Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth-Test Bank

<< Forensic Psychology 4th edition by Joanna Pozzulo Test Bank Foundations of Mental Health Care 4e by Morrison-Valfre-Test Bank >>
Product Code: 222
Availability: In Stock
Price: $24.99
Qty:     - OR -   Add to Wish List
Add to Compare

Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth-Test Bank


Essentials Of Pathophysiology Concepts of Altered States 4th Edition By Porth-Test Bank

chapter 2

1. Which of the following clients would be an example of cellular atrophy?
  A) A middle-aged female experiencing menopause due to loss of estrogen stimulation
  B) A postnephrectomy client whose remaining kidney enlarges to compensate for the loss
  C) A hypertensive, noncompliant client who has developed a progressive increase in left ventricular mass
  D) A female client with the change in uterine size as a result of pregnancy
  Ans: A
  In women, the loss of estrogen stimulation during menopause results in atrophic changes in the reproductive organs. Compensatory hypertrophy is the enlargement of a remaining organ or tissue after a portion has been surgically removed or rendered inactive. For instance, if one kidney is removed, the remaining kidney enlarges to compensate for the loss. In hypertension, for example, the increased workload required to pump blood against an elevated arterial pressure results in a progressive increase in left ventricular muscle mass and need for coronary blood flow. The pregnant uterus undergoes both hypertrophy and hyperplasia as a result of estrogen stimulation.



2. A client has experienced significant decreases in mobility and stamina during a 3-week hospital stay for the treatment of a femoral head fracture. Which of the following phenomena most likely accounts for the clients decrease in muscle function?
  A) Impaired muscle cell metabolism resulting from metaplasia
  B) Dysplasia as a consequence of inflammation during bone remodeling
  C) Disuse atrophy of muscle cells during a prolonged period of immobility
  D) Ischemic atrophy resulting from vascular changes while on bedrest
  Ans: C
  Disuse atrophy frequently occurs as a consequence of prolonged periods of muscle inactivity. Metaplasia and dysplasia are not common consequences of immobility and muscle disuse. Similarly, infrequent muscle use does not typically cause vascular changes that result in ischemic atrophy.



3. The client is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to which phenomenon in the remaining liver cells?
  A) Metaplasia
  B) Organ atrophy
  C) Compensatory hyperplasia
  D) Physiologic hypertrophy
  Ans: C
  Compensatory hyperplasia can be stimulated in response to loss of vital tissue that is capable of regeneration, such as liver cells. Metaplasia involves replacement of one existing cell type with another fully differentiated cell type. Organ atrophy is caused by irreversible loss of cells. Physiologic hypertrophy is increased size of existing cells resulting from increased workload.



4. A client presents for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the smear will examine cell samples for evidence of:
  A) Changes in cell shape, size, and organization
  B) The presence of unexpected cell types
  C) Ischemic changes in cell samples
  D) Abnormally high numbers of cells in a specified field
  Ans: A
  A Pap smear is an example of a diagnostic procedure that tests for the presence of cell dysplasia, that is, deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization. Unexpected cell types are evidence of metaplasia, whereas ischemic changes are associated with cell hypertrophy. Increases in the number of cells are characterized as hyperplasia.



5. When performing an assessment on a school-aged child, the nurse notes that the mucous membranes along the gum margins have a noticeable blue-colored line. At this point, the nurse should ask the parents about possible:
  A) Liver problems as an infant
  B) Congenital heart problems
  C) Exposure to lead
  D) Second-hand smoke exposure
  Ans: C
  The formation of a blue lead line along the margins of the gum is one of the diagnostic features of lead poisoning. Liver problems are usually displayed as jaundice (yellowing of the skin/sclera). Congenital heart problems may exhibit cyanosis, but this would not be just in the gum margins. Second-hand smoke exposure may cause accumulation in the lungs.



