital region. c. Swollen lymph nodes that are painful to touch are most likely characteristic of neoplasms. d. Increased sexual activity in college is a precurser to development of genital cancers.

b. Not all swollen lymph nodes are due to cancer. It could be caused by an infection in the genital region.

A client with systemic lupus erythematosus (SLE) glomerulonephritis is experiencing a worsening of the disease and has progressed to the higher classes resulting in renal involvement. Which medication(s) will likely be prescribed by the health care provider to treat the deterioration of the renal function? Select all that apply. a. Increase in Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) b. Oral corticosteroid c. Lisinipril, an angiotensin-converting enzyme (ACE) inhibitor d. Intravenous antimicrobial combination drug trimethoprim and sulfamethoxazole

b. Oral corticosteroid c. Lisinipril, an angiotensin-converting enzyme (ACE) inhibitor

The nurse is caring for a client with traumatic brain injury and increased intracranial pressure. What findings should the nurse report due to the risk for increasing intracranial pressure? Select all that apply. a. PaCO2 of 28 mm Hg (3.72 kPa) b. PaCO2 of 50 mm Hg (6.65 kPa) c. PaO2 of 70 mm Hg (9.31 kPa) d. pH of 7.25 e. potassium of 3.3 mEq/L (3.3 mmol/L)

b. PaCO2 of 50 mm Hg (6.65 kPa) c. PaO2 of 70 mm Hg (9.31 kPa) d. pH of 7.25

Question 19 (1 point) A 3-year-old boy has developed croup following a winter cold. His care provider would recognize that which microorganisms and treatments are most likely to be related and effective, respectively? a. Respiratory syncytial virus, treated with intubation. b. Parainfluenza virus, treated with a mist tent and oxygen therapy. c. Haemophilus influenzae treated with appropriate antibiotics. d. Staphylococcus aureus treated with bronchodilators and mist tent.

b. Parainfluenza virus, treated with a mist tent and oxygen therapy.

Following head injury from a fall, the child's CT scan reveals a moderate brain injury contusion. Which manifestations will the nurse more than likely assess on this child that supports this diagnosis? Select all that apply. a. Coma with total paralysis b. Periods of unconsciousness c. Aphasia at times d. Nuchal rigidity e. Weakness or slight paralysis affecting one side of the body

b. Periods of unconsciousness c. Aphasia at times e. Weakness or slight paralysis affecting one side of the body

Which statements best captures an aspect of the process of hematopoiesis? a. Colony-stimulating factors (CSFs) produce cytokines that activate progenitor cells. b. Progenitor cells differentiate into precursor cells. c. Various subtypes of pluripotent stem cells eventually differentiate into the cellular components of blood. d. Self-replicating precursor cells differentiate into specific CSFs.

b. Progenitor cells differentiate into precursor cells.

Reviewing pathology for an exam on pulmonary vasculature, the nursing student states that blood enters the right side of the heart via the vena cava, then to the right atrium, right ventricle, and then which vessel carries the deoxygenated blood into the pulmonary system? a. Pulmonary capillaries b. Pulmonary artery c. Pulmonary vein d. Ductus arteriosus

b. Pulmonary artery

A client with a history of epilepsy is brought to the emergency department due to seizure activity. What information about the client is most important for the nurse to collect? a. Family history of seizure disorders b. Recent medication history c. Type of seizure activity experienced d. Allergies to medications

b. Recent medication history

A female dental assistant has developed signs and symptoms of a latex sensitivity, and is undergoing allergy testing as well as blood work. Which component of the assistant's blood work would most likely be the focus of her health care provider's analysis? a. Analysis of class II MHC antigens b. Serum IgE immunoassays c. Serum B-lymphocyte levels d. Serum CD8+ levels

b. Serum IgE immunoassays

The nurse is performing discharge teaching for a client who has recovered from sepsis following an open cholecystectomy. What should be the nurse's primary focus? a. Dietary changes needed after cholecystectomy b. Signs and symptoms of infection c. Follow-up appointments with health care providers d. Exercises that are permitted postoperatively

b. Signs and symptoms of infection

When trying to explain to a client on dialysis the movement of substances through the capillary pores, the nurse will explain that in the kidneys, the glomerular capillaries have: a. no capillary openings since this would lead to extensive hemorrhage. b. Small openings that allow large amounts of smaller molecular substances to filter through the glomeruli. c. Large pores so that substances can pass easily through the capillary wall. d. Endothelial cells that are joined by tight junctions that form a barrier to medication filtration.

b. Small openings that allow large amounts of smaller molecular substances to filter through the glomeruli.

Which statement is an accurate descriptor of the role of viruses in human infections? a. Viruses have no genetic material of their own. b. Some viruses are capable of transforming normal host cells into malignant cells. c. Viruses are often implicated in cases of transmissible neurodegenerative disease. d. Viruses require stimulation after a latent period before they are able to produce symptoms.

b. Some viruses are capable of transforming normal host cells into malignant cells.

A 68-year-old black man who has smoked for at least 50 years reports that lately he feels as though food is getting stuck in his throat. At first this was a problem just with dry food, but now his morning oatmeal is getting "stuck." On questioning, he reports drinking at least 3 alcoholic beverages nearly every day. Which is most likely his problem? a. Achalasia b. Squamous cell carcinoma of the esophagus c. Dysphagia secondary to scleroderma d. Gastrointestinal reflux disease

b. Squamous cell carcinoma of the esophagus

A hospital client is receiving intravenous infusion of heparin for treatment of a pulmonary embolus. Which phenomenon is most likely occurring, resulting in the drug's therapeutic effect? a. Inhibition of vitamin K synthesis in the liver b. Suppression of fibrin formation c. Deactivation of the intrinsic clotting pathway d. Inhibition of ADP-induced platelet aggregation

b. Suppression of fibrin formation

When explaining to a client why his prostate is enlarging, the nurse will mention that which hormones may contribute to the prostatic hyperplasia? Select all that apply. a. Glucocorticoids b. Testosterone c. Dihydrotestosterone d. Estrogens e. Progesterone

b. Testosterone c. Dihydrotestosterone d. Estrogens

Which statement best captures the role of the adrenal cortex in maintaining homeostasis? a. The adrenal cortex is responsible for the production of epinephrine and norepinephrine that are part of the sympathetic nervous system. b. The adrenal cortical hormones are primarily steroids and sex hormones. c. Redundant, secondary production of adrenal cortical hormones can compensate for the loss of the adrenal glands. d. Normal sexual function is dependent on adequate adrenal cortical function.

b. The adrenal cortical hormones are primarily steroids and sex hormones.

A client asks the health care provider why his lower legs look purple. The health care provider will base the response on which pathophysiologic principle? a. Too much trauma breaks capillaries and they bleed into the tissue. b. The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher. c. There is a problem with the plasminogen levels. d. Morbid obesity causes veins to enlarge and bleed into tissues due to stress the abdomen is placing on the vascular system.

b. The bruising around the ankles is due to the fact that it is a dependent area where the capillary pressure is higher.

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 nurse is providing care for an older, previously healthy adult male who has been diagnosed today with pneumococcal pneumonia. Which sign/symptom is the nurse most likely to encounter? a. The man will be hypotensive and febrile and may manifest cognitive changes. b. The client will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles. c. The client will have copious bloody sputum and diffuse chest pain and may lose his cough reflex. d. The client will lack lung consolidation and will have little if any sputum production.

b. The client will have a cough producing clear sputum, and he will have faint breath sounds and fine crackles.

During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle? a. Continued growth of the follicle until it can no longer stay in its membrane. b. The follicle will die, which results in a fall of FSH. c. The follicle will continue to grow and produce estradiol. d. The follicle will secrete additional hormones to attract swimming sperm.

b. The follicle will die, which results in a fall of FSH.

A client is suspected of having an infection, but the microorganism suspected as the cause cannot be cultured. The client asks how the health care provider will identify the organism. What is the nurse's best response as to the methods used? a. The health care provider will administer empiric antimicrobials, and observe your response to treatment. b. The health care provider will introduce cultured, marked antibodies to your blood sample and observe for a reaction with antigens. c. The health care provider will observe for a cytopathic effect on biopsy tissue samples from the your mucosa. d. The health care provider will release purified antigens into your circulation to observe whether you produce the relevant antibodies.

b. The health care provider will introduce cultured, marked antibodies to your blood sample and observe for a reaction with antigens.

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 lymphatic system.

Which situation is most likely to result in an increased binding affinity of hemoglobin for oxygen? a. A client is in respiratory acidosis, with a low pH. b. Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen. c. A client's body temperature is elevated as a result of an infectious process. d. An increase in 2, 3-diphosphoglycerate enhances the loading of oxygen.

b. Three of four binding sites on a client's hemoglobin molecule are occupied by oxygen.

After years of going to different physicians with vague symptoms, a 55-year-old client with a history of Hodgkin lymphoma has been diagnosed with a secondary immunodeficiency syndrome. The client asks the nurse what this means. The nurse knows that secondary immunodeficiency disorders may occur if which background information is available? Select all that apply. a. May be inherited as a sex-linked trait b. Usually develop later in life c. May be a result of chemotherapy being used to treat a cancer d. Can result from frequent recurring Staphylococcus aureus infections e. Can occur in clients taking corticosteroids daily.

b. Usually develop later in life c. May be a result of chemotherapy being used to treat a cancer e. Can occur in clients taking corticosteroids daily.

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

b. Very lipid-soluble and rapidly crosses the blood-brain barrier.

Because nephropathy is an important cause of end-stage renal failure in children, a toddler who has had an uncomplicated bout of urinary tract infection (UTI) should still be evaluated for the presence of which renal disorder? a. Urethrovesical reflux b. Vesicoureteral reflux c. Neurogenic bladder d. Detrusor muscle instability

b. Vesicoureteral reflux

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.

A 44-year-old female client presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which diagnosis would the medical team be most justified in suspecting as a cause of the client's bleeding? a. Excess calcium b. Vitamin K deficiency c. Hemophilia B d. Idiopathic immune thrombocytopenic purpura (ITP)

b. Vitamin K deficiency

An older adult client arrives to the health care provider's office complaining of a "sore" that won't heal on the lower leg. Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the client that the usual treatment is: a. hydrotherapy treatments to facilitate improvement in circulation. b. compression therapy to help facilitate blood flow back to the vena cava. c. initiation of warfarin therapy to maintain an INR of 2-3.0 above norm. d. long-term antibiotic therapy to facilitate healing of the wound.

b. compression therapy to help facilitate blood flow back to the vena cava.

When explaining to a client why there was only minimal muscle damage following 99% occlusion of the left anterior descending artery, the nurse will explain that this is primarily due to: a. the possibility that the person has elevated INR levels that prevents blood from backlogging in the vessel. b. development of collateral circulation that build channels between some of the smaller arteries, usually when the flow is decreased gradually. c. good genetic makeup that allows occluded arteries to keep vasodilating to meet metabolic needs. d. the release of substances formed by special glands that transport the blood cell by cell through smaller spaces.

b. development of collateral circulation that build channels between some of the smaller arteries, usually when the flow is decreased gradually.

While teaching a health class to junior and senior male high school students, the school nurse educates them that the first sign of testicular cancer is: a. one testicle lower than the other in the scrotal sac. b. enlargement of the testicle. c. back pain. d. coughing bloody sputum.

b. enlargement of the testicle.

The nurse is caring for a group of infants with bronchiolitis. Which infant should the nurse prioritize as requiring immediate intervention? The infant who: a. is crying and has audible wheezing. b. has diminishing wheezing and cyanosis. c. is tachypneic and restless. d. is coughing and sounds congested.

b. has diminishing wheezing and cyanosis.

The nurse knows which statement best describes a characteristic trait of Rickettsiae related to Rocky Mountain spotted fever? Rickettsiae: a. are eukaryotic. b. have both RNA and DNA. c. have a distinct spiral-shaped morphology. d. are neither gram-negative nor gram-positive.

b. have both RNA and DNA.

A middle-aged man walks into the emergency department reporting chest pain radiating to the neck, shortness of breath, and nausea. His heart rate is 120 and BP is 94/60. The ED physician recognizes the client is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to: a. the client doesn't have a very high pain tolerance. b. hypoxia exerting a direct effect on the chemoreceptor trigger zone. c. the client hasn't digested his meal completely. d. fear of having to make major lifestyle changes.

b. hypoxia exerting a direct effect on the chemoreceptor trigger zone.

As you are walking in the park, a huge black Labrador [dog] runs up to you and places his paws on your shoulders. Immediately your heart starts racing, you feel palpations, anxiety, and your hands become a little shaky. The nurse knows that this response is primarily caused by: a. fear of dogs that make you feel like your chest is being tightened and that you have lost control of the situation. b. increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level. c. response of the cholinergic muscarinic receptors on innervational targets of postganglionic fibers. d. stimulation of the release of β2 adrenergic receptors, which will open the airway and increase oxygenation.

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

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

b. interruption of the blood/oxygen supply to the brain.

The nurse knows that which statement listed below relative to a client with malignant melanoma treated with alpha interferon (IFN-α) is accurate? Alpha interferon (IFN-α): a. will kill certain microorganisms that may help spread the cancer. b. plays an important role in the modulation of the inflammatory response. c. helps keep all the blood levels at a higher level. d. controls the migration of leukocytes to their primary site.

b. plays an important role in the modulation of the inflammatory response.

A client has recently been diagnosed with H. pylori gastritis. The nurse knows that this form of gastritis is usually treated with a combination of an antibiotic and: a. anti-anxiety medications. b. proton pump inhibitors. c. lactulose, to reduce the blood ammonia levels. d. calcium carbonate, an antacid.

b. proton pump inhibitors.

