Final Exam Review Flashcards

1
Q

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.
A

Acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow.

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2
Q

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.
A

Cough drops or honey may help with the cough.

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3
Q

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.”
A

“Bacteria are present but not active or contagious.”

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4
Q

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
A

Lymphatic System

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5
Q

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.
A

The client states that he has lightheadedness when standing up quickly.

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6
Q

What are the 4 hallmark signs/symptoms of inflammation? In basic terms, why do each of these occur?

A

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

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7
Q

Chvosteck’s and Trousseau’s sign can be used to identify a deficiency of…

  • Bicarbonate
  • Calcium
  • Leukocytes
  • Potassium
A

Calcium

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8
Q

Briefly explain how viruses replicate within the host. Be sure to include how the host cells have to be involved.

A

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.

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9
Q

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
A

B-lymphocytes produce antibodies against a specific rhinovirus

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10
Q

Provide the missing parts of the Chain of Infection: Infectious Agent, Reservoir, Portal of Exit, ?, ?, ?

A
  • Mode of Transmission
  • Portal of Entry
  • Susceptible Host
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11
Q

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
A

Anemia

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12
Q

The etiology of hydronephrosis could be…

  • Nephrolithiasis
  • Urinary Tract Infection (UTI)
  • Excess H+ ions in the kidney
  • Fluid Volume Excess
A

Fluid Volume Excess

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13
Q

Normal urine should…

  • Have a pH of 7.0 or greater
  • Have a specific gravity of 1.0
  • Be sterile
  • Be cloudy
A

Be sterile

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14
Q

What are 3 ways that cancer can spread to new tissues?

A
  1. Direct invasion and extension to new tissue
  2. Seeding of cancer cells in specific body cavities
  3. Metastatic spread through blood or lymph pathways
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15
Q

A painful inflammation of the urinary bladder wall, which may or may not contain Hunner Ulcers, is known as

A

interstitial cystitis

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16
Q

Genetic information encoded within DNA can be found in which organelle?

  • Nucleus
  • Golgi body
  • Plasma membrane
  • Endoplasmic Reticulum
A

Nucleus

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17
Q

AIDS develops when a threshold number of which cells are destroyed?

  • Mast cells
  • Humeral B-cells
  • Killer T-cells
  • Helper T-cells
A

Helper T-cells

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18
Q

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

A urinary tract infection that has progressed to pyelonephritis

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19
Q

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
A

Flank or abdominal pain

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20
Q

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
A
  • Maintain blood volume
  • Regulate body temperature
  • Act as a solvent for biochemical processes
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21
Q

Which electrolytes are primary drivers of fluid balance within the body?

  • Phosphorus and Chloride
  • Calcium and Magnesium
  • Sodium and Chloride
  • Potassium and Bicarbonate
A

Sodium and Chloride

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22
Q

Which of the following is the most concerning sign of a decreased sodium level?

  • Excess thyroid hormone production
  • Confusion
  • Mild pitting edema
  • Cardiac dysfunction
A

Confusion

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23
Q

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
A

prevalence

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24
Q

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

A

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)

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25
Q

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?

A

Hyperkalemia could cause a change in the resting potential for cardiac cells, which could lead to like-threatening dysrhythmias

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26
Q

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
A
  • 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
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27
Q

_____ is the primary driver of a type 1 hypersensitivity IgE mediated reaction such as anaphylaxis

  • Estrogen
  • Antigen-Antibody complex
  • Histamine
  • Cortisol
A

Histamine

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28
Q

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
A

Nephrotic syndrome

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29
Q

Urinating in bed unknowingly at night, mostly referred to in children

A

Nocturnal enuresis

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30
Q

Loss of urine during times of increased intra-abdominal pressure exerted on the bladder by things like coughing, sneezing, laughing, exercising, or lifting.

A

Stress incontinence

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31
Q

Sudden, intense urge to urinate, followed by an involuntary loss of urine

A

Urge incontinence

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32
Q

Involuntary loss of urine when there is any intravascular pressure in the bladder

A

Overflow incontinence

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33
Q

A physical inability to get to the toilet in time when there is a need to urinate, generally referred to in older adults

A

Functional incontinence

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34
Q

Continuous leaking of urine or the periodic uncontrollable leaking of volumes of urine

A

Gross total incontinence

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35
Q

Most urinary tract infections (UTIs) are caused by what type of bacteria?

