_________ is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord.
Meningocele
Prerenal acute kidney injury may be caused by
severe hypotension.
It is true that the synthesis of thyroid hormones
is inhibited by iodine deficiency.
The anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.
True
The underlying pathogenic mechanism for type 1 diabetes is
pancreatic β-cell destruction.
A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing
acute cardiogenic pulmonary edema.
A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102°F. This information is most consistent with
meningitis.
Obstructive disorders are associated with
low expiratory flow rates.
The most appropriate treatment for secondary polycythemia is
measured to improve oxygenation.
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
False
Hepatic encephalopathy is associated with
increased blood ammonia levels.
Cor pulmonale refers to
right ventricular hypertrophy secondary to pulmonary hypertension.
Gastrointestinal drainage, perioperative and postoperative hypotension, and hemorrhage may all contribute to renal failure by causing
acute tubular necrosis.
Asthma is categorized as a(n)
obstructive pulmonary disorder.
A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is
hyponatremia.
A level of ____ on the Glasgow Coma Scale indicates likely fatal damage.
3
Acceleration-deceleration movements of the head often result in polar injuries in which
focal injuries occur in two places at opposite poles.
The primary source of erythropoietin is provided by the
kidney.
The earliest manifestation of scleroderma is
Raynaud phenomenon.
The most common site affected in Paget’s disease is the
lower spine.
In contrast to osteoarthritis, rheumatoid arthritis may be associated with
systemic aching in the musculoskeletal system.
Metabolic alkalosis is often accompanied by
hypokalemia.
________ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes.
Nystagmus
It is true that gallstones are
more common in women.
When a patient experiencing nephrotic syndrome asks, “What causes my urine to be so full of protein,” the nurse’s response is based on the knowledge that
the glomerular membrane has increased permeability.
The best intervention for acute kidney injury (AKI) is prevention.
True
Which assessment would support a diagnosis of type A COPD rather than type B COPD
Normal PaCO2, scant sputum, accessory muscle use, barrel chest
Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.
decreased serum sodium
The most common primary immune deficiency that affects only B cells is
selective IgA.
Bone healing may be impaired by
nicotine use.
A cause of thrombocytopenia includes
chemotherapy.
Signs and symptoms of clinical dehydration include
decreased urine output.
Infection can lead to bladder stone formation.
True
The patient most at risk for postrenal acute kidney injury is a(n)
elderly patient with hypertrophy of the prostate.
Neuromuscular disorders impair lung function primarily because of
weak muscles of respiration.
Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to
autoimmune mechanisms.
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
True
Which electrolyte imbalances cause increased neuromuscular excitability?
Hypocalcemia and hypomagnesemia
The cellular response indicative of injury because of faulty metabolism is
intracellular accumulations.
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.
negative; negative; positive
It is true that polycystic kidney disease is
genetically transmitted.
The pathophysiologic basis of acute glomerulonephritis is
an immune complex reaction.
Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA) is
autoimmune hepatitis.
Legionnaires disease is characterized by
presence of systemic illness.
Most sensory afferent pain fibers enter the spinal cord by way of the ________ nerve roots.
posterior
Clinical manifestations of hypoparathyroidism
result from decreased serum ionized calcium.
Brain injury secondary to high serum bilirubin is called
kernicterus.
How do clinical conditions that increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
Excessive red cell lysis can be detected by measuring the serum
bilirubin
A clinical finding consistent with a hypoglycemic reaction is
tremors.
The stage of spinal shock that follows spinal cord injury is characterized by
absent spinal reflexes below the level of injury.
Cancer grading is based on
cell differentiation.
It is true that growth hormone excess in adults
results in the condition of acromegaly.
Findings that should prompt an evaluation for renal cancer include
hematuria.
In addition to renal colic pain, signs or symptoms of ureteral stones may frequently include
hematuria.
Widespread activation of the clotting cascade secondary to massive trauma is called
disseminated intravascular coagulation (DIC).
The final step in clot formation is
clot retraction.
A ureterocele is
a cystic dilation of a ureter.
What is necessary for red blood cell production?
Iron
Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?
It is a procedure for determining the extent of tumor spread.
The most common direct cause of acute pyelonephritis is
infection by E. coli.
Compartment syndrome occurs secondary to
soft-tissue damage.
A patient, age 3, has vesicoureteral reflux. “Why does that make him have so many bladder infections?” asks his mother. The nurse’s best response is
“When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder.”
Hyperlipidemia occurs in nephrotic syndrome because
hepatocytes synthesize excessive lipids.
Diabetes insipidus is a condition that
results from inadequate ADH secretion.
Chronic bronchitis often leads to cor pulmonale because of
increased pulmonary vascular resistance.
