Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam.
Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.
Text Mode – Text version of the exam 1. The nurse who provides teaching to the female patient regarding prevention of recurrent urinary tract infections includes which of the following statements? 2. A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders? 3. Rejection of a transplanted kidney within 24 hours after transplant is termed 4. When caring for a patient with an uncomplicated, mild urinary tract infection (UTI), the nurse knows that recent studies have shown which of the following drugs to be a good choice for short-course (e.g. 3-day) therapy? 5. Which of the following terms refers to difficult or painful sexual intercourse? 6. The opening into the vagina on the perineum is termed the 7. Which of the following hormones is primarily responsible for stimulating the production of progesterone? 8. When the results of a Pap smear are reported as class 5, the nurse recognizes that the common interpretation is 9. For women aged 19-39 years, recommended health screening diagnostic testing includes which of the following? 10. Which of the following statements reflects nursing care of the woman with mild to moderate ovarian hyperstimulation syndrome (OHSS)? 11. Which of the following terms is used to describe a procedure in which cervical tissue is removed as result of detection of abnormal cells? 12. Of the following terms, which is used to refer to a type of gestational trophoblastic neoplasm? 13. When the female client reports a frothy yellow-brown vaginal discharge, the nurse suspects the client has a vaginal infection caused by 14. The nurse providing education regarding sexually transmitted diseases includes which of the following statements regarding herpes virus 2(herpes genitalis)? 15. An opening between the bladder and the vagina is called a 16. Which of the following statements defines laparoscopic myomectomy—an alternative to hysterectomy for the treatment of excessive bleeding due to fibroids? 17. Stage 3 of breast development, according to Tanner, occurs when 18. When the female patient demonstrates thickening, scaling, and erosion of the nipple and areola, the nurse recognizes that the patient is exhibiting signs of 19. The nurse teaches the female patient who is premenopausal to perform breast self-examination (BSE) 20. Which type of biopsy is used for nonpalpable lesions found on mammography? 21. The nurse recognizes which of the following statements as accurately reflecting a risk factor for breast cancer? 22. Which of the following terms is used to describe removal of the breast tissue and an axillary lymph node dissection leaving muscular structure intact as surgical treatment of breast cancer? 23. Ductal lavage is used for 24. The 2000 NIH Consensus Development Conference Statement states that what percentage of women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1cm in size? 25. Which of the following terms refers to surgical removal of one of the testes? 26. The term or disease associated with buildup of fibrous plaques in the sheath of the corpus cavernosum causing curvature of the penis when it is erect is known as 27. Which of the following terms is used to describe the opening of the urethra on the dorsum of the penis? 28. The nurse teaches the patient who has been prescribed Viagra which of the following guidelines? 29. The obstructive and irritative symptom complex caused by benign prostatic hypertrophy is termed 30. Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as 31. Cytotoxic T cells 32. During which stage of the immune response does the circulating lymphocyte containing the antigenic message return to the nearest lymph node? 33. Which of the following responses identifies a role of T lymphocytes? 34. Of the following classifications of medications, which is known to inhibit prostaglandin synthesis or release? 35. Which of the following statements reflect current stem cell research? 36. The nurse’s base knowledge of primary immunodeficiencies includes which of the following statements? Primary immunodeficiencies 37. Agammaglobulinemia is also known as 38. When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion? 39. Ataxia is the term that refers to 40. Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS? 41. Of the following blood tests, which confirms the presence of antibodies to HIV? 42. When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean 43. Which of the following substances may be used to lubricate a condom? 44. More than 500 CD4+ T lymphocytes/mm3 indicates which stage of HIV infection? 45. The term used to define the balance between the amount of HIV in the body and the immune response is 46. Which of the following statements reflect the treatment of HIV infection? 47. Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? 48. Which type of hypersensitivity reaction involves immune complexes formed when antigens bind to antibodies? 49. When the patient’s eosinophil count is 50-90% of blood leukocytes, the nurse interprets the result as 50. Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis?Practice Mode
Exam Mode
Text Mode
Voiding will serve to flush the urethra, expelling contaminants.
Showers are encouraged rather than tub baths because bacteria in the bath water may enter the urethra.
Coffee, tea, colas, alcohol, and other fluids that are urinary tract irritants should be avoided.
