A 26-year-old male client with Hodgkin’s disease is scheduled to undergo radiation therapy. The client expresses concern about the effect of radiation on his ability to have children. What information should the nurse provide?
A. The radiation therapy causes the inability to have an erection.
B. Radiation therapy with chemotherapy causes temporary infertility.
C. Permanent sterility occurs in male clients who receive radiation.
D. The client should restrict sexual activity during radiotherapy.

Muscular dystrophy is characterized by which pathophysiological condition?

A. Stressed induced tremor and trembling.
B. Cardiac damage.
C. Seizure activity.
D. Skeletal muscle degeneration.


The nurse is assessing a postmenopausal woman who is complaining of urinary urgency and frequency and stress incontinence. She also reports difficulty in emptying her bladder. These complaints are most likely due to which condition?

A. Cystocele
B. Bladder infection
C. Pyelonephritis
Irritable bladder
D. Irritable bladder


The parents of a child with hemophilia A ask the nurse about their probability of having another child with hemophilia A. Which information is the basis for the nurse’s response? (Select all that apply.)

A. Autosomal Dominance occurs with this disorder.
B. Sons of female carriers have a 50% chance of inheriting hemophilia.
C. Men with hemophilia have sons who also manifest the disease.
D. The disease occurs in daughters of men with hemophilia.
E. Hemophilia is an X-linked recessive disorder.

B, E

The nurse is assessing an older client and determines that the client’s left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding?

A. Ptosis on the left eyelid.
B. A nystagmus on the left.
C. Astigmatism on the right.
D. Exophthalmos on the right.


A client with a fractured right radius reports severe, diffuse pain that has not responded to the prescribed analgesics. The pain is greater with passive movement of the limb than with active movement by the client. The nurse recognizes that the client is most likely exhibiting symptoms of which condition?
A. Acute compartment syndrome.
B. Fat embolism syndrome.
C. Venous thromboembolism.
D. Aseptic ischemic necrosis.

The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What response is best for the nurse to provide?

A. Provide a more rapid induction of anesthesia.
B. Decrease the risk of bradycardia during surgery.
C. Induce relaxation before the induction of anesthesia.
D. Minimize the amount of analgesia needed postoperatively.


Which signs and symptoms are associated with arterial insufficiency?

A. Pallor, intermittent claudication.
B. Pedal edema, brown pigmentation.
C. Blanched skin, lower extremity ulcers.
D. Peripheral neuropathy, cold extremities.


A client with a markedly distended bladder is diagnosed with hydronephrosis and left hydroureter after an IV pyelogram. This finding supports which pathophysiological cause of the client’s urinary tract obstruction?

A. Obstruction at the urinary bladder neck.
B. Ureteral calculi obstruction.
C. Uteropelvic junction stricture.
D. Partial post-renal obstruction due to ureteral stricture.


Which condition is associated with an over secretion of renin?

A. Hypertension.
B. Diabetes mellitus.
C. Diabetes insipidus.
D. Alzheimer’s disease.


A client is admitted to the ER with a tension pneumothorax. Which assessment findings should the nurse expect to identify?

A. An absence of lung sounds on the affected side.
B. An inability to auscultate tracheal breath sounds.
C. A deviation of the trachea toward the side opposite the pneumothorax.
D. A shift of the point of maximal impulse to the left, with bounding pulses.


A client with aortic valve stenosis develops heart failure. Which pathophysiological finding occurs in the myocardial cells as a result of the increased cardiac workload?
A. Increase in size.
B. Decrease in length.
C. Increase in number.
D. Decrease in excitability.

The nurse is measuring blood pressure on all four extremities of a child with coaction of the aorta. Which blood pressure finding should the nurse expect to obtain?

A. Higher on the left side.
B. Higher on the right side.
C. Lower in the arms than in the legs.
D. Lower in the legs than in the arms.


A deficiency of intrinsic factor should alert the nurse to assess a client’s history for which condition?

A. Emphysema.
B. Hemophilia.
C. Pernicious anemia.
D. Oxalic acid toxicity.


What is the underlying pathophysiologic process between free radicals and destruction of a cell membrane?

