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Pathophysiology Introductory Concepts And Clinical Perspective By Capriotti Frizzell – Test Bank 

 

 

Chapter 1: The Cell in Health and Illness

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which statement regarding the sodium-potassium pump is correct?

1. The cell’s plasma membrane is more soluble to sodium ions than potassium ions.
2. The concentration of sodium ions should be higher inside the cell compartment.
3. The concentration of potassium ions should be higher outside the cell compartment.
4. The active transport involves pumping out three sodium ions and pumping in two potassium ions.

 

 

____    2.   What is the process in which glucose is used to create energy?

1. Autolysis
2. Glycolysis
3. Heterolysis
4. None of the above

 

 

____    3.   How many adenosine triphosphates (ATPs) are produced in aerobic energy metabolism?

1. 2
2. 3
3. 34
4. None of the above

 

 

____    4.   Which cell organelles are believed to have once been self-sustaining and independent?

1. Ribosomes
2. Mitochondria
3. Ribonucleic acid
4. Deoxyribonucleic acid

 

 

____    5.   Why is more energy produced when a person is exercising?

1. There is an increase in the synthesis of protein.
2. There is an increase in the production of pyruvic acid in the cells.
3. There is an increase in the conversion of pyruvic acid to lactic acid.
4. There is an increase in the production of mitochondria in the muscle cells.

 

 

____    6.   When does ribosomal protein synthesis cease?

1. During endoplasmic reticulum (ER) stress
2. During the synthesis of ATP
3. During severe hypoxic state
4. During the processing of prohormone

 

 

____    7.   The cellular organelle responsible for propelling mucous and inhaled debris out of the lungs is

1. cilia.
2. microfilament.
3. secretory vesicle.
4. endoplasmic reticulum.

 

 

____    8.   Which are the key proteins in the contractile units of the muscle cells?

1. Actin and myosin
2. Myosin and tubulin
3. Tubulin and actin
4. None of the above

 

 

____    9.   Which deficiency causes Tay-Sach’s disease?

1. Proteasome
2. Peroxisome
3. Macrophage
4. Lysosomal enzymes

 

 

____  10.   Adrenoleukodystrophy is characterized by

1. Accumulation of ganglioside.
2. Cessation of ribosomal protein synthesis.
3. Acceleration of cellular proteasome activity.
4. Accumulation of long chain fatty acid s in the nervous system.

 

 

____  11.   Which statement regarding endoplasmic reticulum (ER) stress is correct?

1. During ER stress, proteins are rapidly degraded.
2. During ER stress, lipids cannot travel to their proper intracellular locations.
3. During ER stress, accumulation of long chain fatty acids occurs in the nervous system.
4. During ER stress, accumulation of non-degraded substances occurs in the cells.

 

 

____  12.   Which is referred to as the protein factory of the cell?

1. Ribosome
2. Mitochondria
3. Golgi apparatus
4. Endoplasmic reticulum

 

 

____  13.   Which acts as a blue print for the construction of proteins?

1. Transfer RNA
2. Ribosomal RNA
3. Messenger RNA
4. Mitochondrial DNA

 

 

____  14.   A hiker experiences muscle pain and acidosis as he or she ascends a mountain during a long, steep climb. What is the reason for these symptoms?

1. Cellular hypoxia
2. Autolysis
3. Heterolysis
4. Cellular edema

 

 

____  15.   Which factor provides DNA the unique molecular ability to replicate?

1. The precise pairing of the nitrogenous bases
2. The presence of pyrimidines bases
3. The presence of nucleotides
4. The nitrogenous base and phosphate bond

 

 

____  16.   How many nitrogenous bases compose a single codon?

1. 2
2. 3
3. 4
4. None of the above

 

 

____  17.   The DNA is a polymer of

1. Nucleotides.
2. Amino acids.
3. Fatty acids.
4. Phosphates.

 

 

____  18.   What is the function of ribosomal ribonucleic acid during protein synthesis?

1. It transports genetic information from the DNA for protein synthesis.
2. It gathers and joins the amino acids for specific proteins.
3. It is directly involved in the formation of ribosomes.
4. None of the above.

 

 

____  19.   Tetracycline antibiotic was given to a 30 year old client with Chlamydia infection. What is the mechanism of action of the drug?

1. It prevents the replication of bacteria.
2. It alters the configuration of bacterial cytoplasm.
3. It interferes with the function of bacterial ribosomes.
4. It inhibits the functions of bacterial mitochondria.

 

 

____  20.   Where does the conversion of a prohormone into a hormone take place?

1. Ribosome
2. Golgi apparatus
3. Secretory granule
4. Endoplasmic reticulum

 

 

____  21.   Which is the cell’s “master mind”?

1. Nucleus
2. Ribosome
3. Golgi apparatus
4. Endoplasmic reticulum

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  22.   Which statements regarding the microtubules are true? Select all that apply.

1. Microtubules are solid.
2. Microtubules are flexible.
3. Microtubules are composed of tubulin.
4. Microtubules are called actin filaments.
5. Microtubules comprise of centrioles and mitotic spindle.

