Pathophysiology Review Questions

The cremaster muscles work in concert with the pampiniform plexus that surrounds the testicular artery to

maintain testicular temperature.

Which of the following teaching points is most appropriate for a teenager who has sought care for the treatment of his severe acne?

"You might need antibiotic pills in addition to a cream for your face."

Which of the following hormones are derivatives of cholesterol?

Aldosterone and testosterone

Which of the following pain descriptions would lead the nurse to suspect the client is experiencing ureteral colic?

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

Which of the following statements best describes an aspect of the normal process of glucose metabolism?

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

The nurse knows that if which of the following hormones listed below are not available during embryonic development, a male embryo with an XY chromosomal pattern may develop female external genitalia?

Testosterone Dihydrotestosterone (DHT)

A 34-year-old male client has diagnoses of liver failure, ascites, and hepatic encephalopathy secondary to alcohol abuse.

Normally small transcellular fluid compartment, or third space, is becoming enlarged.

A 28-year-old 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 of the following explanations demonstrates a sound understanding of his health problem?

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

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?

"Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not a very useful screening tool."

When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. They talk about small hormones and hormones as large and complex as growth hormone (GH), which has approximately how many amino acids involved?

200 amino acids

During a period of extreme excess fluid volume, a renal dialysis patient may be administered which type of IV solution to shrink the swollen cells by pulling water out of the cell?

3% sodium chloride

In which of the following locations would a clinician expect to find a ligament?

Around the capsule that forms the knee joint

When working with a patient with diffuse scleroderma who is exhibiting a "stone face" expression, the nurse should consider which of the following to be a priority nursing diagnosis for this patient?

Aspiration, risk related to swallowing impairments

Place the following stages of the hydrogen ion elimination and bicarbonate conservation in the proximal tubules of the nephrons in the ascending chronological order. Use all the options. A) CO2 and H2O are produced. B) H+ is secreting into the tubular fluid. C) Carbonic acid is produced. D) H+ combines with filtered HCO3-.

B, D, C, A

A patient experiencing immotile cilia syndrome should be frequently assessed by the nurse for which priority complication?

Bronchiectasis due to interferences with clearance of inhaled bacteria along the respiratory tract

Which of the following medications would the nurse anticipate being prescribed for the renal failure patient who has hyperphosphatemia?

Calcium carbonate

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 of the following phenomena would the physician most likely consider pathological rather than age-related changes?

Cessation of androgen production

Laparoscopic knee surgery in a 22-year-old basketball player has necessitated entry into the synovial cavity. The surgeon performing the procedure would be aware of which of the following relevant characteristics of synovial tissue?

Few pain receptors are located in the synovial membrane.

An infant born with congenital hypothyroidism and has not sought care from any health care provider is likely to develop which of the following complications? Select all that apply.

Impaired physical growth Mental retardation

A 79-year-old male resident of a long-term care facility has contracted Clostridium difficile and is experiencing consequent diarrhea. Auscultation of the man's abdomen indicates hyperactive bowel sounds. What process in the man's small intestine is most likely accompanying his current status?

Inflammation is accompanied by an increase in peristaltic movements of his small intestine.

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 of the following phenomena could potentially underlie the woman's health problem?

Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells

A nurse is providing care for a client who has been diagnosed with metabolic alkalosis after several days of antacid use. Which of the following treatments should the nurse prepare to give?

Intravenous administration of KCl solution

While assessing a premature infant born at 25 weeks' gestation, the neonatal intensive care unit (NICU) nurse would suspect which diagnosis when the infant displays poor muscle tone, apnea, and a new onset of somnolence?

Intraventricular hemorrhage

Clinical investigation of a 40-year-old female client with diverse dermatological signs and symptoms has focused on the woman's basement membrane. Which of the following skin functions would a clinician most likely attribute to a region of the integument other than the basement membrane?

Lack of sensory nerve impulse conduction

While working in an allergy clinic, the nurse notices that many patients come in with all types of skin reactions. The nurse working in this area knows that which cells play a role in the development of allergic skin condition?

Langerhans cells

Which of the following pathophysiological phenomena would be most indicative of ankylosing spondylitis?

Loss of motion in the spinal column and eventual kyphosis

A 16-month-old boy has a normal weight for his age but a height far below the normal range. His list of symptoms includes a protruding abdomen, lethargy, bow legs, muscle weakness, and irritability. His teeth have not yet developed, and he has difficulty standing. What is the child's most likely diagnosis?

Rickets

A male client complaining of chronic cramping, bloating, and diarrhea has been determined to have a deficiency in brush border enzymes within his small intestine. Which of the following meals or snacks high in carbohydrates and protein will likely exacerbate the client's signs and symptoms?

Roast beef and a baked potato

The nurse should anticipate that which type of antidepressant agent may be prescribed for an elderly patient who has a history of numerous cardiac events and who prefers to take medication only once per day?

Sertraline, a selective serotonin reuptake inhibitor

A patient asks the nurse why his hip fracture (head of the femur) bone has died (osteonecrosis). The nurse responds based on which of the following pathophysiological principles?

Since the head of the femur has only limited collateral circulation, interruption in the blood flow from the fracture causes necrosis and irreversible damage.

Which of the following statements best captures an aspect of the role of hormones in the body?

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

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 of the following diagnostic tests is being performed?

Stimulation test

n occupational therapist conducts a group therapy program called MindWorks with older adults who have diagnoses of dementia and Alzheimer 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?

Tertiary prevention

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/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?

Testicular torsion

A 6-year-old girl with a diagnosis of Marfan syndrome is being assessed at a community health clinic. Which of the following assessments would be the health care professional's lowest priority?

Tests of kidney function

Which of the following statements best captures the role of the adrenal cortex in maintaining homeostasis?

The adrenal cortical hormones are primarily steroids and sex hormones.

Which of the following assessment findings of a male infant 14 hours postpartum would be considered abnormal and would require further assessment and possible intervention?

The baby's skin has a yellowish orange hue.

Which of the following is the best example of a diarthrodial joint?

The interphalangeal joint between the proximal and middle phalanges of the fingers

Which of the following statements most accurately captures a characteristic of the external female genitalia?

The labia majora and clitoris are analogous to the male scrotum and penis, respectively.

A 51-year-old male has been diagnosed with alcohol-induced liver disease. He admits to the nurse providing his care that, "I know what the lungs do, and I know what the heart does, but honestly I have no idea what the liver does in the body." Which of the following statements would best underlie the explanation that the nurse provides?

The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.

During male ejaculation, which of the following statements addresses why sperm is not normally seen inside the bladder?

The musculature of the trigone area, bladder neck, and prostatic urethra contract at the same time.

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.

The patient notes that he has increased work of breathing when lying supine.

Following several days in an acidotic state, a hospital patient has returned to desired pH. Which of the following processes could have contributed to the resolution of the patient's health problem?

The phosphate and ammonia buffer systems in the renal tubules

Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system?

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

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 do not see how he could have developed cancer in his liver. Which of the following facts would underlie the reply that the care team provides?

The portal circulatory system brings venous blood from the GI tract into the liver.

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 reveal a slightly acidic blood sample. The nurse caring for this patient is not surprise with this result

The skeletal muscles are producing large amounts of lactic acid and release it into the bloodstream during heavy work/exercise.

Which of the following statements best captures an aspect of the neural control of sexual function?

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

Which of the following statements best conveys an aspect of the process of keratinization?

The stratum germinativum continuously produces new keratinocytes to replace losses.

A 40-year-old woman has been identified to have a deficiency in estrogen. Which of the following physiological phenomena is most likely to remain unaffected?

The synthesis and release of adrenal glucocorticoids

The nurse is teaching a group of colleagues about the cell division cycle as background to oncology nursing. Which of the following statements is true of the cell cycle?

The two broad phases of the cell cycle are mitosis and synthesis.

Which of the following situations would be considered pathological in an otherwise healthy, 30-year-old female?

The woman's ovaries are not producing progesterone.

A professor is teaching a group of students about the role of mitochondria within the cell. Which of the following statements is true of mitochondria?

They are the site of adenosine triphosphate (ATP) production.

The skin is richly supplied with arteriovenous anastomoses in which blood flows directly between an artery and a vein, bypassing the capillary circulation. What is the primary significance of these structures?

They regulate body temperature.

As part of an orientation to a genetic counseling practice, a group of medical students are differentiating between autosomal recessive disorders and autosomal dominant disorders. Which of the following statements is true of autosomal recessive disorders?

They tend to have a more uniform symptomatology than autosomal dominant disorders.

The homecare nurse is making a home visit to a 51-year-old female client with a long-standing diagnosis of multiple sclerosis. The nurse knows that the muscle wasting and weakness associated with the disease process are ultimately manifested as a failure of what normal process in muscle tissue?

Thick myosin and thin actin filaments sliding over each other

A woman consults her physician about a study (Women's Health Initiative) discussing an increased risk for breast cancer if taking hormones. The physician can allay her fears by sharing which of the following findings?

This 26% increased risk for developing invasive breast cancer occurred in women taking combined continuous estrogen-progesterone therapy.

A 22-year-old male who has been backpacking around Southeast Asia for several months has responded well to treatment for scabies that he acquired while on his trip. What follow-up measures should be taken?

Treatment of individuals that he has been in close contact with

A health care professional works in a context where there are a large number of clients who live with genetic disorders. Which of the following circumstances would most likely involve an individual who has a genetic disorder?

Two chromosomes of the same number have been inherited from one parent.

A client with a history of an endocrine disorder exhibits signs and symptoms of hormone deficiency. Which of the following processes would the client's care team most likely rule out first as a contributing factor?

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

Upon entering the room of a 74-year-old client receiving brachytherapy for cervical cancer, you find the radiation implant and the position-holding device in the client's bed. What is the nurse's first best action?

Use tongs to place the implant in the radiation container.

Which of the following statements most accurately captures an aspect of the basal metabolic rate (BMR)?

Variations in muscle mass account for much of the differences in the BMR that exist between individuals.

A 56-year-old male is obese and has poorly controlled type 2 diabetes mellitus.

Vascular insufficiency has contributed to infection in both soft tissue and now his bone.

Knowing that persons with blonde hair exhibit the phenotype of a recessive gene, which of the following genetic scenarios would most likely underlie such a trait?

aa

While teaching a class on female cancers, the instructor emphasizes to the nursing students that many patients with ovarian cancer may display

abdominal pain, bloating, feeling full quickly after ingesting food.

A nurse practitioner has a 30-year-old male patient presenting with fever and chills, urinary frequency and 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

acute bacterial prostatitis requiring antimicrobial therapy.

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

cohort study.

In the grocery store, a nurse overhears a teenage mother intentionally shaming and verbally reprimanding a child in public. The mother also grabbed the child's stuffed animal and tore the limbs off. From what the nurse remembers about abuse, this would be

emotional abuse.

A 14-year-old female has been experiencing severe internal cramps in the region of the pelvis and weight loss.She has been admitted with rectal bleeding.

endoplasmic reticulum stress in the gastrointestinal system.

While teaching a health class to junior and senior male high school students, the school nurse educates them regarding the first sign of testicular cancer, which would include

enlargement of the testicle.

If a male has a history of impaired blood flow in his vascular system, he may be prone to develop

erectile dysfunction.

A geriatrician has ordered an echocardiogram and stress test for an 80-year-old male client in an effort to gauge the client's cardiovascular health status.

increased resting, supine heart rate

A 46-year-old man who is obese has received news that he has type 2 diabetes. He is in the process of determining a plan of care with an interdisciplinary team at a hospital-based diabetes clinic. The nurse knows that the most likely treatment plan for the man will include

oral antihyperglycemic medications and weight loss measures.

When teaching a community education class about the seven warning signs of cancer, the nurse will note that the most common sign of bladder cancer is

painless bloody urine.

A patient who has suffered a spinal cord injury at C4 is experiencing a sudden change in condition. His BP is 186/101; heart rate is 45; and he is profusely sweating and complaining of "not feeling right." The nurse should

palpate his bladder for overdistention.

A terminally ill cancer patient with metastasis to the bone has been admitted with elevated calcium levels (hypercalcemic crisis). The patient is very lethargic and exhibiting muscle flaccidity. The nurse should be prepared to administer

pamidronate, a bisphosphonate. gallium nitrate, a gallium salt of nitric acid. prednisone, a corticosteroid.

An end-stage renal disease patient has been on peritoneal dialysis at home. Based on his lab work, he regulates the type of solution to infuse into his abdomen. When there is a high concentration of potassium inside the cell (hyperkalemia), the solution infused has a lower concentration so that the potassium ions will diffuse outward. At this point, the cellular membrane is said to be

polarized because of the presence of a negative membrane potential.

A patient 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

proton pump inhibitors.

An example of a single hormone that can exert effects in different tissues, erythropoietin, made in the kidney stimulates the bone marrow to produce

red blood cells.

A child comes in to show his parents (who are nurses) a blister on his foot from "breaking in" a new pair of shoes. The child wants to "pop the blister" to get all the fluid out of it, so it would not hurt so much when he puts on shoes/socks. The parents know that breaking the skin of the blister will put him at risk for

secondary infection.

One of the most reliable predictors for worsening autosomal dominant polycystic kidney disease is

urine albumin excretion (UAE).

A newborn male has been diagnosed with hypospadias following his postpartum assessment by a pediatrician. Which of the following diagnostics and treatment options is the physician most likely to rule out first?

Circumcision

A hospital client with a diagnosis of chronic renal failure has orders for measurement of her serum electrolyte levels three times per week. Which of the following statements best captures the relationship between renal failure and sodium regulation?

Clients with advanced renal failure are prone to hyponatremia because of impaired tubular reabsorption.

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?

Clotrimazole, an antifungal agent

The instructor asks a group of nursing students to explain the function of the omentum. The students will respond based on which pathophysiologic principle?

It has lots of mobility and moves around in the peritoneal cavity with peristaltic movements.

To help diagnose problems in cognitive function, many nursing facilities utilize the Mini-Mental State Examination (MMSE) tool. Which of the following statements accurately describes this tool?

It is a brief, objective tool that will assess memory, orientation, and attention.

Which of the following characteristics most accurately applies to compact (cortical) bone?

It is found along lines of stress in the body.

An instructor is explaining to a group of students the way in which muscles and their associated tendons can be so strongly attached. The instructor makes references to the role of the basal lamina. Which of the following statements most accurately captures an aspect of the basal lamina?

It is present where connective tissue contacts the tissue it supports.

A 40-year-old man who uses heroin intravenously was diagnosed with hepatitis C (HCV) 1 year ago and is now considered to have chronic viral hepatitis. Which of the following statements by the client to his care provider would warrant correction?

It's at least a bit reassuring that my liver isn't undergoing damage when I'm not experiencing symptoms."

Which of the following statements best captures an aspect of the role of progesterone? Progesterone

levels peak after ovulation and is present throughout the menstrual cycle.

A patient with a yeast infection asks the nurse how they diagnose this infection. The nurse will base her response knowing this is primarily diagnosed by

looking at the spores on a wet-mount slide using 20% potassium hydroxide.

Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of

milliseconds

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

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

Growth hormone (GH) secretion is inhibited by

obesity

Following a workup that included endocrine studies (FSH/LH, prolactin, testosterone, DHEAS levels), a 22-year-old college student complaining of abnormal bleeding has been diagnosed with dysmenorrhea due to alterations in her hormone levels. The nurse should anticipate that she will likely be prescribed: Select all that apply.

oral contraceptives. prostaglandin synthetase inhibitors.

A student asks the instructor what are the parameters of infertility. The instructor responds, "Infertility is defined as"

10 million/mL sperm available in seminal fluid.

Following a meal, a woman's blood glucose level has increased. In addition, her pancreas has increased the amount of insulin produced and released. Which of the following phenomena has occurred?

Adjustment according to the level of the substance a hormone regulates

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.

