Final check your understanding
TRUE/FALSE
When the cause is unknown, a condition is said to be idiopathic
TRUE
The initial treatment of an individual experiencing a seizure is concentrated on
maintaining an airway.
Manifestations of acute brain ischemia (Cushing reflex) are due primarily to
sympathetic nervous system activation.
A ureterocele is
a cystic dilation of a ureter.
Which is not a manifestation of acute arterial obstruction?
Pain
Purpura
Pallor
Pulselessness
Purpura
The physiologic change most likely to lead to an increase in intracranial pressure is
cerebral vasodilation.
In older women, osteoporosis is thought to be primarily because of
estrogen deficiency.
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
increased neuromuscular excitability.
Cor pulmonale refers to
right ventricular hypertrophy secondary to pulmonary hypertension.
The ________ is the level of painful stimulation required to be perceived.
threshold
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV.
Tophi are
deposits of urate crystals in tissues.
A fracture in which bone breaks into two or more fragments is referred to as
comminuted.
The pathology report for a patient with penile cancer has this statement: The tumor involves the shaft of the penis. The cancer is at what stage?
Stage II
_________ 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
The expected treatment of a pregnant woman with hyperemesis gravidarum is
intravenous therapy.
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
118/78
128/82
140/88
138/94
128/82
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
Septic
The final step in clot formation is
clot retraction.
A silent abdomen 3 hours after bowel surgery most likely indicates
functional bowel obstruction.
Malignant neoplasms of epithelial origin are known as
carcinomas.
What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission?
Slower rate of action potential conduction
The most common cause of intrinsic kidney injury is _____ injury.
tubular
Leakage of CSF from the nose or ears is commonly associated with
basilar skull fracture.
Ulcerative colitis is commonly associated with
bloody diarrhea.
The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called
tophaceous gout.
Elevated serum lipase and amylase levels are indicative of
pancreatitis.
The dementia of Alzheimer disease is associated with structural changes in the brain, including
deposition of amyloid plaques in the brain.
Extreme cold injures cells by all the following except
decreased blood viscosity.
The strength of the bond between oxygen and hemoglobin is known as the
oxygen-hemoglobin affinity.
It is true that scleroderma involves
inflammation and fibrosis of connective tissue.
A patient with pure left-sided heart failure is likely to exhibit
pulmonary congestion with dyspnea.
Treatment of a uterine prolapse may involve the insertion of a(n) ________ to hold the uterus in place.
pessary.
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
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is
infection.
Velocity of blood flow is measured in
centimeters per second.
The most common source of osteomyelitis is
an infection that migrates via the bloodstream.
TRUE/FALSE
Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
False
A potential risk factor for breast cancer includes
early menarche and late first pregnancy
A patient diagnosed with a micropenis must be evaluated for
endocrine disorders.
The effects of histamine release include
increased vascular permeability.
An abnormally wide (more than 0.10 second) QRS complex is characteristic of
premature ventricular complexes
Two primary acid-base disorders that are present independently are referred to as
mixed acid-base imbalance.
A cause of thrombocytopenia includes
chemotherapy.
Jaundice is a common manifestation of
liver disease.
It is true that fibrocystic breast disease
may be exacerbated by methylxanthines.
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.
Pain with passive stretching of a muscle is indicative of
noncontractile tissue injury.
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?
Inflammation, mucosal edema, and bronchoconstriction
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.
The most common presenting sign/symptom with rheumatic fever is
polyarthritis.
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles
Liver transaminase elevations in which aspartate aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of
alcohol-induced injury.
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH).
In type I diabetes, respiratory compensation may occur through a process of
respiratory alkalosis.
A patient with significant aortic stenosis is likely to experience
syncope.
Which causes vasoconstriction?
Norepinephrine
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with
antiplatelet drugs.
What effect would adrenocortical insufficiency have on an individual’s response to surgical stress?
More prone to hypotension
The ________ system compensates for metabolic acidosis and alkalosis.
respiratory
A diagnostic laboratory finding in myeloma is
Bence Jones proteins in the urine.
Activation of parasympathetic nerves to the bladder will cause
bladder contraction.