 

 

____  23.   Which structures are found in microtubules? Select all that apply.

1. Cilia
2. Centrioles
3. Mitotic spindle
4. Actin filaments
5. Secretory vesicles

 

 

____  24.   What are the characteristics of ribonucleic acid? Select all that apply.

1. Presence of ribose pentose sugar
2. Presence of single stranded helix
3. Presence of double stranded helix
4. Presence of deoxyribose pentose sugar
5. Presence of uracil and cytosine as pyrimidine base

 

 

____  25.   Which are the purine bases found in deoxyribonucleic acid and ribonucleic acid? Select all that apply.

1. Uracil
2. Adenine
3. Guanine
4. Thymine
5. Cytosine

Chapter 2: Cellular Injury, Adaptations, and Maladaptive Changes

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   How does oxidative stress occur?

1. In cells that undergo transient ischemia and subsequent resumption of circulation
2. When estrogen stimulation results in mitotic division of breast gland cells
3. When a blood clot that obstructs a coronary artery causes cardiac muscle ischemia
4. When a cell’s environment cannot support its metabolic requirements

 

 

____    2.   A client is diagnosed with a condition in which the brain cells cannot withstand low oxygen delivery long enough for cell reversible changes to happen. Identify the condition.

1. Organelle disruption
2. Hypoxia
3. Xanthelasma
4. Ischemic-reperfusion injury

 

 

____    3.   What is the process whereby newly growing cells acquire the specialized structure and function of the cells they replace?

1. Apoptosis
2. Differentiation
3. Oxidative phosphorylation
4. Atherosclerosis

 

 

____    4.   What is kwashiorkor?

1. A condition seen in individuals suffering from severe protein starvation
2. A condition where blood pressure within the aorta and systemic arterial circulation is elevated
3. A condition where prostate gland cells increase in number because of testosterone stimulation
4. A condition that causes defective cholesterol metabolism

 

 

____    5.   What are the unique histological findings that represent distinct disease processes?

1. Histology
2. Biopsy
3. Autopsy
4. None of the above

 

 

____    6.   A client is diagnosed with failure of the thyroid gland due to increase in apoptotic cell death. Which condition is the client most likely to have?

1. Xanthomas
2. Hashimoto’s thyroiditis
3. Peptic ulcer
4. Anthracosis

 

 

____    7.   Which field involves harvesting of embryonic stem cells and performing nuclear transfer on these cells?

1. Reproductive cloning
2. Restoration with stem cells
3. Transplantation
4. Therapeutic cloning

 

 

____    8.   A nurse observes that a client has developed a foul odor in the spots where necrosis of tissue has developed. What organism causes the emission of this foul odor?

1. Streptococcus
2. Helicobacter pylori
3. Clostridium perfringens
4. Human papilloma virus

 

 

____    9.   A client is diagnosed with cellular apoptosis. Which disease can this condition lead to?

1. Cancer
2. Degenerative neurological diseases
3. Necrosis
4. Infarction

 

 

____  10.   A client is suffering from prolonged ischemia and tissue death. Which term can be used to refer to such tissue death?

1. Gangrene
2. Infarction
3. Necrosis
4. Apoptosis

 

 

____  11.   A client comes in with persistently uncontrolled hypertension. The nurse informs the client’s spouse that one of the consequences of prolonged raised blood pressure is a weakened area in the wall of the cerebral artery, located on the Circle of Willis. What is this condition known as?

1. Xanthelasma
2. Infarction
3. Berry aneurysm
4. Ischemia

 

 

____  12.   While conducting an endoscopic examination on a client, it is found that the client has acid reflex. Which condition is associated with the gastroesophageal reflux disease (GERD) in which cell injury is reversible?

1. Parkinson’s disease
2. Myocardial infarction
3. Barrett’s esophagus
4. Hashimoto’s thyroiditis

 

 

____  13.   Which body part contains pluripotent stem cells?

1. Umbilical cord
2. Skeletal muscle
3. Cardiac muscle
4. None of the above

 

 

____  14.   A client has an abnormal thickening of the lining of the uterus due to an increase in estrogen levels. How can such a condition be reversed?

1. Restoration of blood circulation
2. Hormone therapy to counteract the effects of excessive estrogen
3. Surgical removal
4. Acid suppression treatment

 

 

____  15.   Which organ is most susceptible to damage and death due to prolonged ischemia?

1. Brain
2. Skeletal muscles
3. Heart
4. None of the above

 

 

____  16.   A genetically programmed cell death is a process that can destroy cells that are no longer needed. What is the best method to do this?

1. Necrosis
2. Apoptosis
3. Infarction
4. Gangrene

 

 

____  17.   Which is the most prevalent method to replace permanently injured tissues and organs?

1. Stem cell restoration
2. Therapeutic cloning
3. Reproductive cloning
4. Transplantation

 

 

____  18.   Arteriosclerosis is the thickening and hardening of arterial walls. Which condition acts as an initiator of arteriosclerosis?

1. Apoptosis
2. Endothelial cell injury
3. Necrosis
4. Infarction

 

 

____  19.   What is the weakened area in an arterial wall called?

1. Neoplasia
2. Aneurysm
3. Hypertrophy
4. Metaplasia

 

 

____  20.   The increase in size of a weightlifter’s muscles is due to muscular

1. Hypertrophy
2. Metaplasia
3. Atrophy
4. Dysplasia

 

 

____  21.   A client reports an itchy, bumpy scar around an old wound that is identified as a keloid. This occurs due to the increase in the number of cells in a tissue or organ. Which term best describes this condition?