A

E. coli

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36
Q

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

A
  • 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
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37
Q

Lithotripsy is utilized to treat ____

A

Kidney stones

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38
Q

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
A

Polycystic Kidney Disease

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39
Q

One symptom of BPH in a male could be difficulty initiating a urine stream, or a weak urine stream. Explain why this symptom occurs

A

The enlarged prostate surrounds the urethra, placing pressure on it, causing difficulty urinating and small urine flow

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40
Q

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
A

Sammy, who has a very weak pulse, his skin is cool and mottled, and he is hypotensive

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41
Q

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 _____

A

Atrophy

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42
Q

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
A

The well-differentiated, neoplastic cells are clustered together in a single mass

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43
Q

_____ syndrome occurs in males when there is an extra X chromosome

  • Triple X
  • Klinefelter’s
  • Trisomy 21
  • Marfan’s
A

Klinefelter’s

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44
Q

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
A

Atrial Flutter

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45
Q

The cause of the disease or what sets the disease process in motion

A

Etiology

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46
Q

The sequence of cellular and tissue events that take place over the course of a disease

A

Pathogenesis

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47
Q

What the patient experiences. Includes signs and symptoms

A

Manifestations

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48
Q

The effects an illness has on a person’s life over time

A

Morbidity

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49
Q

Relates to the amount of death associated to a disease within the population

A

Mortality

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50
Q

The primary hormone responsible for the Alarm stage of the General Adaptation Syndrome is _______

A

cortisol

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51
Q

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
A

Pulseless Electrical Activity

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52
Q

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
A

Autosomal recessive

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53
Q

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
A

Symptoms presentation
CD4 count

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54
Q

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
A

Postrenal

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55
Q

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
A

Palliative

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56
Q

Nicole has renal failure and her kidneys are not working. Which electrolyte imbalances is/are Nicole at risk for?

  • Hypernatremia
    -Hyperkalemia
  • Hyponatremia
  • Hypokalemia
A
  • Hypernatremia
  • Hyperkalemia
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57
Q

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
A

Primary

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58
Q

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
A

Type-I Diabetes

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59
Q

Jaundice may be seen in the skin or eyes. What substance builds up, causing jaundice?

A

Bilirubin

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60
Q

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
A

Bacterial meningitis

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61
Q

Patients with Celiac’s disease must avoid _____ in their diet

A

Gluten

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62
Q

Which cells are primarily responsible for fighting of Salmonella bacteria?

  • Macrophages
  • B-cells
  • T-cells
  • Neutrophils
A

Macrophages

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63
Q

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

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

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64
Q

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
A

Alzheimer’s disease

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65
Q

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
A

Hydrocephalus

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66
Q

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
A

Venous blood has accumulated between Michael’s dura and subarachnoid space

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67
Q

Allison was walking her dog during a wind storm when a large tree limb fell and struck her in the head. The oncoming nurse reviews Allison’s chart and sees that she has suffered a fracture to the left temporal bone of her skull. The nurse knows that Allison is now at risk for a ________ hemorrhage

A

epidural hematoma

68
Q

Too much growth hormone leads to the manifestation of ________
Too little growth hormone leads to the manifestation of ________

A

Gigantism
Dwarfism

69
Q

A seizure disorder may be characterized by which of the following?

  • Spontaneous firing of abnormal neurons
  • Can occur secondary to trauma, hypoglycemia, or fever
  • May be caused by alterations in the cell membrane permeability or distribution of ions across the cell membranes
  • Occurs due to a sudden increase in ATP of the muscle cell
A
  • Spontaneous firing of abnormal neurons
  • Can occur secondary to trauma, hypoglycemia, or fever
  • May be caused by alterations in the cell membrane permeability or distribution of ions across the cell membranes
70
Q

A patient is having continual seizures (seizures that do not stop) despite already receiving first line medications for seizures. What condition is the patient currently experiencing?

A

Status epilepticus

71
Q

A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a “coup” injury. How will the nurse explain this to the family so they can understand?

  • “Your son has a huge laceration inside the brain where the bat hit his skull.”
  • “It’s like squeezing an orange so tight that the juice runs out of the top.”
  • “Your son has a contusion of the brain at the site where the bat his his head.”
  • “When the bat hit his head, his neck jerked backward causing injury to the spine.”
A

“Your son has a huge laceration inside the brain where the bat hit his skull.”

