NSG530 / NSG 530 Exam 4 V1| Latest 2026/2027 Update | Advanced Pathophysiology | Wilkes | Practice Questions & Accurate Solutions

NSG530 / NSG 530 Exam 4 V1| Latest 2026/2027 Update | Advanced Pathophysiology | Wilkes | Practice Questions & Accurate Solutions Q: It is TRUE that the specificity theory of pain: A. focuses on the attention of pain. B. focuses on previous experience of pain. C. relates the amount of pain to the amount of soft tissue injury. D. relates to the emotions exhibited toward pain. C. relates the amount of pain to the amount of soft tissue injury. Q: Which pair of structures regulates the complex emotional responses to pain? A. Frontal and cerebellar lobes B. Limbic and reticular system C. Thalamus and brainstem D. Midbrain and nuclei of thalamus B. Limbic and reticular system Q: Which activity has been documented to increase the levels of circulating endogenous endorphins? A. Cough B. Stress C. Sleep D. Pain B. Stress Q: The appropriate definition of perceptual dominance is: A. the duration of time or intensity of pain before overt pain responses are initiated. B. pain at one location that may cause an increase in threshold at another location. C. repeated exposure to a pain stimulus. D. the point at which pain is perceived. B. pain at one location that may cause an increase in threshold at another location. Q: The appropriate term for pain that is present in an area distant from its point of origin is: A. acute pain. B. chronic pain. C. referred pain. D. somatic pain. C. referred pain. Q: Which mechanism does not result in heat loss? A. Increased respiration B. Conduction C. Convection D. Vasoconstriction D. Vasoconstriction Q: A benefit of fever to human blood includes: A. decreased lymphocytic transformation. B. diminished phagocytosis. C. increased iron concentration. D. a switch to lipolysis and proteolysis. D. a switch to lipolysis and proteolysis. Q: A patient who was outside on a summer day and is now experiencing increased sweating and thirst, weakness, and dizziness is exhibiting signs of: A. heat cramps. B. heat exhaustion. C. hyperthermic stroke. D. malignant hyperthermia. B. heat exhaustion. Q: An obese male presents to a sleep clinic complaining of difficulty sleeping. He reports that he wakes gasping for air. Which is the most likely diagnosis for this patient? A. Primary hypersomnia B. Parasomnia C. Somnambulism D. Obstructive sleep apnea D. Obstructive sleep apnea Q: Involuntary unilateral or bilateral rhythmic movement of the eyes is referred to as: A. nystagmus. B. amblyopia. C. glaucoma. D. strabismus. A. nystagmus. Q: A young child presents with redness of the eyes. The parents indicate that this condition seems to be "going around" the daycare. Which is the most likely diagnosis? A. Blepharitis B. Keratitis C. Trachoma D. Conjunctivitis D. Conjunctivitis Q: Which type of hearing loss is a result of foreign body obstruction of the middle ear? A. Conductive B. Sensorineural C. Functional D. Presbycusis A. Conductive Q: A patient who reports that "everything tastes unpleasant" is exhibiting symptoms of: A. hyposmia. B. anosmia. C. hypogeusia. D. dysgeusia. D. dysgeusia. Q: Endogenous opioids include: (select all that apply) A. enkephalins. B. endorphins. C. dynorphins. D. endomorphins. E. denkephalins. A. enkephalins. B. endorphins. C. dynorphins. D. endomorphins. Q: The classification of acute pain includes: (select all that apply) A. acute visceral. B. pleuritic. C. referred. D. acute somatic. E. cutaneous. A. acute visceral. C. referred. D. acute somatic. E. cutaneous. Q: It is correct to assume that Cheyne-Stokes respirations (CSR): A. involve a pathological pattern of crescendo- decrescendo. B. result in hypocapnia and increased ventilatory stimulus. C. cause changes in PaO2 that produce irregular breathing. D. increase PaCO2 level when overbreathing occurs A. involve a pathological pattern of crescendo- decrescendo. Q: A patient often experiences vomiting with a central nervous system (CNS) injury when the trauma: A. impinges directly on the floor of the third ventricle. B. causes a decrease in intracranial pressure. C. involves the vestibular nuclei. D. also involves the abdominal area. C. involves the vestibular nuclei. Q: Pinhole-sized pupils can be a result of an overdose of: A. atropine. B. scopolamine. C. opiates. D. amphetamines. C. opiates. Q: A patient has sustained a traumatic brain injury but is able to follow simple commands and can manipulate objects. The term used to describe this state is: A. coma B. vegetative C. minimally conscious D. locked-in syndrome C. minimally conscious A patient experiencing the tonic phase of a seizure exhibits: A. muscle contraction with increased muscle tone. B. alternating contraction and relaxation of muscle. C. muscle contraction alternating with placidity. D. complete paralysis. A. muscle contraction with increased muscle tone. A patient who reports a loss of childhood memories is describing a characteristic of: A. selective attention deficit. B. retrograde amnesia. C. anterograde amnesia. D. executive attention deficits. B. retrograde amnesia. A patient who is experiencing difficulty in recognizing a pattern's form and the nature of objects is exhibiting characteristics of: A. agnosia. B. aphasia. C. dysphasia. D. Alzheimer disease. A. agnosia. A patient who is experiencing a loss of comprehension or the production of language is described as having: A. dysphasia. B. aphasia. C. expressive dysphasia. D. transcortical dysphasia. A. dysphasia. A patient who was admitted to a postsurgical unit 2 days ago is now demonstrating progressive restlessness and is uncharacteristically irritable. This scenario is characteristic of: A. Alzheimer disease. B. dementia. C. delirium. D. coma. C. delirium. It is TRUE that Alzheimer disease is: A. an uncommon neurologic disorder. B. not believed to have a genetic relationship. C. a result of neuronal proteins becoming distorted and tangled. D. the cause of plaques increasing nerve impulse transmission. C. a result of neuronal proteins becoming distorted and tangled. The term used to describe a patient who sustains a cerebrovascular accident and the limbs are paralyzed on an entire side is: A. hemiplegia. B. paraplegia. C. diplegia. D. quadriplegia. A. hemiplegia. A patient who exhibits positioning that includes both arms being held close to the body with flexion at the elbows while legs are extended and rotated externally is demonstrating: A. decerebrate posture. B. spastic posture. C. decorticate posture. D. basal ganglion posture. C. decorticate posture A patient is diagnosed with Huntington disease. Which of the following is a TRUE statement? Huntington's disease is: A. a commonly diagnosed neurological disorder. B. a nonhereditary disease. C. also known as chorea. D. asymptomatic until the sixth decade of life. C. also known as