Patho practice questions-all

Flashcard maker : Mary Moore
A nurse is asked what causes secondary amenorrhea. How should the nurse respond? Causes of secondary amenorrhea other than pregnancy and menopause include:
thyroid disorders

Answer Feedback: Pituitary tumors, thyroid disorders, and extreme weight loss can all result in secondary amenorrhea

What complication will the nurse monitor for in a patient with polycystic ovarian syndrome?
Infertility

Answer Feedback: Polycystic ovarian syndrome results in stimulation of follicle growth without ovulation and generally leads to infertility.

Which statement indicates a nurse needs more instruction regarding premenstrual syndrome (PMS)? PMS is the cyclic recurrence that can cause changes:
financially

Answer Feedback: Changes occurring with PMS are behavioral, physical, and psychological. Common problems include depression, headache, irritability, myalgias, fatigue, nausea, diarrhea, and sleep disturbance

A nurse is describing the pathophysiology of pelvic inflammatory disease. Which information should the nurse include? Pelvic inflammatory disease can be caused by:
sexually transmitted infections

Answer Feedback: Pelvic inflammatory disease is caused by infection with sexually transmitted organisms such as Neisseria gonorrhoeae and Chlamydia trachomatis.

A female presents with cervicitis, pelvic pain, vaginal bleeding, and the presence of purulent cervical discharge. Which organism does the nurse suspect caused this condition?
Trichomoniasis

Answer Feedback: Chlamydia, trichomoniasis, and gonorrhea are all sexually transmitted infections that can lead to cervicitis.

A patient presents with protrusion of the uterus into the vaginal canal with occasional protrusion outside the vagina. What medical diagnosis will the nurse observe on the chart? Uterine:
prolapse

Answer Feedback: Uterine prolapse is descent of the uterus into the vaginal canal, which can progress to protrusion outside of the vagina.

A nurse recalls dermoid cysts are tumors that contain elements of skin, hair, glands, muscle, cartilage, and bone that can eventually develop into:
ovarian cancer

Answer Feedback: Dermoid cysts are ovarian tumors that are generally asymptomatic but must be removed to prevent the development of ovarian cancer.

A patient has pain in the abdomen and pelvis occurring with dysmenorrhea, dyschezia, dyspareunia, and adhesions. The nurse will plan to care for a patient with:
endometriosis

Answer Feedback: Endometriosis is the presence of ectopic endometrial glands that can be found throughout the body, especially in the abdominal and pelvic cavities. Endometriosis can lead to a wide variety of pelvic and abdominal symptoms.

Which of the following statements indicates a patient needs more teaching about ovarian cancer?
Women 45 years and younger are at the greatest risk of developing ovarian cancer

Answer Feedback: The highest incidence of ovarian cancer is in elderly women

A nurse is describing the pathophysiology of urethritis. Which information should the nurse include? Urethritis is a common disorder of the male urethra and is most commonly caused by:
sexually transmitted infection.

Answer Feedback: Urethritis is most often caused by sexually transmitted infections from microorganisms such as Neisseria gonorrhoeae and Chlamydia trachomatis

Which patient is most prone to penile cancer?
Black male who smokes

Answer Feedback: Major risk factors for developing penile cancer are human papillomavirus infection, smoking, and black race

A male patient has an abnormal dilation of the spermatic/testicular vein. What term will the nurse use to describe this condition?
Varicocele

Answer Feedback: An abnormal dilation of a vein within the spermatic cord that can lead to infertility is known as a varicocele.

A young male child’s testes have failed to descend from the abdomen into the scrotum. Which condition will the nurse observe documented on the chart?
Cryptorchidism

Answer Feedback: With cryptorchidism, the testicle may remain in the abdomen or arrest in the inguinal canal instead of descending into the scrotum.

What must the nurse monitor for in a patient who has benign prostatic hyperplasia (BPH)?
Urethral obstruction

Answer Feedback: Hyperplasia and hypertrophy of prostatic tissue in BPH lead to the formation of nodules that compress the urethra and cause urethral obstruction.

Which patient should be assessed first for cervical cancer? A patient:
who has an infection with the human papillomavirus (HPV).

Answer Feedback: Most cases of cervical cancer and cervical dysplasia are associated with HPV, a sexually transmitted infection

A nurse is describing the pathophysiology of primary dysmenorrhea. Which information should the nurse include? Excessive uterine contractions and endometrial shedding resulting in painful menstruation is a result of:
excessive prostaglandin levels.

