HESI Flashcards
How does a catalyst increase the rate of a chemical reaction?
By lowering the activation energy
Long bone description and examples
Diaphysis with 2 epiphyses ex: femur, tibia, fibula, humerus, ulnar, radius, clavicle, phalanges, metacarpals, metatarsals
Flat bones description & ex
Thin an broad ex: sternum, ribs, scapula, occipital bone, parietal bone, frontal bone
Short bones description & ex
Cuboidal with similar length and width ex: carpals and tarsals
Irregular bones
Vertebrae, hip bone, sacrum, coccyx, maxilla, mandible, temporal bone, sphenoid bone, zygomatic bone, hyoid bone
Sesamoid bone
Small bone within tendons ex: patella
Synapse
A specialized junction from which nerve impulses pass from one neuron to the next
Bones in the vertebral column
Atlas, axis, cervical, thoracic, lumbar vertebrae, sacral, coccyx,
What is the function of luteinizing hormone?
In males it stimulates production of testosterone , in females stimulates ovulation
What does Follicular Stimulating Hormone (FSH) stimulate?
Spermatogenesis in males and maturation of ovarian follicle in females
What does estrogen stimulate? What are its functions
Stimulates the proliferative phase of the menstrual cycle in females. It is responsible for the female secondary sex characteristics, it’s produced by the cells of the ovarian follicle
Estrogen
Responsible for the female secondary sex characteristics like development of breasts, widening of hips, axiliary and pubic hair. Estrogen is produced by the granules a cells of the ovarian follicle.
Estrogens roles in the menstrual cycle
Stimulates the thickening of the endometrium before ovulation (proliferative phase of menstrual cycle), stimulates the release of FSH in the first half of menstrual cycle, triggers an Lutienizing Hormone surge
Neutrophils
Most numerous WBC and phagocytize bacteria , first cells to respond during an infection
B lymphocytes
Produce antibodies and mature in the Bone marrow
Basophils and Eosinophils
Both are involved in allergic reactions in the release of histamine
Eosinophils
Phagocytize parasites and Protozoa from the body
Red bone marrow
Produces erythrocytes, leukocytes, and thrombocytes. Site of B cell maturation. T cells mature in the Thymus
Function of the spleen
Filters and traps pathogens and damaged cells, which it presents to immune cells. Works with the lymphatic system
What is the role of calcium in muscle contraction?
Calcium binds to troponin and leads to the uncovering of the active site of actin. Calcium binds to troponin and causes tropmyosin to uncover binding sites on the actin filament to which myosin can bind.
Steps of muscle contraction
- Action potential arrives at neuromuscular junction
- Sarcoplasmic reticulum releases calcium molecules
- Calcium binds to troponin, which leads to the active site of actin being exposed
- The myosin head binds to actin and forms a cross bridge
- Myosin tugs on actin and moves it toward the midline causing contraction and shortening of sarcomere
- ADP is released and new ATP binds to myosin
- Myosin head detaches, ATP unbinds , and cycle begins again
Cones of the eye
Are for high light intensity of daytime and color vision
Rods of the eye
Function in low light and are for night vision and black and white color
What controls the activity of the endocrine system?
The hypothalamus , it is the control center of the endocrine system. Produces hormones that regulate activity of anterior pituitary gland like Growth hormone. Also produces hormones stored in posterior pituitary like ADH and oxytocin
Parathyroid gland
Produces PTH and is responsible for calcium homeostasis
What is the most abundant nervous tissue?
Neuroglia, or glial cells, are the non excitable tissue that surrounds neurons and are about 5x more abundant that neurons. They support the neurons by providing nutrients and repair
What does the EKG do?
Records electrical activity of the heart. P wave = atrial depolarization, QRS complex = ventricular depolarization, T wave = ventricular depolarization
Hormones produced by Pancreas
Alpha cells = glucagon (stimulated by low glucose levels , glucagon stimulates glycogenolysis and glucneogenesis)
Beta cells = insulin
Delta cells = somatostatin (inhibits broth endocrine & exocrine pancreatic secretions )
Adrenal Cortex and Medulla hormones
Cortex = cortisol, aldosterone, androgens
Medulla = epinephrine and nor-epinephrine
Hormones produced by the Gonads
Estrogen, progesterone, and testosterone. Regulated by FSH
The nurse notices the presence of periorbital edema when performing an eye assessment on a 70 year old patient. What question should the nurse ask?
If the patient has a history of heart failure
What kind of question is, “You don’t smoke, drink, or take drugs, do you?”
A biased or leading question
A 68 year old woman has some loss of central vision but her peripheral vision is normal. These finding suggest?