1. Neoplasia
2. Hyperplasia
3. Dysplasia
4. Metaplasia

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  22.   Which vitamins are fat-soluble? Select all that apply.

1. Vitamin A
2. Vitamin C
3. Vitamin D
4. Vitamin K
5. Vitamin B6

 

 

____  23.   When does physiological apoptosis occur? Select all that apply.

1. During the embryonic development of the hand
2. During menopause in female adult ovaries
3. When cells die because of stressors
4. When cells have completed their function and need elimination
5. When the liver gets exposed to excessive amounts of alcohol

 

 

____  24.   Which components of the serum level should be measured to confirm myocardial infarction? Select all that apply.

1. Epinephrine
2. Troponin
3. Lysosomal enzyme
4. Acetylcholine
5. CPKmb

 

 

____  25.   A client is suffering from atherosclerosis. What are directly detrimental to the client’s condition? Select all that apply.

1. Depletion of endothelial nitric oxide
2. Helicobacter pylori infection
3. Low-density lipoprotein (LDL) deposition
4. Inflammatory changes of the endothelium
5. Acid reflux

Chapter 3: Genetic Basis of Disease

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which is a test primarily used to diagnose fetal chromosome problems?

1. Cordocentesis
2. Amniocentesis
3. Maternal serum screening
4. Chorionic villus sampling

 

 

____    2.   Which is an inherited connective-tissue disorder?

1. Marfan syndrome
2. Neurofibromatosis
3. Familial hypercholesterolemia
4. Familial adenomatous polyposis

 

 

____    3.   Familial hypercholesterolemia is a genetic disorder characterized by high cholesterol level. Which statement is true regarding the condition?

1. Children are at the risk for early acute myocardial infarction.
2. Untreated men develop symptoms by the fifth decade of life.
3. Untreated women develop symptoms by the fourth decade of life.
4. Homozygous familial hypercholesterolemia is less severe than the heterozygous form.

 

 

____    4.   A client presents with less strength, high elastic skin, and joints that are hypermobile. Which condition can be diagnosed in the client based on these characteristics?

1. Down syndrome
2. Turner syndrome
3. Klinefelter syndrome
4. Ehlers-Danlos syndrome

 

 

____    5.   An adult client is diagnosed with Marfan syndrome after presenting with joint pain and weakness or numbness in the legs. What other clinical finding would be a treatment priority for this client?

1. Scoliosis
2. Pneumothorax
3. Pectus excavatum
4. Heart valve problems

 

 

____    6.   A client presents to the hospital with difficulty in speaking, excessive salivation, and ataxia. What finding would lead to a diagnosis of Wilson disease?

1. Hepatic dysfunction
2. Grand mal seizures
3. Skeletal rigidity
4. Psychiatric symptoms

 

 

____    7.   A client presents with thrombocytopenia and bony fractures. A scan reveals splenomegaly. How would a diagnosis of Gaucher disease be made in the client?

1. Presence of mutation in gene that codes for glucocerebrosidase
2. Cellular analysis
3. Predisposition to bone fractures
4. Presence of splenomegaly

 

 

____    8.   A client, an Ashkenazi Jew, presents with complaints of fever and lymphadenopathy. The client also has a protuberant abdomen. What finding would lead to a diagnosis of Niemann Pick disease?

1. Massive enlargement of spleen
2. Generalized lymphadenopathy
3. Gastrointestinal problems and fever
4. Biochemical assay

 

 

____    9.   A client presents with lethargy and muscle flaccidity. The client’s family members report cognitive impairment in the client. What finding would the nurse look for if Tay Sachs disease is suspected?

1. Cherry-red spot on the retina on ophthalmologic examination
2. Epicanthic folds around the eyes
3. Flapping of eyes
4. Light-colored ring in the iris of the eye

 

 

____  10.   A 19-year-old male client presents with rheumatoid arthritis. The client has a tall, lanky body, sparse facial hair. He complains of decreased physical endurance. How could a diagnosis of Klinefelter syndrome be confirmed in the client?

1. Confirm absence of pubertal changes
2. Evaluate muscle weakness
3. Assess distribution of adipose tissue
4. Perform genetic testing and hormone analysis

 

 

____  11.   A karyotype is the overall picture of

1. all the chromosomal pairs in an individual.
2. all the chromosomal pairs of a species.
3. all the normal chromosomal pairs in an individual.
4. all the abnormal chromosomal pairs in an individual.

 

 

____  12.   What defines translation in protein synthesis?

1. Process of RNA synthesis
2. Process of DNA synthesis
3. Process of ribosome formation
4. Process of protein synthesis from RNA

 

 

____  13.   Similar to sickle cell anemia, which other genetic disorder offers protection against malaria?

1. Turner syndrome
2. G6PD deficiency
3. Wilson disease
4. Tay Sachs disease

 

 

____  14.   What is a characteristic clinical manifestation of Wilson disease?

1. Tremor
2. Excessive salivation
3. Difficulty in speaking
4. Corneal Kayser-Fleischer rings

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  15.   What aspects of polymerase chain reaction make it so useful in research? Select all that apply.

