Description

NR 507 Final Exam Study Guide

28 Pages

1. Acid base imbalance

• While checking arterial blood gas results, a nurse finds respiratory acidosis. What does the nurse suspect is occurring in the patient?
• A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely cause?
• The nurse is assessing a client with suspected respiratory acidosis. Which assessment items are priority for the nurse to​ collect?
• The student nurse is assisting in the care for a client with acute respiratory acidosis. The nurse explains to the student nurse that the​ client’s blood pH initially falls in the development of acute respiratory acidosis because of which​ process?

2. ACTH

• The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process
• A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?
• A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client?
• Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals’ production of cortisol drops. This is an example of which type of endocrine disorder?
• The nurse is preparing a client for a test that will measure negative feedback suppression of ACTH. Which medication will the nurse administer in conjunction for this test?
• ACTH deficiency results in secondary 
• ACTH deficiency is most commonly caused by?
• 6 symptoms of an ACTH deficiency
• interpretation of ACTH levels requires simultaneous assessment of
• ACTH levels are normal to high in primary adrenal insufficiency
• ACTH levels are low to absent in secondary adrenal insufficiency
• The client has been taking an oral cortisol preparation for 2 years to manage an autoimmune disease. What effects does the nurse expect this therapy to have on this client’s circulating levels of ACTH and aldosterone?
• A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of:

3. Acute epiglottitis

• A caregiver calls the pediatrician’s office and reports to the nurse that her 4-year-old, who was fine the previous day, complained of a sore throat early in the morning and now has a temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the child gets panicky, immediately sits back up, and leans forward with her mouth open and tongue out when the caregiver encourages her to lie down. The nurse suspects the child has which of the following conditions?
• The caregivers of a child report that their child had a cold and complained of a sore throat. When interviewed further they report that the child has a high fever, is very anxious, and is breathing by sitting up and leaning forward with the mouth open and the tongue out. The nurse recognizes these symptoms as those seen with which of the following disorders?
• A 5-year-old child is brought to the clinic by his father because the child developed a high fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs and symptoms?
• The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to:

4. AIDS

• A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-brown skin lesions (a symptom of Kaposi’s sarcoma) and a persistent cough. A physical examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte count. Information taken during the personal history reveals that he has multiple sex partners with whom he frequently engages in unprotected sex. What is likely to be the man’s problem and what is his prognosis?
• Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS) include monitoring of T lymphocyte counts?
• What is the length of time from infection with the AIDS virus to seroconversion?
• A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with cytomegalovirus. The nurse explains to the woman that the infection is caused by a common organism that normally does not cause infection in someone with a healthy immune system. This type of infection is called what?
• The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the nurse, “How long will I live?” Which of the following is an appropriate response by the nurse?
• Which of the following clients is at the greatest risk for developing an intracellular pathogen infection?

5. Alveolar ventilation/perfusion

• A consequence of alveolar hypoxia is:
• The pressure required to inflate an alveolus is inversely related to:
• The nurse is describing the movement of blood into and out of the 
  capillary beds of the lungs to the body organs and tissues. What term 
  should the nurse use to describe this process?
• A pulmonologist is discussing the base of the lungs with staff. Which 
  information should be included? At the base of the lungs:
• When the pulmonologist discusses the condition in which a series of alveoli in the left lower lo
• be receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called:
• Which of the following conditions should the nurse monitor for in a patient with hypoventilation?
• A nurse is describing the pathophysiology of emphysema. Which information should the nurse include? Emphysema results in:

6. Alzheimer’s disease

• A patient is admitted to the unit in the middle stages of Alzheimer’s disease. How would the nurse expect to find the patient’s state of mind?
• When teaching the children of a patient who is being evaluated for Alzheimer’s disease (AD) about the disorder, the nurse explains that
• The patient has been diagnosed with the mild cognitive impairment stage of Alzheimer’s disease. What nursing interventions should the nurse expect to use with this patient?
• A patient with Alzheimer’s disease (AD) dementia has manifestations of depression. The nurse knows that treatment of the patient with antidepressants will most likely do what?
• The wife of a patient who is manifesting deterioration in memory asks the nurse whether her husband has AD. The nurse explains that a diagnosis of AD is usually made when what happens?

7. Angiotensin-renin system

• The nurse recognizes that the action of angiotensin II is what?
• The nurse understands that aldosterone secretion is increased when the patient has what?
• With what does the nurse correlate the release of renin?
• What are the 2 most common causes that activate the RAAS system?
• The goal of the RAAS system is to increase BP to thus help restore perfusion pressure to the kidneys

8. Antibodies, IgG, IgA, etc

• A patient has a parasite. Which lab report should the nurse check to help confirm this diagnosis?
• If a patient has a typical secondary immune response, which antibody is most predominant?
• A mother is breastfeeding her infant. The nurse realizes the main antibody being transferred from the mother to her infant through the breast milk is:
• When a person has a life-threatening hypersensitivity/allergic reaction to bee stings, which lab result will the nurse check
• Which immunity principle should guide the nurse when caring for an infant? At birth, IgG levels in newborn infants are:
• While reviewing a patients’ immunological profile, which immunoglobulin does the nurse expect to see elevated if the patient has a type I hypersensitivity reaction?
• The antibody that becomes bound to mast cells and basophils and causes the cells to release histamine and other chemicals is 
• In teaching a patient with SLE about the disorder, the nurse knows that the pathophysiology of SLE includes
• A patient is diagnosed with a hypersensitivity reaction mediated by immunoglobulin E (IgE) antibodies. For which type of hypersensitivity reaction should the nurse plan care for this patient? Type 12

9. Autosomal dominant diseases

• A nurse is assessing a patient with an autosomal-dominant inherited condition. When discussing the risk of transmission to the patient’s offspring, which of the following would the nurse include?
• A client has an autosomal-dominant disorder. His wife is unaffected. When explaining the risk for inheritance of the disorder in their offspring, which statement by the nurse would be most appropriate?
• The daughter of a patient with Huntington disease has requested that she be tested for the disease even though she has no symptoms at this time. What type of test does the nurse anticipate the physician will order?
• Which of the following risk factors have been linked to ovarian cancers? Select all that apply.
• A late acting dominant disorder is:
• Huntignton’s chorea is characterised by
• Dancing gait and bizarre grimacing are characteristics of:
• The RN is reading the chart of a new pt. at the genetic clinic. The chart notes that the pt., her brother, and her mother all have inherited a particular condition. The RN plans care for a condition with which of the following type of inheritance pattern?

10. Bartholin glands

• A woman visits her primary care provider with a complaint of pain and swelling in the vagina area. The pain is present when she sits and walks intercourse is painful. The nurse prepares the patient for an examination. The nurse and health care provider suspect that the patient may have an inflammation or infection of the?
• A patient has been diagnosed with a Bartholin gland cyst. The nurse expects the patient may experience which symptoms if this becomes infected?
• The female external genitalia are made up of several components. What is in the vestibule of the female external genitalia?
• When performing a pelvic examination, the nurse observes a red swollen area on the right side of the vaginal orifice. The nurse would document this as enlargement of which of the following?

11. Bile salt deficiencies

• Clinical manifestations of bile salt deficiencies are related to poor absorption of:

12. Candidiasis exacerbation

• Samantha Velasquez, a 24-year-old preschool teacher, is being seen by the physician in the primary care group where you practice nursing. Over the past 2 months, she has been receiving treatment for multiple ear infections and tonsillitis. She reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of her symptoms?
• A nurse is counseling a client about risk factors for yeast infections. Which of the following should the nurse list as a risk factor for an overgrowth of Candida albicans? 