She may have macular degeneration
Tactile fremitus
The assessment of low-frequency vibration of a patient’s chest. It is caused by sounds generated from the larynx
A person who takes the magi o religious perspective of illness and disease is likely to believe that their illness is caused by ?
Supernatural forces
What are the ABCDEs for moles?
Asymmetry, Border, Color, Diameter (>6mm), Evolving
What kind of question is, “you mentioned shortness of breath. Tell me more about that.” ?
Open-ended question
The assessment findings in the normal adult lung would include the presence of ?
Muffled voice sounds and symmetrical tactile fremitus
Mental status examination is performed by?
An assessment of an individual’s behavior
Air passing through the narrowed bronchioles of a patient with severe asthma would produce what adventitious sound?
Wheezes
When does a newborn infants eyesight develop?
By about 3 months, infants develop more coordinated eye movements and can fixate on an object
Nurse needs to perform anthropometric measures of an 80 year old man who is confined to a wheelchair. What is true in this situation?
Height measurements may not be accurate because of changes in bone.
Anthropometry = measurement of height, weight, head circumference, BMI, body circum to assess for adiposity
Characteristics of open-angle glaucoma
Virtually no symptoms, vision loss begins with peripheral vision, the patient experiences tunnel vision in late stages
An ophthalmic examination reveals papilledema. The nurse is aware that this finding indicates?
Increased intracranial pressure. Papilledema = swelling of the optic nerve which connects the eye and brain. This swelling is caused by a buildup of pressure in or around the brain.
During a mental status examination, the nurse wants to assess a patients affect. The nurse should ask what question?
How do you feel today?
Patient’s affect = patients immediate expression of emotion
Paget’s disease would be indicated by what findings?
Headache, vertigo, tinnitus, and deafness.
Paget’s disease is a chronic bone disease that disrupts bone remodeling / the deposition of new bone
When auscultating the lungs of an adult patient, the nurse notes that over the posterior lower lobes, low-pitches soft breath sounds are heard, with inspiration being longer than expiration. The nurse interprets that these are ?
Vesicular breath sounds that are normal in that location
The radial pulses are documented as 2+. The nurse recognizes that is reading indicates what type of pulse?
A normal pulse
0 = no palpable pulse , 1+ = faint pulse , 2+ = slightly more diminished pulse than normal , 3+ = normal pulse , 4+ = bounding pulse
The auscultation of fine crackles would be most likely noticed in?
The immediate newborn period
When using a Doppler ultrasonic stethoscope, the nurse recognizes arterial flow when hearing what sound?
Swishing, whooshing sound
Among many Asians there is a belief in the yin/yang theory. The nurse recognizes that health in an Asian with this belief could be described as?
All aspects of the person are in perfect balance
During a mental status assessment, which question by the nurse would best assess a person’s judgement?
“Tell me about what you plan to do once you are discharged from the hospital”
Most appropriate action the nurse should take when performing a physical examination to protect against the spread of infectious disease.
Wash hands before and after every physical patient encounter
The nurse is assessing an 80 year old male patient. Which assessment findings would be considered normal?
The presence of kyphosis and flexion in the knees and hips
Kyphosis = excessive curve of the spine that results in abnormal rounding of the upper back
Patient may have perforated ear drum. What would be an important question in this situation?
Was there any relationship between the ear pain and the discharge you mentioned?
During auscultation of the lungs of an adult patient, the nurse notices the presence of bronchophony. The nurse should assess for signs of?
Pulmonary consolidation
Bronchophony = hearing patient’s voice much louder and clearer when auscultating with stethoscope
When assessing the force, or strength of a pulse, the nurse recalls that it is a reflection of what?
The heart’s stroke volume
When the mid-upper arm circumference and triceps skin fold of an 82 year old man are evaluated, which is important for the nurse to remember?
These measurements may not be accurate because of changes in skin and fat distribution
A nurse assessing for clubbing of finger nails would expect to find?
An angle of the nail base of 180 degrees or greater with a nail base that feels spongy
The mother of a 16 month old toddler tells the nurse that her daughter has an earache. What would be an appropriate response?
Please describe what she is doing to indicate she is having pain
When performing a peripheral vascular assessment, the nurse is unable to palpate the ulnar pulses. The patients skin is warm and cap refill time is normal. The nurse should?
Consider this a normal finding and proceed with the peripheral vascular eval
What is the best technique to use to assess a patient’s skin temp during an office visit?
Use the dorsal surface of the hand because the skin is thinner than on the palms
A 65 year old man with emphysema and bronchitis has come to the clinic for a follow-up. On assessment the nurse might expect to find?