The fraction of total body water (TBW) volume contained in the intracellular space in adults is
two thirds.
Rupture of a cerebral aneurysm should be suspected if the patient reports
sudden, severe headache.
The finding of hypotension, rigid abdomen, and absent bowel sounds in a patient with pancreatitis
indicates peritonitis with substantial risk for sepsis and shock.
Myxedema coma is a severe condition associated with
hypothyroidism.
Proton pump inhibitors may be used in the management of peptic ulcer disease to
decrease hydrochloric acid (HCl) secretion.
A patient who should be routinely evaluated for peptic ulcer disease is one who is
being treated with high-dose oral glucocorticoids.
A potential risk factor for breast cancer includes
early menarche and late first pregnancy.
If an individual has a fully compensated metabolic acidosis, the blood pH is
in the normal range.
The condition in which the urethra opens on the dorsal aspect of the penis is known as
epispadias.
Propylthiouracil may be used to treat hyperthyroidism, because it
inhibits thyroid hormone synthesis.
Barrett esophagus is a
preneoplastic lesion.
Secondary injury after head trauma refers to
brain injury resulting from the body’s response to tissue damage.
A patient with chronic gastritis would likely be tested for
Helicobacter pylori.
The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation?
Q = P/R
Referred pain may be perceived at some distance from the area of tissue injury, but generally felt
within the same dermatome.
A patient who has difficulty walking without assistance is incontinent of urine when help doesn’t get to her quickly enough. The term for this type of incontinence is
functional.
Transfusion reactions involve RBC destruction caused by
recipient antibodies.
The hypersecretion of mucus resulting for chronic bronchitis is the result of
recurrent infection.
Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency?
Osteomalacia
Constrictive pericarditis is associated with
impaired cardiac filling.
All these cellular responses are potentially reversible except
necrosis.
Hepatitis B is usually transmitted by exposure to
blood or semen.
The most common tumor-suppressor gene defect identified in cancer cells is
P53.
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics.
When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will
put a sputum cup and a box of tissues on the bedside table.
Which intervention has been found to retard the advancement of chronic kidney disease?
ACE inhibitors
Excessive vomiting in pregnant women is known as
hyperemesis gravidarum.
The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called
tophaceous gout.
The chief pathologic features of osteoarthritis are
degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium.
Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because
demyelination is mediated by immune mechanisms.
A progressive decrease in the force of the urinary stream, dribbling of urine, and difficulty initiating the urinary stream are characteristic of
prostatic enlargement.
Appropriate therapy for prerenal kidney injury includes
fluid administration.
A 52-year-old female had a surgical procedure in which the breast, lymphatics, and underlying muscle were removed. The procedure performed was a
radical mastectomy.
A clinical finding consistent with a diagnosis of rheumatoid arthritis would be
systemic manifestations of inflammation.
A person is unaware that his bladder is full of urine, but complains that he is leaking urine almost constantly. The most accurate term for this type of incontinence is
overflow.
In older women, osteoporosis is thought to be primarily because of
estrogen deficiency.
Bacterial pneumonia leads to hypoxemia caused by
accumulation of alveolar exudates.
Esophageal varices represent a complication of ________ hypertension.
portal
Administration of which therapy is most appropriate for hypovolemic shock?
Crystalloids
The major cause of death from leukemic disease is
infection.
A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)
elderly woman without a previous history of MI.
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure i
digitalis.
Hypertension with a specific, identifiable cause is known as _____ hypertension.
secondary
A diagnostic laboratory finding in myeloma is
Bence Jones proteins in the urine.
Appropriate management of end-stage renal disease includes
erythropoietin administration.
Complete healing of a bone fracture occurs when
the callus has been completely replaced with mature bone.
Copious amounts of foul-smelling sputum are generally associated with
bronchiectasis.
Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to
remove the usual stimuli for pancreatic secretion.
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?
Inflammation, mucosal edema, and bronchoconstriction
Phimosis is a disorder of the penis characterized by
inability to retract the foreskin
When the cause is unknown, a condition is said to be idiopathic
True
Untreated acute cholecystitis may lead to ________ of the gallbladder wall.
gangrene
Hypertrophy of the right ventricle is a compensatory response to
pulmonary stenosis.
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload.
An example of inappropriate treatment for head trauma would be
hypoventilation.
Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.
False
It is true that encephalitis is usually
because of a viral infection in brain cells.
Fecal leukocyte screening would be indicated in a patient with suspected
enterocolitis.
A risk factor for osteoporosis is
early menopause.
Which complication of asthma is life threatening?
Status asthmaticus
The HPV vaccine is recommended for 11- to 12-year-old girls, but can be administered to girls as young as _____ years of age.