A. Inadequate mitochondrial ATP.
B. Enzyme release from lysosomes.
C. Defective chromosomes for protein.
Defective integral membrane proteins.


Which healthcare practice is most important for the nurse to teach a postmenopausal client?

A. Wear layers of clothes if experiencing hot flashes.
B. Use a water-soluble lubricant for vaginal dryness.
C. Consume adequate foods rich in calcium.
D. Participate in stimulating mental exercises.


The nurse is assessing the laboratory results for a client who is admitted with renal failure and osteodystrophy. Which findings are consistent with this client’s clinical picture?

A. Blood urea nitrogen 40 and creatinine 1.0.
B. Cloudy, amber urine with sediment, specific gravity of 1.040.
C. Serum potassium of 5.5 mEq and total calcium of 6 mg/dl.
D. Hemoglobin of 10 g and hypophosphatemia.


A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?

A. Pindolol (visken).
B. Carteolol (ocupress).
C. Meoprolol tartate (Lopressor).
D. Propranolol hydrochloride (Inderal).


1.) The nurse reviews the complete blood count (CBC) findings of an adolescent with acute myelogenous leukemia (AML). The hemoglobin is 13.8 g/dl, hematocrit is 36.7%, white blood cell count is 8,200 mm3, and platelet count is 115,000 mm3. Based on these findings, what is the priority nursing diagnosis for this client’s plan of care?

A. Impaired gas exchange.
B. Risk for infection.
C. Risk for injury.
D. Risk for activity intolerance.


A client who is receiving a whole blood transfusion develops chills, fever, and a headache 30 minutes after the transfusion is started. The nurse should recognize these symptoms as characteristic of what reaction?

A. Mild allergic reaction.
B. Febrile transfusion reaction.
C. Anaphylactic transfusion reaction.
D. Acute hemolytic transfusion reaction.


The nurse is planning care for a client who has a right hemispheric stroke. Which nursing diagnosis should the nurse include in the plan of care?

A. Impaired physical mobility related to right-sided hemiplegia.
B. Risk for injury related to denial of deficits and impulsiveness.
C. Impaired verbal communication related to speech-language deficits.
D. Ineffective coping related to depression and distress about disability.


A mother is crying as she holds and rocks her child with tetanus who is having muscular spasms and crying. After administering diazepam (valium) to the child, what action should the nurse implement?

A. Lay the child down and as the mother to stay near the child in the crib.
B. Encourage the mother to take and break and leave the room to stop crying.
C. Keep all light sources off and close the window blinds to the room.
D. Use calm, reassurance and understanding to comfort the mother.


A client reports unprotected sexual intercourse one week ago and is worried about HIV exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that seroconversion to HIV positive relies on antibody production by B lymphocytes after exposure to the virus. When should the nurse recommend the client return to repeat blood testing?

A. 6 to 18 months.
B. 1 to 12 months.
C. 1 to 18 weeks.
D. 6 to 12 weeks.


What histologic finding in an affected area of the body would suggest the presence of chronic inflammation?

A. Predominance of neutrophils.
B. Absence of fibroblasts and proteases.
C. Decrease in degradation products.
D. Increase in monocytes and macrophages.


The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). This condition is most often related to which predisposing condition?

A. Small cell lung cancer.
B. Active tuberculosis infection.
C. Hodkinae Lymphoma.
D. Tricyclic antidepressant therapy.


A female client tells the nurse that she does not know which day of the month is best to do breast self-exams. Which instruction should the nurse provide?

A. Midway between menstrual cycles.
B. One week before your period.
C. The first day of your period.
D. Five to seven days after menses cease.


Which clinical finding should the nurse identify in a client who is admitted with cardiac cirrhosis?

A. Jaundice
B. Vomiting.
C. Peripheral edema.
D. Left upper quadrant pain.


Physical examination of a comatose client reveals decorticate posturing. Which statement is accurate regarding this client’s status based upon this finding?

A. A cerebral infectious process is causing the posturing.
B. Severe dysfunction of the cerebral cortex has occurred.
C. There is a probable dysfunction of the midbrain.
D. The client is exhibiting signs of a brain tumor.