The physiologic mechanisms involved in the pain phenomenon are termed
nociception.
The disorders characterized by softening and then enlargement of bones is referred to as
Paget disease.
It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for
intervention.
More than half of the initial cases of pancreatitis are associated with
alcoholism.
Which neurologic disorder is commonly referred to as Lou Gehrig disease?
Amyotrophic lateral sclerosis
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.”
The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is
air embolus.
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.
Viral pneumonia is characterized by
a dry cough.
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with
hypophosphatemia
The classic manifestations of Parkinson disease include
rest tremor and skeletal muscle rigidity.
It is true that biliary cancer
tend to be asymptomatic and progress insidiously.
The condition characterized by oliguria and hematuria is
acute glomerulonephritis.
Which statement is true about the incidence of multiple sclerosis?
The age of onset ranges from 20 to 50 years.
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3 – = 24 mEq/L demonstrates
respiratory alkalosis.
A primary effector cell of the type I hypersensitivity response is
mast cells.
A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because
GFR declines.
Dysfunction of which organ would lead to clotting factor deficiency?
Liver
Hyperlipidemia occurs in nephrotic syndrome because
hepatocytes synthesize excessive lipids.
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
deficiency of ATP.
What age group has a larger volume of extracellular fluid than intracellular fluid?
Infants
An example of inappropriate treatment for head trauma would be
hypoventilation.
Risk factors for hemorrhagic stroke include
acute hypertension.
Excessive vomiting in pregnant women is known as
hyperemesis gravidarum.
The principle Ig mediator of type I hypersensitivity reactions is
IgE.
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia.
Bone healing may be impaired by
nicotine use.
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of
bacterial pneumonia.
Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they
increase dopamine activity in the basal ganglia.
The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of
extrinsic pathway.
Most gallstones are composed of
cholesterol.
TRUE/FALSE
The nurse is swabbing a patient’s throat to test for
streptococcal pharyngitis. The nurse must understand that tests such
as this differ in the probability that they will be positive for a
condition when applied to a person with the condition; this
probability is termed sensitivity.
TRUE
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
In which dysrhythmias should treatment be instituted immediately?
Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute
Fever-induced tachycardia at 122 beats/minute
Premature atrial complexes occurring every 20 seconds
Atrial fibrillation with a ventricular rate of 220 beats/minute
Atrial fibrillation with a ventricular rate of 220 beats/minute
The hypersensitivity reaction that does not involve antibody production is type
IV.
Which acid are the kidneys unable to excrete?
Carbonic
What clinical finding would suggest an esophageal cause of a client’s report of dysphagia?
Chest pain during meals
The displacement of two bones in which the articular surfaces partially lose contact with each other is called
Subluxation
The greatest risk factor for bladder cancer is
Smoking
A malignant bone-forming tumor is referred to as a(n)
Osteoscarmoa
The pathophysiology of osteomalacia involves
Inadequate mineralization in the osteoid
What is the effect on resistance if the radius of a vessel is halved?
Resistance increases by a factor of 16
Cervical cancer can be detected in the early, curable stage by the ________ test.
Papanicolaou
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
Healing of a fractured bone with a poor alignment is called
malunion
The normal post-void residual urine in the bladder is
Less than 100 mL
Empyema is defined as an
Infection in the pleural space
Respiratory alkalosis is caused by
Hyperventilation
Compartment syndrome occurs secondary to
soft-tissue damage
The most common sign/symptom of renal calculi is
pain
Anticholinesterase inhibitors may be used to manage
Myasthenia gravis
A 5-year-old patient’s parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child’s most likely diagnosis is
ALL (acute lymphoid leukemia)
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 earliest manifestation of scleroderma is
Raynaud Phenonmenon
Findings that should prompt an evaluation for renal cancer include
Hematuria
Severe combined immunodeficiency (SCID) syndrome is an example of a(n)
deficient immune response
Pain is thought of as
a subjective experience that is difficult to measure objectively
Allostasis is best defined as
the overall process of adaptive change necessary to maintaing survival and well-being
The person at highest risk of a greenstick fracture from falling off a tall ladder is age
8
Greenstick fractures occur primarily in children.