9
The consequence of an upper urinary tract obstruction in a single ureter is
hydronephrosis.
Patients with immunodeficiency disorders are usually first identified because they
develop recurrent infections.
Glomerular disorders include
nephrotic syndrome.
Left-sided heart failure is characterized by
pulmonary congestion.
What problem is a patient likely to experience in end-stage renal disease?
Uremia
The condition associated with end-stage chronic renal disease that is the most immediately life threatening is
hyperkalemia.
Chronic elevation of myocardial wall tension results in atrophy.
False
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II.
While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is
activity restriction.
Which is indicative of a left tension pneumothorax?
Absent breath sounds on the left
Renal insufficiency is a common complication of which disease?
Myeloma
The majority of cardiac cells that die after myocardial infarction do so because of
apoptosis.
Signs consistent with a diagnosis of glomerulonephritis include
proteinuria.
In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?
Class II, Compensated Stage
A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of
primary prevention.
What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission?
Slower rate of action potential conduction
Which dysrhythmia is thought to be associated with reentrant mechanisms?
Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)
Red blood cells obtain nearly all their energy from metabolism of
glucose.
Activation of the extrinsic pathway of coagulation is initiated by
tissue thromboplastin.
What is the effect on resistance if the radius of a vessel is halved?
Resistance increases by a factor of 16.
A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician?
pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high
A person who experiences a panic attack and develops hyperventilation symptoms may experience
numbness and tingling in the extremities.
The cellular change that is considered preneoplastic is
dysplasia.
Which acid are the kidneys unable to excrete?
Carbonic
A silent abdomen 3 hours after bowel surgery most likely indicates
functional bowel obstruction.
An increase in ADH secretion occurs in response to
dehydration.
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone–related peptide monitored for the resulting electrolyte imbalance?
Serum calcium, bowel function, level of consciousness
Which is not normally secreted in response to stress?
Insulin
Healing of a fractured bone with a poor alignment is called
malunion.
In general, the best prognosis for long-term disease-free survival occurs with
ALL (acute lymphoid leukemia).
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH).
What reproductive tract disorder is most likely to be associated with urinary stress incontinence?
Cystocele
A patient with pure left-sided heart failure is likely to exhibit
pulmonary congestion with dyspnea.
Rheumatoid arthritis involves joint inflammation caused by
autoimmune injury.
A loud pansystolic murmur that radiates to the axilla is most likely a result of
mitral regurgitation.
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of
bacterial pneumonia.
A common characteristic of viral pneumonia is
dry cough.
What age group has a larger volume of extracellular fluid than intracellular fluid?
Infants
In general, with aging, organ size and function
decrease.
Angina caused by coronary artery spasm is called _____ angina.
Prinzmetal variant
Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of
nitric oxide.
Apoptosis is a process that results in cellular
death.
Coagulative necrosis is caused by
interrupted blood supply.
A person with acute hypoxemia may hyperventilate and develop
respiratory alkalosis.
Clinical manifestations of moderate to severe hypokalemia include
muscle weakness and cardiac dysrhythmias.
What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus?
Glycosylated hemoglobin levels (HbA1c)
Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures, because
they are deficient in active vitamin D.
Certain autoimmune diseases are associated with the presence of specific proteins on a person’s cells. These proteins are called ________ proteins.
HLA or MHC
The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves
regeneration of the renal tubular epithelium.
The body compensates for metabolic alkalosis by
hypoventilation.
Epigastric pain that is relieved by food is suggestive of
gastric ulcer.
A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because
GFR declines.
A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of
amyotrophic lateral sclerosis.
Calcium oxylate stone formation is facilitated by
hypercalciuria.
Which disorder is considered a primary immunodeficiency disease?
HIV/AIDS
The first indication of brain compression from increasing intracranial pressure (ICP) may be
sluggish pupil response to light.
A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for
delayed healing.
Somatic death refers to death
of the entire organism.
Which statement is true about the incidence of multiple sclerosis?
The age of onset ranges from 20 to 50 years.
The urinalysis finding most indicative of cystitis includes the presence of
nitrites.
Allostasis is best defined as
the overall process of adaptive change necessary to maintain survival and well-being.
The dementia of Alzheimer disease is associated with structural changes in the brain, including
deposition of amyloid plaques in the brain.
The most commonly ordered diagnostic test for evaluation of the urinary system is
ultrasonography.
Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States.
seventh
A patient with heart failure who reports intermittent shortness of breath during the night is experiencing
paroxysmal nocturnal dyspnea.
A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of
hypoparathyroidism.
The cause of the most common form of anemia is
iron deficiency.
