Exam 1: NUR2392/ NUR 2392 (NEW 2023/ 2024) Multidimensional Care II/ MDC 2 Quiz Bank| More than 300 Questions and Verified Answers| Complete Guide| 100% Correct| Grade A Guaranteed- Rasmussen
Exam 1: NUR2392/ NUR 2392 (NEW 2023/
2024) Multidimensional Care II/ MDC 2 Quiz
Bank| More than 300 Questions and Verified
Answers| Complete Guide| 100% Correct|
Grade A Guaranteed- Rasmussen
QUESTION
What is the difference between palliative care and hospice care?
Answer:
Palliative care focuses on providing relief from symptoms and improving quality of life for
patients with serious illnesses, regardless of prognosis. Hospice care is a type of palliative care
specifically for patients who are nearing the end of life.
QUESTION
What interventions should a nurse perform while providing spiritual care for a dying client?
Answer:
Assess the client’s spiritual needs, provide opportunities for prayer or religious rituals, offer
emotional support, and involve the client’s family in discussions about spiritual care.
QUESTION
What concepts and care are provided under the definition of palliative care?
Answer:
Palliative care provides pain relief, integrates spirituality, offers a team approach to care, and
enhances the quality of life for patients with serious illnesses.
QUESTION
What statement can be most helpful when caring for a client in the third stage of Kubler-Ross’
emotional reactions to dying?
Answer:
I understand that it would be wonderful to see your daughter’s graduation.
QUESTION
What intervention should a nurse perform during the grieving period when caring for a dying
client?
Answer:
Avoid criticizing or giving advice to the client.
QUESTION
What is the key difference between conscious sedation and euthanasia?
Answer:
Conscious sedation is a treatment to relieve pain and discomfort without hastening death, while
euthanasia involves intentionally causing the death of a patient.
QUESTION
What should a nurse integrate into the plan of care for a terminally ill client who follows Islamic
traditions and is experiencing pain?
Answer:
An understanding that pain is viewed as a means of cleansing by God in Islamic traditions.
QUESTION
What would be least appropriate to include in a teaching plan for caring for secretions in a
terminally ill client?
Answer:
Using a soft toothbrush to vigorously clean the mouth.
QUESTION
What would be most appropriate when a client’s niece asks about the client’s condition and
prognosis?
Answer:
Ask the client’s consent before sharing any information with the niece.
QUESTION
What are signs of approaching death that the nurse would include in a teaching plan for the
family? (Select all that apply)
Answer:
Gurgling as the client breathes through the mouth, Decrease in amount of urine produced,
Refusal to ingest food or fluids.
QUESTION
What term refers to individual, family, group, and cultural expressions of grief and associated
behaviors?
Answer:
Mourning.
QUESTION
How does a nurse providing home care to a terminally ill client know that the client’s condition
is beginning to deteriorate?
Answer:
Apical pulse reaches 100 beats per minute.
QUESTION
What characteristics of anorexia-cachexia syndrome does the nurse recognize?
Answer:
Alterations in carbohydrate, fat, and protein metabolism; Endocrine dysfunction; Anemia
QUESTION
Which criterion indicates that the client requires more teaching about hospice care?
Answer:
The client entered a clinical trial through the National Cancer Institute.
QUESTION
What medication would the nurse least likely expect the physician to prescribe to stimulate
appetite?
Answer:
Atropine
QUESTION
What are appropriate nursing interventions for anorexia and cachexia at the end of life?
Answer:
Encourage the patient to eat in an upright position; Recommend that the patient eat when hungry,
regardless of usual meal times; Teach the patient how to increase the nutritional value of meals
(i.e., add dry milk powder to milk).
QUESTION
What concept does the nurse share with the health care team about a dying client of the Islamic
(Muslim) religion’s beliefs about death?
Answer:
Death is seen as the beginning of a new and better life, with Islam as the vehicle.
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Protection, sensation, thermoregulation, sweat excretion, vitamin D synthesis
What are the 5 main functions of the integumentary system?
How long does the inflammatory phase last?
How long does the proliferative phase last?
How long does the maturation phase last?
Healing by secondary intention
How does age affect wound healing?
How do co-morbidities such as cardiopulmonary disease and diabetes mellitus affect wound healing?
How does excessive (non-inflammatory) edema affect wound healing?
How does improper wound care affect wound healing?