13. Carbuncles

• Localized skin infection involving hair follicles:

14. Carcinoma

• A nurse is conducting a session on education about cancers of the reproductive tract and is explaining the importance of visiting a health care professional if certain unusual symptoms appear. Which should the nurse include in her list of symptoms that merit a visit to a health care professional for further evaluation
• The postmenopausal woman who has bleeding and spotting and cannot tolerate a endometrial biopsy in the office would expect to have which of the following tests done to rule out endometrial cancer?
• The nursing student correctly identifies which of the following to be the treatment of choice for endometrial cancer?
• The nursing student correctly identifies which of the following age group to be when ovarian cancer occurs more frequently?
• Treatment for Stage IA (Microinvasive Carcinoma) is?
• An aide asks the nurse what is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion. How should the nurse respond?
• The nurse working with oncology clients understands that interacting factors affect cancer development. Which factors does this include?
• A nurse is providing community education on the seven warning signs of cancer. Which signs are included
• The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells?
• The nursing student learning about cancer development remembers characteristics of normal cells. Which characteristics does this include?
• The student nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems?

15. Cervical dysplasia

• The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which of the following information is important for the nurse to include?
• Prime etiologic factor in the development of dysplasia
• Cervical dysplasia and cancer is relatively rare before …. years of age, and the mean age is about …. years.
• After speaking with the RN, Mrs. Sailor understands that the endocervical biopsy will be done by cervical conization to allow for microscopic examination of the cervical tissue. She is scheduled for cervical conization in 2 day. How should the RN respond to the client?
• How often should a Pap and HPV be done

16. Cervical immunoglobulin

• A woman who is 22 weeks pregnant has a vaginal infection. She tells the nurse that she is afraid that this infection will hurt the fetus. The nurse knows that which of these statements is true?

17. Chicken pox

• An older adult client tells the nurse that her granddaughter has chickenpox. The client is afraid to visit because she is afraid of getting shingles from her granddaughter. What is the nurse’s best response?
• The nurse counsels the parent of a 12 year old diagnosed with chickenpox about when the child can return to school. The nurse determines that teaching is effective if the parent makes which statement?
• A parent calls the clinic to report that the child has been exposed to varicella zoster (chicken pox). The nurse should tell the parent that the incubation period for chickenpox is which length of time?

18. Chronic inflammatory joint disease

• In assessing the joints of a patient with rheumatoid arthritis, the nurse understands that the joints are damaged by
• Assessment data in the patient with osteoarthritis commonly include
• The nurse is working with a 73-year-old patient with osteoarthritis (OA). In assessing the patient’s understanding of this disorder, the nurse concludes teaching has been effective when the patient describes the condition as which of the following
• A 60-year-old woman has pain on motion in her fingers and asks the nurse whether this is just a result of aging. The best response by the nurse includes the information that
  The basic pathophysiologic process of rheumatoid arthritis (RA) is
• During the physical assessment of the patient with moderate RA, the nurse would expect to find
• After teaching a patient with RA about the prescribed therapeutic regimen, the nurse determines that further instruction is needed when the patient says,
• A 70-year old patient is being evaluated for symptoms of RA. The nurse recognizes that a major problem in the management of RA in the older adult is that

19. Clonal selection

• When a nurse uses the term clonal diversity, what is the nurse describing?
• Which of the following statements indicates the nurse has a good understanding of clonal selection?
• Cytokines that stimulate bone marrow pluripotent stem and progenitor or precursor cells to produce large numbers of platelets, erythrocytes, lymphocytes, neutrophils, and monocytes, eosinophils, basophils, and dendritic cells are known as:

20. Complications of gastric resection surgery

• Care for the postoperative client after gastric resection should focus on which of the following problems?
• Which of the following complications of gastric resection should the nurse teach the client to watch for?

21. Concept of pain

• The nurse is using the neuromatrix theory when determining a​ patient’s pain. What should the nurse consider when assessing a​ patient’s pain?
• The patient complaining of pain has been waiting for medication to relieve the pain. What should the nurse understand about this​ patient?
• The nurse is assessing a​ patient’s pain perception. What should the nurse use to make this​ assessment?
• A patient is being treated for chronic pain. What should the nurse keep in mind when assessing this​ patient’s level of​ pain?
• A patient is seen talking and laughing in the​ clinic’s waiting room yet complains of excruciating pain. What should the nurse realize this patient is​ demonstrating?

22. Congenital heart defects

• The comment made by a parent of a 1-month-old that would alert the nurse about the presence of a congenital heart defect is:
• The nurse explains that which congenital cardiac defect(s) cause(s) increased pulmonary blood flow?
• A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal
  that the lumen of the duct between the aorta and pulmonary artery remains open.
  This defect is known as patent
• Congenital heart defects (CHDs) are classified by which of the following? 
• Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which of
  the following? 
• A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of decreased pulmonary blood flow called
• While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
• In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs?

23. Congenital intrinsic factor deficiency

• A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?
• A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in intrinsic factor is the most likely cause.

24. Congenital murmurs

• While assessing a newborn with respiratory distress, the nurse auscultates a machine-like
  heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has:
• A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding?
• A newborn develops a murmur and cyanosis shortly after birth. She is diagnosed with pulmonic stenosis (PS) after an echocardiogram revealed narrowing of the pulmonary:

25. Consanguinity

• most common types of relationships in a family
• blood relationship: What specific consequences are there for consanguinity

26. Croup

• The 3-year-old child is seen in the local clinic for croup. The child’s parents ask the nurse what to do for the child at home to alleviate symptoms. Which suggestions by the nurse is most appropriate?
• The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child’s throat using a tongue depressor might precipitate what condition?
• The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which intervention?
• A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup?

27. Dermatologic conditions e.g. pityriasis rosea

• The physician instructs a mother to take her child out in the sun for approximately an hour or until the skin turns red (not sunburned). This is a common medical treatment for
• The patient has a rash on her back that began about 10 days ago with a raised, scaly border and a pink center. Now she has similar eruptions on both sides of her back. From these signs, the nurse would determine the rash to be
• A 28-year-old client comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. Physical examination reveals that the pattern of eruption is like a Christmas tree and that various erythematous papules and macules are on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?

28. Dermatology terminology-macules, nevi, etc

• The nurse’s assessment shows that the patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. In the documentation the nurse would chart this as a
• While waiting to see the physician, a patient shows the nurse skin areas that are flat, nonpalpable, and have had a change of color. The nurse recognizes that the patient is demonstrating what?
• A young student comes to the school nurse and shows the nurse a mosquito bite. As the nurse expects, the bite is elevated and has serous fluid contained in the dermis. How would the nurse classify this lesion?

29. Endogenous antigen

• When a patient asks what activates the immune response, how should the nurse respond? Molecules that are capable of inducing an immune response are called:
• A nurse is discussing an endogenous antigen. Which example indicates the nurse has a good understanding?
• A nurse recalls the major histocompatibility class I (MHC I) antigens are found on which of the following cells?
• While the nurse is discussing the immune system, which information should the nurse include? Plasma cells have the capacity to produce antibodies during an immune response.
• Which cell is a patient missing if the patient’s immune system cannot ingests microorganisms for the purposes of presenting their antigen to the immune system and activating an immune response?
• A nursing student comes to the nurse with some questions about receptors. The student asks about the location of CD8 receptors. The nurse tells the student that these are located on:
• Which class of MHC proteins presents exogenous antigens?
• Class II MHC proteins are found on which of the following cell types?
• Class I MHC proteins are recognized by which of the following cell types (that are destined to become T cells)?
• Which major class of lymphocytes become cytotoxic T cells?

