NR 507 Week 8 Final Exam; Study Guide with Practice Questions and Answers: July 2018

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NR 507 Study Guide with Practice Questions

Types of immunity ch 7 & 8
1. Innate
  1. Natural barriers
  2. Inflamation-
2. Adaptive/ acquired
  1. Active (Acquired)
  2. Passive (Acquired)

Questions

What type of immunity is produced when an immunoglobulin crosses the placenta?
The mucosal secretions of the cervix secrete which immunoglobulin?
A student nurse asks the clinician which cells are most primary in a patient's immunity. What is the clinician's best answer?
A nurse recalls humoral immunity is generated through the process of:
While taking a health history, if a person has resistance to a disease from natural exposure to an antigen, how would the nurse document this form of immunity?
What type of immunity will the nurse expect in an individual who is given a vaccine?
A new mother asks the nurse about immunity of her newborn as she is breastfeeding. The nurse's response should include a discussion on which type of immunity?
The nurse has been explaining to a student nurse about the different types of immunity. Which response indicates that the student nurse has a good understanding of adaptive immunity?
Cancer cells and virus-infected body cells can be killed before activation of adaptive immunity by
The primary immune response ________.
Which of the following is true about the number of binding sites per functional antibody unit?
Which cell of the immune system is absolutely required for an adaptive immune response?
The adaptive immune system involves three major cell types: antigen-presenting cells, T cells, which constitute cell- mediated immunity, and B cells, which govern humoral immunity.
The nurse understands that the function of IgG is as what?
The nurse understands that which type of immunity is the longest acting?
Natural killer cells are specialized lymphocytes that are one of the major parts of which immunity?

Alveolar ventilation/perfusion-

Questions

A consequence of alveolar hypoxia is:
The pressure required to inflate an alveolus is inversely related to:
The nurse is describing the movement of blood into and out of the
capillary beds of the lungs to the body organs and tissues. What term
should the nurse use to describe this process?
A pulmonologist is discussing the base of the lungs with staff. Which
information should be included? At the base of the lungs:
When the pulmonologist discusses the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called:

Which of the following conditions should the nurse monitor for in a patient with hypoventilation?
A nurse is describing the pathophysiology of emphysema. Which information should the nurse include? Emphysema results in:

Dermatologic conditions and terminology ch. 46 pg. 1620,
1. macules
2. nevi
3. pityriasis rosea
4. Patch
5. Plaque
6. Wheal
7. Nodule
8. Tumor
9. Vesicle
10. Bulla
11. Pustule
12. Cyst
13. Telangiectasia

Questions

The physician instructs a mother to take her child out in the sun for approximately an hour or until the skin turns red (not sunburned). This is a common medical treatment for
The patient has a rash on her back that began about 10 days ago with a raised, scaly border and a pink center. Now she has similar eruptions on both sides of her back. From these signs, the nurse would determine the rash to be
A 28-year-old client comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. Physical examination reveals that the pattern of eruption is like a Christmas tree and that various erythematous papules and macules are on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?
The nurse's assessment shows that the patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. In the documentation the nurse would chart this as a
While waiting to see the physician, a patient shows the nurse skin areas that are flat, nonpalpable, and have had a change of color. The nurse recognizes that the patient is demonstrating what?
A young student comes to the school nurse and shows the nurse a mosquito bite. As the nurse expects, the bite is elevated and has serous fluid contained in the dermis. How would the nurse classify this lesion?

Croup- pg. 1294-1296 Croup illness can be divided into two categories

Questions

The 3-year-old child is seen in the local clinic for croup. The child's parents ask the nurse what to do for the child at home to alleviate symptoms. Which suggestions by the nurse is most appropriate?
The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate what condition?
The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which intervention?
A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup?

