A 19-year-old male college student reports to his primary care provider that he cannot stay awake in class regardless of how much sleep he gets. A drug that stimulates which of the following areas would best treat his problem?
Reticular activating system
A 32-year-old female suffers from severe brain damage following a motor vehicle accident. After rehabilitation she notices that her thought processes and goal-oriented behavior are impaired. Which area does the nurse suspect is damaged?
A neurologist is teaching about the location of the primary visual cortex in the brain. Which area is the neurologist discussing?
A nurse is preparing to teach about functions to maintain homeostasis and instinctive behavioral patterns. Which area of the brain is the nurse discussing?
A student nurse asks the nurse what controls reflex activities concerned with heart rate and blood pressure. What is the nurse’s best response? These reflex activities are controlled by the:
What term should the nurse use when talking about the outermost membrane surrounding the brain?
The _____ ensures collateral blood flow from blood vessels supplying the brain.
Circle of Willis
An aide asks a nurse what neurotransmitters interact with. Which response is the nurse’s best answer? Neurotransmitters interact with the postsynaptic membrane by binding to a:
A patient asks the nurse where nociceptors can be found. How should the nurse respond? One location in which nociceptors can be found is the:
Which finding indicates the patient is having complications from heat stroke?
Cerebral edema and degeneration of the CNS
Alterations in calcium uptake
Mild elevation of core body temperatures
Spasmodic cramping in the abdomen and extremities
A 50-year-old diabetic patient experiences visual disturbances and decides to visit his primary care provider. After examination, the primary care provider tells the patient that the cells that allow him to see are degenerated. Which of the following structures is most likely damaged?
When a neurologist explains how pricking a finger with a needle provides minimal pain while cutting the finger with a knife provides more severe pain, what theory is being described?
Gate control theory
A patient has increased intraocular pressure. Which diagnosis will the nurse observe on the chart?
Which group of people is most prone to red-green color blindness?
The nurse would expect the patient with an alteration in proprioception to experience vertigo which is manifested by:
Loss of feeling in the lips
A sensation that the room is spinning
When a patient has a peculiar sensation that immediately precedes a seizure, what term should the nurse use to describe this sensation?
A patient has memory loss of events that occurred before a head injury. What cognitive disorder does the nurse suspect the patient is experiencing?
Selective memory deficit
Executive memory deficit
A 20-year-old male suffers a severe closed head injury in a motor vehicle accident. He remains in a vegetative state (VS) 1 month after the accident. Which of the following structures is most likely keeping him in a vegetative state?
The patient is experiencing an increase in intracranial pressure. This increase results in:
Expansion of the cranial vault
Brain tissue hypoxia
A 20-year-old male is brought to the emergency room (ER) for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. What two regions should the nurse assess as they are most likely to be damaged?
Cervical and thoracic regions
Thoracic and lumbar regions
Cervical and lumbar regions
Lumbar and sacral regions
A 33-year-old male is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:
Bladder emptying will not occur.
Diaphragm function may be impaired.
Reflexes will be disrupted.
Increased ICP may occur.
Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia. What does the nurse suspect the patient is experiencing?
Extreme spinal shock
A 72-year-old male demonstrates left-sided weakness of upper and lower extremities. The symptoms lasted 4 hours and resolved with no evidence of infarction. The patient most likely experienced a(n):
Stroke in evolution
Transient ischemic attack
A 25-year-old female presents to her primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?
A 23-year-old female begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). What is occurring in the patient’s body?
Reduced amounts of acetylcholine at the neuromuscular junction
Depletion of dopamine in the central nervous system (CNS)
Demyelination of nerve fibers in the CNS
The development of neurofibril webs in the CNS
A patient is admitted with amyotrophic lateral sclerosis (ALS). Which classic assessment findings will support the diagnosis of ALS?
Muscle weakness and atrophy
Which statement by a patient indicates teaching was successful regarding myasthenia gravis? Myasthenia gravis results from:
Viral infection of skeletal muscle
Atrophy of motor neurons in the spinal cord
Autoimmune injury at the neuromuscular junction
Demyelination of skeletal motor neurons
As a portion of the assessment of the patient with meningitis, the health care provider flexes the patient’s neck to the chest. The patient responds with flexion of the legs and thighs. The name for this response is:
The patient reports generalized muscle weakness. The health care provider orders administration of the medication edrophonium chloride (Tensilon). This medication is used in the diagnosis of:
Amyotrophic lateral sclerosis
A 15-year-old male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with the medical staff. Upon arrival to hospital, he was alert and oriented. Physical exam reveals confusion and impaired responsiveness. What is the probable nature of his brain injury based on this history?
Mild diffuse axonal injury
Extradural (epidural) hematoma
Which of the following diseases does the nurse screen for in all newborns?
A child presents to his primary care provider with disorientation, delirium, aggressiveness, and stupor. His parents report that he was recently ill with an upper respiratory infection, which they treated with aspirin. Which of the following is the most likely diagnosis?
What nutrient should the nurse encourage a woman in the early stages of pregnancy to consume to prevent neural tube defects?
A newborn child has a herniation of brain and meninges through a defect in the occipital area of the skull. What will the pediatrician call this condition?
A 50-year-old male patient is deficient in ADH production. Which of the following assessment findings would the nurse expect to find?
Increased arterial vasoconstriction
Increased urine osmolality
Increased blood volume
Increased urine volume
A 70-year-old female has brittle bones secondary to osteoporosis. Her primary care provider prescribes calcitonin to:
Inhibit calcium resorption from bones
Stimulate osteoclastic activity
Promote thyroid hormone release
Activate vitamin D
A nurse is reviewing lab results. Which of the following lab results would slow down the rate of parathyroid hormone secretion?
