Question 1
After talking with the healthcare provider, a male client continues to have questions about
the results of
a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels
become elevated. The nurse should explain which pathophysiological mechanism?
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
B. The PSA levels normally rise and fall, so multiple testings over time are necessary.
C. Low PSA levels indicate that the prostate gland is not functioning properly.
D. The PSA blood test is used to determine dosage for Viagra prescriptions.
CORRECT ANSWER
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
Rationale: PSA is a glycoprotein found in prostatic epithelial cells, and elevations are used as
a specific tumor markers. Elevations in PSA are related to gland volume, i.e., benign prostatic
hypertrophy, prostatitis, and cancer of the prostate, indicating (tumor) cell load (A). PSA
levels are also used to monitor response to therapy. (B, C, and D) provide incorrect
information.
Question 2
A 26-year-old male client with Hodgkin's disease is scheduled to undergo radiation
therapy. The client expresses concern about the effect of radiation on his ability to have
children. What information should the nurse provide?
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,A. The radiation therapy causes the inability to have an erection.
B. Radiation therapy with chemotherapy causes temporary infertility.
C. Permanent sterility occurs in male clients who receive radiation.
D. The client should restrict sexual activity during radiotherapy.
CORRECT ANSWER
C. Permanent sterility occurs in male clients who receive radiation.
Rationale: Low sperm count and loss of motility are seen in males with Hodgkin's disease
before any therapy. Radiotherapy often results in permanent aspermia, or sterility (C). (A, B,
and D) are inaccurate.
Question 3
The nurse hears short, high-pitched sounds just before the end of inspiration in the right
and left lower
lobes when auscultating a client's lungs. How should this finding be recorded?
A. Inspiratory wheezes in both lungs.
B. Crackles in the right and left lower lobes.
C. Abnormal lung sounds in the bases of both lungs.
D. Pleural friction rub in the right and left lower lobes.
CORRECT ANSWER
B. Crackles in the right and left lower lobes.
Fine crackles (B) are short, high-pitched sounds heard just before the end of inspiration that
are the result of rapid equalization of pressure when collapsed alveoli or terminal
bronchioles suddenly snap open. Wheezing (A) is a continuous high-pitched squeaking or
musical sound caused by rapid vibration of bronchial walls that are first evident on
expiration and may be audible. Although (C) describes an adventitious lung sound, this
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,documentation is vague. (D) is a creaking or grating sound from roughened, inflamed
surfaces of the pleura rubbing together heard during inspiration, expiration, and with no
change during coughing.
Question 4
A client is admitted to the Emergency Department with a tension pneumothorax. Which
assessment
should the nurse expect to identify?
A. An absence of lung sounds on the affected side.
B. An inability to auscultate tracheal breath sounds.
C. A deviation of the trachea toward the side opposite the pneumothorax.
D. A shift of the point of maximal impulse to the left, with bounding pulses.
CORRECT ANSWER
C. A deviation of the trachea toward the side opposite the pneumothorax.
Tension pneumothorax is caused by rapid accumulation of air in the pleural space, causing
severely high intrapleural pressure. This results in collapse of the lung, and the mediastinum
shifts toward the unaffected side, which is subsequently compressed (C). (A, B, and D) are
not demonstrated with a tension pneumothorax.
Question 5
A client who is receiving a whole blood transfusion develops chills, fever, and a headache
30 minutes
after the transfusion is started. The nurse should recognize these symptoms as characteristic
of what reaction?
A. A mild allergic reaction.
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, B. A febrile transfusion reaction.
C. An anaphylactic transfusion reaction.
D. An acute hemolytic transfusion reaction.
CORRECT ANSWER
B. A febrile transfusion reaction.
Symptoms of a febrile reaction (B) include sudden chills, fever, headache, flushing and
muscle pain. An allergic reaction (A) is the response of histamine release which is
characterized by flushing, itching, and urticaria. An anaphylactic reaction (C) exhibits an
exaggerated allergic response that progresses to shock and possible cardiac arrest. An acute
hemolytic reaction (D) presents with fever and chills, but is hallmarked by the onset of low
back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria, dark urine, acute renal
failure, shock, cardiac arrest, and even death.
Question 6
The nurse is analyzing the waveforms of a client's electrocardiogram. What finding
indicates a
disturbance in electrical conduction in the ventricles?
A. T wave of 0.16 second.
B. PR interval of 0.18 second.
C. QT interval of 0.34 second.
D. QRS interval of 0.14 second.
CORRECT ANSWER
D. QRS interval of 0.14 second.
The normal duration of the QRS is 0.04 to 0.12 second, so a prolonged QRS (D) indicates an
electrical anomaly in the ventricles. The I wave is normally 0.16 seconds (A). The PR interval
range is 0.12 to 0.20 second (B). The QT interval should be 0.31 to 0.38 second (C).