Answer Feedback: Primary dysmenorrhea is the result of excessive prostaglandin F2 alpha levels in the myometrium and endometrium

To prevent prostate cancer, which diet should the nurse encourage men to consume? A diet low in:
fat.

Answer Feedback: A diet high in fat is a risk factor for prostate cancer

The nurse is describing the pathophysiology of prostate cancer. Which factor should the nurse include?
Decreased dihydrotestosterone (DHT)

Answer Feedback: Decreased levels of DHT are associated with the development of prostate cancer

A patient has benign breast disease. Which type of breast lesion does this patient have?
Nonproliferative

Answer Feedback: Nonproliferative, proliferative, and atypical hyperplasia (proliferative with atypia) are examples of benign breast disease

A nurse is asked which of the following hormonal abnormalities is associated with the development of breast cancer. What is the nurse’s best response?
Elevated estrogen

Answer Feedback: Elevated estrogen and progesterone are associated with the development of breast cancer

A 14-year-old girl has failed to menstruate and develop secondary sex characteristics. What term will the nurse use to describe this condition?
Primary amenorrhea

Answer Feedback: Failure to menstruate and develop secondary sex characteristics by age 14 is a condition called primary amenorrhea

A woman has irregular menstrual cycles and heavy bleeding with no disease or physical problems. Which diagnosis will the nurse observe documented on the chart?
Dysfunctional uterine bleeding

Answer Feedback: Irregular and/or heavy bleeding is a condition called dysfunctional uterine bleeding

A patient has the symptoms of pelvic inflammatory disease (PID). During the pain assessment which activity will the patient say lessens the pain?
Resting

Answer Feedback: The pain of PID may worsen with walking, jumping, or intercourse.

A nurse is asked what causes vaginitis. How should the nurse respond? Vaginitis caused by infection is often related to:
antibiotic use.

Answer Feedback: Oral antibiotic use can decrease healthy levels of Lactobacillus acidophilus, resulting in overgrowth of normal vaginal flora

A patient has a cystocele. What other condition should the nurse assess for in this patient?
Stress incontinence

Answer Feedback: A cystocele occurs when the bladder descends into the anterior aspect of the vaginal canal and usually results in bladder control problems such as stress incontinence

A patient has adenomyosis. While the nurse is obtaining the history from the patient, what will the nurse typically find? The patient took:
Answer Feedback: Adenomyosis commonly develops during the late reproductive years, with the highest incidence among women in their forties and women taking tamoxifen
Which cancer is the nurse testing for when the Papanicolaou test (Pap smear) is used for routine screening?
Cervical

Answer Feedback: The Pap smear is routinely used to screen for cervical dysplasia and cervical cancer

A patient has vaginal cancer. While the nurse is obtaining the history from the patient, what will the nurse typically find? The patient was exposed to:
Answer Feedback: Exposure in utero to nonsteroidal estrogens (diethylstilbestrol [DES]) also has been identified as a risk factor for vaginal cancer
A nurse is teaching a class about risk factors for endometrial cancer. Which information should the nurse include? Risk factors for the development of endometrial cancer include:
obesity, early menarche, and late menopause.

Answer Feedback: Risk factors for the development of endometrial cancer include, among others, obesity, early menarche, and late menopause.

Which of the following male reproductive disorders will cause the nurse to prepare the patient for surgery?
Testicular torsion

Answer Feedback: Testicular torsion is a surgical emergency, since the rotation of the testes can interrupt the blood supply to the testes.

A patient wants to know the difference between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). How should the nurse respond? PMDD has:
depression.

Answer Feedback: PMDD is the term often used to refer to the premenstrual disorder with a predominant psychosocial or functional impairment, similar to dysthymia and minor depression

A nurse is describing the pathophysiology of polycystic ovarian syndrome. Which information should the nurse include? The major endocrine abnormality associated with the development of polycystic ovarian syndrome is:
hyperinsulinemia.

Answer Feedback: Hyperinsulinemia plays a key role in androgen excess and the subsequent development of polycystic ovarian syndrome

Which of the following symptoms suggests that a woman should be carefully evaluated for breast cancer?
All of the above

Answer Feedback: Dimpling of the skin often occurs at the site of a tumor of the breast. When breast cancer metastasizes, the cancer cells first migrate to the axillary lymph nodes, manifesting with enlarged lymph nodes. Abnormal discharge from the nipple is also a sign of advanced breast cancer

If sexual maturation occurs before age 6 in girls or age 9 in boys, which term should the nurse use to describe these conditions?
Precocious puberty

Answer Feedback: Early sexual maturation is a rare condition known as precocious puberty

Which condition is the nurse assessing for when the results of the prostate-specific antigen (PSA) test is monitored?
Benign prostatic hyperplasia (BPH)

Answer Feedback: The PSA test is used to screen for prostate tissue hyperplasia, which is present in BPH and prostate cancer

Which patient has the greatest risk of developing testicular cancer? The male patient with a history of:
cryptorchidism.