1. Requires mitotic cells
2. Used for diagnostic testing
3. Used for genetic analysis in cancer
4. Can be applied to a very small sample of DNA
5. Reduces the segment for further study in the laboratory

 

 

____  16.   Prenatal diagnosis is testing for disease or conditions in a fetus. Which statements are true regarding prenatal diagnoses? Select all that apply.

1. Prenatal sex discernment
2. Early detection of birth defects
3. Genetic problems are unidentified
4. Identify disorders such as neural tube defects and Down syndrome
5. Testing procedures exclude amniocentesis and percutaneous umbilical cord blood sampling.

 

 

____  17.   Chorionic villus sampling is performed during pregnancy. What are the characteristics of chorionic villus sampling? Select all that apply.

1. Performed after 10 weeks of pregnancy
2. Offered if an inherited genetic problem is identified
3. Used to diagnose 99% of fetal chromosome abnormalities
4. Offered when a woman is at a maternal age below 35 years
5. Used to diagnose chromosome abnormalities and some inherited disorders

 

 

____  18.   Amniocentesis is a medical procedure that can give physicians essential information about the fetus. Which statements are true regarding amniocentesis? Select all that apply.

1. It is used to detect abnormalities by removing a large amount of amniotic fluid.
2. It is used to diagnose fetal chromosome problems.
3. It is used to study the fetal chromosomes.
4. It is performed on the amniotic fluid before 16 weeks of pregnancy.
5. It is used to detect fetal disorders by inserting a thin needle through the mother’s abdomen into the amniotic sac.

 

 

____  19.   Marfan syndrome is an inherited connective tissue disorder. What are the signs and symptoms that can lead a physician to diagnose a client with Marfan syndrome? Select all that apply.

1. Short stature
2. Low back pain
3. Visual problems
4. Burning sensation
5. Ligament hypermobility

 

 

____  20.   Gene therapy is an experimental technique that uses genes to treat or prevent disease. What are some of the characteristics of gene therapy? Select all that apply.

1. Insertion of a normal gene
2. Used to treat or prevent any disease
3. Used to treat a disorder using drugs or surgery
4. Insertion of a 47th artificial chromosome into the target cells
5. Insertion of the artificial chromosome would affect the function of the standard 46 chromosomes

 

 

____  21.   A five-year-old child presents with inguinal freckling and bowed legs. What clinical criteria can be used to further confirm the diagnosis of neurofibromatosis? Select all that apply.

1. Optic nerve tumor
2. Long-bone abnormalities
3. Two or less tumors in the iris
4. Two or less café-au-lait spots
5. Irregularly shaped raised lesions appear over time in older children

 

 

____  22.   Which clinical manifestations are associated with Ehlers-Danlos syndrome? Select all that apply.

1. Skin is less elastic
2. Joints are hypermobile
3. Easy bruising and poor wound healing
4. Treatment includes high dose of vitamin C
5. Caused by abnormalities in the synthesis of collagen

 

 

____  23.   Which are lysosomal storage diseases? Select all that apply.

1. Tay Sachs disease
2. Niemann-Pick disease
3. Gaucher disease
4. Wilson disease
5. Klinefelter syndrome

 

 

____  24.   How is Gaucher disease treated? Select all that apply.

1. Bone marrow transplantation
2. Genetic testing and counseling
3. Enzyme replacement therapy
4. Antibiotics
5. Vaccine

 

 

____  25.   A client presents with excessive salivation and hepatic dysfunction. A diagnosis of Wilson disease is made through liver biopsy and urine copper levels. What are the treatment options available for the client? Select all that apply.

1. Antibiotics
2. Preventive vaccines
3. Chelating agents
4. Liver transplant
5. Antivirals

Chapter 4: Stress, Exercise, and Immobility

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which is an example of eustress?

1. Job promotion
2. Death of a friend
3. Unemployment
4. Divorce

 

 

____    2.   A client is scheduled for a heart valve replacement. Which strategic action of the primary healthcare provider enhances the client’s adaptive ability and coping mechanism to reduce stress?

1. Encouraging a family member to stay with the client in the pre-operative setting
2. Permitting a family member to stay in the operation theater
3. Administering epinephrine to reduce stress
4. Restricting the family members from talking to the client in the pre-operative setting

 

 

____    3.   In which stage of Hans Selye’s general adaptation syndrome is the sympathetic nervous system (SNS) activated?

1. Alarm stage
2. Resistance stage
3. Exhaustion stage
4. Homeostasis

 

 

____    4.   What is polysomnography?

1. A diagnostic test to examine sleep patterns
2. A diagnostic test to examine eye movement
3. A diagnostic test to examine respiratory functions
4. A diagnostic test to examine electrical activity of the brain

 

 

____    5.   Which problem is a 55-year-old client most likely to exhibit as a result of prolonged benzodiazepine use?

1. Unstable gait
2. Bradycardia
3. Dyspnea
4. Anuria

 

 

____    6.   A client who has been taking an antidepressant for 10 days complains of depression and does not find the medication to be effective. Which is the best response by the nurse?