The finding of ketones in the blood suggests that a person may have
metabolic acidosis.
A primary effector cell of the type I hypersensitivity response is
mast cells.
Which characteristic is indicative of hemolytic anemia?
Jaundice
Insulin binding to its receptor on target cells results in
increased facilitated cellular diffusion of glucose.
In patients with polycystic kidney disease, renal failure is expected to progress over time as the cystic process destroys more nephrons. At what point will a patient reach end-stage renal disease?
Greater than 90% nephron loss
It is recommended that women of childbearing age take folic acid daily for prevention of
neural tube defects.
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles.
A thyroid gland that grows larger than normal is known as
goiter.
The primary reason that prolonged seizure activity predisposes to ischemic brain damage is that
the lack of airway maintenance can lead to hypoxia.
The most common presenting sign/symptom with rheumatic fever is
polyarthritis.
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
deficiency of ATP.
Muscular dystrophy includes a number of muscle disorders that are
genetically transmitted.
Respiratory acidosis may be caused by
hypoventilation.
The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.
True
After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports “moderate” adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time?
Continue lifestyle modifications only.
Gouty arthritis is a complication of
inadequate renal excretion of uric acid.
Nephrotic syndrome involves loss of large amounts of ________ in the urine.
protein
Obstructive sleep apnea would most likely be found in a patient diagnosed with
Pickwickian syndrome.
Hyperaldosteronism causes
ECV excess and hypokalemia.
A patient being treated for hepatic encephalopathy could be expected to receive a(n) ________ diet.
low-protein and high-fiber
A patient injured severely in a motor vehicle accident is hospitalized with acute kidney injury as well as multiple broken bones and lacerations. When family members ask what is meant by the term ‘prerenal,’ the nurse responds
“Your husband’s kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney.”
Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts resulting from cancer paraneoplastic syndromes is
calcium.
Proto-oncogenes
are normal cellular genes that promote growth.
High blood pressure increases the workload of the left ventricle, because it increases
afterload.
What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?
Tachycardia
Fully compensated respiratory acidosis is demonstrated by
pH 7.36, PaCO2 55, HCO3 – 36.
A person who is diagnosed with nephrotic syndrome is also experiencing hypoalbuminemia. This happens because
albumin is excreted in the urine.
Parkinson disease is associated with
a deficiency of dopamine in the substantia nigra.
In which dysrhythmias should treatment be instituted immediately?
Atrial fibrillation with a ventricular rate of 220 beats/minute
Urinary retention with consistent or intermittent dribbling of urine is called
overflow incontinence.
Which treatment is helpful in neuropathic pain but not used for acute pain?
Anticonvulsants
The definitive treatment for cholecystitis is
cholecystectomy.
The most important determinant for prescribing therapy for acute stroke is
ischemic versus hemorrhagic cause.
An important mediator of a type I hypersensitivity reaction is
histamine.
Paget’s disease is characterized by
excessive bone resorption followed by excessive formation of fragile bone.
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because
massive histamine release from mast cells leads to vasodilation.
The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis.
hemolysis
One of the most common causes of acute tubular necrosis (ATN) is
ischemic conditions.
Risk factors for atherosclerosis include
hyperlipidemia.
It is true that Graves disease is
associated with autoantibodies to TSH receptors.
Ankylosing spondylitis is characterized by
inflammation, stiffness, and fusion of spinal joints.
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop
hypophosphatemia.
Myocarditis should be suspected in a patient who presents with
acute onset of left ventricular dysfunction.
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?
Inadequate water intake
What form of viral hepatitis is likely to be transmitted sexually?
Hepatitis B
What type of fracture generally occurs in children?
Greenstick
Diabetic neuropathy is thought to result from
decreased myoinositol transport.
Extreme cold injures cells by all the following except
decreased blood viscosity.
What laboratory data would support a diagnosis of hemochromatosis?
Elevated ferritin
The major cause of glomerulonephritis is
immune system damage to the glomeruli.
The infection frequently associated with development of postinfectious acute glomerulonephritis is
throat infection.
Which change in a patient’s assessment has the greatest urgency?
Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing
Disseminated intravascular coagulation may be treated with heparin therapy to
inhibit clotting factor consumption.
Which vessel normally demonstrates the most rapid blood flow?
The vena cava
A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock.
obstructive
The goal of long term heparin for the management of a deep vein thrombosis is to
prevent further clot formation.
Nephrotic syndrome does not usually cause
hematuria.
Which clinical finding is indicative of compartment syndrome?
Absent peripheral pulses
An increase in the resting membrane potential (hyperpolarized) is associated with
hypokalemia.
The most common sign/symptom of renal calculi is
pain.
A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is
...
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
...