Answer Feedback: The risk of testicular cancer is greater for men who have a history of cryptorchidism

Which principle is most important for the nurse to remember when providing care to a patient with prostate cancer? Symptoms of prostate cancer are similar to:
benign prostatic hyperplasia.

Answer Feedback: The major symptom of prostate cancer is unrelieved urethral obstruction and decreased urinary flow. These problems also occur with BPH

A nurse is explaining the pathophysiology of prostate cancer. Which information should the nurse include? The most important risk factor in the development of prostate cancer is:
older age.

Answer Feedback: By age 85, one in six American men will develop prostate cancer and about 3% will die from

A patient has galactorrhea. Which area is priority to assess?
Breast

Answer Feedback: Galactorrhea is marked by inappropriate lactation from the breast.

Which of the following can the nurse suggest to women to protect against the development of breast cancer?
Regular exercise

Answer Feedback: Regular physical activity may reduce overall risk of breast cancer and may be related to weight loss and subsequent alterations in hormone levels.

A male has overdevelopment of breast tissue. Which term should the nurse use to describe this condition?
Gynecomastia

Answer Feedback: Overdevelopment of breast tissue in males is a condition known as gynecomastia

A nurse is discussing endocrine system dysfunctions with a patient. Which statement indicates the patient understood? Endocrine system dysfunction can result from hyposecretion, hypersecretion, or from:
Abnormal receptor activity
An aide asks the nurse what is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion. How should the nurse respond?
Cancer
A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?
Hyponatremia
A 44-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for SIADH. Which of the following assessment findings would be expected in this patient?
Concentrated urine
A nurse is caring for a patient with SIADH. What severe complications should the nurse assess for?
Neurologic damage
A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate?
Dehydration from polyuria
While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is _______ diabetes insipidus.
Nephrogenic
Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following assessment manifestations?
Thirst
A 50-year-old male patient presents with polyuria and extreme thirst. he was given exogenous ADH. For which of the following conditions would this treatment be effective?
Neurogenic diabetes insipidus
A 25-year-old male presents with fatigue, constipation, and sexual dysfunction. Tests reveal all pituitary hormones are normal and no masses are present. The nurse suspects the most likely cause of his symptoms is a dysfunction in the:
Pituitary stalk
A 15-year-old female presents with breast discharge, dysmenorrhea, and excessive excitability. Tests reveal that all her pituitary hormones are elevated. What does the nurse suspect as the most likely cause for these assessment findings?
A pituitary adenoma
What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma?
Visual disturbances
A 35-year-old female with Graves disease is admitted to a medical-surgical unit. While the nurse is reviewing the lab tests, which results would the nurse expect to find?
High levels of circulating thyroid-stimulating antibodies
While checking the lab results for a patient with Graves disease, the nurse would check the T3 level to be abnormally:
High
A 35-year-old female with Graves disease is admitted to a medical-surgical unit. Which of the following symptoms would the nurse expect to find before treatment?
Skin host and moist, rapid heart rate
Visual disturbances are a common occurrence in patients with untreated Graves disease. The endocrinologist explains to the patient that the main cause of these complications is:
Orbital edema and protrusion of the eyeball
A 25-year-old female with Graves disease is admitted to a medical-surgical unit. Palpation of her neck would most likely reveal:
Diffuse thyroid enlargement
A 22-year-old female has a low level of TSH. What condition does the nurse expect the patient is experiencing?
Secondary hypothyroidism
While planning care for a patient with hypothyroidism, which principle should the nurse remember? The basal metabolic rate is unusually _____ with hypothyroidism.
Low
A 3-year-old male was diagnosed with congenital hypothyroidism. The parents ask the nurse if left untreated what will happen. What is the nurse’s best response? If left untreated, the child would have:
Mental retardation and stunted growth
A 30-year-old male was diagnosed with thyroid carcinoma. The lab tests the nurse would most likely find are _____ T3 and T4 levels.
Normal
What problem should the nurse assess for in a patient with chronic hyperparathyroidism?
Osterporosis and pathologic fractures
A 45-year-old female with Graves disease underwent surgical removal of her thyroid gland. During the postoperative period, her serum calcium was low. the most probably reason for her low serum calcium is:
Hypoparathyroidism caused by surgical injury to the parathyroid glands
A 30-year-old female with Graves disease is admitted to a hospital unit for the surgical removal of her thyroid gland. During the postoperative period, the nurse notes that the patient’s serum calcium is low. The nurse should observe the patient for which of the following signs/symptoms?
Laryngeal spasms and hyperreflexia
