check your understanding week 8 Flashcards
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia.
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.
Diabetic neuropathy is thought to result from
decreased myoinositol transport.
The most common cause of intrinsic kidney injury is _____ injury.
tubular
The prognosis of penile carcinoma depends upon the stage of the disease.
True
The most common symptom of multiple myeloma is
bone pain.
The best intervention for acute kidney injury (AKI) is prevention.
True
The stroke etiology with the highest morbidity and mortality is
intracranial hemorrhage.
The patient most at risk for postrenal acute kidney injury is a(n)
elderly patient with hypertrophy of the prostate.
It is true that Bell palsy is a
paralysis of the muscles innervated by the facial nerve.
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?
Sitting BP 88/60, HR 118
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is
digitalis.
The most commonly ordered diagnostic test for evaluation of the urinary system is
ultrasonography.
Obstructive disorders are associated with
low expiratory flow rates.
The most common type of renal stone is
calcium.
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.
Hypertrophy of the right ventricle is a compensatory response to
pulmonary stenosis.
Causes of hypomagnesemia include
chronic alcoholism.
The breakdown of stored glycogen in the liver and muscles is called
glycogenolysis.
The major cause of death from leukemic disease is
infection.
A breast lump that is painless, hard, and unmoving is most likely
carcinoma.
Untreated acute cholecystitis may lead to ________ of the gallbladder wall.
gangrene
Clinical manifestations of extracellular fluid volume deficit include
weak pulse, low blood pressure, and increased heart 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.
It is true that biliary cancer
tend to be asymptomatic and progress insidiously.
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH).
A primary laboratory finding in end-stage chronic renal disease is
increased serum creatinine.
Antidiuretic hormone (ADH) increases
water reabsorption in the collecting tubule of the kidney.
Which electrolyte imbalances cause increased neuromuscular excitability?
Hypocalcemia and hypomagnesemia
A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is
positive antinuclear antibodies.
The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of
extrinsic pathway.
Pain in fibromyalgia involves
changes in pain transmission in the spinal cord.
The formation of active vitamin D
is impaired in renal failure.
Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.
False
A common characteristic of viral pneumonia is
dry cough.
Prosthetic joint infection is most often because of
hematogenous transfer.
First-degree heart block is characterized by
prolonged PR interval.
The oliguric phase of acute tubular necrosis is characterized by
fluid excess and electrolyte imbalance.
The anemia resulting from a deficiency of either vitamin B12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.
True
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
Dumping syndrome is commonly seen after __________ procedures.
gastric bypass
Clinical manifestations of moderate to severe hypokalemia include
muscle weakness and cardiac dysrhythmias.
Sepsis has been recently redefined as
a systemic inflammatory response to infection.
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by
increased residual lung volumes.
Croup is characterized by
a barking cough.
Metaplasia is
the replacement of one differentiated cell type with another.
A clinical finding consistent with a diagnosis of rheumatoid arthritis would be
systemic manifestations of inflammation.
A patient diagnosed with a micropenis must be evaluated for
endocrine disorders.
People who have osteoporosis are at risk for
bone fractures.
Respiratory alkalosis is caused by
hyperventilation.
Type 2 diabetes mellitus is often associated with
nonketotic hyperosmolality.
Growth hormone-deficient infants would display
normal birth length and weight
Propylthiouracil may be used to treat hyperthyroidism, because it
inhibits thyroid hormone synthesis.
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
Septic
The prevalence of high blood pressure is higher in
non-Hispanic black adults.
The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL.
19.4
The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.
sodium
One of the most common causes of acute pain is
headache.
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?
Increased LDL levels are associated with increased risk of coronary artery disease.
The condition associated with end-stage chronic renal disease that is the most immediately life threatening is
hyperkalemia.
Which is not considered to be a risk factor for thrombus formation?
Thrombocytopenia
A thyroid gland that grows larger than normal is known as
goiter.
A 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?
Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.
The greatest risk factor for bladder cancer is
smoking.