How does infection affect wound healing?
How does physical activity and lifestyle affect wound healing?
Contamination is the presence of NON-replicating bacteria on a wound surface which causes NO additional injury or stimulation of immune response.
Colonization is the presence of REPLICATING bacteria on a wound surface which causes NO additional injury or stimulation of immune response.
Infection is the presence of REPLICATING bacteria on a wound surface which CAUSES additional injury or stimulation of immune response, significantly delaying wound healing.
What is the difference between contamination, colonization, and infection?
Scrape of the skin due to something abrasive
An injury in which soft tissue is torn completely loose or is hanging as a flap.
A wound which enters the interior of an organ or cavity
wound made by a sharp pointed object penetrating the skin
a traumatic wound resulting from separation of the epidermis from the dermis
What are the parameters for a monofilament test?
What are the distinguishing characteristics between arterial and venous insufficiency ulcers?
Pressure injury staging: intact skin with localized area of non-blanchable erythema.
A clear, light color, thin, watery exudate
A red colored, thin, watery exudate
A light red/pink colored, thin, watery exudate
A cloudy/opaque exudate with a yellow or tan color and a thin, watery consistency
A yellow or green colored thick, viscous exudate
Necrotic tissue classification: death of tissue associated with loss of blood supply
A type of selective debridement: establishing a moist wound environment through the use of transparent films, hydrocolloids, hydrogels, and alginates to facilitate the body’s own enzymatic digestion of the nonviable tissue. Requires longer healing period than other methods, so not normally used for infected wounds.
debridement that removes only nonviable tissue
debridement that removes viable and non-viable tissue.
Negative Pressure Wound Therapy (NPWT)
How does ultrasound affect wound healing?
How does e-stim affect wound healing?
Urine and feces are typically acidic in nature and can contribute to skin irritation and erosion
Why is incontinence an issue that has to do with wound healing?
Bursting open of a wound, especially a surgical abdominal wound
redness of the skin due to capillary dilation or inflammation
a solid swelling of clotted blood within the tissues.
softening or dissolution of tissue after lengthy exposure to fluid
Burn classification: Involving only the outer epidermis. May be red with slight edema.
What are the components of the Rule of Nines?
Integumentary pathology: Fast-spreading inflammation caused by a bacterial infection of the skin and connective tissues, usually streptococci or staphylococci. Symptoms include fast-spreading redness, warm/hot skin, local ulceration, fever, and chills. Treatment requires pharmacologic intervention with systemic antibiotics. Conditions which present similarly include DVTs and contact dermatitis.
Integumentary pathology: a superficial irritation of the skin resulting from a localized irritant (poison ivy, latex, soap, etc.). Can be acute or chronic depending on exposure to the irritant. Very common and can occur at any age. Symptoms include intense itching/burning sensation, red skin, and edema. Focus of treatment is identifying and removing source of irritation. Topical steroid application is also used.
Integumentary pathology: Also called dermatitis, this is a group of disorders which cause chronic skin inflammation, usually due to an abnormal immune response, allergic reaction, or external irritant. Children and elderly are at greatest risk. Symptoms include red or brown-gray, itchy, lichenified skin plaques, which may be exacerbated by soaps and lotions. The plaques may display oozing and crusting. Treatment may include corticosteroids, antibiotics, or antihistamines depending on cause. Cold compress can help with itching, and extreme temperatures should be avoided to avoid exacerbation.
Integumentary pathology: A loss of vascular supply resulting in local tissue death where there is no infection present. Distal extremities are most often affected. Necrotic, hardened tissue is not painful, though there may be significant pain at the line of demarcation with still living tissue. Most common causes are diabetes mellitus or atherosclerosis, both of which cause vascular compromise. Symptoms include dark brown or black nonviable tissue that becomes a hardened mass. Pt. may complain of cold or numb skin. Depending on severity, pharmacology, hyperbaric oxygen, or surgery (including amputation) may all be indicated.
Integumentary pathology: A loss of vascular supply resulting in local tissue death and where an associated bacterial infection is present. Requires immediate treatment since it spreads quickly and can be fatal. Due to cessation of bloodflow, leukocytes are unable to fight the bacterial invasion. Symptoms include signs of infection at the wound site (pain, inflammation, redness, and swelling), purulent blisters, fever, and malaise. Treatment is surgical debridement and intervenous antibiotics.