The patient should be encouraged to void every 2-3 hours during the day and completely empty the bladder.
Acute glomerulonephritis is also associated with varicella zoster virus, hepatitis B, and Epstein-Barr virus.
Acute renal failure is associated with hypoperfusion to the kidney, parenchymal damage to the glomeruli or tubules, and obstruction at a point distal to the kidney.
Chronic renal failure may be caused by systemic disease, hereditary lesions, medications, toxic agents, infections, and medications.
Nephrotic syndrome is caused by disorders such as chronic glomerulonephritis, systemic lupus erythematosus, multiple myeloma, and renal vein thrombosis.
Hyperacute rejection may require removal of the transplanted kidney.
Acute rejection occurs within 3-14 days of transplantation.
Chronic rejection occurs after many years.
The term simple is not used in the categorization of types of rejection of kidney transplants.
Levofloxacin, a floroquinolone, is a good choice for short-course therapy of uncomplicated, mild to moderate UTI. Clinical trial data show high patient compliance with the 3-day regimen (95.6%) and a high eradication rate for all pathogens (96.4%).
Trimethoprim sulfamethoxazole is a commonly used medication for treatment of a complicated UTI, such as pyelonephritis.
Nitrofurantoin is a commonly used medication for treatment of a complicated UTI, such as pyelonephritis.
Ciprofloxacin is a good choice for treatment of a complicated UTI. Recent studies have found ciprofloxacin to be significantly more effective than TMP-SMX in community-based patients and in nursing home residents.
Dyspareunia is a common problem of the aged female.
Amenorrhea refers to absence of menstrual flow.
Dysmenorrhea refers to painful menstruation.
Endometriosis is a condition in which endometrial tissue seeds in other areas of the pelvis.
The introitus is the vaginal orifice.
Adnexa is a term used to describe the fallopian tubes and ovaries together.
The cervix is the bottom (interior) part of the uterus that is located in the vagina.
hymen.
Luteinizing hormone is released by the pituitary gland.
Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.
Estrogens are responsible for developing and maintaining the female reproductive tract.
Androgens, secreted in small amounts by the ovaries, are involved in early development of the follicle and also affect the female libido.
A class 5 Pap smear, according to the Bethesda Classification, indicates squamous cell carcinoma.
A class 1 Pap smear is interpreted as normal.
A class 2 Pap smear is interpreted as probably normal.
A class 3 Pap smear is interpreted as suspicious.
A Pap smear is recommended for women aged 19-39 years, as well as for women aged 40 and older.
Mammography is recommended for health screening for women aged 40 years and older.
Cholesterol and lipid profile is recommended for women aged 40 years and older.
Bone mineral density testing is recommended for women aged 40 years and older.
Management in mild and moderate cases of OHSS consists of decreased activity, monitoring of urine output and frequent office visits as designated by the reproductive endocrinologist.
Treatment of severe, not mild to moderate, OHSS includes daily measurements of weight and abdominal circumference.
Symptoms of OHSS include abdominal discomfort, distention, weight gain and ovarian enlargement.
The procedure is also called a cone biopsy.
Colporrhaphy refers to repair of the vagina.
Cryotherapy refers to destruction of tissue by freezing.
Perineorrhaphy refers to sutural repair of perineal lacerations.
Hydatidiform mole occurs in 1 in 1000 pregnancies.
A dermoid cyst is an ovarian tumor of undefined origin that consists of undifferentiated embryonal cells.
Doderlein’s bacilli is one component of normal vaginal flora.
Bartholin’s cyst is a cyst in a paired vestibular gland in the vulva.
Trichomonas vaginalis causes a frothy yellow-white or yellow-brown vaginal discharge.
Candidiasis causes a white, cheeselike discharge clinging to the vaginal epithelium.
Gardnerella vaginalis causes a gray-white to yellow-white discharge clinging to the external vulva and vaginal walls.
Chlamydia causes a profuse purulent discharge.
Therefore, a cesarean delivery may be performed if the virus recurs near the time of delivery.
Asexual transmission by contact with wet surfaces or self-transmission (i.e., touching a cold sore and then touching the genital area) can occur.
Transmission is possible even when the carrier does not have symptoms.
Usually, the virus is killed at room temperature by drying.
A vesicovaginal fistula may occur because of tissue injury sustained during surgery, vaginal delivery, or a disease process.