1. “I will increase the drug dosage after informing the physician”
2. “The medication will take at least 3 weeks to be effective.”
3. “I will change the medication after informing the physician.”
4. “Stop taking the medication.”

 

 

____    7.   Which is the most commonly used over-the-counter sleep aid?

1. Diphenhydramine (Benadryl)
2. Phenylephrine (Neo-Synephrine)
3. Pseudoephedrine (Sudafed)
4. Acetylcholine (Miochol)

 

 

____    8.   A registered nurse is explaining the effects of exercise on cardiovascular system to a student nurse. Which statement by the student nurse indicates effective teaching?

1. “Exercise prevents thrombus formation.”
2. “Exercise increases fibrinogen levels.”
3. “Exercise prevents angiogenesis.”
4. “Exercise increases the heart’s efficiency by decreasing cardiac muscle mass.”

 

 

____    9.   A client is on long-term bed rest. Which condition might the client develop due to immobility?

1. Orthostatic hypotension
2. Venous stasis
3. Hypertension
4. Dyspnea

 

 

____  10.   A bedridden client has frequent gastrointestinal reflux. Which condition might the client develop due to gastrointestinal reflux?

1. Aspiration pneumonia
2. Hypotension
3. Hyperthermia
4. Constipation

 

 

____  11.   A nurse is providing care for a client, who is on bed rest due to immobility. Which measure does the nurse adopt in order to counteract the ill effects of immobility?

1. Assess the client’s skin for erythema.
2. Place the client in prone position.
3. Avoid seating the client on a chair.
4. Change the position of the client every 4 hours.

 

 

____  12.   A client was hospitalized due to immobility. The blood report after one month of hospitalization shows that the client has developed septicemia. Which factor could have caused septicemia?

1. Erythema
2. Decubitus ulcer
3. Antibacterial drugs
4. Excessive exercise

 

 

____  13.   A client, who is on prolonged bed rest, has developed kidney stones. Which factor could have caused kidney stones?

1. Change in the levels of glucose
2. Change in the levels of growth hormone
3. Change in the levels of thyroid hormone
4. Change in the levels of parathyroid hormone

 

 

____  14.   Which statement is correct regarding the effects of exercise?

1. Enlarges the muscle fibers
2. Decreases the rate of breathing
3. Increases the risk of colon cancer
4. Decreases the number of mitochondrial enzymes

 

 

____  15.   What is the effect of physical activity on gastrointestinal system?

1. Increases constipation
2. Improves peristaltic movement
3. Increases the risk of diverticulosis
4. Increases the risk of inflammatory bowel diseases

 

 

____  16.   Which condition commonly found in inactive clients results in edema?

1. Venous stasis
2. Pulmonary embolism
3. Hypertension
4. Orthostatic hypotension

 

 

____  17.   What is the result of decreased cardiac output in a client, who is on a prolonged bed rest?

1. Increase in stroke volume
2. Increase in heart rate
3. Increase in venous returns
4. Increase in diastolic volume

 

 

____  18.   What happens when nitric-oxide dependent vasodilation occurs in the coronary arteries?

1. Increase in platelet activation
2. Increase in thrombus formation
3. Increase in myocardial perfusion
4. Increase in endothelial inflammation

 

 

____  19.   What is the physiological change that occurs in stage 5 of the sleep cycle?

1. Heart rate decreases
2. Breathing becomes rapid
3. Breathing becomes regular
4. None of the above

 

 

____  20.   Which stage of sleep makes it difficult to wake someone?

1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 5

 

 

NARRBEGIN: Exhibit

Exhibit

NARREND

 

 

____  21.   A nurse is assessing the sleep history of different clients for obstructive sleep apnea (OSA). Which signs could indicate that the client has OSA?

 

Client 1 Client 2 Client 3 Client 4
Excessive daytime sleepiness, snoring, and repetitive pauses in breathing during sleep Drowsiness during daytime, able to sleep only 6 hours at night, snoring, and leg cramps at night Difficulty getting back to sleep after waking during the night, hallucinations when awake, and jerking of the legs during sleep Sleepwalking, nightmares, and leg cramps at night

 

1. Client 1
2. Client 2
3. Client 3
4. Client 4

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  22.   A client is on prolonged bed rest. What are the psychological changes the client would exhibit? Select all that apply.

1. Increased anxiety
2. Increased mood swings
3. Altered tactile responses
4. Increased levels of concentration
5. Increased problem solving ability

 

 

____  23.   What gastrointestinal changes are seen in clients on bed rest? Select all that apply.

1. Slowed peristalsis
2. Diminished appetite
3. Increased diaphragm strength
4. Increased rate of intestinal absorption
5. Decreased abdominal and pelvic muscle strength

 

 

____  24.   Which nutritional advice given by a nurse to a client under stress is appropriate? Select all that apply.

1. “Eat a heavy meal before bedtime.”
2. “Consume more soy products.”
3. “Drink a glass of milk before going to bed.”
4. “Add peanuts and brown rice to your diet.”
5. “Add spinach and green vegetables to your diet.”

 

 

Completion

Complete each statement.