30. Folate deficiency

• The nurse recognizes that patients with which disorder are at greatest risk for folate deficiency?
• A person has an inadequate intake of folic acid (folate) what wil happen to this persons RBCs. 
• The nurse teaches the breastfeeding patient that the recommended daily allowance for folic acid is what?
• A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear suggests the deficiency is macrocytic and normochromic. The nurse would expect the hemoglobin to be:
• When a patient wants to know why vitamin B12 and folate deficiencies cause anemia, how should the nurse respond?
• The nurse reviews the medications of a patient taking folic acid. The nurse notes that the patient is concurrently taking vitamin B12. This concerns the nurse because of the fact that folic acid may

31. Gastroesophageal reflux disease

• A patient comes to the clinic complaining of heartburn after meals and is diagnosed with gastroesophageal reflux disease. Which dietary instructions should the nurse include in teaching?
• Which of the following terms refers to the symptom of gastroesophageal reflux disease (GERD) which is characterized by a burning sensation in the esophagus?
• A patient describes a burning sensation in the esophagus, pain when swallowing, and frequent indigestion. What does the nurse suspect that these clinical manifestations indicate?
• A 50-year-old male is experiencing reflux of chyme from the stomach. He is diagnosed with gastroesophageal reflux. This condition is caused by:

32. General adaptation syndrome

• Increased blood volume, heart rate, blood glucose levels, and increased mental alertness occur during which part of the general adaptation syndrome (GAS)?
• While assessing a person for effects of the general adaptation syndrome, the nurse should be aware that:
• A client with cancer has recovered from tumor removal surgery and is now stable while undergoing a chemotherapy treatment schedule. She is not having any symptoms at this time and is continuing to work and enjoy social events. What stage of the general adaptation syndrome (GAS) would you place her in?

33. Genetic disorders such as Down Syndrome, Turner Syndrome, etc

• Which type of genetic test would be used to detect the possibility of Down syndrome?
  The nurse is obtaining health history from a client with a genetic disorder. Which of the following would be most appropriate for the nurse to establish the pattern of inheritance?
• The nurse is assessing a child with Turner syndrome. The nurse anticipates which of the following findings?
• Parents request that a test be done to determine if the fetus has Down syndrome. What type of test does the nurse anticipate the physician will order?
• Nondisjunction of a chromosome results in which of the following diagnoses?
• The nurse is working with a mother whose unborn child was diagnosed as having Down syndrome. The nurse explains to the mother that Down syndrome occurs due to which of the following?
• Match the condition with chromosomal abnormlity or linkage.
• Trisomy 21 is otherwise called:
• Down’s syndrome is due to:
• In Down’s syndrome, the chromosome number in each cell is:
• The risk of Down’s syndrome in offsprings is high to mothers at the age of:
• Persons with Klinfelter’s syndrome have chromosomes:
• Turner’s syndrome is characterised by chromosomes:
• A person having Klinfelter’s syndrome is characterised by:

34. Genital warts

• During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient states that she is not aware of any problems in that area. The nurse recognizes that these lesions may be:
• A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for
• During a health history, a 22-year old woman asks, “Can I get that vaccine for HPV? I have genital warts and I’d like them to go away!” What is the nurse’s best response?
• a patient with an STD who is most likely to have a nursing diagnosis of disturbed image that hinders future sexual relationships is the patient with
• it is most important for the nurse to teach the female patient with genital warts to
• A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client?

35. GI symptoms of conditions such as pyloric stenosis, hiatal hernia, ulcerative colitis

• The nurse explains to the patient with gastroesophageal reflux disease that this disorder:
• The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to teach the client to avoid which action because it is contraindicated with hiatal hernia?
• The client is diagnosed with an acute exacerbation of ulcerative colitis. Which inter- vention should the nurse implement? 
• Which of the following factors would most likely contribute to the development of a client’s hiatal hernia? 

• The client asks the nurse whether he will need surgery to correct his hiatal hernia. Which reply by the nurse would be most accurate? 
• A client with ulcerative colitis (UC) has stage 1 of a restorative proctocolectomy with ileo-anal anastomosis (RPC-IPAA) procedure performed. The client asks the nurse, “How long do people with this procedure usually have a temporary ileostomy?” How does the nurse respond?
• The nurse is caring for a patient with fulminant ulcerative colitis. The nurse would be alert for which of the following symptoms associated with severe fulminant ulcerative colitis?
• Which of the following clients would the nurse suspect to have pyloric stenosis?
• A 3-week-old infant diagnosed with pyloric stenosis is admitted to the hospital during a vomiting episode. Which action by the nurse is most appropriate?
• Which of the following conditions can cause a hiatal hernia?

36. GI symptoms resulting in heart burn

• The nurse is performing an admission assessment on a client diagnosed with gastroesophageal reflux disease (GERD). Which signs and symptoms would indicate GERD? 
• The male client tells the nurse he has been experiencing “heartburn” at night that awakens him. Which assessment question should the nurse ask? 
• The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which of the following symptoms?
• Which of the following symptoms is common with a hiatal hernia?

37. Glaucoma

• A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:
• The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder?
• Which of the following types of glaucoma presents an ocular emergency?
• The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find?
• A 52-year-old woman comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, “I’m hoping that I don’t have to use these drops for very long.” Which response by the nurse would be most appropriate?
•  patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign?

38. Glomerulonephritis

• A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease?
• When a nurse observes post-streptococcal glomerulonephritis as a diagnosis on a patient, which principle will the nurse remember? Acute post-streptococcal glomerulonephritis is primarily caused by?
• A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is?
• A 15-year-old female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what could have caused this, how should the nurse respond?
• Which of the following clusters of symptoms would make a clinician suspect a child has developed glomerulonephritis?
• A 5-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 week before the onset of this condition. The infection was most likely located in the
• A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is?
• A 45-year-old male presents with oliguria. He is diagnosed with chronic glomerulonephritis. The nurse knows oliguria is related to?
• Which assessment finding is most important in determining nursing care for a client with acute glomerulonephritis?
• The nurse is assessing a child with acute post streptococcal glomerulonephritis. Which of the following would the nurse expect to assess?
• A 10-year-old child is diagnosed with glomerulonephritis. Test reveal the disposition of immunonoglobin IgA in the glomerular capillaries. The nurse will monitor for recurrent:
• …………..is an autoimmune disease that severely impairs renal function.
• When reviewing laboratory results, the nurse should immediately notify the health care provider about which finding?

39. Glycoprotein ( this is the only one I COULD NOT FIND

40. Gonococcal disease

• When counseling a woman who is having difficulty conceiving, the nurse will be most concerned about a history of infection
• When a patient returns to the clinic for follow-up after treatment for nongonococcal urethritis, a purulent urethral discharge is still present. When-trying to determine the reason for the recurrent infection, which question is most appropriate for the nurse to ask the patient?
• A woman in the STD clinic tells the nurse that she is concerned she may have been exposed to gonorrhea by her partner. To determine whether the patient has gonorrhea, the nurse will plan to obtain a cervical specimen for an
• The nurse assesses a client in the family planning clinic. Which of the following statements, if made by a client, suggests to the nurse that the client has been exposed to gonorrhea?
• a female patient with a purulent vaginal discharge is seen at the outpatient clinic. The nurse would expect a diagnosis of gonorrhea to
• A 22-year-old male is being treated at a college health care clinic for gonorrhea. Which of the following teaching points should the nurse include in patient teaching?
• The client is single, admits to not using condoms during sexual intercourse, and has had multiple partners over the past year. Which of the following symptoms would alert the nurse to a possible gonorrheal infection? 
• A newborn is diagnosed with ophthalmic neonatorum. The nurse understands that this newborn was exposed to which infection?