When the patient wants to know what most commonly causes hypoparathyroidism, how should the nurse reply? It is most commonly used by:
Parathyroid gland injury
A 25-year-old male presents to his primary care provider reporting changes in facial features. CT scan reveals a mass on the anterior pituitary, and lab tests reveal severely elevated growth hormone (GH). Which of the following would the nurse also expect to find?
Sexual dysfunction
A 30-year-old male presents to his primary care provider reporting visual disturbances. CT reveals a pituitary tumor and lab tests reveal elevated prolactin. He is diagnosed with prolacinoma. Which of the following treatments would the nurse help implement? Administering:
Dopaminergic agonists
A 12-year-old female is newly diagnosed with type 1 DM. When the parents ask what causes this, what is the nurse’s best response?
Immune destruction of the pancreas
A 12-year-old male is newly diagnosed with type 1 DM. Which of the following tests should the nurse prepare the patient to best confirm the diagnosis?
Fasting plasma glucose levels
An 11-year-old male is newly diagnosed with type 1 DM. Which classic symptoms should the nurse assess the patient for?
Polydipsia, polyuria, polyphagia, and weight loss
A 19-year-old female with type 1 DM was admitted to the hospital with altered consciousness and the following lab values: serum glucose 500 mg/dl (high) and serum K+2 (low). Her parents state that she has been sick with the \”flu\” for a week. The diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS). What relationship do these values have with her insulin deficiency?
Decreased insulin causes hyperglycemia and osmotic diuresis.
A nurse is reviewing lab results for glycosylated hemoglobin (Hemoglobin A) levels. A nurse recalls the purpose of this test is to:
Monitor long term serum glucose control
When a patient asks what causes hyperglycemia in type 2 DM, how should the nurse respond? Hyperglycemia is a result of:
Hyperinsulinemia
A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high), urine glucose and ketones 4+ (high), and arterial pH 7.20 (low). Her parents state that she has been sick with the \”flu\” for a week. Which of the following statements best explains her acidotic state?
Insulin deficiency promotes lipid metabolism and ketone formation
A 13-year-old male who uses insulin to control his type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion during gym class. The most probable cause of these symptoms is:
Hypoglycemia caused by increased exercise
A 55-year-old female is admitted to the medical unit for complications of long-term, poorly controlled type 2 DM. Which of the following would the nurse expect to find in addition to elevated glucose?
Atheroslcerosis
When a staff member asks the nurse what causes the chronic complications of DM such as microvascular and macrovascular disease, how should the nurse respond? These complications are primarily related to:
Hyperglycemia
A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of:
Adrenocorticotrophic hormone (ACTH)
Which of the following alterations would the nurse expect to find in a patient with untreated Cushing disease or syndrome?
Hypertension
When a nurse is assessing the physical features of individuals with Cushing syndrome, these findings will include:
Truncal obesity and moon face
A 35-year-old female took corticosteroid therapy for several months. Which of the following would the nurse expect to find?
Type 2 DM
A nurse is preparing to teach a patient about Addison disease. Which information should the nurse include? The most common cause of Addison disease is:
An autoimmune reaction
A 50-year-old female presents with lightheadedness and overal abnormal feelings. Hyperaldosteronism is diagnosed. Which of the following symptoms would the nurse expect?
Hypokalemia
A 49-year-old female is diagnosed with hypercortisolism. Which of the following would the nurse expect?
Osteoporosis
The body’s inability to converse water and sodium when affected by Addison disease is explained by which of the following conditions?
Aldosterone deficiency
A patient with Addison disease has weakness and easy fatigability. A nurse recalls this is due to:
Hypocortisolism
What is the cause of hyperpigmentation seen in people with Cushing syndrome?
Elevated levels of ACTH
A 30-year-old female presents with hypertension, headache, tachycardia, impaired glucose tolerance, and weight loss. Which of the following diagnosis will the nurse see documented on the chart?
Pheochromocytoma
A nurse wants to determine if there is kidney dysfunction in a patient with diabetes. Which of the following is the earliest manifestation?
Microalbuminuria
Which of the following diseases should the nurse teach the patient to prevent as it is the ultimate cause of death in the patient with diabetes?
Cardiovascular disease
A nurse is assessing a patient with hypoparathyroidism. Clinical manifestations of hypoparathyroidism include (select all that apply):
– Tetany
– Chvostek sign
– Trousseau sign
– Hair loss
A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Abnormal thickening and hardening of vessel walls
A patient wants to know what causes atherosclerosis. How should the nurse respond? In general, atherosclerosis is caused by:
Endothelial injury and inflammation
A staff member asks a nurse was foam cells are. What is the nurse’s best response? From cells in a fatty streak are:
Macrophages that engulf low-density lipoprotein (LDL)
A nurse takes an adult patient’s blood pressure and determines it to be normal. What reading did the nurse obtain?