chorea. A patient diagnosed with Parkinson disease initially experiences: A. difficulty walking. B. resting tremors. C. postural instability. D. rigidity of leg muscles. B. resting tremors. A patient presents with a wide-based gait in which the feet are turned outward. Staggering is noted when walking and the pelvis is held stiff. These characteristics are representative of: A. cerebellar gait. B. basal ganglion gait. C. decorticate posture. D. apraxia. A. cerebellar gait. A basic neural system essential to cognitive function would include: (select all that apply) A. attentional systems. B. memory systems. C. affective or emotive systems. D. sensory systems. E. language systems. A. attentional systems. B. memory systems. C. affective or emotive systems. E. language systems. Abnormal findings in which of the following evaluations would indicate possible neurologic dysfunction? (select all that apply) A. Level of consciousness B. Pattern of breathing C. Decreased gastrointestinal motility D. Eye response E. Motor responses A. Level of consciousness B. Pattern of breathing D. Eye response E. Motor responses Criteria for determining brain death include: (select all that apply) A. unresponsive coma. B. no spontaneous respiration. C. isoelectric EEG. D. pupils are reactive but unequal. E. ocular response to head turning. A. unresponsive coma. B. no spontaneous respiration. C. isoelectric EEG. A means of classifying a seizure includes: (select all that apply) A. clinical manifestations. B. site of origin. C. response to therapy. D. length of activity. E. EEG correlates. A. clinical manifestations. B. site of origin. C. response to therapy. E. EEG correlates. A characteristic of Alzheimer disease includes: (select all that apply) A. rapid onset of symptomatology. B. short-term memory loss. C. increased irritability and agitation. D. anxiety and depression. E. remissions resulting in cognitive clarity. B. short-term memory loss. C. increased irritability and agitation. D. anxiety and depression. The person at highest risk for traumatic brain injury (TBI) is: A. black and economically disadvantaged. B. male and disabled. C. female and 20 years of age. D. an economically advantaged young adult. A. black and economically disadvantaged. The most common cause of TBI is: A. motor vehicle accidents. B. falls. C. sports-related events. D. violence. A. motor vehicle accidents. A trauma patient diagnosed with a brain contusion experiences changes in attention, memory, affect, and emotion. In which region of the brain is the contusion most likely located? A. Cerebral B. Frontal C. Cerebellum D. Midbrain B. Frontal After a fall at home, an elderly patient experiences a hematoma located on the top of the brain. The hematoma is most likely: A. subdural. B. epidural. C. extradural. D. intracerebral. A. subdural. A patient is hit in the temporal portion of his skull. Although initial loss of consciousness occurs, the patient soon awakens and is conversant. Three hours later vomiting, drowsiness, and confusion are noted. These symptoms are most likely related to which type of brain injury? A. Diffuse axonal B. Intracerebral C. Subdural D. Epidural D. Epidural A patient experiences a vertebral fracture in which the C1 vertebra is fractured into several fragments. This type of fracture can be described as: A. simple. B. compressed. C. comminuted. D. dislocation. C. comminuted. It is TRUE that spinal shock: A. is characterized by an incomplete loss of reflex function. B. involves all skeletal muscles below the level of injury. C. causes increased muscle tone below the lesion. D. results in no disruption of thermal control. B. involves all skeletal muscles below the level of injury. A patient is experiencing pain that courses over the buttocks and into the calf and ankle. This is suggestive of a herniated disk at which vertebral level? A. Cervical B. Thoracic C. Lumbar D. Coccyx C. Lumbar It is true that an acute cerebrovascular accident (CVA) is: A. the leading cause of disability in the United States. B. the fifth most common cause of death in the United States. C. very likely to be followed by a second stroke within 1 year. D. experienced by 2 million individuals each year. A. the leading cause of disability in the United States. Which is correct regarding hemorrhagic strokes? They: A. are the most common cause of CVA. B. account for 50% of all CVAs. C. are commonly caused by hypertension. D. are often the result of a microinfarct. C. are commonly caused by hypertension. Which is accurate regarding subarachnoid hemorrhages? They are: A. a particular risk for individuals with an intracranial aneurysms. B. seldom experienced in individuals with hypertension. C. a result of vasospasms not caused by trauma to the head. D. rarely fatal and result in minor cognitive impairments A. a particular risk for individuals with an intracranial aneurysms. Which of the following statements is TRUE regarding grading of the astrocytoma? A. Grade I is not treated. B. Grade II is treated with radiation only. C. Grades III and IV are treated with surgery. D. Grade III is not well circumscribed. C. Grades III and IV are treated with surgery. It is correct to assume that Grade III and Grade IV astrocytomas are: A. commonly found in the frontal lobe and cerebral hemisphere. B. generally seen more in women than in men. C. usually necrotic as a result of an absence of vascularity. D. bluish gray in color with a hard purplish center. A. commonly found in the frontal lobe and cerebral hemisphere. Which is TRUE regarding metastatic brain tumors? A. Carcinomas are disseminated to the brain from the circulation. B. One-third of metastatic tumors are located within the brain. C. Two-thirds of metastatic tumors are located in the extradural spaces. D. Tumors of the pelvis tend to involve the frontal lobe. A. Carcinomas are disseminated to the brain from the circulation. Which is TRUE regarding meningitis? A. Bacterial meningitis is a primary infection of the gray matter. B. Aseptic meningitis is most commonly caused by a fungus. C. Fungal meningitis is the most common form worldwide. D. Tubercular meningitis has a 90% recovery rate, if diagnosed early. D. Tubercular meningitis has a 90% recovery rate, if diagnosed early. A patient has a brain abscess with a decreased necrotic center and mature collagen. This is most consistent with which stage? A. Early cerebritis B. Late cerebritis C. Early capsule formation D. Late capsule formation C. Early capsule formation It is TRUE that encephalitis is: A. an afebrile illness lasting 1 week. B. caused by bacteria transmission. C. a result of arthropod-borne viruses. D. caused exclusively by herpes simplex II. C. a result of arthropod-borne viruses. A patient experiences demyelination of the peripheral nerves with sparing of the axons. This is characteristic of: A. Alzheimer