Epigenetic mechanisms

A nurse is teaching a client about the role that skin plays in forming a barrier to environmental agents and microorganisms. The nurse would recognize that which of the following types of cells/junctions are involved in the communication and regulation of the immune response and the secretions of cytokines?

Keratinocytes

Which target of both chemotherapy and radiation treatment accounts for adverse as well as therapeutic effects?

Rapidly proliferating cells

The nurse caring for a lung cancer patient with metastasis to the brain suspects the patient has developed a paraneoplastic syndrome known as syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Which laboratory result in this patient who has gained 3 lb in a day would alert the nurse to the possibility of SIADH?

Serum sodium of 115 mmol/L

To maintain hematocrit levels in people with kidney failure, the nurse should be prepared to

administer a subcutaneous injection of recombinant human erythropoietin (rhEPO).

While studying bones in pathophysiology class, the nursing students learn that the Haversian canals are composed of

lymphatics

A 51-year-old male with a history of hypertension has received a kidney transplant. The client's physician is explaining some of the consequences of the procedure, including the fact that he will need to be on long-term steroid therapy. Which of the following teaching points should the physician emphasize?

"One of the risks that these steroids bring is the possibility that part of a bone might die."

Frustrated with his inability to lose weight despite attempting numerous fad diets, a 42-year-old male who is 5′11″ and 270 lb has visited a clinic to gain tools to achieve long-term weight loss. Which of the following statements by the clinician is most accurate?

"A combined approach of behavior therapy, changing your lifestyle habits, and increased physical activity gives the highest chance of long-term success."

Two health care workers are comparing the etiology and incidence of multifactorial inheritance disorders and single-gene disorders. Which of the following statements best captures the relationship between the two types of genetic disorders?

"A couple with a child with a multifactorial disorder has a higher risk of having another with the same disorder."

A student asks the instructor about the origins of different tissues and their cellular origins during the process of development. Which of the instructor's following statements best describes the process of cell differentiation?

"A fertilized ovum undergoes a series of divisions, yielding many different cell types."

A 31-year-old man who has worked for several years installing fiberglass insulation has developed itchy, irritating lesions on his wrists and forearms over the last several months. He has applied moisturizing creams repeatedly and has taken antihistamines but has experienced no significant improvement. He is understandably concerned about the potential effect this could have on his livelihood and has asked his care provider when treatment will resolve the problem. What is the care provider's most appropriate response?

"A steroid cream will likely help but often the skin problem lasts long after contact with the product that irritates the skin."

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which of the following statements by the client demonstrates the best understanding of his health problem?

"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

A 15-year-old boy 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 of the following responses by his mother is most accurate?

"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 patient has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause?

"Have you had any type of infection within the last 2 weeks?"

A 42-year-old male has been diagnosed with renal failure secondary to diabetes mellitus and is scheduled to begin dialysis soon. Which of the following statements by the client reflects an accurate understanding of the process of hemodialysis?

"I won't be able to go about my normal routine during treatment."

A 17-year-old male has been diagnosed with osteosarcoma of the upper tibia following several months of leg pain. Which of the following statements by the client demonstrates that he has an accurate understanding of his diagnosis?

"I'm really nervous about having to get surgery and chemo."

A 64-year-old man was diagnosed 19 months ago with bilateral osteoarthritis (OA) in his knees, and has come to his family physician for a checkup. The client and his physician are discussing the effects of his health problem and the measures that the man has taken to accommodate and treat his OA in his daily routines. Which of the following statements by the client would necessitate further teaching?

"I've been avoiding painkillers because I know they can mask damage that I might be inflicting on my knees."

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate to include which of the following accurate statements?

"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."

Staff at a women's health center are being briefed by their supervisor on the latest recommendations for breast cancer screening. Which of the following guidelines should staff pass on to their clients?

"Screening mammography and clinical exams are the cornerstones of breast cancer screening."

A client who has had a diagnosis of lung cancer is scheduled to begin radiation treatment. The nurse knows that which of the following statements listed below about potential risks of radiation is most accurate?

"Some clients experience longer-term irritation of skin adjacent to the treatment site."

A new myocardial infarction patient requiring angioplasty and stent placement has arrived to his first cardiac rehabilitation appointment.

"Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks, which lead to my clogged artery."

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 of the following aspects of clients' situations best characterizes pathogenesis rather than etiology?

A client who has increasing serum ammonia levels due to liver cirrhosis

Which of the following clients' diagnostic blood work is most suggestive of chronic kidney disease (CKD)?

A client with low vitamin D levels; low calcitriol levels; and elevated parathyroid hormone (PTH) levels

During a humanitarian trip to an underdeveloped country, a medical student is assessing a 6-year-old male who has a protuberant abdomen, dry hair, and wrinkled skin. The child's heart rate is 59 beats/minute, blood pressure 89/50, and temperature 95.2°F (35.1°C). What is the most likely etiology of the child's health problems?

A diet deficient in both protein and calories

A patient has just been admitted to a nursing unit with the diagnosis of obstructive jaundice. Which of the following assessment findings would the nurse expect to see in this patient? Select all that apply.

A) Clay-colored stools B) Dark urine C) Elevated conjugated bilirubin levels E) Severe itching

An infant who is 4 days postpartum has been diagnosed with a single-gene disorder. The parents of the child have a number of questions about the etiology of the health problem, which the physician is attempting to address in detail. Which of the following teaching points most accurately captures an aspect of single-gene congenital disorders?

A particular defect can be caused by mutations at several different loci.

Parents have brought their 7-year-old child into the emergency room with abdominal pain. Which of the following 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 with palpation C)

A 41-year-old male client has presented to the emergency department with an acute onset of increased respiratory rate and difficulty breathing. STAT chest x-ray indicates diffuse bilateral infiltrates of his lung tissue, and ECG displays no cardiac dysfunction. What is this client's most likely diagnosis?

Acute lung injury

A patient with pancreatic cancer is admitted for portal hypertension in which he is symptomatic with ascites. Following paracentesis and removal of 7.5 L of ascitic fluid, the nurse should anticipate that the physician will order which of the following medications to assist in maintaining an effective circulating fluid volume?

Albumin (human) 5%

For several years, a 39-year-old female has been averaging two to three bottles of wine each night after her children go to sleep and has included several ounces of brandy in recent years as well. Despite negative consequences to her career and the dissolution of her marriage, her drinking has culminated in a diagnosis of cirrhosis. Which of the following physical manifestations of the health problem would her care team anticipate? Select all that apply.

Ascites Anorexia Bleeding tendencies Epigastric pain

When explaining to a class of nursing students the effects of dysregulation of the RANKL/RANK/OPG pathway, the instructor emphasizes that this plays a prominent role in the pathogenesis of: Select all that apply.

B) neoplasia of the bone. C) osteoporosis.

A 45-year-old client who experienced exposure to radiation during an industrial accident several years prior is being assessed. Which of the following phenomena may underlie the genetic changes that have been noted in the client?

Base pairs may have been rearranged by the radiation in the accident.

A middle-aged man with diabetes reports that he must strain to urinate and that his urine stream is weak and dribbling. He also reports feeling that his bladder never really empties. The nurse knows that all of his complaints are likely caused by which of the following medical diagnoses?

Bladder atony with dysfunction

Bone is connective tissue, in which the intercellular matrix has been impregnated with inorganic calcium salts, that has great tensile and compressible strength but is light enough to be moved by coordinate muscle contractions.

Bone cells, blood vessels, and nerves

A community health care nurse is teaching a group of female high school students about the importance of regular Papanicolaou (Pap) smears. The nurse recognizes that what fact underlies the rationale for this teaching?

Cancer of the uterine cervix develops incrementally at a cellular level.

A patient is admitted to the hospital in adrenal crisis 1 month after a diagnosis of Addison disease. The nurse knows which of the following clinical manifestations would support this diagnosis?

Change in the level of consciousness and profound hypotension

A 20-year-old male college student has recently finished a Thanksgiving dinner of heroic proportions while home for the holiday weekend. Which of the following phenomena would most likely have produced his sensation of satiety?

Cholecystokinin and glucagon-like peptide-1 suppress the hunger impulse.

A patient has been admitted with a fractured pelvis that occurred in an auto accident just a few hours ago. The nurse notices a slight change in behavior. Which of the following clinical manifestations would lead the nurse to suspect that the patient has fat emboli that has migrated? Select all that apply.

Complaints of substernal chest pain Pulse rate 120 with temperature of 99.7°F Profuse diaphoresis with pallor noted

A patient has been diagnosed with a brain tumor that cannot be removed surgically. During each office visit, the nurse will be assessing the patient for syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessments would alert the clinic nurse that the patient may be developing this complication?

Complaints that his urine output is decreased, no edema noted in ankles, and increasing headache

During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which of the following diagnoses?

Condylomata acuminata

A physician is working with a 30-year-old male client with Down syndrome who has been admitted to hospital with a diagnosis of acute leukemia.

Congenital heart defects

Which of the following facts accounts for the variation in skin tone that exists between individuals?

Darker-skinned individuals have melanosomes that produce melanin faster.

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 of the following phenomena has contributed to his tissue damage?

Decreased blood flow has induced hypoxia.

A patient arrives in the ED very hypovolemic related to excretion of "at least 3 gallon jugs of urine in the past 24 hours." He describes the urine as being clear-like water. The physician suspects diabetes insipidus. The nurse should be prepared to administer which of the following medications?

Desmopressin acetate (DDAVP)

A 1-year-old baby boy with renal dysplasia risks end-stage renal disease unless intervention occurs. Which of the following treatment options is his care team most likely to reject?

Dietary restriction plus erythropoietin

When educating the patient with ankylosing spondylitis, the nurse should emphasize which of the following treatment interventions? Select all that apply.

Encourage sleeping supine on an extra firm mattress if possible. Try using the heating pad prior to exercise to help stretching and improve movement.

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.

Facilitated diffusion

Of the following list of medications, which would likely be prescribed to a patient with benign prostatic hyperplasia (BPH) as a way to decrease the prostate size by blocking the effects of androgens on the prostate?

Finasteride (Proscar), a 5a-reductase inhibitor

You are volunteering in the medical tent of a road race on a hot, humid day. A runner who has collapsed on the road is brought in with the following symptoms: sunken eyes, a body temperature of 100°F, and a complaint of dizziness while sitting to have his These are signs of a fluid volume deficit. Which of the following treatments should be carried out first?

Give him an electrolyte solution by mouth.

A male patient comes to the clinic asking to speak to a health care provider privately. He reveals that he had shared a needle/syringe with a prostitute (shooting up cocaine) and then had unprotected sex. Upon questioning, it was revealed that the patient had not had any immunization for hepatitis B. Which of the following medications would the nurse anticipate administering today to this patient?

Hepatitis B immunoglobulin (HBIG)

A 30-year-old male who manages his type 1 diabetes with glyburide presents at the emergency room complaining of headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half-marathon. Which of the following is likely to be the cause of his complaints?

Hypoglycemia

When trying to explain the role of potassium and hydrogen related to acid-base balance, which of the following statements is accurate?

Hypokalemia stimulates H+ secretion.

While rock climbing, a 22-year-old male has endured a severe head injury. Which of the following statements best captures expected clinical manifestations and treatments for his immediate condition?

Hypoventilation may exist, resulting in increased PCO2 and hypoxemia that may require mechanical ventilation.

While taking their daily walk, the nurse is asked by a neighbor what centric fusion (robertsonian) translocation means. She tells you that a family member has been diagnosed with this and is now afraid to have children. Given this diagnosis, what may be potential risks for her offspring?

If chromosome 21 is involved, there is a high risk for producing a child with Down syndrome.

The nurse is caring for a patient with ketoacidosis, who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. The nurse understands which of the following phenomena is most likely occurring?

In the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids.

A client with poorly controlled diabetes mellitus presents to the emergency department with suspected ketoacidosis. Which of the following diagnostic results would most likely confirm this diagnosis?

Increased anion gap, base deficit

Which of the following lab results would be associated with abnormalities in kidney function? Select all that apply.

Increased creatinine levels Detectable levels of glucose in a urine sample Elevated cystatin-C level.

A female tennis player has suffered an injury to her shoulder that has affected her bursae in the joint. Which of the following consequences would be most expected from this aspect of her injury?

Increased friction on the tendons of the shoulder joint

Which of the following data would a clinician consider as most indicative of acute renal failure?

Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR)

What topic should health promotion initiatives emphasize if the target audience is parents of preschoolers and the goal is to minimize mortality?

Injury prevention especially when the child is near water

Which of the following statements best communicates the nature of movements in the colon?

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

The nurse assessing a renal failure patient for encephalopathy caused by high uremic levels may observe which of the following clinical manifestations?

Loss of recent memory and inattention

After hearing horror stories about the signs, symptoms, and course of lymphogranuloma venereum (LGV), a high school student has asked a visiting sexual health educator about the odds of acquiring the disease among sexually active Americans. Which of the following facts will most accurately underlie the educator's response?

Men who have sex with men are at particular risk of LGV.

In the context of an explanation of how human growth occurs, a student is explaining to a colleague the necessity and roles of different types of RNA in protein synthesis. Which of the following types of RNA is a result of the process of transcription?

Messenger RNA

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

A 20-year-old female has come to the clinic complaining of severe menstrual cramps. The clinic nurse practitioner knows that dysmenorrhea occurs when which muscle group contracts?

Myometrium

A 77-year-old woman has been admitted to hospital following several weeks of increasing fatigue. On observation, she is pale, and blood work indicates she has low hemoglobin and red cell counts. Stool tests for occult blood are positive, and following endoscopy, she has been diagnosed with an upper GI bleed that has been shown to originate in her stomach. She admits to regularly exceeding the recommended doses of nonsteroidal anti-inflammatory drugs (NSAIDs) in an effort to control her rheumatoid arthritis. Which of the following phenomena is most likely responsible for her present health problems?

NSAIDs can disrupt the permeability of the gastric mucosa, causing hydrogen ions to accumulate in the mucosal cells of the lining.

During a lecture about medication therapy for type 2 diabetic patients, the pharmacology instructor discusses side effects to monitor following subcutaneous injection of exenatide (Byetta), a glucagon-like peptide-1 (GLP-1) agonist. Of the following list, which signs and symptoms should the students be assessing in this patient? Select all that apply.

Nausea Weight loss

To reduce hepatic blood flow and decrease portal pressures in persons with cirrhosis, the nurse should be prepared to administer which of the following medications?

Octreotide, a long-acting synthetic analog of somatostatin

Recognizing the prevalence and incidence of dehydration among older adults, a care aide at a long-term care facility is in the habit of encouraging residents to drink even though they may not feel thirsty at the time. Which of the following facts underlies the care aide's advice?

Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.

The health caregiver is explaining the rationale for administering a hypotonic intravenous solution (lower concentration of solutes in its surroundings) to a client.

Osmosis

A 40-year-old African American patient is at increased risk of developing prostate cancer, since his father was diagnosed with the disease at age 60 and his brother at age 56. What diagnostic measures should be undertaken?

PSA and DRE starting before the age of 50

A 15-year-old female has presented to her family physician complaining of frequent discomfort around the time of her period. She has subsequently been diagnosed with primary dysmenorrhea. Which of the following treatments is most likely to be effective?

Pain control with prostaglandin synthetase inhibitors

A 3-year-old boy has developed croup following a winter cold. His care provider would recognize that which of the following microorganisms and treatments is most likely to be effective?

Parainfluenza virus treated with a mist tent and oxygen therapy

When examining the types of energy expenditure, which of the following statements is accurate?

People who are more active and who fidget may have less fat gain than those with decreased nonexercise activity thermogenesis.

An 87-year-old male resident of an assisted living facility has been consistently continent of urine until the last several weeks. Which of the following actions by the care providers at the facility is the most likely priority?