 

            25.       A 50-year-old male client is scheduled for a cardiac exercise stress test. The predicted maximal heart rate in beats/minute is _

 

Chapter 5: Obesity and Nutritional Imbalances

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   A client has a pigmented rash on the sun-exposed areas of the client’s skin. Which nutrient deficiency results in this condition?

1. Folate
2. Niacin
3. Vitamin A
4. Vitamin K

 

 

____    2.   Which nutrient deficiency causes beriberi?

1. Thiamine
2. Riboflavin
3. Vitamin B6
4. Vitamin B12

 

 

____    3.   A client displays behaviors that involve a desire for perfection and success in academics, and psychiatric characteristics, such as being socially isolated and emotional, and having a severely restricted diet. Which disorder could the client possibly have?

1. Anorexia nervosa
2. Bulimia nervosa
3. Binge eating
4. Purging disorder

 

 

____    4.   According to the United States Department of Agriculture (USDA), what is the recommended daily allowance for calcium consumption?

1. 1.7 mg
2. 60 mg
3. 400 mg
4. 1000 mg

 

 

____    5.   According to the United States Department of Agriculture (USDA), what is the recommended daily allowance for potassium consumption?

1. 20 mg
2. 300 mg
3. 2,400 mg
4. 3,500 mg

 

 

____    6.   A client reports excessive pain in the hips, knees, and joints. Which condition could be the root cause for the development of these symptoms?

1. Dumping syndrome
2. Hypogonadism
3. Insulinoma
4. Obesity

 

 

____    7.   A client is to undergo gastric bypass surgery. Which part of the intestine should be cut to connect to the newly-created pouch in the superior portion of the stomach?

1. Omentum
2. Jejunum
3. Duodenum
4. Subcutaneous tissue

 

 

____    8.   What is the basal metabolic rate (BMR) for a 28-year-old man who weighs 65 kg and is 170 cm tall?

1. 1,616 calories/day
2. 1,166 calories/day
3. 1,161 calories/day
4. 1,661 calories/day

 

 

____    9.   What is the basal metabolic rate (BMR) of a 26-year-old woman who weighs 55 kg and is 163 cm tall?

1. 1,345 calories/day
2. 1,543 calories/day
3. 1,453 calories/day
4. 1,354 calories/day

 

 

____  10.   What percentage of body fat is considered to be acceptable in women?

1. 35% to 40%
2. 25% to 31%
3. 21% to 24%
4. 14% to 20%

 

 

____  11.   What is the percentage of body fat for a man who is considered to be obese?

1. 30% to 40%
2. 20% to 25%
3. 14% to 17%
4. 6% to 13%

 

 

____  12.   What is the lean body mass of a man whose weight is 164 lbs and body fat is 22%?

1. 128 lbs
2. 182 lbs
3. 218 lbs
4. 281 lbs

 

 

____  13.   A client is diagnosed with a deficiency of ascorbic acid. Which disease could this condition lead to?

1. Scurvy
2. Megaloblastic anemia
3. Rickets
4. Beriberi

 

 

____  14.   An 18-year-old client, who is within a normal weight range, admits to using laxatives and diuretics. The client displays increased symptoms of depression and reports a sore throat and tooth decay. What question should a nurse ask the client to evaluate if the client is suffering from bulimia nervosa?

1. “Do you engage in self-induced purging?”
2. “Do you suffer from constipation?”
3. “Do you have hypertension?”
4. “Do you have a habit of starving intentionally?”

 

 

____  15.   Which vitamin works in close correlation with the parathyroid hormones to regulate the absorption of calcium?

1. Vitamin A
2. Vitamin C
3. Vitamin D
4. Vitamin K

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  16.   Which statements are true with regard to liposuction? Select all that apply.

1. It does not involve the use of an anesthetic.
2. It is a cosmetic procedure.
3. It is associated with high mortality rates.
4. It promotes weight loss by limiting the amount of food that the client consumes.
5. It requires clients to wear compression garments preoperatively.

 

 

____  17.   A 40-year-old client has a body mass index (BMI) of 45. The client wants to undergo gastric bypass surgery. Which statements of the nurse would justify the advantages of the surgery? Select all that apply.

1. Gastric bypass surgery limits the volume of food consumed to one-half to 1 ounce.
2. Gastric bypass surgery is done by surgically restructuring the upper portion of the stomach.
3. Gastric bypass surgery usually results in gradual weight loss over a long period of time.
4. Gastric bypass surgery does not involve any complications or surgical risks.
5. Gastric bypass surgery alters the ability of the stomach and small bowel to absorb calories and nutrients.

 

 

____  18.   A client undergoes gastric bypass surgery and reports symptoms postsurgery. Which symptoms can be interpreted as dumping syndrome?  Select all that apply.

1. Rapid food digestion
2. Abdominal cramps
3. Proximal stomach pouch herniation
4. Severe hypotension
5. Diarrhea

 

 

____  19.   A nurse is explaining about the advantages and disadvantages of gastric banding surgery to a client who is scheduled for the procedure. Which statements made by the nurse with regard to the advantages and disadvantages of gastric banding surgery are correct? Select all that apply.