Clubbing of the nails
During the assessment of a an infant, the nurse notes that the fontanels are depressed and sunken. The nurse suspects what condition?
Dehydration
The nurse would use i manual palpation technique in which situation?
Palpating the kidneys and uterus
A 65 year old patient with a history of heart failure comes to the clinic with complaints of being awakened from sleep with shortness of breath. What action by the nurse is the most appropriate?
Assess for other signs and symptoms of paroxysmal nocturnal dyspnea
Paroxysmal nocturnal dyspnea = sensation of shortness of breath that awakens patient due to increased venous return to heart and reabsorption of fluid from tissues
To assess for increased intracranial pressure, what would the nurse include in the assessment?
Level of consciousness, motor function, pupillary response, and vital signs
During an abdominal assessment, the nurse would consider which of these findings normal?
A tympanic percussion note in the umbilical region
Tympany = structure filled with gas like the large and small intestines.
Dullness is typically heard over fluid or solids organs like the liver or spleen
Percussion over an area of atelectasis in the lungs would reveal?
Dullness
Nurse is interviewing patient who has a hearing impairment. What techniques would be most beneficial in communicating with this patient?
Determine the communication method they prefer.
Working with children with a different cultural perspective may be especially difficult because?
Children have spiritual needs that are influenced by their stages of development
A patient has hypo active bowel sounds. The nurse knows that a potential cause of hypoactive bowel sounds is ?
Peritonitis
The changes in hearing that occur with aging include?
Finding it harder to hear consonants than vowels, sounds may be garbled and difficult to localize, the progression is slow
Patient comes to the emergency department after a boxing match and his left eye is swollen almost shut. He “can’t see well” from left eye and physician suspects retinal detachment. Signs of retinal detachment would include?
Shadow or diminished vision in one quadrant or one half of the visual field
The nurse is performing an eye assessment on an 80 year old patient. Which of the findings is considered abnormal?
Unequal pupillary constriction in response to light
The nurse is assessing a patient’s apical impulse. Which of these statements is true regarding the apical impulse?
It’s location may be indicative of heart size.
Apical impulse = the pulse found on the left side of the chest over the apex of the heart (pointed end)
A patient has abdominal borborygmi. The nurse knows this term refers to ?
Hyperactive bowel sounds
Borborygmi = the sound that the stomach and intestines make as food, fluids, and gas move through them. The rumbling sounds during peristalsis
A patient has been admitted for sever psoriasis. The nurse can expect to see what finding in the patient’s fingernails?
Pitting
The nurse auscultating the lungs of a patient who has been sleeping and notices short, popping, crackling sounds that stop after a few breaths. The nurse recognizes these breath sounds are?
Atelectatic crackles, and they are not pathologic
The nurse is unable to palpate the right radial pulse on a patient. The best action would be to?
Use a Doppler device to check for pulsations over the area
Nurse suspects patient has a distended bladder. How should the nurse assess for this condition?
Percuss and palpate the midline areas above the Supra pubic bone
When assessing tactile fremitus, the nurse recalls that it is normal to feel tactile fremitus most intensely over which location?
Between the scapulae
The nurse has discovered decreased skin turgor in a patient and knows that this is an expected finding in which of these conditions?
Severe dehydration
Skin turgor = skin elasticity. The ability of the skin to change shape and return to normal
22 year old woman has a head injury from a car accident 4 hours ago and pupils were equal but now the right pupil is fully dilated and no reactive. This suggests?
Increased intracranial pressure
During assessment of an 80 year old, the nurse notices the inability of the patient to identify vibrations at the ankle, position of big toe, and slower and more deliberate gait, and slightly impaired tactile sensation. All other neurologic findings are normal. These findings indicate?
Normal changes due to aging
Patient states he is hearing a buzzing sound and says that is is “driving me crazy!”. The nurse recognizes the symptom indicates ?
Tinnitus = perception of sound that does not have an external source. Often described as a ringing sound, sometimes roaring or buzzing
6 month old infant has been brought in for a check-up. She is currently sleeping .What should the nurse first do when beginning the exam?
Auscultate the lungs and heart while the infant is still sleeping
Nurse is unable to hear bowel sounds in a patient’s abdomen. Before reporting this finding as “silent bowel sounds” the nurse should listen for at least?
5min
What technique for auscultating heart sounds is correct?
Listen by inching the stethoscope in a rough Z pattern, from the base of the heart across and down, then over to the apex
Patient is suspected of having inflammation of the gallbladder, or cholecystitis. The nurse should conduct which of these techniques to assess for this condition?