Performing a physical examination and history to determine the exact cause and character of the incontinence

A 70-year-old woman who delivered four children during her reproductive years has weakened pelvic floor muscles. Which of her following anatomical structures is least susceptible to inappropriate herniation into her vagina?

Peritoneum

A 56-year-old female with a diagnosis of breast cancer has developed bone metastases, which her oncologist would like to treat with radiation therapy. What is her physician's most likely primary goal in the treatment plan of the metastases?

Prevention of pathologic fractures

As part of a community class, student nurses are developing a class 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 vehicles. This is an example of which type of prevention?

Primary prevention

A 30-year-old woman has just given birth to a boy. How will the mother's bone marrow differ from that of her son?

Proportionately, the infant will have more red marrow and less yellow marrow than his mother.

After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem?

Proton pump inhibitors; avoiding large meals; remaining upright after meals

A few of the more experienced nurses are sitting around a lunch table discussing the changes they are seeing in their skin. Which of the following would be considered normal age-related changes? Select all that apply.

Reduction in subcutaneous tissue; Dry, scaly skin.

Which of the following phenomena contributes to the difficulties with absorption, distribution, and elimination of drugs that are associated with kidney disease?

Reductions in plasma proteins increase the amount of free drug and decrease the amount of protein-bound drug.

In the neurotrauma unit, a teenager with a closed head injury related to an automobile accident is experiencing high intracranial pressure (ICP). He is intubated and is on a ventilator. One treatment for this is to allow him to progress into which acid-base imbalance in an attempt to lower ICP?

Respiratory alkalosis

A patient who overdosed on aspirin is brought to the emergency department. The nurse caring for this patient should anticipate which of the following clinical manifestations? Select all that apply.

Respiratory rate of 40 ABG report: pH 7.50, PCO2 31 mm Hg, and HCO3 level 19 mmol/L.

Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system?

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

A 22-year-old female with a history of intermittent flank pain, repeated UTIs, and hematuria has been diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which of the following phenomena has most likely contributed to the development of this diagnosis?

She has inherited a tendency for epithelial cells in her tubules to proliferate inappropriately.

A multidisciplinary health care team operates a program aimed at the prevention, identification, and treatment of diabetes on a large Indian reservation.

Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked

An 8-year-old child has just been diagnosed with systemic lupus erythematosus (SLE). The parents wonder what the child's prognosis is going to be. Which of the following findings would be considered a good prognostic indicator of the extent/seriousness of the disease?

Swelling in the face and eyes and rust/blood-colored urine

Blood-borne cancerous cells have recently spread from a woman's primary tumor in her pancreas to her bones.

T lymphocytes B) Macrophages C) Natural killer (NK) cells D) B cells

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?

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

Following a long history of fatigue, weakness, and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source?

The man has a chronic platelet deficiency and is occasionally anemic.

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 in the unit would recognize that which of the following factors likely contributed to the health problem and would anticipate which of the following treatments?

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

Following a biopsy, a 54-year-old man has been diagnosed as having a benign neoplastic tumor. Which of the following characteristics most likely applies to his tumor?

The well-differentiated, neoplastic cells are clustered together in a single mass.

Although the client's primary care provider has downplayed the symptoms, a geriatrician suspects that an 82-year-old female has polymyalgia rheumatica. Which characteristic symptomatology would most likely have led the specialist to suspect this health problem?

The woman complains of aching and morning stiffness in her neck, shoulder, and pelvis.

A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would most likely lead clinicians to this conclusion?

The woman experiences intermittent, painful locking of her joint.

Which of the following statements best captures an aspect of the process of fat digestion and absorption?

Triglycerides are digested with the aid of bile salts.

A 24-year-old college student has presented to the campus medical clinic with complaints of frequent, burning urination and has, subsequent to urinalysis, been diagnosed with an acute lower urinary tract infection (UTI) caused by E. coli.

What teaching will the clinician most likely provide to the student? "Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe."

A 77-year-old female diagnosed with chronic obstructive pulmonary disease (COPD) is experiencing impaired gas exchange and CO2 retention, despite a rapid respiratory rate. Which of the following pathophysiological principles would her health care team expect if her compensatory mechanisms are working?

Which of the following pathophysiological principles would her health care team expect if her compensatory mechanisms are working? Her kidneys will adapt with an increase in plasma HCO3- and her pH will decrease.

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 of the following statements most accurately underlies the dominant regulation process of hormone levels in the body?

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

A care aide who works in a long-term care facility recognizes the high incidence and prevalence of a stage I pressure ulcer in immobile older adults. Which of the following protocols in the facility would the care aide advocate changing?

Wound dressings are applied promptly to all identified or potential pressure ulcers.

Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the emergency department with malaise, nausea, and "yellow eyes." Serology has confirmed a diagnosis of hepatitis A (HAV), to the shock of the client. What teaching is most appropriate for this client?

"A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time."

A 24-year-old man is currently in a rehabilitation facility following a spinal cord injury at level T2.

"An indwelling catheter certainly would work well, but it comes with a number of risks and possible complications."

New parents were just told by their physician that their son is two standard deviations above the mean. The parents later asked the nurse what that means. The nurse will explain by stating,

"Being two standard deviations above the mean translates into that your child will likely be taller than 95% of children in the population."

Two nursing students are debating the merits and demerits of infant circumcision. Which of the following statements is most accurate?

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

Knowing the high incidence and prevalence of heart failure among the elderly, the manager of a long-term care home has organized a workshop on the identification of early signs and symptoms of heart failure. Which of the following teaching points is most

"Displays of aggression, confusion, and restlessness when the resident has no history of such behavior can be a sign of heart failure."

A 31-year-old male has been newly diagnosed with early-onset Parkinson disease. As the nurse is educating the patient and family, they ask how this happened so early in his life.

"Disruption in some proteins called molecular chaperones causes intracellular molecules to become denatured and insoluble leading to clumping and the development of inclusion bodies."

A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications?

"Do you have pain when you urinate or have difficulty starting the stream?"

A patient has been diagnosed with a neurodegenerative disease called multiple sclerosis (MS).

"Dysregulated apoptosis has caused an excessive rate of programmed cell death along the neuropathways."

A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which of his statements is most accurate?

"Even when I'm not having a recurrence, I could still pass the virus on to you."

A campus-based peer counseling group is conducting an information blitz on sexually transmitted diseases. Which of the following statements about genital warts requires correction?

"Genital warts can take up to a month after exposure to first become visible."

A 51-year-old woman who has been receiving estrogen and progesterone therapy (EPT) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns?

"HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear."

As part of the intake protocol at an eating disorders clinic, an interview precedes a physical examination. Which of the following questions would a clinician be justified in excluding from an intake interview of a 16-year-old female referred by her pediatrician for the treatment of anorexia nervosa?

"Have you had any episodes of shortness of breath in the recent past?"

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.

"Have you had unprotected sex in the past?"

A new older female client at a long-term care facility has a diagnosis of type 1 neurofibromatosis. As part of the intake assessment protocol for the facility, the clinical educator is teaching the care staff about the diagnosis. Which of the following statements most accurately conveys an aspect of neurofibromatosis?

"Her diagnosis puts her at higher risk of developing a malignant neoplasm."

After hearing daunting reports from her slightly older coworkers and friends, a 44-year-old woman has a number of questions for her physician about what to expect during perimenopause and why. Which of the following teaching points is most accurate?

"Hot flashes are a reality for most women in menopause, and the exact cause of them isn't known yet."

Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis?

"How many sexual partners have you had?"

A male client of a nurse practitioner has an autosomal dominant disorder. The client and his partner are considering starting a family.

"I know that a single mutant allele is to blame for the health problem."

Which of the following statements by a student demonstrates a sound understanding of the cellular processes of hypertrophy and hyperplasia?

"I know that cells like neurons have little capacity for hyperplastic growth."

Which of the following clients is at a high risk for developing dilated cardiomyopathy?

A 44-year-old noncompliant female who forgets to take her hypertensive medications

A patient who is still breast-feeding her infant has arrived at the clinic complaining of sore breasts. The physician has diagnosed mastitis. Which of the following statements made by the patient will require correction by the nurse?

"I need to stop breast-feeding until all my antibiotics have been taken."

An 18-year-old female of Southeast Asian ancestry is distraught over the recent appearance of white patches on her forearms and upper arms, which have been subsequently confirmed as vitiligo. Which of the following statements by the woman express an accurate understanding of her condition?

"I suppose this shouldn't come as too much of surprise, since this tends to run in my family."

How could a health care professional most accurately explain an aspect of the underlying structure of DNA to a colleague who is unfamiliar with genetics?

"In the base pairs, adenine combines with thymine and guanine with cytosine."

While being tackled, a 20-year-old football player puts out his hand to break his fall to the ground. Because the intense pain in his wrist did not subside by the end of the game, he was brought to an emergency department where diagnostic imaging indicated an incomplete tear of the ligament surrounding his wrist joint. At the time of admission, his wrist was swollen with a severely restricted range of motion. What will his care team most likely tell the player about his diagnosis and treatment?

"It looks like a mild to moderate sprain, and you'll need to keep it immobilized for a few weeks."

A diabetes education nurse is teaching a group of recently diagnosed diabetics about the potential genitourinary complications of diabetes and the consequent importance of vigilant blood glucose control. Which of the following teaching points best conveys an aspect of bladder dysfunction and diabetes mellitus?

"It's important for you to empty your bladder frequently because diabetes carries risks of kidney damage that can be exacerbated by incomplete bladder emptying."

A 63-year-old woman has visited a physician because she has been intermittently passing blood-tinged urine over the last several weeks, and cytology has confirmed a diagnosis of invasive bladder cancer. Which of the following statements by the physician is most accurate?

"It's likely that you'll need surgery, possibly a procedure called a cystectomy."

A patient comes into the orthopedic clinic complaining of severe pain in his hip that was not caused by a fall. On inspection, the femur and tibia are bowed. There is also a reduced angle of the femoral neck, which gives the patient a "waddling gait" appearance. The doctor suspects Paget disease. The patient asks how he got that. The nurse will respond,

"It's most likely a genetic predisposition. Do you know if anyone else in your family has this problem?"

A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of Web sites. Which of the following statements that he has read is most plausible?

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

A public health nurse is conducting a health promotion teaching session at a seniors' drop-in center. Which of the following teaching points about hip fractures in older adults is most justified?

"Most hip fractures are actually a break at the very top of the thigh bone."

Which of the following statements made by parents of high schoolers would be a cause for the concern the child may be thinking about suicide?

"My child has never had problems in school until now. He is failing classes and getting in trouble."

A nurse educator is performing client education with a 51-year-old man who has been recently diagnosed with chronic kidney disease. Which of the following statements by the client would the nurse most likely want to correct or clarify?

"My kidney problems increase my chance of developing high blood pressure or diabetes."

An 81-year-old female is attending a scheduled visit to her family physician. The client asks her doctor why it is that she and her peers seem to get sick frequently, in spite of their efforts to stay active and eat nutritiously.

"Normal, age-related changes combined with outside factors make older adults more susceptible to getting sick."

A patient in a hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine collection test. He asks the nurse why the test is necessary since he provided a single urine sample 2 days ago. How could the nurse best respond to the patient's question?

"Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine."

A person with severe lymphedema is asking the nurse where specifically are the lymph vessels located in the skin layers. The nurse would respond,

"Papillary dermis layer."

The educator of a geriatric, subacute medical unit in a hospital is oriented new staff and teaching orientees' strategies for communicating with older adults with impaired hearing. Which of the following teaching points is most justifiable?

"Speak slowly and directly to these clients."

Following a progressive onset of fatigue, aching, and joint stiffness over the last 2 years, a 69-year-old male has recently been diagnosed with rheumatoid arthritis (RA). Which of the following teaching points should his primary care physician include during the office visit in which this diagnosis is communicated to the client?

"Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief to your symptoms."

The physician is considering prescribing an anti-tumor necrosis factor (TNF) like infliximab for a rheumatoid arthritis patient. Which of the following statements is accurate about the advantages of using a TNF inhibitor?

"TNF inhibitors help slow the disease progression and improve your ability to perform routine ADL functions."

During a group prenatal class, the nurse teaching the course is explaining the thinning of the cervix that accompanies the stages of labor leading up to delivery. A participant admits that she is not familiar with either the location or normal role of the cervix. Which of the following responses by the nurse would be most appropriate?

"The cervix is the opening between the uterus and the vagina, and so it opens wide during the lead-up to birth."

A male patient with a history of heavy alcohol use has been admitted to hospital for malnutrition and suspected pancreatitis. The patient's diagnostic workup suggests alcoholic ketoacidosis as a component of his current health problems. He is somewhat familiar with the effect that drinking has had on his nutrition and pancreas but is wholly unfamiliar with the significance of acid-base balance. How best could his care provider explain the concept to him?

"The chemical processes that take place throughout your body are thrown off very easily when your body is too acidic or not acidic enough.

A gastroenterologist is teaching a group of medical students about the enteric nervous system in preparation for a consult on client who has suffered a spinal cord injury. Which of the physician's teaching points is most accurate?

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

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 of the statements made by one of the workers indicates that further teaching is necessary?

"The greater the skin resistance, the greater the amount of deep and systemic damage a victim is likely to incur."

A man and woman are eager to determine the sex of their unborn child and have asked the nurse at the fertility clinic how this is possible at an early stage of in vitro development. Which of the nurse's responses best captures the genetic rationale for early sex identification through tissue samples?

"The inactive X chromosome can be visible in a female."

A 57-year-old woman has been diagnosed with atrophic vaginitis and has expressed surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond?

"The lower levels of estrogen since you've begun menopause make your vagina prone to infection."

A public health nurse has learned that a colleague has been screening for scoliosis during visits made to schools even though such screening is not mandated. How should the nurse best respond to the colleague?

"The potentially harmful outcomes of screening have been shown to outweigh the benefits."

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?

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

A male patient has just been diagnosed with esophageal cancer. He knew that 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 patient asks the nurse what he can expect if he agrees to the treatments. The nurse responds,

"The therapies may shrink the cancer."

A 36-year-old female who has experienced diverse symptoms for several years has finally had her health problems attributed to scleroderma (systemic sclerosis) and has committed herself to learning as much about the disease as she can. Which of her following statements would her nurse want to correct or clarify?

"The worst part of this so far has been learning that there aren't any treatments for scleroderma."

A woman is surprised to read on the Internet that certain infections can cause cancer and has sought clarification from her family physician during an office visit. How can the physician best respond to the woman's query?

"There are many viruses, but only a very few of them have been shown to cause cancer in humans."

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 of the nurse's following responses most accurately addresses the clients concerns?

"There are some modest risks, but they are only associated with some long-living fish."

While explaining to the parents of a 5-year-old why the child's fractured femur has so much swelling and bruising, the nurse will include which of the following statements?

"This bone is hollowed out, and the inside of the shaft produces marrow where red blood cells are formed."

Following several days of intermittent upper right quadrant pain, a 29-year-old obese, Native American woman has been diagnosed with cholelithiasis. The nurse at the clinic has taught the client about the pathophysiology and contributing factors to her health problem, as well as some of the likely treatment options. Which of the following statements by the client demonstrates a sound understanding of her diagnosis?

"This explains why my skin was yellow-tinged lately and why I had those pains that spread to my upper back and right shoulder."

The parents of a newborn who has been diagnosed with developmental dysplasia of the hip ask the nurse about the reason this harness has to be on their child. The nurse responds,

"This harness allows your baby some mobility as it slowly brings the leg back into abduction."

The osteoporosis patient asks the nurse to explain what a bisphosphonate medication does. The nurse will respond,

"This medication helps prevent bone resorption, which will help prevent fractures."

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.

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

A geriatric clinical nurse educator is teaching the other members of the health care team about the incidence, prevalence, and course of depression among older adults. Which of the following statements is most likely to appear in the physician's teaching?