Integumentary pathology: a chronic autoimmune disease of the skin. T cells trigger inflammation within the skin producing an accelerated rate of skin cell growth, resulting in accumulations of raised red patches on the surface. Some pts. are genetically predispositioned, while others are triggered by external factors (skin injury, stress, excessive alcohol, sunlight, smoking). Blotches typically present bilaterally and can appear anywhere on the body. Itchiness and flaking. Primary treatment is symptom management and prevention of secondary infection near the skin breakdown sites. A lifelong condition which can be effectively managed.
Metabolic pathways that break down molecules, releasing energy.
Metabolic pathways that construct molecules, requiring energy.
Metabolic disorder: Genetic condition. Consists of intellectual disability as well as behavioral and cognitive issues secondary to elevation of serum phenylalanine due to a deficiency of the enzyme which breaks it down, phenylalanine hydroxylase. Brain is the primary organ affected. Symptoms usually present within a few months of birth. Treatment is lifetime dietary restriction of phenylalanine.
Metabolic disorder: A group of over 100 disorders characterized by impaired functioning of mitochondrial proteins, either due to spontaneous mutation or genetic inheritance. Symptoms vary but can include loss of coordination, muscle weakness, respiratory compromise, and visual and hearing problems. Treatment depends on the specific disorder but generally aims at alleviating symptoms and slowing progression of the disease process.
Metabolic disorder: occurs when there’s either an increase in bicarbonate accumulation or an abnormal loss of acids, resulting in pH rising above 7.45. Commonly occurs with severe vomiting episodes or ingestion of antacids or other alkaline substances. Symptoms include nausea, diarrhea, vomiting, confusion, and muscle cramping. If left untreated, can progress to coma, seizures, and respiratory paralysis. Treatment is administration of potassium chloride and correcting electrolyte imbalance.
Metabolic disorder: occurs when there’s either an accumulation of acids or bicarbonate loss, resulting in pH dropping below 7.35. Commonly occurs with renal failure, starvation, diabetic or alcoholic ketoacidosis, severe diarrhea, or certain toxic poisoning. Symptoms include compensatory hyperventilation, vomiting, diarrhea, headache, and weakness. If left untreated, can lead to coma and death. Treatment includes administration of sodium bicarbonate and correcting electrolyte imbalance.
Metabolic disorder: bones become soft secondary to a calcium or phosphorus deficiency. There is adequate bone matrix, but insufficient calcification of the matrix. Usually caused by inadequate intestinal absorption or excessive renal secretion. Vague presentation of aching, fatigue, and weight loss. May see thoracic kyphosis or bow-legged deformity. Treatment focuses on underlying etiology, namely: increased nutrition and Vitamin D or phosphorus supplements.
Metabolic disorder: A decrease in bone mass which increases risk of fracture. Declining osteoblast function coupled with calcium and phosphate salt loss causes the bone to become brittle. Commonly occurs post-menopause or as a result of certain medications. Symptoms include compression fractures and other types of fractures, loss of lumbar lordosis, height decrease, or dowager’s hump. Treatment includes load-bearing activity to promote bone growth, vitamin supplementation, AD prescription, and potentially surgery to stabilize fractures.
Metabolic disorder: A genetic condition. Heightened osteoclast activity. Bone formation occurs, and bones can even appear enlarged, but the bones lack strength due to increased osteoclastic proliferation. Symptoms include musculoskeletal pain, bony deformities (kyphosis, coxa varus, bowing, vertebral compression), headache, vertigo, and hearing loss. Treatment is mostly pharmacological, relying on bisphosphates to inhibit bone resorption and improve bone quality. Weight control and cardiac fitness are also important.
A condition presenting as low bone mass which is not severe enough to qualify as osteoporosis
A gland of the endocrine system in that it directly impacts the pituitary gland.
Oxytocin (OT) and antidiuretic hormone (ADH)
Which two hormones are secreted by the posterior pituitary?
What are the seven hormones secreted by the anterior pituitary gland?
Follicle-stimulating hormone (FSH)
Adrenocorticotropic hormone (ACTH)
Hormone secreted by the anterior pituitary gland. Increases cortisol synthesis (adrenal steroids).
Thyroid-stimulating hormone (TSH)
Hormone secreted by the anterior pituitary gland. Increases synthesis of thyroid hormones T3 and T4.