Types of anemia
1. Pernicious Anemia (PA)
2. Macrocytic-normochromic anemia
3. Microcytic-hypochromic anemia
4. Normocytic-normochromic anemia

Questions

Continued therapy of pernicious anemia (PA) generally last how long?
Which of the following describes how the body compensates for anemia
What is the primary cause of the symptoms of polycythemia vera?
What is the treatment of choice for pernicious anemia (PA)?
What is the function of erythrocytes?
The nurse is collecting data on a patient with suspected
pernicious anemia. Which of these signs or symptoms
would the nurse expect to find for this patient?
Megaloblastic anemia is a result of insufficient folic acid or vitamin B12, affecting which of the following?
A patient with anemia who is given iron salts could expect to show a therapeutic increase in hematocrit
After reviewing the major types of anemia, students demonstrate understanding of the info when they identify which of the following as an example of a hemolytic anemia?
Which of the following would the nurse encourage a pt. to consume to prevent folic acid anemia?
A pt. is receiving ferrous sulfate as treatment for iron deficiency anemia. After teaching the pt., which statement indicates the need for additional teaching?
An 82-year-old client has pernicious anemia and has been receiving treatment for several years. What is she lacking that results in pernicious anemia?
An 82-year-old client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults?
A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?
During the review of morning lab values on a patient complaining of severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which of the following findings?
You are caring for an 87-year-old female who has been admitted to your unit with iron-deficiency anemia. What would you suspect?
A patient is brought to the ER complaining of fatigue, large amounts of bruising on the extremities, and abdominal pain localized in the left upper quadrant. A health history reveals the patient has been treated three times in the past 2 months for a sore throat. Lab tests indicate severe anemia, significant neutropenia, and thrombocytopenia. Based on the symptoms, with what could the patient be diagnosed?
The nurse understands which is the most common type of anemia?
THE NURSE CARES FOR A CLIENT DIAGNOSED WITH POLYCYTHEMIA VERA. THE NURSE EXPECTS TO MAKE WHICH OBSERVATION?
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:
The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings?
Which type of anemia is associated with normochromic and macrocytic red blood cells (RBCs)?
What is the genetic disorder that is associated with excessive red blood cell (RBC) destruction?
A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be:
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 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 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment. His condition is at risk for converting to:
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?
How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?
A 67-year-old female has chronic gastrointestinal bleeding. A nurse recalls the primary cause of her anemia is:
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 nurse is preparing to teach the staff about aplastic anemia. Which information should the nurse include? Aplastic anemia is caused by:
A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?

The inflammatory process upon injury

Questions

A nurse will be teaching about body defenses. Which information should the nurse include? The body's first line of defense against microorganisms is comprised of the:
While planning care for a patient with an infection, which principle should the nurse remember? In contrast with the inflammatory response, the immune response
The nurse assesses clients for the cardinal signs of inflammation.
A client has a leg wound that is in the second stage of the inflammatory response. For what manifestation does the nurse assess?
Which event in the inflammatory response would the nurse correlate with the action of bradykinin?
A nurse recalls if the surface barriers such as the skin or mucus membranes are breached, the second line of defense in innate immunity is the:
A nurse is teaching about inflammation. Which information should be included? The first vascular response in inflammation is:
When a nurse is asked about the purpose of vasodilation and increased vascular permeability during inflammation, how should the nurse respond?
When a nurse is asked which of the following inhibits the inflammatory response, what is the nurse's best answer?
While reviewing lab results, which finding would alert the nurse to a patient with acute inflammation?
While planning care for a patient with acute inflammation and pain, which principle should the nurse remember? The inflammatory chemicals responsible for inducing pain during inflammation are:
While planning care for a patient, which principle should the nurse use to guide care? The first line of defense against pathogens is the:

GI symptoms resulting in heart burn

Questions

The nurse is performing an admission assessment on a client diagnosed with gastroesophageal reﬂux disease (GERD). Which signs and symptoms would indicate GERD?
The male client tells the nurse he has been experiencing "heartburn" at night that awakens him. Which assessment question should the nurse ask?
The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which of the following symptoms?
Which of the following symptoms is common with a hiatal hernia?

Pulmonary terminology - Ch 35 pg. 1248
1. dyspnea
2. Orthopnea
3. Paroxysmal nocturnal dyspnea

Questions

A patient has dyspnea upon lying down. What term should the nurse use to document this finding?
A patient has dyspnea. Which of the following typical findings will the nurse observe during the assessment?
A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition?

