Patho - Final Flashcards


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1

It is true that Bell palsy is a

C. paralysis of the muscles innervated by the facial nerve.

2

Angiotensin-converting enzyme (ACE) inhibitors block the

B. conversion of angiotensin I to angiotensin II.

3

Before making a diagnosis of Alzheimer disease

C. other potential causes of dementia must be ruled out.

4

An example of inappropriate treatment for head trauma would be

C. hypoventilation.

5

Which neurologic disorder is commonly referred to as Lou Gehrig disease?

D. Amyotrophic lateral sclerosis

6

Brain injury secondary to high serum bilirubin is called

C. kernicterus.

7

A patient being treated for hepatic encephalopathy could be expected to receive a(n) ________ diet.

A. low-protein and high-fiber

8

Diarrhea causes

C. metabolic acidosis.

9

Patent ductus arteriosus is accurately described as a(n)

C. communication between the aorta and the pulmonary artery.

10

The conversion of plasminogen to plasmin results in

B. fibrinolysis.

11

To avoid the progression of cutaneous lesions, a patient diagnosed with systemic lupus erythematosus (SLE) should

A. avoid sun exposure.

12

A silent abdomen 3 hours after bowel surgery most likely indicates

D. functional bowel obstruction.

13

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because

D. GFR declines.

14

Which dysrhythmia is thought to be associated with reentrant mechanisms?

D. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

15

The most common cause of mechanical bowel obstruction is

C. adhesions.

16

Surgical removal of a gland may result in

B. hyposecretion.

17

A person who has hyperparathyroidism is likely to develop

D. hypercalcemia.

18

Somatic death refers to death

B. of the entire organism.

19

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by

A. norepinephrine.

20

Hyperaldosteronism causes

B. ECV excess and hypokalemia.

21

The movement of blood through the vascular system is opposed by the force of

D. resistance.

22

The direct cause of stress incontinence is

B. pelvic muscle weakness.

23

The primary reason that prolonged seizure activity predisposes to ischemic brain damage is that

D. the lack of airway maintenance can lead to hypoxia.

24

A major cause of treatment failure in tuberculosis is

C. noncompliance.

25

Steatohepatitis is caused by an accumulation of ________ in the liver cells.

A. fat

26

RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.

C. negative; negative; positive

27

Parkinson disease is associated with

D. a deficiency of dopamine in the substantia nigra.

28

Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord.

A. True

29

A diagnostic laboratory finding in myeloma is

A. Bence Jones proteins in the urine.

30

Clinical manifestations of hypoparathyroidism

D. result from decreased serum ionized calcium.

31

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?

B. Class II, Compensated Stage

32

Systemic disorders include

D. rheumatoid arthritis.

33

It is true that fibrocystic breast disease

B. may be exacerbated by methylxanthines.

34

The best intervention for acute kidney injury (AKI) is prevention.

A. True

35

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)

A. elderly woman without a previous history of MI.

36

Anticholinesterase inhibitors may be used to manage

B. myasthenia gravis.

37

A 32-year-old female complaining of severe pain with menstruation and inability to participate in her routine household activities is likely experiencing

A. dysmenorrhea.

38

Clinical manifestations of hyponatremia include

C. confusion, lethargy, coma, and perhaps seizures.

39

A potential risk factor for breast cancer includes

D. early menarche and late first pregnancy.

40

The most common cause of ischemic acute tubular necrosis (ATN) in the United States is

D. sepsis.

41

An increase in hemoglobin affinity for oxygen occurs with

D. shift to the left.

42

The underlying pathogenic mechanism for type 1 diabetes is

A. pancreatic β-cell destruction.

43

In addition to renal colic pain, signs or symptoms of ureteral stones may frequently include

A. hematuria.

44

One cause of an extrinsic renal system obstruction is

B. pelvic tumor.

45

A serious complication of deep vein thrombosis is

D. pulmonary embolus.

46

What clinical finding would suggest an esophageal cause of a client’s report of dysphagia?

C. Chest pain during meals

47

The most common symptom of multiple myeloma is

C. bone pain

48

Administration of which therapy is most appropriate for hypovolemic shock?

A. Crystalloids

49

The pain of nonarticular rheumatism (“growing pain”) is worse

D. during the night

50

Reperfusion injury to cells

D. involves formation of free radicals.

51

The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII.

A. True

52

A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm?

C. Ventricular escape rhythm

53

Antidiuretic hormone (ADH) increases

C. water reabsorption in the collecting tubule of the kidney.

54

People who have osteoporosis are at risk for

D. bone fractures.

55

The most definitive diagnostic method for active tuberculosis is acquired via

A. sputum culture.

56

The major cause of glomerulonephritis is

B. immune system damage to the glomeruli.

57

It is true that Graves disease is

B. associated with autoantibodies to TSH receptors.

58

Which symptom suggests the presence of a hiatal hernia?

B. heartburn

59

Hypertension with a specific, identifiable cause is known as _____ hypertension.

C. secondary

60

Tissues are able to autoregulate their rate of blood flow by controlling

C. vascular resistance.

61

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes

D. a butterfly pattern rash on the face across the bridge of the nose.

62

The breakdown of stored glycogen in the liver and muscles is called

C. glycogenolysis.

63

Ascending paralysis with no loss of sensation is characteristic of

B. Guillain-Barré syndrome.

64

Clinical manifestations of chronic arterial obstruction include

B. intermittent claudication.

65

The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension.

