Final Exam Review Flashcards
A patient arrives at the ED complaining of a sudden onset of numbness in left lower leg. Upon assessment, the nurse finds the lower left leg to be cold to the touch, pale in color with pedal and posterior tibial pulses non-palpable, and a sharp line of paralysis/paresthesia. The nurse’s best action is based on the fact that:
- The immediate infusion of Heparin will not correct the problem and should only be used for CVAs.
- Administration of an aspirin and sublingual nitroglycerin will vasodilate the artery to restore perfusion.
- Submersion in a whirlpool with warm water will improve the venous blood flow and restore pulses.
- Acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow.
Acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow.
Bronchitis is often caused by a viral infection. How might a nurse advise her client on the best way to treat acute bronchitis?
- An immediate dose of vaccine should help lessen symptoms.
- Cough drops or honey may help with the cough.
- You must immediately contact your healthcare provider for prescription medications.
- Antibiotics will help the infection clear more quickly.
Cough drops or honey may help with the cough.
A client is informed they have latent Tuberculosis. The client asks the nurse what this means. The nurse’s best answer is which of the following?
- “This just means that you must be careful when you are around other people and wear a mask.”
- “Bacteria are present but not active or contagious.”
- “This is the stage where you will be the most contagious.”
- “This is a period of remission and you can consider yourself cured.”
“Bacteria are present but not active or contagious.”
Molly has presented to the clinic due to having swelling to her left arm. When the nurse presses her thumb into Molly’s arm, the indentation of her thumb remains. All other limbs appear normal and she does not have breathing concerns. What body system is likely being affected to cause this problem?
- Renal System
- Vascular System
- Lymphatic System
- Respiratory System
Lymphatic System
Which of the following aspects of a client’s health would be best characterized as a symptom rather than a sign?
- The client’s respiratory rate is 28 breaths per minute.
- The client’s oxygen saturation is 85% by pulse oximetry.
- The RN hears diminished breath sounds to the client’s lower lung field bilaterally.
- The client states that he has lightheadedness when standing up quickly.
The client states that he has lightheadedness when standing up quickly.
What are the 4 hallmark signs/symptoms of inflammation? In basic terms, why do each of these occur?
Heat: excess blood from dilated vessels
Redness (erythema): excess blood from dilated vessels
Swelling: excess fluid in tissue from increased permeability of vessels
Pain: prostaglandin and swelling increasing stimulation of pain receptors
Chvosteck’s and Trousseau’s sign can be used to identify a deficiency of…
- Bicarbonate
- Calcium
- Leukocytes
- Potassium
Calcium
Briefly explain how viruses replicate within the host. Be sure to include how the host cells have to be involved.
Viruses must enter the host cell and use the host cell’s ability to replicate DNA. The virus causes the host cell to replicate the viral DNA, thus the host cell reproduces the virus.
Which is an example of Adaptive (or Specific) immunity?
- Cilia within the respiratory tract move bacteria and debris away from the lungs
- Macrophages clear debris and foreign cells from tissue
- B-lymphocytes produce antibodies against a specific rhinovirus
- The skin prevents a staph bacteria from entering the body
B-lymphocytes produce antibodies against a specific rhinovirus
Provide the missing parts of the Chain of Infection: Infectious Agent, Reservoir, Portal of Exit, ?, ?, ?
- Mode of Transmission
- Portal of Entry
- Susceptible Host
Bernard has Chronic Kidney Disease. He states that the doctor told him he might not have enough erythropoietin. He doesn’t understand what this means. You know that this means his CKD may cause him to suffer from what disease?
- Nephrolithiasis
- Pyelonephritis
- Anemia
- Interstitial Cystitis
Anemia
The etiology of hydronephrosis could be…
- Nephrolithiasis
- Urinary Tract Infection (UTI)
- Excess H+ ions in the kidney
- Fluid Volume Excess
Fluid Volume Excess
Normal urine should…
- Have a pH of 7.0 or greater
- Have a specific gravity of 1.0
- Be sterile
- Be cloudy
Be sterile
What are 3 ways that cancer can spread to new tissues?