A risk factor for osteoporosis is
early menopause.
Jaundice is a common manifestation of
liver disease.
The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII.
True
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?
Iron deficiency
In addition to E. coli, a risk factor for development of pyelonephritis is
urinary retention and reflux.
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because
demyelination is mediated by immune mechanisms.
Inflammation of the sacs that overlie bony prominences is called
bursitis.
All the following stress-induced hormones increase blood glucose except
aldosterone.
The definitive treatment for cholecystitis is
cholecystectomy.
The pathophysiologic basis of acute glomerulonephritis is
an immune complex reaction.
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?
Ventricular escape rhythm
A progressive decrease in the force of the urinary stream, dribbling of urine, and difficulty initiating the urinary stream are characteristic of
prostatic enlargement.
Myxedema coma is a severe condition associated with
hypothyroidism.
Pelvic floor muscle training is appropriate for
urge incontinence.
Which type of leukemia primarily affects children?
ALL (acute lymphoid leukemia)
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
hyperglycemia.
The effects of histamine release include
increased vascular permeability.
The risk for contrast media–induced acute tubular necrosis (ATN) is highest in
a 70-year-old patient with heart failure.
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload.
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 American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes.
less than 180
Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to
autoimmune mechanisms.
The most commonly recognized outcome of hypertension is pulmonary disease.
False
The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient
has chronic heart failure that is treated with diuretics.
Signs and symptoms of clinical dehydration include
decreased urine output.
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of
tumor necrosis factor.
The gate control theory of pain transmission predicts that activity in touch receptors will
decrease pain signal transmission in the spinal cord.
Empyema is defined as an
infection in the pleural space.
The most common source of osteomyelitis is
an infection that migrates via the bloodstream.
Which causes vasoconstriction?
Norepinephrine
Thalassemia may be confused with iron-deficiency anemia, because they are both
microcytic.
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
interstitial cystitis.
The most common presenting sign/symptom with rheumatic fever is
polyarthritis.
When the cause is unknown, a condition is said to be idiopathic
True
The physiologic mechanisms involved in the pain phenomenon are termed
nociception.
Surgical removal of a gland may result in
hyposecretion.
Calcium oxylate stone formation is facilitated by
hypercalciuria.
What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus?
Glycosylated hemoglobin levels (HbA1c)
A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache.
migraine
Excessive red cell lysis can be detected by measuring the serum
bilirubin.
Of the statements below, the accurate statement regarding nutrition and cellular health is
deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.
The dementia of Alzheimer disease is associated with structural changes in the brain, including
deposition of amyloid plaques in the brain.
The most common types of uterine tumors are known as
leiomyomas.
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?
Begin antihypertensive drug therapy.
A bone disorder that results from insufficient vitamin D is referred to as
osteomalacia.
Neuromuscular disorders impair lung function primarily because of
weak muscles of respiration.
Cardiogenic shock is characterized by
reduced cardiac output.
The direct cause of stress incontinence is
pelvic muscle weakness.
Malignant neoplasms of epithelial origin are known as
carcinomas.
Excessive vomiting in pregnant women is known as
hyperemesis gravidarum.
The organism most commonly associated with acute pyelonephritis is
Escherichia coli.
The most important determinant for prescribing therapy for acute stroke is
ischemic versus hemorrhagic cause.
The most appropriate treatment for secondary polycythemia is
measured to improve oxygenation.
Anemia in people who have end-stage chronic renal disease is caused by
decreased secretion of erythropoietin.
Which is indicative of a left tension pneumothorax?
Absent breath sounds on the left
Burkitt lymphoma is most closely associated with
Epstein–Barr virus.
What is likely to lead to hyponatremia?
Frequent nasogastric tube irrigation with water
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
128/82
Which pulmonary function test result is consistent with a diagnosis of asthma?
Reduced forced expiratory volume in 1 second (FEV1)
The ________ is the level of painful stimulation required to be perceived.
threshold
In general, with aging, organ size and function
decrease.