disease. B. Guillain-Barré. C. myasthenia gravis. D. amyotrophic lateral sclerosis (ALS). B. Guillain-Barré. A patient is brought to the emergency room following a motor vehicle accident in which a diffuse brain injury is sustained. Which symptoms would be expected to accompany the injury? (select all that apply) A. Memory deficits B. Swallowing disorders C. Agitation D. Fatigue E. Short attention span A. Memory deficits B. Swallowing disorders C. Agitation E. Short attention span Risk factors for a CVA include: (select all that apply) A. obesity. B. smoking. C. diabetes. D. arterial hypertension. E. atrial fibrillation. B. smoking. C. diabetes. D. arterial hypertension. E. atrial fibrillation. A patient is diagnosed with a meningioma. The most likely site of the tumor is the: (select all that apply) A. sella turcica. B. olfactory groove. C. tuberculum sellae. D. sphenoidal wing. E. cerebellopontine angle. A. sella turcica. B. olfactory groove. C. tuberculum sellae. D. sphenoidal wing. E. cerebellopontine angle. A cause of a cerebral aneurysm includes: (select all that apply) A. arteriosclerosis. B. heroin abuse. C. congenital anomaly. D. trauma. E. cocaine abuse. A. arteriosclerosis. . C. congenital anomaly. D. trauma. E. cocaine abuse. At birth, a newborn has separations in the skull that contain unossified membranous tissue. These structures are referred to as: A. sutures. B. fontanels. C. Schwann cells. D. myelins. B. fontanels. An anomaly in which the soft, bony components of the skull and part of the brain are missing is called a(n): A. anencephaly. B. cyclopia. C. encephalocele. D. meningocele. A. anencephaly. A patient has a hernial protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a deficit in the spinal column. This condition is described as a(n): A. encephalocele. B. meningocele. C. myelomeningocele. D. Arnold-Chiari malformation. C. myelomeningocele. The appropriate term for premature closure of one or more cranial sutures during the first 18-20 months of life is: A. acrania. B. craniosynostosis. C. microcephaly. D. congenital hydrocephalus B. craniosynostosis. A child presents with congenital hydrocephalus. Upon tapping of his skull, a resonant sound is appreciated, which is referred to as: A. Macewen sign. B. sunsetting. C. Dandy-Walker deformity. D. Arnold-Chiari malformation A. Macewen sign. A patient diagnosed with cerebral palsy exhibits increased muscle tone, prolonged primitive reflexes, scoliosis, and contractures. These are characteristic signs of a form of cerebral palsy called: A. spastic. B. dyskinetic. C. ataxic. D. mixed variety A. spastic. A patient recovering from varicella-zoster experiences obtundation, coma, and hyperventilation and is diagnosed with Reye syndrome. Which stage of the syndrome is this patient experiencing? A. Stage I B. Stage II C. Stage III D. Stage IV C. Stage III A newborn develops bacterial meningitis. The most common bacteria that cause this is: A. Escherichia coli. B. Haemophilus influenzae type B. C. Neisseria meningitidis. D. Streptococcus pneumoniae. A. Escherichia coli. Pathology reports indicate that a child's brain tumor developed in the vermis of the cerebellum and extended into the fourth ventricle. The tumor is most likely a(n): A. medulloblastoma. B. ependymoma. C. cerebellar astrocytoma. D. brainstem glioma. A. medulloblastoma. Environmental factors that affect the development of a fetus's neural tube include: (select all that apply) A. maternal nutrition. B. maternal exposure to toxins. C. alcohol consumption by the mother. D. paternal abuse of drugs. E. birth in an urban setting. A. maternal nutrition. B. maternal exposure to toxins. C. alcohol consumption by the mother. A nurse is discussing endocrine system dysfunction with a patient. Which statement indicates the patient understood? Endocrine system dysfunction can result from hyposecretion, hypersecretion, or from: a. Abnormal receptor activity b. Abnormal hormone levels c. Increased synthesis of second messengers d. Extracellular electrolyte alterations a. 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? a. Autoimmune disease b. Cancer c. Pregnancy d. Heart failure b. 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? a. Hyponatremia b. Hyperkalemia c. Hypernatremia d. Hypokalemia a. 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? a. Peripheral edema b. Tachycardia c. Low blood pressure d. Concentrated urine d. Concentrated urine A nurse is caring for a patient with SIADH. What severe complication should the nurse assess for? a. Stroke b. Diabetes insipidus c. Neurologic damage d. Renal failure c. 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? a. Dilutional hyponatremia b. Dehydration from polyuria c. Cardiac arrest from hyperkalemia d. Metabolic acidosis b. 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. a. Neurogenic b. Nephrogenic c. Psychogenic d. Allogenic b. Nephrogenic Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following assessment manifestations? a. Polyuria b. Edema c. Vomiting and abdominal cramping d. Thirst d. 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? a. Neurogenic diabetes insipidus b. Psychogenic diabetes insipidus c. Nephrogenic diabetes insipidus d. SIADH a. 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: a. Anterior pituitary b. Posterior pituitary c. Pars intermedia d. Pituitary stalk d. 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. A pituitary adenoma b. Hypothalamic hyposecretion c. Hypothalamic inflammation d. Pheochromocytoma a. A pituitary adenoma What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma? a. Coma b. Visual disturbances c. Confused states d. Breathing abnormalities b. 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? a. High levels of circulating thyroid-stimulating antibodies b. Ectopic secretion of thyroid-stimulating hormone (TSH) c. Low circulating levels of thyroid hormones d. Increased circulation of iodine a. 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: a. Low b. High c. Variable d. Absent b. 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? a. Weight gain, cold intolerance b. Slow heart rate, rash c. Skin hot and moist, rapid heart rate d. Constipation, confusion c. Skin hot 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: a. Decreased blood flow to the eye b. Orbital edema and protrusion of the eyeball c. TSH neurotoxicity to retinal cells d. Local lactic acidosis b. 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: a. A normal-sized thyroid b. A small discrete thyroid nodule c. Multiple discrete thyroid nodules d. Diffuse thyroid enlargement d. Diffuse thyroid enlargement A 22-year-old female has a low level of TSH. What condition does the nurse expect the patient is experiencing? a. Primary hypothyroidism b. Secondary hypothyroidism c. Autoimmune hypothyroidism d. Atypical hypothyroidism b. Secondary hypothyroidism While planning care for a patient with hypothyroidism, which principle should the nurse remember? The basal metabolic rate is unusually _____ with hypothyroidism. a. High b. Low c. Steady d. Variable b. 