GI System
In what part of the GI tract does most digestion and absorption occur?
Most digestion and absorption occurs in the small intestine (specifically in the ileum and jejunum).
End Stage Liver Disease develops after an inflammation of the liver. Which type of tissue develops at this point in the disease ?
fibrosis (scarring)
A client with chronic obstructive pulmonary disease presents to the emergency department with difficulty breathing. Physical examination reveals bluish skin, nail beds, and mucous membranes. Which term correctly describes this condition?
Cyanosis
refers to the bluish discoloration of the skin and mucous membranes that result from an excessive concentration of reduced or deoxygenated hemoglobin in the small blood vessels. It usually is most marked in the lips, nail beds, ears, and cheeks. The degree of cyanosis is modified by the amount of cutaneous pigment, skin thickness, and state of the cutaneous capillaries.
When the semilunar valves open it signals the onset of the ejection period. The aortic pressure reflects changes in the ejection of blood from which part of the heart?
The aortic pressure reflects changes in the ejection of blood from the left ventricle, not the right ventricle or atrium.
Which serum biomarker is highly specific for myocardial tissue?
The troponin assays have high specificity for myocardial tissue and have become the primary biomarker tests for the diagnosis of myocardial infarction. Creatine kinase is specific for muscle injury but is not as focused as is troponin. White blood cells and C-reactive protein are associated with inflammation.
Name the two hormones are secreted in the GI tract:
Gastrin and Ghrelin
Name 3 mild clinical manifestations that occur with mild liver damage:
A client with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior–posterior chest diameter. Which term should the nurse use to document this finding?
An increased anterior–posterior chest diameter is referred to as a barrel chest.
Although some in the medical community may use the term "pink puffer" to help remember the typical presentation of emphysema, this term and "blue bloater" related to chronic bronchitis are inappropriate for a medical record. A pneumothorax does not affect the anterior-posterior chest diameter.
A client has prominent jugular veins. What type of medical problem is associated with prominent jugular veins?
Right-sided heart failure is seen with prominent jugular veins.
The nurse knows that the primary long-term regulation of blood pressure is exerted by which body system?
The kidneys exert long-term control of blood pressure by modulating sodium content and extracellular fluid volume. An increase in extracellular fluid will yield an increase in blood volume and an increase in cardiac output. If this results in too great an increase in blood pressure, the kidneys will excrete sodium and water. Neural (autonomic nervous system) and humoral mechanisms (renin–angiotensin–aldosterone system and vasopressin) exert short-term control of blood pressure. Hormonal influence involves release of epinephrine (which works through the sympathetic nervous system) from the adrenal glands.
Which GI disorder is associated with the symptoms of diarrhea, weight loss, abdominal cramping, anemia, and blood or pus in bowel movements.
Ulcerative Colitis
Elevated levels of which liver enzymes may signify liver damage in a person. Name both:
AST and ALT
(alanine aminotransferase or ALT and aspartate aminotransferase or AST)
Acute-onset bronchial asthma causes wheezing and breathlessness as a result of which of the following?
Airway inflammation.
Bronchial asthma represents a reversible form of obstructive airway disease caused by narrowing of airways due to bronchospasms, inflammation, and increased airway secretions; this inflammatory process produces recurrent episodes of airway obstruction, characterized by wheezing, breathlessness, chest tightness, and cough. Vascular flow through the lungs is unaffected by the airway inflammation and bronchospasms. Hyperinflated alveoli are characteristic of the emphysema type of obstructive pulmonary disease. Compression atelectasis is associated with high external pressure that blocks lung expansion.
The electrical activity of the heart is recorded on the ECG. What does the T wave on the ECG represent?
The P wave represents the depolarization of the sinoatrial node. The QRS complex represents the depolarization of the ventricles. The T wave represents repolarization of the ventricles, not the atrium.
The nurse is reviewing laboratory results for a client who is experiencing angina. Which finding might be expected in a client with dyslipidemia?
Elevated total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride levels are associated with dyslipidemia. All the other answers are normal findings.
Ulceration that occurs as the result of traumatic injury to the epithelial surface in the GI systems is called:
Peptic ulcer
Common causes of elevated ALT and AST are:
A client hospitalized for 72 hours has developed symptoms of a lower respiratory tract infection. Sputum cultures reveal S. aureus as the infectious organism. The nurse explains to the client that the most likely cause of this infection is:
Nosocomial hospital-acquired infection (HAI)
A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume?
Sinus bradycardia is a slow (<60 bpm) heart rate. In sinus bradycardia, a P wave precedes each QRS. A normal P wave and PR interval (0.12 to 0.20 sec) indicates that the impulse originates in the SA node rather than in another area of the conduction system that has a slower inherent rate. Vagal stimulation as well as some medications decrease the firing rate of the sinoatrial node and conduct through the atrioventricular node to cause a decrease in heart rate. This rhythm may be normal in trained athletes, who maintain a large stroke volume, and during sleep. In most cases, it is a benign rhythm unless the client has had a myocardial infarction or after resuscitation from cardiac arrest.
Dysrhythmias can occur in clients with heart failure. The dysrhythmia that occurs most frequently in heart failure is:
In heart failure, atrial fibrillation is the most frequently occurring dysrhythmia. Occasionally, ventricular fibrillation causes sudden death in clients with heart failure. Atrioventricular heart block and nodal tachycardia are not characteristic of heart failure.
Symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus or into the oral cavity (including the larynx) or the lung
GERD (Gastroesophageal Reflux Disease)
Many drugs may cause elevated blood levels of AST, and ALT and some medications can cause severe damage. Name a common OTC medication that can cause severe liver damage:
acetaminophen (Tylenol)
Ventilation is driven by which alteration in arterial blood?
Increased PCO2
Ventilatory drive is exquisitely sensitive to PCO2 of the blood perfusing the central chemoreceptors. These receptors are located in chemosensitive regions near the respiratory center in the medulla and are bathed in cerebrospinal fluid (CSF).
Cardiac reserve refers to...
Cardiac reserve refers to the ability of the heart to increase cardiac output when body requirements for oxygen and nutrients increase with physical exercise. The volume of blood ejected with each ventricular contraction is stroke volume. Blood in the left ventricle at systole is preload. Venous return to the heart directly affects preloading.
What is the most common identifiable cause of secondary cardiomyopathy?
Alcohol abuse is a cause of secondary cardiomyopathy