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who
has had diarrhea for over a week.
________ edema occurs when ischemic tissue swells because of cellular energy failure.
Cytotoxic
The pain of nonarticular rheumatism (“growing pain”) is worse
during the night.
A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because
GFR declines.
It is true that Graves disease is
associated with autoantibodies to TSH receptors.
The most common cause of ischemic acute tubular necrosis (ATN) in the United States is
sepsis.
Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency?
Osteomalacia
The organism that causes pulmonary tuberculosis is
Mycobacterium tuberculosis.
A unique characteristic feature of fibromyalgia is the presence of
tender point pain.
Hypernatremia may be caused by
decreased antidiuretic hormone secretion.
Scrotal pain in males and labial pain in females may accompany renal pain as a result of
associated dermatomes.
Systemic disorders include
rheumatoid arthritis.
Transfusion reactions involve RBC destruction caused by
recipient antibodies.
In older women, osteoporosis is thought to be primarily because of
estrogen deficiency.
A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for
pneumothorax.
Upper extremity weakness in association with degeneration of CNS neurons is characteristic of
amyotrophic lateral sclerosis.
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.
latent
The initial treatment of an individual experiencing a seizure is concentrated on
maintaining an airway.
Pain is thought of as
a subjective experience that is difficult to measure objectively.
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3– = 24 mEq/L demonstrates
respiratory alkalosis.
A person with acute hypoxemia may hyperventilate and develop
respiratory alkalosis.
The hallmark manifestation of acute respiratory distress syndrome is
hypoxemia.
Celiac sprue is a malabsorptive disorder associated with
inflammatory reaction to gluten-containing foods.
A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of
octreotide acetate.
What clinical finding would suggest an esophageal cause of a client’s report of dysphagia?
Chest pain during meals
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.
False
In type I diabetes, respiratory compensation may occur through a process of
respiratory alkalosis.
Clinical manifestations of Graves disease may include
tremor.
The classic manifestations of Parkinson disease include
rest tremor and skeletal muscle rigidity.
Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
False
Prerenal acute kidney injury may be caused by
severe hypotension.
Which group of clinical findings indicates the poorest neurologic functioning?
Assumes decorticate posture with light touch, no verbal response
The cellular response indicative of injury because of faulty metabolism is
intracellular accumulations.
Infection by ________ accounts for nearly half of all reported cases of vulvovaginitis.
Candida albicans
A severe complication of elevated intracranial pressure is
brain herniation.
The person at highest risk for developing hypernatremia is a person who
receives tube feedings because he or she is comatose after a stroke.
A clinical finding consistent with a hypoglycemic reaction is
tremors.
The most common site affected in Paget’s disease is the
lower spine.
The major buffer in the extracellular fluid is
bicarbonate.
Congenital adrenal hyperplasia (adrenogenital syndrome) results from
blocked cortisol production.
Constipation in an elderly patient can be best treated by
increasing fiber in the diet.
The condition characterized by oliguria and hematuria is
acute glomerulonephritis.
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.
III
Dysfunction of which organ would lead to clotting factor deficiency?
Liver
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
metabolic acid deficit.
A patient with chronic gastritis would likely be tested for
Helicobacter pylori.
Copious amounts of foul-smelling sputum are generally associated with
bronchiectasis.
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will
kill rapidly dividing cells.
More than half of the initial cases of pancreatitis are associated with
alcoholism.
Hepatic encephalopathy is associated with
increased blood ammonia levels.
Manifestations from sodium imbalances occur primarily as a result of
cellular fluid shifts.
The first indication of brain compression from increasing intracranial pressure (ICP) may be
sluggish pupil response to light.
Hypertension is closely linked to
obstructive sleep apnea.
Following a bone fracture, the most likely event to occur is
development of a blood clot beneath the periosteum.
A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as ________ hepatitis B.
acute
A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is
hypokalemia.
A ureterocele is
a cystic dilation of a ureter.
Emesis causes
metabolic alkalosis.