A middle-aged client asks the nurse what findings from his digital rectal examination (DRE) prompted the HCP to prescribe a repeat serum prostatic surface antigen (PSA) level. What information should the nurse provide?

A. A uniformly enlarged prostate is benign prostatic hypertrophy that occurs with aging.
B. The spongy or elastic texture of the prostate is normal and requires no further testing.
C. An infection is usually present when the prostate indents when a finger is pressed on it.
D. Stony, irregular nodules palpated on the prostate should be further evaluated.


After talking with the HCP, a male client continues to have questions about the results of a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels become elevated. The nurse should explain which pathophysiological mechanism.

A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
B. The PSA levels normally rise and fall, so multiple testing’s over time are necessary.
C. Low PSA levels indicate the prostate gland is not functioning properly.
D. The PSA blood test is used to determine dosage for Viagra prescriptions.


While the nurse obtains a male client’s history, review of systems, and physical examination, the client tells the nurse that his breast drains fluid secretions from the nipple. The nurse should seek further evaluation of which endocrine gland function?

A. Posterior pituitary and testes.
B. Adrenal medulla and adrenal cortex.
C. Hypothalamus and anterior pituitary.
D. Parathyroid and islets of Langerhans.


A male client who has never smoked but has COPD for the past 5 years is now being assessed for cancer of the lung. The nurse knows that he is most likely developing which type of lung cancer?

A. Adenocarcinoma.
B. Oat-cell carcinoma.
C. Malignant melanoma.
D. Squamous-cell carcinoma.


The nurse is analyzing the waveforms of a client’s electrocardiogram. What finding indicates a disturbance in electrical conduction in the ventricles?

A. T wave of 0.16 second.
B. PR interval of 0.18 second.
C. QT interval of 0.34 second.
D. QRS Interval of 0.14 second.


The nurse is caring for a client who had an excision of a malignant pituitary tumor. Which findings should the nurse document that indicate the client is developing syndrome of inappropriate antidiuretic hormone (SIADH)?

A. Hypernatremia and periorbital edema.
B. Muscle spasticity and hypertension.
C. Weight gain and low serum sodium.
D. Increased urinary output and thirst.


The nurse is teaching a client with maple syrup urine disease (MSUD), an autosomal recessive disorder, about the inheritance pattern. What information should the nurse provide?

A. This recessive disorder is carried only on the X chromosome.
B. Occurrences mainly effect males and heterozygous females.
C. Both genes of a pair must be abnormal for the disorder to occur
D. One copy of the abnormal gene is required for this disorder.


Which reaction should the nurse identify in a client who is responding to stimulation of the sympathetic nervous system?

A. Pupil constriction.
B. Increased heart rate.
C. Bronchial constriction.
D. Decreased blood pressure.


A client is brought to the emergency center after a snow-skiing accident. Which intervention is most important for the nurse to implement?

A. Review the electrocardiogram tracing.
B. Obtain blood for coagulation studies.
C. Apply a warming blanket.
D. Provide heated PO fluids.


The severity of diabetic retinopathy is directly related to which condition?

A. Poor blood glucose control.
B. Neurological effects of diabetes.
C. Susceptibility to infection.
D. Uncontrolled hypertension


The nurse hears short, high-pitched sounds just before the end of inspiration in the right and left lower lobes when ausculatating a client’s lungs. How should this finding be recorded?

A. Inspiratory wheezes in both lungs.
B. Crackles in the right and left lower lobes.
C. Abnormal lung sounds in the bases of both lungs.
D. Pleural friction rubs in the right and left lower lobes.


A client’s family asks why their mother with heart failure needs a pulmonary artery catheter now that she is in ICU. What information should the nurse include in the explanation to the family?

A. A central monitoring system reduces the risk of complications undetected by observation.
B. A pulmonary artery catheter measures central pressures for monitoring fluid replacement.
C. Pulmonary artery catheters allow for early detection of lung problems.
D. The healthcare provider should explain the many reasons for its use.


The nurse is assessing a client with a ruptured small bowel and determines that the client has a temperature of 102.8. which assessment finding provides the earliest indication that the client is experiencing septic shock?

A. Bilateral crackles.
B. Hyperpnea.
C. Mucus production.
D. Weak peripheral pulses.


A nurse is planning to teach self-care measures to a female client about prevention of yeast infections. Which instructions should the nurse provide?