72
Q

What is the difference in the pathogenesis between hemorrhagic and ischemic strokes? Which is more common?

A

Ischemic strokes are caused by a blockage of blood flow to an area of the brain, usually by a clot. Hemorrhagic strokes are caused by bleeding into the brain.

Ischemic are much more common than hemorrhagic

73
Q

After an extensive work-up, Mallory is diagnosed with viral meningitis. As a nurse you expect that her treatment plan will state which of the following?

  • She can control symptoms as needed, such as taking tylenol for fevers aches
  • She will need daily visits from a home health nurse to be assess for a blood infection, as is likely to get very sick
  • There is a high death rate for viral meningitis
  • She will need to be hospitalized for intravenous antibiotics
A

She can control symptoms as needed, such as taking tylenol for fevers aches

74
Q

Edwin has cirrhosis of the liver. This has led to Barrett’s Esophagus, and he has been throwing up. You suspect he may have a bleeding varicose vein in his throat due to the disease. What clue about his emesis may strengthen your conclusion that he has a bleeding esophageal varicosity.

  • Coffee-ground emesis
  • Only food in his emesis
  • Bright red blood in his emesis
  • Fecal material in his emesis
A

Bright red blood in his emesis

75
Q

The nurse asks Jenny what medical problems she has. Jenny responds that she has been told that part of her stomach sticks through the diaphragm into her chest cavity, but cannot recall what it is called. The nurse can identify this disease as…

  • A bowel obstruction
  • Esophageal atresia
  • An intussusception
  • A hiatal hernia
A

a hiatal hernia

76
Q

Cleft palate has obvious implications for appearance and self confidence. Beyond personal aesthetics, what are 2 physiological complications that are concerning for patients with cleft palate.

A

Impaired ability to feed
Delayed/difficult speech
Hearing problems
Ear infections

77
Q

Which of the following would a nurse utilize to assess a client’s pain?

  • Color of pain
  • Location of pain
  • Severity of pain
  • Character of pain
A
  • Location of pain
  • Severity of pain
  • Character of pain
78
Q

Ulcerative colitis and Crohn’s disease make up the general disease of inflammatory bowel syndrome. While _______ can be present anywhere along the GI tract from the mouth to the anus, _______ does not affect the small intestines

A

Crohn’s disease, Ulcerative Colitis

79
Q

Which of the following are part of the immunological pathogenesis of Multiple Sclerosis?

  • There is a cytokine response that allows for increased permeability of the blood brain barrier
  • Lymph nodes expand and herniate
  • Antinuclear antibodies are produced
  • Macrophages engulf oligodendrocytes
  • Killer T cells cross the blood brain barrier, become activated by myelin and allow more cells to cross the blood brain barrier
A
  • There is a cytokine response that allows for increased permeability of the blood brain barrier
  • Macrophages engulf oligodendrocytes
  • Killer T cells cross the blood brain barrier, become activated by myelin and allow more cells to cross the blood brain barrier
80
Q

The trauma nurse is monitoring Sara, a 24 year old female who was hospitalized earlier today following a motor vehicle crash. During report, the nurse noted that Sara’s healthcare team was concerned that she may have suffered a head injury during the crash. The nurse has orders to complete a neural exam every hour to monitor for an increase in intracranial pressure. What are 3 signs/symptoms that the nurse would note as concerning for Sara having an increased intracranial pressure?

A
  • Changes/Decreases in level of consciousness
  • Papilledema
  • Impaired eye movement
  • Decreased sensory/motor function
  • Headache
  • Changes to pupils
  • Cushing’s Triad (increase in BP, decrease in pulse, decrease in respiration)
81
Q

Which of the following statements is most true regarding the pathophysiology of Type II Diabetes Mellitus?

  • Most patients suffering from Type II Diabetes Mellitus were born with the disease
  • Type II Diabetes Mellitus is the result of insulin resistance of the cells that utilize insulin
  • In Type II Diabetes Mellitus, the pancreas fails to make insulin
  • The most common cause of Type II Diabetes Mellitus is chronic liver cirrhosis
A

Type II Diabetes Mellitus is the result of insulin resistance of the cells that utilize insulin

82
Q

Unilateral throbbing headache, often preceded by an aura

A

Migraine headache

83
Q

Headache that is usually bilateral and tight feeling, often with stress etiology

A

Tension-type headache

84
Q

Headache that is usually unilateral, severe, located behind the eye. May be treated with oxygen

A

Cluster headache

85
Q

Headache that often accompanies an upper respiratory infection

A

Sinus headache

86
Q

Moonface, fat deposits on back of shoulders, and gynecomastia are all ways that _____ can change a person’s looks

  • Hyperthyroid
  • Cushing’s disease
  • Hypothyroid
  • Celiac Disease
A

Cushing’s disease

87
Q

What is happening in the body that seems to be the basic pathogenesis of Parkinson’s Disease?