Hormone secreted by the anterior pituitary gland. Facilitates lactation.
Endocrine disorder: condition of excessive hormonal secretion from the pituitary gland. Frequent presentation includes acromegaly, gigantism, galactorrhea (abnormal lactation in males or females), amenorrhea, infertility, and impotence. Most commonly caused by tumor, so treatment focuses on that (surgery, radiation, etc.). If needed afterwards, hormone suppression.
Endocrine disorder: hypofunction of the adrenal cortex, resulting in decreased levels of cortisol (glucocorticoid) and aldosterone (mineralocorticoid). Symptoms include fluid and electrolyte imbalance. Presentation includes hypotension, weakness, anorexia, weight loss, and altered pigmentation. If left untreated, pt. can go into shock and die. Treatment is long-term regimen of synthetic corticosteroids and mineralocorticoids.
Endocrine disorder: hyperfunction of the adrenal gland, allowing for excess cortisol (glucocorticoid) production. Usually due to an excess production of adrenocorticotropic hormone (ACTH) from the pituitary gland. Symptoms include hyperglycemia, truncal obesity, “moon face,” “buffalo hump,” weakness, and male lactation. Treatment is usually focused on the likely pituitary tumor and hormone suppression if necessary.
Endocrine disorder: Painless inflammation of the thyroid gland following pregnancy. Consists of a hyperactive phase for up to the first 4 months followed by a hypoactive phase lasting up to a further 4 months. Symptoms of the hyperactive phase include tachycardia, fatigue, unexplained weight loss, anxiety, and irritability. Symptoms of the hypoactive phase include depression, cold sensitivity, and poor exercise intolerance. Pharmacological interventions can assist during both phases, either hormone suppression or supplementation.
Endocrine disorder: the most common specific cause of hyperthyroidism. Most common in women over 20yo but can affect any population. An autoimmune disease in which certain antibodies stimulate the thyroid causing it to become overactive. Symptoms include mild enlargement of the thyroid gland (goiter), heat intolerance, nervousness, weight loss, and tremors/palpitations. Treatment includes pharmacological suppression or surgical removal of the thyroid gland.
Endocrine disorder: decreased production of parathyroid hormone resulting in decreased blood calcium levels. Symptoms include hypocalcemia, cardiac arrhythmias, seizures, cognitive defects, tetany, muscle pain, and cramps. Short-term treatment requires intravenous calcium. Long-term treatment is pharmacological and dietery modification.
Endocrine disorder: increased production of parathyroid hormone resulting in increased blood calcium levels. Symptoms include renal stones, gout, kidney damage, muscle wasting, and bone deformity. Acute treatment includes diuretics and antiresorptive medications to decrease calcium levels. Long-term treatment is usually surgical removal of the diseased parathryroid gland.
Endocrine disorder: a failure of the pancreas to produce sufficient insulin. Normally diagnosed in childhood but can occur at any age. Exact cause unknown, but there appears to be a genetic predisposition component. Symptoms are often rapid onset and include polyphagia, weight loss, ketoacidosis, polyuria, polydipsia, blurred vision, and fatigue. Treatment is exogenous blood glucose control through insulin injections and proper nutrition.
Endocrine disorder: an increased resistance to insulin action often combined with inadequate insulin production. Obesity is a contributing factor to insulin resistance. Characterized by hyperglycemia, though ketoacidosis does not occur since insulin is still typically produced. Symptoms are gradual in onset and include polyphagia, polyuria, polydipsia, blurred vision, and fatigue. Treatment is exogenous blood glucose control through diet, exercise, or insulin injections when necessary.
what is the normal range of glucose in the blood?
Endocrine disorder: a deficiency of testosterone secondary to failure of the testes to respond to FSH and LH. Most common cause is Klinefelter’s syndrome. Can also be caused by a failure of the hypothalamus/pituitary glands to produce sufficient hormones to stimulate production of testosterone. If experienced prior to puberty, symptoms can include sparse body hair, underdevelopment of skeletal muscles, and long limbs due to delayed closure of growth plates. If experienced in adulthood, symptoms include decreased libido, erectile dysfunction, infertility, mood changes, and sleep disturbances. Treatment is hormone replacement.