6. An elderly client asks her health care provider if the reason she has developed aortic stenosis is because she drank so much milk as a child growing up on a farm. Which of the following responses is most accurate?
  A) Drinking lots of real milk as a child may have contributed to the damage in your valve.
  B) Atherosclerosis is a long process that eventually results in calcification of heart valves.
  C) This calcification of your aortic valve is more than likely due to an undiagnosed thyroid problem.
  D) More than likely, calcium has left your bones and collected on your aortic valve.
  Ans: B
  Dystrophic calcification represents the macroscopic deposition of calcium salts in injured tissue. Dystrophic calcification is commonly seen in atheromatous lesions of advanced atherosclerosis, in areas of injury in the aorta and large blood vessels, and in damaged heart valves. For example, calcification of the aortic valve is a frequent cause of aortic stenosis in the elderly. Drinking milk, undiagnosed thyroid problems, and calcium loss from bone causing osteoporosis do not cause damaged heart valves.



7. Which of the following pathophysiologic processes is most likely to result in metastatic calcification?
  A) Benign prostatic hyperplasia
  B) Liver cirrhosis
  C) Impaired glycogen metabolism
  D) Hyperparathyroidism
  Ans: D
  Metastatic calcification is a result of markedly increased serum calcium levels. Because the parathyroid gland is responsible for the regulation of serum calcium levels, hyperparathyroidism creates a risk for hypercalcemia and consequent metastatic calcification. Benign prostatic hypertrophy, cirrhosis, and impaired glycogen metabolism are not implicated in cases of metastatic calcification.



8. Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician is aware of the need to minimize her exposure to ionizing radiation. What is the primary rationale for the technicians precautions? Radiation:
  A) Stimulates pathologic cell hypertrophy and hyperplasia
  B) Results in the accumulation of endogenous waste products in the cytoplasm
  C) Interferes with DNA synthesis and mitosis
  D) Decreases the action potential of rapidly dividing cells
  Ans: C
  Radiation has a damaging effect on DNA synthesis and mitosis, a process that is especially harmful to rapidly dividing cells. Radiation does not directly influence the action potential of cells or the accumulation of endogenous waste products. Cell changes such as hypertrophy or hyperplasia may result from radiation exposure, but such changes are secondary to interference with DNA synthesis and mitosis.



9. A mother rushes her 4-year-old child to the emergency department after she found an empty Tylenol (acetaminophen) bottle beside her child. The nurse is trying to explain why it is so important to give the child Ipecac to induce vomiting in order to prevent:
  A) Renal failure
  B) Seizures
  C) Liver failure
  D) Hemorrhage
  Ans: C
  Acetaminophen, a commonly used over-the-counter analgesic drug, is detoxified in the liver, where small amounts of the drug are converted to a highly toxic metabolite. This metabolite is detoxified by a metabolic pathway that uses a substance normally present in the liver. When large amounts of the drug are ingested, this pathway becomes overwhelmed and toxic metabolites accumulate, causing massive liver necrosis.



10. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?
  A) White blood cell levels with differential
  B) Red blood cell levels and morphology
  C) Urea and creatinine levels
  D) Liver function panel
  Ans: B
  Anemia is a cardinal sign of lead toxicity. Consequently, assessment of the quantity and morphology of RBCs is paramount in cases of suspected lead toxicity. White blood cell and liver studies are not central to the care of this client. Lead is indeed nephrotoxic, and urea and creatinine levels are relevant to assessment, but the priority blood test is assessment of the RBCs.



11. A pregnant client is attending a nutrition class for first-time moms. During the class, the instructor stressed that they should avoid consumption of which food that may cause brain damage from methyl mercury exposure?
  A) Tuna
  B) Raw hamburger
  C) Fresh milk
  D) Beets
  Ans: A
  The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Fish concentrate mercury from sediment in the water. Because the developing brain is more susceptible to mercury-induced damage, it is recommended that young children and pregnant and nursing women should avoid consumption of fish known to contain high mercury content. None of the other foods listed pose a threat of mercury toxicity.



12. A client has been diagnosed with a gram-negative bacillus in his blood cultures. The health care providers know these bacteria may produce clinical manifestations such as high temperature, high respiratory rate, and low blood pressure. These manifestations are primarily caused by:
  A) Disrupting the sodium/potassium ATPase pump
  B) Interrupting oxidative metabolism processes
  C) The outer layer of the bacterial membrane acting as an endotoxin
  D) The bacteria causing a decrease in protein synthesis and function
  Ans: C
  Bacteria and viruses can replicate within a cell, thus perpetuating the injuries. Gram-negative bacilli have unique characteristics in the structure of the outer membrane. The outer leaflet of the membrane has a lipid portion that acts as an endotoxin. If this bacillus enters the circulatory system, it causes a toxic reaction, with the sufferer developing a high temperature, high respiration rate, and low blood pressure. Other agents that are injurious to cells are unable to replicate in the cell, but they may disrupt the sodium/potassium pump, interrupt oxidative metabolism, or decrease protein synthesis.