- Direct invasion and extension to new tissue
- Seeding of cancer cells in specific body cavities
- Metastatic spread through blood or lymph pathways
A painful inflammation of the urinary bladder wall, which may or may not contain Hunner Ulcers, is known as
interstitial cystitis
Genetic information encoded within DNA can be found in which organelle?
- Nucleus
- Golgi body
- Plasma membrane
- Endoplasmic Reticulum
Nucleus
AIDS develops when a threshold number of which cells are destroyed?
- Mast cells
- Humeral B-cells
- Killer T-cells
- Helper T-cells
Helper T-cells
Olga presents to the clinic stating symptoms at home of dysuria, urinary frequency, and bad smelling urine for 4 days. Today she also has been vomiting and has a fever. You suspect that she has …
- Diverticula of the urinary bladder that have now become infected
- Diverticula of the bladder that are bleeding into the abdomen
- A urinary tract infection that has progressed to pyelonephritis
- A urinary tract infection that has not congealed into kidney stones
A urinary tract infection that has progressed to pyelonephritis
David drinks a lot of dairy so he has a high calcium diet. He learns that most kidney stones are made of calcium deposits. You, the nurse, are able to educate him that his diet will not necessarily lead to kidney stones. He asks what to expect if he were develop a kidney stone. You explain that the primary symptom of kidney stones is..
- Anuria
- Flank or abdominal pains
- Fever
- Hematochezia
Flank or abdominal pain
What of the following are functions of water in the body?
- Release oxygen molecules into tissue for energy production
- Maintain blood volume
- Regulate body temperature
- Act as a solvent for biochemical processes
- Maintain blood volume
- Regulate body temperature
- Act as a solvent for biochemical processes
Which electrolytes are primary drivers of fluid balance within the body?
- Phosphorus and Chloride
- Calcium and Magnesium
- Sodium and Chloride
- Potassium and Bicarbonate
Sodium and Chloride
Which of the following is the most concerning sign of a decreased sodium level?
- Excess thyroid hormone production
- Confusion
- Mild pitting edema
- Cardiac dysfunction
Confusion
Taylor is a nurse that works with the county health department. She is charged with determining how many people in the county have HIV. She will report that ______ of HIV in her report.
- prevalence
- incidence
- mortality
- morbidity
prevalence
Match the following processes to the appropriate acid/base imbalance
- Diabetic Ketoacidosis
- COPD
- Anxiety
- Loss of gastric juices
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Diabetic Ketoacidosis - D (Metabolic Acidosis - generates ketones in the body while using fat for energy… ketones are acidic)
COPD - A (Respiratory Acidosis - COPD patients retain CO2)
Anxiety - C (Respiratory Alkalosis - Anxiety can cause hyperventilation and excessive loss of CO2)
Loss of gastric juices - B (Metabolic Alkalosis - Loss of acidic gastric juices can lead to alkalosis)
A patient with a potassium imbalance is of particular concern for healthcare workers. What is the immediate cause for concern, which could be devastating, for a patient with hyperkalemia?
Hyperkalemia could cause a change in the resting potential for cardiac cells, which could lead to like-threatening dysrhythmias
Arthur states that he has many older family members with Chronic Kidney Disease. He wants to know how to best protect himself from this disease. Which of the following answers are correct?
- If you smoke, stop. If you don’t smoke, don’t start
- If you have diabetes mellitus, be sure to control it well
- If you have hypertension, be sure to control it will
- You are already at risk because you played football when you were younger
- If you smoke, stop. If you don’t smoke, don’t start
- If you have diabetes mellitus, be sure to control it well
- If you have hypertension, be sure to control it will
_____ is the primary driver of a type 1 hypersensitivity IgE mediated reaction such as anaphylaxis
- Estrogen
- Antigen-Antibody complex
- Histamine
- Cortisol
Histamine
You have just received a urine sample from Matilda. Despite that it takes you as long as 15 minutes to get the sample prepared and sent to the lab for testing, you note that the urine is still cloudy and frothy. You recognize that this may mean there is protein and fat in the urine and that Matilda may be suffering from…
- Nephrotic syndrome
- Pyelonephritis
- Polycystic kidney disease
- Hydronephrosis
Nephrotic syndrome
Urinating in bed unknowingly at night, mostly referred to in children
Nocturnal enuresis
Loss of urine during times of increased intra-abdominal pressure exerted on the bladder by things like coughing, sneezing, laughing, exercising, or lifting.
