Pathophysiology Exam 3 NR 283 Questions with 100% correct answers -Chamberlain

c. Striated and voluntary

1. Which types of muscles make up most of the musculoskeletal system?

a. Striated and involuntary

b. Smooth and voluntary

c. Striated and voluntary

d. Smooth and involuntary

d. Heberden's nodes

2. Irreversible changes in the distal joints of the fingers caused by osteoarthritis are known as:

a. Bouchard's nodes

b. Lymph nodes

c. Haygarth's nodes

d. Heberden's nodes

a. Porosity and brittleness

3. Osteoporosis is characterized by:

a. Porosity and brittleness

b. Brittleness and swelling of the joints

c. Crystal deposition and brittleness

d. Progressive inflammatory destruction after new bone formation

d. Oral antidiabetic agent

4. Which treatment is commonly indicated for type 2 diabetes mellitus?

a. High-fiber, low-fat diet

b. Fluid restriction

c. Insulin

d. Oral antidiabetic agent

a. Decreased blood glucose level

5. Which of the following is caused by the release of insulin?

a. Decreased blood glucose level

b. Increased blood glucose level

c. Increased lipid breakdown

d. Increased protein breakdown

a. Can be treated with oral glycemic agents

6. Which of the following is not true of type 1 diabetes?

a. Can be treated with oral glycemic agents

b. Pancreas is completely unable to produce insulin

c. Acute onset

d. Definite genetic link

c. Significant weight loss occurs as a symptom

7. Which of the following is not true about type 2 diabetes?

a. Accounts for up to 95% of diabetics

b. Gradual onset

c. Significant weight loss occurs as a symptom

d. Risk factors are hypertension, family history, and obesity

d. Low blood glucose level

8. Which of the following is not a sign of DKA?

a. Kussmaul respirations

b. Dehydration

c. Ketonuria

d. Low blood glucose level

a. HbA1c (hemoglobin A1c)

9. Which laboratory test is the best predictor of blood glucose control over the previous few months?

a. HbA1c (hemoglobin A1c)

b. Fasting blood glucose

c. Urinalysis

d. Feasting (postprandial) blood glucose

b. Thickening and ischemia of the vessels that supply the nerve fibers

10. Neuropathies are a potential complication of diabetes. Why do these occur?

a. Infection in the nerves

b. Thickening and ischemia of the vessels that supply the nerve fibers

c. Inability to provide continuous glucose to the brain and spinal cord

d. Excessive glucose exposure to the brain and spinal cord

a. Insulin is destroyed in the gastrointestinal tract if taken orally, so it must be injected subcutaneously

11. What is your explanation to the parents who do not want to give their child insulin injections to treat type 1 diabetes because they have heard that pills can be used to treat this condition?

a. Insulin is destroyed in the gastrointestinal tract if taken orally, so it must be injected subcutaneously

b. The child can go ahead and take the oral medication because he does have type 1 diabetes

c. The child cannot take the pills because we can't be sure that he would take the entire dose

d. The pills are reserved for those over the age of 12

b. How the condition is treated between type 1 and type 2

12. A major difference between Bobby (type 1 diabetes) and his father (type 2 diabetes) is:

a. How the condition is diagnosed between type 1 and type 2

b. How the condition is treated between type 1 and type 2

c. The potential long-term complications

d. The overall goal of treatment between type 1 and type 2

b. An elevated glycosylated hemoglobin level

13. Bobby comes into the clinic after 6 months for a follow-up visit. He indicates that his blood sugars have been around 100 to 120 mg/dL and he has been fully participating in the other aspects of his diabetes management plan. Which would lead you to believe that he has not been in tight control of his diabetes?

a. A reduced glycosylated hemoglobin level

b. An elevated glycosylated hemoglobin level

c. A random blood sugar of 150 mg/dL performed in the clinic

d. There is no method to determine whether or not he is in tight control

b. Cushing syndrome

14. Excess cortisol is represented by which condition?

a. Addison disease

b. Cushing syndrome

c. Diabetes insipidus

d. Hyperthyroidism

Dehydration

15. Diabetes insipidus, if left untreated, will rapidly develop into:

a. Malignant hypertension

b. Diabetic coma

c. Dehydration

d. Metabolic alkalosis

d. Hypothyroidsm

16. You are experiencing constipation, dry skin, weight gain, and cold intolerance. Which condition are you most likely experiencing?