A health care provider has prescribed blood products for a trauma client with a history of selective immunoglobulin A deficiency (SIGAD) who is going into hypovolemic shock. Which blood product is most appropriate for the nurse to infuse? a. platelets from a single donor b. specially washed erythrocytes from normal donor c. fresh frozen plasma from multiple donors d. cryoprecipitate from pooled donors

b. specially washed erythrocytes from normal donor

The nurse is creating a plan of care for a client with erectile dysfunction. Which type of medication is most likely to make achieving an erection more difficult? Medications that: a. suppress the sympathetic nervous system b. suppress the parasympathetic nervous system c. promote vasoconstriction d. increase heart rate

b. suppress the parasympathetic nervous system

A health educator is performing a health promotion workshop with the staff of a large, urban homeless shelter, and a component of the teaching centers around tuberculosis. One of the staff members comments, "Anyone who's had contact with tuberculosis in the past can give it to any of the other residents of the shelter, even if they didn't get sick themselves." How could the educator best respond to this comment? a. "Many people do manage to fight off the infection, but you're right—they can still spread it by coughing or sneezing." b. "If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease." c. "Actually, people who have the latent form of the disease won't be sick and can't spread it either." d. "There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past."

c. "Actually, people who have the latent form of the disease won't be sick and can't spread it either."

Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students' statements best captures an aspect of the two health problems? a. "Both diseases can result from inadequate production of thrombopoietin by megakaryocytes. b. "ITP can be either inherited or acquired, and if it's acquired, it involves an enzyme deficiency." c. "Both of them involve low platelet counts, but in TTP there can be more, not less, hemostasis. d. "TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma."

c. "Both of them involve low platelet counts, but in TTP there can be more, not less, hemostasis.

An adolescent male with type 1 diabetes is exasperated by his regimen of blood sugar monitoring and insulin administration, and has told his mother that he wants to scale both back. Which response by his mother is most accurate? a. "I know it's not fun, but you're even more susceptible to complications when you're young if you don't stay on top of your diabetes." b. "Even though you might save some time and energy by doing this, remember that high blood sugars cause a lot of pain and will cause you to gain weight." c. "Even though it's hard to do, you need to continue so you don't go blind or need a kidney transplant down the road." d. "You need to be vigilant now if you want to be free of diabetes when you grow up."

c. "Even though it's hard to do, you need to continue so you don't go blind or need a kidney transplant down the road."

A client diagnosed with H. pylori asks the nurse, "How can an infection occur in the stomach since it is an acid environment?" The nurse responds: a. "We have many infectious agents that can live in an acidic environment with a pH more than 8.0." b. "H. pylori is a virus and is still being researched as to how it is able to survive in the stomach acids." c. "H. pylori produces an enzyme called urease that converts gastric juices into ammonia, which neutralizes the acidic stomach environment." d. "This parasite secretes an enzyme called coagulase, which protects the pathogen from the antibodies."

c. "H. pylori produces an enzyme called urease that converts gastric juices into ammonia, which neutralizes the acidic stomach environment."

A 23-year-old man has received a recent diagnosis of appendicitis. The nurse providing care for the man is explaining that the inflammation of his appendix is playing a role in his body's fight against the underlying infectious process. Which teaching points should the nurse eliminate from client education? a. "Inflammation can help to remove the body tissue cells that have been damaged by infection." b. "Inflammation will start your body on the path to growing new, healthy tissue at the site of infection." c. "Inflammation helps your body to produce the right antibodies to fight the infection." d. "Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix."

c. "Inflammation helps your body to produce the right antibodies to fight the infection."

The physician knows the client, G1P0, has correctly understood the prenatal education regarding sexually transmitted infection as evidenced by which statement listed below? a. "Out of the various infectious agents, gonorrhea and chlamydia pose the greatest risks of transmission from mother to child." b. "I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery." c. "My baby could become infected either across the placenta or during the birth itself." d. "If I receive prophylactic immunization I will reduce my baby's chance of being born with an illness."

c. "My baby could become infected either across the placenta or during the birth itself."

As part of their orientation to a cardiac care unit, a group of recent nursing graduates is receiving a refresher in cardiac physiology from the unit educator. Which teaching point best captures a component of cardiac function? a. "Efficient heart function requires that the ventricles not retain any blood at the end of the cardiac cycle. b. "Recall that the heart sounds that we listen to as part of our assessments are the sounds of the myocardium contracting." c. "The diastolic phase is characterized by relaxation of ventricles and their filling with blood." d. "Aortic pressure will exceed ventricular pressure during systole."

c. "The diastolic phase is characterized by relaxation of ventricles and their filling with blood."

A client arrives for his scheduled vasectomy. During preoperative education, the client asks the nurse, "Now tell me again what is going to be cut to stop my production of sperm?" Which response by the nurse is the most appropriate? a. "The provider is going to incise your testes and heat the inside matter so sperm can no longer be produced." b. "The provider is not going to 'cut' anything. The provider is going to use cryotherapy to freeze the gland responsible for sperm production." c. "The provider will surgically disconnect the vas deferens in the scrotal area, which is the system that transports sperm during ejaculation." d. "Both testes will be removed and replaced with a testicular prosthesis to fill in the empty space. You will not be able to tell the difference."

c. "The provider will surgically disconnect the vas deferens in the scrotal area, which is the system that transports sperm during ejaculation."

When educating a college student who lives in a crowded apartment and was recently diagnosed with tuberculosis, the school nurse will emphasize which treatment plan? a. "Once your fever goes away you can stop taking the streptomycin injection." b. "If isoniazid makes you nauseous, we can substitute something milder." c. "To destroy this bacterium, you must strictly adhere to a long-term drug regimen of several medications." d. "You will have to wear a N95 mask while on campus at all times."

c. "To destroy this bacterium, you must strictly adhere to a long-term drug regimen of several medications."

A number of older adults have come to attend a wellness clinic that includes both blood pressure monitoring and education about how to best control blood pressure. Which teaching point is most accurate? a. "It's important to minimize the amount of potassium and, especially, sodium in your diet." b. "High blood pressure is largely controllable, except for those with a significant family history or black persons." c. "Too much alcohol, too little exercise, and too much body fat all contribute to high blood pressure." d. "Hypertension puts you at a significant risk of developing type 2 diabetes later in life."

c. "Too much alcohol, too little exercise, and too much body fat all contribute to high blood pressure."

A 71-year-old male has been recently diagnosed with a stage III tumor of colorectal cancer, and is attempting to increase his knowledge base of his diagnosis. Which statement about colorectal cancer demonstrates a sound understanding of the disease? a. "If accurate screening test for this type of cancer existed, it could likely have been caught earlier." b. "The NSAIDs and aspirin that I've been taking for many years probably contributed to my getting cancer." c. "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown." d. "A large majority of clients who have my type of colon cancer survive to live many more years."

c. "While diet is thought to play a role in the development of colorectal cancer, the ultimate causes are largely unknown."

A 68-year-old man has revealed to his care provider that he is distraught over his increasingly frequent inability to maintain an erection. Which teaching point is most warranted? a. "Above the age of 65, erectile dysfunction is largely inevitable and untreatable." b. "With lifestyle modifications like exercise, weight loss, and quitting smoking you can most likely correct this and prevent it in the future." c. "While this problem is often a part of the aging process, it might be a result of some of the medications that you take." d. "Most often this problem is transient and will resolve with time."

c. "While this problem is often a part of the aging process, it might be a result of some of the medications that you take."

Which teaching point by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer? a. "Thanks to new treatment advances, there's a very good chance that I won't have to remove a testicle." b."If steroid treatment fails, then we can consider surgery and/or chemotherapy." c. "You should know that there might be adverse effects on your sexual function after treatment is finished." d. "The advantage of performing an orchiectomy over other treatments is that it rules out recurrence."

c. "You should know that there might be adverse effects on your sexual function after treatment is finished."

A client with a newly diagnosed adrenal tumor asks the nurse, "So what kind of hormones will be affected if I have my adrenal gland removed?" Which response(s) by the nurse is accurate to relay to this client? Select all that apply. a. "Your growth hormones will be affected." b. "It could interfere with your thyroid hormone levels." c. "You will have changes in your sympathetic nervous system responses to stress." d. "It could affect sodium and potassium electrolyte levels." e. "Blood glucose levels may become elevated."

c. "You will have changes in your sympathetic nervous system responses to stress." d. "It could affect sodium and potassium electrolyte levels." e. "Blood glucose levels may become elevated."

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which teaching point should his caregiver provide? a. "While your diet most certainly contributed to this problem, the good news is that changing your diet can help solve it." b. "Ulcers like yours do not penetrate all layers of the stomach or duodenum so you don't have to worry about losing too much blood." c. "Your family history, your smoking history, and NSAID use may all have contributed to this problem." d. "While there aren't really any effective medications for these ulcers, changes in lifestyle can keep them well controlled."

c. "Your family history, your smoking history, and NSAID use may all have contributed to this problem."

A client has been taking up to 2400 mg of ibuprofen per day for chronic pain following a motor vehicle accident. The client is diagnosed with chronic analgesic nephritis. The client states, "I thought that taking too many drugs hurt your liver if anything, not your kidneys." What is the most appropriate response to the client's statement? a. "Your liver does perform most of the detoxifying in your body, but your kidneys can perform this role if the liver is unable to." b. "High drug intake can cause your kidneys to be very vulnerable to infections, which is likely what happened in your case." c. "Your kidneys are vulnerable to damage because of how much blood flows through them and the fact that they break down many drugs." d. "It is very rare for someone as young as yourself to have kidney damage like this; usually only older people are vulnerable to kidney damage from drugs."

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

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

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

A surgeon is explaining to the parents of a 6-year-old boy the rationale for the suggestion of removing the boy's spleen. Which teaching point would be most accurate? a. "We believe that your son's spleen is causing the destruction of many of his blood platelets, putting him at a bleeding risk." b. "Your son's spleen is inappropriately destroying the platelets from his blood and needs to be removed." c. "Your son's spleen is holding on to too many of his platelets so they're not available for clotting." d. "We think that his spleen is inhibiting the production of platelets by his bone marrow."

c. "Your son's spleen is holding on to too many of his platelets so they're not available for clotting."

A client is diagnosed with pernicious anemia and asks, "Why is my body not able to absorb vitamin B12?" Which response by the nurse is most accurate? a. "You have too many ulcers in your stomach." b. "More than likely, you were born with deficient vitamin B12 stores." c. "Your stomach is not secreting a substance known as intrinsic factor, which is needed to absorb vitmin B12." d. "Your daily intake of high saturated fats is interfering with the stomach's ability to absorb the nutrients that it needs, especially vitamin B12."

c. "Your stomach is not secreting a substance known as intrinsic factor, which is needed to absorb vitmin B12."

The nurse is counseling a client who is going for major surgery and must stop taking aspirin to reduce the risk for bleeding. The nurse knows aspirin decreases platelet activity for the duration of the platelet's lifespan. How many days prior to the surgery should the nurse tell the client to stop taking aspirin? a. 2 b. 5 c. 10 d. 14

c. 10

A nurse is reviewing a client's laboratory results and notices the blood urea nitrogen (BUN):creatinine ratio is 16:1. This ratio most likely correlates to which factor in the client's medical history? a. Hepatitis, a liver disease b. Recent weight loss by following a low-protein diet c. 10-year history of heart failure treated medically d. Chronic hemodialysis three times/week

c. 10-year history of heart failure treated medically

Question 14 (1 point) The neonatal ICU nurse is aware that type II alveolar cells produce surfactant and they usually develop at how many weeks' gestation? a. 17-18 weeks b. 19-20 weeks c. 24-28 weeks d. 34-38 weeks

c. 24-28 weeks

A client's urine results reveal proteinuria and microalbuminuria. The health care provider is likely to prescribed an examination that will assist in quantifying the amount of protein loss by the kidney. For which examination should the nurse prepare to educate the client? a. Specific gravity calculation b. Serum albumin level c. 24-hour urine test d. Nitrate chemistry determination looking for infection

c. 24-hour urine test

Following ejaculation in a healthy adult, there are approximately 300 million sperm present. What percentage of these sperm would be considered normal [mobile and morphologically healthy] and able to fertilize an egg? a. 95% b. 75% c. 55% d. 45%

c. 55%

Which client may be experiencing a sensory focal seizure that has sent an abnormal cortical discharge to the autonomic nervous system (ANS)? a. 44-year-old client reporting constant movement and pain in the legs that gets worse when attempting to sleep b. 85-year-old client experiencing drooping of the right side of face and numbness in right arm and leg c. 56-year-old reporting tingling sensations and has both an elevated pulse and BP d. 22-year-old reporting a stiff neck and achiness, along with some nausea and vomiting

c. 56-year-old reporting tingling sensations and has both an elevated pulse and BP

Which neurologic client is most likely to have abnormalities in breathing regulation? a. A 23-year-old male who has an injury to his frontal lobe following a sports injury b. A 45-year-old female with a spinal cord injury at C7 following a motor vehicle accident c. A 34-year-old male with damage to his upper and lower pons following a blow to the back of the head d. A 66-year-old male with temporal lobe infarcts secondary to a stroke

c. A 34-year-old male with damage to his upper and lower pons following a blow to the back of the head

In which of the following hospital clients would the care team most realistically anticipate finding normal cholesterol levels? a. A 44-year-old male admitted for hyperglycemia and with a history of diabetic neuropathy b. A 77-year-old female admitted for rheumatoid arthritis exacerbation who is receiving hormone replacement therapy and has a history of hypothyroidism c. A 51-year-old male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness d. A morbidly obese 50-year-old female who is taking diuretics and a beta-blocker to treat her

c. A 51-year-old male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness

Which client should the emergency department staff suspect to be high risk for the development of a thoracic aortic aneurysm? a. A 60-year-old client with diminished oxygen saturation, low red blood cell levels, and pallor b. A 70-year-old woman with jugular venous distention, shortness of breath, and pulmonary edema c. A 66-year-old client with facial edema, a cough, and neck vein distention d. An 81-year-old man with acute cognitive changes as well as difficulty speaking and swallowing

c. A 66-year-old client with facial edema, a cough, and neck vein distention

In which situation would blood most likely be rapidly relocated from central circulation to the lower extremities? a. A client undergoes a stress test on a treadmill. b. A client does isotonic exercises in a wheelchair. c. A client is helped out of bed and stands up. d A client reclines from a sitting to supine position.

c. A client is helped out of bed and stands up.