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 nurses best response? If left untreated, the child would have: a. Mental retardation and stunted growth b. Increased risk of childhood thyroid cancer c. Hyperactivity and attention deficit disorder d. Liver, kidney, and pancreas failure a. 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. a. High b. Low c. Normal d. Variable c. Normal What problem should the nurse assess for in a patient with chronic hyperparathyroidism? a. Seizure disorders b. Vitamin D malabsorption c. Hyponatremia d. Osteoporosis and pathologic fractures d. Osteoporosis 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 probable reason for her low serum calcium is: a. Hyperparathyroidism secondary to Graves disease b. Myxedema secondary to surgery c. Hypoparathyroidism caused by surgical injury to the parathyroid glands d. Hypothyroidism resulting from lack of thyroid replacement c. 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 patients serum calcium is low. The nurse should observe the patient for which of the following signs/symptoms? a. Muscle weakness and constipation b. Laryngeal spasms and hyperreflexia c. Abdominal pain and fever d. Anorexia, nausea, and vomiting b. Laryngeal spasms and hyperreflexia When a patient wants to know what most commonly causes hypoparathyroidism, how should the nurse reply? It is most commonly caused by: a. Pituitary hyposecretion b. Parathyroid adenoma c. Parathyroid gland injury d. Hypothalamic inactivity c. 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? a. Decreased IGF-1 b. Hypotension c. Sexual dysfunction d. Height increases c. 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 prolactinoma. Which of the following treatments would the nurse help implement? Administering: a. Dopaminergic agonists b. Calcium c. Insulin d. Radiation a. Dopaminergic agonists A 12-year-old female is newly diagnosed with type 1 DM. When the parents ask what causes this, what is the nurses best response? a. A familial, autosomal dominant gene defect b. Obesity and lack of exercise c. Immune destruction of the pancreas d. Hyperglycemia from eating too many sweets c. 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? a. Fasting plasma glucose levels b. Random serum glucose levels c. Genetic testing d. Glycosylated hemoglobin measurements a. 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? a. Recurrent infections, visual changes, fatigue, and paresthesias b. Polydipsia, polyuria, polyphagia, and weight loss c. Vomiting; abdominal pain; sweet, fruity breath; dehydration; and Kussmaul breathing d. Weakness, vomiting, hypotension, and mental confusion b. 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? a. Increased glucose utilization causes the shift of fluid from the intravascular to the intracellular space. b. Decreased insulin causes hyperglycemia and osmotic diuresis. c. Increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte loss. d. Increased insulin use results in protein catabolism, tissue wasting, and electrolyte loss. b. Decreased insulin causes hyperglycemia and osmotic diuresis. A nurse is reviewing lab results for glycosylated hemoglobin (hemoglobin A1c) levels. A nurse recalls the purpose of this test is to: a. Measure fasting glucose levels. b. Monitor long-term serum glucose control. c. Detect acute complications of diabetes. d. Check for hyperlipidemia. b. 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: a. Insulin deficiency b. Hyperinsulinemia c. Glucagon deficiency d. Liver dysfunction b. 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? a. Increased insulin levels promote protein breakdown and ketone formation. b. Her uncontrolled diabetes has led to renal failure. c. Low serum insulin promotes lipid storage and a corresponding release of ketones. d. Insulin deficiency promotes lipid metabolism and ketone formation. d. 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: a. Hyperglycemia resulting from incorrect insulin administration b. Dawn phenomenon caused by eating a snack before gym class c. Hypoglycemia caused by increased exercise d. Somogyi effect caused by insulin sensitivity c. 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? a. Atherosclerosis b. Metabolic alkalosis c. Elevated liver enzymes d. Anemia a. Atherosclerosis 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: a. Pancreatic changes b. Hyperglycemia c. Ketone toxicity d. Hyperinsulinemia b. Hyperglycemia A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of: a. ADH b. Cortisol c. Adrenocorticotropic hormone (ACTH) d. Aldosterone c. Adrenocorticotropic hormone (ACTH) Which of the following alterations would the nurse expect to find in a patient with untreated Cushing disease or syndrome? a. Bradycardia b. Tachypnea c. Hyperkalemia d. Hypertension d. Hypertension When a nurse is assessing the physical features of individuals with Cushing syndrome, these findings will include: a. Weight loss and muscle wasting b. Truncal obesity and moon face c. Pallor and swollen tongue d. Depigmented skin and eyelid lag b. 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? a. Renal toxicity b. Episodes of hypoglycemia c. Hypotension d. Type 2 DM d. 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: a. An autoimmune reaction b. Dietary deficiency of sodium and potassium c. Cancer d. Viral infection of the pituitary gland a. An autoimmune reaction A 50-year-old female presents with lightheadedness and overall abnormal feelings. Hyperaldosteronism is diagnosed. Which of the following symptoms would the nurse expect? a. Hypovolemia b. Hypotension c. Hypokalemia d. Hyponatremia c. Hypokalemia A 49-year-old female is diagnosed with hypercortisolism. Which of the following would the nurse expect? a. Weight loss b. Hypoglycemia c. Decreased urination d. Osteoporosis d. Osteoporosis The bodys inability to conserve water and sodium when affected by Addison disease is explained by which of the following conditions? a. Elevated levels of cortisol b. Decreased levels of ACTH c. Hypersecretion of ADH d. Aldosterone deficiency d. Aldosterone deficiency A patient with Addison disease has weakness and easy fatigability. A nurse recalls this is due to: a. Hyperkalemia b. Hypoglycemia c. Hypocortisolism d. Metabolic acidosis c. Hypocortisolism What is the cause of the hyperpigmentation seen in people with Cushing syndrome? a. Abnormal levels of cortisol b. Permissive effects of aldosterone when cortisol levels are altered c. Elevated levels of ACTH d. Hypersensitivity of melanocytes with sun exposure c. 