41. Guillain-Barre Syndrome

• patient with Guillain-Barré syndrome has experienced a sharp decline in vital capacity. What is the nurse’s most appropriate action?
• nurse caring for a patient diagnosed with Guillain-Barré syndrome is planning care with regard to the clinical manifestations associated this syndrome. The nurse’s communication with the patient should reflect the possibility of what sign or symptom of the disease
• The nurse caring for a patient in ICU diagnosed with Guillain-Barré syndrome should prioritize monitoring for what potential complication
• nurse is teaching a patient with Guillain-Barré syndrome about the disease. patient asks how he can ever recover if demyelination of his nerves is occurring. the nurse’s best response
• The nurse recognizes which pathophysiologic feature as a hallmark of Guillain-Barré syndrome?
• The nurse correlates which clinical manifestation of Guillain-Barré syndrome as the most common?
• In reviewing laboratory data on a client, the nurse correlates which findings with Guillain-Barré syndrome (GBS)?
• A nurse is caring for a client with Guillain-Barré syndrome who has been admitted to the intensive care unit. During the last 2 hours, the nurse notes that the client’s vital capacity has declined to 12 mL/kg, and the client is having difficulty clearing secretions. Which is the nurse’s priority action?
• A patient with Guillain-Barré syndrome asks the nurse what has caused the disease. In responding to the patient, the nurse explains that Guillain-Barré syndrome
• A 29 -year-old patient is hospitalized with the onset of Guillain-Barré syndrome. During this phase of the patient’s illness, the most essential assessment for the nurse to carry out is
• Guillain-Barré syndrome is an autoimmune attack on the peripheral myelin sheath. Which of the following is an action of myelin?

42. Hormonal regulation of calcium

• When evaluating the laboratory findings of a patient with decreased function of the anterior pituitary gland, the nurse would expect to find
• When teaching a patient with hypoparathyroidism about the disorder, the nurse explains that blood calcium levels are altered because the role of parathyroid hormone is to
• Parathyroid hormone (PTH) has which effects on the kidney?
• Which serum laboratory result should the nurse monitor in a patient with primary hyperparathyroidism?

43. Hypersensitivity reaction

• A patient had a hypersensitivity reaction involving the formation of antibodies against tissue-specific antigen. Which type of hypersensitivity reaction did the patient experience?
• A patient has a hypersensitivity reaction mediated by Tc cells. A nurse recalls that this type of hypersensitivity reaction is called:
• The patient is having a reaction to a bee sting. Which type of hypersensitivity reaction does the nurse expect to see documented in the patient’s chart?
• Which type of hypersensitivity reaction is characterized by the formation of antigen-antibody complexes deposited on vessel walls or in extravascular tissues?
• The nurse is interpreting a patient’s positive tuberculin skin test. This finding is consistent with which type of hypersensitivity reaction?
• A nurse is conducting a physical assessment on a patient. Which symptoms would indicate to the nurse that the patient experienced a type I hypersensitivity reaction?
• The nurse is concerned about the patient having tissue injury during type II hypersensitivity. Which mechanism provides the rationale for this concern?
• The patient has a type IV hypersensitivity reaction. In planning care for this patient, the nurse should consider that this type of reaction is related to:
• Type IV hypersensitivity tissue effects are initiated by:
• …………..is the most common type of immediate hypersensitivity.

44. Kidney stones

• A client presents to the emergency department complaining of a dull, constant ache along the right costovertebral angle along with nausea and vomiting. The most likely cause of the client’s symptoms is:
• The nurse reviews a client’s history and notes that the client has a history of hyperparathyroidism. The nurse would identify that this client most likely would be at risk for which of the following?
• Which of the following are appropriate interventions in the care of a patient diagnosed with renal calculi?
• A nurse is administering medications to a patient with a kidney stone. Which medication does the nurse administer that will lower urinary calcium by increasing tubular reabsorption to decrease the amount of calcium in the urine?
• Which of the following is a nonsurgical method of treatment for renal calculi (kidney stones)?
• A patient is being treated with colchicine (Colcrys) for pain in the big right toe. The patient begins to complain of severe right flank pain and is diagnosed with kidney stones. Which of the following types of kidney stones does the nurse recognize this patient is most likely affected by?
• A patient has chronic hyperparathyroidism. Which complication should the nurse monitor for in the patient?
• While planning care for a patient with renal calculi, the nurse remembers the most important factor in renal calculus formation is:

45. Lactose intolerance

• During the nursing assessment a patient reveals that he has diarrhea and cramping every time he has ice cream. He attributes this to the cold nature of the food. However, the nurse begins to suspect that these symptoms are associated with:
• A client receiving enteral feedings develops abdominal distention and diarrhea shortly after initiation of the feedings. In review of the nursing history for this client, which of these notations indicates the need to notify the health care provider?
• is working with a client with lactose intolerance. What can this nurse suggest to this client to increase tolerance to small amounts of milk?
• People who have lactose intolerance suffer from bloating, gas, and diarrhea. What type of diarrhea is caused by lactose intolerance?

46. Large bowel obstruction

• The nurse is taking a health history of a newly admitted patient with a diagnosis Rule/out bowel obstruction. Which of the following is the priority question to ask the patient?
• You are admitting a patient with complaints of abdominal pain, nausea, and vomiting. A bowel obstruction is suspected. You assess this patient for which anticipated primary acid-base imbalance if the obstruction is high in the intestine?

47. Loss of language and/or comprehension-such as terms-aphasia, etc.

• The nurse is planning health teaching for a 65-year-old woman who has had a cerebrovascular accident (stroke) and has aphasia. Which of these questions is most important to use when assessing mental status in this patient?
• The nurse discovers speech problems in a patient during an assessment. The patient has spontaneous speech, but it is mostly absent or is reduced to a few stereotypical words or sounds. This finding reflects which type of aphasia?
• The nurse is caring for a patient with dysphagia. Which of the following interventions would be contraindicated while caring for this patient?
• The nurse is caring for a patient with aphasia. Which of the following strategies will the nurse use to facilitate communication with the patient?
• A patient has been diagnosed as having global aphasia. The nurse recognizes that the patient will be unable to do which of the following actions?
• A patient with a cerebrovascular accident (stroke) has left-sided flaccidity and is unable to speak but seems to understand everything the nurse says. Which term should the nurse use to document the patient’s communication impairment
• A patient tells the nurse that at times it seems like the mouth muscles do not want to work and the patient’s speech is slurred. What should the nurse realize that the patient is describing?