13. Which of the following diseases would be considered to be caused by a lack of a specific vitamin or mineral?
  A) Anorexia nervosa
  B) Scurvy
  C) Sickle cell anemia
  D) Atherosclerosis
  Ans: B
  Dietary deficiencies can occur because of a selective deficiency of a single nutrient. Iron deficiency anemia, scurvy, beriberi, and pellagra are examples of injury caused by a lack of specific vitamins or minerals. Anorexia nervosa, sickle cell anemia, and atherosclerosis are not caused by lack of a vitamin/mineral.



14. Free radicals damage cells by:
  A) Destroying phospholipids in the cell membrane
  B) Altering the immune response of the cell
  C) Disrupting calcium storage in the cell
  D) Inactivation of enzymes and mitochondria
  Ans: A
  Free radicals are highly reactive and can damage cells in several ways. One way is by destroying lipids, which results in a loss of cell membrane integrity. Free radicals modify proteins but do not affect the immune function, calcium storage, or intracellular enzymes of cells.



15. 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?
  A) Free radical injury
  B) Hypoxia and ATP depletion
  C) Interference with DNA synthesis
  D) Impaired calcium homeostasis
  Ans: B
  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.



16. An elderly client has experienced some hypoxia as a result of chronic respiratory problems. Knowing that oxygen -deprived cells result in an accumulation of lactic acid in the cells, physiologically, the client may experience:
  A) An increase in fat load
  B) Altered cell membrane permeability
  C) Retention of lysosomal enzymes
  D) Cellular shrinkage and dehydration
  Ans: B
  Altered membrane permeability impairs the balance, allowing too much of some and not enough of other substances to flow in and out of the cell. The altered permeability, lack of ATP, and loss of functional surface receptors make it difficult for glucose to enter the cell. Excess fat accumulates because it is unable to move through the damaged membrane. Injury to the lysosomal membranes results in the leakage (not retention) of destructive lysosomal enzymes into the cytoplasm and enzymatic digestion of cell components.



17. Injured cells become very swollen as a result of:
  A) Increased cell protein synthesis
  B) Altered cell volume regulation
  C) Passive entry of potassium into the cell
  D) Bleb formation in the plasma membrane
  Ans: B
  Altered cell volume regulation, caused by the impaired permeability of the cell membrane, leads to sodium retention and substance accumulation within the cell. Sodium attracts water, and the cell swells even more. Protein synthesis is decreased in injured cells. Potassium has difficulty entering the cell and accumulates in the serum, due to loss of the ATPase sodium/potassium pump. Bleb formation occurs in the cell that is already swollen and ready to burst.



18. Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of:
  A) Release of stored calcium from the mitochondria
  B) Improved intracellular volume regulation
  C) Decreased influx across the cell membrane
  D) Attraction of calcium to fatty infiltrates
  Ans: A
  Disruption of the normal intracellular functions causes the impaired mitochondria to release stored calcium. Cell injury disrupts intracellular volume regulation, allowing excessive influx of substances across the impaired cell membrane. Fatty infiltrate is an ominous sign of cell damage and does not interact with calcium.



19. Which of the following processes associated with cellular injury is most likely to be reversible?
  A) Cell damage resulting from accumulation of fat in the cytoplasm
  B) Cellular changes as a result of ionizing radiation
  C) Cell damage resulting from accumulation of free radicals
  D) Apoptosis
  Ans: A
  Intracellular accumulation of fat leads to serious cell damage, but this is a potentially reversible effect. Ionizing radiation and damage from free radicals are more likely to be permanent, whereas apoptosis is defined as the permanent removal of injured and aged cells.