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? a. Addison disease b. Conn disease c. Cushing disease d. Pheochromocytoma d. Pheochromocytoma A nurse wants to determine if there is kidney dysfunction in a patient with diabetes. Which of the following is the earliest manifestation? a. Polyuria b. Glycosuria c. Microalbuminuria d. Decreased glomerular filtration c. 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? a. Renal disease b. Stroke c. Cardiovascular disease d. Cancer c. Cardiovascular disease A nurse is assessing a patient with hypoparathyroidism. Clinical manifestations of hypoparathyroidism include (select all that apply): a. Tetany b. Chvostek sign c. Trousseau sign d. Oily skin e. Hair loss a. Tetany b. Chvostek sign c. Trousseau sign e. Hair loss A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be: a. Pale in color b. Present in various sizes c. Able to assume various shapes d. Live only a few days REF: p. 501 c. Able to assume various shapes REF: p. 501 A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart? a. Iron deficiency anemia b. Pernicious anemia c. Sideroblastic anemia d. Hemolytic anemia b. Pernicious anemia REF: p. 502 When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes: a. Hyperchromic b. Hypochromic c. Macrocytic d. Microcytic b. Hypochromic REF: p. 501 A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has? a. Sideroblastic anemia b. Hemolytic anemia c. Pernicious anemia d. Iron deficiency anemia b. Hemolytic anemia REF: p. 501 After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes? a. Increased viscosity of blood b. Decreased cardiac output c. Altered coagulation d. Hyperdynamic circulatory state d. Hyperdynamic circulatory state REF: p. 501 A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations should the nurse expect? a. Movement of fluid into the cell b. Decreased cardiac output c. Decreased oxygen release from hemoglobin d. Peripheral vasoconstriction d. Peripheral vasoconstriction REF: p. 501 A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness, and fatigue with exertion. Which of the following respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand? a. Bronchoconstriction b. Increased rate and depth of breathing c. Dyspnea d. Activation of the renin-angiotensin response b. Increased rate and depth of breathing REF: p. 501 A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear suggests the deficiency is macrocytic and normochromic. The nurse would expect the hemoglobin to be: a. Normal b. Sporadic c. Low d. High a. Normal REF: p. 501 A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is: a. Defective DNA synthesis b. Abnormal synthesis of hemoglobin c. Defective use of vitamin C d. Blocked protein synthesis a. Defective DNA synthesis A 40-year-old male vegetarian is diagnosed with folate deficiency anemia. He reports that he is an alcoholic. Which of the following factors put him at greatest risk for developing his disease? a. Being vegetarian b. Being alcoholic c. Age d. Gender b. Being alcoholic REF: p. 503 A 65-year-old male experienced loss of appetite, weight loss, lemon-yellow skin, liver enlargement, and a beefy red tongue shortly before his death. Autopsy suggested pernicious anemia, and the cause of death would most likely reveal: a. Brain hypoxia b. Liver hypoxia c. Heart failure d. Kidney failure c. Heart failure REF: p. 503 Which of the following individuals should the nurse assess first for a vitamin B12 deficiency anemia? a. 3-year-old female who is a fussy eater b. 26-year-old female in the second trimester of her first pregnancy c. 47-year-old male who had a gastrectomy procedure (removal of the stomach) d. 64-year-old male with a history of duodenal ulcers and gastrointestinal bleeding c. 47-year-old male who had a gastrectomy procedure (removal of the stomach) REF: p. 503 When a patient wants to know why vitamin B12 and folate deficiencies cause anemia, how should the nurse respond? a. Red blood cells are unable to differentiate into erythrocytes. b. Red blood cells have malformed hemoglobin molecules. c. Red blood cells have decreased O2-carrying capacity. d. Red blood cells have a shorter life span. d. Red blood cells have a shorter life span. REF: p. 506 A 20-year-old female undergoes lab testing for anemia. Results show high iron, bilirubin, and transferrin and low hemoglobin and hematocrit. Which of the following is the most likely diagnosis to be documented on the chart? a. Pernicious anemia b. Folate deficiency anemia c. Iron deficiency anemia d. Sideroblastic anemia d. Sideroblastic anemia A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause. a. Ferritin b. Gastric enzymes c. Intrinsic factor d. Erythropoietin c. Intrinsic factor How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia? a. Administer radioactive cobalamin and measure its excretion in the urine. b. Measure antigen-antibody immune complexes. c. Measure serum ferritin and total iron-binding capacity. d. Administer folate and evaluate folate content in a blood serum sample. a. Administer radioactive cobalamin and measure its excretion in the urine. REF: p. 503 A 67-year-old female has chronic gastrointestinal bleeding. A nurse recalls the primary cause of her anemia is: a. Vitamin B12 deficiency b. Iron deficiency c. Folate deficiency d. Bone marrow failure b. Iron deficiency A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These assessment findings are consistent with which type of anemia? a. Posthemorrhagic anemia b. Iron deficiency anemia c. Aplastic anemia d. Hemolytic anemia d. Hemolytic anemia REF: p. 501 A 57-year-old male presents to his primary care provider for red face, hands, feet, ears, and headache and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating: a. Polycythemia vera (PV) b. Leukemia c. Sideroblastic anemia d. Hemosiderosis a. Polycythemia vera (PV) REF: p. 506 A 58-year-old female presents in the clinic presenting with fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit, a high mean corpuscular volume, and normal plasma iron. These assessment findings are consistent with which type of anemia? a. Hemolytic anemia b. Pernicious anemia c. Iron deficiency anemia d. Aplastic anemia b. Pernicious anemia A nurse recalls posthemorrhagic anemia can result in death when a patient's blood loss is in excess of: a. 20% to 29% b. 30% to 39% c. 40% to 49% d. 50% to 59% c. 40% to 49% REF: p. 506 A nurse is preparing to teach the staff about aplastic anemia. Which information should the nurse include? Aplastic anemia is caused by: a. Iron deficiency b. Excess levels of erythropoietin c. Hemolysis d. Stem cell deficiency d. Stem cell deficiency REF: p. 506 The nurse will check which of the following tests to directly measure iron stores? a. Serum ferritin b. Transferrin saturation c. Bone marrow biopsy d. Total iron-binding capacity c. Bone marrow biopsy REF: p. 504 A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur? a. Bronze