Identifying Other Conditions - NCLEX-PN
Card 0 of 204
What is the most common cause of renal failure in the United States?
What is the most common cause of renal failure in the United States?
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
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Which of the following is an insect vector-borne illness?
Which of the following is an insect vector-borne illness?
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
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An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario.
The nurse examining the client should be aware that __________.
An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario.
The nurse examining the client should be aware that __________.
The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis.
The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis.
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A nurse is caring for a client experiencing the oliguric phase of acute kidney failure. The nurse is aware that this condition is highly associated with electrolyte imbalances, in addition to the kidney's inability to produce sufficient amounts of urine.
Which of the following electrolyte imbalances should the nurse monitor for?
A nurse is caring for a client experiencing the oliguric phase of acute kidney failure. The nurse is aware that this condition is highly associated with electrolyte imbalances, in addition to the kidney's inability to produce sufficient amounts of urine.
Which of the following electrolyte imbalances should the nurse monitor for?
During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF.
During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF.
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Ed is an 85-year-old male who lives at a long-term care facility. He has recently begun having difficulty brushing his teeth, an activity he would previously complete on his own. He has also appeared to be more confused while engaging in basic conversation with the nursing staff. The nurse should first evaluate Ed for which of the following?
Ed is an 85-year-old male who lives at a long-term care facility. He has recently begun having difficulty brushing his teeth, an activity he would previously complete on his own. He has also appeared to be more confused while engaging in basic conversation with the nursing staff. The nurse should first evaluate Ed for which of the following?
Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.
Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.
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The fact that an elementary school is shut down due to a measles outbreak is an example of a(n) __________.
The fact that an elementary school is shut down due to a measles outbreak is an example of a(n) __________.
The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.
The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.
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A 3-year-old child is admitted to the pediatric medical unit from the emergency department with suspected rheumatic fever. Which of the following is not indicative of rheumatic fever?
A 3-year-old child is admitted to the pediatric medical unit from the emergency department with suspected rheumatic fever. Which of the following is not indicative of rheumatic fever?
Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.
Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.
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A nurse is teaching a 20-year-old male client newly diagnosed with herpes simplex virus (HSV) type 2.
All of the following teaching points in regards to this condition should be included except which of these?
A nurse is teaching a 20-year-old male client newly diagnosed with herpes simplex virus (HSV) type 2.
All of the following teaching points in regards to this condition should be included except which of these?
Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative.
Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative.
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A 35-year-old male has just been admitted to the emergency department in a sickle cell crisis. The nurse caring for this client is aware of the signs and symptoms associated with this condition.
The proper nursing management for this patient should include which of these?
A 35-year-old male has just been admitted to the emergency department in a sickle cell crisis. The nurse caring for this client is aware of the signs and symptoms associated with this condition.
The proper nursing management for this patient should include which of these?
A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis.
A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis.
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The SIRS (Systemic Inflammatory Response Syndrome) criteria includes which of the following?
The SIRS (Systemic Inflammatory Response Syndrome) criteria includes which of the following?
The SIRS criteria includes 4 factors. 1.) temperature greater than 
or less than 
2.) A respiratory rate > 20, or 
< 
, 3.) Heart rate greater than 
, and 4.) 
, 
, or immature neutrophils greater than 10% bands. To meet the SIRS definition must have 2 or more of these findings.
The SIRS criteria includes 4 factors. 1.) temperature greater than
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Which of the following physical exam findings would you expect to find in a patient who overdosed on heroin?
Which of the following physical exam findings would you expect to find in a patient who overdosed on heroin?
Opioid (heroin) overdose is marked by a decreased respiratory drive, shallow breathing, and pin-point pupils. Treatment is with naloxone and reverses overdose quickly. Heroin overdoses can be fatal if untreated because of the respiratory depression.
Opioid (heroin) overdose is marked by a decreased respiratory drive, shallow breathing, and pin-point pupils. Treatment is with naloxone and reverses overdose quickly. Heroin overdoses can be fatal if untreated because of the respiratory depression.
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A patient arrives to the ER in a comatose state. He is shallowly breathing, appears disheveled, and has pin-point pupils. There are track marks on his right arm and it appears swollen. Which of the following conditions does this patient likely have?