Increased serum calcium levels
Decreased levels of TSH
Increased levels of TSH
Decreased serum calcium levels
An endocrinologist is teaching about aldosterone secretion. Which information should the endocrinologist include? Aldosterone secretion is regulated by:
The renin-angiotension system
The sympathetic nervous system
When catecholamines are released in a patient, what should the nurse assess for?
When a patient asks about target cell receptors, which is the nurse’s best response? Target cell receptors for most water-soluble hormones are located in the:
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:
Increased synthesis of second messengers
Extracellular electrolyte alterations
Abnormal receptor activity
Abnormal hormone levels
What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma?
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?
Slow heart rate, rash
Skin hot and moist, rapid heart rate
Weight gain, cold intolerance
A 22-year-old female has a low level of TSH. What condition does the nurse expect the patient is experiencing?
What problem should the nurse assess for in a patient with chronic hyperparathyroidism?
Vitamin D malabsorption
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:
Myxedema secondary to surgery
Hypoparathyroidism caused by surgical injury to the parathyroid glands
Hypothyroidism resulting from lack of thyroid replacement
Hyperparathyroidism secondary to Graves disease
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?
A familial, autosomal dominant gene defect
Obesity and lack of exercise
Hyperglycemia from eating too many sweets
Immune destruction of the pancreas
A nurse is reviewing lab results for glycosylated hemoglobin (hemoglobin A1c) levels. A nurse recalls the purpose of this test is to:
Monitor long-term serum glucose control.
Measure fasting glucose levels.
Detect acute complications of diabetes.
Check for hyperlipidemia.
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.
Low serum insulin promotes lipid storage and a corresponding release of ketones.
Increased insulin levels promote protein breakdown and ketone formation.
Her uncontrolled diabetes has led to renal failure.
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?
Elevated liver enzymes
A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of:
Adrenocorticotropic hormone (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 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?
Cardiac arrest from hyperkalemia
Dehydration from polyuria
Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following assessment manifestations?
Vomiting and abdominal cramping
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?
Psychogenic diabetes insipidus
Neurogenic diabetes insipidus
Nephrogenic diabetes insipidus
During an infection, the nurse assesses the lymph nodes. Lymph nodes enlarge and become tender because:
Edema accumulates within the fibrous capsule.
Microorganisms are accumulating.
The nodes are not functioning properly.
Lymphocytes are rapidly dividing.
A nurse is discussing a cell that can differentiate into any tissue type. Which term is the nurse describing?
Which condition will cause a patient to secrete erythropoietin?
Hypoxia (oxygen deficient)
Low blood pressure
After erythrocytes have circulated for about 120 days, they are removed by macrophages, which are mainly in the:
A nurse is caring for a patient who cannot clot. Which end product of the clotting cascade is this patient unable to make?
When a staff member asks how erythrocytes can carry oxygen, which of the following properties should the nurse describe that allow erythrocytes to function as gas carriers? (Select all that apply.)
Presence of many mitochondria
Undergoes mitotic division
Presence of a nucleus
Which of the following individuals should the nurse assess first for a vitamin B12 deficiency anemia?
3-year-old female who is a fussy eater
26-year-old female in the second trimester of her first pregnancy
64-year-old male with a history of duodenal ulcers and gastrointestinal bleeding
47-year-old male who had a gastrectomy procedure (removal of the stomach)
A 67-year-old female has chronic gastrointestinal bleeding. A nurse recalls the primary cause of her anemia is:
Bone marrow failure
Vitamin B12 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?
Iron deficiency anemia
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?
Misshapen erythrocytes with low hemoglobin
Premature erythrocyte destruction and erythropoietin deficiency
Decreased levels of tissue iron with megaloblastic erythrocytes
Ineffective iron uptake and abnormal hemoglobin production
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:
Acute renal failure
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:
An immune response to hypersplenism
T cell injury to megakaryocytes
Antibody destruction of platelets
Allergy-induced platelet lysis
A nurse checks individuals with liver disease for clotting problems because:
High levels of bilirubin interfere with the clotting system.
Treatment medications for liver failure cause fibrinolysis.
Clotting factors are produced in the liver.
The liver is often the site of platelet pooling.
A 40-year-old female develops disseminated intravascular coagulation (DIC). Upon obtaining the history, which finding is the most likely cause of this condition?
Immune thrombocytopenic purpura (ITP)
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.)
Lymph node enlargement.
Fever and sore throat
Enlargement of liver and spleen
Rash on the trunk and extremities
A 12-year-old male is diagnosed with sickle cell anemia. A blood smear reveals severely sickled cells. A nurse recalls the sickled cells will be removed from circulation mostly by the:
A geneticist is discussing thalassemias. Which information should be included? The alpha and beta thalassemias are inherited in an _____ fashion.
The mother of a 3-year-old child speaks to the pediatrician because the child took several hours to stop bleeding following a minor scrape. Testing reveals that the child has hemophilia A resulting from a deficiency in factor:
Which mother is at most risk for a maternal-fetal blood incompatibility?
Mother is Rh-negative, and fetus is Rh-positive.
Mother has type A blood, and fetus has type O blood.
Mother has type AB, blood and fetus has type B blood.
Mother is Rh-positive, and fetus is Rh-negative.
A 10-year-old male is diagnosed with sickle cell anemia. When the parents ask who is responsible for this disease, what is the nurse’s best response? He most likely inherited it from:
None of the above; sickle cell disease is not clearly an inherited disease.
Both his mother and father