Endocrine disorder: a deficiency of estrogen secondary to failure of the ovaries to respond to FSH and LH. Most common cause is Turner syndrome. Can also be caused by failure of the hypothalamus/pituitary glands to pruduce sufficient hormones to stimulate estrogen production. If experienced prior to puberty, symptoms can include gonadal dysgenesis, short stature, and amenorrhea. If experienced in adulthood, primary symptom is amenorrhea. Treatment is hormone replacement.
What are the components of the upper GI tract?
What are the components of the lower GI tract
Mechanical and chemical digestion
What is the primary function of the Upper GI?
What is the primary function of the small intestine?
What is the primary function of the large intestine
Stores and releases bile into duodenum to assist with digestion of fats
What is the function of the gallbladder?
What are the functions of the liver?
What are the functions of the pancreas?
What are some general implications for pts. with GI disease?
gastroesophageal reflux disease (GERD)
GI disorder: result of an incompetent lower esophageal sphincter which allows reflux of gastric contents, causing esophageal tissue injury over time. Caused by muscular weakness or direct damage of the sphincter through NSAIDs, alcohol, or smoking. Symptoms include heartburn, regurgitation, belching, chest pain, hoarseness, coughing, and hematemesis. Can progress to strictures, aspiration pneumonia, or esophageal adenocarcinoma. Treatment is pharmacological. PT: avoid certain positions and recognize signs (tight clothing, constipation, etc.)
GI disorder: inflammation of the gastric mucosa, the inner layer of the stomach. High intensity symptoms, including heartburn, belching, nausea, vomiting. Can be caused by stress, NSAIDs, alcohol, direct trauma, or H. pylori bacterial infection. Treatment is usually removal of the stimulus and/or antibiotics for bacterial etiology.
GI disorder: erosion of the gastrointestinal mucusa due to an imbalance between the protective mechanisms of the stomach’s lining and its acidic secretions. Can be caused by H. pylori infection, chronic NSAID use, or overintake of irritants (alcohol, certain acidic foods, and smoking). Symptoms include epigastric pain, heartburn, nausea, vomiting, bleeding, bloody stools. Symptoms specific to H. pylori infection include halitosis, rosacea, and flushing. Complications include hemorrhage, perforation, and obstruction secondary to scarring. Treatment is primarily pharmacological and diet modification, but surgical intervention may be necessary in severe cases.
Irritable bowel syndrome (IBS)
GI disorder: a syndrome of recurrent symptoms of upper and lower GI which interferes with normal functioning of the colon. No known etiology, but it appears some people’s colons are sensitive to certain foods or stress. Other theories hypothesize autoimmune or bacterial causation. Females slightly > males. Symptoms include abdominal pain, bloating, nausea, vomiting, changes in form and frequency of stool, and mucusy stools. Treatment is multifactorial and includes lifestyle changes, nutritional regulation, and psychotherapy. Pt. should avoid large meals, dairy, alcohol, and caffeine.
GI disorder: a condition of having inflamed outpouchings in the wall of the colon. Usually results from a low fiber diet. Symptoms include abdominal cramping, constipation or diarrhea, nausea, fever. Complications can include bleeding, blockage, perforation or tears, or peritonitis. Treatment includes diet modification and lowering internal colonic pressure through increased fiber intake. NG tube may be required to give the intestines a break.
A condition of having abnormal outpouchings in the intestinal wall of the colon
A viral inflammation of the liver. Transmission is fecal-oral, usually via contaminated water and food. Typically flu-like symptoms which do not progress to chronic disease or cirrhosis. Symptoms include fever, fatigue, headache, jaundice, darkened urine, and lighter stool. Spontaneous recovery typically in 6-10 weeks as virus is self-limiting.
A viral infection which affects the liver and its function. Transmission is blood-, semen-, or maternal-fetal transmission, usually through sharing needles or sexual intercourse. Symptoms include fever, fatigue, headache, jaundice, darkened urine, and lighter stool. A small portion of patients progress to a chronic condition since the body is not always able to fight off the infection by itself. A vaccine is available.
A viral infection which affects the liver and its function. Transmission is blood-, semen-, or maternal-fetal transmission, usually through sharing needles, blood transfusion, or sexual intercourse. Symptoms include fever, fatigue, headache, jaundice, darkened urine, and lighter stool. Often asymptomatic, but can become chronic in about half of cases, with some progressing to cirrhosis of the liver. There is no vaccine and only a small percentage of patients respond to interferon to reduce inflammation and liver damage.
