Mod A
A nurse is educating a client on how pain is perceived in the body. Which of the following steps represents the transduction phase of nociception?
A. Pain signal travels through the dorsal horn to the brainstem
B. Tissue injury releases prostaglandins and bradykinin, activating nociceptors
C. The brain processes the pain signal and determines a response
D. Inhibitory interneurons block the pain signal at the spinal cord
Correct Answer: B
Rationale: Transduction is the conversion of noxious stimuli into electrical signals by nociceptors, initiated by chemicals like prostaglandins, bradykinin, and histamine.
A patient is diagnosed with heart failure. Which of the following best describes the relationship between preload, afterload, and cardiac output?
A. Preload is the volume of blood entering the heart during diastole, which affects stroke volume and cardiac output.
B. Afterload refers to the amount of blood returned to the heart during systole, influencing stroke volume.
C. Cardiac output increases with increased afterload due to the increased pressure in the ventricles.
D. Preload decreases as the heart fills more during diastole, reducing stroke volume and cardiac output.
Correct Answer: A
Rationale: Preload is the volume of blood in the ventricles at the end of diastole, and it directly influences stroke volume, which affects cardiac output. An increased preload results in increased stroke volume and, consequently, higher cardiac output.
A patient with diabetes has a blood glucose level of 320 mg/dL and presents with fruity-smelling breath, polyuria, and Kussmaul respirations. What is the most likely diagnosis
A) Hyperosmolar Hyperglycemic State (HHS)
B) Diabetic Ketoacidosis (DKA)
C) Hyperglycemia
D) Hypoglycemia
Answer: B
Rationale: The patient’s symptoms of fruity breath, polyuria, and Kussmaul respirations, along with a high blood glucose level, are characteristic of Diabetic Ketoacidosis (DKA), which is more common in Type 1 Diabetes.
Which of the following is a risk factor for macular degeneration (AMD)?
A. Smoking
B. High-fiber diet
C. Family history of glaucoma
D. Age younger than 50
Correct Answer: A. Smoking
Rationale: Smoking is a significant risk factor for macular degeneration, along with aging and family history. A high-fiber diet and being younger than 50 do not increase the risk for AMD.
A nurse is preparing a care plan for a client diagnosed with age-related macular degeneration (AMD). Which intervention should the nurse prioritize to assist the client in maintaining independence in daily activities?
A. Encourage the use of large-print books and magnifiers
B. Advise the client to avoid wearing corrective glasses
C. Suggest the use of a hearing aid to address possible auditory changes
D. Instruct the client to limit driving at night
Correct Answer: A. Encourage the use of large-print books and magnifiers
Rationale: Interventions that enhance visual functioning, such as providing large-print materials or magnifying devices, will help the client adapt to changes in vision. These approaches support independence and quality of life in clients with AMD.
A patient with type 2 diabetes reports burning and shooting pain in their feet. What is this called?
Neuropathic pain
A patient is diagnosed with coronary artery disease. Which mechanism most directly contributes to plaque formation in atherosclerosis?
A. Smooth muscle relaxation in arterial walls
B. Destruction of myocardial cells by free radicals
C. Infiltration of lipids and inflammatory cells into the intimal layer of arteries
D. Decrease in circulating erythrocytes and hemoglobin levels
Correct Answer: C
Rationale: Atherosclerosis begins with endothelial injury, followed by lipid infiltration, inflammatory response, and formation of fibrous plaques within the intima of arteries.
A patient with osteoporosis asks the nurse how they can prevent fractures. Which recommendation should the nurse provide?
A) Avoid weight-bearing exercises to prevent bone stress.
B) Consume a diet low in calcium to reduce bone density.
C) Engage in weight-bearing exercises to strengthen bones.
D) Limit sun exposure to avoid excessive vitamin D production.
Answer: C
Rationale: Weight-bearing exercises help to rebuild and maintain bone mass, which is crucial in osteoporosis prevention.
Which STI can lead to fetal blindness?
Gonorrhea!
A nurse is caring for four patients. Which patient should the nurse assess first?
A. A COPD patient with an oxygen saturation of 88% on 2L nasal cannula
B. A post-op patient complaining of moderate incisional pain
C. A patient with asthma who reports new-onset difficulty speaking in full sentences
D. A patient receiving nebulizer treatment with bilateral wheezing
C: rational-> New-onset difficulty speaking indicates worsening airway obstruction or impending respiratory failure — this is priority. An SpO₂ of 88% may be baseline for a COPD patient.
A nurse is reviewing the pathophysiology of asthma. Which of the following best explains the primary cause of airway obstruction during an acute asthma attack?
A. Collapse of alveoli and surfactant loss
B. Mucosal inflammation and bronchial smooth muscle constriction
C. Alveolar wall destruction and loss of capillary beds
D. Fluid accumulation in the alveoli and decreased surfactant production
Correct Answer: B
Rationale: Asthma is characterized by airway hyperresponsiveness, leading to bronchoconstriction, mucosal edema, and mucus production, which narrows airways and causes obstruction.
A nurse is caring for a patient with left-sided heart failure. Which of the following clinical manifestations would the nurse expect to observe?
A. Jugular vein distention (JVD) and peripheral edema.
B. Shortness of breath, pulmonary congestion, and orthopnea.
C. Increased appetite and weight gain.
D. Hepatomegaly and ascites.
Correct Answer: B
Rationale: Left-sided heart failure is characterized by pulmonary congestion, which leads to symptoms like shortness of breath, orthopnea, and pulmonary edema. The clinical manifestations of right-sided heart failure would include JVD, peripheral edema, and hepatomegaly.