48. Lupus

• A 26-year-old woman has been diagnosed with early systemic lupus erythematosus (SLE) involving her joints. In teaching the patient about the disease, the nurse includes the information that SLE is a(n):
• A patient with polyarthralgia with joint swelling and pain is being evaluated for systemic lupus erythematosus (SLE). The nurse knows that the serum test result that is the most specific for SLE is the presence of:
• A client is suspected of having systemic lupus erythematous. The nurse monitors the client, knowing that which of the following is one of the initial characteristic sign of systemic lupus erythematous?
• The nurse is assigned to care for a client with systemic lupus erythematosus (SLE). The-nurse plans care knowing that this disorder is:

49. Male and female sex hormone production

• The nurse is conducting a prenatal class for expectant parents on conception. The nurse provides additional teaching when a parent states which of the following?
• A human male produces sperms with genotypes AB, Ab, aB, and ab in equal proportions. What is the genotype of the person?
• Females seldom become bald as they lack:
• A 30-year-old female patient was brought to the emergency department (ED) after a seizure at work. During the assessment she mentions hair loss and menstrual irregularities. What diagnostic tests would be helpful to determine if endocrine problems are a cause of her problem
• Which hormone is best described by “tropic hormone that stimulates the gonads to secrete sex hormones”?
• The external and internal female reproductive organs develop and mature in response to what hormones?
• Ovarian hormones include which of the following?
• The nurse working with pediatric clients knows that the primary hormone secretions that induce puberty include which of the following?

50. Maternal immune system

• If a patient has a typical secondary immunity response, which antibody is most predominant
• A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which of the following statements should the nurse include in the teaching plan for the client?
• The laboratory finds IgA in a sample of cord blood from a newborn infant. This finding is important because it signifies what?
• A woman experiences a viral infection while pregnant. Which of the following types of immunity does an infant have at birth against this infection?
• The nurse is aware that the only class of immunoglobulins to cross the placenta is:

51. Nephrotic syndrome

• A urologist is discussing nephritic syndrome. Which information should be included? If nephrotic syndrome is not caused initially by kidney disease, it is termed ____ nephrotic syndrome?
• A 4-year-old male is diagnosed with nephrotic syndrome. Which of the following assessment findings accompanies this condition?
• A 7-year-old female is diagnosed with nephrotic syndrome. Which of the following should the nurse ask the parents if they or the child has noticed recently?
• Nephrotic syndrome occurs when there is loss of _____ in the urine.
• Secondary forms of nephrotic syndrome are associated with all of the following conditions except:
• Which of the following diseases is a glomerular disorder?
• Which assessment finding is common in children diagnosed with nephrotic syndrome?
• A child is getting a diagnostic work-up for nephrotic syndrome. Which of the following lab results would the nurse expect to see?

52. Neural tube defect

• The nurse clarifies to the parents of a child with spina bifida that their child has a portion of the spinal cord in the sac in addition to the meninges. This type of spina bifida is known as a(n)
• How are neural tube defects detected before delivery?
• How are neural tube defects prevented?
• Where do neural tube defects occur?
• How are neural tube defects detected?

53. Obstructive sleep apnea

• When assessing a client for obstructive sleep apnea (OSA), the nurse understands the most common symptom is:
• The nurse is caring for a client who is experiencing sleep apnea. The nurse understands that which elements occur when a client has sleep apnea?
• The patient is diagnosed with obstructive sleep apnea. Identify the symptoms you would expect the client to exhibit.
• The nurse knows the following risk factors are associated with obstructive sleep apnea (OSA)

54. Pancreatic enzymes

• The nurse understands which of the following is the principal reason for the use of enzyme inhibitors (Diamox) in a patient with pancreatitis?
• The nurse is administering a pancreatic enzyme to the client diagnosed with chronic pancreatitis. Explain the rationale for this.
• Of the following enzymes, which one is responsible for the breakdown of starch?
• The nurse is reviewing with a client the digestive pathway. The steps involved in the digestive pathway are in random order. The nurse asks the client to place them in the correct sequence. Which does the client say are the correct sequences of steps involved in the digestive pathway?
• Most digestive processes occur in the small intestine. The nurse is reviewing with a client who has had gastrointestinal surgery that these intestinal enzymes are proteins that act as catalysts, which promote and speed up chemical reactions. Based on this information, which enzyme would be the best response from the client about the enzymes that are responsible for facilitating the formation of proteins into amino acids
• Which of the following processes breaks up food into absorbable nutrients?
• Which of the following begins the digestive process?
• An instructor is describing the action of pancreatic enzymes on substances. Which of the following would the instructor include as being acted on by these enzymes?
• After reviewing the process of secretion, a group of students demonstrate understanding when they identify which pancreatic enzyme as being secreted to break down sugars?
• High levels of acid in the gastrointestinal (GI) tract decrease the secretion of which of the following enzymes? 
• A 22-year-old male exercises by swimming laps. Which organ secretes enzymes responsible for the digestion of carbohydrates to provide energy?

55. Pancreatic insufficiency

• A nurse has admitted a client suspected of having acute pancreatitis. The nurse knows that mild acute pancreatitis is characterized by:
• student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority?
• Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes?
• The nurse, interviewing a patient with acute pancreatitis, expects what finding in the patient’s history?

56. Parts of the heart in terms of function, such as pericardium

• How does the nurse differentiate a pleural friction rub from a pericardial friction rub?
• A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks the nurse to explain where the infection is. In providing an accurate description, the nurse states that the pericardium is:
• A nurse is explaining the function of the heart. Which is a correct response by the nurse? A function of the pericardium is to:
• A nurse is teaching about the heart. Which information should the nurse include? The chamber of the heart that generates the highest pressure is the:
• A nurse recalls the chamber that receives blood from the systemic circulation is the:
• Which statement indicates the nurse understands blood flow? Oxygenated blood flows through the:
• While viewing the electrocardiogram, the nurse recalls the ……………conducts action potentials down the atrioventricular septum.

57. Pituitary hormone secretion

• Which hormones are secreted by the anterior pituitary gland?
• When educating a group of students about the pituitary hormones, which should the nurse identify as the function of vasopressin?
• The nurse is explaining to the nursing students the relationship between “releasing” hormones and “inhibiting” hormones. What is the best answer by the nursing students of which part of the body is responsible for releasing hormones that either inhibit release or promote release of other hormones from the anterior lobe of the pituitary?
• A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory results to show
• A client thought to have a problem with the pituitary gland is given a stimulation test using insulin. A short time later, blood analysis reveals elevated levels of growth hormone (GH) and adrenocorticotropic hormone (ACTH). Which is the nurse’s interpretation of this finding?

58. Process of muscle contraction

• The nurse encourages the patient to do his own activities of daily living such as bathing, eating, dressing, and toileting activities. How do these activities promote physical conditioning:
• A patient is admitted for electroconvulsive treatment (ECT). The physician orders the neuromuscular blocking agent succinylcholine to reduce trauma by relaxing skeletal muscles. Explain the process of muscle contraction and how a neuromuscular blocking agent such as succinylcholine would interfere with muscle contraction. 
• While assessing a patient, the patient tells the nurse that she is experiencing rhythmic muscle contractions when the nurse performs passive extension of her wrist. What is this pattern of muscle contraction referred to as?

59. Pulmonary terminology such as dyspnea, orthopnea, etc

• A patient has dyspnea upon lying down. What term should the nurse use to document this finding?
• A patient has dyspnea. Which of the following typical findings will the nurse observe during the assessment?
• A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition?