20. A client with diabetes has impaired sensation, circulation, and oxygenation of his feet. He steps on a piece of glass, the wound does not heal, and the tissue area becomes necrotic. The necrotic cell death is characterized by:
  A) Rapid apoptosis
  B) Cellular breakage
  C) Shrinkage and collapse
  D) Chronic inflammation
  Ans: B
  Apoptosis is a programmed cell death, unrelated to cell injury, and occurs in a controlled, organized manner. Necrosis is an unorganized death of cells that initiates the acute inflammatory response with intracellular swelling and resulting cellular breakage (rupture).



21. A client has been diagnosed with gram-negative pneumonia of the lower lobe. Knowing that gram-negative bacteria have a lipopolysaccharide endotoxin on their outer cell membrane, the health care provider should be assessing the client for which pathophysiological end result?
  A) Damage to cellular mitochondria
  B) Increased ATP levels
  C) Activation of the p53 protein
  D) Apoptosis
  Ans: D
  The extrinsic pathway of apoptosis involves extracellular signaling proteins that bind to cell surface molecules called death receptors and trigger apoptosis. The end result includes activation of endonucleases that cause fragmentation of DNA and cell death. In addition to TNF and Fas ligand, primary signaling molecules known to activate the extrinsic pathway include TNF-related apoptosis-inducing ligand (TRAIL); the cytokine interleukin-1 (IL-1); and lipopolysaccharide (LPS), the endotoxin found in the outer cell membrane of gram-negative bacteria. DNA damage, activation of the p53 protein, and decreased ATP levels are associated with the intrinsic pathway.



22. A person eating peanuts starts choking and collapses. His airway obstruction is partially cleared, but he remains hypoxic until he reaches the hospital. The health care providers will be assessing this client for which of the following physiological events? Select all that apply.
  A) Cerebral infarction
  B) Coagulation necrosis
  C) Rapid phagocytosis
  D) Protein p53 deficiency
  Ans: A, B
  Tissue infarction is caused by prolonged oxygen deprivation, and the resulting large group of dead cells coagulates in the damaged area. During coagulation necrosis, acidosis develops and denatures the enzymatic and structural proteins of the cell. Phagocytosis occurs rapidly during apoptosis, so it does not elicit an inflammatory response. Protein p53 activation initiates apoptosis.



23. A client with diabetes and severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. The client asks, How this can happen? Which of the following pathophysiologic processes should the nurse explain to this client? More than likely, your gangrene is caused by:
  A) Inappropriate activation of apoptosis, which means death of your cells.
  B) Bacterial invasion into the foot and toe.
  C) Impaired arterial blood supply to your toe.
  D) Metaplastic cellular changes in your toe.
  Ans: C
  Dry gangrene is often a result of impaired arterial blood supply to the extremities. A bacterial etiology is more common in wet gangrene, whereas neither metaplasia nor activation of apoptosis is implicated in cases of dry gangrene.



24. A group of elderly residents were commenting on how many cell functions decline with age. One resident commented that many of his friends who lived under large electromagnetic towers seemed to experience aging at an accelerated rate in comparison with residents who lived nearby in lakefront housing. This observation is the basis for which theory on aging?
  A) Theories of genetic influences
  B) Programmed cell receptor theories
  C) Insufficient telomerase enzyme theory
  D) Error theory associated with DNA damage
  Ans: D
  Error theory suggests that aging results from DNA mutation or faulty repair. Another group of theories of aging focuses on programmed cell changes with genetic influences that systematically cause cell senescence. Elimination of receptor sites is not part of aging theory. Telomerase enzyme is thought to reduce the shortening of the chromosomes and loss of telomere DNA with each cell replication.



25. Which of the following facts underlies the concept of replicative senescence?
  A) Genes controlling longevity are present or absent in varying quantities among different individuals.
  B) Telomeres become progressively shorter in successive generations of a cell.
  C) The damaging influence of free radicals increases exponentially in later generations of a cell.
  D) Aging produces mutations in DNA and deficits in DNA repair.
  Ans: B
  Replicative senescence implies that cells have limited capacity for reproduction, largely as a result of the shortening of telomeres and consequent chromosomal damage. Genetic theories, the influence of free radicals, and DNA mutation are not central to the concept of replicative senescence.


chapter 10

1. A large, high-calorie meal has resulted in the intake of far more energy than a person requires. What will the individuals body do with the excess carbohydrates provided by this meal?
  A) Convert them into glucose and store them in the liver and muscles
  B) Excrete most of the excess polysaccharides through the kidneys
  C) Convert the carbohydrates into amino acids in preparation for long-term storage
  D) Create structural proteins from some of the carbohydrates and store the remainder as triglycerides
  Ans: A
  Dietary carbohydrates are largely converted to glucose, which is stored as glycogen in the liver and skeletal muscle cells. They are not excreted by the kidneys, and carbohydrates cannot be directly converted into amino acids or structural proteins.