GI disorder: inflammation of the gallbladder which may be acute or chronic. Most common cause is gallstones which develop as a result of gallbladder hypomobility or crystal formation from bilirubin salts. Often asymptomatic, the most common symptom is upper-right quadrant pain and tenderness to palpation which may radiate to the interscapular region. If symptomatic, treatment is lithotripsy to break up the stones or cholecystectomy to remove the gallbladder and lodged stones, and low-fat diet modification.
Pain originating from internal organs. Often difficult to localize due to the pain being referred elsewhere in the body. E.g., left arm or jaw pain associated with myocardial infarction. Since visceral pain is transmitted via ANS pathways, a key sign to look out for as a PTA is the pain being accompanied by other ANS response symptoms: sweating, nausea, pallor, flushing, etc.
Abnormal accumulation of fluid in the peritoneal cavity, usually causing abdominal swelling
A lab test used to check a stool sample for blood
Surgical creation of an opening from the ileum through the abdominal wall
Involuntary contraction and relaxation of the muscles of the intestines which propels food
Small non-cancerous growths on the inner lining of the colon
An artificial opening of the intestine through the abdominal wall
Large, swollen veins that develop in the esophagus or stomach, often causing internal bleeding
Provide protection and hydration of vaginal tissue and urethra
What are the functions of the female extermal genitalia
Receptacle for male sperm, birth canal, excretory duct for menstrual fluid
What are the functions of the vagina
Houses the fetus during development
What is the function of the uterus
Provides transport for the ovum from the ovary to the uterus
What is the function of the uterine tubes
Produce estrogen and progesterone, storage of oocytes prior to ovulation
What are the functions of the ovaries
Genitourinary disorder: A condition where the kidneys experience a decrease in glomerular filtration rate, inadequately filtering toxins and waste from the blood. Can be either acute or chronic. Signs and symptoms include ↑BUN and creatinine, hyperkalemia, hypernatremia, HTN, nausea, vomiting, seizures, and coma. Treatment is pharmacological and diuretics, with hemodialysis and/or transfusions if applicable.
Genitourinary disorder: A dysfunction where there is damage to the cerebral control resulting in urinary dysfunction. If urine cannot properly be released, it can result in UTI or kidney damage. Can be caused by diabetes, hyperactive detrusor muscle, CVA, or other nerve damage. Symptoms include frequent UTIs, urine leakage, and loss of urinary urge. Treatment is based on preventing bladder overdistention, including pt. education on urinary scheduling, bladder techniques, lower abdominal massage, or temporary catheterization.
What is a normal daily fluid intake for adults?
Stress urinary incontinence (SUI)
Urge urinary incontinence (UUI)
Genitourinary disorder: involuntary urine voiding following a sudden, intense urge to void due to the bladder detrusor muscle involuntarily contracting. Most common incontinence among the geriatric population. Caused by changes to the smooth muscle over the lifespan and is associated with various neurological disorders such as MS, SCI, CVA, and Parkinson’s. Often brought about due to a conditioned reflex, such as arriving home or running water.
Overflow Urinary Incontinence (OUI)
Genitourinary disorder: involuntary voiding of urine when the intra-bladder pressure exceeds the urethra’s capacity to remain closed, secondary to excessive and usually prolonged urine retention. Caused by a narrowed or obstructed urethra due to a prolapsed pelvic organ, prostate enlargement, or chronic constipation. Main symptom is difficulty initiating urination, weak stream once initiated, and post-void dribbling. Treatment is likely surgical to correct cause or pelvic floor strengthening if cause is detrusor muscle weakness.
Functional Urinary incontinence (FUI)
Genitourinary disorder: a very common occurrence in the general population, even more so among women and geriatrics. Occurs when bacteria infiltrate the urethra or further into the bladder itself. Symptoms include frequent urination, pain/burning with urination, cloudy urine, fever, back pain, and confusion. Treatment is antibiotics and increased fluid intake.
Obstetrics disorder: separation of the rectus abdominis along the linea alba during pregnancy. Due to biomechanical and hormonal changes. Therapist should not how many fingers wide the separation is while the woman lifts her head and shoulders off the table in order to gauge treatment. Treatment is abdominal strengthening and stabilization, postural exercises, and body mechanics.