60. Risk factors for hypertension

• What target cultural population is a priority for the nurse to educate about prevention of hypertension?
• An older African-American client with hypertension is admitted to the hospital. Which data from the client’s history and diagnostic workup represent risk factors for hypertension
• What significant risk factor for hypertension does the student nurse identify for Mr. Dunn according to this health history?
• The student nurse continues to talk with Mr. Dunn about hypertension. Mr. Dunn states he feels physically and does not see why he needs to see his healthcare provider. How should the student nurse respond?
• What information obtained during the assessment supports this diagnosis (stage 2, primary [essential] hypertension)?
• He asks, “shouldn’t the healthcare provider find out why I have hypertension?” How should the nurse respond to Mark’s question?
• A nurse takes an adult patient’s blood pressure and determines it to be normal. What reading did the nurse obtain?
• Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as ………
• 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling. He has an elevated level of low-density lipoprotein (LDL) and a low level of high-density lipoprotein (HDL). Which of the following should the nurse advise him to avoid?
• A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:
• A 30-year-old Caucasian female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis?
• A 52-year-old male is diagnosed with primary hypertension. He has no other health problems. Present treatment would cause the nurse to anticipate administering which drug to the patient?
• A 55-year-old female has undiagnosed hypertension. She presents to her primary care provider reporting impaired vision and chronic edema. Lab tests reveal that she also has renal insufficiency. While planning care, the nurse realizes the most likely cause for these findings is:
• A nurse monitors the patient for ……………when rapid onset of malignant hypertension results.
• A nurse is teaching an adolescent about primary hypertension. Which statement made by
  the adolescent indicates an understanding of primary hypertension?

61. Signs of breast cancer

• A client is at risk for breast cancer. Which of the following would reflect the client’s genotype for this disorder? 
• A 32-year-old patient has just been told that she has the BRCA1 hereditary breast cancer gene mutation. What is her risk of developing cancer by the age of 65 years?
• The nurse is reviewing statistics regarding breast cancer. Which woman, aged 40 years in the United States, has the highest risk for development of breast cancer?
• The nurse is preparing for a class in early detection of breast cancer. Which statement is true with regard to breast cancer in African-American women in the United States?
• The nurse is reviewing risk factors for breast cancer. Which of these women have risk factors that place them at a higher risk for breast cancer?
• A 43-year-old woman is at the clinic for a routine examination. She reports that she has had a breast lump in her right breast for years. Recently, it has begun to change in consistency and is becoming harder. She reports that 5 years ago her physician evaluated the lump and determined that it “was nothing to worry about.” The examination validates the presence of a mass in the right upper outer quadrant at 1 o’clock, approximately 5 cm from the nipple. It is firm, mobile, nontender, with borders that are not well defined. The nurse’s recommendation to her is:
• A 54-year-old man comes to the clinic with a “horrible problem.” He tells the nurse that he has just discovered a lump on his breast and is fearful of cancer. The nurse knows that which statement about breast cancer in males is true?
• The nurse is assessing the breasts of a 68-year-old woman and discovers a mass in the upper outer quadrant of the left breast. When assessing this mass, the nurse keeps in mind that characteristics of a cancerous mass include which of the following?
• A 26-year-old female presents to the health care clinic for a yearly pap & physical exam. She tells the nurse that she has felt a few tender areas in the left breast that are only occasionally palpable. She drinks about 3 cups of coffee daily and an occasional soft drink with caffeine. Family history reveals a maternal aunt with breast cancer at age 75 years. Which nursing diagnosis can be confirmed from this data?
• While interviewing a client, a nurse asks the client whether she has ever noticed any lumps or swelling in the breasts. What other area associated with the possible risk for breast cancer should she ask about regarding the presence of lumps or swelling?
• During the physical examination of a female client, the nurse notes that the client’s axillary lymph nodes are enlarged, hard, and fixed. The nurse recognizes that these findings are consistent with what disease process?
• A 63-year-old nurse comes to the office upset because she has found an enlarged lymph node under her right arm. She states she found it last week while taking a shower. She-isn’t sure if she has any breast lumps because she doesn’t know how to do self-breast examinations. She states her last mammogram was 5 years ago and it was normal. Her past medical history is significant for high blood pressure and chronic obstructive pulmonary disease. She quit smoking 2 years ago after a 55-pack a year history. She denies any illegal drugs and drinks alcohol rarely. Her mother died of a heart attack and her father died of a stroke. She has no children. Examination shows an older woman appearing her stated age. Visual inspection of her right axilla reveals nothing unusual. Palpation reveals a 2-cm hard fixed lymph node. She denies any tenderness. Visualization of both breasts is normal. Palpation of her left axilla and breast is unremarkable. On palpation of the right breast, the nurse detects a nontender 1-cm lump in the tail of Spence. What disorder of the axilla is most likely responsible for her symptoms?
• A client comes to the clinic for a routine evaluation. During the physical examination, the nurse palpates the client’s breast and finds a small lump. Which of the following would lead the nurse to suspect possible breast cancer? 
• A nurse is reviewing a client’s history for possible risk factors associated with breast cancer. Which of the following would the nurse identify as increasing the client’s risk? 

62. Skin cancer

• nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?
• A patient complains that he has basal cell carconima and is going to die. The nurse knows that
• Which patient would be more likely to have the highest risk of developing malignant melanoma?
• In teaching a patient with basal cell carcinoma (BCC) about this disorder, the nurse considers that which statement about this skin cancer is true?
• When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin cancer cases have been reported in white patients than in African American patients. What could be the most likely cause of such an occurrence?
• The nurse, preparing educational information about types of skin cancer, recalls that which type has a higher risk for metastasis and poor prognosis unless it is treated early?

63. Skin cancer lesions

• A patient is scheduled for Mohs’ microscopic surgery for removal of a skin cancer lesion on his forehead. The nurse knows to prepare the patient by explaining that this type of surgery requires:
• Removal of the tumor, layer by layer
• A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?
• A patient has just been told that he has malignant melanoma. The nurse caring for this patient should anticipate that the patient will undergo what treatment?
• A patient with a suspected malignant melanoma is referred to the dermatology clinic. The nurse knows to facilitate what diagnostic test to rule out a skin malignancy?
• While performing an initial assessment of a patient admitted with appendicitis, the nurse observes an elevated blue-black lesion on the patient’s ear. The nurse knows that this lesion is consistent with what type of skin cancer?

64. Small patent ductus arteriosus

• An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because blood is:
• The nurse assessing a premature newborn infant auscultates a continuous machinery-like
  This finding is associated with which congenital heart defect?
• Before preparing a teaching plan for the parents of an infant with ductus arteriosus, it is
  important that the nurse understands this condition. Which statement best describes patent
  ductus arteriosus?

65. Sympathetic/parasympathetic nervous system

• By which of these ways does the sympathetic nervous system (SNS) help to regulate body temperature?
• The nurse is teaching a patient about the functions of the sympathetic nervous system related to a prescribed medication. What should the nurse tell the patient about the functions of this system? 
• The nurse is reviewing the sympathetic nervous system (SNS) effects on the heart and blood vessels. Which statement is correct regarding the effect of SNS stimulation?
• A patient is experiencing symptoms of the fight-or-flight response. Which autonomic process stimulates this response?
• The nurse is teaching a group of coworkers about the functions of the sympathetic nervous system (SNS). Which statement by a coworker would require correction?
• Cholinergic (parasympathomimetic) drugs that stimulate muscarinic receptors are indicated for which situation?
• A nurse is preparing to give a drug that stimulates the parasympathetic nervous system. Which patient response is an expected outcome of this drug?
• A patient is experiencing symptoms of the fight-or-flight response. Which autonomic process orchestrates this response?
• Which organs are controlled primarily by the parasympathetic system?

66. Terms such as hypochromic, macrocytic, microcytic, etc

• A patient is admitted with a 2-month history of fatigue, shortness of breath, pallor, and dizziness. The patient is diagnosed with idiopathic autoimmune hemolytic anemia. On reviewing the laboratory results, the nurse notes which of the following that confirms this diagnosis?
• the client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which of the following complete blood count (CBC) results is characteristic of her type of anemia?
• A patient’s anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be:
• A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
• A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:
• A patient has microcytic hypochromic anemia. Which of the following pathogenic mechanisms may cause anemia in this patient?