"Though they are certainly not synonymous, depression can be an indicator of dementia."

The clinical nurse educator on a nephrology unit of a large, urban hospital is orientating recent nursing graduates to the unit. Which of the following teaching points about acute tubular necrosis (ATN) should the educator include in the orientation session?

"Trauma, burns, and major surgery are common precursors to ATN."

A nurse is collecting a urine specimen prior to measuring the albumin level in a client's urine. A colleague questions the rationale for the test, stating, "I thought albumin was related to liver function, not kidney function." How can the nurse best respond to this statement?

"Urine albumin levels are useful for diagnosing diabetic kidney disease."

A 70-year-old woman's family physician has recommended a vitamin D supplement. The woman states that she tries hard to take as few pills as possible and questions her physician on the rationale and necessity of the hormone. How can the physician most accurately reply to the client's concerns?

"Vitamin D is important in order for your body to absorb the calcium that you consume in your diet."

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 fistulae (EA/TEF). Which of the following explanations should the care team provide to the infant's parents?

"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 female toddler has been diagnosed with toeing-in (metatarsus adductus). What teaching should the pediatrician provide to the parents of the child about her diagnosis?

"We'll likely need to start putting the first of a series of casts on her legs quite soon."

A 60-year-old woman who is 11 years menopausal has presented to the emergency department stating, "I haven't had my period in years, but lately I've been bleeding again, and quite heavily in the last few days." The care team needs to rule out endometrial cancer. How should they best explain the most accurate plan for confirming or ruling out the diagnosis?

"We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus."

A nurse is teaching a wellness group among a group of older adult women. One of the women has asked for advice about preventing osteoporosis, which affects many of her friends. What is the nurse's best response to the woman's query?

"Weight-bearing exercise is helpful, as are calcium supplements."

A midwife who is providing care for a woman during her first pregnancy is assessing for intrauterine growth retardation (IUGR) during an early prenatal checkup. Which of the following questions best addresses the risks for IUGR?

"What does your typical diet look like over the course of a day?"

A 60-year-old man has been diagnosed with renal calculi after repeated episodes of excruciating flank pain in recent weeks. The man states that, "I don't know how this could happen to me, since I'm so careful about eating a healthy diet." What is the most appropriate response to the man's statement?

"What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved."

A 51-year-old male professional is in the habit of consuming six to eight rum and cokes each evening after work. He assures the nurse practitioner who is performing his regular physical exam that his drinking is under control and does not have negative implications for his work or family life. How could the nurse best respond to the client's statement?

"When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts."

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 of the following teaching points about the client's future health risks is most accurate?

"When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

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 of the following statements about colorectal cancer demonstrates a sound understanding of the disease?

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

A care aide at a long-term care facility has left a note for the care director stating that an 82-year-old resident has a grossly distended scrotum and a likely inguinal hernia. On examination, the resident has been diagnosed instead with hydrocele. What will the care team most likely tell the resident and his family about his diagnosis?

"While distressing to look at, this condition usually doesn't have any significant consequences and won't need treatment."

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 of the following teaching points is most warranted?

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

A 7-year-old boy has been diagnosed with juvenile idiopathic arthritis (JIA), and his parents are anxious to know how his health problem will affect his short-term and longer-term future. What can his health care provider most accurately tell the family?

"With appropriate use of anti-inflammatory drugs along with lifestyle modifications, your son stands a good chance of leading a normal life."

A 24-year-old male patient with a complete transection of the spinal cord asks, "Will I be able to father children in the future?" The nurse responds,

"With proper stimulation of your genitals, you may be able to produce an erection and ejaculation."

A nurse who is visiting a seniors' wellness center is teaching a group of older adult women about sexual activity among older adults. Which of the following teaching points best captures the reality of sexual activity among older adults?

"You can expect the duration and intensity of sexual response to decrease with age."

A client has been diagnosed with having calcium oxalate kidney stones following intravenous pyelography. Which of the following teaching points about the treatment of the health problem are justifiable? Select all that apply.

"You may need to cut out cocoa, chocolate, and some nuts from your diet." "Extracorporeal shock-wave lithotripsy treatment may be used to fragment larger stones."

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 of the following teaching points should the nurse include in a conversation with the player?

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

Which of the following teaching points by an oncologist is most appropriate for a 33-year-old male who will begin treatment shortly for his testicular cancer?

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

A 70-year-old male with a 40 pack-year history of smoking and long-standing non-insulin-dependent diabetes has been diagnosed with pancreatic cancer. Which of the following teaching points should the physician provide?

"You will likely be facing surgery in the near future, but know that this is very unlikely to eliminate your cancer."

Following genetic testing and a thorough history from the child's mother and father, a 5-month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father?

"You'll need to be very careful to avoid causing fractures to his fragile bones."

Following an oral glucose tolerance, a 36-year-old mother of four has been diagnosed with gestational diabetes mellitus (GDM), a problem that was not present in any of her previous pregnancies. What should her primary care provider tell her about this new health problem?

"Your baby could become too large or have low blood sugars if we're not vigilant about controlling your sugars."

A family physician is providing care for a 61-year-old obese male who has a history of diabetes and hypertension. Blood work has indicated that the man has a GFR of 51 mL/minute with elevated serum creatinine levels. Which of the following statements will the physician most likely provide the client in light of these results?

"Your chronic kidney disease has likely been caused by your diabetes and high blood pressure."

The first-time parents of an infant girl 2 days postpartum are distressed at the jaundiced appearance of her skin and are eager for both an explanation and treatment for the problem. Which of the following responses by their physician is most accurate?

"Your daughter's young liver is unable to get rid of the waste products from old red blood cells."

As part of her prenatal care, a pregnant woman and her partner are being taught by a community health nurse. Which of the following points about the teratogenic effects of different substances should the nurse include in his teaching?

"Your developing baby is most vulnerable during the first 2 months of your pregnancy."

Following a history of gastric pain and an endoscopy, a client has been diagnosed with a duodenal peptic ulcer. Which of the following teaching points should his caregiver provide?

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

A dietitian is working with a morbidly obese client in an effort to facilitate weight loss. Which of the dietitian's following teaching points about the nature of adipose tissue should be included in the client education?

"Your fat cells can be considered to be one large energy storage organ that also has a role in hormone production."

A 34-year-old man has been taking up to 2400 mg of ibuprofen per day following a motor vehicle accident several months ago and consequent chronic pain. He has recently been diagnosed with chronic analgesic nephritis as a result of his high analgesic intake. The man is surprised at the diagnosis stating, "I thought that taking too many drugs hurts your liver if anything, not your kidneys." What is the most appropriate response to the man's statement?

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

A pharmacist is teaching a group of nurse practitioners about the differences between pharmacokinetics among older adults and among younger clients. Which of the following teaching points best captures an aspect of drug therapy among older adults?

"Your older patients are going to have higher serum concentrations of water-soluble drugs because of the patients' leaner body mass."

A nurse in a medical unit has noted that a client's potassium level is elevated at 6.1 mEq/L. The nurse has notified the physician, removed the banana from the client's lunch tray, and is performing a focused assessment. When questioned by the client for the rationale for these actions, which of the following explanations is most appropriate?

"Your potassium level is high, and so I need you let me know if you feel numbness, tingling, or weakness."

A patient has just been diagnosed with pernicious anemia. The patient asks the nurse why his body is not able to absorb vitamin B12. The nurse responds,

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

A female patient presented to her primary care physician with classic signs and symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the health care providers explain her Cushing syndrome signs and symptoms to this patient?

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

A frantic mother brings her young child into the emergency department. She states that during the evening bath, she noticed a large mass in her child's abdomen. After diagnostic testing, the pediatrician tells the parents that their child has Wilms tumor, stage IV. After the doctor leaves the room, the parents ask the nurse, "What does this mean?" The nurse will respond, "Your child ('s)

"has cancer in the kidney that has spread most likely to his lungs."

While educating a mother about the benefits of giving her child the human papilloma virus (HPV) vaccine, gardisil, which of the following statements will the nurse need to clarify for the parent? Select all that apply. The vaccine is

100% effective against development of cervical cancer for her life span. only recommended for females between the ages of 9 and 26.

When counseling a group of overweight individuals, the nurse should stress that during parties, the oxidation of alcohol provides how many kilocalorie/gram to one's diet?

7 kcal/g

Assuming that they have not responded to drug therapy, which of the following clients is likely to be the best candidate for surgical cardiac ablation?

A 46-year-old man with unstable angina and a history of myocardial infarction who is found to have long QT syndrome and episodes of frequent ventricular arrhythmias

Due to rapid neural growth, a child can begin to control the bowel and bladder sphincters by what age?

2 years

When explaining a cystometry test to measure bladder pressure during filling and voiding in a normal adult, the nurse informs the nursing students that the normal capacity when adults have a desire to void is

400 to 500 mL.

Following ejaculation in a healthy adult, approximately 300 million sperm is present. Which percent of these sperm would be considered normal (mobile and morphologically healthy) and able to fertilize an egg?

55%

Which of the following clients would be considered to have a significant risk of developing the prerenal form of acute renal failure? Select all that apply.

A 22-year-old male who has lost large amounts of blood following a workplace injury A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and heart failure An 80-year-old female who has been admitted for the treatment of dehydration and malnutrition

Which of the following patients would the nurse expect to find woven bone scaffolding in place to facilitate healing? Select all that apply.

A 22-year-old patient recovering from an auto accident where he incurred a fracture of his femur A 55-year-old prostate cancer patient undergoing radiation therapy for bone metastasis

Which of the following individuals is most likely to develop a form of reactive arthritis?

A 24-year-old male who completed treatment for a chlamydial infection 1 year ago

A nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which of the following individuals are at risk of developing urinary obstructions? Select all that apply.

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

Which of the following individuals is at the highest risk of developing a urinary tract infection (UTI)?

A 30-year-old woman with poorly controlled diabetes mellitus

Which of the following neurological patients is most likely to have abnormalities in breathing regulation?

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

Which of the following patients of a primary care physician would not require extra screening for cancer?

A 38-year-old female with Down syndrome and congenital scoliosis

Which of the following individuals demonstrates a health problem with his or her axial skeleton?

A 40-year-old man who has a contusion to the left temporal bone of his skull following a motor vehicle accident.

Which of the following women is most likely to have a sexually transmitted infection as a contributing factor to her health problem?

A 41-year-old with a diagnosis of mucopurulent cervicitis

Which of the following sexually active women most likely faces the highest risk of developing an ectopic pregnancy?

A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed.

Of the following situations, which one would be an example of a maladaptive cellular change?

A 44-year-old male with a 60-pack-per year smoking history who was diagnosed with a histological grade 3 lung cancer

Which of the following clients is most clearly displaying the signs and symptoms of irritable bowel disease (IBD)?

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"

Of the following patient conditions, which patients would be 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 A 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) A 18-year-old female anorexia nervosa patient weighing 78 lb and has consumed no protein for the past 3 years

Which of the following clients would be most reasonably expected to have the highest basal metabolic rate (BMR), assuming none is obese or malnourished?

A 60-year-old man, 72 inches tall, who is recovering from heart surgery

Which of the following clients is most likely to have low bone density?

A 65-year-old male who is noted to have osteopenia.

Which of the following individuals are likely to display identified risk factors for the development of lower urinary tract obstruction? Select all that apply.

A 68-year-old man who has been diagnosed with benign prostatic hyperplasia (BPH) A 30-year-old woman who has been diagnosed with gonorrhea A 74-year-old woman who has developed a lower bowel obstruction following several weeks of chronic constipation A 20-year-old man who has spina bifida and consequent impaired mobility.

Which of the following clients of an oncologist is likely to have the poorest prognosis?

A 69-year-old man who has been diagnosed with stage IV malignant melanoma

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

A 70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and has an elevated temperature of 103.2°F

Recognizing that falls are a significant source of morbidity among older adults, the manager of a geriatric medical unit is conducting a workshop for the health care team on fall prevention. Which of the following patients would the care providers most likely anticipate being at a potentially high risk for falls?

A 76-year-old woman with diagnoses of Parkinson disease and orthostatic hypotension

Which of the following clinical findings among older adults is most unlikely to warrant further investigation and possible treatment?

A 78-year-old female's GFR has been steadily declining over several years.

Which of the following individuals who has recently presented to a hospital emergency department is displaying an injury that involves his or her fibrocartilage?

A 78-year-old man who has fallen and is suspected of having a "slipped disc" in his back

A nurse provides care for a number of older adult residents of a long-term care facility. Which of the following events from the last shift is most deserving of further assessment and possible interventions?

A 79-year-old male client displays unprecedented forgetfulness.

Which of the following individuals is likely to have the highest risk of developing tuberculosis osteomyelitis?

A 79-year-old man who is immunocompromised following a bone marrow transplant

A 30-year-old woman, who just found out that she is pregnant, seeks a treatment for her severe acne. What is the most appropriate treatment for her skin condition?

A benzoyl peroxide agent

Which of the following newborn infants demonstrates the highest risk of presenting with developmental dysplasia of the hip (DDH)?

A girl who was born with toeing-in and who was in a breech presentation

A 40-year-old male client with multiple health problems has been diagnosed with a testosterone deficiency. The nurse knows that which of the following assessment findings would correlate with a testosterone deficiency? Select all that apply.

A high-pitched voice A low muscle mass in proportion to his total body weight

Which of the following infants most likely requires medical intervention?

A male infant whose vertex delivery resulted in a brachial plexus injury

Which of the following changes in an 86-year-old male's skin would necessitate further examination and possible medical treatment?

A new mole-like growth on his forearm

An ECG technician is performing an ECG on a hospital patient who has developed hypokalemia secondary to diuretic use. Which of the following manifestations of the client's health problem will the technician anticipate on the ECG?

A prominent U wave and a flattened T wave

A man's primary care physician has characterized his skin lesion as being a temporary eruption but has cautioned him against repeated rubbing or scratching as to avoid lichenization. What is the most likely categorization of the man's skin lesion?

A rash

A client is experiencing muscle atrophy following 2 weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the client's muscle cells?

A reduction of skeletal muscle use secondary to the traction treatment

A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. Which of the following phenomena most likely contributed to her present condition?

A sharp reduction in the number of lactobacilli in the client's vaginal flora.

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 of the following phenomena would the physician most likely suspect as contributing factor to the boy's short stature?

A shortage of hypothalamic GHRH production

A clinician who works on a cardiac care unit of a hospital is providing care for a number of clients. Which client most likely has a genetic disorder arising from inheritance of a single gene?

A tall, thin, myopic, 28-year-old woman with mitral valve prolapse

The father of an 18-month-old girl noticed a small vesicle on her face several days ago. The lesion ruptured and left a straw-colored crust that remained on the girl's face. The eruption of new vesicles has prompted him to bring the child to the emergency department. Which of the following treatments for the child's skin problem is most likely?

A topical antibiotic

A 41-year-old female with a family history of breast cancer 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 of the following principles?

A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.

Which of the following statements about types of obesity is most accurate?

A waist-hip ratio greater than 1.0 in men can be interpreted to mean upper body obesity.

A patient exhibiting problems with his or her thyroid has been scheduled for a radioactive scan. From the following list of patients, what would the nurse question as to whether this would be a safe procedure for this patient?

A young female patient who has been trying to get pregnant

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which of the following teaching points 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 not only on 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."

During a prenatal education class, a participant has related a story about how her friend's infant died of sudden infant death syndrome (SIDS). What can the educator tell the group about how they can prevent SIDS when they have their babies? Select all that apply.

A) "The best sleeping position for your baby is on his back." C) "Using drugs during pregnancy has been shown to be associated with SIDS after birth, which is one more reason for mothers to avoid them." D) "It's important if anyone in your home smokes to make sure they only do it outside."

Which of the following individuals are at risk of developing metabolic alkalosis? Select all that apply.