a. Hyperthyroidism

b. Addison disease

c. Cushing syndrome

d. Hypothyroidism

a. Fatty acids are mobilized

Rationale: With Cushing syndrome, excess secretion of glucocorticoids can result in excessive circulating glucose and subsequent glucose intolerance, suppression of the inflammatory and immune responses, protein degradation, and mobilization of fats and changes in fat metabolism)

17. Which of the following occurs with elevated levels of cortisol?

a. Fatty acids are mobilized

b. Glucose levels are suppressed

c. Plasma protein levels increase

d. Inflammation increases

c. Graves disease

18. A patient presents with exophthalmos. What condition is she likely experiencing?

a. Addison disease

b. Cushing disease

c. Graves disease

d. Diabetes insipidus

b. Addison's disease

19. A patient with weight loss, GI disturbances, dehydration, fatigue, and a craving for salty food probably has which disorder?

a. Cushing's syndrome

b. Addison's disease

c. Hypothyroidism

d. Diabetes insipidus

c. Glucocorticoid excess

20. Cushing's syndrome may be caused by which of the following?

a. Destruction of more than 90% of the adrenal gland

b. Thyroid hormone overproduction

c. Glucocorticoid excess

d. Insufficient antidiuretic hormone production

a. An Asian woman

c. A client who started menopause early

d. A client with a family history of the disease

f. A client with an inadequate intake of calcium and vitamin D

21. The nurse is working at an osteoporosis screening clinic and is interviewing and performing health assessments on women. Which clients are at greatest risk for developing osteoporosis? Select all that apply.

a. An Asian woman

b. A large-boned, dark-skinned woman

c. A client who started menopause early

d. A client with a family history of the disease

e. A client who has a physically active lifestyle

f. A client with an inadequate intake of calcium and vitamin D

d. "If hypoglycemia occurs, I need to take my regular insulin as prescribed."

22. The nurse is instructing a client with diabetes mellitus regarding hypoglycemia. Which statement by the client indicates the need for further teaching?

a. "Hypoglycemia can occur at any time of the day or night."

b. "I should drink 6 to 8 ounces of milk if hypoglycemia occurs."

c. "If I feel sweaty or shaky, I might be experiencing hypoglycemia."

d. "If hypoglycemia occurs, I need to take my regular insulin as prescribed."

Aldosterone

The most important regulator of electrolyte concentrations in extracellular fluids is __________.

Epinephrine

Which of the following is not a steroid-based hormone?

Estrogen

Aldosterone

Epinephrine

Cortisone

Steroid hormones, because both diffuse easily into target cells

Thyroid hormone (a small iodinated amine) enters target cells in a manner similar to ___________.

adipocytes

Leptin is secreted by ___________.

Cortisol

Mineralocorticoid is to aldosterone as glucocorticoid is to __________.

epinephrine

When it becomes necessary to enlist the fight-or-flight response, a hormone that is released during the alarm phase of the general adaptation syndrome is _________.

Humoral stimulation

One of the least complicated of the endocrine control systems directly responds to changing blood levels of ions and nutrients. Which of the following describes this mechanism?

humoral

When blood glucose increases and the pancreas releases insulin is an example of __________________ stimulation.

The heart

Which organ is responsible for synthesizing ANP?

Atrial Natriuretic Peptide

It secreted of myocytes of the cardiac and promotes salt and water excretion which lowers blood pressure.

What is ANP?

targeting the bone and activating osteoclasts so that calcium will be released.

The parathyroid glands maintain adequate levels of blood calcium. This is accomplished through ______________.

Complete

Open, oblique, spiral, transverse, impacted, and pathologic are all what type of fractures?

Paget disease

This is excessive resorption of spongy bone. Formation of softened bone follows.

Osteoporosis

This is imbalance in bone resorption and formation, increased binding of RANKL with age.

Osteomalacia

Osteoid tissue is not mineralized.

Osteomyelitis

This is the acute inflammatory process in bone marrow and cortex. If blood supply is interrupted, bone necrosis leads to the production of sequestrum and involucrum surrounding the infected area of the bone.

Fibroblast

Osteosarcoma is derived from which cell type?