Stress incontinence
Sudden, intense urge to urinate, followed by an involuntary loss of urine
Urge incontinence
Involuntary loss of urine when there is any intravascular pressure in the bladder
Overflow incontinence
A physical inability to get to the toilet in time when there is a need to urinate, generally referred to in older adults
Functional incontinence
Continuous leaking of urine or the periodic uncontrollable leaking of volumes of urine
Gross total incontinence
Most urinary tract infections (UTIs) are caused by what type of bacteria?
E. coli
Hyperkalemia can lead to life-threatening conditions, making it important to treat it promptly if there are concerns. List 2 drugs that you would expect to be ordered immediately for a patient at risk for conditions related to hyperkalemia, and explain how they work in this case
- Calcium: Increases the resting potential of the cardiac muscle cells, stabilizing the cell membranes
- Insulin: shifts potassium to the ICF, removing it from ECF, which results in it being inactivated
- Glucose: counteracts Insulin’s effect on blood sugar
- Albuterol: can shift some potassium to ICF
- Potassium binders
- Diuretics
- Dialysis
Lithotripsy is utilized to treat ____
Kidney stones
Esra is talking with his family about a visit at his doctor’s office. He explains that he remembers the doctor saying that his problem was strongly genetic, one of his kidneys is very large, and it is important that he control his blood pressure well in the future. He can’t remember what the disease is called. As a nurse, you know he is likely talking about which disease?
- Interstitial Cystitis
- Glomerulonephrosis
- Polycystic Kidney Disease
- Hydronephrosis
Polycystic Kidney Disease
One symptom of BPH in a male could be difficulty initiating a urine stream, or a weak urine stream. Explain why this symptom occurs
The enlarged prostate surrounds the urethra, placing pressure on it, causing difficulty urinating and small urine flow
The nurse is assessing all the following patients that have some degree of dehydration. Which of the following is most concerning to the nurse caring for them?
- Buddy, who has warm skin and decreased urine production
- Stacia, who is mildly tachycardic and has slightly sticky mucus membranes
- Stormy, who has instant recoil on a skin turgor test and capillary refill 2 seconds
- Sammy, who has a very weak pulse, his skin is cool and mottled, and he is hypotensive
Sammy, who has a very weak pulse, his skin is cool and mottled, and he is hypotensive
Kristen had a fall which resulted in a fractured ulna to her right forearm. It was placed in a cast for 6 weeks. Upon removing the cast, she noted that her right forearm was smaller than her left one. The nurse explained that the muscle has gotten smaller because she has not been using it. A decrease in the number of cells within a tissue, resulting in a smaller tissue, is known as _____
Atrophy
Following a biopsy, a client has been diagnosed as having a benign neoplastic tumor. Which of the following characteristics most likely applies to the tumor?
- It has a rapid rate of growth and can quickly induce ischemia
- The tumor is poorly approximated and is likely to break loose and spread to other tissues
- The tumor may secrete hormones or cytokines
- The well-differentiated, neoplastic cells are clustered together in a single mass
The well-differentiated, neoplastic cells are clustered together in a single mass
_____ syndrome occurs in males when there is an extra X chromosome
- Triple X
- Klinefelter’s
- Trisomy 21
- Marfan’s
Klinefelter’s
Which cardiac rhythm is associated with a rhythmic, circular pattern of electrical activity in the atria and regular ventricular beats?
- Atrial flutter
- Atrial fibrillation
- Ventricular fibrillation
- Asystole
Atrial Flutter
The cause of the disease or what sets the disease process in motion
Etiology
The sequence of cellular and tissue events that take place over the course of a disease
Pathogenesis
What the patient experiences. Includes signs and symptoms
Manifestations
The effects an illness has on a person’s life over time
Morbidity
Relates to the amount of death associated to a disease within the population
Mortality
The primary hormone responsible for the Alarm stage of the General Adaptation Syndrome is _______
cortisol
You are working in the hospital in a unit that has the ability to monitor heart rhythms. Barry is a patient who is suspected to have taken a drug overdose. During your shift, your team is called to the bedside because Barry’s heart has stopped. You arrive and CPR is in progress. During a pulse check, you feel for Barry’s femoral artery pulse. There is no pulse but as you watch the monitor, you see a normal sinus pattern on the heart monitor. What heart rhythm is associated with Barry’s current state?