A) A 70-year-old woman who has taken two tablespoons of baking soda to settle her "sour stomach" B) A hospital patient who is on nasogastric suction following gastric surgery C) A 20-year-old male who has been regularly inducing himself to vomit following binge eating

Of the following list of nursing interventions, which would be considered priority when managing a patient with life-threatening myxedematous 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.

Which of the following endocrine functions are responsible for increased resorption of bone that results in a reduction of the number and function of osteoclasts? Select all that apply.

A) Calcitonin secretion B) Decrease in estrogen levels

A 31-year-old woman and her husband have presented to their family physician due to their inability to conceive a child after trying for the last 18 months. Which of the following will the nurse practitioner want to specifically rule out as potential contributing factors? Select all that apply.

A) Cryptorchidism in the husband B) Slow maturation of the endothelial lining after ovulation C) Low levels of LH and FSH in the wife E) Sexually transmitted diseases like gonorrhea or chlamydial infection.

A 55-year-old male client with a history of cardiovascular disease has been admitted to the intensive care unit after recovering from cardiogenic shock. In the hours since admission, the client's arterial blood gases indicate acidosis, most likely acute lactic acidosis. Which of the following signs, symptoms, and diagnostic findings might his care team anticipate before the acid-base balance is restored? Select all that apply.

A) Decreased pH B) Cardiac dysrhythmias C) Decreased alertness and cognition E) Nausea and vomiting

The neonatologist suspects an infant has developed sepsis with multiorgan system illness. The nurse caring for this infant will note which of the assessment findings support this diagnosis. Select all that apply.

A) Decreasing BP with increase in heart rate indicative of shock B) Prolonged PT and PTT and decrease in platelet count

While taking BP for a new geriatric patient, the nurse notes that his BP is 162/70. When questioned by the nurse, the patient states, "That's a pretty good BP for me. My upper number is usually higher." Based on this finding, the nurse should further collect data related to which of the following body systems? Select all that apply.

A) Detailed history surrounding cardiac events like chest pain or pressure B) Any paresthesia in limbs or noticeable facial drooping C) Decrease in urine output with increase in edema in the feet/legs

The nurse should anticipate that a patient diagnosed with spastic bladder dysfunction may be prescribed which of the following medications that will help decrease detrusor muscle tone and increase bladder capacity? Select all that apply.

A) Ditropan (Oxybutynin), an antimuscarinic drug B) Detrol LA (tolterodine tartrate), an antimuscarinic drug

If a male child was born with Klinefelter syndrome, as the child matures and becomes an adolescent, the nurse will assess the child for which of the following clinical manifestations listed below? Select all that apply.

A) Enlarged breast tissue B) Sparse facial and pubic hair C) Tall stature out of proportion

A premature infant who is receiving care in a neonatal intensive care unit (NICU) has just been identified as having necrotizing enterocolitis (NEC).

A) Feeding intolerance C) Hard, taut abdomen with increasing distention D) Blood noted in stools

While working in a sexually transmitted disease (STD) clinic, the nurse should be aware that which of the following diagnostic tools are available for diagnosing chlamydial infections? Select all that apply.

A) Gram stain where polymorphonuclear leukocytes are identified B) Direct fluorescent antibody testing C) Enzyme-linked immunosorbent assay (ELISA) E) Nucleic acid amplification tests (NAATs)

The ICU nurse is concerned with her patient's arterial blood gas (ABG) results—especially the pH 7.30; and PCO2 49 mm Hg. The nurse interprets these ABG results to mean respiratory acidosis. The nurse knows which of the following are clinical manifestations of respiratory acidosis? Select all that apply.

A) Headache with complaints of blurred vision B) Muscle twitching

Testing for short stature growth hormone (GH) problems can be done by pharmacologic means. Which of the following medications can be utilized to test for a rise in GH? Select all that apply.

A) Insulin B) Levodopa

Prior to performing a laparoscopy, a patient exhibiting which of the following clinical manifestations would be treated with oral antibiotic therapy for suspected pelvic inflammatory disease (PID)? Select all that apply.s

A) Lower abdominal pain. B) Tenderness when cervix is touched during bimanual exam. D) Purulent cervical drainage noted on tissue after voiding. E) Elevated white cell count.

The nurse knows that a diabetic patient admitted for a lower limb infection likely is experiencing which of the following pathophysiologic principles listed below? Select all that apply.

A) Many diabetic patients have sensory deficits and ignore minor trauma just because they can't feel it in their feet. B) Patients with chronic diabetes may have vascular problems that impair circulation, and therefore cells needed for adequate inflammatory response cannot reach the site. C) Hyperglycemia may provide an environment that enhances the growth of microorganisms.

When explaining the role of protein and the nine essential amino acids' needs of the body to a group of students, the nurse should emphasis that which of the following foods are complete proteins (foods that provide the essential amino acids in adequate amounts)? Select all that apply.

A) Milk B) Fish C) Poultry D) Nuts E) Grains

A pediatric unit will be receiving an 8-day-old infant with a suspected congenital renal disorder. Which of the following renal abnormalities could be the possible cause? Select all that apply.

A) One of the infant's kidneys may have failed to develop normally. B) The kidneys may be misshapen and have cysts present. C) The upper or lower poles of the two kidneys may be fused.

A boy has arrived home after experiencing his first outdoor camping trip with his Boy Scout troupe. Upon arrival at home, he is very uncomfortable and scratching at a rash. It appears that he contacted poison ivy and that it has spread to many areas on his body. The nurse in the clinic will likely prescribe which of the following treatment measures for this child? Select all that apply.

A) Prescription for corticosteroids. B) Cool showers especially right before bedtime. C) Over-the-counter antihistamines.

A 13-year-old female is undergoing rapid development of her breasts after experiencing menarche several months ago. Which of the following hormones are active in the development of her breasts? Select all that apply.

A) Prolactin C) Luteinizing hormone D) Estrogen E) Follicle-stimulating hormone F) Progesterone

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 of the following 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

The physician has asked a newly diagnosed cardiac patient to begin taking omega-3 fatty acids to help prevent inflammation and blood clotting. The patient asks the nurse what types of food sources are high in omega-3 fatty acids. The nurse should educate the patient to increase his intake of which of the following items? Select all that apply.

A) Salmon B) Walnuts C) Seeds

The nurse caring for a male child with respiratory problems is concerned he may be developing respiratory failure. Upon assessment, the nurse knows that which of the following are clinical manifestations of respiratory failure? Select all that apply.

A) Severe accessory muscle retractions B) Nasal flaring C) Grunting on expiration

An elderly patient suspected of having delirium will likely display which of the following clinical manifestations? Select all that apply.

A) Sudden onset of agitation B) Disorganized thinking pattern C) Altered level of consciousness

A female client with suspected glomerular disease has been referred to a nephrologist. The nurse knows that which of the following clinical manifestations may be present with the diagnosis of acute nephritic syndrome? Select all that apply.

A) Sudden onset of hematuria B) Proteinuria E) Edema

A 17-year-old male experienced third-degree full-thickness burns 2 days ago to his lower limbs after a fire at his workplace. Which of the following complications should his care team foresee and regularly assess for? Select all that apply.

A) Systemic infection B) Fluid volume deficit C) Respiratory dysfunction D) Hypermetabolic response E) Constipation and bowel obstruction

While taking a prenatal history, the nurse would be most concerned about severe teratogenic effects on the fetus if the mother admits to taking which medications prior to finding out that she was pregnant. Select all that apply.

A) Warfarin (Coumadin) for chronic atrial fibrillation B) Ethyl alcohol ingestion regularly every weekend and some nights throughout the week C) Isotretinoin (Accutane) for acne D) Over-the-counter cetirizine (Zyrtec) for seasonal allergies

Which of the following clinical manifestations would lead the nurse to suspect the renal failure patient is developing uremia? Select all that apply.

A) Weakness and fatigue B) Lethargy and confusion C) Extreme itching

Following kidney transplantation, the patient is prescribed maintenance immunosuppressive therapy consisting of prednisone, azathioprine, and cyclosporine. Educating the patient about long-term maintenance on immunosuppressive therapy should include discussion of side effects that may include: (Select all that apply).

A) cardiovascular complications. B) increased risk of developing cancer.

A teenage female has been admitted for complications resulting from bulimia nervosa. She has abused laxatives for many years and has been self-inducing vomiting since the age of 9. The nurse's admission assessment should pay close attention to which of the following complications that can arise from this disorder? Select all that apply. Assess for

A) dry, cracked lips and poor skin turgor. B) missing tooth enamel and increased number of dental cavities. C) painful swallowing and stomach cramping related to reflux and esophagitis.

Child/parents are coming into the physician's office to get the results of some diagnostic testing relating to his knee pain and unusual stiffness and fatigue. The physician suspects the child may have slipped capital femoral epiphysis. The nurse should anticipate that the treatment will involve: Select all that apply.

A) no weight bearing on the femur. B) bed rest. C) traction.

Vitamin D is integral to the regulation of calcium and phosphate levels. Put the following steps in the action of vitamin D into the correct sequence. Use all the options. A) Vitamin D is present in the skin or intestine. B) Vitamin D is concentrated in the liver. C) Absorption of calcium from the intestine increases. D) Vitamin D is transported to the kidneys. E) Calcitriol is produced.

A, B, D, E, C

While on tour, a 32-year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include temperature 46.8°C (101.8°F), blood pressure 89/48 mm Hg, and heart rate 116 beats/minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of the following diagnoses would the care team suspect first?

Acute pancreatitis

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, pulse 88, BP 140/87, and respiratory rate 18. Which of the following potential contributing factors would the health care team suspect first?

Alcohol consumption

The Women's Health Initiative results have led the Institute of Medicine (2010) to recommend which of the following guidelines related to hip fractures in women?

All adults should take 600 IU/day of vitamin D to maintain healthy bones.

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 of the following statements would best characterize a high positive predictive value but a low negative predictive value for this screening test?

All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

A 4-year-old boy who has been deaf since birth and has bilateral cataracts has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the health care team's initial differential diagnosis most likely be?

Alport syndrome

Which of the following recent admissions to an emergency department is most likely to be diagnosed with a greenstick fracture?

An 8-year-old boy who fell out of a tree and on to his arm

Which of the following individuals would be considered to be at risk for the development of edema? Select all that apply.

An 81-year-old man with right-sided heart failure and hypothyroidism A 34-year-old industrial worker who has suffered extensive burns in a job-related accident A 22-year-old female with hypoalbuminemia secondary to malnutrition and anorexia nervosa

The nurse knows that which of the following patients listed below is at high risk for developing a hip fracture?

An 82-year-old female with macular degeneration and uses a walker to go to the bathroom.

A nurse is providing care for a client who has had a cast applied to her fractured arm 6 hours prior.

Assessment of motor and sensory function with the goal of identifying compartment syndrome

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. Which of the following aspects of the etiology of celiac disease would underlie the explanation that the physician provides?

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

While reviewing the role of glucagon in regard to regulation of blood glucose, the nurse knows which of the following situations could lead to an inhibition of glucagon release?

An increase in glucose levels.

A new patient arrives at the clinic. The physician is suspecting that the patient may have systemic lupus erythematosus (SLE) given the clinical manifestations related to joint pain, skin changes, and a history of pleural effusions. The nurse should anticipate which of the following diagnostic test will be a priority to facilitate with the diagnosis?

Anti-DNA antibody test

Following a long history of intermittent back pain and urinary urgency, a 50-year-old client has been diagnosed with chronic bacterial prostatitis. Which of the following factors is most likely to influence his health care provider's choice of treatment?

Antibacterial drugs penetrate poorly into the chronically inflamed prostate.

After a long and frustrating course of constant vaginal pain, a 38-year-old woman has diagnosed with generalized vulvodynia by her gynecologist. What treatment plan is her physician most likely to propose?

Antidepressant and antiepileptic medications

A nurse is teaching a group of older adults about the value of including foods containing antioxidants in their diet. Which of the following statements best captures the rationale underlying the nurse's advice?

Antioxidants inhibit the actions of reactive oxygen species.

A 44-year-old woman who has a long-standing diagnosis of SLE has been able to control her symptoms with lifestyle modifications for several years, but has presented to her care provider due to recent exacerbation. Which of the following pharmacological treatment options is her care provider most likely to rule out first?

Antiplatelet aggregators

A 17-year-old female has announced to her family physician a desire to wholly eliminate fats from her diet. Which of the following aspects of the role of fats would underlie the physician's response to the client?

Apart from providing energy, fats are necessary as carriers of certain vitamins and are precursors to prostaglandins.

Which of the following structures would likely be present in a hair follicle in a man's groin but not in a follicle on his face?

Apocrine gland

A frustrated 26-year-old female has sought a referral to a dermatologist in an effort to resolve her sweating and body odor that persists despite good hygiene. Which of the following facts would underlie the explanation that her physician provides about her problem?

Apocrine sweat glands produce a substance that is more oily than sweat from other sources.

A patient being seen in the clinic has just received his routine lab results. The patient has been told that his cholesterol level is extremely elevated. The physician plans to give the patient a prescription for medication to help control this condition. Which of the following medications should the nurse prepare to educate the patient on?

Atorvastatin (Lipitor)

A young patient has just been diagnosed with xeroderma pigmentosum. When teaching the family about this disease, the nurse should emphasize which of the following points? Select all that apply.

B) "Wear long sleeves, long pants, gloves, a hat, sunglasses with side shields, and sunscreen while outdoors." D) "The best time to allow the child to play outside is in the evening hours after the sun goes down."

Which of the following patients scheduled for an interventional radiology procedure requiring administration of radiocontrast dye would be considered at high risk for nephrotoxicity? Select all that apply.

B) A 25-year-old with a history of glomerular nephritis who is complaining of severe flank pain C) A 67-year-old diabetic undergoing diagnostic testing for new-onset proteinuria

An 81-year-old woman has noted a gradual decrease in the moisture of her skin over many years. Which phenomena associated with the aging process are known to contribute to her xerosis? Select all that apply.

B) Changing composition of sebaceous gland secretions C) Flattening of the dermal rete ridges D) Decreased moisture secretions from sweat glands E) Decrease in skin capillaries

The nursery has just admitted a new infant born 1 hour ago. While performing an assessment, the nurse suspects the infant may have hypoglycemia based on which of the following assessment data? Select all that apply.

B) Infant having periods of apnea requiring physical stimulation C) Muscle twitching noted while lying in crib undisturbed by nurses E) Poor suck reflex resulting in an inability to feed properly

A 14-year-old boy has experienced a pronounced growth spurt over the last several months. While discussing this with his parents, the nurse educates what normal male growth patterns contain. Of the following, which are accurate statements to relay to the parents? Select all that apply.

B) It is not usual for their son to gain up to 30 kg in weight. D) Expect the thorax to become broader and for the pelvis to remain narrow.

Which of the following factors are known to contribute to vaginal yeast infections? Select all that apply.

B) Poorly controlled diabetes C) Recent antibiotic therapy E) Use of oral contraceptives F) High hormone levels during pregnancy

The nurse working in a pediatric office is scheduled to assess a female adolescent diagnosed with neurofibromatosis (NF) type 1. During this assessment, the nurse should be assessing the teenager for which of the following clinical manifestations of NF-1? Select all that apply.

B) Severe scoliosis D) Complaints of having a hard time concentrating in school E) Speech impediments

When explaining to a patient why his prostate is enlarging, the nurse will mention that which of the following hormones may contribute to the prostatic hyperplasia? Select all that apply.

B) Testosterone C) Dihydrotestosterone D) Estrogens

The neuroscience nursing unit has developed a set of step-by-step directions of what should occur if a nursing assessment reveals that the patient may be exhibiting clinical manifestations of a cerebrovascular accident (CVA).

B) The development of evidence-based practice guidelines requires a research review from different studies to develop the most accurate diagnostic method to implement. D) 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. E) A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method.