Test for Murphy’s sign = asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs when the inflamed gallbladder is palpated, the test is positive
what is a normal finding of the ear examination of an 80 year old?
High-tone frequency loss
Nurse suspects patient has an appendicitis. Which of these procedures are appropriate for use when assessing for appendicitis or a perforated appendix?
Test for blumberg’s sign and perform iliopsoas muscle test
Blumberg’s sign = rebound tenderness , pain on removal of pressure than on application
Iliopsoas muscle test = hand placed just above the knee and ask patient to lift leg against resistance of your hand which causes friction of the psoas muscle over the inflamed appendix
The nurse is conducting an interview and is using a computer to record data. What is the best use of the computer?
Collect the patient’s data in a direct, face to face manner, type the data into the computer after the narrative is fully explored, allow the patient to see the monitor during typing
Assessing a 70 year old patient who has had a recent cerebrovascular accident, the nurse notices right-sided weakness. What might the nurse expect to find when testing the reflexes on the right side?
Hyperactive reflexes
Nurse asks 68 year old patient to stand with feet together and arms at his side with eyes closed. He starts to sway and moves his feet farther apart. This finding is?
A positive Romberg sign = the inability to maintain an erect posture for 60 sec with eyes closed
Paget’s disease would be indicated by what assessment findings?
Headache, vertigo, tinnitus, and deafness.
Paget’s disease = improper bone remodeling with spongy bone
Woman says she’s been sick for so long, eyes got puffy, and eyebrows and hair have become coarse and dry. Nurse will assess for other signs of ?
Myxedema = severely advanced hypothyroidism
During assessment, the profile sign is used to detect?
Early clubbing = clubbing is the nail base at a 180 degree angle or more. Nail base flattens out instead of curving slightly inward at 160 degree angle
Nurse suspects hyperthyroidism , what would you be most likely to find on assessment?
Tachycardia = HR over 100 beats/min
During assessment of 80 year old patient, nurse notices that his hands show tremors when he reaches for something and his head is always nodding. There is no rigidity with movement. What should he be evaluated for?
For a cerebellar lesion
I
1
V
5
X
10
L
50
C
100
D
500
M
1,000
1 Quart
2 Pints
1 Pint
2 Cups
1 cup
8oz
1 oz
30 ml
1 inch in cm
2.54cm
1 gallon
3.8 L
1 oz in grams
1 oz = 28.3g
What type of tissue is most widely distributed throughout the body?
Connective tissue
What part of the brain is involved in processing auditory information?
The temporal lobe.
The temporal lobe contains the primary auditory context, which receives direct sound input from the ears, so it plays a major role in auditory functioning (hearing).
The frontal lobe is important for cognitive functions (knowledge) and control of voluntary movement or activity.
The parietal lobe processes information about temperature, taste, touch, and movement.
The occipital lobe is primarily responsible for vision.
In what reproductive structure does the fertilization of an ovum occur?
In the fallopian tubes
An ovum is a mature female reproductive cell – it is an unfertilized egg. When an ovum is fertilized, it means that the ovum has united with a male reproductive cell (a sperm cell) and becomes a zygote. This happens in the fallopian tube, (also called the oviduct).
The endometrium is the innermost lining of the uterus. Its function is to provide structure to the uterus and maintain patency (openness). If the ovum is fertilized in the fallopian tubes, the fertilized ovum (zygote) travels down and implants itself in the endometrium. If the ovum does not become fertilized, the lining of the endometrium is shed during menstruation.
The corpus luteum (which means “yellow body”) is a yellowish mass of endocrine tissue that forms in the ovaries immediately after ovulation. It secretes progesterone and estrogen, which help develop and maintain the endometrium.
The uterus is a hollow muscular organ located in the female pelvis. Functions of the uterus include nurturing the fertilized ovum that develops into the fetus and holding it until the baby is mature enough for birth.
What describes cellular respiration?
It’s an oxidative catabolic activity
An anabolic reaction is a reaction that uses energy to build molecules the organism needs. A catabolic reaction breaks down complex molecules into smaller molecules to create energy for the organism to use.
Oxidation is when an element loses one or more electrons to oxygen. Reduction is when an element gains one or more electrons.
Cellular respiration is the process in which a cell takes in oxygen and uses it to break down glucose to create energy in the form of ATP. In the final stage of cellular respiration (called the electron transport chain), oxygen accepts electrons and picks up protons to form water. So, because elements lose electrons to oxygen and it is a reaction in which energy is created, cellular respiration is both an oxidative and catabolic activity.