Systolic pressure less than 120 mmHg and diastolic pressure less than 80 mmHg
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Primary
A 30-year-old Cuacasian 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?
Genes
A 65-year-old male presents for a routine checkup. A blood pressure check reveals a systolic pressure of 160 mmHg and a diastolic pressure of 70 mmHg. Which of the following is the most likely cause of this type of pressure evaluation?
Rigidity of the aorta
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 diuretic
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:
End-organ damage
A nurse monitors the patient for _____ when rapid onset of malignant hypertension results.
Encephalopathy
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
Stand up
A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?
Syncope and fainting
A 65-year-old female presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:
Throacic aorta
A 60-year-old male is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located?
Circle of Willis
What term should the nurse document for a detached blood clot?
Thromboembolus
A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient’s history, which finding could have caused her condition?
Venous thrombus
A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:
Deep veins of the leg
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?
Cold exposure
A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?
Long periods of standing
A 52-year-old male presents with pooling of blood in the veins and the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is:
Skin hyperpigmentation
While planning care for a patient with superior vena cava sydrome (SVCS), which principle should the nurse remember? SVCS is a progressive ____ of the superior vena cava (SVC) that leads to venous distention of the upper extremities and head.
Occlusion
A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart?
Superior vena cava sydnrome (SVCS)
A 52-year-old female is diagnosed with coronary artery disease. The nurse assesses for myocardial:
Ischemia
A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change?
Smoking cigarettes
A 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 low level of high-density lipoprotein (HDL). Which of the following should the nurse advise him to avoid?
Trans fats
When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:
Atherosclerosis
A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
The myocardial oxygen supply has fallen below demand
A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?
Prinzmetal
A 51-year-old male is at the health clinic for an annual physical exam. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:
Stable angina
A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Apply oxygen to increase myocardial oxygen supply
A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:
Impending myocardial infarction (MI)
A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal:
Platelet aggregation within the atherosclerotic coronary artery
A 60-year-old female has a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because:
The resulting ischemia leads to hypoxic injury and myocardial cell death.
A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of cardiac troponins I and T. Based upon the lab findings, the nurse suspects which of the following has occurred?
Myocardial infarction (MI)
A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the nurse determines the patient is experiencing:
Acute pericarditis
A 56-year-old male presents to his primary care provider for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?
Tamponade
A 42-year-old female is diagnosed with constrictive pericarditis. The nurse assesses the blood pressure for decreased cardiac output because of:
Fibrosis and calcification of the pericardial layers
Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following conditions should alert the nurse that the patient may have both types of valve dysfunction?
Rheumatic fever or heart disease
While planning care, the nurse remembers which principle? In valvular ____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.
Stenosis
A 67-year-old female was previously diagnosed with rheumatic heart disease. Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which of the following is the most likely diagnosis recorded on the chart?
Aortic stenosis
A 60-year-old female was diagnosed with mitral stenosis. As a result, the nurse realizes the patient has incomplete emptying of the:
Left atrium
A 72-year-old female has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis documented on the chart?
Aortic regurgitation
Upon assessment of the patient, the nurse finds a widened pulse pressure and throbbing peripheral pulses. Which valve disorder does the nurse suspect?
Aortic regurgitation
A 35-year-old male presents with pulmonary hypertension. Testing reveals he is in right heart failure. Which of the following is the most likely diagnosis the nurse will see listed on the chart?
Tricuspid regurgitation
A nurse recalls the most common cardiac valve disease in the United States, which tends to be most prevalent in young women, is:
Mitral valve prolapse
A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. When a staff member asks what caused the disease, what is the nurse’s most correct response? The most likely cause of this disease is:
Group A ?-hemolytic streptococcus infections
A 10-year-old male presents with fever, lymphadenopathy, arthralgia, and nose bleeds. He is diagnosed with rheumatic heart disease. While planning care, which characteristic changes should the nurse remember?