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which phenomenon would the physician most likely suspect as contributing factor to the boy's short stature? a. Genetic short stature b. Lack of IGF receptors in epiphyseal long bones c. A shortage of hypothalamic GHRH production d. Excess insulin production resulting in chronically low blood glucose levels

c. A shortage of hypothalamic GHRH production

Which phenomenon would be least likely to result in activation of the complement system? a. Recognition of an antibody bound to the surface of a microbe b. Increase tissue blood flow and capillary permeability so fluids/proteins can leak into the area. c. Activation of toll-like receptors (TLRs) on complement proteins. d. Direct recognition of microbial proteins.

c. Activation of toll-like receptors (TLRs) on complement proteins.

When teaching a class of nursing students, the pathophysiology instructor asks, "What is the majority of energy used for by the kidney?" Which response is most accurate? a. Filtration of drugs out of the body. b. Secretion of erythropoietin for production of red blood cells. c. Active sodium transport mechanisms. d. Removal of excess glucose from the blood.

c. Active sodium transport mechanisms.

Which hormones are derivatives of cholesterol? a. Epinephrine and norepinephrine b. Insulin and glucagon c. Aldosterone and testosterone d. Eicosanoids and retinoids

c. Aldosterone and testosterone

The nurse is caring for a client who has dysphagia after suffering a stroke. Which principle related to the phases of swallowing will the nurse employ to best reduce the risk for aspiration? a. Sit the client up at an angle of 45° to 75° so food will be able to move more easily into the stomach during swallowing. b. Feed the client on the unaffected side to maximize the movement of the bolus during the esophageal phase. c. Allow the client to lean forward while eating to reduce the effects of gravity on the oral phase of swallowing. d. Have the client sit up for at least 30 minutes after eating to allow the completion of the pharyngeal phase.

c. Allow the client to lean forward while eating to reduce the effects of gravity on the oral phase of swallowing.

A client in the emergency department is experiencing a massive stroke with extremely low blood flow to the brain exhibited by a BP <60 mm Hg. The nurse suddenly notes there is a sharp rise in the BP to 250 mm Hg. This high BP lasts about 5 minutes and then the BP drops sharply again. The pathophysiologic principle behind this is likely due to the: a. activation of the autonomic nervous system. b. release of mineralocorticoids. c. CNS ischemic response. d. protective homeostatic mechanism.

c. CNS ischemic response.

A 71-year-old man has visited his family physician for a checkup, during which the physician has initiated a discussion about the client's sexual function. Which phenomenon would the physician most likely consider pathological rather than an age-related change? a. The presence of an enlarging prostate gland. b. A decrease in the size and firmness of the client's testes. c. Cessation of androgen production. d. A decrease in the force of the man's ejaculation.

c. Cessation of androgen production.

A 4-year-old boy presents with a chronic cough and swollen lymph nodes. His records show that he has been given antibiotics several times in the past year with limited success, most recently for a liver abscess. He also has a recurring fungal skin condition. Which diagnosis is most likely the cause of this child's manifestations? a. Selective IgA deficiency b .A deficiency in IgG2 subclass antibodies c. Chronic granulomatous disease d. Ataxia-telangiectasia

c. Chronic granulomatous disease

From the assigned team of clients, which client is at highest risk for the development of endothelial damage that may lead to disseminated intravascular coagulation (DIC)? a. Client who had an automobile accident client and sustained three broken ribs resulting in a small pneumothorax b. Adolescent clilent who developed blisters on the back from sunbathing requiring pain medication c. Client with chronic obstructive pulmonary disease (COPD) who is diagnosed with pneumonia, most likely from a virus d. Client on a monitor displaying frequent premature ventricular contractions (PCVs)

c. Client with chronic obstructive pulmonary disease (COPD) who is diagnosed with pneumonia, most likely from a virus

A physical assessment of a 28-year-old female client indicates that the blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which possibility would her care provider be most likely to suspect? a. Pheochromocytoma b. Essential hypertension c. Coarctation of the aorta d. An adrenocortical disorder

c. Coarctation of the aorta

A nurse is providing care for a 17-year-old boy who has experienced recurrent sinus and chest infections throughout his life and presently has enlarged tonsils and lymph nodes. Blood work indicated normal levels of B cells and free immunoglobins but a lack of differentiation into normal plasma cells. The boy is currently receiving intravenous immunoglobulin (IVIg) therapy. What is the boy's most likely diagnosis? a. X-linked hypogammaglobulinemia b. Transient hypoglobulinemia c. Common variable immunodeficiency d. IgG subclass deficiency

c. Common variable immunodeficiency

A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which medical diagnosis listed below may be associated with these clinical manifestations? a. Rocky mountain spotted fever b. Lyme disease c. Encephalitis d. Spinal infection

c. Encephalitis

An adult diagnosed with type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which physiologic processes are actions of insulin? Select all that apply. a. Increasing the metabolic needs of body cells b. Promoting the breakdown of stored triglycerides c. Facilitating triglyceride synthesis by the liver d. Inhibiting protein breakdown e. Promoting glucose uptake by target cells.

c. Facilitating triglyceride synthesis by the liver d. Inhibiting protein breakdown e. Promoting glucose uptake by target cells.

Following physical assessment, which abnormality(ies) leads the health care provider to suspect the client has metabolic syndrome? Select all that apply. Select 3 correct answer(s) a. Blood glucose level of 100 mg/dL (5.6 mmol/L) b. Fasting high-density lipoprotein (HDL) level of 80 mg/dL (2.07 mmol/L) c. Fasting triglyceride level of 230 mg/dL 92.6 mmol/L) d. Five foot (1.5 meter) tall female with abdominal waist measurement of 45 inches (114 cm) e. Sitting blood pressure reading of 145/96 mm Hg

c. Fasting triglyceride level of 230 mg/dL 92.6 mmol/L) d. Five foot (1.5 meter) tall female with abdominal waist measurement of 45 inches (114 cm) e. Sitting blood pressure reading of 145/96 mm Hg

A 63-year-old woman has begun a diet that purports to minimize the quantity and effects of free radicals in her body. Which physiologic process could best underlie her care provider's teaching about her new diet? a. Free radicals act as direct mediators in the inflammatory process. b. Free radicals inhibit the inflammatory response, limiting pre-adaptive response to infection. c. Free radicals increase cytokine expression and adhesion molecule levels, resulting in increased inflammation. d. Free radicals contribute to atherosclerosis and decreased immune response.

c. Free radicals increase cytokine expression and adhesion molecule levels, resulting in increased inflammation.

A college student has been experiencing frequent headaches that he describes as throbbing; he is reporting difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which pathophysiologic concept is likely responsible for his symptoms? a. Increased tissue perfusion at the site of the malformation b. Hydrocephalus and protein in the cerebrospinal fluid c. High pressure and local hemorrhage of the venous system d. Localized ischemia with areas of necrosis noted on CT angiography

c. High pressure and local hemorrhage of the venous system

A nurse on a respiratory unit of a hospital is providing care for a client with end-stage lung disease. Consequently, measurement of the client's arterial blood gases indicates increased PCO2. Which associated consequence would the nurse anticipate? a. A shift to the left of the oxygen-hemoglobin dissociation curve b. Lower than normal production of HCO3 c. Higher than normal production of H+ d. An absence of carbaminohemoglobin

c. Higher than normal production of H+

While undergoing a kidney transplant from a non-family member, the client's transplanted kidney has just had the arterial clamps removed. The OR staff notices that the organ is turning purple with no urine output. When explaining to the family why they had to remove the donor kidney, the nurse will anticipate that the surgeon would likely include which statement? a. Obviously, there has been a mismatch during the human leukocyte antigens (HLA) testing. b. The circulating B and T lymphocytes are just doing their job. c. Hyperacute rejection occurs because antibodies against HLA antigens are deposited in vessels, causing necrosis. d. Previous exposure to the HLA antigens is responsible for the high titers of complement-fixing antibodies that cause the rejection.

c. Hyperacute rejection occurs because antibodies against HLA antigens are deposited in vessels, causing necrosis.

A 51-year-old man is receiving his annual physical exam and his care provider is explaining the rationale for performing a digital rectal exam (DRE). Which statement best captures the rationale for the procedure? a. DRE, combined with a measurement of prostate-specific antigen (PSA), is the easiest way to confirm or rule out benign prostatic hyperplasia (BPH). b. The presence of an enlarged prostate provides a definitive diagnosis of prostate cancer. c. If the prostate is hardened on examination, a biopsy is indicated for further investigation. d. DRE is a screening test recommended for men who are experiencing either reduced urine flow or pain on urination.

c. If the prostate is hardened on examination, a biopsy is indicated for further investigation.

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

c. Impaired function of her hypothalamus

As a result of dehydration, a client's epithelial cells are producing insufficient amounts of mucus. Consequently, the client's mucociliary blanket is compromised. Which change would the care provider anticipate as a direct result of this change? a. Impaired function of the client's cilia b. decreased levels of oxygen saturation c. Increased amounts of bacteria in the lungs d. Increased carbon dioxide levels

c. Increased amounts of bacteria in the lungs

A nurse practitioner is providing care for a client with low levels of the plasma protein gamma globulin. The nurse would recognize that the client is at risk of developing which health problem? a. Jaundice b. Anemia c. Infections d. Blood clots

c. Infections

A 51-year-old client with a history of alcohol abuse and liver disease has low serum levels of albumin, and presents with ascites (excess fluid in his peritoneal space) and jaundice. A health care professional would recognize that which process is most likely underlying his health problems? a. Low albumin is contributing to excess hydrostatic pressure and inappropriate fluid distribution. b. Low albumin is inducing hypertension and increased filtration of fluid into interstitial spaces. c. Insufficient albumin is causing insufficient absorption of fluid into the capillaries. d. Low albumin is contributing to an inability to counter gravitational effects.

c. Insufficient albumin is causing insufficient absorption of fluid into the capillaries.

A 51-year-old woman has been experiencing signs and symptoms of perimenopause and has sought help from her family physician. A deficiency in estrogen levels has been determined to be a contributing factor. Which phenomenon could potentially underlie the woman's health problem? a. Sufficient synthesis of estrogen but inadequate vesicle-mediated release. b. Inadequate synthesis in the rough endoplasmic reticulum of her ovarian cells. c. Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells. d. A lack of prohormone precursors needed for estrogen synthesis and release.

c. Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells.

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 54-year-old diabetic client has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required bypass graft 3 years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil. Which home medication is contraindicated if taken concurrently with sildenafil? a. Diltiazem, a calcium channel blocker b. Amiodarone, an antiarrhythmic c. Isosorbide mononitrate, a vasodilator d. Furosemide, a diuretic

c. Isosorbide mononitrate, a vasodilator

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle? a. It holds organs in place. b. It attaches the jejunum and ileum to the abdominal wall. c. It has substantial mobility and moves around in the peritoneal cavity with peristaltic movements. d. It is mainly there to prevent any noxious substance from entering into the gut.

c. It has substantial mobility and moves around in the peritoneal cavity with peristaltic movements.

A speech therapist is performing a swallowing assessment on a client who had a stroke, because the health care team is considering the introduction of oral food. The client will most likely have conscious control over which process? a. Initiation of primary peristalsis b. Moving the epiglottis back to cover the larynx c. Moving a bolus to the posterior wall of the pharynx d. Moving the bolus backwards in the esophagus

c. Moving a bolus to the posterior wall of the pharynx

A client has been inhaling viruses periodically while on a cross-country flight. Which situation listed below would most likely result in the stimulation of the client's T lymphocytes and adaptive immune system? a. Presentation of a foreign antigen by a familiar immunoglobulin b. Recognition of a foreign major histocompatibility complex (MHC) molecule c. Recognition of a foreign peptide bound to a self-major histocompatibility complex (MHC) molecule d. Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation.

c. Recognition of a foreign peptide bound to a self-major histocompatibility complex (MHC) molecule

An example of a single hormone that can exert effects in different tissues is erythropoietin. Erythropoietin is made in the kidney and stimulates the bone marrow to produce: a. Platelets b. Natural killer cells c. Red blood cells d. Mast cells

c. Red blood cells

A client arrives for "testing to see if my kidney arteries are open and working OK." The nurse interprets this statement and plans to educate the client about which radiologic study? a. A cystoscopy where an instrument is inserted into the bladder to visualize and biopsy specimens. b. An intravenous pyelography exam where dye is injected in a vein and x-ray films are taken as the dye moves through the kidneys. c. Renal angiography where dye is injected directly into the renal artery looking for vascular damage in the renal arteries. d. Computed tomographic scans to outline the kidneys and looking for tumors that may be pressing on the artery.

c. Renal angiography where dye is injected directly into the renal artery looking for vascular damage in the renal arteries.