Which of the following hormones stimulates the release of calcium from the bones into the bloodstream when blood calcium levels are low?
A) Calcitonin
B) Parathyroid hormone
C) Insulin
D) Vitamin D
Answer: B
Rationale: Parathyroid hormone (PTH) is released when blood calcium levels are low and stimulates osteoclasts to release calcium from the bones into the bloodstream.
A client presents with an auditory complaint and is diagnosed with otosclerosis. Which of the following manifestations would the nurse expect to assess in this client?
A. Gradual hearing loss, particularly at lower frequencies
B. Sudden hearing loss following trauma
C. Severe vertigo and tinnitus
D. Progressive hearing loss with age-related changes
Correct Answer: A. Gradual hearing loss, particularly at lower frequencies
Rationale: Otosclerosis typically causes gradual conductive hearing loss, which may be more pronounced at lower frequencies. This is a hereditary condition in which the ossicles of the middle ear become immobilized.
A nurse is educating a patient with Type 1 Diabetes about insulin administration. Which of the following actions is essential for effective insulin therapy?
A) Avoid insulin injections on the abdomen to prevent absorption complications.
B) Rotate injection sites to prevent lipodystrophy.
C) Inject insulin into the same site to increase absorption rates.
D) Administer insulin only when blood glucose levels exceed 200 mg/dL.
Answer: B
Rationale: Rotating injection sites is important to prevent lipodystrophy, a condition that can affect insulin absorption and cause uneven blood glucose levels.
A client has tissue injury and inflammation. Which of the following mediators is primarily responsible for increasing vascular permeability and vasodilation during the acute inflammatory response?
A. Histamine
B. Interleukin-2
C. Tumor necrosis factor-alpha (TNF-α)
D. Immunoglobulin E (IgE)
Rationale: Histamine, released by mast cells, is a key early mediator causing vasodilation and increased capillary permeability, leading to swelling and redness.
Which client is at highest risk for developing iron-deficiency anemia?
A. A 65-year-old male with chronic kidney disease
B. A 28-year-old pregnant woman in her third trimester
C. A 70-year-old with atrial fibrillation on warfarin
D. A 52-year-old vegetarian who eats a varied diet
B: Rationale-> Pregnancy increases iron demands significantly, especially in the third trimester, leading to iron-deficiency anemia.
A nurse is monitoring a patient with Type 2 Diabetes. Which of the following lab results would indicate that the patient’s diabetes is well controlled?
A) Fasting blood glucose of 140 mg/dL
B) Hemoglobin A1c of 6.5%
C) Random blood glucose of 200 mg/dL
D) Two-hour postprandial glucose of 180 mg/dL
Answer: B
Rationale: A Hemoglobin A1c level of 6.5% indicates that the patient’s blood glucose levels have been well controlled over the past 2-3 months.
What is edema on the face/ hands a danger sign for in pregnancy??
Hypertension and preeclampsia
A patient with a fractured femur is at risk for fat embolism. Which of the following is a key clinical manifestation of fat embolism?
A) Widespread rash and fever
B) Chest pain and shortness of breath
C) Numbness and tingling in the affected leg
D) Increased blood pressure and bradycardia
Answer: B
Rationale: Chest pain, shortness of breath, and hypoxia are signs of fat embolism, a serious complication of long bone fractures.
A nurse is teaching a patient about how pain is perceived in the body. Which statement by the patient indicates a correct understanding of the process?
A. "Pain signals travel through the bloodstream to reach the brain."
B. "Pain perception begins when specialized receptors are activated by tissue damage."
C. "The spinal cord completely blocks pain signals from reaching the brain."
D. "Pain is only experienced if there is visible injury or bleeding."
Correct Answer: B
Rationale: Pain perception starts with nociceptors, which are specialized sensory receptors that respond to potentially harmful stimuli like tissue damage. These receptors send signals via nerve fibers to the spinal cord and brain for interpretation.
A nurse is educating a male patient with benign prostatic hyperplasia (BPH) about potential symptoms. Which of the following symptoms is most likely to occur with this condition?
A. Increased force of urinary stream and increased urinary frequency
B. Weak urinary stream and postvoid dribbling
C. Difficulty holding urine and increased urge to void
D. Involuntary leakage of urine with sneezing and coughing
Correct Answer: B
Rationale: BPH causes weak urinary stream, urinary hesitancy, postvoid dribbling, and urinary retention due to compression of the urethra by an enlarged prostate.
Which of the following conditions is most commonly associated with metabolic syndrome?
A) High HDL cholesterol
B) Low blood pressure
C) Visceral obesity
D) Hypoglycemia
Answer: C
Rationale: Visceral obesity, characterized by excess abdominal fat, is a key feature of metabolic syndrome, which also includes insulin resistance, hypertension, and abnormal lipid levels.
What is Caput Succedaneum?
is a temporary swelling of the scalp in a newborn, often causing a "conehead" appearance, due to pressure on the head during vaginal delivery
A nurse is caring for a client who has been diagnosed with sickle cell anemia and is experiencing a pain crisis. The nurse needs to ensure the delivery of appropriate care during this acute episode. Which of the following interventions is most critical in this situation?
A. Administering pain medications as prescribed
B. Encouraging physical activity to promote circulation
C. Limiting the client's fluid intake to reduce swelling
D. Reducing oxygen saturation levels to improve tissue perfusion
Correct Answer: A. Administering pain medications as prescribed
Rationale: Sickle cell pain crises are acute episodes of severe pain due to blocked blood flow. Managing pain effectively is the highest priority. Ensuring adequate fluid intake, oxygenation, and promoting circulation are also important, but pain management takes precedence in acute episodes.