Complications of gastric resection surgery
1. Signs and symptoms-
2. A BMI of 25 to 29.9 kg/m2 is considered a grade 1 (overweight) classification.

Questions

The World Health Organization (WHO) defines grade 1 (overweight) as a BMI of:
Care for the postoperative client after gastric resection should focus on which of the following problems?
Which of the following complications of gastric resection should the nurse teach the client to watch for?

Chicken pox- pg. 1660, ch. 47.

Questions

An older adult client tells the nurse that her granddaughter has chickenpox. The client is afraid to visit because she is afraid of getting shingles from her granddaughter. What is the nurse's best response?
The nurse counsels the parent of a 12 year old diagnosed with chickenpox about when the child can return to school. The nurse determines that teaching is effective if the parent makes which statement?
A parent calls the clinic to report that the child has been exposed to varicella zoster (chicken pox). The nurse should tell the parent that the incubation period for chickenpox is which length of time?

Maternal immune system-

Questions

If a patient has a typical secondary immunity response, which antibody is most predominant
A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which of the following statements should the nurse include in the teaching plan for the client?
The laboratory finds IgA in a sample of cord blood from a newborn infant. This finding is important because it signifies what?
A woman experiences a viral infection while pregnant. Which of the following types of immunity does an infant have at birth against this infection?
The nurse is aware that the only class of immunoglobulins to cross the placenta is:

Candidiasis exacerbation

Questions

Samantha Velasquez, a 24-year-old preschool teacher, is being seen by the physician in the primary care group where you practice nursing. Over the past 2 months, she has been receiving treatment for multiple ear infections and tonsillitis. She reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of her symptoms?
A nurse is counseling a client about risk factors for yeast infections. Which of the following should the nurse list as a risk factor for an overgrowth of Candida albicans?

Carbuncles- pg. 1635

Questions

Localized skin infection involving hair follicles:

Terms such as hypochromic, macrocytic, microcytic
1. Hypochromic
2. Macrocytic
3. Microcytic
4. Hyperchromic
5. Normochromic
6. Normocytic

Questions

A patient is admitted with a 2-month history of fatigue, shortness of breath, pallor, and dizziness. The patient is diagnosed with idiopathic autoimmune hemolytic anemia. On reviewing the laboratory results, the nurse notes which of the following that confirms this diagnosis?
the client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which of the following complete blood count (CBC) results is characteristic of her type of anemia?
A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be:
A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:
A patient has microcytic hypochromic anemia. Which of the following pathogenic mechanisms may cause anemia in this patient?

Antibodies pg. 229-230
1. IgG
2. IgA
3. IgM
4. IgD
5. IgE

Questions

What characteristic do atopic individuals have that make them genetically predisposed to develop allergies?
The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins?
A patient has a parasite. Which lab report should the nurse check to help confirm this diagnosis?
If a patient has a typical secondary immune response, which antibody is most predominant?
A mother is breastfeeding her infant. The nurse realizes the main antibody being transferred from the mother to her infant through the breast milk is:
When a person has a life-threatening hypersensitivity/allergic reaction to bee stings, which lab result will the nurse check
Which immunity principle should guide the nurse when caring for an infant? At birth, IgG levels in newborn infants are:
While reviewing a patients' immunological profile, which immunoglobulin does the nurse expect to see elevated if the patient has a type I hypersensitivity reaction?
The antibody that becomes bound to mast cells and basophils and causes the cells to release histamine and other chemicals is
In teaching a patient with SLE about the disorder, the nurse knows that the pathophysiology of SLE includes
A patient is diagnosed with a hypersensitivity reaction mediated by immunoglobulin E (IgE) antibodies. For which type of hypersensitivity reaction should the nurse plan care for this patient?

Skin cancer- pg. 1641.
1. Basal cell
2. Squamous cell

Questions

nurse is participating in a health promotion campaign that has the goal of improving outcomes related to skin cancer in the community. What action has the greatest potential to achieve this goal?
A patient complains that he has basal cell carcinoma and is going to die. The nurse knows that
Which patient would be more likely to have the highest risk of developing malignant melanoma?
In teaching a patient with basal cell carcinoma (BCC) about this disorder, the nurse considers that which statement about this skin cancer is true?
When studying the incidence of skin cancers in a population, a nurse finds that a greater number of skin cancer cases have been reported in white patients than in African American patients. What could be the most likely cause of such an occurrence?
The nurse, preparing educational information about types of skin cancer, recalls that which type has a higher risk for metastasis and poor prognosis unless it is treated early?