If an Rh-negative mother is giving birth to an Rh-positive infant, the nurse should be prepared to administer: a. antihistamines like dyphenhydramine. b. alpha interferon. c. Rh immune globulin. d. a monoclonal antibody like infliximab.

c. Rh immune globulin.

A client reports chronic cramping, bloating, and diarrhea and is diagnosed with a deficiency in brush border enzymes within the small intestine. Which meal/snack, high in carbohydrates and protein, will likely exacerbate the client's signs and symptoms? a. Grapefruit and prunes b.Tossed salad with an oil and vinegar dressing c. Roast beef and a baked potato d. Tortilla chips and guacamole

c. Roast beef and a baked potato

A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. Upon assessment of the lungs, what clinical manifestations should the nurse expect? a. Rapid, deep breaths. b. Wheezing throughout lung fields. c. Short, shallow breaths. d. Pursed-lip breaths with slow, steady breaths.

c. Short, shallow breaths.

The nurse is caring for a client with small cell lung cancer (SCLC) and known mediastinal lymph node involvement. What new assessment finding should the nurse prioritize as evidence the client requires emergent intervention? a. Decrease in urine output b. Increase in peripheral edema c. Swelling of the neck and face d. Oxygen saturation of 90%

c. Swelling of the neck and face

The nurse knows that the cells primarily programmed to remove the invading organisms and remember the antigen to respond rapidly during the next exposure are: a. CD4 and CD8 cells. b. Natural Killer (NK) cells and macrophages. c. T-lymphocytes and B-lymphocytes. d. White blood cells and platelets.

c. T-lymphocytes and B-lymphocytes.

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

c. TIAs resolve rapidly but may place the client at an increased risk for stroke.

A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats per minute and he has vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen and the testes are firm to touch and tender, with extensive cremaster muscle contraction noted. What is the boy's most likely diagnosis? a. Epididymitis b. Hydrocele c. Testicular torsion d. Varicocele

c. Testicular torsion

A 74-year-old man is being assessed by a nurse as part of a weekly basic health assessment at the long term care facility where he resides. His blood pressure at the time is 148/97 mm Hg, with a consequent pulse pressure of 51 mm Hg. The nurse would recognize that which of the following is the most significant determinant of the resident's pulse pressure? a. Blood volume, resistance, and flow b. The cardiac reserve, or possible increase in cardiac output over normal resting level c. The amount of blood that his heart ejects from the left ventricle during each beat d. The relationship between total blood volume and resting heart rate

c. The amount of blood that his heart ejects from the left ventricle during each beat

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

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

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

c. Unless remyelination occurs, the axon will eventually die.

An 8-year-old female is diagnosed with a third urinary tract infection (UTI) this calendar year. For what condition is it most important for the nurse to advocate assessment? a. Nephrotic syndrome b. Autosomal dominant polycystic kidney disease c. Vesicoureteral reflux d. Goodpasture syndrome

c. Vesicoureteral reflux

The nurse walks into a room and finds the client forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term: a. Nauseous b. Retching c. Vomiting d. Expatriate

c. Vomiting

A 24-year-old male client with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds: a. Probably not since your spinal cord has been completely severed. b. A urologist may be able to insert a needle into your testes and withdraw some sperm. c. With proper stimulation of your genitals, you may be able to produce an erection and ejaculation. d. It takes sympathetic innervation to produce an erection and ejaculation, which is lost with your type of injury.

c. With proper stimulation of your genitals, you may be able to produce an erection and ejaculation.

A client has experienced a pontine stroke which has resulted in severe hemiparesis. What priority assessment should the nurse perform prior to allowing the client to eat or drink from the food tray? a. blood pressure reading looking for hypertension b. cornea blink reflex for ability to see the food tray c. gag reflex assessing for problems with chewing and swallowing d. ability to follow commands looking for hearing loss

c. gag reflex assessing for problems with chewing and swallowing

When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is: Question 7 options: a. dormant. b. positively charged. c. inhibitory. d. overstimulated.

c. inhibitory.

Which client is most likely to have impairments to the wound healing process? A client with: a. chronic obstructive pulmonary disease. b. a diagnosis of multiple sclerosis and consequent impaired mobility. c. poorly controlled blood sugars with small blood vessel disease. d. congenital heart defects and anemia.

c. poorly controlled blood sugars with small blood vessel disease.

A 5-year-old needs to undergo a bone marrow biopsy. When educating the parents, which site should the nurse state is the most commonly used? a. sternum b. spinous c. posterior iliac crest d. anterior iliac crest

c. posterior iliac crest

During clinical skills lab, a student walks away from the "client" the student just catheterized. The faculty assesses the student's ability to clean up after the procedure and finds the student has not replaced the client's foreskin over the glans. Which problem will the faculty review with this student? a. proper sterile technique b. how to remove excess betadine from the penile tip c. that tight foreskin can lead to ischemia at the penile tip d. advantages of the foreskin in adult males

c. that tight foreskin can lead to ischemia at the penile tip

Since steroid hormones are bound to protein carriers for transport, this means: a. they are water-soluble and circulate freely in the blood. b. they are degraded by enzymes in the blood. c. they are inactive in the bound state. d. they will be converted into a useable form by enzymes in the blood.

c. they are inactive in the bound state.

A community health nurse is conducting the nutritional component of a class for new mothers. Which teaching point would be most justified? a. "Iron supplementation is not necessary provided you are breast-feeding your infant." b. "Be aware that cow's milk depletes your baby's supply of iron." c. "Your infant needs the same amount of iron as you, but has far fewer sources for obtaining it." d. "If you choose to feed your baby with formula, ensure that it is iron-fortified."

d. "If you choose to feed your baby with formula, ensure that it is iron-fortified."

A young woman has been diagnosed by her family physician with primary Raynaud disease. The woman is distraught, stating, "I've always been healthy and I can't believe I have a disease now." What would be her physician's most appropriate response? a. "This likely won't have a huge effect on your quality of life and I'll prescribe anti-clotting drugs to prevent attacks." b. "I'll teach you some strategies to minimize its effect on your life, and minor surgery to open up your blood vessels will help too." c. "You need to make sure you never start smoking, and most of the symptoms can be alleviated by regular physical activity." d. "If you make sure to keep yourself warm, it will have a fairly minimal effect; I'll also give you pills to enhance your circulation."

d. "If you make sure to keep yourself warm, it will have a fairly minimal effect; I'll also give you pills to enhance your circulation."

A client expresses frustration at the inconvenience of having to collect urine for an entire day and night as part of a prescribed 24-hour urine collection test. The client asks the nurse, "Why is this test necessary since I gave a single urine sample 2 days ago?" How could the nurse best respond to this question? a. "A single urine sample lets your care team determine if there are bacteria in your urine, but other tests of urine chemistry need a longer term view." b. "Current lab tests are not able to detect the small quantities of most substances contained in a single urine sample. c. "Only a longer term test is able to show whether your kidneys are letting sugar spill out into your urine." d. "Often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."

d. "Often when an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much is present in your urine."

Amniocentesis has suggested that a couple's first child will be born with sickle cell disease. The parents are unfamiliar with the health problem and their caregiver is explaining the complexities. Which statement by the parents would suggest a need for further teaching or clarification? a. "Our baby's red cells are prone to early destruction because of their weak membranes." b. "Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so." c. "Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones." d. "Our son or daughter likely won't show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies."

d. "Our son or daughter likely won't show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies."

A physician is teaching a group of medical students about the physiologic basis for damage to the circulatory and neurologic systems that can accompany hypotension. Which response by a student would warrant correction by the physician? a. "As vessel wall thickness increases, tension decreases." b. "Smaller blood vessels require more pressure to overcome wall tension." c. "The smaller the vessel radius, the greater the pressure needed to keep it open." d. "Tension and vessel thickness increase proportionately."

d. "Tension and vessel thickness increase proportionately."

A client with a diagnosis of hemolytic anemia has gone to a community-based laboratory for follow-up blood work. The lab technician confirms with the client that hematocrit is one of the components of the blood work. The client replies, "I thought the point of the blood work was to see how many red blood cells I have today." How could the technician best respond to the client's statement? a. "This result will tell your care provider about the number of red blood cells in a given quantity of your blood plasma." b. "Your hematocrit measures the average size of your red blood cells, and indirectly measures your oxygen-carrying capacity." c. "The result will indicate how many of your red blood cells are new and young, and will indicate your body's production rate of red cells." d. "The hematocrit measures the mass that your red blood cells account for in a quantity of your blood."

d. "The hematocrit measures the mass that your red blood cells account for in a quantity of your blood."

The nurse knows which of statement below is appropriate to be included in an education session for a 21-year-old male with a diagnosis of malaria? a. "Your infection likely began with the introduction of fertilized protozoal ova from a mosquito." b. "The protozoa responsible have hijacked the genetic material of your cells in order to reproduce." c. "You are very tired because the pathogens are utilizing the ATP that your own cells need." d. "The infectious organisms are considered tiny, single-celled animals, given their complete eukaryotic machinery."

d. "The infectious organisms are considered tiny, single-celled animals, given their complete eukaryotic machinery."

A 40-year-old male client is shocked to receive a diagnosis of mature B-cell lymphoma, and is doing research on his diagnosis on the Internet. Which statement that he reads on various websites is most reliable? a. "Like most forms of Hodgkin lymphoma, mature B-cell lymphoma often requires radiation treatment." b. "Doctors are able to diagnose mature B-cell lymphoma by the presence of Reed-Sternberg cells." c. "Unlike many other lymphomas, mature B-cell lymphoma is often self-limiting and treatment is focused on symptoms." d. "The lymph nodes are usually affected, and often the spleen and bone marrow."

d. "The lymph nodes are usually affected, and often the spleen and bone marrow."

A client has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The client asks the nurse what this test will tell the doctor. The nurse replies: a. "They will wash your RBCs. Then mix the cells with a reagent to see if they clump together." b. "They will look at your RBCs under a microscope to see if they have an irregular shape (poikilocytosis)." c. "They will be looking to see if you have enough ferritin in your blood." d. "They are looking for the presence of antibody or complement on the surface to the RBC."

d. "They are looking for the presence of antibody or complement on the surface to the RBC."

When a 55-year-old client's routine blood work returns, the nurse notes that the client's C-reactive protein (CRP) is elevated. The client asks what that means. The nurse responds: a. "You must eat a lot of red meat since this means you have a lot of fat floating in your vessels." b. "You are consuming high levels of folate, which works with the B vitamins and riboflavin to metabolize animal protein." c. "This means you have high levels of HDL to balance the LDL found in animal proteins." d. "This means you have elevated serum markers for systemic inflammation that has been associated with vascular disease."

d. "This means you have elevated serum markers for systemic inflammation that has been associated with vascular disease."

A client has been diagnosed with herpes simplex virus. The client states that, "modern medicine produces more and more antivirals every year and so the treatment should be simple." Which statement is the best response? a. "The recent rise of drug resistance has significantly hampered the elimination of viruses." b. "The cell coat of viruses is particularly resilient to the available synthetic antivirals." c. "The use of antivirals is severely limited by the unwanted adverse effects that they cause." d. "Treatment options for viruses are often limited because what destroys viruses often damages your own body cells."

d. "Treatment options for viruses are often limited because what destroys viruses often damages your own body cells."

As part of a public health initiative, a nurse is teaching a group of older adults about ways to promote and maintain their health. Which teaching points about the common cold is most accurate for the nurse to share with this group of senior citizens? a. "You shouldn't be taking antibiotics for a cold until your doctor has confirmed exactly which bug is causing your cold." b. "It's important to both cover your mouth when you cough or sneeze and to encourage others to do so, since most colds are spread by inhaling the germs." c. "Scientists don't yet know exactly what virus causes the cold, and there is not likely to be a vaccine until this is known." d. "Use caution when choosing over-the-counter drugs for your cold; most people do best with rest and anti-fever medications."

d. "Use caution when choosing over-the-counter drugs for your cold; most people do best with rest and anti-fever medications."

A 36-year old woman with a diagnosis of antiphospholipid syndrome is receiving a scheduled checkup from her nurse practitioner. Which teaching point would the nurse most likely prioritize? a. "It's important for you to do regular physical activity and maintain a healthy body weight." b. "Good nutrition and blood sugar control are important in your case." c. "You'll need to avoid taking nonsteroidal anti-inflammatory drugs when you have menstrual cramps." d. "We need to ensure your birth control pills don't contain estrogen."

d. "We need to ensure your birth control pills don't contain estrogen."

An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of growth hormone (GH). Which teaching point about the client's future health risks is most accurate? a. "It's not unusual for high GH levels to cause damage to your hypothalamus." b. "GH excess inhibits your pancreas from producing enough insulin." c. "The high levels of GH that circulate in your body can result in damage to your liver." d. "When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

d. "When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

An older adult male resident has a grossly distended scrotum. On examination, the resident has been diagnosed with a hydrocele. What will the nurse most likely tell the resident and his family about his diagnosis? a. "We'll get you to the hospital quickly, because if this isn't treated it can result in a blockage in the blood flow to your testes." b. "This isn't a result of your intestine entering your scrotum, but an accumulation of fluid within your testes." c. "This can sometimes result from the lower level of sex hormones that comes with age, so you will likely benefit from a testosterone supplement." d. "While distressing to look at, this condition usually doesn't have any significant consequences and won't need treatment."

d. "While distressing to look at, this condition usually doesn't have any significant consequences and won't need treatment."