A 9-year-old boy has been diagnosed with the nephrotic syndrome. Place the following stages in the development of his health problem in ascending order. Use all the options. A) Hypoalbuminemia B) Increased glomerular membrane permeability C) Decreased colloidal osmotic pressure D) Proteins escape from the plasma to the glomerular filtrate E) Accumulation of fluid in the interstitial tissue (edema)

B, D, A, C, E

A health care researcher has identified the gene of interest in a particular genetic disorder as well as the gene's location Xq97. Where would one find a gene named Xq97?

Band 9, region 7 of the long arm of the X chromosome

While speaking to a senior citizen club about osteoarthritis (OA), which of the following facts are accurate to share? Select all that apply.

By the time you are in your 70s, about 85% of adults will have some form of OA Obesity in women has been correlated to having OA in the knees

A patient is suspected to have osteomalacia based on his clinical manifestations and lab/diagnostic workup (low calcium levels, transverse lines on x-ray). The nurse would expect the patient to have which of the following clinical manifestations? Select all that apply.

C) Bone pain. D) Muscle weakness.

Which of the following changes associated with aging contributes to heart failure development in older adults? Select all that apply.

C) Elevated diastolic BP D) Increased vascular stiffness

A 30-year-old man with a diagnosis of type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which of the following physiological processes are actions of insulin?

C) Facilitating triglyceride synthesis from glucose in fat cells D) Inhibiting protein breakdown E) Promoting glucose uptake by target cells

A patient is showing the nurse some changes in his skin that he found while taking a shower. Which of the following lesions would give the nurse concern that it might be a precancerous lesion? Select all that apply.

C) Several dry, brown, scaly lesions that are approximately 1 cm in diameter, and a few of the lesions are showing some ulceration. D) Tan to brown lesions commonly called "liver spots" are located on the forearm and hands.

A 68-year-old woman has had her mobility and quality of life severely affected by rheumatoid arthritis (RA). Place the following pathophysiological events involved in her health problem in the correct order that they most likely occurred. Use all the options. A) Inflammatory response B) Interaction between rheumatoid factor (RF) and IgG C) T-cell-mediated immune response D) Pannus invasion E) Destruction of articular cartilage

C, B, A, D, E

Unbeknownst to him, a 30-year-old male has contracted Treponema pallidum during a sexual encounter the night before. Place the following manifestations of the microorganism in the chronological order that they would occur in the absence of treatment. Use all the options. A) Formation of aneurysms B) Appearance of a rash on the man's palms and feet C) Development of painless chancres on the man's scrotum. D) Latency

C, B, D, A

A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options. A) Decrease in pH B) Breakdown of triglycerides C) Low serum insulin levels D) Ketone production by the liver E) Production of fatty acids and glycerol

C, B, E, D, A

A male infant who is 48 hours postpartum is undergoing phototherapy for the treatment of jaundice and accompanying high levels of bilirubin. Place the following components of the production of bilirubin in the correct chronological order. Use all the options. A) Conjugated bilirubin B) Urobilinogen C) Red blood cells D) Biliverdin E) Free bilirubin

C, D, E, A, B

When explaining how carbon dioxide combines with water to form carbonic acid as part of acid-base lecture, the faculty instructor emphasized that which enzyme is needed as a catalyst for this reaction?

Carbonic anhydrase

Which of the following is an aspect of the bone growth and development that occurs during the first two decades of life?

Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells.

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 of the following types of study is the epidemiologist most likely conducting?

Case-control study

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 of the following characteristics of cell membranes underlies the nurse's teaching?

Cell membranes are impermeable to all but lipid-soluble substances.

A 42-year-old female client with a long-standing history of chronic nausea and vomiting but a near-insatiable appetite has had her symptoms attributed to an enzyme deficiency.Further diagnostic testing indicates that she has inadequate pancreatic enzyme levels and that her large appetite is due to a lack of enzyme control of food intake inhibition. In which of the following enzymes is the woman most likely deficient?

Cholecystokinin

A student is trying to understand the possible reasons that a genetic abnormality might exist in an individual. Which of the following reasons is most plausible?

Chromatin has maintained its stable structure during the DNA replication process.

A woman gives birth to a small infant with a malformed skull. The infant grows abnormally slowly and shows signs of substantial cognitive and intellectual deficits. The child also has facial abnormalities that become more striking as it develops. What might you expect to find in the mother's pregnancy history?

Chronic alcohol use

Which of the following medications used in the treatment of peptic ulcers and gastroesophageal reflux binds to H2 receptors and blocks the action of histamine on parietal cells?

Cimetidine (Tagamet)

A 24-year-old woman undergoing a premarital screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which of the following treatments is most likely to be effective for her?

Corticosteroids and immunosuppressant drugs

As a follow-up to the introduction of a new medication regimen for an older adult client, the physician is interpreting the client's recent blood work, paying particular attention to the client's serum creatinine (Cr) levels (normal range 0.6 to 1.2 mg/100 mL) and glomerular filtration rate or GFR (normal value >60 mL/minute). Which of the following lab results would be considered typical of an older adult with impaired renal function?

Cr 1.1; GFR 22

A 28-year-old man presents with complaints 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 complains of pain and stiffness in his elbows and knees. Sigmoidoscopy reveals discontinuous, granulomatous lesions; no blood is detected in his stool. Which of the following diagnoses would his care team first suspect?

Crohn disease

Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of which of the following?

Crystallization of inorganic salts

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?

Cytoplasm

Following the diagnosis of acute renal failure, the nurse knows that one of the earliest manifestations of residual tubular damage is which of the following lab/diagnostic results?

Elevated blood urea nitrogen (BUN)

Events in the ovulatory cycle progress in a similar manner each month. Place the following events in the ovulatory cycle in the correct chronological order. Use all the options. A) Formation of the theca B) Formation of the corpus luteum C) Formation of the antral follicle D) Development of the zona pellucida E) Bursting of the mature follicle

D, A, C, E, B

The nurse is providing teaching to a student nurse about how antidiuretic hormone (ADH) plays a central role in the reabsorption of water by the kidneys. The nursing student is correct to place the following components of the homeostatic action of ADH in the correct sequence. Use all the options. A) Stored ADH is released into circulation. B) ADH is transported along a neural pathway to the posterior pituitary gland. C) Aquaporins are inserted into tubular cell membranes. D) ADH is synthesized by cells in the supraoptic and paraventricular nuclei of the hypothalamus. E) Serum osmolality increases.

D, B, E, A, C

Place the following components of the gastrointestinal tract in the chronological order that a bolus of food would pass through them. Use all the options. A) Ileum B) Pylorus C) Jejunum D) Hiatus E) Cecum F) Duodenum

D, B, F, C, A, E

Following a 14-day course of broad-spectrum antibiotics for the treatment of sepsis, a 60-year-old woman has developed watery diarrhea. Her care team attributes this to likely elimination of normal intestinal flora by the antibiotics. What other phenomena is most likely accompanying her low levels of normal flora?

Decreased fermentation of undigestible dietary residue; decreased vitamin absorption

A 22-year-old woman has sustained a lateral blow to her right knee during a game, and subsequent imaging has confirmed a severe meniscus injury. Which of the following consequences should the woman expect over the course of recovery? Select all that apply.

Decreased lubrication in the knee joint Decreased stability of the knee Reduced shock absorption capacity

An 80-year-old female with a diagnosis of osteoporosis receives daily supplements of calcitonin in the form of a nasal spray that she instills each morning. Which of the following phenomenon would her care providers expect to result from her supplementation?

Decreased serum calcium levels

The exasperated parents of a 4-month-old infant with colic have asked their health care provider what they can do to alleviate their child's persistent crying. Based on their concerns, the nurse should educate/discuss with the parents which of the following?

Demonstrating how to use a soothing voice and slow rocking back and forth as a way to calm the infant

The health nurse is dealing with a case of untreated chlamydial infection. The nurse suspects the patient has developed Reiter syndrome. Which of the following clinical manifestations would support this diagnosis? Select all that apply.

Diffuse pinkness of the conjunctiva along with watery and itchy eyes B) Asymmetric complaints of stiffness and pain in knees and sacroiliac joints D) Pain when urinating

A pancreatitis patient is admitted with weight loss, nausea, and vomiting. To maintain nutrition, the physician orders parental nutrition to be started. Knowing that a major side effect of parenteral nutrition is a hyperosmolar hyperglycemic state, the nurse should assess the patient for which clinical manifestation (listed below)?

Dry lips, excess urine output, and seizures

Sperm follow a prescribed route through the excretory ducts of the male reproductive system. Place the following components of the genital duct system in the order that sperm follow. Use all the options. A) Efferent ductules B) Ductus deferens C) Prostatic urethra D) Urethra E) Seminiferous tubules F) Epididymis

E, A, F, B, C, D

A physician is working with a family whose daughter has been recently diagnosed with the chromosomal disorder Turner syndrome. The physician would recognize that which of the following statements about the characteristics of human chromosomes is accurate?

Each of the 22 pairs of autosomes has a homolog.

Which of the following statements best captures an aspect of normal spermatogenesis?

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

An 11-year-old girl is suspected of having Turner syndrome. Which of the following diagnostic tests would be the most useful component of screening to confirm or rule out the diagnosis?

Echocardiogram

A 53-year-old woman with a history of chronic alcohol abuse but without visible jaundice comes to the clinic complaining of nausea and weakness. She admits to taking acetaminophen for persistent headaches but denies exceeding the recommended daily dose; she has not taken any other medications. She is suspected of having acetaminophen toxicity. Which of the following diagnostic test findings would implicate a different cause of her symptoms?

Elevated serum HBsAg level

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 of the following health problems would the care team first suspect?

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 of the following statements is most likely to be true of this client?

Estrogen will continue to pass freely through the cellular membranes.

A pregnant client who is taking Risperidone (Risperdal), an antipsychotic prescribed for her bipolar disorder, is at high risk for developing which of the following hormonal adverse effects?

Excess prolactin secretion

A 15-year-old who has just been diagnosed with type 1 diabetes says she read on the Internet that diabetes is the leading cause of acquired blindness among Americans. She asks you if she will lose her sight. In addition to explaining that new treatment technologies are being worked on every day, which of the following would be the most appropriate response?

Explain that almost all people with type 1 diabetes do experience some degree of vision loss.

After falling off his bicycle, an 8-year-old boy has a large abrasion on his posterior thigh that has removed the epidermis in the region but left the dermis largely intact. Which of the following changes in integumentary system would be expected in the area of his wound?

Fewer Merkel and Langerhans cells in the region

A nurse in an acute medical unit of a hospital has admitted a 62-year-old female from the emergency department who has been diagnosed with acute pyelonephritis. Which of the following statements most accurately conveys an aspect of the knowledge base that the nurse needs to perform adequate care and teaching?

Flank pain, dysuria, and nausea and vomiting are likely assessment findings.

A client is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in lower lung fields bilaterally. What is the client's most likely diagnosis?

Fluid volume excess

A 14-year-old boy, appearing to be intoxicated, is brought to the emergency room by ambulance. The EMTs report that the boy has denied consuming anything out of the ordinary, but an open antifreeze container was found in the boy's room. Which of the following is likely to be used to treat the patient's symptoms?

Fomepizole

Having heard positive reports of the benefits of hormone therapy (HT) from her sister-in-law and friends, a 49-year-old woman has presented to her family physician asking to start HT. Her uterus is intact, and previous bone scans have indicated low bone density. The client also has a family history of heart disease. She characterizes her symptoms of menopause as "noticeable, but not debilitating by any means." Based on the most current research, what is her physician's best course of action?

Forego HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life.

A researcher is involved in the investigation of an individual's genetic abnormality. Which of the following situations could the researcher most likely rule out as the genetic cause of a mutation?

Formation of an adenine-uracil base pair

A woman has recently determined that she is pregnant, and her clinician believes that the conception occurred around 8 weeks prior.

Formation of upper limbs and opening of the eyes

A 40-year-old man who is morbidly obese and leads a sedentary lifestyle has recently been diagnosed with type 2 diabetes. Which of the following aspects of the man's obesity likely contributed to his new health problem?

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

Following exposure to poison oak while camping, a 20-year-old male is experiencing pruritus as a consequence of his immune response to irritants in the plant. What physiological process best accounts for his complaint?

Free nerve endings are initiating an itch-specific signal to the somatosensory cortex.

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 pathophysiological principle?

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

Which of the following measures would likely be rejected as part of a first-line weight loss plan for a client with a BMI of 30.2, type 2 diabetes, and hypertension?

Gastric bypass

When a 4-year-old boy stands erect with his medial malleoli touching, the distance between his knees is 2 inches. What is the child's most likely diagnosis and treatment?

Genu varum, which can be treated by bracing

A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last 2 days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's first priority?

Gonorrhea

During pathophysiology class, a nursing student asks the faculty what purpose do the osteoprogenitor cells serve. From the following list, identify the purpose of these cells. Select all that apply.

Growth and remodeling of bone Repair of bone

A science teacher is talking to a group of fifth graders about the role of "spit." During the course of the discussion, the teacher asks the students which of the following are functions of saliva?

Has antibacterial action to help keep the mouth clean

If there is a sudden change in extracellular fluid osmolality that results in a too rapid blood glucose lowering, the nurse will likely observe which of the following clinical manifestations? A patient has been admitted with diabetic ketoacidosis. The emergency department starts an IV to improve circulatory volume.

Headaches, dizziness, change in level of consciousness

A 7-year-old boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which of the following assessment findings is most congruent with the client's diagnosis?

Hemoglobin 9.9 g/dL

A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the client's liver and diagnostic results would the care team most likely anticipate?

Hepatocellular necrosis evidenced by increased ALT and AST levels

A 55-year-old woman has presented to the emergency department following a panic attack. Her blood pressure, respiratory rate, and heart rate are all highly elevated, while her temperature and oxygen saturation are within normal ranges. What is the woman's body most likely doing to address the changes in pH associated with her situation?

Her kidneys will limit the amount of bicarbonate that they reabsorb.

A 62-year-old woman with high blood pressure is to begin long-term treatment with a thiazide diuretic that she thinks she will need to take for some time. What should the nurse expect to happen to her potassium and calcium levels?

Her potassium level will drop, but her calcium level may rise.

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 of the following statements best conveys an accurate epidemiological characterization of the disease?

High morbidity; low mortality; high prevalence, low incidence

The laboratory technologists are 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 patients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of patients who do not have cardiac etiologies for their shortness of breath also test positive. Which of the following statements best characterizes this blood test?

High sensitivity; low specificity

A 29-year-old woman has been trying for many months to become pregnant, and fertilization has just occurred following her most recent ovulation. What process will now occur that will differentiate this ovulatory cycle from those prior?

Human chorionic gonadotropin will be produced, preventing luteal regression.

A 73-year-old man presents to his family physician with complaints of recent urinary hesitation and is eventually diagnosed with benign prostatic hyperplasia (BPH). Which of the following clinical consequences would his care provider expect prior to the resolution of his health problem?

Hydroureter and pain

A 68-year-old woman with a new onset of vascular dementia has recently begun retaining urine. Which of the following physiological phenomena would her care providers most realistically expect to currently occur as a result of her urinary retention?

Hypertrophy of the bladder muscle and increased bladder wall thickness

A nurse practitioner is providing care for a male client with a long-standing hiatal hernia. Which of the following statements most accurately captures an aspect of the pathophysiology of hiatal hernias?

If esophageal acid clearance is impaired, esophagitis can result.

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 of the following statements best captures the rationale for the procedure?

If the prostate is hardened on examination, a biopsy is indicated for further investigation.

A 54-year-old diabetic patient has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease that required CABG 3 years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil (Viagra). Which of the following home medications is contraindicated if taken concurrently with sildenafil?

Imdur (isosorbide mononitrate), a vasodilator

A 16-year-old boy has been diagnosed with ankylosing spondylitis. Which of the following etiologies is responsible for his health problem?

