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PMHNP Questions with Rationales (7-24-22) > [Ex4] - Added Questions - AP > Flashcards

[Ex4] - Added Questions - AP Flashcards

1
Q

A __________________ is a hernial protrusion of a sac-like cyst (containing meninges, spinal
fluid, and a portion of the spinal cord with its nerves) through a defect in the posterior arch of
a vertebra in the lower spine.

A

Myelomeningocele.

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2
Q

Osteosarcoma occurs mainly in the _____________ of long bones near sites of active physical
growth, not in the epiphyses.

A

Metaphyses

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3
Q

________ palsy is the most common type of cerebral palsy.

A

Spastic

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4
Q

Scleroderma can trigger __________________.

A

Raynaud Phenomenon

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5
Q

Excessive vomiting is a symptom of a mass in the ________________.

A

Medulla Oblongata

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6
Q

This medication is used to treat rheumatoid arthritis.

A

Methotrexate

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7
Q

This anemia can cause symptoms of tingling parathesias in the feet and fingers.

A

Pernicious anemia

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8
Q

A ___________________ originates from the pituitary gland or hypothalamus.

A

Craniopharyngioma

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9
Q

This medication is used in the treatment of myasthenia gravis.

A

Edrophonium Chloride (Tensilon)

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10
Q

A complication of osteogenesis imperfecta is _______________.

A

Aortic aneurysm

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11
Q

Vesicular Impetigo is caused by this organism.

A

S. pyogenes

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12
Q

Most common location of brain tumors in children.

A

Posterior Fossa

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13
Q

This reflex lasts up until 24 months.

A

Landau reflex

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14
Q
  • Hormone-secreting Adrenal Tumor
  • Usually benign
  • Causes hypertension, headache, tachycardia, impaired glucose tolerance, and weight loss
A

Pheochromocytoma

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15
Q

Complications:

  • Hypertension can damage multiple organs, particularly tissues of the cardiovascular system, brain and kidneys.
  • Heart disease, stroke, kidney failure, acute respiratory distress
A

Pheochromocytoma

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16
Q
  • High levels of circulating thyroid-stimulating antibodies/immunoglobulins (TSI)
  • Autoimmune condition causing exophthalmos
A

Hyperthyroidism/Graves disease - Thyrotoxicosis

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17
Q
  • High levels of circulating thyroid stimulating hormone (TSH )
  • Low levels of thyroxine (T4) stimulating anterior pituitary to increase TSH
A

Hypothyroidism

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18
Q

Infected hair follicle
- bacteria
- pus-filled, caused by staphylococcal infection

A

Carbuncle

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19
Q

Circular, demarcated, and salmon-pink lesion
- viral

A

Pityriasis rosea

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20
Q

Painful vesicular eruptions along nerve path (shingles).

  • viral
  • chicken pox history can erupt decades later
A

Herpes zoster

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21
Q

Severe degeneration of basal ganglia.

  • Tremor, rigidity, bradykinesia w postural disturbances
  • Autonomic and neuroendocrine symptoms w cognitive-affective symptoms
  • Tx: dopamine promotor, ropinirole, pramipexole, rotigotine
A

Parkinson’s Disease

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22
Q

Fatal genetic disorder w progressive cerebral neuron breakdown.

  • Autosomal dominant hereditary degenerative disorder
  • Uncontrolled movement w intellectual dysfunction progressing to dementia
  • Tx: suppress the involuntary jerking w off label use of risperidone, haloperidol and chlorpromazine
A

Huntington’s Disease

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23
Q

There are 9 types, best known is Duchenne.

  • Most common in childhood but also adult types
  • Childhood starts w developmental delays
  • Tx: prednisone/steroids delay progression of certain types of muscular dystrophy
A

Muscular Dystrophy

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24
Q

Acquired autoimmune disease, four subtypes.

  • Progressive, inflammatory, demyelinating disorder of the CNS
  • Paresthesia, weakness, impaired gait, visual disturbances, or urinary incontinence
A

Multiple Sclerosis

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25
Q

Acquired inflammatory disease w demyelination of the peripheral nerves.

  • Acute onset, ascending motor paralysis
  • Triggered by an acute bacterial or viral infection
  • Usually recover in 6 to 12 months.
A

Guillain-Barré Syndrome.

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26
Q

Acquired chronic autoimmune disease.

  • IgG antibody produced against acetylcholine receptors (antibodies)
  • Weakness and fatigue of muscles of the eyes and the throat causing diplopia and difficulty chewing, talking, swallowing
  • Myasthenic crisis, Cholinergic crisis
A

Myasthenia Gravis

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27
Q

Most common typeof aggressive malignant neoplasm/bone tumor

  • Frequently occurs in adolescence when rapid bone growth
  • Metastasis often to lungs with night cough & dyspnea
  • Severe pain that awakes the child from sound sleep, swelling, warmth, redness
A

Osteosarcoma

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28
Q

Malignancy in the bones or soft tissue around the bones

  • Affects mostly children and teenagers
  • Metastasis to almost every organ
A

Ewing Sarcoma

29
Q

Malignancy that primarily affects the cartilage cells & bone

  • Most commonly- pelvis, hip & shoulder
  • Occurs in middle aged & older adults
A