A. Use of a douche preparation no more than once a month.
B. Increase daily intake of fiber and leafy green vegetables.
C. Select nylon underwear that is loose-fitting, white, and comfortable.
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.


Several hours after surgical repair of an abdominal aortic aneurysm, the client develops left flank pain. The nurse determines the client’s urinary output is 20 ml/hr for the past two hours. The nurse should conclude that these findings support which complication.

A. Infection
B. Hypovolemia.
C. Intestinal ischemia.
D. Renal artery embolization.


The nurse is caring for a client with syndrome of inappropriate antiduretic hormone (SIADH), which is manifested by which symptoms?

A. Loss of thirst, weight gain.
B. Dependent edema, fever.
C. Polydipsia, polyuria.
D. Hypernatremia, tachypnea.


What information should the nurse include in a teaching plan about the onset of menopause? (Select all that apply).

A. Smoking.
B. Oophorectomy and hysterectomy.
C. Early menarche.
D. Cardiac disease.
E. Genetic influence.
F. Chemotherapy exposure.

A, B, C, E, F

Which client is at the highest risk for chronic kidney disease, secondary to diabetes mellitus?

A. Type 1 DM and a serum hemoglobin-A1c of 3.5%.
B. Type 1 DM and retinopathy and mild vision loss.
C. Type 2 DM and hypertension controlled by metoprolol.
D. Type 2 DM and a history of morbid obesity for 5 years.


When observing a client for symptoms of a large bowel obstruction, the nurse should assess for which finding?
A. Distention of the lower abdomen.
B. Nausea and profuse vomiting.
C. Upper abdominal discomfort.
D. Fluid and electrolyte imbalances.

Which rationale best supports an older client’s risk of complications related to a dysrhythmia?

A. An older client usually lives alone and cannot summon help when symptoms appear.
B. An older client is more likely to eat high-fat diets which predisposes to heart disease.
C. Cardiac symptoms, such as confusion, are more difficult to recognize in an older client.
D. An older client is intolerant of decreased cardiac output which may cause dizziness and falls.


Which pathophysiological response supports a client’s vomiting experience?

A. Sensory input of noxious stimuli relayed to the cognitive centers is associated with disgust and illicit vomiting.
B. Response of stimulation of the posterior oropharynx results in reverse peristalsis of the gastrointestinal tract.
C. Spasmodic reflex of respiratory and gastric movements results from stimulation of the chemoreceptor trigger zone.
D. Increased gastric and colonic pressures move gastrointestinal contents to the orifice of least resistance.


A man who was recently diagnosed with Huntington’s disease asks the nurse if his adolescent son should be tested for the disease. What response is best for the nurse to provide?

A. Autosomal dominant disorders, such as Huntington’s, cannot be inherited.
B. Testing is needed because there is a 50 percent risk of passing the gene to each offspring.
C. Genetic counselling should be provided to ensure an informed decision by the family.
D. Positive genetic testing may contribute to insurance discrimination that denies coverage.


A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides definitive information that the nurse should report to the HCP? Lung Tissue Biopsy (http://en.wikipedia.org/wiki/Sarcoidosis) A 58y/o client who has been post-menopausal for 5 years is concerned …

A registered nurse is assigned to a step-down coronary care unit with 20 clients in various stages of recovery. What is the primary consideration in assigning the unit staff that includes 2 RNs, 2 LPNs, and 1 CNA. A. Distance …

The nurse observes that a male client has removed the covering from an ice pack applied to his knee. what action should the nurse take first? observe the appearance of the skin under the ice pack The nurse mixes 50 …

The charge nurse working the 3 to 11 shift of a 24-bed medical unit in a large acute care hospital is making assignments. Currently, there are 20 clients on the unit and 4 admissions are scheduled to arrive during the …

Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? Client states chest pain is relieved. Following heparin treatment for a pulmonary …

1. A 12-year-old female is seen by the school nurse after recently experiencing increasing difficulty sitting and paying attention in class, and increasingly illegible handwriting. The nurse observes that the child has protruding eyeballs and a staring expression. What action …

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