Bone marrow

Osteosarcoma is most often found in _____.

Chondrosarcoma

a large, ill-defined tumor located in the trabeculae of spongy bone.

Fibrosarcoma

a solitary, cancerous tumor typically located in the metaphyseal region of the femur or tibia.

Giant cell tumors

a solitary, cancerous tumor typically located within the center of the epiphysis of the femur, tibia, radius, or humerus.

Pain experience

These factors all affect the quality and severity of the ____________________?

Mobility, Sleep, Nutrition, Fatigue, Tissue Integrity, Culture, Coping mechanisms, Stress, Mood & affect. (diet & current health can also have an impact)

Specificity

Theory that explains that the level of experienced pain is related to the amount of tissue damaged. But this theory fails to describe the driver behind chronic pain.

Gate Control

Theory suggests that pain responses are filtered through pain-modulated impulses conducted to the spinal cord. Special cells in the substantia gelatinosa regulate the pain transmission to the central nervous system. Transmission of pain impulses opens the gate and allows the perception of pain to be recognized. The stimulation of skin receptors can act to partially close the gate, thereby reducing the pain sensation.

Neuromatrix

Theory describes the pain sensation as a series of patterns derived from genetics and previous experiences with pain (both psychological and cognitive). It also describes pain as initiating from areas of the body that no longer exist, such as phantom pain. Pain perception may be influenced by factors that includd age, gender, previous experiences with pain, and cultural preferences.

Seizure

Alcohol or drug withdrawal, metabolic disorder, cerebrovascular disease (e.g., stroke, aneurysm), brain tumor, central nervous system degenerative disease (e.g., Alzheimer's disease, multiple sclerosis), brain injury are all possible causes of _______________ disorder.

c. Vasoconstriction

.What is an effect of the sympathetic nervous system?

a. Bradycardia

b. Increased peristalsis

c. Vasoconstriction

d. Bronchoconstriction

Brain death

2. The following are the criteria for _____________?

b. Absence of brain stem reflexes

e. Cessation of brain stem function

f. Absence of spontaneous respirations when ventilator is withdrawn

b. Glasgow coma scale

3. What is the best way to assess Level of Consciousness?

Intracranial Pressure (ICP)

The following are manifestations of __________________________.

b. Headache

c. Change in Level of Consciousness

d. Projective vomiting

e. Cushing's triad reflex

f. Pupil abnormalities

c. TIAs are temporary, partial blockages while CVAs are total obstructions.

5. A nurse is educating a client after a stroke. What is the difference between a Transient Ischemic Attack (TIA) and a Cerebral Vascular Accident (CVA)?

d. Locked-in syndrome

6. When a client is aware and capable of thinking but is paralyzed and cannot communicate, what do we call this?

a. Closed

7. Which type of head injury has the highest risk for Increased Intracranial Pressure

c. Results may improve with rehabilitation

8. Which of the following is true about spinal cord injuries?

c. Multiple Sclerosis

9. A client has a chronic neuro disease causing a progressive demyelinating of neurons including remissions/exacerbations. Symptoms include weakness, blurred vision, impaired bowel/bladder function, and chronic fatigue. What disease is this?

a. I need to take medication to decrease my dopamine levels

10. After educating a client with Parkinson's, which statement made by client requires clarification?

Respiratory acidosis

The nurse is aware that hypercapnia can lead to which of the following?

Sudden onset of fever and chills, with course crackles and rusty sputum.

Which of the following describes lobar pneumonia?

Oxygen diffusion is impaired by the congestion

The patient with pneumonia asks the nurse , "why is my oxygen level low?" The nurse knows that the reason is

HIV & homelessness

Areas in the United States that show higher rates than the national rate of tuberculosis are areas that have high incidence of:

Dyspnea

A 10-year-old develops pneumonia. Physical exam reveals subcostal and intercostal retractions. The child reports that breathing is difficulty with feelings that , "I cannot get enough air." What term should the nurse use to document this condition?

Hyperventilation

A patient's arterial blood gas (ABG) reveals decreased carbon dioxide (CO2) levels. What is the most likely cause of this situation?

Elevated PaCO2

Which of the following lab values would the nurse expect in a patient who has sustained trauma to the lungs and chest wall and is experiencing respiratory failure?