A

Neurodegenerative disorder that decreases the production of dopamine

88
Q

Explain what a concussion is.

A

An immediate and transient loss of consciousness accompanied by a brief period of amnesia after a blow to the head - recovery usually takes place within 24 hours

89
Q

Body type and adipose tissue distribution can have an effect on overall health. What body type is most at risk of developing cardiovascular disease?

A

Apple shaped

90
Q

President John F. Kennedy had an adrenal insufficiency. He fought fatigue, weakness, and depression, had difficulty maintaining weight and often would not stand up suddenly in the presence of those he was meeting with. What disease did John F. Kennedy have?

  • Hyperthyroid
  • Hypothyroid
  • Addison’s disease
  • Cushing’s disease
A

Addison’s disease

91
Q

Bridgete suffers from Graves Disease. Her family brings her into the ER one day with a very high fever, tachycardia, and restlessness. You quickly recognize that this could be an emergency situation if she is having….

  • Urgently low levels of cortisol
  • Diabetic ketoacidosis
  • Hyperglycemia
  • A thyroid storm
A

A thyroid storm

92
Q

What are 2 reasons that ascites develops in cirrhosis liver failure?

A

Lack of albumin and other proteins makes intravascular lose osmotic property to retain fluid
Pressure back up from difficulty moving blood through liver causes fluid to leak out

93
Q

Brad has type-I diabetes. He states he has been feeling very weak, unwell and has been nauseated. His blood sugar is 624 today. You notice that there is a slightly fruity smell coming from his breath. What disease are you concerned about with Brad?

A

Diabetic Ketoacidosis

94
Q

Which of the following could be a complication of a spinal cord injury that leaves a patient without some of their motor ability?

  • Loss of pain reception
  • Problems with skin integrity
  • Loss of sexual function
  • Problems with bladder and bowel control
A
  • Loss of pain reception
  • Problems with skin integrity
  • Loss of sexual function
  • Problems with bladder and bowel control
95
Q

________ _________ is a group of non-progressive disorders that appear in young children and affect motor movement, muscle coordination, and proprioception.

A

Cerebral palsy

96
Q

West Nile Virus is transmitted by mosquitoes in endemic areas. It can cause a disease known for infection deep in the parenchyma of the brain that can cause damage to nerve cell bodies and diffuse brain destruction. This disease is known as….

  • Barrett’s esophagus
  • Encephalitis
  • Meningitis
  • Cerebral palsy
A

Encephalitis

97
Q

A gallstone lodged in the common bile duct could cause disease in which of the following organs?

  • Cecum
  • Gallbladder
  • Liver
  • Pancreas
A
  • Gallbladder
  • Liver
  • Pancreas
98
Q

A nurse at a long-term care facility provides care for Elmer, an 85 year old man who has had recent transient ischemic attacks (TIAs). Elmer looks quite well and is acting normally now. However, the nurse is concerned about Elmer. Which of the following statements best identifies future complications associated with TIAs?

  • TIAs resolve rapidly, but may place patients at an increased risk for stroke
  • TIAs damage the liver, however liver regeneration allows them to remain subclinical
  • TIAs are small bleeds that clot quickly and have a risk of jaundice as these clots resolve
  • The initial TIAs resolve in a short time, however they remain dormant and can have a sudden resurgence causing death
A

TIAs resolve rapidly, but may place patients at an increased risk for stroke

99
Q

Bella is a 5-day old infant in the pediatric clinic where you are working. She is losing weight, despite being hungry frequently and eating well. Every time she eats, she vomits several minutes later. What disease are you concerned is affecting Bella?