A. True

66

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

D. calcium.

67

In contrast to osteoarthritis, rheumatoid arthritis may be associated with

D. systemic aching in the musculoskeletal system.

68

________ edema occurs when ischemic tissue swells because of cellular energy failure.

D. Cytotoxic

69

It is true that encephalitis is usually

C. because of a viral infection in brain cells.

70

Cor pulmonale refers to

C. right ventricular hypertrophy secondary to pulmonary hypertension

71

The disease that is similar to osteomalacia and occurs in growing children is

A. rickets.

72

The pathophysiology of osteomalacia involves

D. inadequate mineralization in the osteoid.

73

Second-degree heart block type I (Wenckebach) is characterized by

B. lengthening PR intervals and dropped P wave.

74

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

B. “Your husband’s kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney.”

75

Celiac sprue is a malabsorptive disorder associated with

A. inflammatory reaction to gluten-containing foods.

76

Which vessel normally demonstrates the most rapid blood flow?

D. the vena cava

77

The most likely cause of acidosis in a patient with end-stage renal disease is

C. insufficient metabolic acid excretion resulting from nephron loss.

78

An erroneously low blood pressure measurement may be caused by

A. positioning the arm above the heart level.

79

Atherosclerotic plaques with large lipid cores are prone to

C. rupture.

80

Myxedema coma is a severe condition associated with

A. hypothyroidism.

81

Obstructive sleep apnea would most likely be found in a patient diagnosed with

C. Pickwickian syndrome.

82

The organism most commonly associated with acute pyelonephritis is

B. Escherichia coli.

83

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

B. meningitis.

84

A patient who should be routinely evaluated for peptic ulcer disease is one who is

B. being treated with high-dose oral glucocorticoids.

85

The infection frequently associated with development of postinfectious acute glomerulonephritis is

B. throat infection.

86

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.

C. III

87

Which condition is caused by a genetic defect?

D. Polycystic kidney disease

88

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation?

A. Q = P/R

89

Individuals diagnosed with systemic lupus erythematosus (SLE) are at risk for developing numerous complications of various organs because of

C. immune injury to basement membranes.

90

Proto-oncogenes

B. are normal cellular genes that promote growth.

91

A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing

A. vitamin K deficiency bleeding.

92

Calcium oxylate stone formation is facilitated by

A. hypercalciuria.

93

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is

B. ST-segment elevation.

94

What results when systemic blood pressure is increased?

C. Vasoconstriction

95

What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?

D. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

96

Which pulmonary function test result is consistent with a diagnosis of asthma?

A. Reduced forced expiratory volume in 1 second (FEV1)

97

After evaluation, a child’s asthma is characterized as “extrinsic.” This means that the asthma is

B. associated with specific allergic triggers.

98

Two primary acid-base disorders that are present independently are referred to as

D. mixed acid-base imbalance.

99

Activation of the extrinsic pathway of coagulation is initiated by

C. tissue thromboplastin.

100

The type of glomerulonephritis which is most likely to result in a swift decline in renal function that then progresses to acute kidney injury is

B. crescentic glomerulonephritis.

101

An elderly patient’s blood pressure is measured at 160/98. How would the patient’s left ventricular function be affected by this level of blood pressure?

B. Left ventricular workload is increased with high afterload.

102

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt

C. within the same dermatome.

103

Which condition enhances lymphatic flow?

B. Increased interstitial fluid colloid osmotic pressure

104

Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures, because

D. they are deficient in active vitamin D.

105

Clinical manifestations of a stroke within the right cerebral hemisphere include

D. left-sided muscle weakness and neglect.

106

Hypernatremia may be caused by

B. decreased antidiuretic hormone secretion.

107

Rupture of a cerebral aneurysm should be suspected if the patient reports

D. sudden, severe headache.

108

Respiratory acidosis is associated with

A. increased carbonic acid.

109

Jaundice is a common manifestation of

C. liver disease.

110

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.

D. septic

111

In general, with aging, organ size and function

B. decrease.

112

The hallmark manifestation of acute respiratory distress syndrome is

D. hypoxemia.

113

Secondary injury after head trauma refers to

C. brain injury resulting from the body’s response to tissue damage.

114

Primary treatment for myocardial infarction (MI) is directed at

B. decreasing myocardial oxygen demands.

115

What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?

C. Inadequate water intake

116

Complete healing of a bone fracture occurs when

B. the callus has been completely replaced with mature bone.

117

Which intervention has been found to retard the advancement of chronic kidney disease?

D.ACE inhibitors

118

Which is indicative of a left tension pneumothorax?

C. Absent breath sounds on the left

119

Severe combined immunodeficiency (SCID) syndrome is an example of a(n)Correct Answer

A. deficient immune response.

120

Low cardiac output in association with high preload is characteristic of ________ shock.

B. cardiogenic

121

A patient presents to the physician’s office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years.

B. 4 and 7

122

What is likely to lead to hyponatremia?

D. Frequent nasogastric tube irrigation with water

123

Scrotal pain in males and labial pain in females may accompany renal pain as a result of

B. associated dermatomes.

124

The difference between stress incontinence and urge incontinence is that stress incontinence

C. is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.

125

A unique characteristic feature of fibromyalgia is the presence of

A. tender point pain.

126

The principle Ig mediator of type I hypersensitivity reactions is

D. IgE.

127

Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to

B. initiate action to have the cast split or removed.

128

Signs and symptoms of extracellular fluid volume excess include

C. bounding pulse.

129

What laboratory data would support a diagnosis of hemochromatosis?