1. Gastric banding surgery promotes weight loss by limiting the amount of food that can be consumed and producing early satiety.
2. Gastric banding surgery is a laparoscopic procedure and does not carry the typical risks associated with surgery.
3. Gastric banding surgery carries no risk of a ruptured suture line.
4. Gastric banding surgery may cause vomiting.
5. Gastric banding surgery carries the risk of rapid gastric emptying.

 

 

____  20.   A nurse is explaining about the risks of dumping syndrome to a client who recently had undergone gastric bypass surgery. Which statements made by the nurse with regard to the risks of dumping syndrome are correct? Select all that apply.

1. Dumping syndrome may cause excessive sweating.
2. Dumping syndrome is too severe a complication to be controlled through changes to the diet and eating habits.
3. Dumping syndrome may place the client at risk for hyperglycemia.
4. Dumping syndrome causes a malabsorption of nutrients.
5. Dumping syndrome may cause diarrhea.

 

 

____  21.   Which vitamins are fat-soluble? Select all that apply.

1. Vitamin A
2. Vitamin B
3. Vitamin C
4. Vitamin D
5. Vitamin E

 

 

____  22.   Which statements are true about pharmacological interventions for weight loss? Select all that apply.

1. Weight loss medications are very effective.
2. Weight loss is short term.
3. Weight loss medications, such as over-the-counter appetite suppressants, have sympathomimetic side effects.
4. Weight loss medications are indicated for people who have a body mass index (BMI) of 27 or greater with concurrent obesity-related medical problems.
5. Weight loss medications, such as appetite suppressants, are relatively safe and can be bought over the counter without a prescription from a primary health-care provider.

 

 

____  23.   A client is diagnosed with obesity as a secondary effect. Which disorder could possibly be caused by obesity? Select all that apply.

1. Hypothyroidism
2. Prader-Willi syndrome
3. Polycystic ovarian syndrome
4. Cushing’s syndrome
5. Leptin receptor gene mutation at 7q31

 

 

____  24.   Which statements are true with regard to free fatty acids? Select all that apply.

1. They cause glucose intolerance.
2. They send satiety signals to the brain.
3. They cause cirrhosis.
4. They are created through lipolysis.
5. They cause hypertension.

 

 

Completion

Complete each statement.

 

  1. A client comes in for a consultation with a bariatric surgeon to inquire about surgical options to lose weight. The client’s body mass index (BMI) is checked to see if the client would be a candidate for the bariatric surgery. A nurse records the client’s height as 5 feet, 4 inches and weight as 258 pounds. What is the client’s BMI? Record your answer to one decimal point. ____________________

 

 

Chapter 6: Pain

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which statement is related to a simplex reflex arc?

1. Interpretation of the brain is necessary when it occurs in the body.
2. An efferent neuron connects with an interneuron in the substantia gelatinosa.
3. An interneuron connects to an afferent neuron that exits through the ventral horn.
4. An afferent neuron carries sensory impulses into the dorsal horn of the spinal cord.

 

 

____    2.   Pain that is dull or aching and that occurs in certain parts of the body is referred to as deep somatic pain. Explain how somatic pain is different from other pain.

1. Pain that occurs from ligaments, tendons, and bones
2. Pain originating in an amputated part of the body
3. Pain from deep organs resulting from disease processes
4. Pain originating from the chest and left arm

 

 

____    3.   Pain is an unpleasant sensation that is associated with disease. The process by which people experience pain occurs in four phases. Choose the first phase that converts painful stimuli into neuronal impulses.

1. Perception
2. Modulation
3. Transduction
4. Transmission

 

 

____    4.   Which statement is related to gate control theory?

1. The first neuron is an interneuron.
2. The second neuron is an afferent neuron.
3. Sensation travels both to and from the brain.
4. The interneuron is influenced by descending nerve tracts from the spinal cord.

 

 

____    5.   A 40-year-old client experiences problems such as sleeplessness, fear, irritability, anxiety, and stress. The client has pain that lasts longer than 6 months. Which type of pain can be diagnosed from the symptoms?

1. Acute pain
2. Chronic pain
3. Neuropathic pain
4. Phantom limb pain

 

 

____    6.   What is the process by which the body responds to nonpharmacological treatments to relieve pain?

1. The body responds by secreting inflammatory mediators.
2. The body responds by secreting endothelin-1.
3. Nonpharmacological treatments activate the body’s prostaglandins.
4. Nonpharmacological treatments activate the body’s own endorphins and enkephalins.

 

 

____    7.   A client presents with a greater than 3-month history of widespread aches and pains. The client also points to several tender locations. On further questioning, the client mentions disturbed sleep and feeling fatigued. Which is the likely diagnosis for the client?

1. Complex regional pain syndrome
2. Fibromyalgia
3. Spinal nerve radiculopathy
4. Trigeminal neuralgia

 

 

____    8.   A client presents with symptoms of trigeminal neuralgia and wants the best pain management available. Which treatment will address the client’s need?

1. Surgery
2. Acupuncture
3. Guided imagery
4. Anticonvulsants

 

 

____    9.   A client presents with symptoms of fibromyalgia. Which treatment option can be offered to the client?

1. Curative prescription drugs
2. Relieving and coping therapies
3. Preventive vaccines
4. Surgery

 

 

____  10.   A client complains of headaches during morning hours and sleep, and also rhinorrhea and tearing of the eye. Which type of headache is likely to be diagnosed for the client?

