- A case study!!! A patient e exposed to group A hemolytic Streptococcus developed a pharyngeal infection. Clinic examination: oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. Complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of disease is….WHAT?
- Streptococcus infection
- After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of ????
- tertiary prevention
A disease that is native to a particular region is called…????
endemic
Your patient’s red blood cell count is slightly elevated today. This might be explained by ( all that apply.)
A. gender difference.
B. situational factors.
C. normal variation.
E. illness.
When determining additional data to gather before making a diagnosis, what factors need to be considered? (All that apply.)
...
Selye’s three phases of the stress response include all the following except….NICE!!!!
allostasis
The effects of excessive cortisol production include…..WHAT
- Increased stress levels, weakened immune system, weight gain, high blood pressure, and mood swings.
Persistence of the alarm stage will ultimately result in WHAT?
- Exhaustion
Aldosterone may increase during stress, leading to (All that apply.)
A. decreased urinary output.
C. increased sodium
retention.
D. increased blood volume.
Chronic activation of stress hormones can lead to (All that apply.)
a. cardiovascular disease.
b. depression.
c. impaired
cognitive function.
d. autoimmune disease.
Apoptosis is a process that results in cellular…..What ?
death
Necrotic death of brain tissue usually produces …What kind of necrosis.
- Liquefactive necrosis
Reperfusion injury to cells…How?
Reperfusion injury to cells occurs when the blood supply returns to the tissue after a period of ischemia or lack of oxygen. The return of blood supply causes inflammation and oxidative damage through the induction of oxidative stress rather than the restoration of normal function
Bacteria cause injury to cells by which mechanisms? (All that apply.)
a. producing exotoxins.
b. producing endotoxins.
c.
producing destructive enzymes.
e. evoking an immune reaction.
Viruses differ from most bacteria in that they act in which of the following ways? (All that apply.)
a. enter the host cell.
c. use the host's metabolic processes to survive and replicate.
e. do not produce toxins.
Infectious injury often results from which of the following? (All that apply.)
a. exotoxins.
b. endotoxins.
c. self-destruction of cells.
e. enzymes from white blood cells.
Breast cancer in women who have the breast cancer gene………is ?
genetic
Malignant neoplasms of epithelial origin are known as…What ?
carcinomas
Tumor markers (All that apply.)
- Circulating tumor markers.
- Tumor tissue markers.
Side effects of chemotherapy include (All that apply.)
fatigue
loss of appetite
nausea
constipation
diarrhoea
hair loss
mouth sores
skin and nail problems.
What roles does inflammation play in cancer development? (All that apply.)
cell mutation and proliferation can result, often creating an environment that is conducive to the development of cancer.
Which viruses are associated with human cancers? (All that apply.)
Epstein-Barr virus
human papilloma virus
hepatitis B virus
human herpes virus-8
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions because???
- Histamine release from mast cells and basophils causes vasodilation and increased vascular permeability.
RhoGAM is given to an Rh-negative mother in order to prevent…WHAT….EASY!!!
Rh incompatibility in future pregnancies.
The principle Ig mediator of type I hypersensitivity reactions is…..WHAT?
IgE
Myasthenia gravis is a type II hypersensitivity disorder that involves…WHAT?
Antibody-mediated immune response
Secondary immune deficiency problems may be caused by what? (All that apply.)
- surgery.
- high blood sugar.
- corticosteroids.
-
low protein level.
Diseases due to type IV hypersensitivity? (All that apply.)
tuberculosis (tuberculosis)
M. leprae (leprosy)
Histoplasma capsulatum.
Which form of leukemia demonstrates the presence of the Philadelphia chromosome?
- Chronic Myelogenous Leukemia
Burkitt lymphoma is most closely associated with WHAT?
- Epstein-Barr Virus
You as nurse educating a patient on a new diagnosis of non-Hodgkin lymphoma you would provide which information in the teaching plan?
- Information about the disease, treatment options, possible side effects, lifestyle changes, and resources for emotional support.