2. While educating a class about adipocytes in adipose tissue, the faculty will emphasize these cells not only serve as storage sites but also are able to:
  A) Produce linoleic fatty acid
  B) Synthesize triglycerides
  C) Increase glucagon release
  D) Degrade fat-soluble vitamins
  Ans: B
  Adipocytes synthesize and store lipids as triglycerides. Polyunsaturated linoleic fatty acid is obtained from dietary fats. Fat-soluble vitamins are components of the enzyme system required for energy to be released from fat. Adipocytes store glycerol and release it as an energy source when needed.



3. When educating students about the differences between brown fat versus white fat, the instructor will share that brown fat has iron in its mitochondria that will facilitate:
  A) Production of a protein that releases the energy generated from metabolism as heat
  B) The primary function of storing fat energy
  C) Insulation and cushioning of the bodys vital organs
  D) Concentration of the fat tissue in the greater omentum and around the kidneys
  Ans: A
  Brown fat differs from white fat in terms of its thermogenic capacity (its ability to produce heat). The color of brown fat reflects the presence of iron in its abundant mitochondria. Brown fat mitochondria produce a specific protein called uncoupling protein-1 (UCP-1) that releases the energy generated from metabolism as heat. The functions of white fat include energy storage, endocrine and adipocytokine secretion, insulation, and cushioning of vital organs. Internally, white adipose tissue is preferentially located in the greater omentum, mesentery, and retroperitoneal space and is usually abundant around the kidney.



4. Which of the following clients is most likely to be in positive nitrogen balance? A client:
  A) Who is receiving treatment for sepsis
  B) Whose diagnosis of pneumonia is causing a fever
  C) Who has been admitted to the hospital in early labor
  D) Who sustained extensive burns in a recent industrial accident
  Ans: C
  Pregnancy is associated with a positive nitrogen balance, whereas illness, fever, infection, and burns typically result in a negative nitrogen balance.



5. Protein contains nitrogen. A negative nitrogen balance represents:
  A) More protein consumed than excreted
  B) A reduced need for nitrogen as protein
  C) More nitrogen excreted than consumed
  D) Less use of nitrogen for protein synthesis
  Ans: C
  Negative nitrogen balance represents more excretion of nitrogen than consumed as protein. It represents a state of tissue breakdown. Positive nitrogen balance is when more protein (nitrogen) is consumed than is needed or excreted. A normal nitrogen balance is when protein intake is equivalent to nitrogen output.



6. In addition to facilitating bowel movements, a diet that is high in fiber confers which of the following benefits?
  A) Lowering cholesterol and blood glucose
  B) Removing toxins and metabolic by-products
  C) Lowering blood pressure and resting heart rate
  D) Increasing intestinal absorption of vitamins and minerals
  Ans: A
  Fiber binds with cholesterol and prevents it from being absorbed by the body as well as lowers blood glucose. It does not directly detoxify the body or increase intestinal absorption of vitamins and minerals. Fiber alone does not cause a reduction in blood pressure or heart rate.



7. Which of the following body mechanisms is necessary for food intake control?
  A) Ketoacid deficiency
  B) Cholecystokinin storage
  C) Decreased blood glucose
  D) Leptin receptor stimulation
  Ans: D
  Leptin receptor stimulation of the hypothalamus causes decreased appetite and increased metabolic rate/energy consumption. Natural appetite suppression is a response to cholecystokinin release and increased ketoacids. Decreased blood glucose causes a hunger response.



8. From the following list of physical assessment results, which would be interpreted as the client has developed obesity?
  A) Female body fat of 20%
  B) Body mass index (BMI) of 40
  C) Relative body weight of 70%
  D) Abdominal fat/hip ratio of 0.8
  Ans: B
  A person with a BMI of 30 or greater is classified as obese. Relative body weight greater than 120% indicates obesity. Body fat percentage over 30% indicates obesity in females. Waisthip ratio that calculates abdominal fat in proportion to total body fat is greater than 1.0 when upper body obesity is present.