When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. The instructor talks about small hormones and hormones as large and complex as growth hormone (GH), which has approximately how many amino acids involved? a. 50 amino acids b. 100 amino acids c. 150 amino acids d. 200 amino acids

d. 200 amino acids

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).

Which situation would be most deserving of a pediatrician's attention? a. The mother of an infant 2 days postpartum notes that her baby has intermittent periods of hyperventilation followed by slow respirations or even brief periods of apnea. b. A volunteer in the nursery notes that one of the infants, aged 2 weeks, appears unable to breathe through his mouth, even when his nose is congested. c. A neonate is visibly flaring her nostrils on inspiration. d. A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting.

d. A midwife notes that a newborn infant's chest is retracting on inspiration and that the child is grunting.

A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL (58 g/L) has been prescribed a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which blood type would be least likely to produce a transfusion reaction? a. B- b. B+ c. A+ d. A-

d. A-

A 77-year-old lifetime smoker has been diagnosed with a tumor in his lung at the site of an old tubercule scarring site, located in a peripheral area of his bronchiolar tissue. What is this client's most likely diagnosis? a. Squamous cell carcinoma b. Small cell lung cancer c. Large cell carcinoma d. Adenocarcinoma

d. Adenocarcinoma

The physician mentions that a client has developed alveolar dead space. The nurse interprets this to mean which finding? a. Air that is moved in and out of the lungs with each breath. b. Air that cannot participate in gas exchange and remains in the main bronchus. c. Air trapped in the conducting airways. d. Alveoli are ventilated but not perfused.

d. Alveoli are ventilated but not perfused.

A female client is requiring supplementary oxygen by face mask due to her reduced lung compliance. Which pathophysiologic process is most likely to be a contributor to her low lung compliance? a. The woman's lungs have more recoil than a healthy person's. b. Her type II alveolar cells are producing a slight excess of surfactant. c. Turbulent airflow is taking place in the client's large airways. d. Her thoracic cage is less flexible than when she was healthy.

d. Her thoracic cage is less flexible than when she was healthy.

Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto thyroiditis. In light of this diagnosis, which assessment result would constitute an unexpected finding? a. The presence of myxedema in the woman's face and extremities. b. Recent weight gain despite a loss of appetite and chronic fatigue. c. Coarse, dry skin and hair with decreased sweat production. d. Increased white cell count and audible crackles on chest auscultation.

d. Increased white cell count and audible crackles on chest auscultation.

A resident of a long-term care facility has contracted Clostridium difficile with frequent diarrhea and hyperactive bowel sounds. What process in the small intestine is most likely accompanying the current status? a. Pathogenic microorganisms are causing dilation of the small intestine, increasing motility. b. Segmentation waves have become more frequent as a result of the infection. c. Intestinal stasis brought on by infection is preventing the small intestine from sufficiently slowing the rate of motility. d. Inflammation is accompanied by an increase in peristaltic movements of the small intestine.

d. Inflammation is accompanied by an increase in peristaltic movements of the small intestine.

A 39-year-old male client has been recently diagnosed with primary hypogonadism. Which lab result would be most indicative of this diagnosis? a. Normal levels of free testosterone; low levels of total testosterone b. Low free testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels c. Low levels of gonadotropin-releasing hormone (GnRH) d. Low testosterone levels; high levels of LH and FSH

d. Low testosterone levels; high levels of LH and FSH

Around three weeks after razing an old chicken house, a 71-year-old retired farmer has developed a fever, nausea and vomiting. After ruling out more common health problems, his care provider eventually made a diagnosis of histoplasmosis. Which physiologic process is most likely taking place? a. Toxin production by Histoplasma capsulatum is triggering an immune response. b. Antibody production against the offending fungi is delayed by the client's age and the virulence of the organism. c. Spore inhalation initiates an autoimmune response that produces the associated symptoms. d. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.

d. Macrophages are able to remove the offending fungi from the bloodstream but can't destroy them.

A 20-year-old woman has visited her family physician due to occasional bouts of bloody diarrhea over the past several weeks, a phenomenon that she experienced 2 years prior as well. Her physician has diagnosed her with ulcerative colitis based on her history and visualization of the affected region by colonoscopy and sigmoidoscopy. Which pathophysiologic phenomenon is most likely to underlie the client's health problem? a. Fissures and crevices developing in the mucosa that are seen as a characteristic "cobblestone" appearance. b. Erosion of the endothelial lining of the distal small intestine by a combination of genetic, autoimmune, and environmental factors. c. Compromise of the mucosal layer of the large intestinal surface by the effects of H. pylori. d. Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated.

d. Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated.

An older adult is reporting increasing fatigue and dark stools. On assessment, the nurse notes pale mucous membranes, low hemoglobin and red cell counts, and upper gastrointestional bleed in the stomach via endoscopy. Questioning reveals excess nonsteroidal anti-inflammatory drug (NSAID) usage to control rheumatoid arthritis pain. Which phenomenon is responsible for the present health problems? a. NSAIDs increase the gastric production of gastrin, increasing gastric secretions and lowering stomach pH. b. Drugs such as NSAIDs increase the H+ levels and thus decrease gastric pH, resulting in insult to the stomach lining. c. NSAIDs, aspirin, and other drugs increase prostaglandin synthesis, resulting in disruption of cellular structures lining the stomach. d. NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

d. NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

Which statement best conveys an aspect of the respiratory pressures that govern ventilation? a. Intrapleural pressure slightly exceeds that of the inflated lung. b. The chest wall exerts positive pressure on the lungs, which contributes to expiration. c. The lungs are prevented from collapse by constant positive intrapulmonary pressure. d. Negative intrapleural pressure holds the lungs against the chest wall.

d. Negative intrapleural pressure holds the lungs against the chest wall.

A client presented to the emergency department of the hospital with a swollen, reddened, painful leg wound and has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) cellulitis. The client's physician has ordered a complete blood count and white cell differential. Which blood component would the physician most likely anticipate to be elevated? a. Basophils b. Eosinophils c. Platelets d. Neutrophils

d. Neutrophils

A nursing instructor is explaining the role of vascular smooth muscle cells in relation to increases in systemic circulation. During discussion, which neurotransmitter is primarily responsible for contraction of the entire muscle cell layer, thus resulting in decreased vessel lumen radius? a. Nitric Oxide b. Adrenal glands c. Fibroblast growth factor d. Norepinephrine

d. Norepinephrine

Which of these activities or conditions will inhibit growth hormone (GH)? a. Hypoglycemia b. Starvation c. Heavy exercise d. Obesity

d. Obesity

A client has a ureteral calculi in the proximal region. The nurse is planning to educate the client about the treatment of choice for removal of the stone in this location. For which intervention will the nurse educate the client? a. Nephrostomy tube b. Extracorporeal shock wave lithotripsy c. Ureteral stenting d. Percutaneous nephrolithotomy

d. Percutaneous nephrolithotomy

A nurse is taking a manual measure of a client's blood pressure. The nurse knows that which factors related to blood flow underlies the ability to hear blood pressure by auscultation (listening)? a. The force of blood with each cardiac contraction produces friction on vessel walls that can be heard and felt. b. The movement of smooth muscle surrounding vessels produces noise that is audible by stethoscope. c. Turbulent flow of blood during systole produces sound while laminar flow during diastole is silent. d. Pressure pulsation that exceeds the velocity of blood flow is audible and coincides with systolic BP.

d. Pressure pulsation that exceeds the velocity of blood flow is audible and coincides with systolic BP.

After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to best address the woman's health problem? a. Surgical correction of the incompetent pylorus. b. Antacids; avoiding positions that exacerbate reflux; a soft-textured diet c. Weight loss and administration of calcium channel blocking medications. d. Proton pump inhibitors; avoiding large meals; remaining upright after meals

d. Proton pump inhibitors; avoiding large meals; remaining upright after meals

A client has been identified as having an excess of macrophage inhibitory factor, causing the client to have inhibited movement and activity of macrophages. Which process listed below would the health care team member expect to remain unaffected? a. Amplification of the immune response b. Destruction of virus-infected or tumor cells c. Initiation of adaptive immunity d. Specificity and memory of the immune response

d. Specificity and memory of the immune response

While assessing a client with urosepsis, the nurse notes the client's blood pressure is 80/54 mm Hg; heart rate is 132 beats/min; respiratory rate is 24 breaths/min; pulse oximetry 89% on 6 lpm O2. Over the last hour, the clients' urine output is 15 mL. When explaining to a new graduate nurse, the nurse will explain which physiologic principle? a. The infection is deep inside the kidney and it will take a long time for the antibiotics to kill the bacteria. b. The client's sympathetic nervous system has been stimulated, which has resulted in vasoconstriction of the afferent arteriole that in turn causes a decrease in renal blood flow. c. The glomeruli filtration system gets overwhelmed in times of stress (like infections) and can become clogged with waste material from the bacteria. d. The ability to transport substances from the tubular fluid into the peritubular capillaries becomes impaired, which results in fluid being forced out of capillaries into the glomerulus.

d. The ability to transport substances from the tubular fluid into the peritubular capillaries becomes impaired, which results in fluid being forced out of capillaries into the glomerulus.

A physiotherapist is measuring the lying, sitting, and standing blood pressure of a client who has been admitted to the hospital following a syncopal episode and recent falls. Which fact about the client best relates to these health problems? a. The client is male and has a history of hypertension. b. The client's cardiac ejection fraction was 40% during his last echocardiogram. c. The client has a history of acute and chronic renal failure. d. The client is 89 years old and takes a diuretic medication for his congestive heart failure.

d. The client is 89 years old and takes a diuretic medication for his congestive heart failure.

Which statement best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function? a. The hypothalamus directly measures the levels of most hormones throughout the body and inhibits or stimulates the pituitary accordingly. b. The pituitary gland coordinates and dictates the release of hormones from the hypothalamus that act on their intended target cells. c. The pituitary gland and hypothalamus have two-way communication that mediates the signals from neuronal inputs. d. The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.

d. The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.

When looking at a granulocyte under a microscope, the anatomy student would describe it as: a. lacking granules. b. having a kidney-shaped nucleus. c. having no nuclei. d. shaped like a sphere with multilobar nuclei.

d. shaped like a sphere with multilobar nuclei.

The nurse is explaining the workings of selective serotonin reuptake inhibitors (SSRIs) to a client with a diagnosis of depression. Within the teaching, the nurse mentions that in the nervous system, the transmission of information by neurotransmitters is: a. paracrine signaling. b. autocrine signaling. c. endocrine signaling. d. synaptic signaling.

d. synaptic signaling.

Which statement most accurately captures the function of the ascending loop of Henle? a. Urine is concentrated by the selective absorption of free water in the ascending limb. b. Sodium and water are reabsorbing in equal amounts, reducing filtrate quantity but maintaining osmolality. c. The majority of solute and water reabsorption occur in the ascending loop of Henle. d.Impermeability to water and absorption of solutes yields highly dilute filtrate.

d.Impermeability to water and absorption of solutes yields highly dilute filtrate.

A client has been diagnosed with a neurodegenerative disease called multiple sclerosis (MS). The physician explains to the client that this disease may be caused by dysregulated apoptosis. Later that day, the client asks the nurse what this means. The nurse should reply: a. There is an inappropriately low rate of apoptosis occurring within the cells. b. The cells around your nerves don't know how to die correctly. c. The cytoplasm should neutralize the various apoptotic inhibitors but isn't working correctly. d. Dysregulated apoptosis has caused an excessive rate of programmed cell death along the neuro-pathways.

d. Dysregulated apoptosis has caused an excessive rate of programmed cell death along the neuro-pathways.

A student asks the instructor about the origins of different tissues and their cellular origins during the process of development. Which statement by the instructor best describes the process of cell differentiation? a. "A fertilized ovum undergoes a series of divisions, yielding many different cell types." b. "Cells of the hematopoietic system produce the appropriate body cells that are required at each stage of development." c. "A single stem cell differentiates into approximately 200 different types of cells." d. "Cells differentiate into necessary body cells peaking after conception and ceasing near the time of birth."

a. "A fertilized ovum undergoes a series of divisions, yielding many different cell types."

Which student statement demonstrates a sound understanding of the cellular processes of hypertrophy and hyperplasia? a. "I know that cells like neurons have little capacity for hyperplastic growth." b. "A remaining kidney can sometimes undergo hyperplasia in response to one that has been removed." c. "When male clients experience 'an enlarged prostate,' they are describing a form of hypertrophy." d. "Clients with cardiomyopathy undergo myocardial hypertrophy with proportional increases in cell length and width."

a. "I know that cells like neurons have little capacity for hyperplastic growth."

During a discussion with a client recently diagnosed with stage IV kidney cancer, which statement is most accurate? a. "Many times, kidney cancer goes completely undetected until a metastatic lesion is found in the lung." b. "You likely had some kidney pain that you associated with a back strain instead of cancer." c. "Most people ignore the blood they see in their urine thinking they have a kidney stone." d. "The health care community needs to do a better job informing people that blood clots in the urine is not normal."

a. "Many times, kidney cancer goes completely undetected until a metastatic lesion is found in the lung."

A client who has a diagnosis of lung cancer is scheduled to begin radiation treatment. The nurse knows that which statement about potential risks of radiation is most accurate? a. "Some clients experience longer-term irritation of skin adjacent to the treatment site." b. "Sometimes you might find that your blood takes longer to clot than normal." c. "The changes that you might see are normally irreversible." d. "The unwanted effects will be limited to the exposed portions of your skin."

a. "Some clients experience longer-term irritation of skin adjacent to the treatment site."