  • Crohn’s disease
  • Pyloric Stenosis
  • Cleft Palate
  • Esophageal Atresia
A

Pyloric Stenosis

100
Q

You are a nurse caring for Marcia. You go to visit Marcia and realize that her doctor has just left the room and told her that she has been diagnosed with a benign brain tumor. Marcia smiles at you and states that she is glad there is nothing to worry about since the tumor is benign. You know you need to correct her. Why is it wrong for Marcia to state that there is nothing to worry about?

A

While a benign tumor will not spread, even if it grows slowly, it will take up limited space in the cranium and can cause problems related to increased intracranial pressure

101
Q

Millies is 5ft, 6 in tall and weighs 100 pounds. She diets hard to lose weight. When she looks in the mirror she sees many areas of her body that she thinks are too fat. What disease is Millie suffering from?

  • Anorexia Nervosa
  • Roux-en-Y syndrome
  • Esophageal Atresia
  • Bulimia Nervosa
A

Anorexia Nervosa

102
Q

The following terms are used to provide some objectivity to a patient’s level of consciousness. With 1 being the most healthy and 5 being the most neurologically tenuous, list the order of most responsive to least responsive.

A. Somnolent
B. Stuporous
C. Lethargic
D. Alert
E. Comatose

A

D, C, A, B, E

103
Q

Spina Bifida is one of the most common, severe birth defects in the United States. What is the anatomical characteristic that leads to Spina Bifida?

  • The lumbar spine meninges do not have all 3 cell layers
  • Herniation of intervertebral disk material
  • A build-up of folic acid residue along the spinal canal
  • The posterior spinus processes of the vertebrae fail to fuse
A

The posterior spinus processes of the vertebrae fail to fuse

104
Q

Which patient is most likely to be suffering from acute cholecystitis?

  • Ronald: a 40 year old male who is overweight and has diabetes mellitus
  • Sophia: a 50 year old overweight female who went through menopause at age 44
  • Anna: a 45 year old female who is overweight and has not gone through menopause
  • Carmandy: a 17 year old female who has already had 3 sexual partners
A

Anna: a 45 year old female who is overweight and has not gone through menopause

105
Q

Which disease is found in only one salivary gland and often requires hospitalization during treatment?

  • Salivary Atresia
  • Hydronephrosis
  • Choledocolithiasis
  • Sialadenitis
A

Sialadenitis

106
Q

Kegan is a 30 year old man. He presents to your clinic complaining of flu-like symptoms and abdominal pain. He has multiple tattoos, some appearing quite crude, and admits to a long history of intravenous drug use and unprotected sex with multiple male and female partners. Which type or types of hepatitis is Kegan most at risk for?

A

Hepatitis B and C

107
Q

What is the most common cause of Peptic Ulcer Disease? Luckily with proper treatment this cause can be cured with antibiotics

A

h. pylori

108
Q

Which disease is often triggered by a fecalith?

  • Appendicitis
  • Pancreatitis
  • Pyloric Stenosis
  • Cholecystitis
A

Appendicitis

109
Q

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 touch, pale in color with pedal and posterior tibial pulses non-palpable, and a shape line of paralysis/paresthesia. The nurse’s next 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
A

Acute arterial occlusion is a medical emergency requiring immediate intervention to restore blood flow

110
Q

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 up more quickly
A

Cough drops or honey may help with the cough

111
Q

Chest pain that occurs with exertion, then stops within 20 minutes of resting is known as…

  • Myocardial Infarction
  • Infective Endocarditis
  • Unstable Angina Pectoris
  • Stable Angina Pectoris
A

Stable Angina Pectoris

112
Q

Asthma is a disease that causes decreased air movement through the bronchi due to bronchial constriction and inflammation. As asthma attack that lasts more than 30 minutes and is not responding to treatments would be called ________ _________

A

Status asthmaticus

113
Q

Failure of the circulatory system to supply peripheral tissues and organs with adequate blood supply caused by the heart’s inability to pump adequate blood is known as _________ ________

A

Cardiogenic shock

114
Q

The narrowing of an opening created by a heart valve

A

Stenosis

115
Q

A lack of the valve opening that would otherwise allow blood flow

A

Atresia

116
Q

When blood leaks backwards through a heart valve

A

Regurgitation

117
Q

An enlarged heart

A

Cardiomegaly

118
Q

Which is more common, Hodgkin or non-Hodgkin Lymphoma?
What is the defining cellular characteristic that distinguishes one from the other?