1. Tension headache
2. Migraine
3. Cluster headache
4. Cephalgia

 

 

____  11.   Some forms of complex regional pain syndrome have no causes, and in some cases there are precipitating factors. What is the precipitating factor of complex regional pain syndrome?

1. Injury and surgery
2. Viral infection
3. Brain tumor
4. Radiculitis

 

 

____  12.   A client presents with episodic headache associated with muscular tightness in the neck and shoulders. The client is given a diagnosis of tension headaches based on which symptom?

1. Sharp, stabbing pain in the face with radiation to the jaw
2. Bandlike pain sensation in the head
3. Throbbing headache with associated symptoms of nausea
4. A perception of lights flashing in the visual field

 

 

____  13.   A client comes in with symptoms typical of a migraine attack. Which treatment option is the most apt for the client?

1. Tricyclic antidepressants
2. Beta blockers
3. Sumatriptan
4. Anticonvulsants

 

 

____  14.   A client complains of pain in the neck that radiates down the right arm with numbness in the fingers. What would the client most likely be checked for?

1. Postherpetic neuralgia
2. Fibromyalgia
3. Complex regional pain syndrome
4. Cervical radiculopathy

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  15.   What are the characteristics of afferent neurons? Select all that apply.

1. They are motor nerves.
2. They extend to the muscles of the body.
3. They enter the dorsal horn.
4. They exit through the ventral horns.
5. They carry pressure sensations into the spinal cord.

 

 

____  16.   Which are the features of A-delta fibers? Select all that apply.

1. Myelinated
2. Persisting dull pain
3. Small in diameter
4. Cause long-lasting pain
5. Conduct impulses slowly

 

 

____  17.   The spinothalamic tract is a sensory pathway from the skin to the thalamus. Select the clinical significance of the spinothalamic tract. Select all that apply.

1. Cross over at the medulla
2. Exit through the ventral horn
3. Descend downward in the spinal cord
4. Direct sensory neuronal impulses to hypothalamus
5. Direct sensory neuronal impulses to the upper regions of the brain cortex

 

 

____  18.   A client visits a primary health-care provider and complains of pain. The primary health-care provider diagnoses the pain as neuropathic pain. Which are the symptoms of neuropathic pain?  Select all that apply.

1. Arises as a result of sustained noxious stimuli
2. Is often acute and chronic
3. Is burning, tingling, and shooting in sensation
4. Occurs in the skin, muscles, and bones
5. Leads to conditions such as postherpetic neuralgias and spinal nerve radiculopathy

 

 

____  19.   Which steps are necessary to identify the severity of pain in a client? Select all that apply.

1. It is necessary to ask if the pain is aching, throbbing, or stabbing.
2. It is unnecessary to use a 0 to 10 scale.
3. It is necessary to ask the client for a number to describe the severity of pain.
4. It is necessary to ask about the associated symptoms such as depression.
5. It is unnecessary to obtain the history of the client.

 

 

____  20.   Which clinical criteria should the physician follow to analyze pain? Select all that apply.

1. Examine the area of pain first.
2. Assess the history of the client.
3. Listen to the client’s complaint of pain.
4. Assess the pain.
5. Allow the client to point to the area of pain after a physical exam.

 

 

____  21.   A 35-year-old client presents with colicky pain. When seeking a diagnosis, which conditions are likely to be causing the pain in the client? Select all that apply.

1. Hyperperistalsis
2. Muscular spasm
3. Cholecystitis
4. Esophagitis
5. Abdominal pain

 

 

____  22.   Depression is common in clients with chronic pain. Identify the signs and symptoms than can be observed in a client with depression. Select all that apply.

1. Increased appetite
2. Restricted activity levels
3. Excess sleep
4. Hyperfocus or concentration
5. Chronic fatigue

 

 

____  23.   A client prefers nonpharmacological treatment for regional complex pain syndrome. What treatment options can be offered to the client? Select all that apply.

1. Counseling
2. Alternative medicine
3. Acupuncture
4. Transcutaneous electrical neural stimulation (TENS)
5. Guided imagery

 

 

____  24.   Which statements are true regarding intradiscal electrothermal therapy (IDET)? Select all that apply.

1. It uses thoughts and suggestions to guide the imagination.
2. It uses heat to modify the nerve fibers of a spinal disc.
3. It uses electrodes to deliver electrical current through the skin.
4. It uses a wire called an electrothermal catheter that is placed through an incision into the spinal disc.
5. It uses thin solid metallic needles.

 

 

____  25.   A nursing instructor is educating student nurses on the cause of bone pain in cancer clients. Which statement by a nurse student indicates effective learning? Select all that apply.

1. “Metastasis of cancer to the bones is one of the reasons for bone pain.”
2. “Entrapment of the spinal nerve in a herniated disc is a reason for bone pain.”
3. “Excess glucose in the nerves leads to structural breakdown of the nerves.”
4. “A tumor within the bone can cause bone pain.”
5. “Enzyme and inflammatory mediators cause bone pain.”