B. Elevated ferritin

130

Asthma is categorized as a(n)

C. obstructive pulmonary disorder.

131

Pain is thought of as

A. a subjective experience that is difficult to measure objectively.

132

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

D. kill rapidly dividing cells.

133

Mitral stenosis is associated with

B. a pressure gradient across the mitral valve.

134

The effects of excessive cortisol production include

A. immune suppression.

135

Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of

B. metabolic acid deficit.

136

Restriction of which electrolytes is recommended in the management of high blood pressure?

C. Sodium

137

Coagulative necrosis is caused by

D. interrupted blood supply.

138

The gate control theory of pain transmission predicts that activity in touch receptors will

B. decrease pain signal transmission in the spinal cord.

139

After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of

C. tertiary prevention.

140

Untreated acute cholecystitis may lead to ________ of the gallbladder wall.

A. gangrene

141

The effects of histamine release include

C. increased vascular permeability.

142

The effect of nitric oxide on systemic arterioles is

A. vasodilation.

143

A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of

D. Graves disease.

144

Chronic bronchitis often leads to cor pulmonale because of

B. increased pulmonary vascular resistance.

145

A patient, who is 8 months pregnant, has developed eclampsia and is receiving intravenous magnesium sulfate to prevent seizures. To determine if her infusion rate is too high, you should regularly

B. check the patellar reflex; if it becomes weak or absent, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest.

146

The pathophysiologic basis of acute glomerulonephritis is

D. an immune complex reaction.

147

The effect of stress on the immune system

D. may involve enhancement or impairment the immune system.

148

A type of insulin that would be most appropriate for acute management of hyperglycemia is

C. regular.

149

The cellular component that is most susceptible to radiation injury is the

B. DNA

150

Which response to an injection of ACTH indicates a primary adrenal insufficiency?

A. No change in serum glucocorticoid level

151

Selye’s three phases of the stress response include all the following except

A. allostasis.

152

Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called

A. tension pneumothorax.

153

The major cause of death from leukemic disease is

A. infection.

154

Croup is characterized by

B. a barking cough.

155

Respiratory acidosis may be caused by

D. hypoventilation.

156

Osteoporosis commonly occurs in patients with end-stage renal disease because of

A. hyperparathyroidism.

157

Beta-blockers are advocated in the management of heart failure because they

B. reduce cardiac output.

158

Dysfunctional uterine bleeding (DUB) is caused by

D. absent or diminished levels of progesterone.

159

Anemia in people who have end-stage chronic renal disease is caused by

C. decreased secretion of erythropoietin.

160

At his most recent clinic visit, a patient with end-stage renal disease is noted to have edema, congestive signs in the pulmonary system, and a pericardial friction rub. Appropriate therapy at this time would include

A. initiation of dialysis.

161

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?

A. Sitting BP 88/60, HR 118

162

Signs consistent with a diagnosis of glomerulonephritis include

B. proteinuria.

163

When a patient is struck in the eye by a baseball, the result is redness and swelling. This increase in blood flow to a localized area is called

C. hyperemia.

164

A patient who reported a very painful sore throat 3 weeks ago is now diagnosed with acute post-streptococcal glomerulonephritis. When asked, “Why is my urine the color of coffee?”, the nurse responds

B. “Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored.”

165

The process responsible for distribution of fluid between the interstitial and intracellular compartments is

B. osmosis.

166

Hypertrophy of the right ventricle is a compensatory response to

D. pulmonary stenosis.

167

Appropriate management of end-stage renal disease includes

C. erythropoietin administration.

168

Constrictive pericarditis is associated with

A. impaired cardiac filling.

169

Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.

B. decreased serum sodium

170

Fully compensated respiratory acidosis is demonstrated by

A. pH 7.36, PaCO2 55, HCO3 36.

171

Which disorder is caused by inhalation of organic substances?

B. Hypersensitivity pneumonitis

172

The most common tumor-suppressor gene defect identified in cancer cells is

B. P53.

173

Burkitt lymphoma is most closely associated with

A. Epstein–Barr virus.

174

When systemic vascular resistance is decreased, blood flow

B. decreases.

175

Velocity of blood flow is measured in

A. centimeters per second.

176

An increased urine bilirubin is associated with

D. hepatitis.

177

A fracture in which bone breaks into two or more fragments is referred to as

A. comminuted.

178

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is

C. air embolus.

179

When exposed to inhaled allergens, a patient with asthma produces large quantities of

B. IgE.

180

Individuals who have chronic bronchitis most often have

A. a productive cough.

181

Of the statements below, the accurate statement regarding nutrition and cellular health is

C. deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.

182

Clinical manifestations of severe symptomatic hypophosphatemia are caused by

C. deficiency of ATP.

183

Legionnaires disease is characterized by

A. presence of systemic illness.

184

The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

bcr-abl.

185

Which assessment would support a diagnosis of type A COPD rather than type B COPD

C. Normal PaCO2, scant sputum, accessory muscle use, barrel chest

186

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating

C. “His renal tubules are recovering, so he is making more urine, but he is not able to concentrate urine well, because he is not fully recovered.”

187

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is

C. positive antinuclear antibodies.

188

Postrenal acute kidney injury may be caused by

C. bilateral kidney stones.

189

The fraction of total body water (TBW) volume contained in the intracellular space in adults is

B. two thirds.

190

Which characteristic is indicative of hemolytic anemia?

D. Jaundice

191

The main clinical manifestation of a kidney stone obstructing the ureter is

B. renal colic.

192

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

B. “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.”

193

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?