A cystocele is a downward displacement of the bladder toward the vaginal orifice.
A rectocele is a bulging of the rectum into the vagina.
A rectovaginal fistula is an opening between the rectum and the vagina.
Laparoscopic myomectomy is the removal of fibroids through a laparoscope inserted through a small abdominal incision.
Laparoscopic myolysis is the procedure in which a laser or electrial needles are used to cauterize and shrink the fibroid.
Laparoscopic cryomyolysis is the procedure in which electric current is used to coagulate the fibroids.
Hysteroscopic resection of myomas is the procedure in which a laser is used through a hyserscope passed through the cervix; no incision or overnight stay is needed.
Stage 3 also involves further enlargement of breast tissue.
Breast budding is the first sign of puberty in a female.
In stage 4, the nipple and areola form a secondary mound on top of breast tissue.
In stage 5, the female demonstrates continued development of a larger breast with a single contour.
Paget’s disease is a malignancy of mammary ducts with early signs of erythema of nipple and areola.
Acute mastitis is demonstrated by nipple cracks or abrasions along with reddened and warm breast skin and tenderness.
Fibroadenoma is characterized as the occurrence of a single, nontender mass that is firm, mobile, and not fixed to breast tissue or chest wall.
Peau d’orange is associated with the breast and demonstrates an orange peel apearance of breast skin with enlargement of skin pores.
BSE is best performed after menses, when less fluid is retained.
Because most women notice increased tenderness, lumpiness, and fluid retention before their menstrual period, BSE is not recommended with the onset of menses.
Because the tenderness, lumpiness, and fluid retention problems noticed by women in relation to onset of menses generally continue through menses, BSE is not recommended during that time.
Because most women notice increased tenderness, lumpiness, and fluid retention before their menstrual period, BSE is best performed when the time for menses is taken into account.
Stereotactic biopsy utilizes computer location of the suspicious area found on biopsy, followed by core needle insertion and sampling of tissue for pathologic examination.
Excisional biopsy is the usual procedure for any palpable breast mass.
Incisional biopsy is performed on a palpable mass when tissue sampling alone is required.
Risk for breast cancer increases twofold if first-degree female relatives (sister, mother, or daughter) had breast cancer.
Increased risk is associated with early menarche (i.e., menses beginning before 12 years of age).
Nulliparity and later maternal age for first birth are associated with increased risk for breast cancer.
Alcohol use remains controversial; however, a slightly increased risk is found in women who consume even one drink daily and doubles among women drinking three drinks daily.
A modified radical mastectomy leaves the pectoralis major and minor muscles intact.
In a segmental mastectomy, varying amounts of breast tissue are removed, including the malignant tissue and some surrounding tissue to ensure clear margins.
In a total mastectomy, breast tissue only is removed.
Radical mastectomy includes removal of the pectoralis major and minor muscles in addition to breast tissue and axillary lymph node dissection.
Performed in the doctor’s office, a microcatheter is inserted through the nipple while instilling saline and retrieving the fluid for analysis. It has been shown to identify atypical cells in this population and has been found to be adept at detecting cellular changes within the breast tissue.
Ductal lavage is used for women at higher risk, not low risk, for benign proliferative breast disease.
Ductal lavage is used for women at higher risk for benign proliferative breast disease; it is not used as a screening tool.
Ductal lavage is used for women at higher risk for benign proliferative breast disease; it is not specific for women with breast implants.
The 2000 Consensus Development Conference Statement states that all women with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
All women (100%) with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
All women (100%) with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
All women (100%) with invasive breast cancer should consider the option of systemic chemotherapy, not just women whose tumors are greater than 1 cm in size.
Orchiectomy is required when the testicle has been damaged.
Circumcision is excision of the foreskin, or prepuce, of the glans penis.
Vasectomy is the ligation and transection of part of the vas deferens to prevent the passage of the sperm from the testes.
Hydrocelectomy describes the surgical repair of a hydrocele, a collection of fluid in the tunica vaginalis.
Peyronie’s disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible.
Bowen’s disease refers to a form of squamous cell carcinoma in situ of the penile shaft.
Phimosis refers to the condition in which the foreskin is constricted so that it cannot be retracted over the glans.
