Pathophysiology Final

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Question 1 of 1

Time Left

544000

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The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply.

Select the correct answer(s).

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Explanation

Although different staging schemas exist, three broad stages of Alzheimer dementia have been identified, each of which is characterized by progressive degenerative changes. The early stage is characterized by short-term memory loss, lack of spontaneity, and social withdrawal. The moderate stage of dementia is marked by extreme confusion, disorientation, and personal hygiene (ADLs) is neglected. During this stage, there are also changes in higher cortical functioning needed for language, spatial relationships, and problem solving. In severe Alzheimer disease, in the terminal stage, the person typically becomes incontinent.

544001

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Which of the following statements by the husband of a client with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen?

Select the correct answer(s).

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Explanation

There is presently no cure for Alzheimer disease. Medications do not directly address the physical manifestations of Alzheimer disease. Rather, drugs are used primarily to slow the progression and to control depression, agitation, or sleep disorders.

544002

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A client with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The client's psychomotor deficits are likely the result of:

Select the correct answer(s).

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Explanation

Vascular dementia is caused by brain injury resulting from ischemic or hemorrhagic damage. Smoking and hypertension are contributing factors, and slowness in psychomotor functioning is a main clinical feature of vascular dementia. The client's history and symptomatology are not characteristic of Alzheimer disease, FTD, or Wernicke-Korsakoff syndrome.

543826

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Which of the following physiologic processes results from the synthesis and release of testosterone?

Select the correct answer(s).

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Explanation

Among the numerous effects of testosterone are the promotion of musculoskeletal growth in particular and protein anabolism in general. LH and FSH precede the synthesis and release of testosterone, whereas prostatic hyperplasia is not a normal effect of testosterone.

543827

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A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique?

Select the correct answer(s).

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Explanation

When the male ejaculates, the smooth muscle in the wall of the epididymis contracts vigorously, moving sperm into the next segment of the ductal system, the ductus deferens, also called the vas deferens. A vasectomy severs this conduit, rendering the male effectively infertile within a few weeks of the procedure. The procedure has no hormonal effect and neither the epididymis nor the rete testis is altered.

543828

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A client has been diagnosed with an anterior pituitary tumor, and synthesis and release of follicle-stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine function?

Select the correct answer(s).

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Explanation

Two gonadotropic hormones are secreted by the pituitary gland: FSH and luteinizing hormone (LH). In the male, LH also is called interstitial cell–stimulating hormone. The production of testosterone by the interstitial cells of Leydig is regulated by LH. FSH binds selectively to Sertoli cells surrounding the seminiferous tubules, where it functions in the initiation of spermatogenesis. FSH does not directly affect the production of LH, since both are produced by the anterior pituitary. FSH does not stimulate testosterone synthesis, and impaired detumescence is unlikely to be a direct consequence of changes in FSH synthesis and release.

543829

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While discussing the physiological process behind penile erection, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting of blood into the sinusoids?

Select the correct answer(s).

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Explanation

Parasympathetic innervation must be intact and nitric oxide synthesis must be active for erection to occur. Parasympathetic stimulation results in release of nitric oxide, a nonadrenergic–noncholinergic neurotransmitter, which causes relaxation of the trabecular smooth muscle of the corpora cavernosa. This relaxation permits inflow of blood into the sinuses of the cavernosa at pressures approaching those of the arterial system. The nicotinic acid in cigarette smoke can induce vasoconstriction and penile venous leakage because of its effects on cavernous smooth muscle. Nitroglycerine is a vasodilator that has no effect on trabecular smooth muscle. A norepinephrine action is vasoconstriction, rather than relaxation, as part of sympathetic nervous system response.

543830

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Common risk factors associated with erectile dysfunction due to generalized penile arterial insufficiency include:

Select the correct answer(s).

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Explanation

Common risk factors for generalized penile arterial insufficiency include hypertension, hyperlipidemia, cigarette smoking, diabetes mellitus, and pelvic irradiation. Cigarette smoking induces vasoconstriction and penile venous leakage because of its effects on cavernous smooth muscle. Cryptorchidism is a major risk factor for testicular cancer. Benign prostate hypertrophy (BPH) is a risk factor for ejaculatory pathway obstruction rather than erectile difficulties. With testicular torsion, testicular arterial perfusion is impaired.

543831

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Which of the following clients is at greatest risk for developing balanitis xerotica obliterans?

Select the correct answer(s).

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Explanation

Balanitis xerotica obliterans is a chronic, sclerosing, atrophic process of the glans penis that occurs solely in uncircumcised men. As such, the uncircumcised state supersedes the influence of sexual behavior, prostatitis, or hormonal effects of not having a pituitary gland.

543832

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Which of the following clinical manifestations are characteristic for clients with Peyronie disease? Select all that apply.

Select the correct answer(s).

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Explanation

Peyronie disease involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. The manifestations of Peyronie disease include painful erection, bent erection, and the presence of a hard mass at the site of fibrosis. Approximately two thirds of men complain of pain as a symptom. Discharge and lesions from the penis is usually caused from infections or STDs. Thick, nonretractable foreskin of uncircumcised male is associated with balanitis xerotica obliterans.

543833

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From the following list of clients, which ones are at high risk for developing priapism? Select all that apply.

Select the correct answer(s).