B. Stage II

194

Tachycardia is an early sign of low cardiac output that occurs because of

C. baroreceptor activity.

195

The most common agent resulting in nephrotoxicity and subsequent acute tubular necrosis (ATN) in hospitalized patients is

A. contrast media.

196

Treatment for hemophilia A includes

C. factor VIII replacement.

197

Which treatment is helpful in neuropathic pain but not used for acute pain?

C. Anticonvulsants

198

Uterine prolapse is caused by a relaxation of the

A. cardinal ligaments.

199

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.

D. renin

200

A patient has ureteral colic. The manifestation that requires immediate notification of the physician is

D. chills and fever.

201

“Tell me again the name of that chemical that makes crystals when my gout flares up,” asks the client. The nurse’s best response is

C. uric acid.

202

Cerebral aneurysm is most frequently the result of

B. subarachnoid hemorrhage.

203

Tophi are

B. deposits of urate crystals in tissues.

204

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.

A. True

205

Administration of a vasodilator to a patient in shock would be expected to

C. decrease left ventricular afterload.

206

A progressive decrease in the force of the urinary stream, dribbling of urine, and difficulty initiating the urinary stream are characteristic of

D. prostatic enlargement.

207

Orthostatic hypotension may be a manifestation of

C. Parkinson disease.

208

The stage during which the patient functions normally, although the disease processes are well established, is referred to as

B. subclinical.

209

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of

B. amyotrophic lateral sclerosis.

210

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of

A. appendicitis.

211

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.

A. True

212

A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with

A. hemophilia.

213

Manifestations from sodium imbalances occur primarily as a result of

A. cellular fluid shifts.

214

Transfusion reactions involve RBC destruction caused by

B. recipient antibodies.

215

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

B. the glomerular membrane has increased permeability.

216

Hypertension is closely linked to

A. obstructive sleep apnea.

217

It is true that polycystic kidney disease is

D. genetically transmitted.

218

The physiologic change most likely to lead to an increase in intracranial pressure is

B. cerebral vasodilation.

219

Lack of α-antitrypsin in emphysema causes

B. destruction of alveolar tissue.

220

A patient diagnosed with a micropenis must be evaluated for

A. endocrine disorders.

221

Findings that should prompt an evaluation for renal cancer include

C. hematuria.

222

A patient receiving chemotherapy may be at greater risk for development of

B. stomatitis.

223

Normal bile is composed of

A. water, electrolytes, and organic solutes.

224

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?

A. Continue lifestyle modifications only.

225

A restrictive respiratory disorder is characterized by

B. decreased residual volume.

226

The stage of spinal shock that follows spinal cord injury is characterized by

C. absent spinal reflexes below the level of injury.

227

Which is not a manifestation of acute arterial obstruction?

B. Purpura

228

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with

C. high cardiac output.

229

Renal compensation for respiratory acidosis is evidenced by

D. elevated bicarbonate ion concentration.

230

The cellular response indicative of injury because of faulty metabolism is

D. intracellular accumulations.

231

Leakage of CSF from the nose or ears is commonly associated with

C. basilar skull fracture.

232

The pain associated with chronic pancreatitis is generally described as ________ in nature.

B. steady and boring

233

The most common cause of intrinsic kidney injury is _____ injury.

B. tubular

234

Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.

B. False

235

What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission?

A. Slower rate of action potential conduction

236

Fecal leukocyte screening would be indicated in a patient with suspected

B. enterocolitis.

237

In addition to E. coli, a risk factor for development of pyelonephritis is

A. urinary retention and reflux.

238

Decreased neuromuscular excitability is often the result of

A. hypercalcemia and hypermagnesemia.

239

Blood flow is slow through capillaries because capillaries

B. have the largest total cross-sectional area.

240

The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?

D. The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.

241

A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with

C. telangiectasia.

242

A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is

B. hyponatremia.

243

Patients who experience anemic episodes when exposed to certain drugs most likely have

D. glucose-6-phosphate dehydrogenase deficiency.

244

Most gallstones are composed of

B. cholesterol.

245

A patient with pure left-sided heart failure is likely to exhibit

B. pulmonary congestion with dyspnea.

246

Excessive red cell lysis can be detected by measuring the serum

C. bilirubin.

247

What laboratory finding is usually found in aplastic anemia?

D. Pancytopenia

248

Accumulation of fluid in the pleural space is called

D. pleural effusion.

249

A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is

D. gastroesophageal varices.

250

A ureterocele is

C. a cystic dilation of a ureter.

251

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?

C. Iron deficiency

252

Hypotension associated with neurogenic and anaphylactic shock is because of

B. peripheral pooling of blood.

253

The patient most at risk for postrenal acute kidney injury is a(n)

A. elderly patient with hypertrophy of the prostate.

254

An important mediator of a type I hypersensitivity reaction is

D. histamine.

255

A compound, transverse fracture is best described as a bone that is

D. broken and protruding through the skin.

256

Apoptosis is a process that results in cellular

B. death

257

Modulation of pain signals is thought to be mediated by the release of

B. endorphins.

258

Appropriate therapy for prerenal kidney injury includes

A. fluid administration.

259

Liver transaminase elevations in which aspartate aminotransferase (AST) is markedly greater than alanine aminotransferase (ALT) is characteristic of

B. alcohol-induced injury.

260

Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with

C. hypophosphatemia.

261

It is recommended that women of childbearing age take folic acid daily for prevention of

A. neural tube defects.

262

What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus?