9. A client is undergoing a bioelectrical impedance test to estimate body fat. The nurse will explain to the client that this test involves:
  A) Not eating anything after midnight and walking/running on a treadmill
  B) Measuring skin fold thicknesses in a number of different sites on the body
  C) Taking quantitative pictures to determine the thickness of the body fat
  D) Using electrodes to send harmless current through the body to measure resistance to estimate body fat
  Ans: D
  Bioelectrical impedance involves the use of electrodes attached to the wrists and ankles to send a harmless current through the body. The flow of the current is affected by the amount of water in the body. Because fat-free tissue contains virtually all the water and current-conducting electrolytes, measurements of the resistance (i.e., impedance) can be used to estimate the percentage of body fat present. Computed tomography and MRI can be used to provide quantitative pictures from which the thickness of fat can be determined. Measurements of skinfold thickness can provide a reasonable assessment of body fat, particularly if taken at multiple sites.



10. Which of the following statements best conveys the endocrine function of adipose tissue? Adipose tissue:
  A) Antagonizes the effects of insulin on cell membranes
  B) Produces ghrelin, which stimulates both appetite and eating
  C) Produces and secretes cholecystokinin (CCK), which stimulates the hypothalamic feeding center
  D) Produces leptin, which mediates body weight
  Ans: D
  Adipose tissue is now recognized as an endocrine organ that produces several hormones, including leptin, an important mediator of body weight. It does not produce CCK or ghrelin, however, and adipose tissue does not directly antagonize the effects of insulin.



11. Knowing that excess adipose tissue can result in chronic inflammation, the high school nurse should be assessing obese students for which of the following health problems?
  A) Osteoporosis
  B) Type 2 diabetes
  C) Rheumatoid arthritis
  D) Systemic lupus erythematosus (SLE)
  Ans: B
  The inflammatory response that is initiated by adipose tissue is implicated in the pathogenesis of insulin resistance and type 2 diabetes. This inflammatory process is not known to contribute directly to osteoporosis, rheumatoid arthritis, or SLE.



12. Following yearly routine physical examination by the health care provider, a client has been diagnosed with upper body obesity along with central fat distribution. The client is at greater risk for developing which of the following disease processes?
  A) Osteoporosis
  B) Renal disease
  C) Cardiometabolic disorders
  D) Chronic anemia
  Ans: C
  Upper body obesity, more than other types of obesity, carries a high cardiometabolic risk. Obese people tend to develop joint problems and arthritis, but there is no direct association with osteoporosis. Chronic anemia is associated with malnutrition and starvation. Primary renal disease is unrelated to excessive weight.



13. When discussing adolescent health with a group of high school teachers, the school nurse shares that each year their student population is becoming increasingly obese. Therefore, the school nurse took the opportunity to educate the teachers about signs and symptoms of which of the following high-risk disease processes?
  A) Type 2 diabetes mellitus
  B) Attention deficit disorder
  C) Juvenile rheumatoid arthritis
  D) Antibiotic-resistant bacterial infections
  Ans: A
  Childhood obesity is directly related to the increased incidence of type 2 diabetes. Until recently, type 2 diabetes rarely developed in children. Rheumatoid arthritis, attention deficit disorder, and resistant bacterial infections are unrelated to excessive fat storage (obesity).



14. In collecting assessment data on the school-aged population, which of the following factors could be the most significant predictor of childhood obesity?
  A) Low socioeconomic status
  B) Low self-esteem
  C) Having parents who are obese
  D) Living in a rural neighborhood
  Ans: C
  The most significant risk for childhood obesity is having parents who are obese. This variable is more important than socioeconomic status, low self-esteem, or a rural or inner-city residence.



15. Which of the following measures should a school nurse prioritize in the treatment and prevention of childhood obesity?
  A) Group cognitive therapy
  B) Use of selective serotonin reuptake inhibitors (SSRIs)
  C) Education on exercise and nutrition
  D) High-protein, low-carbohydrate diet
  Ans: C
  Teaching children about the pivotal roles of regular exercise and a healthy diet should be the primary focus of treatment for the majority of obese children. Pharmacologic treatments and cognitive therapy are measures that are likely to be appropriate for only a small minority of obese children. A high-protein, low-carbohydrate diet is a short-term weight loss strategy that is not synonymous with creating lifelong healthy eating habits.