A patient arrives to the ER in a comatose state. He is shallowly breathing, appears disheveled, and has pin-point pupils. There are track marks on his right arm and it appears swollen. Which of the following conditions does this patient likely have?
This patient likely has opioid (heroin) overdose. Common signs of overdose include: altered mental states, decreased respiratory rate and effort, and pin-point pupils. Treatment includes inhalation of naltrexone to remove the opioids off their receptors in the body. Additionally, track marks are a sign that the patient injects heroin.
This patient likely has opioid (heroin) overdose. Common signs of overdose include: altered mental states, decreased respiratory rate and effort, and pin-point pupils. Treatment includes inhalation of naltrexone to remove the opioids off their receptors in the body. Additionally, track marks are a sign that the patient injects heroin.
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A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On urinalysis the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
This individual is most likely experiencing a urinary tract infection (UTI) due to which of the following organisms?
A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On urinalysis the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
This individual is most likely experiencing a urinary tract infection (UTI) due to which of the following organisms?
While all of the organisms listed are capable of causing UTI's, Staphylococcus species are all Gram-positive. _Escherichia coli, while responsible for 75-95% of all UTI's, would not result in a urinary pH of 9.5. The high alkalinity of this patient's urine suggest a urea-splitting bacteria such as Proteus.
While all of the organisms listed are capable of causing UTI's, Staphylococcus species are all Gram-positive. _Escherichia coli, while responsible for 75-95% of all UTI's, would not result in a urinary pH of 9.5. The high alkalinity of this patient's urine suggest a urea-splitting bacteria such as Proteus.
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A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On UA the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
If the organism identified in this patient's urine sample is Proteus mirabilis, which of the following would be the appropriate treatment?
A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On UA the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
If the organism identified in this patient's urine sample is Proteus mirabilis, which of the following would be the appropriate treatment?
The first-line treatment for uncomplicated urinary tract infection with Proteus mirabilis is a 3 day course of either oral quinolone or trimethoprim/sulfamethoxazole (TMP/SMZ). 10-21 day courses are only appropriate in patients with complicated UTI or co-infections. Ampicillin and cefalexin are poor choices for initial treatment due to a 10-20% rate of resistance in Proteus species.
The first-line treatment for uncomplicated urinary tract infection with Proteus mirabilis is a 3 day course of either oral quinolone or trimethoprim/sulfamethoxazole (TMP/SMZ). 10-21 day courses are only appropriate in patients with complicated UTI or co-infections. Ampicillin and cefalexin are poor choices for initial treatment due to a 10-20% rate of resistance in Proteus species.
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A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On UA the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
In the case of chronic Proteus mirabilis infection, which of the following is a common sequelae?
A 23 year old female comes in for urinary frequency and dysuria. This morning she noticed that her urine seemed slightly "tea" colored. On UA the nurse sees a large amount of leukocyte esterase, moderate red blood cells, and a pH of 9.5. On lab analysis a Gram-negative anaerobic bacteria with swarming motility is cultured out of her urine sample.
In the case of chronic Proteus mirabilis infection, which of the following is a common sequelae?
Due to its production of urease, Proteus mirabilis infection results in alkalinization of urine (as urease hydrolyzes urea to produce ammonia). This can cause the formation of calcium, struvite, or apatite crystals in the urine, which may form renal calculi.
P. mirabilis is not associated with increased risk for infertility, PID, or bladder cancer.
Due to its production of urease, Proteus mirabilis infection results in alkalinization of urine (as urease hydrolyzes urea to produce ammonia). This can cause the formation of calcium, struvite, or apatite crystals in the urine, which may form renal calculi.
P. mirabilis is not associated with increased risk for infertility, PID, or bladder cancer.
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You are the nurse taking care of a 21-year old female who complains of two days dysuria, that over the last 24 hours has been accompanied by fever, chills, and lower back pain. Her physical exam is remarkable for right-sided costovertebral angle tenderness. Which of the following is the most likely diagnosis?