Priapism refers to an uncontrolled, persistent erection of the penis occurring from either neural or vascular causes.
Epispadias is a congenital anomaly in which the urethral opening is on the dorsum of the penis and is usually repaired through plastic surgery when the boy is very young.
Hypospadias is a congenital anomaly in which the urethral opening is on the underside of the penis and is usually repaired through plastic surgery when the boy is very young.
Urethral stricture is a condition in which a section of urethra is narrowed.
Urethritis refers to inflammation of the urethra and is commonly associated with sexually transmitted disease.
Taking Viagra more than once a day will not improve its effects and the patient may experience back and leg aches as well as nausea and vomiting.
Viagra should be taken one hour before intercourse.
Viagra will not create the erection; the erection must be created by sexual stimulation.
Viagra will not restore desire or sex drive.
Symptoms of prostatism include increased frequency of urination, nocturia, urgency, dribbling, and a sensation that the bladder has not completely emptied.
Prostatitis is an inflammation of the prostate gland.
Prostaglandins are physiologically active substances present in tissues with vasodilator properties.
Prostatectomy refers to the surgical removal of the prostate gland.
Interferons are biologic response modifiers with nonspecific viricidal proteins.
Antibodies are protein substances developed by the body in response to and interacting with a specific foreign substance.
Antigens are substances that induce formation of antibodies.
Cytotoxic T cells play a role in graft rejection.
B cells are lymphocytes important in producing circulating antibodies.
Helper T cells are lymphocytes that attack antigens directly.
Suppressor T cells are lymphocytes that decrease B-cell activity to a level at which the immune system is compatible with life.
Once in the node, the sensitized lymphocyte stimulates some of the resident dormant T and B lymphocytes to enlarge, divide, and proliferate.
In the recognition stage, the immune system distinguishes an invader as foreign, or non-self.
In the response stage, the changed lymphocytes function either in a humoral or cellular fashion.
In the effector stage, either the antibody of the humoral response or the cytotoxic T cell of the cellular response reaches and couples with the antigen on the surface of the foreign invader.
Transplant rejection and graft-versus-host disease are cellular response roles of T cells.
Anaphylaxis is a humoral response role of B-lymphocytes.
Allergic hay fever and asthma are humoral response roles of B-lymphocytes.
Bacterial phagocytosis and lysis are humoral response roles of B-lymphocytes.
NSAIDs include aspirin and ibuprofen.
Antibiotics in large doses are known to cause bone marrow suppression.
Adrenal corticosteroids are known to cause immunosuppression.
Antineoplastic agents are known to cause immunosuppression.
The stem cell is known as a precursor cell that continually replenishes the body’s entire supply of both red and white cells. Stem cells comprise only a small portion of all types of bone marrow cells.
Research conducted with mouse models has demonstrated that once the immune system has been destroyed experimentally, it can be completely restored with the implantation of just a few purified stem cells.
Stem cell transplantation has been carried out in human subjects with certain types of immune dysfunction such as severe combined immunodeficiency (SCID).
Clinical trails are underway in patients with a variety of disorders with an autoimmune component including systemic lupus erythematosus,rheumatoid arthritis, scleroderma, and multiple sclerosis.
These disorders may involve one or more components of the immune system.
Primary immunodeficiencies are seen primarily in infants and young children.
Primary immunodeficiencies are rare disorders with genetic origins.
Without treatment, infants and children with these disorders seldom survive to adulthood.
Bruton’s disease is a sex-linked disease that results in infants born with the disorder suffering severe infections soon after birth
Nezelof syndrome is a disorder involving lack of a thymus gland.
Wiskott-Aldrich syndrome involves the absence of T cells and B cells and the presence of thrombocytopenia.
CVID is another term for hypogammaglobulinemia.
Flank pain, tightness in the chest, or hypotension indicates adverse effects of gamma-globulin infusion.
Nasal stuffiness is not recognized as an adverse effect of gamma-globulin infusion.
Increased thirst is not recognized as an adverse effect of gamma-globulin infusion.
Burning urination is a sign of urinary tract infection, not an adverse effect of gamma-globulin infusion.
Ataxia-telangiectasia is an autosomal recessive disorder affecting both T-cell and B-cell immunity.
Telangiectasia is the term that refers to vascular lesions caused by dilated blood vessels.