C. Glycosylated hemoglobin levels (HbA1c)

263

The final step in clot formation is

D. clot retraction.

264

The normal post-void residual urine in the bladder is

A. less than 100 mL.

265

Clinical manifestations of extracellular fluid volume deficit include

A. weak pulse, low blood pressure, and increased heart rate.

266

The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of

A. tumor necrosis factor.

267

Neuromuscular disorders impair lung function primarily because of

C. weak muscles of respiration.

268

Sepsis has been recently redefined as

C. a systemic inflammatory response to infection.

269

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

B. is malignant.

270

What type of seizure usually occurs in children and is characterized by brief staring spells?

D. Absence

271

Pelvic floor muscle training is appropriate for

C. urge incontinence

272

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

D. Septic

273

Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States.

D. seventh

274

The most common presenting sign/symptom with rheumatic fever is

B. polyarthritis.

275

In the acute phase of stroke, treatment is focused on

A. stabilization of respiratory and cardiovascular function.

276

Sudden, severe testicular pain is indicative of

C. testicular torsion.

277

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

B. functional.

278

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

A. massive histamine release from mast cells leads to vasodilation.

279

Premature infants are at greater risk for developing

A. necrotizing enterocolitis.

280

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.

A. True

281

A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of this disease. This stage of illness is called the _____ stage.

B. latent

282

The expected treatment of a pregnant woman with hyperemesis gravidarum is

D. intravenous therapy.

283

Retroviruses are associated with human cancers, including

D. Burkitt lymphoma.

284

Following a bone fracture, the most likely event to occur is

A. development of a blood clot beneath the periosteum.

285

Cervical cancer can be detected in the early, curable stage by the ________ test.

A. Papanicolaou

286

An increase in the resting membrane potential (hyperpolarized) is associated with

A. hypokalemia.

287

A level of ____ on the Glasgow Coma Scale indicates likely fatal damage.

A. 3

288

Which complication of asthma is life threatening?

C. Status asthmaticus

289

Rupture of esophageal varices is a complication of cirrhosis with portal hypertension and carries a high ________ rate.

D. mortality

290

The pathophysiology of rheumatoid arthritis involves

A. immune cells accumulating in pannus and destroying articular cartilage.

291

The chief pathologic features of osteoarthritis are

C. degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium.

292

A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of

B. hypoparathyroidism.

293

New-organ damage is a function of both the stage of hypertension and its duration.

B. False

294

The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who

C. has had diarrhea for over a week.

295

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

C. Anaphylactic

296

The most helpful laboratory value in monitoring the progression of declining renal function is

A. serum creatinine.

297

Osmoreceptors located in the hypothalamus control the release of

D. vasopressin (antidiuretic hormone, ADH).

298

Myasthenia gravis is a type II hypersensitivity disorder that involves

A. impaired muscle function.

299

Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure.

B. mean arterial

300

A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of

B. octreotide acetate.

301

Upper extremity weakness in association with degeneration of CNS neurons is characteristic of

D. amyotrophic lateral sclerosis.

302

The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient

D. has chronic heart failure that is treated with diuretics.

303

Infection can lead to bladder stone formation.

A. True

304

The microorganism that causes the vast majority of urinary tract infections is

B. Escherichia coli.

305

Cystic fibrosis is associated with

C. bronchiectasis.

306

Familial retinoblastoma involves the transmission of what from parent to offspring?

A. Mutant tumor-suppressor gene

307

The goal of long term heparin for the management of a deep vein thrombosis is to

D. prevent further clot formation.

308

The progressive stage of hypovolemic shock is characterized by

A. tachycardia.

309

Metaplasia is

A. the replacement of one differentiated cell type with another.

310

Growth hormone-deficient infants would display

B. normal birth length and weight.

311

The earliest manifestation of scleroderma is

D. Raynaud phenomenon.

312

The person at highest risk of a greenstick fracture from falling off a tall ladder is age

C. 8

313

Carbon monoxide injures cells by

B. reducing oxygen level on hemoglobin.

314

A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop

C. hypophosphatemia.

315

The most common primary immune deficiency that affects only B cells is

D. selective IgA.

316

The risk for contrast media–induced acute tubular necrosis (ATN) is highest in

A. a 70-year-old patient with heart failure.

317

The most likely cause of anemia in a patient with end-stage renal disease is

A. insufficient erythropoietin.

318

Clinical manifestations of moderate to severe hypokalemia include

B. muscle weakness and cardiac dysrhythmias.

319

In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.

B. False

320

Hepatic encephalopathy is associated with

D. increased blood ammonia levels.

321

Which is not considered to be a risk factor for thrombus formation?

A. Thrombocytopenia

322

An abnormally wide (more than 0.10 second) QRS complex is characteristic of

D. premature ventricular complexes.

323

Type 2 diabetes mellitus is often associated with

A. nonketotic hyperosmolality.

324

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by

C. increased residual lung volumes.

325

The condition associated with end-stage chronic renal disease that is the most immediately life threatening is

D. hyperkalemia.

326

Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they

A. increase dopamine activity in the basal ganglia.

327

The primary source of erythropoietin is provided by the

B. kidney.

328

Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA) is

B. autoimmune hepatitis.

329

One of the most frequent causes of chronic kidney disease is

A. hypertension.

330

Activation of parasympathetic nerves to the bladder will cause

A. bladder contraction.

331

Slow pain sensation is transmitted primarily by

C. unmyelinated C fibers.

332

Uncompensated metabolic alkalosis would result in

A. increased pH, increased HCO3 .

333

The primary cause of infant respiratory distress syndrome is

B. lack of surfactant.

334

Emphysema results from destruction of alveolar walls and capillaries, which is because of

A. release of proteolytic enzymes from immune cells.

335

0 / 0.05 ptsA patient who reports an intestinal fistula also reports feeling “weak and dizzy” when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician?

C. Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.

336

A person with acute hypoxemia may hyperventilate and develop

B. respiratory alkalosis.

337

Glomerular disorders include

D. nephrotic syndrome.

338

Sexual impotence is rarely because of

C. primary causes.

339

The ________ system compensates for metabolic acidosis and alkalosis.

D. respiratory

340

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?

B. pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high

341

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be

B. an autoimmune process.

342

The most commonly ordered diagnostic test for evaluation of the urinary system is

C. ultrasonography.

343

Empyema is defined as an

B. infection in the pleural space.

344

A clinical finding consistent with a hypoglycemic reaction is

C. tremors.

345

Which electrolyte imbalances cause increased neuromuscular excitability?

C. Hypocalcemia and hypomagnesemia

346

What is necessary for red blood cell production?

B. Iron

347

A disease that is native to a particular region is called

B. endemic.

348

________ disease is a rare autosomal recessive disorder in which excessive amounts of copper accumulate in the liver.

B. Wilson

349

A risk factor for osteoporosis is

B. early menopause.

350

The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL.

A. 19.4

351

A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is

B. hypoglycemia

352

The most common cause of urinary obstruction in male newborns and infants is urethral valves.

A. True

353

Ankylosing spondylitis is characterized by

A. inflammation, stiffness, and fusion of spinal joints.

354

Aortic regurgitation is associated with

A. diastolic murmur.

355

The most appropriate treatment for secondary polycythemia is

B. measured to improve oxygenation.

356

Ulcerative colitis is commonly associated with

A. bloody diarrhea.

357

Pneumocystitis is a term that refers to a

A. fungal pneumonia secondary to HIV.

358

Inflammation of the sacs that overlie bony prominences is called

D. bursitis.

359

A patient with flail chest will demonstrate

D. outward chest movement on expiration.

360

Effects of hypernatremia on the central nervous system typically include

A. confusion.

361

C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.’s disease is

B. streptococcal infection.

362

A patient with chronic gastritis would likely be tested for

A. Helicobacter pylori.

363

The prognosis of penile carcinoma depends upon the stage of the disease.

A. True

364

A cause of thrombocytopenia includes

C. chemotherapy.

365

The majority of penile cancer cases are classified as basal cell carcinoma.

B. False

366

First-degree heart block is characterized by

A. prolonged PR interval.

367

Which form of leukemia demonstrates the presence of the Philadelphia chromosome?

D. CML (chronic myeloid leukemia)

368

A breast lump that is painless, hard, and unmoving is most likely

D. carcinoma.

369

A patient with pancreatitis may experience muscle cramps secondary to

C. hypocalcemia.

370

Paget’s disease is characterized by

B. excessive bone resorption followed by excessive formation of fragile bone.

371

Risk factors for hemorrhagic stroke include

C. acute hypertension.

372

Elevated serum lipase and amylase levels are indicative of

C. pancreatitis.

373

A known cause of hypokalemia is

C. insulin overdose.

374

The physiologic mechanisms involved in the pain phenomenon are termed

A. nociception.

375

Angina caused by coronary artery spasm is called _____ angina.

D. Prinzmetal variant

376

All these cellular responses are potentially reversible except

A. necrosis.

377

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient’s symptomology is most likely related to

B. hypotension.

378

Nephrotic syndrome does not usually cause

C. hematuria.

379

The oliguric phase of acute tubular necrosis is characterized by

A. fluid excess and electrolyte imbalance.

380

A primary laboratory finding in end-stage chronic renal disease is

D. increased serum creatinine.

381

Dysfunction of which organ would lead to clotting factor deficiency?

A. Liver

382

Which statement is true about the incidence of multiple sclerosis?

A. The age of onset ranges from 20 to 50 years.

383

A tool used to assess levels of consciousness is

C. Glasgow Coma Scale (GCS).

384

In general, the best prognosis for long-term disease-free survival occurs with

A. ALL (acute lymphoid leukemia).

385

The definitive treatment for cholecystitis is

D. cholecystectomy.

386

The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes.

A. less than 180

387

Compartment syndrome occurs secondary to

B. soft-tissue damage.

388

Propylthiouracil may be used to treat hyperthyroidism, because it

D. inhibits thyroid hormone synthesis.

389

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.

B. False

390

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

D. antibiotics.

391

The most commonly recognized outcome of hypertension is pulmonary disease.

B. False

392

Intracranial pressure normally ranges from ______ mm Hg.

A. 0 to 15

393

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache.

B. migraine

394

Myocarditis should be suspected in a patient who presents with

B. acute onset of left ventricular dysfunction.

395

A commonly ingested substance associated with prolongation of the bleeding time is

D. aspirin.

396

Insulin binding to its receptor on target cells results in

C. increased facilitated cellular diffusion of glucose.

397

Risk factors for atherosclerosis include

B. hyperlipidemia.

398

Renal insufficiency occurs when _____ of the nephrons are not functional.

C. 75% to 90%

399

Respiratory alkalosis is caused by

A. hyperventilation

400

Most carbon dioxide is transported in the bloodstream as

B. bicarbonate ion.

401

Congenital adrenal hyperplasia (adrenogenital syndrome) results from

D. blocked cortisol production.

402

Urinary retention with consistent or intermittent dribbling of urine is called

D. overflow incontinence.

403

Peripheral edema is a result of

B. venous thrombosis.

404

An example of an acyanotic heart defect is

C. ventricular septal defect.

405

The primary effect of aging on all body systems is

A. decreased functional reserve.

406

A major modifiable risk factor for nephrolithiasis is

B. dehydration.

407

In which dysrhythmias should treatment be instituted immediately?