Which viruses have been implicated as cancer-causing agents? (All that apply.)
HPVs),
Epstein-Barr (EBV),
Hepatitis B, C (HBV), (HCV),
(HIV),
Human herpes 8 (HHV-8),
A patient with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (All that apply.)
Fatigue
Weight loss
Sweat
Bleeding
ABD discomfort (SPLEEN)
A patient with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient’s cancer? (All that apply.)
Radiation
Bone Marrow transplant
Chemotherapy
Monoclonal antibody therapy
A patient with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (All that apply.)
LIVER,
SPLEEN
KIDNEYS
Which clinical findings describe the typical presentation of ALL (acute lymphoid leukemia)? (All that apply.)
Pain in long bones
infection
fever
bruising
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?
- Iron deficiency anemia
The cause of the most common form of anemia is WHICH ONE?
iron defiency
You again as nurse is educating a patient about the disease with anemia of chronic renal failure . Which statements made by the nurse are correct regarding the patient’s treatment? (All that apply.)
Erythropoiesis-stimulating agents
iron supplementation
Anemia related to vitamin B12 or folate deficiency is characterized by what laboratory features? (All that apply.)
RBC 500,000 to 750,000 WBC 4000 to 5000 cells/mm3
Regarding iron-deficiency anemia, what laboratory features are typically decreased? (All that apply.)
MCV
MCH
MCHC
One of the cardinal features of sickle cell anemia includes acute and chronic dysfunction of which organs? (All that apply.)
Spleen
Bones
Brain
Lungs
Stomach
A newborn patient is diagnosed with hemolytic disease. The nurse may expect to find what signs and symptoms? (All that apply.)
Petechial hemorrhages
Hepatomegaly
Splenomegaly
Kernicterus
Dysfunction of which organ would lead to clotting factor deficiency?
liver
The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of WHAT?
the extrinsic pathway
Disseminated intravascular coagulation may be treated with heparin therapy to..DO WHAT?
Prevent further clotting
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing WHAT?
- Vitamin K deficiency bleeding
What information about INR does the nurse understand?...nice question
INR (International Normalized Ratio) is a standardized number that's figured out in the lab. If you take blood thinners, also known as anticoagulants, INR is a test that's monitored.
What is involved in the release of plasminogen activators? (All that apply.)
Factor XII
HMWK,
kallikrein
thrombin
Which involves bleeding associated with vascular or platelet defects? (All that apply.).
Bleeding occurs immediately after trauma, involves skin or mucous membranes, is brief in duration
Risk factors for atherosclerosis include…..WHAT?
- High cholesterol, hypertension, smoking, diabetes, obesity, and physical inactivity.
Which is not a manifestation of acute arterial obstruction?
purpura
A serious complication of deep vein thrombosis is???
pulmonary embolism
Which is not considered to be a risk factor for thrombus formation?
Thrombocytopenia
Findings in compartment syndrome……
- Increased pressure within a muscle compartment
The pain characteristics of chronic venous insufficiency include which of the following? (All that apply.)
aching and cramping in the affected area
relief with elevation to the area
relief with ambulation if pain is in the legs.
Which changes in the circulatory system occur in the older adult? (All that apply.)
decreased cardiac output
increased blood pressure,
decreased compliance of the heart muscle
thickening of the heart valves
What results when systemic blood pressure is increased?
- The workload of the heart increases.
A case study ….patient diagnosed with hypertension, returns to the clinic 6 weeks later. The 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
High blood pressure increases the workload of the left ventricle because it increases..?????
afterload
A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of..WHAT??
hypertensive crisis
The nurse understands that which is the correct description of a Korotkoff sound?
- Phase 2: Murmuring or swishing sounds
High blood pressure increases the risk of which conditions? (All that apply.)
Heart Attack
Eye damage
Kidney Failure
Atherosclerosis
Congestive Heart Failure
Atherosclerosis puts a patient at risk for which of the following problems? (All that apply.)
Hyperlipidemia.