You are the nurse taking care of a 21-year old female who complains of two days dysuria, that over the last 24 hours has been accompanied by fever, chills, and lower back pain. Her physical exam is remarkable for right-sided costovertebral angle tenderness. Which of the following is the most likely diagnosis?
The correct answer is "pyelonephritis." This is the correct answer because the patient's presentation with dysuria that progresses to include fever, chills, and lower back pain, is a very classic presentation of pyelonephritis. Pyelonephritis is an infection of the renal parenchyma, most commonly due to an ascending urinary tract infection. In this patient, who is a female (which places her at a greater risk for UTI's as compared to males due to females having shorter urethras than males) who initially has dysuria, this is a convincing story for a UTI. Further, the fact that the symptoms of fever, chills, and lower back pain are not present initially with the dysuria, but develop over the next day, is further evidence that pyelonephritis is the likely diagnosis. The physical exam finding of unilateral costovertebral angle tenderness also is highly suggestive of pyelonephritis.
The other choices are incorrect. Spinal stenosis is not a common diagnosis in young, otherwise healthy patients, and would not account for dysuria and unilteral costovertebral angle tenderness. A pneumothorax would not cause dysuria and would likely present with shortness of breath. Primary syphilis and genital herpes would not account for dysuria, lower back pain, or costovertebral angle tenderness.
The correct answer is "pyelonephritis." This is the correct answer because the patient's presentation with dysuria that progresses to include fever, chills, and lower back pain, is a very classic presentation of pyelonephritis. Pyelonephritis is an infection of the renal parenchyma, most commonly due to an ascending urinary tract infection. In this patient, who is a female (which places her at a greater risk for UTI's as compared to males due to females having shorter urethras than males) who initially has dysuria, this is a convincing story for a UTI. Further, the fact that the symptoms of fever, chills, and lower back pain are not present initially with the dysuria, but develop over the next day, is further evidence that pyelonephritis is the likely diagnosis. The physical exam finding of unilateral costovertebral angle tenderness also is highly suggestive of pyelonephritis.
The other choices are incorrect. Spinal stenosis is not a common diagnosis in young, otherwise healthy patients, and would not account for dysuria and unilteral costovertebral angle tenderness. A pneumothorax would not cause dysuria and would likely present with shortness of breath. Primary syphilis and genital herpes would not account for dysuria, lower back pain, or costovertebral angle tenderness.
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A 32-year old male presents to his primary care physician's office complaining of a 2-cm painless chancre on the glans of his penis. He denies any other bodily aches or pains, any penile discharge, dysuria, fevers, chills, or other skin rashes. Which of the following is the most likely diagnosis?
A 32-year old male presents to his primary care physician's office complaining of a 2-cm painless chancre on the glans of his penis. He denies any other bodily aches or pains, any penile discharge, dysuria, fevers, chills, or other skin rashes. Which of the following is the most likely diagnosis?
The correct answer is "primary syphilis." This is the correct answer as the classic presentation of primary syphilis is a painless chancre found on the base, shaft, or glans of the penis. The other choices are incorrect. A urinary tract infection would not present with a chancre, and would typically present with dysuria. Chlamydia or gonorrhea would typically present with penile discharge in males, not a painless chancre. Genital herpes would typically present with one or multiple painful ulcers on the penis, not a single painless chancre.
The correct answer is "primary syphilis." This is the correct answer as the classic presentation of primary syphilis is a painless chancre found on the base, shaft, or glans of the penis. The other choices are incorrect. A urinary tract infection would not present with a chancre, and would typically present with dysuria. Chlamydia or gonorrhea would typically present with penile discharge in males, not a painless chancre. Genital herpes would typically present with one or multiple painful ulcers on the penis, not a single painless chancre.
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What is the most common cause of renal failure in the United States?
What is the most common cause of renal failure in the United States?
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.
Compare your answer with the correct one above
Which of the following is an insect vector-borne illness?
Which of the following is an insect vector-borne illness?
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect.
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An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario.
The nurse examining the client should be aware that __________.
An electrical worker has been brought to the emergency department after an electrical burn injury sustained while in the field. The possibility of additional injuries are greatly increased when dealing with this type of clinical scenario.
The nurse examining the client should be aware that __________.
The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis.
The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis.
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