Chondrosarcoma

30
Q

Painful weakening of the bones often from inadequate bone mineralization

A

Osteomalacia

31
Q

Distortion of the normal skeletal remodeling

  • Presents with pain or bowing
  • Etiology unknown, genetic & environmental factors have been implicated.
A

Paget’s disease

32
Q

Pain syndrome, lateral & medial segments of elbow joint

  • most common overuse syndrome in the elbow
A

Epicondylopathy

33
Q

Staphylococcus aureus primary causative organism

A

Osteomyelitis

34
Q
  • lab value of significance - creatine kinase (CK)
  • Muscle pain, tea colored urine, weakness
  • Creatinine kinase level diagnostic & monitored
A

Rhabdomyolysis

35
Q
  • Diffuse pain, fatigue, and tender points
  • Characterized by tender or trigger points
A

Fibromyalgia

36
Q

Sudden, forced motion, muscle stretched beyond normal capacity
- Can also involve the tendons
- Healing in three phases - destruction, repair & remodeling

A

Muscle Strain

37
Q

Systemic, autoimmune inflammatory disease

  • Pain and stiffness can begin at early age
  • Chronic inflammation of the spine and the sacroiliac joints
  • End result is fibrosis, ossification, and joint fusion
A

Ankylosing spondylitis

38
Q

All newborns are screened for _____________.

A

PKU

39
Q

_____________ anemia is caused by diminished erythropoiesis despite an increased need for new
erythrocytes.

A

Aplastic

40
Q

___________ of intracranial HTN is characterized by decreasing levels of arousal or central neurogenic hyperventilation,
widened pulse pressure, bradycardia, and pupils that become small and sluggish.

A

Stage 3

41
Q

___________ of intracranial HTN is
characterized by an ICP that may not change because of the effective compensatory

A

Stage 1

42
Q

___________ of intracranial HTN is characterized by subtle and transient
symptoms, including episodes of confusion, restlessness, drowsiness, and slight pupillary and
breathing changes.

A

Stage 2

43
Q

___________ of intracranial HTN is characterized by cessation of cerebral blood flow.

A

Stage 4

44
Q

________________ is manifested by loss of past personal history memories or past factual
memories.

A

Retrograde amnesia

45
Q

____________ is manifested by chronic blister formation.

A

Pemphigus

46
Q

A ______________ fracture occurs straight across the bone.

A

Transverse

47
Q

______________ is a disorder resulting from autoimmune injury at the neuromuscular
junction.

A

Myasthenia gravis

48
Q

Hypokalemia is a hallmark of primary
________________.

A

hyperaldosteronism

49
Q

The pathophysiology of ______________ includes demyelination of nerve fibers.

A

Multiple sclerosis

50
Q

_____________ diabetes insipidus is caused by the insufficient secretion of ADH; thus, exogenous
ADH would be useful in the treatment of this disorder.

A

Neurogenic

51
Q

Endocrine system dysfunction may result from _______________________________.

A

abnormal cell receptor function

52
Q

_____________ (central)—insufficient secretion of ADH

A form of diabetes insipidus.

A

Neurogenic

53
Q

_______________ —inadequate response to ADH

A form of diabetes insipidus.

A

Nephrogenic

54
Q

Manifestations of this disease include polyuria, nocturia, and continuous thirst

A

Diabetes insipidus

55
Q

Which of the following is a condition associated with polyuria and polydipsia?

A) Diabetes insipidus
B) Hypoparathyroidism
C) Hyperthyroidism
D) Graves disease

A

Correct Answer: A

Diabetes insipidus (DI) is an insufficiency of ADH activity leading to polyuria (frequent urination) and polydipsia (frequent drinking). Symptoms associated with hypoparathyroidism are primarily those of hypocalcemia. Hyperthyroidism is associated with an increased metabolic rate with heat intolerance and increased tissue sensitivity to stimulation by the sympathetic nervous system. Graves disease is an underlying cause of hyperthyroidism.

56
Q

Hallmark manifestations of this endocrine alteration are hypercalcemia and hypophosphatemia

A

Hyperparathyroidism

57
Q

Lab values for this acute complication of DM

  • Severe hyperglycemia — blood glucose usually >600 mg/dL (>33.3 mM) and generally 1000 mg/dL to 2000 mg/dL (55.5 mM to 111.1 mM)
  • Absence of or slight ketosis.
  • Plasma or serum hyperosmolality (>340 mOsm)
A

Hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

58
Q

This disease involves severe degeneration of the basal ganglia with loss of dopamine-producing neurons.

A

Parkinson’s disease

59
Q

A category of TBI

  • No or short loss of consciousness
  • Confusion for several minutes, retrograde amnesia
  • GCS: 13-15
A

Mild TBI (concussion)

60
Q

A category of TBI

  • Loss of consciousness 30 minutes to 6 hours
  • Confusion with amnesia longer than 24 hours
  • GCS: 9-12
A

Moderate TBI

61
Q

A category of TBI

  • Loss of consciousness longer than 6 hours
  • Severe cognitive system defects
  • GCS: 3-8
A

Severe TBI

62
Q

Which term is characteristic for a fracture in which one cortex is perforated and the spongy bone is splintered?