Immune response

A 25-year-old Asian American man arrives in the emergency room in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine.

Immunoglobulin A nephropathy and may be advised to use omega-3 fatty acids to delay progression of disease

A 51-year-old female has been found to have a metastatic lesion in her lung, and her oncologist is unsure of the site of the primary tumor. Which of the following procedures is most likely to aid in this determination?

Immunohistochemistry

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 of the following health consequences would be attributa Which of the following health consequences would be attributable to her low levels of cortisol?

Impaired immunological and inflammatory response

A 40-year-old male client has a congenital syndrome that affects the function of the Langerhans cells of his epidermis. The man's care provider would expect which of the following manifestations of his condition?

Increased susceptibility to infection

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.

Increased white cell count and audible crackles on chest auscultation

A 20-year-old male who is addicted to crystal methamphetamine has been admitted to a hospital with a diagnosis of protein-calorie malnutrition after many months of inadequate food intake. Which of the following treatment plans would the care team most likely favor?

Incrementally feeding combined with vitamin and mineral supplementation

A nurse who works in a neonatal intensive care unit is providing care for an infant born at 26 weeks' gestation. Which of the following assessments would lead the nurse to suspect that the infant has developed respiratory distress syndrome (RDS)?

Infant is grunting and has notable intercostal retractions with respirations.

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. The diarrhea is bloody, frequent, and small in volume. These clinical manifestations are sufficiently distressing that he is visiting a local medical clinic in the area. Which of the following diagnoses best characterizes this health problem?

Inflammatory diarrhea

The nurse knows that when combined continuous estrogen-progesterone therapy (CCEPT) is prescribed, the drug is considered effective if which of the following occurs?

Inhibited endometrial development resulting in no menses

Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect?

Inhibition of the actions of Brunner glands

When educating the patient about possible treatments following surgery for bladder cancer, the nurse might include which of the following chemotherapy options? Select all that apply.

Intravesical chemotherapy with doxorubicin (Adriamycin) Bacillus Calmette-Guérin (BCG) vaccine Endocan, a tumor angiogenesis inhibitor

The patient who has been consuming a very low-calorie diet (VLCD) of 450 kcal/day should be assessed for which of the following high-risk complications? Select all that apply.

Irregular heart rhythms Abdominal pain related to gallstones

A patient with excruciating back pain that has been getting worse over the past few months comes to the Emergency Department. His chief complaint is excruciating back pain that has been getting worse over the past few months. He has also noticed decreased sensation in his lower extremities, some urinary incontinence, and feels like he never really empties his bladder all the way after voiding. Following diagnostic testing, the patient is diagnosed with advanced prostate cancer with spinal cord compression. The nurse should anticipate administering which medications to this patient? Select all that apply.

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

A patient who has just had her first postoperative dinner out to celebrate her recovery from an intestinal bypass is brought to the emergency room by her spouse. He reports that the patient seems disoriented and is slurring her words. The patient did not have any alcohol with her pasta dinner. Which of the following might be the cause of her symptoms?

Lactic acidosis

A 23-year-old woman has been referred to a fertility clinic after 1 year of attempting to become pregnant. Her diagnostic workup has resulted in a diagnosis of polycystic ovary syndrome (PCOS). What will the first line of treatment most likely consist of?

Lifestyle modifications to include weight loss by lowering calories and fat consumption

A 28-year-old female has been told she has atypical glandular cells following Pap smear. The physician will likely recommend which procedure that can be performed in his office to remove the abnormal zone and provide a specimen for further histological evaluation?

Loop electrosurgical excision procedure (LEEP)

Due to her progressing osteoarthritis (OA), an 80-year-old woman is no longer able to perform her activities of daily living without assistance. Which of the following phenomena most likely underlies the woman's situation?

Loss of articular cartilage and synovitis has resulted from inflammation caused when joint cartilage attempted to repair itself.

A 31-year-old client with a diagnosis of end-stage liver failure has been admitted to the intensive care unit of a hospital. Arterial blood sampling indicates that the man has an acid-base imbalance. Which of the following situations is most likely to result in an inappropriate pH?

Low albumin and plasma globulin levels

A 39-year-old male client has been recently diagnosed with primary hypogonadism. Which of the following lab results would be most indicative of this diagnosis?

Low testosterone levels; high levels of LH and FSH

A 31-year-old male has been referred to a fertility clinic following a count of 2 million sperm/mL on seminal fluid analysis. Which of the following 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.

Luteinizing hormone (LH) Follicle-stimulating hormone (FSH) Gonadotropin-releasing hormone (GnRH)

Which of the following components of immune function is absent in the dermis?

Lymph nodes

Which of the following situations would be classified as a complication of a disease or outcome from the treatment regimen? Select all that apply.

Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation; Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma

A 51-year-old woman who was born congenitally blind and deaf is able to distinguish individuals by light touch of the individual's face. Which of the following components of the woman's skin innervation likely contributes the most to this ability?

Meissner corpuscles

A hospital patient's arterial blood gases indicate normal levels of oxygen and increased carbon dioxide. The patient's respiratory rate is 12 breaths/minute (normal 14 to 20 breaths/minute) with all other vital signs within normal range. While not evident from assessment and diagnostics, the patient's kidneys are minimizing both H+ excretion and HCO3- reabsorption. What is this client's most likely diagnosis?

Metabolic alkalosis

A 13-year-old patient undergoing puberty is alarmed to find small, white bumps surrounding the areolae on her nipples. You reassure her that these are a normal sign of her sexual maturation and tell her that they are which of the following?

Montgomery tubercles

A speech therapist is performing a swallowing assessment on a 72-year-old man who has suffered a stroke 3 weeks ago. The man has been NPO (nothing by mouth) since his stroke, and the health care team is considering the introduction of oral food. The speech therapist is cueing the client to swallow to preclude either aspiration of food or pocketing of food in the sides of his mouth. The client most likely to have conscious control over which of the following processes listed below involved in swallowing?

Moving a bolus to the posterior wall of the pharynx

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 of the following pathophysiological phenomena is most likely to underlie the client's health problem?

Mucosal hemorrhages that have developed into crypt abscesses, which have in turn necrotized and ulcerated

A 26-year-old male patient with a diagnosis of schizophrenia has been admitted with suspected hyponatremia after consuming copious quantities of tap water. Given this diagnosis, what clinical manifestations and lab results should the nurse anticipate the patient will exhibit?

Muscle weakness, lethargy, and headaches.

An 81-year-old female has a long-standing diagnosis of hypocalcemia secondary to kidney disease. She will be moving into an assisted living facility shortly. Which of the following clinical manifestations would the nursing staff at the facility likely obs

Muscular spasms and complaints of tingling in the hands/feet

Of the following aging theory examples, which one supports the nonstochastic beliefs about aging?

Mutations in BRCA1 and BRCA2 have been associated with increased risk for developing breast and ovarian cancer.

A 35-year-old female ultramarathon runner is admitted to the hospital following a day-long, 50-mile race because her urinary volume is drastically decreased and her urine is dark red. Tests indicate that she is in the initiating phase of acute tubular necrosis. Why is her urine red?

Myoglobinuria

A 31-year-old patient with breast cancer is concerned about being prescribed a hormonal medication to help block the effects of estrogen on the growth of breast cancer cells. The nurse should provide education about which of the following likely medications?

Nolvadex (Tamoxifen), a nonsteroidal antiestrogen

While measuring the height of a 12-year-old girl during an office visit, the primary care physician noted a deviation of the girl's spine. This was subsequently quantified as being a right curve scoliosis of approximately 10-degree deviation. Which of the following treatment options is most clearly indicated?

Observation and no active treatment

At an international nursing conference, many discussions and breakout sessions focused on the World Health Organization (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 elderly population engaged in such activities as book reviews and word games during social time B) Increase in the number of chair aerobics classes provided in the skilled care facilities C) Interventions geared toward keeping the elderly 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 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What are the woman's most likely treatment and prognosis?

Oral antiprotozoals to the patient and sexual partners to help prevent complications.

While an infant is in the supine position with both knees flexed, the clinician applies gentle downward pressure to both knees, and the knee and thigh are abducted as an upward and medial pressure is applied to the proximal thigh. This examination technique, used to screen for a reducible dislocation, is called

Ortolani maneuver.

A 40-year-old female has been categorized as being obese, with a body mass index (BMI) of 33.2. Which of the following health problems place the client at a significantly increased risk for when compared with individuals with a BMI below 25? Select all that apply.

Osteoarthritis Gallbladder disease Insulin resistance

Following a fall 4 weeks prior that was caused by orthostatic hypotension, an 83-year-old male has fractured his femoral head. His care provider has stated that the healing process is occurring at a reasonable pace and that the man will regain full function after healing and rehabilitation. Which of the following cells is most responsible for restoring the integrity of the man's broken bone?

Osteoblast

A 35-year-old woman who has been in recovery from alcoholism for 2 years presents at her primary care physician's office with chronic hip pain. She reports that as part of her commitment to her recovery, she began exercising regularly about a year earlier. After a month or two, her hip began to hurt when she ran on the treadmill. She stretches, has had a physical trainer check her form to ensure that it is correct, and rests adequately between each workout. Six months ago, the pain began waking her at night, and now it is constant. She is not aware of any injury to her hip and has no other outward symptoms. Which of the following is most likely to be the cause of her pain?

Osteonecrosis

A 13-year-old girl and her father come in to the local health clinic hoping to see an orthopedic doctor about the girl's stiff and warm knee. The father reports that she hurt it sliding into base during a softball game, and the daughter concurs, but with further discussion, it becomes clear that the slide made an existing pain worse. Her knee had been stiff, warm, and shiny and had been keeping her awake at night for a week or so before the game. Which of the following might be the cause of the girl's symptoms?

Osteosarcoma

A 55-year-old man has made an appointment to see his family physician because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day. What is the man's most likely diagnosis and possible underlying pathophysiological problem?

Overactive bladder that may result from both neurogenic and myogenic sources

While explaining milk production and release to a group of expectant parents, the nurse educates the parents on the fact that suckling by the infant provides the stimulus for milk ejection. This suckling sends feedback to the hypothalamus, which stimulates the release of which hormone from the pituitary gland responsible for the ejection of milk into the ductal system?

Oxytocin

A 52-year-old patient has just passed a kidney stone and has high levels of calcium in her urine. Blood tests show high levels of calcium in her blood as well. What subsequent lab results would be most likely to distinguish between primary hyperparathyroidism and hypercalcemia of malignancy?

Parathyroid hormone level

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 of the following statements best captures the nature of his health problem?

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

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?

Performs an active role of protein synthesis, where mRNA molecules direct the assembly of proteins on ribosomes to the cytoplasm

While studying the skin in a science class, a student asks why all people have a pinkish color to their lips/mucous membranes. The instructor would respond by citing which of the following responses?

Pheomelanin is the yellow to red pigment particularly concentrated in the lips and nipples of humans.

A 13-year-old girl has presented to a clinic with her mother explaining that she had an oval-shaped red patch on her chest a week ago but that more of the lesions are now appearing on her back. On examination, the lesions on her back are in a "Christmas tree" pattern. What is the girl's most likely diagnosis?

Pityriasis rosea

Which of the following pathophysiological processes would a clinician most likely expect in a client with a diagnosis of dementia rather than delirium?

Plaques have developed between neurons, and neurofibrillary tangles have developed within neurons.

The nurse is caring for a patient in the hospital for pneumonia but also has a severe case of psoriasis that is being treated with methotrexate. During the morning assessments, which of the following lab values would alert the nurse that the patient may be experiencing a side effect to this medication? Select all that apply.

Platelet count 37 × 103/µL White blood cell count 1.2 × 103/µL

Which of the following factors in an elderly client may increase his risk for an adverse drug reaction? Select all that apply.

Poor eyesight requiring prescription lens; Short-term memory loss leading to forgetfulness (as to whether he took the medications)

A 51-year-old woman has been diagnosed with Cushing syndrome after a diagnostic workup that reveals cortisol hyper secretion. The nurse knows which of the following assessment findings would be inconsistent with her diagnosis?

Poor stress management and hyperpigmentation

An 11-year-old boy with skin lesions on his trunk characteristic of ringworm has been brought to the family's primary care provider by his mother. Which of the following aspects of the clinician's assessment relates most directly to the suspected diagnosis?

Potential contact with the fungus from pets or other children

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 of the following phenomena best accounts for the client's anorexia and cachexia?

Products of the tumor itself as well as a hypermetabolic state cause cachexia.

A nurse who works on an oncology ward is providing care for a 68-year-old female patient with a diagnosis of lung cancer with bone metastases. The client is experiencing rapid weight loss and is exhibiting the signs and symptoms of malnutrition. The nurse would recognize that which of the following factors is most likely contributing to the client's malnutrition?

Protein mass is being lost from the liver and other organs, and the liver is synthesizing fewer serum proteins.

A 55-year-old man has been diagnosed with a gastroesophageal reflux disease (GERD), in which the function of his lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely to occur?

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

When educating the parents of an infant diagnosed with hemochromatosis, the nurse should consider which of the following topics a priority for the parents to know?

Provide a restricted iron diet to prevent organ damage

A nurse who works on a urology-gynecology ward of a hospital is coming on shift and will be caring for a 34-year-old woman who has been admitted overnight for the treatment of a large endometriosis. What interventions should the nurse most realistically anticipate providing over the course of the shift and the next several days?

Providing pain control; preparing the client for a laparoscopic procedure or hysterectomy.

A 48-year-old woman has been diagnosed with extrahepatic cholestasis following a thorough history, ultrasound, and blood work. Which of the following symptoms most likely caused her to seek medical treatment, and what consequence to her health problem would the medical team anticipate?

Pruritus with consequences of deficient levels of fat-soluble vitamins

A male infant is brought into the clinic because of colic-like symptoms. The mother states he acts like something is hurting. After eating, he vomits most of the feeding and then assumes a fetal position. He is also not gaining weight. The nurse practitioner is thinking that he is displaying clinical manifestations of obstruction and may have which of the following medical diagnoses?

Pyloric stenosis

A nurse practitioner student is trying to distinguish the various rashes they will be seeing in their pediatric rotation. Their nurse preceptor is assisting by describing the rash associated with rubeola. Which of the following characteristics would apply to rubeola? Select all that apply.

Rash is macular and blotchy; The rash usually begins on the face and then spreads to the legs/arms.

A renal failure patient with severe hyperkalemia (K+ level 7.2 mEq/L) has just been admitted to the nursing unit. Given the severity of this situation, the nurse should be prepared to administer which intravenous infusion stat?

Regular insulin infusion, rate dependent on lab values

Following a motorcycle accident that resulted in bilateral femoral fractures, a 42-year-old male has been receiving skeletal traction for the past 8 days. His care providers would recognize that which of the following risks is paramount?

Risk of thromboemboli

Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder?

Secondary

While explaining to a group of nursing students what the function of the first mucosal layer of the lower two thirds of the esophagus, the pathophysiology instructor mentions which of the following functions? Select all that apply.

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

A 6-year-old child cuts his leg while playing outside. An inflammatory process begins the healing process by moving leukocytes and platelets through the endothelial lining of blood vessels.

Selectins

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

Seminoma

While discussing embryogenesis to a group of students moving through the maternity ward, the nurse quizzes them to see if they know what is happening during sonic hedgehog signaling. Which of the following answers would be considered accurate? Select all that apply.

Separation of the brain into two cerebral hemispheres; Development of the correct number of fingers and toes

A 77-year-old female hospital patient has contracted Clostridium difficile during her stay and is experiencing severe diarrhea. Which of the following statements best conveys a risk that this woman faces?

She is susceptible to isotonic fluid volume deficit.