67. The inflammatory process upon injury

• A nurse will be teaching about body defenses. Which information should the nurse include? The body’s first line of defense against microorganisms is comprised of the:
• While planning care for a patient with an infection, which principle should the nurse remember? In contrast with the inflammatory response, the immune response
• The nurse assesses clients for the cardinal signs of inflammation. 
• A client has a leg wound that is in the second stage of the inflammatory response. For what manifestation does the nurse assess?
• Which event in the inflammatory response would the nurse correlate with the action of bradykinin?
• A nurse recalls if the surface barriers such as the skin or mucus membranes are breached, the second line of defense in innate immunity is the:
• A nurse is teaching about inflammation. Which information should be included? The first vascular response in inflammation is:
• When a nurse is asked about the purpose of vasodilation and increased vascular permeability during inflammation, how should the nurse respond?
• When a nurse is asked which of the following inhibits the inflammatory response, what is the nurse’s best answer?
• While reviewing lab results, which finding would alert the nurse to a patient with acute inflammation?
• While planning care for a patient with acute inflammation and pain, which principle should the nurse remember? The inflammatory chemicals responsible for inducing pain during inflammation are:
• While planning care for a patient, which principle should the nurse use to guide care? The first line of defense against pathogens is the:

68. Type 2 diabetes

• What characterizes type 2 diabetes
• The nurse is teaching the patient with prediabetes ways to prevent or delay the development of type 2 diabetes. What information should be included
• A client with Type II diabetes has an order for regular insulin 10 units SC each morning. The client’s breakfast should be served within:
• A patient diagnosed with type 2 diabetes mellitus is admitted to the medical unit with pneumonia. The patient’s oral antidiabetic medication has been discontinued and the patient is now receiving insulin for glucose control. Which of the following statements best explains the rationale for this change in medication?
• The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient’s long-term glucose management?
• A 54 year old patient admitted with type 2 diabetes asks the nurse what “type 2” means. What is the most appropriate response by the nurse?
• The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2 diabetes. In formulating a teaching plan that encourages the patient to actively participate in management of the diabetes, what should be the nurse’s initial intervention?
• The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient is considered one of the classic clinical manifestations of diabetes?
• The nurse is teaching a patient with type 2 diabetes mellitus about exercise to help control his blood glucose. The nurse knows the patient understands when the patient elicits which exercise plan?

69. Types of anemia

• The nurse is collecting data on a patient with suspected
  pernicious anemia. Which of these signs or symptoms
  would the nurse expect to find for this patient?
• Megaloblastic anemia is a result of insufficient folic acid or vitamin B12, affecting which of the following?
• A patient with anemia who is given iron salts could expect to show a therapeutic increase in hematocrit
• After reviewing the major types of anemia, students demonstrate understanding of the info when they identify which of the following as an example of a hemolytic anemia?
• Which of the following would the nurse encourage a pt. to consume to prevent folic acid anemia?
• A pt. is receiving ferrous sulfate as treatment for iron deficiency anemia. After teaching the pt., which statement indicates the need for additional teaching? 
• An 82-year-old client has pernicious anemia and has been receiving treatment for several years. What is she lacking that results in pernicious anemia?
• An 82-year-old client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults?
• A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?
• During the review of morning lab values on a patient complaining of severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which of the following findings?
• You are caring for an 87-year-old female who has been admitted to your unit with iron-deficiency anemia. What would you suspect?
• A patient is brought to the ER complaining of fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the patient has been treated three times in the past 2 months for a sore throat. Lab tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, with what could the patient be diagnosed?
• The nurse understands which is the most common type of anemia?
• THE NURSE CARES FOR A CLIENT DIAGNOSED WITH POLYCYTHEMIA VERA. THE NURSE EXPECTS TO MAKE WHICH OBSERVATION?
• A 57-year-old male presents to his primary care provider for red face, hands, feet, ears, and headache and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:
• Polycythemia vera (PV)
• The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings?
• Which type of anemia is associated with normochromic and macrocytic red blood cells (RBCs)?
• What is the genetic disorder that is associated with excessive red blood cell (RBC) destruction?
• A patient’s anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be:
• A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?
• A 70-year-old male is brought to the emergency department, where he dies shortly thereafter. Autopsy reveals polycythemia vera (PV). His death was most likely the result of:
• A 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment. His condition is at risk for converting to:
• A 20-year-old female undergoes lab testing for anemia. Results show high iron, bilirubin, and transferrin and low hemoglobin and hematocrit. Which of the following is the most likely diagnosis to be documented on the chart?
• How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?
• A 67-year-old female has chronic gastrointestinal bleeding. A nurse recalls the primary cause of her anemia is:
• A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These assessment findings are consistent with which type of anemia?
• A nurse is preparing to teach the staff about aplastic anemia. Which information should the nurse include? Aplastic anemia is caused by:
• A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?

70. Types of fractures

• The human body is designed to protect its vital parts. A fracture of what type of bone may interfere with the protection of vital organs?
• A patient has sustained a long bone fracture. The nurse is preparing a care plan for this patient. Which intervention should the nurse include in the care plan to enhance fracture healing?
• The nurse is writing a care plan for a patient admitted to the Emergency Department (ED) with an open fracture. The nurse will assign priority to what nursing diagnosis for a patient with an open fracture of the radius?
• While caring for a patient with a hip fracture, the nurse will instruct the patient to do what to prevent the most common complication associated with a hip fracture?
• Radiographs were ordered for a 10-year-old boy who had his right upper arm injured. The radiographs show that the humerus appears to be fractured on one side and slightly bent on the other. What type of fracture is this an example of?
• A 76-year-old female was diagnosed with osteoporosis by radiologic exam. She is at high risk for: 
• A 65-year-old Hispanic female is admitted to the hospital with a pathologic, compound, transverse fracture of the femur. Which of the following statements best describes this type of fracture? 
• A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the 
• A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This is referred to as a what type of fracture?
• What does prolonged bed rest put the older adult at risk for
• A nurse is describing the pathophysiology of a torus fracture. Which information should the nurse include? A torus fracture is a type of: 
• A patient has a fracture that broke into several fragments. Which type of fracture did the patient sustain? 
• A torus fracture occurs when:
• While teaching a group of student nurses about different types of fractures, the nursing instructor says, “This fracture is characterized by the crushing of cancellous bone.” Which type of fracture is the nursing instructor describing? 
• A client sustained multiple fractures in a motor vehicle accident. The nurse determines that the client is at a high risk for osteomyelitis due to which type of fracture? 
• A patient has a fracture line at an angle to the long axis of the bone. Which type of fracture did the patient sustain?
• transchondral fractures are most prevalent in
• An adolescent patient has sustained a fracture that involves fragmentation of the articular cartilage. Which type of fracture did the adolescent sustain? 
• The orthopedic nurse is caring for a client diagnosed with a fracture of the radius. When the nurse is considering all of the various types of bone fractures, which bone type is most anticipated? 
• Radiographic evaluation of a client’s fracture reveals that a bone fragment has been driven into another bone fragment. The nurse identifies this as which type of fracture?
• The nurse understands which of the following are
  considered the key components of the musculoskeletal
  system?
• A patient has a fracture in a bone that does not have the ability to recover. The nurse will be caring for which type of fracture?