A

non-Hodgkin Lymphoma is more common
Reed-Sternberg cells are present in Hodgkin

119
Q

A client presents with the following symptoms:
- Fever off-and-on for several weeks
- Weakness and weight loss
- Swollen lymph nodes
- Petechiae and night sweats
- History of three infections in the last 2 months
The nurse suspects which of the following disease processes?

  • Breast cancer
  • Leukemia
  • Congestive Heart Failure
  • Renal calculi
A

Leukemia

120
Q

Angie has just been to see her Nurse Practitioner due to her symptoms of nasal stuffiness, itchy nose, sneezing, and watery nasal discharge. Her Nurse Practitioner explained that she was likely having ________ ________, and antihistamines may help to ease her symptoms.

A

Allergic rhinitis

121
Q

Which disease process is characterized by fluid or pus filling alveoli in the lungs? With the exception of COVID, it is often bacterial and treated aggressively with antibiotics.

  • Pneumothorax
  • Pneumonia
  • Neurofibromatosis
  • Chronic Obstructive Pulmonary Disease (COPD)
A

Pneumonia

122
Q

Which is/are considered high-risk populations for serious COVID-19 manifestations?

  • Those with diabetes
  • Those of white/caucasian descent
  • Individuals with COPD
  • Young adults in college
  • Older adults
A
  • Those with diabetes
  • Individuals with COPD
  • Older adults
123
Q

Infective endocarditis is caused by an infection of the endocardium of the heart valves. A clump of platelets, fibrin, microorganisms, and white blood cells that develops on the valve is referred to as a _______

A

vegetation

124
Q

The nurse is meeting with a patient who has recently been given a diagnosis of Pernicious Anemia. The nurse explains to the patient that she may have to receive periodic injections of

  • Iron
  • Erythropoietin
  • B12
  • Blood
A

B12

125
Q

A woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client’s husband is confused as to why a disease of coagulation can result in bleeding. How should the nurse respond to his question?

A

There is so much clotting taking place in the body that there are no available clotting components left, and bleeding ensues.

126
Q

Edward is 4 years old. His mother brings him to the clinic stating that he had a very difficult time sleeping last night due to a persistent cough that sounds like a seal barking. Edward is likely to be diagnosed with ______

A

croup

127
Q

A client is having shortness of breath, wheezing, chest tightness, and a change in his AP (anterior/posterior) diameter that resembles a ‘barrel chest’. The oxygen saturation is 88%. The client most likely has which of the following diagnoses?

  • COPD
  • Upper respiratory tract infection
  • Pneumonia
  • Asthma
A

COPD

128
Q

A thrombus is a ________
Whereas an embolus is a ________

  • Stationary blood clot; a blood clot that is traveling around the body
  • Stationary blood clot; a blood clot in the lungs
  • A collection of macrophages; a blockage of a blood vessel
  • A pancytopenia structure; a blockage of a blood vessel
A

Stationary blood clot; a blood clot that is traveling around the body

129
Q

A patient presents to the ER with complaints of dizziness and fainting upon standing. Sitting, the patient’s blood pressure reads 155/78. However, upon standing the patient’s blood pressure drops to 88/58. What condition is the patient likely exhibiting?

  • Orthostatic hypotension
  • Hypertension
  • Disseminated Intravascular Coagulation (DIC)
  • Polycythemia
A

Orthostatic hypotension

130
Q

A ______ aneurysm does not completely surround the affected blood vessel and is most often located in the brain along the circle of Willis

A

saccular

131
Q

Genetic mutations that affect the Cystic Fibrosis Transmembrane Regulator (CFTR) protein could likely cause what manifestations?

  • left sided heart failure
  • salty tasting skin
  • recurring upper respiratory tract infections
  • foul-smelling, greasy stools
A
  • salty tasting skin
  • recurring upper respiratory tract infections
  • foul-smelling, greasy stools
132
Q

A patient has had a myocardial infarction (MI). The nurse knows that one of the most common causes of an MI is which of the following?

  • Atherosclerosis
  • Endocarditis
  • Tear in coronary artery
  • Cardiomyopathy
A

Atherosclerosis

133
Q

What organism is the most common cause of epiglottitis?

A

HiB

134
Q

All of the following mechanisms might be involved in compensating for heart failure except…

  • The sympathetic nervous system
  • Liver glycogen release
  • The renin-angiotensin-aldosterone system
  • The Frank-Starling principle
A

Liver glycogen release

135
Q

Jenna is a public health nurse in a rural area in the south of the United States. She has been tasked with reducing the rate of COPD among her community. Her primary goal toward reaching a reduction in COPD is to educate the community to do what?