. Orthostatic hypotension is a risk factor for which conditions? (All that apply.)
stroke
cognitive impairment
death
Primary treatment for myocardial infarction (MI) is directed at…….What ?
decreasing myocardial oxygen demands
Restoring blood flow to the affected area of the heart.
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with…..What?
- Antiplatelet and anticoagulant medications
Aortic regurgitation is associated with…what?
heart valve disease
Angina caused by coronary artery spasm is called what kind of angina?
- Prinzmetal's angina
Atherosclerotic plaques with large lipid cores are prone to WHAT?
- Rupture
Acute coronary syndrome in the presence of thrombosis may present with which manifestations? All that apply.)
Unstable angina
MI
sudden cardiac arrest
Diagnostic tests used to diagnose or confirm MI include which of the following? (All that apply.)
EKG
cardiac catheterization
echocardiography
radionuclide scintigraphy
Hypertrophy of the right ventricle is a compensatory response to..WHAT
pulmonary hypertension
First-degree heart block is characterized by…WHAT
prolonged PR interval
A patient with pure left-sided heart failure is likely to exhibit….WHAT
pulmonary edema
A patient is diagnosed with heart failure with preserved ejection fraction (HFpEF). This patient is most likely described as a(n)…..WHAT
elderly woman without a previous history of MI
Right-sided heart failure is usually a consequence of which conditions? (All that apply.)
Coronary artery disease
hearth attack
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?
anaphylactic
Which causes of shock are considered to be obstructive? (All that apply.)
Pulmonary embolus,
Cardiac tamponade,
Tension pneumothorax
A patient experiencing shock may exhibit which signs and symptoms? (All that apply.)
Pulse of more than 100 beats/minute
Fast and deep respirations
The urinary signs and symptoms of acute renal failure associated with the progressive stage of shock are which of the following? (All that apply.)
oliguria
increased serum creatinine.
A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient? (All that apply.)
Hypotension
Urticaria
Angioedema
Wheezing
Septic shock is commonly associated with Gram-negative infections and Gram-positive organisms that enter the body through which body systems? (All that apply.)
genitourinary
gastrointestinal
respiratory tract
skin
. Allergic (extrinsic) asthma is associated with..What?
- An overactive immune response to allergens
Emphysema results from destruction of alveolar walls and capillaries, which is because of?
- Chronic exposure to irritants, especially tobacco smoke.
Chronic bronchitis often leads to cor pulmonale because of?
- Increased resistance in the pulmonary circulation
Cystic fibrosis is associated with..WHAT?
- A defect in chloride ion transport
Croup is characterized by…..WHAT?
- A barking cough, hoarseness, and difficulty breathing.
COPD leads to a barrel chest, because it causes…to WHAT?
- Air to be trapped in the lungs
Which of the following are characteristics of asthma? (All that apply.)
Edema
Airway inflammation
Collagen deposits
The hallmark manifestation of acute respiratory distress syndrome is…WHAT?
- Severe shortness of breath.
Empyema is defined as an??????
Infection in the lung that leads to a collection of pus in the pleural cavity.
Pneumocystis is a term that refers to a….WHAT?
- Non-compliance to medication regimen
Bacterial pneumonia leads to hypoxemia caused by…..WHAT??
- Impaired gas exchange
A common characteristic of viral pneumonia is…..WHAT?
inflammatiomn of the lungs
Which alteration can lead to edema?
- Increased capillary permeability.
Hypernatremia may be caused by Clinical manifestations of hyponatremia include
Excessive sodium intake
Clinical manifestations of moderate to severe hypokalemia include
deficiency of ATP
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
hypocalcemia
Which acid are the kidneys unable to excrete?
sulfuric acid
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
metabolic alkalosis
Respiratory acidosis may be caused by
hypoventilation
diarrhea causes what
dehydration
Uncompensated metabolic alkalosis would result in What?
increased blood pH
A patient is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?
Rapid
deep breathing
lethargy
abdominal pain