Receptive aphasia is an inability to understand the spoken word.
Dysphagia refers to difficulty swallowing.
Cytomegalovirus is a species-specific herpes virus.
Cryptococcus neoformans is a fungus that causes an opportunistic infection in patients with HIV/AIDS.
Mycobacterium avium is an acid-fast bacillus that commonly causes a respiratory illness.
ELISA, as well as Western blot assay, identifies and confirms the presence of antibodies to HIV.
The ESR is an indicator of the presence of inflammation in the body.
The p24 antigen is a blood test that measures viral core protein.
Reverse transcriptase is not a blood test. Rather, it is an enzyme that transforms single-stranded RNA into a double-stranded DNA.
A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn.
A negative test result should be interpreted as demonstrating that if infected, the body has not produced antibodies (which take from 3 weeks to 6 months or longer). Therefore, subsequent testing of an at-risk patient must be encouraged.
The test result does not mean that the patient is immune to the virus, nor does it mean that the patient is not infected. It just means that the body may not have produced antibodies yet.
When antibodies to the AIDS virus are detected in the blood, the test is interpreted as positive.
K-Y jelly is water-based and will provide lubrication while not damaging the condom.
The oil in skin lotion will cause the condom to break.
Baby oil will cause the condom to break.
The oil in petroleum jelly will cause the condom to break.
More than 500 CD4+ T lymphocytes/mm3 indicates CDC category A – HIV asymptomatic.
The period from infection with HIV to the development of antibodies to HIV is know as primary infection.
200-499 CD4+ T lymphocytes/mm3 indicates CDC category B – HIV symptomatic.
Less than 200 CD4+ T lymphocytes/mm3 indicates CDC category C – AIDS.
The viral set point is the balance between the amount of HIV in the body and the immune response.
During the primary infection period, the window period occurs since a person is infected with HIV but negative on the HIV antibody blood test.
The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage.
The amount of virus in circulation and the number of infected cells equals the rate of viral clearance.
Although specific therapies vary, treatment of HIV infection for an individual patient is based on three factors: the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
Treatment should be offered to all patients with the primary infection (acute HIV syndrome).
Treatment should be offered to all patients with the primary infection (acute HIV syndrome).
In general, treatment should be offered to individuals with fewer than 350 CD4+ T cells/mm3 or plasma HIV RNA levels exceeding 55,000 copies/mL (RT-PCR assay).
When cells are damaged, histamine is released.
Bradykinin is a polypeptide that stimulates nerve fibers and causes pain.
Serotonin is a chemical mediator that acts as a potent vasoconstrictor and bronchoconstrictor.
Prostaglandins are unsaturated fatty acids that have a wide assortment of biologic activity.
Type III hypersensitivity is associated with systemic lupus erythematosus, rheumatoid arthritis, serum sickness, certain types of nephritis, and some types of bacterial endocarditis.
Type I or anaphylactic hypersensitivity is an immediate reaction, beginning within minutes of exposure to an antigen.
Type II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign.
Type IV, or delayed-type, hypersensitivity occurs 24-72 hours after exposure to an allergen.
When eosinophils make up 50-90% of white cell count, the patient is demonstrating severe eosinophilia.
Moderate eosinophilia, 15-40% of white cell count consisting of eosinophils, are found in patients with allergic disorders.
A level between 5 and 15% eosinophils is nonspecific but does suggest allergic reaction.
Eosinophils normally make up 1-3% of the total number of white blood cells.
People who have experienced food, medication, idiopathic, or exercise-induced anaphylactic reactions should always carry an emergency kit containing epinephrine for injection to prevent the onset of the reaction upon exposure.
While helpful, the patient may require epinephrine to treat a potential reaction.
While helpful, there must be no lapses in desensitization therapy because this may lead to the reappearance of an allergic reaction when the medication is re-instituted.
Medical-Surgical Nursing Exam 16
Choose the letter of the correct answer. Good luck!
Congratulations - you have completed Medical-Surgical Nursing Exam 16 (PM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Choose the letter of the correct answer. You got 50 minutes to finish the exam .Good luck!
Congratulations - you have completed Medical-Surgical Nursing Exam 16 (EM).
You scored %%SCORE%% out of %%TOTAL%%.
Your performance has been rated as %%RATING%%
Your answers are highlighted below.