Antigens that bind to the valvular lining, triggering an autoimmune response
A 30-year-old female presents to her primary care provider with fever, cardiac murmur, and petechial skin lesions. She is diagnosed with infective endocarditis. When the patient wants to know what caused the disease, what is the nurse’s best response? the most likely cause of the disease is:
Bacteria
A nurse is teaching staff about endocarditis. Which information should the nurse include? Inflammatory cells have difficulty limiting the colonization of microorganisms in infective endocarditis because the:
Microorganisms are sequestered in a fibrin clot
A 50-year-old male visits the cardiologist for an EKG. Results indicate that he has no PR interval and a variable QRS rate with rhythm irregularity. Which of the following is the most likely diagnosis to be recorded on the chart?
Atrial fibrillation
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
Left ventricular preload increases
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:
Myocardial hypertrophy and ventricular remodeling
A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:
Increased systemic vascular resistance
A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure. The nurse understands this is most likely caused by:
Sympathetic nervous system compensation for decreased cardiac output
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Pulmonary vascular congestion
A 73-year-old female has increased pulmonary pressure resulting in right heart failure. The nurse should monitor for a possible complication because a potential cause for her heart to fail is:
Left heart failure
A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?
Right heart failure
A 72-year-old female has a history of a right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?
Significant edema to both lower legs and feet
Which condition should cause the nurse to assess for high-output failure in a patient?
Anemia
When a person is in shock, a nurse remembers impairment in cellular metabolism is caused by:
Inadequate tissue perfusion
One consequence of switching from aerobic to anaerobic cellular metabolism during shock states is:
Decrease adenosine triphosphate (ATP) production
A nurse is planning care for a patient in shock. Which principle should the nurse remember? During shock states, glucose uptake is usually:
Impaired
A 50-year-old male was admitted to the intensive care unit with a diagnosis of acute myocardial infarction (MI). He is being treated for shock. His cardiopulmonary symptoms include low blood pressure, tachycardia, and tachypnea. His skin is pale and cool. The primary cause of his shock is most likely:
Decreased cardiac contractility
An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body’s compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing?
Hypovolemic
A 27-year-old male is admitted to a neurologic unit with a complete C-5 spinal cord transection. On initial assessment, he is bradycardic, hypotensive, and hyperventilating. He appears to be going into shock. The most likely mechanism of his shock is:
Vasodilation caused by a decrease in sympathetic stimulation
What factors make a patient prone to neurogenic shock? Neurogenic shock can be caused by any factor that inhibits the:
Sympathetic nervous system
A 15-year-old male who is allergic to peanuts eats a peanut butter cup. He then goes into anaphylactic shock. Which assessment findings will the nurse asses for?
Bronchoconstriction, hives or edema, and hypotension
A nurse is teaching a patient about anaphylactic shock. Which information should the nurse include? The onset of anaphylactic shock is usually:
Immediate and life threatening
For an infection to progress to septic shock, which of the following factors should the nurse determine occurred?
Bacteria must enter the bloodstream
A 20-year-old female is being admitted to the hospital with fever and septic shock. Which set of assessment findings would the nurse expect the patient to exhibit?
Low blood pressure, tachycardia, generalized edema
The hypotensive state seen in septic shock can lead to:
Gut lining disruption and the translocation of bacteria into the bloodstream
Which patient is most prone to multiple organ dysfunction syndrome (MODS)? In a patient with:
Septic shock
A 75-year-old female has been critically ill with multiple organ dysfunction syndrome (MODS) for longer than a week and has developed a severe oxygen supply and demand imbalance. The statement that best describes this imbalance is which of the following?
The reserve has been exhausted, and the amount of oxygen consumed depends on the amount the circulation is able to deliver?
Which organ should the nurse monitor closely since it is often the first to fail in patients with multiple organ dysfunction syndrome (MODS)?
Lungs
Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?
The patient smokes cigarettes
Which of the following lab tests will the nurse check to help diagnose heart failure and provide insight into its severity?
Brain natriuretic
A nurse recalls acute orthostatic hypotension can be caused by (select all that apply):
– Prolonged immobility
– Drug action
– Starvation
– Volume depletion
A patient has been researching cardiac cells on the internet. Which information indicates the patient has a good understanding? Cardiac cells can withstand ischemic conditions for ___ minutes before irreversible cell injury occurs.
20

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