It is true that epidural bleeding is
characterized by a lucid interval immediately after injury.
What is necessary for red blood cell production?
Iron
Nephrotic syndrome involves loss of large amounts of ________ in the urine.
protein
Detrusor muscle overactivity can be improved by administration of
botulinum toxin.
Allergic (extrinsic) asthma is associated with
IgE-mediated airway inflammation.
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?
Inadequate water intake
A malignant bone-forming tumor is referred to as a(n)
osteosarcoma.
A disease that is native to a particular region is called
endemic.
Esophageal varices represent a complication of ________ hypertension.
portal
The most helpful laboratory value in monitoring the progression of declining renal function is
serum creatinine.
Patients with immunodeficiency disorders are usually first identified because they
develop recurrent infections.
A patient who should be routinely evaluated for peptic ulcer disease is one who is
being treated with high-dose oral glucocorticoids.
The major underlying factor leading to the edema associated with glomerulonephritis and nephrotic syndrome is
proteinuria.
Orthostatic hypotension may be a manifestation of
Parkinson disease.
The primary source of erythropoietin is provided by the
kidney.
The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called
tophaceous gout.
Which characteristic is indicative of hemolytic anemia?
Jaundice
Infection can lead to bladder stone formation.
True
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics.
Cryptorchidism is
associated with an increased incidence of testicular cancer.
The cause of the most common form of anemia is
iron deficiency.
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?
The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
Findings that should prompt an evaluation for renal cancer include
hematuria.
Which is not a manifestation of acute arterial obstruction?
Purpura
Asthma is categorized as a(n)
obstructive pulmonary disorder.
An increased urine bilirubin is associated with
hepatitis.
To avoid the progression of cutaneous lesions, a patient diagnosed with systemic lupus erythematosus (SLE) should
avoid sun exposure.
The urinalysis finding most indicative of cystitis includes the presence of
nitrites.
The cellular change that is considered preneoplastic is
dysplasia.
Pain that waxes and wanes and is exacerbated by physical exertion is likely related to
fibromyalgia syndrome.
The majority of tachydysrhythmias are believed to occur because of
reentry mechanisms.
One of the most common causes of acute tubular necrosis (ATN) is
ischemic conditions.
Pain with passive stretching of a muscle is indicative of
noncontractile tissue injury.
A 52-year-old female had a surgical procedure in which the breast, lymphatics, and underlying muscle were removed. The procedure performed was a
radical mastectomy.
A potential risk factor for breast cancer includes
early menarche and late first pregnancy.
The stage of spinal shock that follows spinal cord injury is characterized by
absent spinal reflexes below the level of injury.
The most common agent resulting in nephrotoxicity and subsequent acute tubular necrosis (ATN) in hospitalized patients is
contrast media.
The conversion of plasminogen to plasmin results in
fibrinolysis.
A person who has hyperparathyroidism is likely to develop
hypercalcemia.
What type of seizure usually occurs in children and is characterized by brief staring spells?
Absence
How do clinical conditions that increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
Beta-blockers are advocated in the management of heart failure because they
reduce cardiac output.
Treatment for hemophilia A includes
factor VIII replacement.
The pathophysiology of rheumatoid arthritis involves
immune cells accumulating in pannus and destroying articular cartilage.
The activated partial thromboplastin time (aPTT) is a measure of the integrity of
the intrinsic pathway.
Second-degree heart block type I (Wenckebach) is characterized by
lengthening PR intervals and dropped P wave.
The cellular component that is most susceptible to radiation injury is the
DNA.
A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is
gastroesophageal varices.
The condition in which the urethra opens on the dorsal aspect of the penis is known as
epispadias.
Premature infants are at greater risk for developing
necrotizing enterocolitis.
Which disorder is considered a primary immunodeficiency disease?
HIV/AIDS
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.
When a patient experiencing nephrotic syndrome asks, “What causes my urine to be so full of protein,” the nurse’s response is based on the knowledge that
the glomerular membrane has increased permeability.
Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of
appendicitis.