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After talking with the healthcare provider, a male client continues to have questions about
the results of
a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels
become elevated. The nurse should explain which pathophysiological mechanism?
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
B. The PSA levels normally rise and fall, so multiple testings over time are necessary.
C. Low PSA levels indicate that the prostate gland is not functioning properly.
D. The PSA blood test is used to determine dosage for Viagra prescriptions.
CORRECT ANSWER
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
Rationale: PSA is a glycoprotein found in prostatic epithelial cells, and elevations are used as
a specific tumor markers. Elevations in PSA are related to gland volume, i.e., benign prostatic
hypertrophy, prostatitis, and cancer of the prostate, indicating (tumor) cell load (A). PSA
levels are also used to monitor response to therapy. (B, C, and D) provide incorrect
information.
Question 2
A 26-year-old male client with Hodgkin's disease is scheduled to undergo radiation
therapy. The client expresses concern about the effect of radiation on his ability to have
children. What information should the nurse provide?
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@THE STUDY VAULT
,A. The radiation therapy causes the inability to have an erection.
B. Radiation therapy with chemotherapy causes temporary infertility.
C. Permanent sterility occurs in male clients who receive radiation.
D. The client should restrict sexual activity during radiotherapy.
CORRECT ANSWER
C. Permanent sterility occurs in male clients who receive radiation.
Rationale: Low sperm count and loss of motility are seen in males with Hodgkin's disease
before any therapy. Radiotherapy often results in permanent aspermia, or sterility (C). (A, B,
and D) are inaccurate.
Question 3
The nurse hears short, high-pitched sounds just before the end of inspiration in the right
and left lower
lobes when auscultating a client's lungs. How should this finding be recorded?
A. Inspiratory wheezes in both lungs.
B. Crackles in the right and left lower lobes.
C. Abnormal lung sounds in the bases of both lungs.
D. Pleural friction rub in the right and left lower lobes.
CORRECT ANSWER
B. Crackles in the right and left lower lobes.
Fine crackles (B) are short, high-pitched sounds heard just before the end of inspiration that
are the result of rapid equalization of pressure when collapsed alveoli or terminal
bronchioles suddenly snap open. Wheezing (A) is a continuous high-pitched squeaking or
musical sound caused by rapid vibration of bronchial walls that are first evident on
expiration and may be audible. Although (C) describes an adventitious lung sound, this
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@THE STUDY VAULT
,documentation is vague. (D) is a creaking or grating sound from roughened, inflamed
surfaces of the pleura rubbing together heard during inspiration, expiration, and with no
change during coughing.
Question 4
A client is admitted to the Emergency Department with a tension pneumothorax. Which
assessment
should the nurse expect to identify?
A. An absence of lung sounds on the affected side.
B. An inability to auscultate tracheal breath sounds.
C. A deviation of the trachea toward the side opposite the pneumothorax.
D. A shift of the point of maximal impulse to the left, with bounding pulses.
CORRECT ANSWER
C. A deviation of the trachea toward the side opposite the pneumothorax.
Tension pneumothorax is caused by rapid accumulation of air in the pleural space, causing
severely high intrapleural pressure. This results in collapse of the lung, and the mediastinum
shifts toward the unaffected side, which is subsequently compressed (C). (A, B, and D) are
not demonstrated with a tension pneumothorax.
Question 5
A client who is receiving a whole blood transfusion develops chills, fever, and a headache
30 minutes
after the transfusion is started. The nurse should recognize these symptoms as characteristic
of what reaction?
A. A mild allergic reaction.
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, B. A febrile transfusion reaction.
C. An anaphylactic transfusion reaction.
D. An acute hemolytic transfusion reaction.
CORRECT ANSWER
B. A febrile transfusion reaction.
Symptoms of a febrile reaction (B) include sudden chills, fever, headache, flushing and
muscle pain. An allergic reaction (A) is the response of histamine release which is
characterized by flushing, itching, and urticaria. An anaphylactic reaction (C) exhibits an
exaggerated allergic response that progresses to shock and possible cardiac arrest. An acute
hemolytic reaction (D) presents with fever and chills, but is hallmarked by the onset of low
back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria, dark urine, acute renal
failure, shock, cardiac arrest, and even death.
Question 6
The nurse is analyzing the waveforms of a client's electrocardiogram. What finding
indicates a
disturbance in electrical conduction in the ventricles?
A. T wave of 0.16 second.
B. PR interval of 0.18 second.
C. QT interval of 0.34 second.
D. QRS interval of 0.14 second.
CORRECT ANSWER
D. QRS interval of 0.14 second.
The normal duration of the QRS is 0.04 to 0.12 second, so a prolonged QRS (D) indicates an
electrical anomaly in the ventricles. The I wave is normally 0.16 seconds (A). The PR interval
range is 0.12 to 0.20 second (B). The QT interval should be 0.31 to 0.38 second (C).
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