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Explanation

Priapism is due to impaired blood flow in the corpora cavernosa of the penis. Priapism is classified as primary (idiopathic) or secondary to a disease or drug effect. Secondary causes include hematologic conditions (e.g., leukemia, sickle cell disease, polycythemia), neurologic conditions (e.g., stroke, spinal cord injury), and renal failure. Two mechanisms for priapism have been proposed: low-flow (ischemic) priapism, in which there is stasis of blood flow in the corpora cavernosa with a resultant failure of detumescence (diminution of swelling or erection), and Peyronie disease, which involves a localized and progressive fibrosis of unknown origin that affects the tunica albuginea (i.e., the tough, fibrous sheath that surrounds the corpora cavernosa) of the penis. Circumcision trauma to the penis and abnormal tightening of foreskin are external penile problems associated with phimosis rather than the internal vascular problem of priapism.

543834

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Squamous cell cancer of the penis is characterized by which of the following clinical manifestations?

Select the correct answer(s).

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Explanation

The cause of penile cancer is unknown. Invasive squamous cell carcinoma of the penis usually begins as a small lump or ulcer on the glans or inner surface of the prepuce. Several risk factors have been suggested, including poor hygiene, human papillomavirus infections (rather than herpes simplex virus infections), ultraviolet radiation exposure, and immunodeficiency states. There is an association between penile cancer and poor genital hygiene and phimosis. Circumcision confers protection, and hence cancer of the penis is extremely rare in men circumcised at birth. It is thought that circumcision is associated with better genital hygiene, which, in turn, reduces exposure to carcinogens that may accumulate in smegma and decreases the likelihood of potentially oncogenic strains of HPV. Erectile dysfunction can be the result of depression, androgen level imbalance, systemic medications, or arterial insufficiency that are unrelated to squamous cell tissue changes.

543835

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During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should:

Select the correct answer(s).

(0/0)

Explanation

Hydroceles are palpated as cystic masses that may attain massive proportions. If there is enough fluid, the mass may be mistaken for a solid tumor. Transillumination of the scrotum (i.e., shining a light through the scrotum to visualize its internal structures) or ultrasonography can help to determine whether the mass is solid or cystic and whether the testicle is normal. A dense hydrocele that does not illuminate should be differentiated from a testicular tumor. The fluid cannot be removed by diuretics or by trying to express the fluid out of the scrotum.

543836

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Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

Select the correct answer(s).

(0/0)

Explanation

Although all of the noted health problems warrant monitoring and possible treatment, intravaginal testicular torsion is an emergency that requires prompt surgery to save the torsed testicle.

543837

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A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. Their pulse rate is 120 beats/minute. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:

Select the correct answer(s).

(0/0)

Explanation

With testicular torsion, the testis rotates about the distal spermatic cord, obstructs perfusion through the testicular arteries and spermatic veins, and obstructs nerve conduction. The torsion obstructs venous drainage, with resultant edema and hemorrhage, and subsequent arterial obstruction. The dartos muscle separates the two testes and responds to changes in temperature by contracting when cold and relaxing when warm. Most squamous cell cancers of the scrotum occur after 60 years of age and are linked to poor hygiene, chronic inflammation, exposure to ultraviolet A radiation, or human papilloma virus (HPV). After descent of the testes, the inguinal canal normally closes almost completely; failure of this canal to close predisposes to the development of an inguinal hernia later in life.

Pathophysiology Final

Question 1 of 1

Time Left

The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

Which of the following statements by the husband of a client with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen?

Select the correct answer(s).

(0/0)

Explanation

A client with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The client's psychomotor deficits are likely the result of:

Select the correct answer(s).

(0/0)

Explanation

Which of the following physiologic processes results from the synthesis and release of testosterone?

Select the correct answer(s).

(0/0)

Explanation

A 41-year-old male client is planning on having a vasectomy. While explaining this surgery to the client, the health care worker will include which physiologic principle as the basis for this contraception technique?

Select the correct answer(s).

(0/0)

Explanation

A client has been diagnosed with an anterior pituitary tumor, and synthesis and release of follicle-stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine function?

Select the correct answer(s).

(0/0)

Explanation

While discussing the physiological process behind penile erection, the anatomy and physiology instructor mentions that what substance is released to facilitate smooth muscle relaxation and shunting of blood into the sinusoids?

Select the correct answer(s).

(0/0)

Explanation

Common risk factors associated with erectile dysfunction due to generalized penile arterial insufficiency include:

Select the correct answer(s).

(0/0)

Explanation

Which of the following clients is at greatest risk for developing balanitis xerotica obliterans?

Select the correct answer(s).

(0/0)

Explanation

Which of the following clinical manifestations are characteristic for clients with Peyronie disease? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

From the following list of clients, which ones are at high risk for developing priapism? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

Squamous cell cancer of the penis is characterized by which of the following clinical manifestations?

Select the correct answer(s).

(0/0)

Explanation

During a visit to the health care provider, a client complains of swelling in the scrotum. The health care worker suspects a hydrocele and performs an exam by shining a light through the scrotum. If the hydrocele is dense, the health care worker should:

Select the correct answer(s).

(0/0)

Explanation

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive surgical treatment?

Select the correct answer(s).

(0/0)

Explanation

A client arrives in the emergency department complaining of severe testicular pain associated with nausea and vomiting. Their pulse rate is 120 beats/minute. Physical exam reveals an enlarged testis that is painful to palpation. The nurse suspects:

Select the correct answer(s).

(0/0)

Explanation

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