A new client who suffered a myocardial infarction requires angioplasty and stent placement. He has arrived to his first cardiac rehabilitation appointment. In this first session, a review of the pathogenesis of coronary artery disease is addressed. Which statement by the client verifies to the nurse that he has understood the nurse's teachings about coronary artery disease? a. "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery." b. "All I have to do is stop smoking and then I won't have any more heart attacks." c. "If you do not exercise regularly to get your heart rate up, blood pools in the veins causing a clot which stops blood flow to the muscle and you have a heart attack." d. "My artery was clogged by fat so I will need to stop eating fatty foods like french fries every day."

a. "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery."

A client overheard the provider discussing the case and mentioning a "mutation in the TP53 gene." The client asks the nurse, "What does that mean?" Which response is the most appropriate for this client? a. "The TP53 gene is a group of tumor suppressor genes associated with lung, breast and colon cancer." b. "The TP53 gene was likely damaged when you were in utero and exposed to a toxin." c. "All cancers result from an abnormality in some gene or chromosome." d. "This means that they are looking for a monoclonal antibody that will selectively kill your tumor."

a. "The TP53 gene is a group of tumor suppressor genes associated with lung, breast and colon cancer."

As part of a first aid class, a health care instructor is teaching a group of industrial workers about how electrical injuries can cause cell damage. Which statement made by one of the workers indicates that further teaching is necessary? a. "The greater the skin resistance, the greater the amount of deep and systemic damage a victim is likely to incur." b. "The particular pathway that a current takes through the body is very significant." c. "Resistance to flow is the phenomenon that transforms electrical energy into heat." d. "The most severe damage is likely to occur where the current enters and leaves the body."

a. "The greater the skin resistance, the greater the amount of deep and systemic damage a victim is likely to incur."

The nurse is teaching a group of new mothers about postpartum nutrition, when one of the clients states that she was told to avoid eating fish too often due to the risk of mercury poisoning. Which response by the nurse most accurately addresses the clients concerns? a. "There are some modest risks, but they are only associated with some long-living fish like tuna." b. "Provided you avoid salmon, you likely won't be putting yourself or your child at risk." c. "The risk of mercury toxicity from eating fish has been shown to be insignificant." d. "You're right. It's best to avoid eating fish, especially while you are breast-feeding."

a. "There are some modest risks, but they are only associated with some long-living fish like tuna."

The family member of a client with terminal metastatic cancer who is experiencing cachexia-related weight loss asks the nurse why the client is losing weight despite taking in a large amount of calories per day. What is the nurse's best response? a. "This weight loss is related to the cancer itself and occurs despite an intake of adequate calories." b. "When clients are at this stage of metastatic cancer the food being eaten is not being digested." c. "We likely need to increase the calories more; you are welcome to bring food from home." d. "We can consult with the doctor and dietitian about tube feeding to prevent more weight loss."

a. "This weight loss is related to the cancer itself and occurs despite an intake of adequate calories."

A 60-year-old man has presented to a clinic and is requesting screening for tumor markers after reading about them in a magazine. What can the clinician most accurately tell the man about the clinical use of tumor markers? a. "Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not a very useful screening tool." b. "Tumor markers are a very useful screening tool, but they only exist for a very few types of cancer." c. "Tests for the presence of tumor markers are limited by the fact that they are only accurate in the very early stages of cancer." d. "Tumor markers are an excellent screening tool, but it's only practical to test for those cancers that you're at risk of."

a. "Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not a very useful screening tool."

Of the following situations, which one would be an example of a maladaptive cellular change? a. 44-year-old male with a 60 pack/year smoking history who was diagnosed with a histological grade-3 lung cancer b. 18-year-old body builder who has developed extremely large pectoral muscles following years of weight lifting. c. 31-year-old marathon runner who has developed hypertrophied myocardial cells d. 54-year-old female who has developed ovarian atrophy following loss of estrogen stimulation during menopause

a. 44-year-old male with a 60 pack/year smoking history who was diagnosed with a histological grade-3 lung cancer

Which client is at high risk for developing dilated cardiomyopathy? a. 44-year-old noncompliant female who forgets to take her hypertensive medications b. 17-year-old with a diving injury resulting in paraplegia c. 4-year-old child born with cerebral palsy and confined to a wheelchair d. 78-year-old Alzheimer client who received a third-degree burn following an oven fire

a. 44-year-old noncompliant female who forgets to take her hypertensive medications

Which client of a primary care physician would not require extra screening for cancer? a. A 38-year-old female with Down syndrome and congenital scoliosis b. A 51-year-old woman whose grandmother died of breast cancer c. A 48-year-old man who takes immunosuppressant drugs following a kidney transplant. d. A 50-year-old male who is obese and has a low-fiber, high-fat diet.

a. A 38-year-old female with Down syndrome and congenital scoliosis

The nurse is caring for a client with arterial insufficiency of the left leg with gangrenous wounds on the second and third toes. What characteristics of the wounds should the nurse evaluate as expected? Select all that apply. a. A clear demarcation between the healthy and affected tissue b. Diminished pulse strength c. Atrophy to the affected toes d. Darkened appearance of affected tissue e. Edema to the left lower leg f. Moist wound with evidence of liquefaction

a. A clear demarcation between the healthy and affected tissue b. Diminished pulse strength c. Atrophy to the affected toes d. Darkened appearance of affected tissue

A member of the health care team is researching the etiology and pathogenesis of a number of clients who are under his care in a hospital context. Which aspect of clients' situations best characterizes pathogenesis rather than etiology? a. A client who is has increasing serum ammonia levels due to liver cirrhosis. b. A client who has been exposed to the mycobacterium tuberculosis bacterium. c. A client with multiple skeletal injuries secondary to a motor vehicle accident. d. A client who was admitted with the effects of methyl alcohol poisoning.

a. A client who is has increasing serum ammonia levels due to liver cirrhosis.

The nurse is planning care for a group of clients. Which clients should the nurse prioritize as "at risk" for hypercalcemia and advocate for monitoring calcium levels? Select all that apply. a. A client with prolonged immobility b. A client with hypophosphatemia c. A client who has breast cancer with bone metastasis d. A client with hypoparathyroidism e. A client with heart failure who is taking a loop diuretic

a. A client with prolonged immobility b. A client with hypophosphatemia c. A client who has breast cancer with bone metastasis

A client is experiencing muscle atrophy following 2 weeks in traction after a motor vehicle accident. Which factor has most likely contributed to the atrophy of the client's muscle cells? a. A reduction of skeletal muscle use secondary to the traction treatment b. High levels of insulin and IGF-1 in the client's blood during immobilization c. Denervation of the affected muscles during the time of traction d. Reduced oxygen consumption and cellular function that ensures muscle cell survival

a. A reduction of skeletal muscle use secondary to the traction treatment

A 41-year-old female with a family history has had a baseline mammogram. She states that she performs monthly self breast exams but really has a hard time evaluating her lumps since she has numerous cysts. At her annual mammogram, the technician views a suspicious area and refers her to the radiologist. She asks the nurse in the office, "How can a lump appear so quickly?" The nurse's response is based on which principle? a. A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells. b. Many tumor cells never leave the M phase of the cell cycle. c. Cancer cells are undifferentiated and come in various shapes and sizes. d. If the breast has a lot of cysts, then the fluid within those sacs makes it hard to feel the hard lumps of a cancer.

a. A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.

The nurse is caring for an 8-year-old client who has cystic fibrosis. What aspect of client care should the nurse prioritize? a. Airway clearance b. Infection control c. Pain control d. Nutritional status

a. Airway clearance

The nurse is providing care for a client with a diagnosis of amyotrophic lateral sclerosis (ALS). The nurse recognizes that which mechanism is suspected to play a role in the cellular death associated with ALS? a. Apoptosis b. Liquefaction necrosis c. Hypoxic cell injury d. Caseous necrosis

a. Apoptosis

A client experiencing immotile cilia syndrome (Kartagener syndrome) should be frequently assessed by the nurse for which priority complication? a. Bronchiectasis due to interferences with clearance of inhaled bacteria along the respiratory tract. b. Inability to hear soft sounds related to kinocilium on the hair cells in the inner ear. c. Epistaxis resulting from loss of cilia in the nasal passageway. d. Sterility caused by inability of sperm to swim downstream.

a. Bronchiectasis due to interferences with clearance of inhaled bacteria along the respiratory tract.

A nurse is triaging clients at a disaster site. Local facilities have different specialized units. To what facility should the nurse send a client who has sustained an electrical injury to his left thigh? a. Burn unit b. Cardiac care unit c. Surgical intensive care unit d. Neurology unit

a. Burn unit

A nurse practitioner is working in a crowded neighborhood where the population is primarily immigrants from China. The nurse has designed a research study to follow children from kindergarten to the age of 25. She is going to be looking at their diet, successful progression in school, health practices, and development of disease, to name a few items. This type of research is known as: a. Cohort study b. Epidemiologic study c. Case-control study d. Cross-sectional study

a. Cohort study

The nurse is administering a calcium channel blocker to a client with a cardiac dysrhythmia. For what side effect should the nurse assess? a. Constipation b. Tachycardia c. Hypertension d. Polyuria

a. Constipation

The nurse is caring for a client with small cell lung carcinoma who has developed syndrome of inappropriate antidiuretic hormone (SIADH). What should the nurse incorporate into the plan of care? Select all that apply. a. Daily weights b. Maintenance of fluid restriction c. Frequent repositioning d. Administration of hypotonic intravenous solutions e. Restriction of sodium in the diet

a. Daily weights b. Maintenance of fluid restriction c. Frequent repositioning

A nurse is teaching clients about the benefits of smoking cessation. What should the nurse include as the most accurate reason for the development of a chronic "smoker's cough"? a. Damage to cilia in the respiratory tract make it necessary to cough to clear the airway. b. Smoke is an irritant that chronically triggers the coughing centers in the brain. c. Build-up of fluids in the alveolar spaces promotes a cough in an attempt to clear secretions. d. Substances in the smoke interfere with gas exchange and hypoxia triggers a cough response.

a. Damage to cilia in the respiratory tract make it necessary to cough to clear the airway.

A nurse in the emergency department admits a male client who has experienced severe frostbite to his hands and toes after becoming lost on a ski hill. The nurse recognizes that which phenomena has contributed to his tissue damage? a. Decreased blood flow has induced hypoxia. b. Decreased blood viscosity has resulted in interstitial bleeding. c. Reactive vasodilation has compromised perfusion. d. Autonomic nervous stimulation has resulted in injury.

a. Decreased blood flow has induced hypoxia.

Which situation would be classified as a complication of a disease or outcome from the treatment regimen? Select all that apply. Select correct answer(s) a. Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma. b. Burning, intense incision pain following surgery to remove a portion of colon due to intestinal aganglionosis. c. Massive pulmonary emboli following diagnosis of new onset atrial fibrillation. d. Gradual deterioration in ability to walk unassisted for a client diagnosed with Parkinson disease.

a. Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma. c. Massive pulmonary emboli following diagnosis of new onset atrial fibrillation.

Unbeknownst to her or her care team, a 51-year-old woman's breast cancer has an etiology rooted in the fact that tumor suppressing genes are present but have been silenced. Consequently, she has not synthesized normal cancer-suppressing proteins and neoplasia has resulted. What process has accounted for the woman's cancer? a. Epigenetic mechanisms b. Chromosomal translocation c. The "two-hit" hypothesis of carcinogenesis d. A DNA repair defect.

a. Epigenetic mechanisms

Parents bring their 18-month-old child to the emergency room exhibiting behavior changes and vomiting. They are concerned the child ingested something in the older home they are renovating. Laboratory findings indicate low hemoglobin and elevated creatinine. Which diagnostic test should the nurse advocate for first? a. Erythrocyte protoporphyrin (EP) level b. Urine test for a mercury level c. Ultrasound of the kidneys d. Erythrocyte sedimentation rate

a. Erythrocyte protoporphyrin (EP) level

The nurse is planning care for a client who is receiving antimetabolite chemotherapy. What should the nurse include in the plan of care? Select all that apply. a. Falls prevention protocol b. Daily weights c. Monitor bowel movements closely. d. Encourage intake of a soft diet with fresh fruits and vegetables. e. Indwelling urinary catheter for accurate output record

a. Falls prevention protocol b. Daily weights c. Monitor bowel movements closely.

A client with malignant melanoma has been prescribed alpha interferon, a biologic response modifier. Since this drug prolongs the cell cycle, increasing the percentage of cells in the G0 phase, and stimulates NK cells and T-lymphocyte killer cells, the nurse can anticipate that they may experience which common side effects? a. Fever, chills, and fatigue b. Nausea, vomiting, and diarrhea c. Opportunistic infections like Candida d. Renal damage with an increased creatinine level

a. Fever, chills, and fatigue

A 26-year-old man who survived childhood acute lymphocytic leukemia (ALL), one of the most common childhood cancers, now complains of weakness, fatigue, and shortness of breath. His treatment for ALL likely included anthracyclines. What is the most likely cause of his symptoms? a. Heart failure resulting from childhood chemotherapy b. Recurrence of ALL c. CNS problems resulting from childhood chemotherapy d. Hormonal dysfunction resulting from childhood chemotherapy

a. Heart failure resulting from childhood chemotherapy

A 7-year-old boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which assessment finding is most congruent with the client's diagnosis? a. Hemoglobin 9.9 g/dL (99 g/L) b. Diffuse muscle pain c. White blood cells (WBC) 11,000/mm3 (11.0 x 109/L) d. Decreased deep tendon reflexes

a. Hemoglobin 9.9 g/dL (99 g/L)

A particular disease has a debilitating effect on the ability of sufferers to perform their activities of daily living, and is a significant cause of decreased quality of life. However, few people die as a result of the disease's direct effects. There are hundreds of thousands of Americans living with the disease but relatively few new cases in recent years. Which statement best conveys an accurate epidemiologic characterization of the disease? a. High morbidity; low mortality; high prevalence, low incidence. b. High mortality; low morbidity; high incidence; low prevalence. c. Low mortality; high morbidity; low prevalence; high incidence. d. Low mortality; high morbidity; high incidence; low prevalence.

a. High morbidity; low mortality; high prevalence, low incidence.