- Pulseless Electrical Activity
- Atrial Fibrillation
- Asystole
- Hyperkalemia
Pulseless Electrical Activity
A couple is heterozygous for a disease. One of their four children expresses the disease. What is the best way to describe the gene expressed by the one of four children?
- Autosomal recessive
- Sex-linked dominant
- Sex-linked recessive
- Autosomal dominant
Autosomal recessive
As the clinical course of HIV/AIDS progresses, the patient has increased difficulty fighting the disease. What factors help us to classify the severity of HIV/AIDS
- Symptoms Presentation
- CD4 count
- Skin coloration
- Antigen activation
Symptoms presentation
CD4 count
Jarod has BPH and his physician is concerned that this is causing some acute renal failure. BPH would be considered a _____ cause of renal failure
- Intrarenal
- Corresponding
- Prerenal
- Postrenal
Postrenal
An RN develops a treatment plan for a client with stage 4 pancreatic cancer. One component of the plan includes a pain pump. Another component of the plan is that she will no longer travel to see her speciality physicians, rather only communicate with them over the phone if she is experiencing uncomfortable symptoms. Which of the following is the most likely intended outcome of the client’s treatment plan?
- Control
- Palliative
- Primary
- Curative
Palliative
Nicole has renal failure and her kidneys are not working. Which electrolyte imbalances is/are Nicole at risk for?
- Hypernatremia
-Hyperkalemia - Hyponatremia
- Hypokalemia
- Hypernatremia
- Hyperkalemia
Elise, a school nurse, has started a campaign with her students promoting the use of helmets at all times while riding a bicycle in order to prevent head injuries. Which type of prevention is this?
- Primary
- Secondary
- Tertiary
- Ancillary
Primary
When Mallory was 5 years old, her parents were told she is not making enough insulin. You know Mallory has….
- Diabetes Insipidus
- Type-I Diabetes
- Type-II Diabetes
- Gestational Diabetes
Type-I Diabetes
Jaundice may be seen in the skin or eyes. What substance builds up, causing jaundice?
Bilirubin
While the incidence of ______ has greatly decreased due to vaccinations, healthcare workers must still be aware of this disease because it can lead to high morbidity and mortality, especially if not treated early.
- Viral meningitis
- Bacterial meningitis
- Viral palsy
- Bacterial palsy
Bacterial meningitis
Patients with Celiac’s disease must avoid _____ in their diet
Gluten
Which cells are primarily responsible for fighting of Salmonella bacteria?
- Macrophages
- B-cells
- T-cells
- Neutrophils
Macrophages
A brain herniation occurs when one part of the brain moves out of place. Please explain the movement that occurs during a trans-calvarial brain herniation.
A portion of the brain (usually cerebral cortex) moves through an opening in the skull.
(Can occur with a skull fracture or surgical craniotomy to remove a portion of the skull to allow for herniation to release ICP
Which of the following is characterized by the formation of beta-amyloid plaques and neurofibral tangles?
- Alzheimer’s disease
- Amyotrophic Lateral Sclerosis (ALS)
- Multiple Sclierosis
- Huntington’s disease
Alzheimer’s disease
The nurse is discussing a patient’s medical history. The patient explains they have a shunt that extends from the third ventricle in his brain to his abdomen that allows CSF to drain through the shunt. He explains this shunt was initially placed when he was quite young. The nurse knows that the patient was likely diagnosed with ______ as a child
- Spina Bifida
- Hydrocephalus
- Esophageal Atresia
- Ascites
Hydrocephalus
Following a motorcycle wreck, Micheal, a 22 year old male, is found to have an acute subdural hematoma. Which of the following pathophysiological processes most likely underlies his diagnosis?
- Venous blood has accumulated between Michael’s dura and subarachnoid space
- A traumatic lesion in the frontal or temporal lobe has resulted in an increased intracranial pressure
- Vessels have burst between Michael’s skull and dura mater due to a fractured skull
- Blood has displaced CSF in the ventricles as a consequence of his coup-countercoup injury
Venous blood has accumulated between Michael’s dura and subarachnoid space