Tension pneumothorax

A 50-year-old presents with hypotension, hypoxemia and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing?

chemotherapy

A 5-year-old patient is diagnosed with acute leukemia. The patient will most likely be treated with

antibody destruction of platelets

A 30-year-old presenting with hematuria, menorrhagia, and bleeding gums is diagnosed with immune thrombocytic purpura (ITP). The nurse realizes the most likely cause is

Sepsis

A 40-year-old develops disseminated intravascular coagulation (DIC). Upon obtaining the history, which finding is most likely the cause for this condition?

Clotting factors are depleted

In disseminiated intravascular coagulation (DIC), the nurse assesses for active bleeding after intravascular clotting

because:

Iron deficiency

A patient who experiences chronic gastrointestinal bleeding is diagnosed with anemia. What is the primary cause

of the patient's anemia?

Smoking cigarettes

A patient is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change?

Abnormal thickening & hardening of the vessel walls.

A patient presents to the primary care provider reporting chest pain and is diagnosed with arteriosclerosis. This disease is caused by

Apply oxygen to increase myocardial oxygen supply

A 49-year-old male presents to the Emergency Department with chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial for the nurse to

implement?

Myocardial Infarction (MI)

A 75-year-old male arrives to the Emergency Department via ambulance after calling 911 to report severe chest pain. Lab results show that the patient has elevated cardiac troponin levels. Which of the following does the nurse

suspect has occurred?

Acute pericarditis

A 28-year-old presents to the Emergency Department with the chief complaint of severe chest pain that worsens

with respirations or when lying down. Upon assessment, the nurse identifies a fever, tachycardia, and auscultates

a friction rub. Assessment findings support which of the following medical diagnosis?

Decreased hematocrit

Which of the following would result from a reduced number of erythrocytes in the blood?

Pncytopenia

The nurse is aware that a deficit of all types of blood cells is described as

circulating leukocytes are immature

Multiple opportunistic infections develop with acute leukemia primarily because

inability of the heart to pump enough blood to meet the metabolic needs of the body

The definition of congestive heart failure is

increased renin and aldosterone secretions

Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include

Excess fluid in the pericardial cavity, which decreases ventricular filling.

Pericarditis causes a reduction in cardiac output as a result of which of the following?

pericarditis

A friction rub is associated with

These tests help determine the degree of damage to the heart tissues.

The nurse is teaching the partner of a patient who has an acute myocardial infarction (MI) about the reason the

blood was drawn from the patient. Which of the following statements should the nurse make regarding cardiac

enzyme studies?

Vitamin B12 deficient causing peripheral nerve demyelination

What causes numbness and tingling in the fingers of individuals with untreated pernicious anemia?

a microbe of low virulence attacks abnormal or damaged heart valves.

The nurse caring for a patient with a sub-acute infective endocarditis knows that

movement of the heart valves

The nurse is preparing a patient for an echo-cardiogram. The nurse explains that an echo-cardiogram is used to demonstrate any abnormal

infective endocarditis

Prophylactic antibiotics are given to patients with damaged heart valves immediately before invasive procedures to prevent

Small areas of calcification on a chest x-ray

Which of the following would confirm a diagnosis of primary tuberculosis?

Perform neurovascular checks with vital signs

A nurse is planning care for a client following a cardiac catheterization accessed through his femoral artery. Which of the following actions should the nurse plan to take?

Hypoxemia

A nurse is caring for a client 1 day postoperative who has developed atelectasis. Which of the following manifestations is an expected finding for this condition?

Agitation

A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect?

Crohn's disease

An inflammatory bowel disease that begins in adolescence - can be in patches (with normal areas) or all the way from mouth to anus - malabsorption issue

Ulcerative colitis

Inflammatory bowel disease that Starts at rectum and moves up - rectum issue - bloody, mocusy stools - up to 12 stools per day (profuse diarrhea)

Olguria

Reduced urine output

Cancer

Anything that stays inflamed too long can lead to

Peritonitis

a rupture that causes pain out of proportion and requires immediate surgery.

Osteoarthritis

bone on bone - lost of cartilage

osteoporosis

spongy bone - porous weak bone) estrogen depletes bones causing a spongy bone, collagen pillars start to break, low calcium and vitamin D

o Usually compression fracture

Spiral

fracture often caused by abuse