colored skin b. Decreased iron c. Normochromic erythrocytes d. Aplastic bone marrow a. Bronze colored skin REF: p. 505 A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit? a. Hyperactivity b. Spoon-shaped nails c. Gait problems d. Petechiae b. Spoon-shaped nails REF: p. 504 A 45-year-old male is diagnosed with sideroblastic anemia. When he asks what the most likely cause of this disease is, what is the nurse's best response? a. Ineffective iron uptake and abnormal hemoglobin production b. Misshapen erythrocytes with low hemoglobin c. Decreased levels of tissue iron with megaloblastic erythrocytes d. Premature erythrocyte destruction and erythropoietin deficiency a. Ineffective iron uptake and abnormal hemoglobin production REF: p. 505 A 21-year-old woman was recently diagnosed with iron deficiency anemia. Her hematocrit is 32%. Which of the following treatments would the nurse expect to be prescribed for her? a. Iron replacement b. Splenectomy c. A bone marrow transplant d. No treatment is necessary a. Iron replacement REF: p. 504 A 67-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera. Upon taking the history, the patient will most likely report: a. Hyperactivity b. Decreased blood pressure c. Chest pain d. A pale skin color c. Chest pain REF: p. 507 A 68-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera (PV). A nurse realizes the patient's symptoms are mainly the result of: a. A decreased erythrocyte count b. Rapid blood flow to the major organs c. Increased blood viscosity d. Vessel injury c. Increased blood viscosity REF: p. 507 A 67-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera (PV). Which treatment should the nurse discuss with the patient? a. Therapeutic phlebotomy b. Restoration of blood volume by plasma expanders c. Administration of packed red blood cells d. Iron replacement therapy a. Therapeutic phlebotomy REF: p. 507 A 70-year-old male is brought to the emergency department, where he dies shortly thereafter. Autopsy reveals polycythemia vera (PV). His death was most likely the result of: a. Acute renal failure b. Cerebral thrombosis c. Sepsis d. Acute leukemia b. Cerebral thrombosis REF: p. 508 A 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment. His condition is at risk for converting to: a. Chronic lymphocytic leukemia b. Burkitt lymphoma c. Multiple myeloma d. Acute myeloid leukemia d. Acute myeloid leukemia REF: p. 508 A 5-year-old female is diagnosed with acute leukemia. The nurse will most likely treat this patient with: a. Bone marrow transplant b. Immunotherapy c. Chemotherapy d. Localized radiation therapy c. Chemotherapy REF: p. 513 A 10-year-old male is diagnosed with leukemia. The nurse assesses for which other condition that could be associated with his disease? a. Down syndrome b. Hemophilia c. Hyperthyroidism d. Pheochromocytoma a. Down syndrome A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph node enlargement. She is diagnosed with infectious mononucleosis. What should the nurse tell the patient about the recovery time? a. 72 hours b. 3 to 5 days c. A few weeks d. Six months c. A few weeks REF: p. 511 A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others. Which statement represents a correct instruction? a. Wear a surgical mask when others are in the room. b. Do not share drinking glasses or eating utensils. c. Avoid all contact with other people. d. No precautions are necessary. b. Do not share drinking glasses or eating utensils. REF: p. 511 A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how he got this disease, how should the nurse respond? The most likely cause is: a. Adenovirus b. Epstein-Barr virus (EBV) c. Cytomegalovirus (CMV) d. Toxoplasma gondii b. Epstein-Barr virus (EBV) REF: p. 511 A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as: a. A normal leukocyte count b. A high leukocyte count c. A low leukocyte count d. Another term for leukopenia b. A high leukocyte count REF: p. 508 A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. A nurse monitors for which of the following conditions that could result secondary to the treatment? a. Eosinophilia b. Basophilia c. Monocytosis d. Lymphocytosis b. Basophilia REF: p. 509 A 20-year-old female has an increase in eosinophils. When the patient wants to know the most likely cause of the eosinophilia. What is the nurse's best response? a. Parasitic invasion and allergic reactions b. Viral and bacterial infections c. Stress and anxiety reactions d. Fungal infections and delayed hypersensitivity a. Parasitic invasion and allergic reactions REF: p. 509 An oncologist is discussing multiple myeloma. Which information should the oncologist include? Multiple myeloma can be defined as a neoplasm of: a. T cells b. B cells c. Immature plasma cells d. Mature red blood cells b. B cells REF: p. 518 | p. 520 A 65-year-old male is diagnosed with multiple myeloma. He reports severe pain. This pain can be attributed to: a. Neuropathic infiltrations b. Destruction of bone tissue c. Tissue hypoxia d. Accumulation of toxic proteins b. Destruction of bone tissue REF: p. 520 A 35-year-old female is diagnosed with lymphadenopathy. Which assessment finding will help confirm this diagnosis? a. Small, hard lymph nodes b. Disordered lymph nodes c. Nonpalpable, non-tender lymph nodes d. Enlarged lymph nodes d. Enlarged lymph nodes REF: p. 515 A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease? a. Merkel cell b. Schwann cell c. Reed-Sternberg cell d. Kupffer cell c. Reed-Sternberg cell REF: p. 516 The people from which country have the lowest risk for Hodgkin lymphoma? a. United States b. Japan c. Denmark d. Great Britain b. Japan REF: p. 517 A 62-year-old female tells her health care provider she has been experiencing regular night sweats that cause her to wake up drenched. She also remarks that she has been unintentionally losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful. She should be screened for which of the following cancers? a. Epstein-Barr virus b. Hodgkin lymphoma c. Acute leukemia d. Burkitt lymphoma b. Hodgkin lymphoma REF: p. 517 A 50-year-old female is diagnosed with primary thrombocythemia. A nurse would expect the blood smear to reveal _____ platelets. a. Defective b. Fragmented c. Consumed d. Overproduced d. Overproduced REF: p. 525 A 30-year-old female presents with hematuria, menorrhagia, and bleeding gums. She is diagnosed with immune thrombocytic purpura (ITP). A nurse realizes the most likely cause is: a. Allergy-induced platelet lysis b. An immune response to hypersplenism c. Antibody destruction of platelets d. T cell injury to megakaryocytes c. Antibody destruction of platelets REF: p. 524 For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be: a. Proliferated b. Activated c. Sequestered d. Infected c. Sequestered REF: p. 521 Thrombocytopenia may be: a. Transient or consistent