  • Test their FEV1 every year
  • Have a chest X-ray done every 2 years
  • Stop smoking
  • Get genetic counseling prior to having children
A

Stop smoking

136
Q

Thalassemia is a genetic disorder that can lead to…

  • Excessive clotting
  • Anemia
  • Excessive weight gain
  • Excessive energy
A

Anemia

137
Q

What are 2 things that can cause asthma attacks?

A

Allergens
Smoke
Exercise
Emotions

138
Q

The nurse is visiting with her patient, Albert. Albert states that the physician has just told him he has an empyema. This nurse explains to Albert that…

  • This is a specific type of pneumonia
  • There is excess blood in the chest cavity
  • He has pus accumulated in the space around his lung
  • He should practice pursed lip breathing to help get air out of his lungs
A

He has pus accumulated in the space around his lung

139
Q

Treatment for hemophilia A includes:

  • Heparin administration
  • Factor VIII replacement
  • Platelet transfusion
  • Factor IX replacement
A

Factor VIII replacement

140
Q

Frank has just received the devastating news that he has non-small cell lung cancer present in his lungs. They have not found cancer in any other parts of his body, including none in his other lung and none in the nearby lymph nodes. What stage lung cancer does Frank have?

  • Stage 1
  • Stage 2
  • Stage 3
  • Extensive stage
A

Stage 1

141
Q

An elderly client is being seen by his care provider for pain in his legs when he exercises. The provider also notices opaque toe nails, cool skin below the knees. and an open ulceration on his Left calf that the client reports has been there for ‘a while and just won’t heal’. The most likely diagnosis for this client would be which of the following?

  • Peripheral vascular disease
  • Left-sided congestive heart failure
  • Iron-deficiency anemia
  • High blood pressure
A

Peripheral vascular disease

142
Q

Anemia characterized by microcytic, hypochromic red blood cells

A

Iron deficiency anemia

143
Q

Anemia characterized by macrocytic, immature red blood cells

A

Pernicious anemia

144
Q

Anemia characterized by pancytopenia

A

Aplastic anemia

145
Q

Anemia characterized by crescent shaped red blood cells

A

Sickle cell anemia

146
Q

An isolated left-sided heart failure could cause the following symptoms

  • Dyspnea on exertion
  • shortness of breath
  • Moist crackles when listening to lung fields with a stethoscope
  • Pitting edema
A
  • Dyspnea on exertion
  • shortness of breath
  • Moist crackles when listening to lung fields with a stethoscope
147
Q

With heart failure, remodeling of the cardiac muscle can occur. In hypertrophic cardiomyopathy….

  • The heart enlarges causing increased muscle tissue and allowing it to beat with more force
  • The heart becomes smaller and weaker
  • The heart enlarges and stretches causing a weakening of the heart muscle
  • The heart becomes smaller so that less blood can be pumped out during a single beat
A

The heart enlarges and stretches causing a weakening of the heart muscle

148
Q

Treatment for Polycythemia Vera could include:

  • Monoclonal antibodies
  • Chemotherapy
  • Blood letting
  • Blood transfusion
A

Chemotherapy
Blood letting

149
Q

Andrew is a 15 year old male who has been having fevers, sore throat, and swollen occipital lymph nodes. He has just received test results stating he has Infectious Mononucleosis. The healthcare provider has advised that he cannot participate in football for several weeks. Why has he been given this advice to avoid contact sports like football?

A

Mono causes inflammation to the spleen, which predisposes it to rupture. A blow to the spleen during contact sports could cause splenic rupture, a life threatening emergency.

150
Q

_______ lipoprotein is considered “good cholesterol”. It is considered good because ______

A

HDL; transports cholesterol to be excreted

151
Q

What type of shock would be expected in a trauma patient who has just been involved in a severe motor vehicle crash?

  • Hypovolemic shock
  • Septic shock
  • Cardiogenic shock
  • Neurogenic shock
A

Hypovolemic shock

152
Q

A client has congestive heart failure (CHF) and asks a nurse how long he has to be on the medications before he is cured. Which of the following is the accurate response for the nurse to make?

