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 (HbA_1c)

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