b. Normal or abnormal c. Congenital or acquired d. Active or inactive c. Congenital or acquired REF: p. 523 A 10-year-old male presents with abdominal swelling, night sweats, fever, and weight loss. He is diagnosed with Burkitt lymphoma. Upon obtaining the history, which of the following is the most likely cause? a. Cytomegalovirus (CMV) b. Adenovirus c. Human papillomavirus (HPV) d. Epstein-Barr virus (EBV) d. Epstein-Barr virus (EBV) REF: p. 519 A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. The nurse suspects a decrease in which of the following vitamins? a. K b. D c. E d. B12 a. K REF: p. 526 A nurse checks individuals with liver disease for clotting problems because: a. The liver is often the site of platelet pooling. b. Clotting factors are produced in the liver. c. High levels of bilirubin interfere with the clotting system. d. Treatment medications for liver failure cause fibrinolysis. b. Clotting factors are produced in the liver. REF: p. 526 A 40-year-old female develops disseminated intravascular coagulation (DIC). Upon obtaining the history, which finding is the most likely cause of this condition? a. Snake bite b. Blood transfusion c. Sepsis d. Immune thrombocytopenic purpura (ITP) c. Sepsis REF: p. 527 A nurse is teaching the staff about disseminated intravascular coagulation (DIC). Which information should the nurse include? The sequence of events in DIC is initiated by the release of: a. Histamine b. Fibrin c. Tissue factor d. Plasmin c. Tissue factor REF: p. 527 A 22-year-old female just delivered a healthy baby girl. She suffered from eclampsia during her pregnancy, and on the second postpartum day she complained of bleeding gums and bruising on her arms and legs. Hematology lab tests indicate that she had disseminated intravascular coagulation (DIC). Further review of lab tests by the nurse revealed an increase in: a. Platelets b. Hematocrit c. Fibrin degradation products (FDPs) d. Protein C c. Fibrin degradation products (FDPs) REF: p. 528 When the nurse sees a diagnosis of hereditary hemochromatosis on the chart, the nurse knows this is a disorder of: a. Intravascular coagulation b. Iron overload c. Leukocytosis d. Granulocytosis b. Iron overload REF: p. 508 In disseminated intravascular coagulation (DIC), the nurse assesses for active bleeding after intravascular clotting because: a. Prothrombin is activated. b. Clotting factors are depleted. c. Inflammatory mediators are released. d. Tissue factor (TF) is inactivated. b. Clotting factors are depleted. REF: p. 532 A patient has microcytic hypochromic anemia. Which of the following pathogenic mechanisms may cause anemia in this patient? (Select all that apply.) a. Decreased erythrocyte life span b. Failure of mechanisms of compensatory erythropoiesis c. Disturbances of the iron cycle d. Increased basal metabolic rate e. Swelling in the tissues a. Decreased erythrocyte life span b. Failure of mechanisms of compensatory erythropoiesis c. Disturbances of the iron cycle REF: p. 501 A 15-year-old male is diagnosed with infectious mononucleosis. Which of the following assessment findings would he most likely demonstrate? (Select all that apply.) a. Lymph node enlargement. b. Fever and sore throat c. Rash on the trunk and extremities d. Fatigue e. Enlargement of liver and spleen a. Lymph node enlargement. b. Fever and sore throat d. Fatigue e. Enlargement of liver and spleen REF: p. 511 A patient wants to know about risk factors for acute leukemia. Which of the following should the nurse include? (Select all that apply.) a. Cytomegalovirus (CMV) infection b. Eating genetically modified food c. Chemotherapy treatment for other cancers d. Excessive ultraviolet radiation exposure e. Ovarian cancer c. Chemotherapy treatment for other cancers d. Excessive ultraviolet radiation exposure e. Ovarian cancer REF: p. 513 A 35-year-old male was diagnosed with hepatitis B. Further tests revealed neutropenia characterized by a neutrophil count less than _____ per milliliter. 2000 REF: p. 509 A nurse realizes a patient has thrombocytopenia when the platelet count is below _____ platelets per cubic millimeter. 100,000 REF: p. 532 Which statement regarding anemia in children is TRUE? A. The most common cause of sickle cell disease is anemia. B. Anemia is the most common blood disorder in children. C. There is only one cause of hemolytic anemia. D. Children rarely present with iron deficiency anemia. B. Anemia is the most common blood disorder in children. Which statement regarding maternal antibodies is TRUE? A. Placental detachment does not result in fetal erythrocytes crossing the placenta. B. The first Rh-incompatible pregnancy usually presents with severe complications. C. Anti-Rh antibodies are formed only in the response to transfusion. D. ABO incompatibility can cause hemolytic disease without erythrocytes escaping maternal circulation. D. ABO incompatibility can cause hemolytic disease without erythrocytes escaping maternal circulation. Which condition is defined as "the release of immature nucleated red cells into the bloodstream"? A. Erythroblastosis fetalis B. Hydrops fetalis C. Icterus neonatorum D. Icterus gravis neonatorum A. Erythroblastosis fetalis Which statement regarding a Coombs test is accurate? A. Indirect Coombs confirms the diagnosis of antibody-mediated hemolytic disease. B. Indirect Coombs measures antibodies in the mother's circulation. C. Direct Coombs indicates if the fetus is at risk for hemolytic disease. D. Direct Coombs measures free antibodies. B. Indirect Coombs measures antibodies in the mother's circulation. Which disease process occurs in patients with two hemoglobin (Hgb) abnormalities in which at least one involves the Hb gene? A. Sickle cell anemia B. Sickle cell thalassemia C. Sickle cell trait D. Hereditary spherocytosis B. Sickle cell thalassemia Which of the following is a characteristic of sickle cell disease? It is: A. the trait is the homozygous form of the disease. B. a disease in which the patient has HbA genes. C. most common in European descent. D. an autosomal recessive disease. D. an autosomal recessive disease. Which event is the most common trigger for the sickling process seen in sickle cell disease? A. Hypoxemia B. Increased plasma volume C. Decreased plasma osmolality D. High temperature A. Hypoxemia Which condition is defined as the "profound anemia caused by decreased erythropoiesis"? A. Vaso-occlusive crisis B. Aplastic crisis C. Sequestration crisis D. Hyperhemolytic crisis B. Aplastic crisis Which statements regarding hemophilia are accurate? (select all that apply) A. There is a dangerous tendency to bleed. B. Transmission of the disorder to sons occurs via the father. C. It is considered a hereditary disorder. D. Blood coagulation is chronically impaired. E. Women are carriers of the disorder. A. There is a dangerous tendency to bleed. C. It