A 51-year-old female has been found to have metastatic lesions in her lung but her oncologist is unsure of the primary tumor site. Which procedure is most likely to aid in this determination? a. Immunohistochemistry b. Tumor markers c. Microarray technology d. Tissue biopsy

a. Immunohistochemistry

A community health care worker is explaining to a group of factory workers the importance of wearing gloves when working with strong chemicals such as turpentine and paint thinner. Which characteristics of cell membranes underlies the nurse's teaching? a. Impermeability of cell membranes to all but lipid-soluble substances. b. Cell membranes have a hydrophilic head and a hydrophobic tail. c. Receptors for hormones and biologically active substances are found on cell membranes. d. A disorder within the water channel of the cell membrane can result in cancer formation.

a. Impermeability of cell membranes to all but lipid-soluble substances.

While attending an international nursing conference, many discussions and break-out sessions focused on the World Health Organization's (WHO) views on health. Of the following comments made by nurses during a discussion session, which statements would be considered a good representation of the WHO definition? Select all that apply. a. Interests in keeping the older adult population engaged in such activities as book reviews and word games during social time b. Providing transportation for renal dialysis clients to and from their hemodialysis sessions c. Increase in the number of chair aerobics classes provided in the skilled care facilities d. Interventions geared toward keeping the older adult population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes e. Providing handwashing teaching sessions to a group of young children

a. Interests in keeping the older adult population engaged in such activities as book reviews and word games during social time c. Increase in the number of chair aerobics classes provided in the skilled care facilities d. Interventions geared toward keeping the older adult population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes e. Providing handwashing teaching sessions to a group of young children

Which breakfast diet contains chemicals that likely can contribute to a higher rate of cancer risk? a. Sausage fried in reused grease and biscuits and gravy. b. Pancakes made with buttermilk and warm maple syrup. c. English muffin with jelly and scrampled eggs. d. Tofu stir-fried with peppers and onions and topped with cheddar cheese.

a. Sausage fried in reused grease and biscuits and gravy.

A client has been told she has elevated levels of low-density lipoproteins (LDL). The client says, "I have always followed a low-cholesterol diet, so how could it be elevated?" How should the nurse respond? a. LDL needs to be taken up into the intracellular space and this process does not work well in some people, causing LDL elevations in the blood. b. We should review your low-cholesterol diet. There are many hidden sources you may not have been aware you were eating. c. This type of cholesterol is protective for your blood vessels, so having it elevated is good for your cardiovascular health. d. Diet does not really influence LDL levels; the levels depend solely on internal processes in the liver, which is determined by genetics.

a. LDL needs to be taken up into the intracellular space and this process does not work well in some people, causing LDL elevations in the blood.

The mother of an 18-month-old child is concerned that her child is lethargic and not eating foods that he normally enjoys. She takes him to the pediatrician for a check-up. Which clinical manifestations lead the health care provider to suspect the child may have a neuroblastoma? Select all that apply. a. Large, protruding abdomen b. Weight loss c. Crying when joints/position changed d. Excessive burping e. Large amount of pale urine

a. Large, protruding abdomen b. Weight loss c. Crying when joints/position changed

The health care provider is discussing the treatment protocol using ionizing radiation to treat the client's cancer. The client asks, "What side effects can occur with this treatment?" Which response(s) is accurate? Select all that apply. a. Low blood counts b. Excessive diarrhea c. New-onset seizures d. Photosensitivity e. Kidney stone formation

a. Low blood counts b. Excessive diarrhea

A 31-year-old man has been referred to a fertility clinic following a count of 2 million sperm/mL on seminal fluid analysis. Which hormone levels would a clinician want to examine in an effort to ascertain the cause of the client's low sperm count? Select all that apply. a. Luteinizing hormone (LH) b. Adrenocorticotropic hormone (ACTH) c. Follicle-stimulating hormone (FSH) d. Cortisol e. Somatostatin f. Gonadotropin-releasing hormone (GnRH)

a. Luteinizing hormone (LH) c. Follicle-stimulating hormone (FSH) f. Gonadotropin-releasing hormone (GnRH)

The nurse is caring for a client whose potassium level is 5.9 mEq/L (5.9 mmol/L). Which treatment should the nurse be prepared to administer? a. Medication to promote the movement of potassium into the intracellular space b. Intravenous fluids to dilute the quantity of potassium in the plasma c. Magnesium infusion to counteract the effects of high potassium levels on cells d. An aldosterone antagonist to alter renal excretion of potassium

a. Medication to promote the movement of potassium into the intracellular space

A worker in a warehouse is trying to have children but think he or she has handled "mercury" while cleaning equipment. Which statement by the occupational nurse is most appropriate at this time? a. Most mercury toxicity involves central nervous system changes. b. Usually mercury toxicity appears as skin rashes and lesions. c. You should have all the mercury fillings in your teeth changed to newer products. d. Infertility is caused by too much mercury exposure.

a. Most mercury toxicity involves central nervous system changes.

As part of a community class, student nurses are developing curriculum to teach expectant parents the importance of having their child properly secured in a child safety seat. During the class, the students are going to have a safety officer examine the car seats that the parents have installed in their vehicle. This is an example of which type of prevention? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Prognosis enhancement

a. Primary prevention

The family of a 68-year-old man who is in the end stages of small-cell lung cancer are distraught at his visible body wasting that has worsened in recent weeks. Which phenomena best accounts for the client's anorexia and cachexia? a. Products of the tumor itself as well as a hypermetabolic state cause cachexia. b. Inadequate cellular metabolism of glucose results from tumor factors. c. High-fat losses coupled with preservation of muscle mass exaggerate the appearance of wasting. d. Inadequate food intake due to symptoms and treatment results in loss of both muscle and fat.

a. Products of the tumor itself as well as a hypermetabolic state cause cachexia.

The nurse caring for a lung cancer client with metastasis to the brain suspects the client has developed a paraneoplastic syndrome known as Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion. Which laboratory result in this client who has gained 3 lb in a day would alert the nurse to the possibility of SIADH? a. Serum sodium of 115 mEq/L (115 mmol/L) b. Serum potassium of 5.0 mEq/L (5.0 mmol/L) c. BUN of 8 mg/dL (2.86 mmol/L) d. Hematocrit of 40%

a. Serum sodium of 115 mEq/L (115 mmol/L)

A nurse is providing care for a client with a diagnosis of Crohn's disease. The nurse recognizes the fact that the disease involves the inflammation and irritation of the intestinal lining. Which type of tissue is most likely involved in the client's pathology? a. Simple columnar epithelium b. Glandular epithelium c. Simple cuboidal epithelium d. Stratified epithelium

a. Simple columnar epithelium

Blood-borne cancerous cells have recently spread from a woman's primary pancreas tumor to her bones. Which components of the woman's immune system are likely to be directly involved in the attempt to eradicate the potential metastasis? Select all that apply. a. T lymphocytes b. Macrophages c. Natural killer (NK) cells d. B lymphocyte cells e. Mast cells

a. T lymphocytes b. Macrophages c. Natural killer (NK) cells d. B lymphocyte cells

A 68-year-old male client with aortic stenosis secondary to calcification of the aortic valve is receiving care. Which statement best captures an aspect of this client's condition? a. The client has possibly undergone damage as a result of calcification following cellular injury. b. Paget disease, cancer with metastases, or excess vitamin D may have been contributors. c. Increased calcium intake over time may have contributed to the problem. d. The client has possibly exhibited phosphate retention leading to calcium deposits.

a. The client has possibly undergone damage as a result of calcification following cellular injury.

A 77-year-old male client with a diagnosis of stomach cancer has been found to have metastases in his liver. The client and his family are surprised at this turn of events, stating that they don't see how he could have developed cancer in his liver. Which fact would underlie the reply that the care team provides? a. The portal circulatory system brings venous blood from the GI tract into the liver. b. The parenchymal tissue of the liver is particularly susceptible to secondary malignancies. c. Hepatic stromal tissue shares characteristics with cancerous cells, including lack of anchorage dependence. d. The proximity of the liver to the stomach allows for direct spread of cancerous cells due to a lack of contact inhibition.

a. The portal circulatory system brings venous blood from the GI tract into the liver.

Following a biopsy, a 54-year-old man has been diagnosed as having a benign neoplastic tumor. Which characteristic most likely applies to his tumor? a. The well-differentiated, neoplastic cells are clustered together in a single mass. b. The tumor is poorly approximated and has the potential to break loose. c. The tumor may secrete hormones, cytokines. d. It has a rapid rate of growth and can induce ischemia.

a. The well-differentiated, neoplastic cells are clustered together in a single mass.

An oncology nurse who has worked for many years providing care for children with cancer has taken a job on an adult oncology unit of a hospital. What differences might the nurse anticipate in this new job? a. There will be a greater number of cancers that are epithelial in origin. b. A greater proportion of the clients will have cancer that involves the hematopoietic system. c. The nurse will be working with more clients who have blastomas. d. More clients will be receiving treatment for leukemia.

a. There will be a greater number of cancers that are epithelial in origin.

The home care nurse is making a home visit to a 51-year-old female client with a longstanding diagnosis of multiple sclerosis. The nurse knows that the muscle wasting and weakness associated with the disease process is ultimately manifested as a failure of what normal process in muscle tissue? a. Thick myosin and thin actin filaments sliding over each other. b. The contraction of the epimysium. c. The surrounding of fascicles by perimysium. d. The contraction of fascicles within myofibrils.

a. Thick myosin and thin actin filaments sliding over each other.

During a myocardial infarction (MI), a client with a 97% occlusion of the left descending artery develops ventricular dysrhythmias due to the amount of ischemia occurring in the myocardium. While providing education about MI's, which statement is most accurate to share with this client? a. Treatment needs to be sought immediately so that the buildup of lactic acid is limited and cellular changes can be reversed. b. Once the oxygen supply has been occluded, cellular changes are irreversible even if oxygenation is restored. c. The body will grow new genes thru the process of angiogenesis, thereby avoiding any permanent damage to the myocardium. d. Permanent damage will occur in the myocardium if the vessel is not opened within a 1-2 minute window following the occlusion.

a. Treatment needs to be sought immediately so that the buildup of lactic acid is limited and cellular changes can be reversed.

The nurse is educating a client who is undergoing gamma knife radiosurgery for a brain metastasis. What advantage to this procedure should the nurse share when comparing it to other conventional treatments? a. less cognitive dysfunction b. less chance of developing focal seizures c. less explosive vomiting d. lessen the number of migraine headaches per day

a. less cognitive dysfunction

A young client has just been diagnosed with xeroderma pigmentosum. When teaching this family about this disease, the nurse should emphasize which teaching points? Select all that apply. a. Wear long sleeves, long pants, gloves, a hat, sunglasses with side shields, and sunscreen while outdoors. b. The best time to allow the child to play outside is in the evening hours after the sun goes down. c. Wash hands thoroughly when working in the garden to prevent infection. d. Apply antibacterial ointment to any break in the skin and cover wounds with bandages. e. The best time for this family to go to the beach is in the fall/winter months.

a. Wear long sleeves, long pants, gloves, a hat, sunglasses with side shields, and sunscreen while outdoors. b. The best time to allow the child to play outside is in the evening hours after the sun goes down.

The neuroscience nursing unit has developed a set of step-by-step directions of what should occur if a nursing assessment reveals the client may be exhibiting clinical manifestations of a cerebrovascular accident (CVA). Which statement about clinical practice guidelines are accurate? Select all that apply. Select correct answer(s) a. When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot test it for further feedback. b. Step-by-step guidelines are usually developed and based primarily on "how it has always been done before." c. The development of evidence-based practice guidelines require a research review from different studies to develop the most accurate diagnostic method to implement. d. Once developed, practice guidelines only need to be reviewed if a national committee sends out an update on new research. e.A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method.

a. When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot test it for further feedback. c. The development of evidence-based practice guidelines require a research review from different studies to develop the most accurate diagnostic method to implement. e. A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method.

A caregiver is working with a client who is having poorly controlled pain due to shingles. The associated pain travels to the client's nervous system via: a. afferent neurons. b. synapses. c. axons. d. efferent neurons.

a. afferent neurons.

A home health nurse is making a visit to a family with an 8-month-old infant with severe motor deterioration. The physician has diagnosed the infant with Tay-Sachs disease. The parents are asking the nurse why this happened. The nurse will base her answer knowing the root cause of Tay-Sachs is: a. an enzyme defect causing abnormal lipid accumulation in the brain. b. hypoxia caused by placing the infant on his or her abdomen during sleep. c. an increase in bilirubin retention leading to destruction of RBCs. d. high exposure to lead in the home environment.

a. an enzyme defect causing abnormal lipid accumulation in the brain.