Parts of the heart in terms of function Ch. 31 pg. 1085
1. The heart wall has three layers
2. Epicardium
3. Myocardium-
4. Endocardial lining
5. pericardium

Questions

Pressure in the left ventricle must exceed pressure in which structure before the left ventricle can eject blood?
How does the nurse differentiate a pleural friction rub from a pericardial friction rub?
A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks the nurse to explain where the infection is. In providing an accurate description, the nurse states that the pericardium is:
A nurse is explaining the function of the heart. Which is a correct response by the nurse? A function of the pericardium is to:
A nurse is teaching about the heart. Which information should the nurse include? The chamber of the heart that generates the highest pressure is the:
A nurse recalls the chamber that receives blood from the systemic circulation is the:
Which statement indicates the nurse understands blood flow? Oxygenated blood flows through the:
While viewing the electrocardiogram, the nurse recalls the

Congenital heart defects

Questions

An infant has a continuous machine-type murmur best heard at the left upper sternal boarder throughout systole and diastole, as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect?
The comment made by a parent of a 1-month-old that would alert the nurse about the presence of a congenital heart defect is:
The nurse explains that which congenital cardiac defect(s) cause(s) increased pulmonary blood flow?
A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal
that the lumen of the duct between the aorta and pulmonary artery remains open.
This defect is known as patent
Congenital heart defects (CHDs) are classified by which of the following?
Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which of
the following?
A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of decreased pulmonary blood flow called
While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding?
In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs?

Urinary tract obstruction

Questions

Kidney stones in the upper part of the ureter would produce pain referred to which anatomical area?
A patient is admitted with lower urinary tract obstruction and stasis. Which of the following is the primary intervention?
The nursing students have learned in class that causes of urinary obstruction and urinary incontinence include which of the following?
An elderly client has just been admitted for urinary tract obstruction and retention. Which of the following are symptoms that the nurse should suspect this client to demonstrate?
Which of the following individuals are displaying identified risk factors for the development of lower urinary tract obstruction?

If obstructed, which component of the urination system would cause peristaltic waves?
The nurse is planning care for a patient with a urinary tract obstruction. The nurse includes assessment for which of the following possible complications?

GI symptoms of conditions
1. pyloric stenosis
2. hiatal hernia
3. ulcerative colitis

Questions

The nurse explains to the patient with gastroesophageal reflux disease that this disorder:
The client with a hiatal hernia chronically experiences heartburn following meals. The nurse plans to teach the client to avoid which action because it is contraindicated with hiatal hernia?
The client is diagnosed with an acute exacerbation of ulcerative colitis. Which inter- vention should the nurse implement?
Which of the following factors would most likely contribute to the development of a client's hiatal hernia?
The client asks the nurse whether he will need surgery to correct his hiatal hernia. Which reply by the nurse would be most accurate?
A client with ulcerative colitis (UC) has stage 1 of a restorative proctocolectomy with ileo-anal anastomosis (RPC-IPAA) procedure performed. The client asks the nurse, "How long do people with this procedure usually have a temporary ileostomy?" How does the nurse respond?
The nurse is caring for a patient with fulminant ulcerative colitis. The nurse would be alert for which of the following symptoms associated with severe fulminant ulcerative colitis?
Which of the following clients would the nurse suspect to have pyloric stenosis?
A 3-week-old infant diagnosed with pyloric stenosis is admitted to the hospital during a vomiting episode. Which action by the nurse is most appropriate?
Which of the following conditions can cause a hiatal hernia?

Skin cancer lesions

Questions

A patient is scheduled for Mohs' microscopic surgery for removal of a skin cancer lesion on his forehead. The nurse knows to prepare the patient by explaining that this type of surgery requires:
A patient with squamous cell carcinoma has been scheduled for treatment of this malignancy. The nurse should anticipate that treatment for this type of cancer will primarily consist of what intervention?