D. Atrial fibrillation with a ventricular rate of 220 beats/minute

408

The greatest risk factor for bladder cancer is

A. smoking.

409

Prerenal acute kidney injury may be caused by

A. severe hypotension.

410

The HPV vaccine is recommended for 11- to 12-year-old girls, but can be administered to girls as young as _____ years of age.

C. 9

411

A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?

C. Rapid, deep breathing, lethargy, abdominal pain

412

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is

A. stable angina.

413

Venous obstruction leads to edema because it ________ pressure.

D. increases capillary hydrostatic

414

Pernicious anemia is caused by a lack of

B. intrinsic factor.

415

Which is not normally secreted in response to stress?

D. Insulin

416

Myasthenia gravis is an autoimmune disease in which

C. acetylcholine receptors are destroyed or dysfunctional.

417

A 52-year-old female had a surgical procedure in which the breast, lymphatics, and underlying muscle were removed. The procedure performed was a

A. radical mastectomy.

418

Excessive vomiting in pregnant women is known as

C. hyperemesis gravidarum.

419

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

B. cardiac tamponade.

420

Airway obstruction in chronic bronchitis is because of

A. thick mucus, fibrosis, and smooth muscle hypertrophy.

421

It is true that epidural bleeding is

D. characterized by a lucid interval immediately after injury.

422

A primary effector cell of the type I hypersensitivity response is

B. mast cells.

423

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?

D. Tachycardia

424

Cryptorchidism is

A. associated with an increased incidence of testicular cancer.

425

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct?

B. “Lung cancer has about a 15% survival rate.”

426

A patient has a positive Chvostek sign. The nurse interprets this as a sign of

D. increased neuromuscular excitability.

427

Which causes vasoconstriction?

A. Norepinephrine

428

To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke

A. impairs α1-antitrypsin, allowing elastase to predominate.

429

The condition in which the urethra opens on the dorsal aspect of the penis is known as

C. epispadias

430

Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to

A. cerebral vasospasm.

431

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is

A. elevated total iron-binding capacity.

432

It is true that biliary cancer

D. tend to be asymptomatic and progress insidiously.

433

Obstructive disorders are associated with

B. low expiratory flow rates.

434

Which clinical manifestation is not likely the result of a tuberculosis infection?

D. Cyanosis

435

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient’s blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time?

B. Begin antihypertensive drug therapy.

436

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

A. ALL (acute lymphoid leukemia)

437

The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis.

A. hemolysis

438

The most frequent initial symptom of bladder cancer is

B. hematuria.

439

Most sensory afferent pain fibers enter the spinal cord by way of the ________ nerve roots.

B. posterior

440

In the United States, nearly ________ people have diabetes mellitus.

B. 29.1 million

441

Pain in fibromyalgia involves

D. changes in pain transmission in the spinal cord.

442

What reproductive tract disorder is most likely to be associated with urinary stress incontinence?

C. Cystocele

443

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?

A. Increased LDL levels are associated with increased risk of coronary artery disease.

444

The imbalance that occurs with oliguric renal failure is

B. hyperkalemia.

445

Enteropathic arthritis is associated with

B. inflammatory bowel disease.

446

A common component of renal calculi is

B. calcium

447

Which alterations can lead to edema?

C. Decreased lymphatic flow

448

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is

C. activity restriction.

449

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.

A. True

450

Ankylosing spondylitis causes

A. intervertebral joint fusion.

451

Copious amounts of foul-smelling sputum are generally associated with

D. bronchiectasis.

452

In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.

B. False

453

The ________ is the level of painful stimulation required to be perceived.

D. threshold

454

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with

B. antiplatelet drugs.

455

“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

C. “No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone.”

456

Which group is at the highest risk for urinary tract infection?

B. Sexually active women

457

A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of

A. bacterial pneumonia.

458

Red blood cells differ from other cell types in the body, because they

B. have no cytoplasmic organelles.

459

The condition characterized by oliguria and hematuria is

A. acute glomerulonephritis.

460

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

D. hypertensive crisis.

461

Endometriosis is a condition in which

B. ectopic endometrial tissue is present.

462

A common characteristic of viral pneumonia is

D. dry cough.

463

The major buffer in the extracellular fluid is

C. bicarbonate.

464

If an individual has a fully compensated metabolic acidosis, the blood pH is

C. in the normal range.

465

The underlying pathogenic mechanism for type 2 diabetes is

B. insulin resistance and β-cell dysfunction.

466

The hypersensitivity reaction that does not involve antibody production is type

D. IV

467

The most common source of osteomyelitis is

A. an infection that migrates via the bloodstream.

468

The inward-pulling force of particles in the vascular fluid is called _____ pressure.

C. capillary osmotic

469

________ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes.

A. Nystagmus

470

The prevalence of high blood pressure is higher in

C. non-Hispanic black adults.

471

Vesicoureteral reflux is associated with

B. recurrent cystitis.

472

The activated partial thromboplastin time (aPTT) is a measure of the integrity of

B. the intrinsic pathway.

473

The consequence of an upper urinary tract obstruction in a single ureter is

B. hydronephrosis.

474

The major underlying factor leading to the edema associated with glomerulonephritis and nephrotic syndrome is

D. hematuria.

475

If acute tubular necrosis (ATN) does not resolve and continued tubular dysfunction ensues, the patient will then experience

D. polyuria and sodium wasting.

476

In type I diabetes, respiratory compensation may occur through a process of

A. respiratory alkalosis.

477

A change occurring in a pregnant woman that is indicative of a potential disorder is

D. increased urinary protein.

478

A person with acute pyelonephritis would most typically experience

A. fever

479

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?