71. Types of gastric ulcers-signs and symptoms, characteristics

• The nurse understands that most cases of peptic ulcer disease is caused by what?
• Which are pathologic changes associated with acute gastritis?
• Which are possible complications of chronic gastritis?
• What is true regarding duodenal​ ulcers? 
• A client with a duodenal ulcer asks the nurse why antibiotics are a part of the treatment plan. Which information should the nurse include in the explanation?
• When obtaining a nursing history from a client with suspected gastric ulcer, which signs and symptoms should the nurse assess?

72. Types of hormones

• A nurse is teaching staff about protein hormones. Which information should the nurse include? One of the protein hormones is:
• -A patient has high levels of hormones. To adapt to the high hormone concentrations, the patient’s target cells have the capacity for:
• -A patient has researched lipid-soluble hormones on the Internet. Which information indicates the patient has a good understanding? Lipid-soluble hormone receptors cross the plasma membrane by:
• Hormones are effective communicators because they:
• Which of the following is a protein hormone that is water soluble?
  From where is the hormone glucagon secreted?
• Which endocrine gland secretes cortisol?
• What accurately demonstrates that hormones of one gland influence the function of hormones of another gland?

73. Types of immunity-e.g. innate, active, etc

• A student nurse asks the clinician which cells are most primary in a patient’s immunity. What is the clinician’s best answer?
• A nurse recalls humoral immunity is generated through the process of:
• While taking a health history, if a person has resistance to a disease from natural exposure to an antigen, how would the nurse document this form of immunity?
• What type of immunity will the nurse expect in an individual who is given a vaccine?
• A new mother asks the nurse about immunity of her newborn as she is breastfeeding. The nurse’s response should include a discussion on which type of immunity?
• The nurse has been explaining to a student nurse about the different types of immunity. Which response indicates that the student nurse has a good understanding of adaptive immunity?
• Cancer cells and virus-infected body cells can be killed before activation of adaptive immunity by
• The primary immune response ________.
• Which of the following is true about the number of binding sites per functional antibody unit?
• Which cell of the immune system is absolutely required for an adaptive immune response?
• The adaptive immune system involves three major cell types: antigen-presenting cells, T cells, which constitute …………immunity, and B cells, which govern …………immunity.
• The nurse understands that the function of IgG is as what?
• The nurse understands that which type of immunity is the longest acting?
• Natural killer cells are specialized lymphocytes that are one of the major parts of which immunity?

74. Urinary tract obstruction

• A patient is admitted with lower urinary tract obstruction and stasis. Which of the following is the primary intervention? 
• The nursing students have learned in class that causes of urinary obstruction and urinary incontinence include which of the following? 
• An elderly client has just been admitted for urinary tract obstruction and retention. Which of the following are symptoms that the nurse should suspect this client to demonstrate?
• Which of the following individuals are displaying identified risk factors for the development of lower urinary tract obstruction?
• If obstructed, which component of the urination system would cause peristaltic waves?
• The nurse is planning care for a patient with a urinary tract obstruction. The nurse includes assessment for which of the following possible complications?

75. Vaginal candidiasis

• During a vaginal examination of a 38-year-old woman, the nurse notices that the vulva and vagina are erythematous and edematous with thick, white, curdlike discharge adhering to the vaginal walls. The woman reports intense pruritus and thick white discharge from her vagina. The nurse knows that these history and physical examination findings are most consistent with which of these conditions?
• A patient undergoing treatment for vaginitis is also counseled about measures to prevent its recurrence. Which patient statement best indicates effective counseling?
• A nurse is reviewing a client’s medical history. Which factor indicates the client is at risk for candidiasis?
• A nurse who works in a gynecologist’s office frequently cares for patients who are diagnosed with vulvovaginal candidiasis. The nurse should teach the patients how to manage and treat the most common symptom of:
• A patient with HIV has recently completed a 7-day regimen of use of antibiotics. She reports vaginal itching and irritation. In addition, the patient has a white, cottage cheese-like vaginal discharge. Which of the following is the patient most likely suffering?
• A woman complains to the nurse that she has developed a yeast infection. The woman does not understand how she could get a yeast infection since she has been on antibiotics for a urinary tract infection. What is the rationale for this patient’s complaint?

76. Ventilation/perfusion ratio

• A nurse recalls a high ventilation/perfusion (V/Q) ratio can be caused by:
• A nurse is teaching about the functions of the pulmonary system. Which 
  information should the nurse include? One of the functions of the 
  pulmonary system is the:
• Which of the following terms should the nurse use when there is a 
  balance between outward recoil of the chest wall and inward recoil of 
  lungs at rest?
• The nurse is describing the receptors in the lung that decrease 
  ventilatory rate and volume when stimulated. Which receptors is the 
  nurse discussing?
• While reviewing the results of the pulmonary functions test, the nurse 
  is aware that the maximum amount of gas that can be displaced (expired) 
  from the lung is called:
• While auscultating a patient’s lungs, a nurse recalls the alveoli in the apexes of the lungs are …………..than alveoli in the bases.

77. Vitamin B-12 therapy

• The nurse knows the Vitamin B12 is ….naturally in many foods. Which foods contain the LEAST amount of B12?
• B12 is ….in meats, seafood, fermented cheeses.
• A patient had a portion of stomach remove and must take vitamin B12. Which of the following statements should be included in the patient teaching?
• After teaching a patient with pernicious anemia about vitamin B12, therapy, which patient statement would indicate that the teaching was successful?
• When describing the function of vitamin B12, which of the following would be appropriate to include?
• A patient has vitamin B12 deficiency following a subtotal gastrectomy. The nurse understands the patient has which type of anemia?
• The nurse is teaching a patient with B12 deficiency caused by a previous gastrectomy and lack of intrinsic factor. Which statement by the nurse is the most appropriate to include in the teaching plan?
• The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive vitamin B12. What test is the patient being prepared for?
• A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy?
• The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12?
• The nurse recognizes that which patient is at the greatest risk for pernicious anemia or vitamin B12 deficiency?
• In monitoring a patient for early signs of vitamin B12 deficiency, the nurse correlates which clinical manifestation with this disorder?
• A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear suggests the deficiency is macrocytic and normochromic. The nurse would expect the hemoglobin to be:
• Which of the following individuals should the nurse assess first for a vitamin B12 deficiency anemia?
• A patient with chronic idiopathic thrombocytopenia purpura (ITP) asks the nurse at the doctor’s office what causes all the nosebleeds that have been occurring. The nurse’s best response would be the presence of which of the following?
• A hospital laboratory technologist is analyzing the complete blood count (CBC) of a hospital patient. Which of the following statements best reflects an aspect of the platelets that would constitute part of the CBC?
• How many days do erythrocytes live in circulation?
• Mature red blood cells have a life span of approximately how many days?
• A patient with a history of acquired idiopathic thrombocytopenic purpura (ITP) arrives at the emergency department complaining of fatigue, shortness of breath, and multiple nosebleeds during the previous week. The platelet level is 10,000/μL, and the hemoglobin is significantly below normal. The nurse would anticipate which of the following interventions?
• A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as:
• The parent of a 5 year old who was ….with a sudden onset of purpura following the flu and who was diagnosed with acute idiopathic thrombocytopenic purpura (ITP). Is very concernthat the child will have ITP for the rest of his life. The best response for the nurse to make is which of the following?
• Which disorder does the nurse know is considered to be an autoimmune disease?
• The nurse is completing a health assessment of a 42-year-old female with suspect Graves’ disease. The nurse should assess this client for:
• A client visits the physician’s office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves’ disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterize by:
• Propylthiouracil (PTU) is prescribe for a client with Graves’ disease. The nurse should teach the client to immediately report