A) Torus
B) Spiral
C) Bowing
D) Greenstick

A

Correct Answer: D

A greenstick fracture is one that perforates one cortex and splinters the spongy bone. In a torus fracture, the cortex buckles but does not break. Bowing fractures usually occur with longitudinal force; typically, this occurs in paired bones. One is fractured and the other bows. A spiral fracture is one that encircles the bone.

63
Q

Inflammation of a tendon where it attaches to a bone. Examples include Tennis and Golfer’s elbow.

A

Epicondylopathy

64
Q
  • Rapid breakdown of muscle that causes the release of intracellular contents, including the protein pigment myoglobin, into the extracellular space and bloodstream
  • Can result in acute renal failure and electrolyte imbalances
A

Rhabdomyolysis

65
Q

Triad of manifestations
- Muscle pain
- Weakness
- Dark urine

A

Rhabdomyolysis

66
Q

Q
20-28. A 19-year-old female with type 1 DM was admitted to the hospital with the following lab
values: serum glucose 500 milligrams per deciliter (high), urine glucose and ketones 4+
(high), and arterial pH 7.20 (low). Her parents state that she has been sick with the “flu” for a
week. Which of the following statements best explains her acidotic state?
a. Increased insulin levels promote protein breakdown and ketone formation.
b. Her uncontrolled diabetes has led to renal failure.
c. Low serum insulin promotes lipid storage and a corresponding release of ketones.
d. Insulin deficiency promotes lipid metabolism and ketone formation.

A

ANS: D
With insulin deficiency, lipolysis is enhanced, and there is an increase in the amount of
nonesterified fatty acids delivered to the liver. The consequence is increased glyconeogenesis
contributing to hyperglycemia and production of ketone bodies (acetoacetate,
hydroxybutyrate, and acetone) by the mitochondria of the liver at a rate that exceeds
peripheral use. Insulin levels are decreased. There is no evidence that the patient is in renal
failure. Insulin is low, but the ketones are the result of fatty acid breakdown due to lack of
insulin, not because of lipid storage.

67
Q

Q
20-28. A 19-year-old female with type 1 DM was admitted to the hospital with the following lab
values: serum glucose 500 milligrams per deciliter (high), urine glucose and ketones 4+
(high), and arterial pH 7.20 (low). Her parents state that she has been sick with the “flu” for a
week. Which of the following statements best explains her acidotic state?
a. Increased insulin levels promote protein breakdown and ketone formation.
b. Her uncontrolled diabetes has led to renal failure.
c. Low serum insulin promotes lipid storage and a corresponding release of ketones.
d. Insulin deficiency promotes lipid metabolism and ketone formation.

A

ANS: D
With insulin deficiency, lipolysis is enhanced, and there is an increase in the amount of
nonesterified fatty acids delivered to the liver. The consequence is increased glyconeogenesis
contributing to hyperglycemia and production of ketone bodies (acetoacetate,
hydroxybutyrate, and acetone) by the mitochondria of the liver at a rate that exceeds
peripheral use. Insulin levels are decreased. There is no evidence that the patient is in renal
failure. Insulin is low, but the ketones are the result of fatty acid breakdown due to lack of
insulin, not because of lipid storage.

68
Q

Q
20-28. A 19-year-old female with type 1 DM was admitted to the hospital with the following lab
values: serum glucose 500 milligrams per deciliter (high), urine glucose and ketones 4+
(high), and arterial pH 7.20 (low). Her parents state that she has been sick with the “flu” for a
week. Which of the following statements best explains her acidotic state?
a. Increased insulin levels promote protein breakdown and ketone formation.
b. Her uncontrolled diabetes has led to renal failure.
c. Low serum insulin promotes lipid storage and a corresponding release of ketones.
d. Insulin deficiency promotes lipid metabolism and ketone formation.

A

ANS: D
With insulin deficiency, lipolysis is enhanced, and there is an increase in the amount of
nonesterified fatty acids delivered to the liver. The consequence is increased glyconeogenesis
contributing to hyperglycemia and production of ketone bodies (acetoacetate,
hydroxybutyrate, and acetone) by the mitochondria of the liver at a rate that exceeds
peripheral use. Insulin levels are decreased. There is no evidence that the patient is in renal
failure. Insulin is low, but the ketones are the result of fatty acid breakdown due to lack of
insulin, not because of lipid storage.

69
Q

23-6. A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.
Which of the following adaptations should the nurse expect?
a. Movement of fluid into the cell
b. Decreased cardiac output
c. Decreased oxygen release from hemoglobin
d. Peripheral vasoconstriction

A

ANS: D
When the anemia is severe or acute in onset (e.g., hemorrhage), the initial compensatory
mechanism is peripheral blood vessel constriction, diverting blood flow to essential vital
organs. Fluid moves into the vascular space, not the cell. Blood volume increases; thus,
cardiac output increases. There is an increase in hemoglobin release of oxygen.

PMHNP Questions with Rationales (7-24-22) (36 decks)

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