A. Class I

480

Nephrotic syndrome involves loss of large amounts of ________ in the urine.

D. protein

481

It is true that the synthesis of thyroid hormones

D. is inhibited by iodine deficiency.

482

Metabolic alkalosis is often accompanied by

D. hypokalemia.

483

An increase in ADH secretion occurs in response to

B. dehydration.

484

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of

A. vitamin K deficiency.

485

Excessive vomiting in pregnant women is known as

B. hyperemesis gravidarum.

486

Manifestations of acute brain ischemia (Cushing reflex) are due primarily to

B. sympathetic nervous system activation.

487

Infection by ________ accounts for nearly half of all reported cases of vulvovaginitis.

B. Candida albicans

488

A person who experiences a panic attack and develops hyperventilation symptoms may experience

C. numbness and tingling in the extremities.

489

Absence of menstruation is called

A. amenorrhea.

490

Barrett esophagus is a

B. preneoplastic lesion.

491

A malignant bone-forming tumor is referred to as a(n)

C. osteosarcoma.

492

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of

C. nitric oxide.

493

Malignant neoplasms of epithelial origin are known as

C. carcinomas.

494

The signs and symptoms of adrenocortical hormone excess may occur from either a primary or secondary disorder. A symptom associated with primary Cushing syndrome is

C. hyperglycemia.

495

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.

B. obstructive

496

Emesis causes

D. metabolic alkalosis.

497

A patient diagnosed with chronic compensated heart failure reports that, “My feet swell if I eat salt but I don’t understand why” The nurse’s best response is

A. “Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell.”

498

A major risk factor for the development of active pulmonary tuberculosis (TB) disease is

B. immunosuppression.

499

The patient reports persistent pelvic pain and urinary frequency and urgency. She says the pain improves when she empties her bladder. She does not have a fever and her repeated urinalyses over the past months have been normal, although she has a history of frequent bladder infections. She also has a history of fibromyalgia and hypothyroidism. Based on her history and complaints, her symptoms are characteristic of

D. interstitial cystitis.

500

The primary adaptive purpose of the substances produced in the alarm stage is

A. energy and repair.

501

Hemophilia B is also known as Christmas disease.

A. True

502

Bacterial pneumonia leads to hypoxemia caused by

C. accumulation of alveolar exudates.

503

Pulse pressure is defined as

C. systolic pressure – diastolic pressure.

504

One of the most common causes of acute tubular necrosis (ATN) is

A. ischemic conditions.

505

Dumping syndrome is commonly seen after __________ procedures.

D. gastric bypass

506

Prosthetic joint infection is most often because of

C. hematogenous transfer.

507

An early indicator of colon cancer is

C. a change in bowel habits.

508

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

B. secondary prevention.

509

What problem is a patient likely to experience in end-stage renal disease?

C. Uremia

510

Esophageal varices represent a complication of ________ hypertension.

C. portal

511

Which condition is associated with an elevated reticulocyte count?

D. Hemolytic anemia

512

The majority of tachydysrhythmias are believed to occur because of

D. reentry mechanisms.

513

Left-sided heart failure is characterized by

A. pulmonary congestion.

514

The most challenging aspect of treatment for chronic pancreatitis is

D. pain control

515

Which type of leukemia primarily affects children?

A. ALL (acute lymphoid leukemia)

516

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?

A. It is a procedure for determining the extent of tumor spread.

517

Constipation in an elderly patient can be best treated by

D. increasing fiber in the diet.

518

What is the effect on resistance if the radius of a vessel is halved?

D. Resistance increases by a factor of 16.

519

Muscular dystrophy includes a number of muscle disorders that are

A. genetically transmitted.

520

Pain with passive stretching of a muscle is indicative of

A. noncontractile tissue injury.

521

When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will

A. put a sputum cup and a box of tissues on the bedside table.

522

The displacement of two bones in which the articular surfaces partially lose contact with each other is called

A. subluxation.

523

Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of

A. acute respiratory distress syndrome.

524

Persistence of the alarm stage will ultimately result in

B. permanent damage and death.

525

Diabetes insipidus is a condition that

A. results from inadequate ADH secretion.

526

The most important determinant for prescribing therapy for acute stroke is

C. ischemic versus hemorrhagic cause.

527

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

A. delayed healing.

528

Which acid are the kidneys unable to excrete?

B. Carbonic

529

Allostasis is best defined as

D. the overall process of adaptive change necessary to maintain survival and well-being.

530

Rheumatoid arthritis involves joint inflammation caused by

C. autoimmune injury.

531

Diabetic neuropathy is thought to result from

A. decreased myoinositol transport.

532

Indicators that an individual is experiencing high stress include all the following except

D. pupil constriction.

533

Hepatitis B is usually transmitted by exposure to

C. blood or semen.

534

The dementia of Alzheimer disease is associated with structural changes in the brain, including

A. deposition of amyloid plaques in the brain.

535

Blood flow throughout the periphery is regulated by

B. the autonomic nervous system.

536

Causes of metabolic acidosis include

C. tissue anoxia.

537

It is true that gallstones are

B. more common in women.