The most important determinant for prescribing therapy for acute stroke is
Ischemic vs. hemorrhagic cause
Clinical manifestations of hypoparathyroidism
Result from decreased serum ionized calcium
Selye’s three phases of the stress response include all the following except
allostasis
TRUE/FALSE
Erection requires the release of nitrous oxide into the corpus cavernosum during sexual stimulation
True
Constipation in an elderly patient can be best treated by
Increasing fiber in the diet
It is true that Graves disease is
associated with autoantibodies to TSH receptors
Blood flow throughout the periphery is regulated by
The autonomic nervous system
Increased preload of the cardiac chambers may lead to which patient symptom?
Edema
Which alterations can lead to edema?
Decreased lymphatic flow
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
Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States.
Seventh
A person who experiences a panic attack and develops hyperventilation symptoms may experience
numbness and tingling in the extremities
The definitive treatment for cholecystitis is
cholecystectomy
Endometriosis is a condition in which
ectopic endometrial tissue is present
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding
inadequate water intake
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
Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate.
mortality
What finding should prompt further diagnostic testing in a child presenting with diarrhea
blood and mucus in the stools
Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to
autoimmune mechanisms
The conversion of plasminogen to plasmin results in
fibrinolysis
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?
Septic
The difference between stress incontinence and urge incontinence is that stress incontinence
is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.
Hyperaldosteronism causes
ECV excess and hypokalemia.
Which form of leukemia demonstrates the presence of the Philadelphia chromosome?
CML (chronic myeloid leukemia)
Propylthiouracil may be used to treat hyperthyroidism, because it
inhibits thyroid hormone synthesis
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 common component of renal calculi is
calcium
The pain that accompanies kidney disorders is called
nephralgia
A person who is diagnosed with nephrotic syndrome is also experiencing hypoalbuminemia. This happens because
albumin is excreted in the urine.
The most effective therapy for anemia associated with kidney failure is
erythropoietin administration
A patient presents to the physician’s office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years
4 and 7
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
It is true that growth hormone excess in adults
results in the condition of acromegaly
The most common type of osteomyelitis is
hematogenous
The cause of the most common form of anemia is
iron deficiency
Carbon monoxide injures cells by
reducing oxygen level on hemoglobin
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of
tumor necrosis factor
Insulin binding to its receptor on target cells results in
increased facilitated cellular diffusion of glucose
It is recommended that women of childbearing age take folic acid daily for prevention of
neural tube defects
Pathophysiologically, esophageal varices can be attributed to
portal hypertension
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
Patients with acute pancreatitis are generally made NPO and may require continuous gastric suctioning in order to
remove the usual stimuli for pancreatic secretion
First-degree heart block is characterized by
prolonged PR interval
After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of
right-sided heart failure
Which condition enhances lymphatic flow?
increased interstitial fluid colloid osmotic pressure
Hepatic encephalopathy is associated with
increased blood ammonia levels
Celiac sprue is a malabsorptive disorder associated with
inflammatory reactions to gluten-containing foods
A thyroid gland that grows larger than normal is known as
goiter
In the acute phase of stroke, treatment is focused on
stabilization of respiratory and cardiovascular function
TRUE/FALSE
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes
TRUE
It is true that encephalitis is usually
because of viral infection in brain cells.
A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct?
“Lung cancer has about a 15% survival rate.”
Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be
an autoimmune process
Autologous stem cell transplantation is a procedure in which
stem cells are harvested from the patient and then returned to the same patient.
Bacterial pneumonia leads to hypoxemia caused by
accumulation of alveolar exudate
“Please explain the pathophysiology of osteoarthritis to me,” says another nurse. “Is it just wear and tear so that the cartilage wears out?” Your best response is
“No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone.”
A common characteristic of viral pneumonia is
dry cough
All these cellular responses are potentially reversible except
necrosis
A person who has hyperparathyroidism is likely to develop
hypercalcemia
A 32-year-old female complaining of severe pain with menstruation and inability to participate in her routine household activities is likely experiencing
dysmenorrhea
The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves
regeneration of the renal tubular epithelium