A 41-year-old woman has made the recent decision to start a family and is eager to
undergo testing to mitigate the possibility of having a child with Down syndrome. Which
of the following tests is most likely to provide the data the woman seeks?
Select one:
a. Ultrasonography
b. Genetic testing of the woman
c. Prenatal blood tests
d. Genetic testing of the woman and the father - ANS - c. Prenatal blood tests
Down syndrome is a result of chromosomal abnormality and is not a single-gene
disorder. As a result, genetic testing of the mother and/or father is not relevant.
Ultrasonography does not have predicative value for Down syndrome, but blood tests
such as α-fetoprotein, human chorionic gonadotropin (HCG), unconjugated estriol,
inhibin A, and pregnancy-associated plasma protein A have helped ascertain the risks.
A 48-year-old male client, who normally enjoys good health, has been admitted to the
hospital for the treatment of polycythemia vera. The nurse who is providing care for the
client should prioritize assessments aimed at the early identification of which of the
following health problems?
Select one:
a. Thromboembolism
b. Hyperventilation
c. Vasculitis
d. Orthostatic hypotension - ANS - a. Thromboembolism
The increased blood viscosity that accompanies primary polycythemia creates a
significant risk of thromboembolism. Hypertension, not hypotension, is also a common
sign. Vasculitis and hyperventilation are unlikely to result directly from polycythemia
vera.
A 55-year-old male client has reported joint pain in his feet. Which of the following blood
work results should prompt further testing to rule out primary gout?
Select one:
a. Increased polymorphonuclear leukocytes
b. Increased C-reactive protein (CRP)
c. Increased serum cortisol
d. Increased serum uric acid - ANS - d. Increased serum uric acid
, Although hyperuricemia is not diagnostic of gout, it is suggestive and should prompt
further assessment. Increases in CRP, polymorphonuclear leukocytes, and cortisol
levels are not as closely associated with the body's response to gout.
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of
hormone therapy. What is the goal of this pharmacologic treatment?
Select one:
a. Increasing serum hormone levels to promote tumor cell lysis
b. Blocking effects of estrogen on the growth of malignant cells
c. Blocking the entry of malignant cells into the axillary lymph nodes
d. Blocking the effects of progesterone on tumor growth - ANS - b. Blocking effects of
estrogen on the growth of malignant cells
Hormone therapy is used to block the effects of estrogen on the growth of breast cancer
cells. Among the most common drugs used for hormone therapy is tamoxifen, a
nonsteroidal antiestrogen that binds to estrogen receptors and blocks the effects of
estrogens on the growth of malignant cells in the breast. Such drugs do not directly
block axillary node involvement or induce tumor cell lysis.
A 70-year-old client admitted to a hospital for a prostatectomy is surprised to learn that
his physician has prescribed insulin on a sliding scale, despite the fact that the client
successfully manages his type 2 diabetes using diet and oral antihyperglycemics when
at home. Which of the following facts may underlie the physician's action?
Select one:
a. The stress of illness stimulates the hypothalamus to release corticotropin-releasing
factor (CRF).
b. Stress-induced release of vasopressin increases serum blood glucose.
c. Increased levels of epinephrine and norepinephrine cause alterations in glucose
metabolism.
d. Stress and illness can increase glycogenolysis and insulin resistance. - ANS - d.
Stress and illness can increase glycogenolysis and insulin resistance.
Stress-induced hyperglycemia results from numerous factors, including enhanced
release of glucose from glycogen stores, increased production of glucose from
noncarbohydrate sources such as amino acids, and an accompanying state of insulin
resistance that impairs glucose uptake into skeletal muscle. CRF, vasopressin,
epinephrine, and norepinephrine do not have direct and pronounced effects on blood
glucose levels during times of stress and illness.
, A 70-year-old male client has been admitted to a hospital for the treatment of a recent
hemorrhagic stroke that has left him with numerous motor and sensory deficits. These
deficits are most likely the result of which of the following mechanisms of cell injury?
Select one:
a. Free radical injury
b. Impaired calcium homeostasis
c. Hypoxia and ATP depletion
d. Interference with DNA synthesis - ANS - c. Hypoxia and ATP depletion
Stroke is characterized by impaired cerebral circulation and consequent death of
neurons from cellular hypoxia. Free radical injury, abnormal DNA synthesis, and
impaired calcium homeostasis are not direct consequences of lack of blood flow to body
cells.
A client presents to a STI clinic. Her primary complaint is related to purulent exudate
and bleeding after intercourse. The health care worker will primarily focus on the
diagnosis of which STI?
Select one:
a. Human papillomavirus infection
b. Chlamydial infection
c. Gonorrhea
d. Genital herpes simplex virus infection - ANS - c. Gonorrhea
The gonococcus is a pyogenic (i.e., pus-forming), gram-negative diplococcus that
evokes inflammatory reactions characterized by purulent exudates. Internal human
papillomavirus (HPV) condylomata acuminata warts are cauliflower-shaped lesions that
affect the mucous membranes of the vagina, urethra, anus, or mouth. The initial
symptoms of primary genital herpes (herpes simplex virus, HSV) infections include
tingling, itching, and pain in the genital area, followed by eruption of small pustules and
vesicles.
A client with a diagnosis of chronic renal failure secondary to diabetes has seen a
gradual increase in her blood pressure over the past several months, culminating in a
diagnosis of secondary hypertension. Which of the following has most likely resulted in
the client's increased blood pressure?
Select one:
a. Coarctation of the client's aorta
b. Increased sympathetic stimulation by the autonomic nervous system (ANS)
c. Activation of the renin-angiotensin-aldosterone mechanism
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