16. Which of the following clients coming to a small free clinic are at high risk for malnutrition? Select all that apply.
  A) An 88-year-old senior citizen on a fixed budget
  B) A 60-year-old homeless Vietnam veteran complaining of pain
  C) A 4-year-old child who lives with a single mom in a rooming house
  D) A 17-year-old female who thinks she might have been exposed to syphilis
  E) A 32-year-old construction working having muscle spasms in his back
  Ans: A, B, C
  Among the many causes of malnutrition are poverty and lack of knowledge, acute and chronic illness, and self-imposed dietary restrictions. Homeless people, the elderly, and the children of the poor often demonstrate the effects of protein and energy malnutrition, as well as vitamin and mineral deficiencies. Sexually active teenagers and working young adults are not usually at high risk for malnutrition.



17. Which of the following characteristics distinguishes kwashiorkor from marasmus?
  A) Impairment of immune function
  B) Lack of dietary fat intake
  C) High intake of carbohydrates
  D) Impaired pigment synthesis
  Ans: C
  Kwashiorkor is a protein deficiency coupled with a high-carbohydrate diet; marasmus is a deficiency in both calories and protein. Both forms of malnutrition impair immune function and pigment synthesis, and each is normally accompanied by inadequate intake of dietary fats.



18. A child has been diagnosed with marasmus due to the fact that the parents have both lost their jobs and have very limited funds for food. Which of the following clinical manifestations would the school nurse assess that would confirm this diagnosis? Select all that apply.
  A) Discolored hair
  B) Bradycardia
  C) Enlarged liver
  D) Pitting edema
  E) Stunted growth pattern
  Ans: B, E
  Inadequate food intake, with equal deficiencies of calories and protein, is the cause of marasmus, which is characterized by low heart rate, blood pressure, and body temperature; dull hair; and an emaciated appearance. Hair discoloration, enlarged liver, and pitting edema are manifestations of kwashiorkor, which is a severe protein deficiency.



19. A school nurse has identified a student with noticeable loss of lean tissues and muscle mass. More than likely, this is caused by proteincalorie malnutrition. The nurse should ask the student if he is experiencing which of the following clinical manifestations that helps confirm this diagnosis?
  A) Respiratory muscle stimulation
  B) Excessive blood cell production
  C) Diarrhea
  D) Increased cardiac contractility
  Ans: C
  Proteincalorie malnutrition results in skeletal muscle loss and diarrhea. This type of malnutrition is also characterized by respiratory muscle weakness and blood cell loss that impairs the immune response.



20. A homeless client asks, Why cant I get this wound on my foot to heal? Knowing that the client is not receiving good nutrition on a regular basis, the nurse will reply:
  A) Maybe if you could come to the clinic every day, we can help you change your dressing.
  B) Right now your immune system is decreased because you are not eating a balanced diet.
  C) Maybe if you could find a place to sleep that is cleaner than where you usually sleep that will help.
  D) We just need to make sure you are getting the right antibiotics.
  Ans: B
  As protein is lost from the liver, hepatic synthesis of proteins declines, and plasma protein levels decrease. There also is a decrease in immune cells. Wound healing is poor, and the body is unable to fight off infection because of multiple immunologic malfunctions throughout the body.



21. A frail, 87-year-old female client has been admitted to a hospital after a fall and has been diagnosed with failure to thrive. Which of the following laboratory values would suggest that the client may be experiencing malnutrition?
  A) Low prealbumin
  B) High C-reactive protein
  C) High bilirubin
  D) Low fasting blood sugar
  Ans: A
  Prealbumin levels are a reliable indicator of calorieprotein malnutrition. Low blood sugar does not necessarily indicate malnutrition, and neither C-reactive protein nor bilirubin levels are sensitive or specific indicators of nutrit

Write a review

Your Name:

Your Review: Note: HTML is not translated!

Rating: Bad           Good

Enter the code in the box below:


Once the order is placed, the order will be delivered to your email less than 24 hours, mostly within 4 hours. 

If you have questions, you can contact us here