A 51-year-old woman diagnosed with a cerebrovascular accident (CVA) 5 months prior is distressed that she has had several recent episodes of urinary incontinence. She has asked her nurse practitioner why this is the case. Which of the following statements best captures the fact that would underlie the nurse's response to the client?

She may be unable to sense her bladder filling as a result of her MS.

A nurse is providing care for a client with a diagnosis of Crohn disease. The nurse recognizes the fact that the disease involves the inflammation and irritation of the intestinal lining.

Simple columnar epithelium

In a busy STD clinic on a large university campus, a group of students have developed tetracycline- and penicillin-resistant strains of N. gonorrhoeae. Given these results, the nurse can expect that which of the following medications will be prescribed?

Single injection of Rocephin (ceftriaxone)

A community health nurse is working with an 81-year-old female client who states that she has made a concerted effort throughout her life to protect her skin from the sun and regularly applies topical moisturizers.

Skin becomes more fragile and prone to hematomas because of impaired vascularity.

A couple who have three daughters would like to add a son to their family, and they have recently learned that the woman is pregnant.

Suppression of female reproductive structures by anti-Müllerian hormone (AMH)

A 71-year-old male with a suspected diagnosis of osteoarthritis is being scheduled for a knee aspiration. The client is surprised to learn that his knee joint contains fluid and asks the physician ordering the procedure what the main role of the fluid is. Which of the following statements best underlies the explanation that the physician will provide?

Synovial fluid allows for joint movement by minimizing friction.

While reviewing the following diagnostic findings on a group of patients with joint complaints, which finding would be a priority for further investigation and possible medical intervention?

Synovial fluid aspiration indicates the presence of monosodium urate crystals.

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 its sugar that's the problem." What aspect of physiology will underlie the care provider's response to the client?

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

A 61-year-old woman who has had an upper respiratory infection for several weeks has presented to her family physician with complaints of a recent onset of urinary retention. She reveals to her physician that she has been taking nonprescription cold medications over and above the suggested dose for the past 2 weeks. Which of the following phenomena will her physician most likely suspect is contributing to her urinary retention?

The anticholinergic effects of the medication are impairing normal bladder function.

Following bone density scanning and diagnostic imaging, a 4-year-old boy has been diagnosed with Legg-Calvé-Perthes disease. Which of the following findings, signs, and symptoms would lead clinicians to this conclusion? Select all that apply.

The boy has significant difficulty in walking. The child has limited abduction of the affected hip. His femoral head region is noted to be necrotic.

A 6-year-old boy who has mental retardation secondary to fragile X syndrome has been admitted to hospital with a mitral valve prolapse. A health care worker who is providing care for the family should have which of the following statements as part of her knowledge base around the disease?

The boy will pass the gene to all his future daughters who will become carriers.

When explaining the role of liver Kupffer cells to a group of nursing students, which of the following statements about the function of these cells is most accurate?

The cells are capable of removing and phagocytizing old and defective blood cells.

Which of the following characteristics could apply to healthy somatic cells rather than cancerous cells?

The cells are unable to proliferate except by mitotic division.

The infant of a family that has recently immigrated to the United States from South Asia has been diagnosed with rickets. Bone density scanning would yield which of the following characterizations of the infant's bones?

The child's bones are far softer than those of healthy children.

A nurse is performing a 5-minute Apgar score on a newborn female. Which of the following characteristics of the infant's current condition would not be reflected in the child's Apgar score?

The child's temperature is 35.0°C (95°F) by axilla.

A 54-year-old male who lives alone and has poorly controlled type 1 diabetes has been admitted to hospital for treatment of sepsis resulting from a chronic foot ulcer. Which of the other findings from the man's admission assessment and history would his care team likely to attribute to his diabetes? Select all that apply.

The client complains of bloating after eating a meal and states that he is unable to eat much food at any one sitting. He states that his bowel movements are almost always loose. The client states that he has been unable to maintain an erection in recent years.

A physician is attempting a differential diagnosis of a 30-year-old female who is suspected of having systemic lupus erythematosus (SLE). Which of the following aspects of the physician's assessment and the client's history would be considered potentially indicative of SLE? Select all that apply.

The client has a "butterfly rash" on her nose and cheeks. She complains of intermittent joint pain. The client has been hospitalized twice in the past for pleural effusions. Blood work indicates low red cells, white cells, and platelets.

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 client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.

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?

The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.

A 68-year-old male client with aortic stenosis secondary to calcification of the aortic valve is receiving care. Which of the following statements best captures an aspect of this client's condition?

The client has possibly undergone damage as a result of calcification following cellular injury.

A 56-year-old female hospital patient with a history of alcohol abuse is receiving intravenous (IV) phosphate replacement. Which of the following health problems will this IV therapy most likely resolve?

The client is acidotic and has impaired platelet function.

A 43-year-old male who is 5′10″ tall and weighs 216 lb has been informed by his nurse practitioner that his body mass index (BMI) is 31. Which of the following clinical conclusions based on these data would his nurse be most justified in rejecting?

The client is borderline obese but is not yet at the point of significantly increased risks to health.

An occupational therapist (OT) is assessing an 80-year-old male client who is poised to return to his assisted living residence following a 14-day hospital stay with a diagnosis of bilateral pneumonia. As part of the OT's functional assessment, the client's activities of daily living (ADL) and instrumental activities of daily living (IADL) are being assessed. Which of the following assessment findings is most indicative of a deficit in ADL?

The client requires help with dressing himself in the morning.

A 38-year-old male has presented to a clinic for the treatment of severe dermatitis after contact with poison ivy on a camping trip. The client has been prescribed prednisone, a corticosteroid, for the treatment of his skin condition. The client's care provider has emphasized that dosages of the drug will be gradually tapered off rather than stopped upon resolution of the symptoms. What is the most accurate rationale for this dosing protocol?

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

A group of researchers have identified that the prevalence of two particular genetic disorders shares a statistical correlation. Which of the following statements best conveys the genetic rationale for this situation?

The genes causing each disorder are likely in the same section of the same chromosome.

A middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which of the following results?

The growth hormone level will not be suppressed following glucose load.

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 of the following statements most accurately captures a guiding principle of the nurse's task?

The guidelines will combine individual expertise with external systematic evidence.

Which of the following statements best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function?

The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.

A patient who has had a prolonged period of nasogastric (NG) suctioning following colon surgery is experiencing electrolyte imbalances.

The magnesium level is low (1.2 mg/dL). Knowing that magnesium deficiency occurs in conjunction with low calcium levels, the nurse should assess the patient for which of the following clinical manifestations of hypocalcaemia? Select all that apply. A) Personality changes B) Hyperactive reflexes C) Increase in ventricular arrhythmias

A child possesses a trait that is the result of the interaction of two different genes, neither of which could have produced the trait independently. Which of the following explanations best captures the genetic explanation for this?

The outcome is the result of the interaction between collaborative genes.

A 74-year-old female has been diagnosed with osteoporosis after her bone density scan indicated osteopenia. Which of the following factors would her care team be most likely to rule out as contributors to her health problem?

The woman is an African American and was exposed to asbestos in her work.

A female client who is suspected of having psoriasis. Which of the following aspects of the woman's history and her care provider's assessment would be potential contributors to her health problem? Select all that apply.

The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension. She has been diagnosed with arthritis. Skin trauma of any kind often precedes an outbreak.

A 71-year-old man diagnosed with a stage T2 prostate tumor 2 years ago has elected watchful waiting, based upon an underlying heart condition that renders surgery potentially fatal. 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?

Treatment with GnRH agonists alone

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 of the following imaging techniques will be most helpful to the surgeon in visualization of the nodes for fine needle aspiration?

Ultrasound

An 82-year-old resident of a long-term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which of the following actions by the care team is most appropriate?

Ultrasound bladder scanning to determine the residual volume of urine after voiding

A mom asks her neighbor, a nurse, why every time she takes her daughter (10 years old) out for ice cream she comes home with a stomachache and then experiences a bout of diarrhea.

a deficiency of lactase.

A nurse in an acute medical unit is providing care for a number of patients with a variety of diagnoses. Which of the following patients most likely exhibits risk factors for impaired coughing? A patient with

a nasogastric (NG) tube attached to suction.

Laboratory testing is ordered for a male patient during a clinic visit for a routine follow-up assessment of hypertension. When interpreting lab values, the nurse knows that

a normal value represents the test results that fall within the bell curve.

A caregiver is working with a client who is having poorly controlled pain due to shingles. The associate pain travels to the client's nervous system via

afferent neurons.

A male patient in his 50s has just been diagnosed with hyperuricemia. He has had multiple flare-ups of his first metatarsophalangeal joint pain and swelling. The pain is so severe that he cannot sleep with any covers/sheets over his feet at night. The nurse should anticipate that the patient will likely be prescribed: Select all that apply.

allopurinol (Zyloprim) to decrease uric acid levels; Anturane (sulfinpyrazone) to increase excretion of urate.

An elderly male patient is complaining of dribbling after he urinates and feeling like he never empties his bladder. The nurse suspects the patient may have a problem with

an enlarged prostate gland.

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

an enzyme defect causing abnormal lipid accumulation in the brain.

A 44-year-old man has been diagnosed with chronic urticaria, the exact cause of which cannot be determined. What is the pharmacological treatment that is most likely to be of most use to the man?

antihistamines

A 66-year-old man has presented to a nurse practitioner to get a refill for his antiplatelet medication. The client has a history of ischemic heart disease and suffered a myocardial infarction 5 years ago and has unstable angina; he uses a transdermal nitroglycerin patch to control his angina. The client has a 40 pack-year smoking history and uses nebulized bronchodilators at home for the treatment of transient shortness of breath. He has long-standing hypertension that is treated with a potassium-sparing diuretic and a β-adrenergic-blocking medication. During the nurse's assessment, the man states that he has been unable to maintain his erection in recent months. Which of the following aspects of the man's health problems and treatments would the nurse identify as contributing to his erectile difficulty (ED)? Select all that apply. His

antihypertensive hypertension smoking history.

Following prosthetic joint replacement of the knee, the patient continues to complain of pain and discomfort above what would be expected.

antimicrobial treatment depending on the microbe.

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

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 contration.

A pregnant teenager has arrived at a free clinic seeking care. She has had no prenatal care and is currently 27 weeks' gestation. Upon testing for a sexually transmitted disease (STD), it is found that she has active T. pallidum (syphilis). Given the fact that she has active syphilis at this stage in her pregnancy, it is very likely her fetus is at risk for: Select all that apply.

being born prematurely. congenital defects.

When trying to explain the advantages of using an emollient over other products to a patient suffering from dry skin, the nurse will emphasize emollients

can replenish the oils on the skin surface because they contain fatty acids.

A patient with ESRD comes into the emergency department in severe acidosis. The nurse notes that the respiratory rate is 36 breaths/minute. The nurse understands the pathophysiology of this response and explains to the student nurse that the patient's

chemoreceptors in the carotid and aortic bodies have noticed the pH change and altered the ventilator rate.

When the sympathetic nervous system is stimulated, the interstitial cells of Cajal, pacemaker cells of the GI tract, react by

decreasing amplitude or abolishing the slow waves that control the spontaneous oscillations in membrane potentials.

When explaining about the passage of urine to a group of nursing students, the clinic nurse asks them which muscle is primarily responsible for micturition? Their correct reply is the

detrusor

When trying to discern the extent of a burn, the nurse will note that second-degree full-thickness burns are characterized by

extensive pain along with waxy white areas with blister formation.

During a family picnic, a relative of a nurse asks what he should do if there is blood in his urine and some pain in his lower abdomen. The best advice the nurse could give this family member would be for him to

get an appointment with his family doctor.

When educating a patient about glargine (Lantus), the nurse should explain that this medication

has a prolonged absorption rate and provides a relatively constant concentration for 12 to 24 hours.

An elderly patient has arrived at the physician's office complaining of a rash. Upon further investigation, the patient states that the rash feels like a burning pain but also has some tingling. It is extreme sensitive to touch, and it's "like crazy." The nurse notes that the rash is made up of vesicles and located on the right thoracic region. The nurse suspects the patient has

herpes zoster.

The nurse is teaching new nursing assistants on the unit about the phenomenon of muscle hypertrophy. Which of the following clients on the unit is most likely to experience muscle hypertrophy? A client with

hypertension, obesity, and decreased activity tolerance.

A middle-aged male walks into the emergency department complaining of 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 patient is having an acute MI with decreased cardiac output. The nurse identifies the nausea to be in response to

hypoxia exerting a direct effect on the chemoreceptor trigger zone.

A patient with distal symmetric polyneuropathy usually begins to complain of

loss of feeling or touch in the feet.

Which of the following clients in a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? An adult with

low hemoglobin levels, low platelet levels, and spider angiomas present.

A stroke patient is having difficulty swallowing food and beverages. The patient complains that he feels like "the food is sticking to the back of his throat." Given this information, the priority nursing interventions would be to

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

The son of an 80-year-old man has noticed that in recent weeks his father has become incontinent of urine for the first time in his life. The man is later diagnosed with transient urinary incontinence, a condition that is most often attributable to

medications

A college student has come to the health clinic complaining of heavy bleeding during and between her menstrual periods. The nurse practitioner will document this as

menometrorrhagia

While reviewing the role of the parathyroid hormone in the balance of calcium and phosphate levels, the nursing faculty will emphasize that the kidney responds to parathyroid stimulation by

reducing the reabsorption of phosphate.

A woman has gone to her gynecologist complaining of pain during intercourse. The physician orders a maturation index on her vaginal scrapings. The results return an index of 75-25-0. The nurse can interpret this to mean

she is experiencing postmenopausal vaginal dryness.

While reviewing the bones in anatomy class, the instructor discusses this type of bone that protects the underlying structures. A good example of a flat bone is:

skull

A 68-year-old African American 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 three alcoholic beverages nearly every day. His problem is most likely

squamous cell carcinoma of the esophagus.

Because they strengthen the pelvic floor muscles, Kegel exercises are most likely to help

stress incontinence.

The nurse is explaining the workings of selective serotonin reuptake inhibitors 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

synaptic signaling.

When trying to explain to a patient diagnosed with a benign bone tumor, the nurse should emphasize the fact that benign tumors primarily

tend to grow very slowly without destroying the supporting tissue.

As of November 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.

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 United States, he exhibited no symptoms and returned to his usual activities. During this period of no outward symptoms, the man would be classified as being in

the preclinical stage of disease.

A cancer patient has been prescribed 5-fluorouracil, an antimetabolite chemotherapy agent. This medication stops normal development and division by interrupting the S-phase of the cell cycle. When teaching this patient, the nurse explains that during the S-phase of the cell cycle,

the synthesis of DNA occurs, causing two separate sets of chromosomes to develop.

Since steroid hormones are bound to protein carriers for transport, this means

they are inactive in the bound state.

A patient asks the nurse what it means when the doctor said that he had adenocarcinoma of the bladder. Reviewing the pathophysiologic principles behind this type of cancer, the nurse knows

this is a rare but highly metastatic tumor that has a very poor prognosis.

A 10-year-old boy has a body mass index that places him in the 96th percentile for his age and gender.

type 2 diabetes.

Because the associated nephropathy is an important cause of end-stage renal failure in children and adolescents, a toddler who has had an uncomplicated bout of urinary tract infection (UTI) should still be evaluated for

vesicoureteral reflux.

One of the residents in a long-term care facility has developed numbness, tremor, and gross lack of coordination of muscle movements in his lower limbs. The nurse knows that this may be caused by

vitamin B12 deficiency.

The nurse walks into a room and finds the patient forcefully expelling stomach contents into a wash basin. When documenting this occurrence, the nurse will use the term

vomiting.

A nurse on a medical unit is providing care for a 37-year-old female patient who has a diagnosis of Graves disease. Which of the following treatments would the nurse most likely anticipate providing for the client?

β-Adrenergic-blocking medications to reduce sympathetic nervous stimulation