is considered a hereditary disorder. D. Blood coagulation is chronically impaired. E. Women are carriers of the disorder. Which characteristic of non-Hodgkin lymphoma (NHL) is TRUE when diagnosed in children? (select all that apply) A. It is more commonly diagnosed than Hodgkin lymphoma. B. It is seldom seen in children younger than 5 years of age. C. An immunodeficiency is a risk factor. D. Diagnosis can take months since the disease progresses slowly. E. A palpable abdominal mass is generally the first symptom. A. It is more commonly diagnosed than Hodgkin lymphoma. B. It is seldom seen in children younger than 5 years of age. C. An immunodeficiency is a risk factor. Which clinical manifestation is suggestive of leukemia? (select all that apply) A. Sudden onset B. Fever present C. Fatigue D. Hemoglobin 7 g/dl E. Unaffected white blood counts B. Fever present C. Fatigue D. Hemoglobin 7 g/dl The incidence of fractures of the pelvis is highest in: a. preadolescent boys. b. adolescent boys. c. adolescent girls. d. older adults. ANS: D The incidence of fractures of the upper femur, upper humerus, vertebrae, and pelvis is highest in older adults and is often associated with osteoporosis. Fractures of healthy bones, particularly the tibia, clavicle, and lower humerus, tend to occur in young persons and without gender preference. REF: p. 991 A client is admitted to the hospital with a transverse fracture of the femur. Which statement best describes this type of fracture? a. The fracture line is parallel to the bone. b. The fracture line is straight across the bone. c. The fracture line is perpendicular to the bone. d. The fracture line is vertical to the shaft of the bone. ANS: B A transverse fracture occurs straight across the bone. Such a fracture would not occur either perpendicularly or vertically in relationship to the bone. A linear fracture runs parallel to the long axis of the bone. REF: p. 991 A 70-year-old diagnosed with osteoporosis fell and fractures the left leg at a location of pre existing abnormality. Which term describes the fracture? a. Fatigue b. Stress c. Pathologic d. Greenstick ANS: C A pathologic fracture is a break at the site of a pre-existing abnormality, usually by force such as a fall that would not fracture a normal bone. A fatigue fracture is caused by abnormal stress or torque applied to a bone with normal ability to deform and recover. Stress fractures occur in normal or abnormal bone that is subjected to repeated stress, such as occurs during athletics. A greenstick fracture perforates one cortex and splinters the spongy bone. REF: p. 992 A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This is referred to as a what type of fracture? a. Comminuted b. Greenstick c. Fatigue d. Compound ANS: C A fatigue fracture is caused by abnormal stress or torque applied to a bone that usually occurs in individuals who engage in a new activity that is both strenuous and repetitive. A comminuted fracture is one in which a bone breaks into two or more fragments. A greenstick fracture perforates one cortex and splinters the spongy bone. A compound fracture is a complete and incomplete fracture that breaks through the skin. REF: p. 993 Transchondral fractures are most prevalent in: a. adolescents. b. older adults. c. infants. d. premenopausal females. ANS: A Transchondral fractures are most prevalent in adolescents. Such fractures are not associated with older adults, infants, or premenopausal females. REF: p. 993 A 35-year-old suffers a broken clavicle following a motor vehicle accident. X-ray reveals that the bone surfaces in the joint partially lost contact with each other. This condition is called: a. dislocation. b. subluxation. c. distortion. d. nonunion. ANS: B Subluxation occurs when contact between the opposing joint surfaces of a fracture are partially lost. Dislocation is the displacement of one or more bones in a joint in which the opposing joint surfaces lose contact entirely. Distortion is not a term applicable to fracture healing. Nonunion is failure of the bone ends to grow together. REF: p. 994 What term is used to describe a torn ligament? a. Sprain b. Strain c. Disunion d. Subluxation ANS: A A torn ligament is also called a sprain. Tearing or stretching of a muscle or tendon is commonly known as a strain. Disunion occurs when fracture ends fail to heal. Subluxation occurs when contact between the opposing joint surfaces of a fracture are partially lost. REF: p. 995 A 36-year-old reports pain and weakness in the elbow. MRI reveals inflammation of the tendon and the presence of microtears where it attaches to bone. This condition is called: a. periostitis. b. muscle strain. c. bursitis. d. epicondylopathy. ANS: D When force is sufficient to cause microscopic tears (microtears) in tissue, the result is known as epicondylopathy. Such an injury is not referred to as periostitis which involves the presence of inflammation. Muscle strain is local muscle damage that occurs when the muscle is stretched beyond capacity. Bursitis is inflammation of the bursae. REF: p. 995 Which clinical finding would be expected in the patient with rhabdomyolysis? a. Sweating b. Dark urine c. Yellow color to the skin d. Lower extremity swelling ANS: B A classic triad of muscle pain, weakness, and dark urine is considered typical of rhabdomyolysis. Neither sweating, yellow skin, nor lower extremity swelling is associated with rhabdomyolysis. REF: p. 997 The diagnosis of rhabdomyolysis is based on the measurement of which laboratory value? a. White blood cell count (WBC) b. Antinuclear antibodies c. Aspartate aminotransferase d. Creatine kinase (CK) ANS: D The most important and clinically useful measurement in rhabdomyolysis is serum CK. A level five times the upper limit of normal (about 1000 units per liter) is used to identify rhabdomyolysis. While the other options may be measured, they are not used as diagnostic criteria. REF: p. 998 A 70-year-old female presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase in bone: a. density. b. formation. c. resorption. d. mineralization. ANS: C In osteoporosis, old bone is being resorbed faster than new bone is being made, causing the bones to lose density, becoming thinner, and more porous. Mineralization is not increased by osteoporosis. REF: p. 1001 When a 70-year-old female presents with a hip fracture she is diagnosed with osteoporosis. One factor that most likely contributed to her condition is: a. increased androgen levels. b. decreased estrogen levels. c. strenuous exercise. d. excessive dietary calcium. ANS: B Osteoporosis can be attributed to decreased estrogen levels. Osteoporosis is not attributed to increased androgen levels, excessive exercise, or excessive dietary calcium. REF: p. 1002 Osteomalacia is a result of: a. collagen breakdown in the bone matrix. b. excessive bone resorption. c. c