  • As soon as the fluid in your lungs has decreased enough for you to maintain a 93% oxygen saturation
  • There is no cure for CHF, but we hope to control your symptoms with medication
  • As soon as you are able to walk up 3 flights of stairs without being winded, you will be cured
  • You will be cured when the edema in your legs is below 1+ bilaterally
A

There is no cure for CHF, but we hope to control your symptoms with medication

153
Q

Infectious Mononucleosis is caused by…

  • Herpes Simplex 3
  • A bone marrow tumor
  • A mutation in the erythrocyte gene
  • the Epstein Barr virus
A

the Epstein Barr virus

154
Q

Which of the following disease processes are directly related to a blood clot?

  • Myocardial Infarction
  • Heart failure
  • Deep Vein Thrombosis
  • Pulmonary Embolism
  • Ischemic Cerebral Vascular Accident
A
  • Myocardial Infarction
  • Deep Vein Thrombosis
  • Pulmonary Embolism
  • Ischemic Cerebral Vascular Accident
155
Q

A congenital heart defect occurs at birth. What defect occurs in coarctation of the aorta?

  • The aorta and pulmonary artery are switched in position
  • A single common blood artery branches off the heart instead of the two usual vessels (the pulmonary artery and the aorta)
  • A narrowing of the aorta
  • An opening between the aorta and atria
A

A narrowing of the aorta

156
Q

Norman accidently got stabbed in the right side of his chest wall with a sharp drill bit. When he breathes in, air leaks into his chest cavity, but the hole seals over when he exhales so air does not leak back out. As air keeps leaking in, the pressure in his chest cavity exceeds that of the atmosphere. His heart shifts toward the left side and his trachea deviates to the left.

  • Elephant pneumothorax
  • Spontaneous pneumothorax
  • Failed pneumothorax
  • Tension pneumothorax
A

Tension pneumothorax

157
Q

What things can cause a pulmonary embolism?

  • Schwann cells
  • Hypotonic saline solution
  • Amniotic fluid
  • Air
  • Clot embolus from a DVT
  • Fat (bone marrow)
A
  • Amniotic fluid
  • Air
  • Clot embolus from a DVT
  • Fat (bone marrow)
158
Q

Sickle Cell Anemia is characterized by a crescent shaped red blood cell. What problems can occur in a patient with Sickle Cell Anemia?

  • A large antibody response
  • Increased red blood cell destruction
  • Clumping of cells leading to ischemia
  • Long term proliferation of fetal hemoglobin
A
  • Increased red blood cell destruction
  • Clumping of cells leading to ischemia
159
Q

Naturally occuring re-routing of blood flow around a vascular blockage is called _______ circulation. A treatment where a surgeon artificially re-routes blood flow around a vascular blockage is called a _______

A

Collateral; Bypass

160
Q

A client is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the client has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. The vital signs include pulse rate of 110 and BP drop to 95/56. What is the nurse’s priority action?

  • Recheck the type of blood infusing with the chart documentation of client’s blood type
  • Discontinue the transfusion
  • Slow the rate of the blood transfusion to 50 mL/hour
  • Document the assessment as the only action
A

Discontinue the transfusion

161
Q

Pericarditis in it’s most extreme form could lead to cardiac tamponade. How could cardiac tamponade lead to cardiogenic shock?

A

Pressure on the heart does not allow for chambers to fill, decreasing CO

162
Q

________ play a role in atherosclerosis in that they can collect lipid molecules at a site in the vasculature and generate foam cells that can help promote plaques.

  • Bradykinins
  • Cytokines
  • T-lymphocytes
  • Macrophages
A

Macrophages

163
Q

Beverly presents to the clinic with pitting edema in her ankles. The nurse understands that this is consistent with which type of heart failure?

  • Left sided
  • Superior variant
  • Inferior variant
  • Right sided
A

Right sided

164
Q

What is difficult about the treatment for TB (tuberculosis)?

A

TB must be treated for an extended period of time, up to 9 months.

People have a difficult time with this, and stopping the treatment early allows increased opportunity for the bacteria to become resistant to antibiotics.

165
Q

LeRoy is 6 years old. He presents with cyanosis, looks scared and insists on sitting up in a tripod position. The healthcare provider is very concerned because she knows that the tripod stance can be used to identify..

  • Bronchitis
  • Epiglottitis
  • Laryngitis
  • Tracheitis
A

Epiglottitis