During a crime scene investigation, the coroner confirms that rigor mortis has set in. This helps to confirm an approximate time of death. The forensic nurse can explain this process (rigor mortis) to a group of students based on the fact that: a. at death, the body is unable to complete the actin/myosin cycle and release the coupling between the myosin and actin, creating a state of muscular contraction. b. troponin is being prevented from forming a cross-bridge between the actin and myosin. c. when activated by ATP, cross-bridges become attached to the actin filament. d. the myosin head catalyzes the breakdown of ATP to provide the energy need so that a cross-bridge can be formed.

a. at death, the body is unable to complete the actin/myosin cycle and release the coupling between the myosin and actin, creating a state of muscular contraction.

A nurse is considering setting up a screening program for a specific health condition in a population. What characteristic of the condition would need to be true for the nurse to justify screening a population? The condition should: a. be asymptomatic at an early stage. b. have a noninvasive diagnostic test available. c. be curable with available treatment. d. have a high mortality rate.

a. be asymptomatic at an early stage.

When discussing the function of the cell membrane during pathophysiology class, which statement(s) by the faculty is accurate? Select all that apply. a. helps determine what can and cannot enter and exit cells b. contains receptors for hormones and neurotransmitters c. allow ions to cross the membrane during electrical signaling in cells d. carry out most of the functions of the cells e. responsible for helping cytoplasm and cell membrane movement during endocytosis

a. helps determine what can and cannot enter and exit cells b. contains receptors for hormones and neurotransmitters c. allow ions to cross the membrane during electrical signaling in cells

A community health nurse is discussing preventative vaccines with a group of primigravda women. Which cancer-causing virus(es) should the nurse discuss that have a vaccine to prevent developing the disease? Select all that apply, a. hepatitis B b. human papillomavirus (HPV) c. chlamydia d. meningitis e. zika virus

a. hepatitis B b. human papillomavirus (HPV)

The nurse is teaching new nursing assistants on the unit about the phenomenon of muscle hypertrophy. Which client on the unit is most likely to experience muscle hypertrophy? A client with: a. hypertension, obesity, and decreased activity tolerance. b. peripheral edema secondary to heart failure (HF). c. possible rejection symptoms following a liver transplant. d. urinary incontinence following a cerebrovascular accident (CVA).

a. hypertension, obesity, and decreased activity tolerance.

A client has stage IV cancer but further testing is needed to determine the site of origin of this metastatic tumor. Which form of testing will the health care provider be discussing with this client? a. immunohistochemistry b. Papanicolaou test c. sentinal node recovery d. microarray technology

a. immunohistochemistry

The parents of a child newly diagnosed with Tay-Sachs disease asks what signs and symptoms they will see if the disease is progressing. Which response(s) by the nurse is most accurate? Select all that apply. a. loss of motor skills like turning over b. vision loss c. chronic constipation d. hyperactivity in lower limbs e. skin rashes

a. loss of motor skills like turning over b. vision loss

When educating a client who has tested positive for human T-cell leukemia virus-1 (HTLV-1), what mode(s) of transmission should the nurse discuss to prevent the spread? Select all tht apply. a. sexual intercourse b. blood by sharing needles c. infants through breast milk d. sneezing (releasing droplets) e. kissing a person on the forehead

a. sexual intercourse b. blood by sharing needles c. infants through breast milk

As of Nov. 1, 2012, there were a total of 10 confirmed cases of hantavirus infection in people who were recent visitors (mid-June to end of August, 2012) to Yosemite National Park. Three visitors with confirmed cases died. Health officials believe that 9 out of the 10 cases of hantavirus were exposed while staying in Curry Village in the Signature Tent Cabins. This is an example of: a. the incidence of people who are at risk for developing hantavirus while staying in Yosemite National Park. b. the low rate of morbidity one can expect while traveling to Yosemite National Park. c. the prevalence of hantavirus one can anticipate if he or she is going to vacation in Yosemite National Park. d. what the anticipated mortality rate would be if a family of five were planning to vacation in Yosemite National Park.

a. the incidence of people who are at risk for developing hantavirus while staying in Yosemite National Park.

A male international business traveler has returned from a trip to Indonesia. While there, he hired a prostitute for companionship and engaged in unprotected sex on more than one occasion. Unbeknownst to him, this prostitute harbored the hepatitis C virus. Upon return to the U.S., he exhibited no symptoms and returned to his usual activities. During this period of no outward symptoms, the disease would be classified as being in: a. the preclinical stage of disease. b. the clinical disease stage of hepatitis C. c. remission and unlikely to develop hepatitis C. d. the chronic phase of hepatitis C.

a. the preclinical stage of disease.

A clinical nurse specialist is interested in developing a research study focused on clients living with the sequelae of ischemic stroke. Which clients should the nurse include? Select all that apply. The nurse should include clients with: Select correct answer(s) a. vision changes. b. falls. c. dysphagia (difficulty swallowing). d. unilateral weakness. e. aspiration pneumonia.

a. vision changes. c. dysphagia (difficulty swallowing). d. unilateral weakness.

As part of a screening program for prostate cancer, men at a senior citizens center are having their blood levels of prostate-specific antigen (PSA) measured. Which statement would best characterize high positive predictive value but low negative predictive value for this screening test? a. Men who had low PSA levels also displayed false positive results for prostate cancer; men with high levels were often falsely diagnosed with prostate cancer. b. All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer. c. All of the men who had low PSA levels were cancer-free; several men who had high levels also remained free of prostate cancer. d. The test displayed low sensitivity but high specificity.

b. All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

An epidemiologist is conducting a program of research aimed at identifying factors associated with incidence and prevalence of congenital cardiac defects in infants. The researcher has recruited a large number of mothers whose infants were born with cardiac defects as well as mothers whose infants were born with healthy hearts. The researcher is comparing the nutritional habits of all the mothers while their babies were in utero. Which type of study is the epidemiologist most likely conducting? a. Cohort study b. Case-control study c. Risk factor study d. Cross-sectional study

b. Case-control study

The nurse is providing care for a client with a diagnosis of cirrhosis, and she notes that the client's sclerae are jaundiced. The nurse recalls that jaundice is a pigment that can accumulate in which part of the cell? a. Rough endoplasmic reticulum (ER) b. Cytoplasm c. Nucleus d. Golgi apparatus

b. Cytoplasm

A nurse is teaching a client with a recent diagnosis of diabetes about the roles that glucose and insulin play in the disease pathology and the fact that glucose must enter the body cell in order to provide energy for the client. The nurse knows that which process allows glucose to enter body cells? a. Osmosis b. Facilitated diffusion c. Diffusion d. Active transport

b. Facilitated diffusion

The laboratory technologists are a discussing a new blood test that helps establish a differential diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a respiratory/pulmonary etiology. A positive result is purported to indicate a cardiac etiology. The marketers of the test report that 99.8% of clients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of clients who do not have cardiac etiologies for their shortness of breath also test positive. Which statement best characterizes this blood test? a. High sensitivity; low reliability b. High sensitivity, low specificity c. Low validity; high reliability d. High specificity; low reliability

b. High sensitivity, low specificity

The health caregiver is explaining the rationale for administering a hypotonic intravenous solution (lower concentration of solutes in its surroundings) to a client. Which mechanism of membrane transport most likely underlies this action? a. Facilitated diffusion b. Osmosis c. Active transport d. Diffusion

b. Osmosis

During a discussion on cellular components and their function, a student asked the instructor the purpose of messenger RNA (mRNA). Of the following, which is the most accurate answer? a. Assists cells in forming neoplastic progression by altering the response of chromatin in the nuclear matrix. b. Performs an active role of protein synthesis, where mRNA molecules direct the assembly of proteins on ribosomes to the cytoplasm. c. Acts as an inner nuclear support membranes for a rigid network of protein filaments that binds DNA to the nucleus. d. To transport amino acids to the site of protein synthesis.

b. Performs an active role of protein synthesis, where mRNA molecules direct the assembly of proteins on ribosomes to the cytoplasm.

A nurse is investigating the epidemiologic factors influencing breast cancer for women in a population. What information should the nurse include? Select all that apply. Select correct answer(s) a. The currently known incidence and prevalence for this population b. The age of women at the time of diagnosis c. How cancer cells divide and multiply in breast tissue d. The number of women whose diagnosis was assisted by the use of mammography e. The geographic location of women diagnosed with breast cancer

b. The age of women at the time of diagnosis e. The geographic location of women diagnosed with breast cancer

A 62-year-old male collapsed while unloading a truck of heavy sacks of feed for his cattle. When he arrived in the emergency department, blood gases revealed a slightly acidic blood sample. The nurse caring for this client is not surprised with this result based on which pathophysiologic rationale? a. During exercise, catabolism will break down stored nutrients and body tissues to produce energy. b. The skeletal muscles are producing large amounts of lactic acid and release it into the bloodstream during heavy work/exercise. c. Large amounts of free energy is released when ATP is hydrolyzed and then converted into adenosine diphosphate. d. Within the mitochondria, energy from reduction of oxygen is used for phosphorylation of ADP to ATP.

b. The skeletal muscles are producing large amounts of lactic acid and release it into the bloodstream during heavy work/exercise.

The nurse is teaching a group of colleagues about the cell division cycle as background to caring for oncology clients. Which statement is true of the cell cycle? a. Some cells lack a G0 phase. b. The two broad phases of the cell cycle are mitosis and synthesis. c. Mitosis is a process that occurs in steps over 1 to 2 days. d. Nondividing cells such as nerve cells are said to be in the S0 phase.

b. The two broad phases of the cell cycle are mitosis and synthesis.

A professor is teaching a group of students about the role of mitochondria within the cell. Which statement is true of mitochondria? a. Mitochondrial DNA is inherited patrilineally. b. They are the site of adenosine triphosphate (ATP) production. c. They are replicated within the smooth endoplasmic reticulum (ER). d. The number of mitochondria in a cell is equal to the number of nuclei.

b. They are the site of adenosine triphosphate (ATP) production.

Laboratory testing is ordered for a male client during a clinic visit for routine follow-up assessment of hypertension. When interpreting lab values, the nurse knows: a. all lab values are adjusted for gender and weight. b. a normal value represents the test results that fall within the bell curve. c. if the result of a very sensitive test is negative, that does not mean the person is disease free. d. if the lab result is above the 50% distribution, the result is considered elevated.

b. a normal value represents the test results that fall within the bell curve.

The nurse is questioning the validity of oxygen saturation readings from the new oximeters on the unit. Which action should the nurse take to best determine if the results from the oximeter are valid? a. Compare the findings with all clients' results on the unit to determine if there is a trend in the results. b. Repeat the test on the same client to determine if the oximeter offers the same results. c. Compare clients' results to measurements taken using arterial blood gas analyses. d. Review the literature about this brand of oximeter provided by the company.

c. Compare clients' results to measurements taken using arterial blood gas analyses.

A nurse researcher is interested in the natural history of a disease being studied. What should the nurse focus on to best understand the condition's natural history? a. Examining outcomes across a wide variety of treatment approaches b. Following client cases from initial diagnosis and throughout treatment c. Focusing on clients who did not receive treatment for the condition d. Interviewing clients for their first-hand experience with the condition

c. Focusing on clients who did not receive treatment for the condition

A multidisciplinary healthcare team operates a program aimed at the prevention, identification, and treatment of diabetes on a large Indian reservation. Which aspect of the program would most likely be classified as secondary prevention? a. Administering oral antihyperglycemic medications to clients who have a diagnosis of diabetes. b. Regularly scheduled wound dressing changes for clients who have foot ulcers secondary to peripheral neuropathy and impaired wound healing. c. Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked. d. Teaching school children how a nutritious, traditional diet can lessen their chances of developing adult-onset diabetes.

c. Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked.

An occupational therapist conducts a group therapy program called MindWorks with older adults who have diagnoses of dementia and Alzheimer's disease. The goal of the group is to slow the cognitive decline of clients by engaging them in regular, organized mental activity such as reading maps and solving puzzles. How would the program most likely be characterized? a. Prognosis enhancement b. Secondary prevention c. Tertiary prevention d. Primary prevention

c. Tertiary prevention

A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time. Which aspect of the client's current state of health would be best characterized as a symptom rather than a sign? a. The RT hears diminished breath sounds to the client's lower lung fields bilaterally. b. The client's respiratory rate is 31 breaths per minute. c. The client notes that he has increased work of breathing when lying supine. d. The client's oxygen saturation is 83% by pulse oximetry.

c. The client notes that he has increased work of breathing when lying supine.

The clinical educator of a hospital medical unit has the mandate of establishing evidence-based practice guidelines for the nursing care on the unit. Which statement most accurately captures a guiding principle of the nurse's task? a. Evidence-based practice guidelines will be rooted in research rather than nurses' subjective practice preferences and experiences. b. Guidelines are synonymous with systematic research reviews. c. The guidelines will combine individual expertise with external systematic evidence. d. The need for continuity and standardization of guidelines will mean that they will be fixed rather than changeable.

c. The guidelines will combine individual expertise with external systematic evidence.

The public health nurse is designing a course about risk factors for various chronic illnesses. For risk factors about which chronic illness will the nurse consult the Framingham study? a. Type 2 diabetes mellitus b. Breast cancer c. Chronic obstructive pulmonary disease (COPD) d. Cardiovascular disease

d. Cardiovascular disease

A community health nurse is teaching a group of recent graduates about the large variety of factors that influence an individual's health or lack thereof. The nurse is referring to the Healthy People 2020 report from the U.S. Department of Health and Human Services as a teaching example. Of the following aspects discussed, which would be considered a determinant of health that is outside the focus of this report? a. The client has a good career with exceptional preventive health care benefits. b. The client has a diverse background by being of Asian and Native American/First Nation descent and practices various alternative therapies to minimize effects of stress. c. The client lives in an affluent, clean, suburban community with access to many health care facilities. d. The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.

d. The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.