Obstetrics disorder: compression of the sciatic nerve where is passes under/through the piriformis muscle as a result of its shortening or spasming due to postural changes and hip rotation alteration during pregnancy. Treatment is stretching, muscle energy techniques, joint mobilization, STM, and heat application.
Moderation, 50-60% of max HR, non-weightbearing exercises preferred, avoid supine position
What are the general recommendations for exercising while pregnant?
Bulging of the bladder into the vagina
Implantation of a fertilized ovum outside of the uterus, most commonly in the fallopian tube
Specialized ball of capillaries within the kidneys that are needed for the filtration of fluide
What are the primary functions of the lymphatic system?
What is the ratio of venous return to lymphatic return?
What are the two main lymphatic trunks of the body
Protein-rich fluid transported back to the heart via the lymphatic system
Lymphatic disorder: a chronic, incurable condition in which lymph accumulates in the body. Typically presents in the extremities but can occur anywhere in the body. Can be primary (due to abnormal development of the lymphatic system) or secondary (caused by disease, trauma, surgery, radiation, or chronic venous insufficiency). Symptoms include swelling, achiness, fullness, and a feeling of heaviness in the affected region. If fluid stasis remains prolonged, lymphatic valves can become incompetent under the sustained pressure, worsening the problem, and the proteins in the lymph can degrade causing chronic inflammation in the surrounding tissues.
Stage 0 – no visible edema, though lymphatic function is known to be compromised.
Stage 1 – pitting edema is present and increases with activity or heat, but resolves with elevation and rest.
Stage 2 – edema is non-pitting and does not decrease with elevation or rest. Positive Stemmer’s sign.
Stage 3 – elephantiasis stage. Extensive non-pitting edema. Significant fibrotic changes to the skin. Presence of papillomas, deep skinfolds, and hyperkeratosis.
Lymphedema classification with <3 cm difference between affected and unaffected limbs
Lymphedema classification with 3 – 5 cm difference between affected and unaffected limbs
Lymphedema classification with >5 cm difference between affected and unaffected limbs
Complete decongestive therapy (CDT)
Lymphedema treatment therapy intervention consisting of:
-manual lymphatic drainage
-compression bandaging using short-stretch not long-stretch (ACE wraps), followed by custom compression garments (after decongestion
-skin care
-decongestive exercises for bandages extremities
-patient education in self-management techniques (compliance determines success)
Manual lymphatic drainage (MLD)
Wrap bandage with high working pressure and low resting pressure
Wrap bandage with low working pressure and high resting pressure
Short-stretch, as they have low resting pressure, so as to not impede lymph flow
Would you use short-stretch or long-stretch bandages to manage lymphedema?
a benign wart-like skin growth that is typically observed with stage 3 lymphedema
Edema which retains an imprint when depressed. Observed in the earlier stages of lymphedema.
a malignant tumor that occurs in epithelial tissue (e.g., skin, lining of lungs or stomach, etc.)
A malignancy of the pigmented cells, the melanocytes
A malignancy of connective tissue (muscle, blood vessels, bone, etc.)
A malignancy of lymph tissue (lymph nodes, spleen, tonsils, etc.)
A malignancy of white blood cells
early malignancy that is present only in the layer of cells in which it began
Malignancy limited to the tissue of origin with no lymph node involvement or metastasis
Malignancy spreading into adjacent tissues; lymph nodes may show signs of micrometastases
Malignancy that has metastasized beyond the primary site, for example, to bone or another organ
What are the signs and symptoms of brain cancer
Firm, irregular, and non-painful lump, nipple discharge
What are the signs and symptoms of breast cancer?
A new cough or change in chronic cough, hemoptysis, SOB, wheezing, weight loss, and bone pain
What are the signs and symptoms of bronchial carcinoma?
Always check MD’s orders for exercise prescription/contraindication, monitor blood values daily to ensure safe participation, don’t exceed 40-65% of max HR, treatment times should be scheduled around the time of day when pt’s energy levels are highest, be mindful of potential side effects of cancer treatment (fatigue, pain, GI distress, depression, anxiety)
What are general recommendations for exercise in patients with cancer?
Contraction of the human papilloma virus (HPV)
What is the primary cause of cervical cancer?
Abnormal bleeding, pelvic and lumbar pain, bowel/bladder dysfunction
What are the signs and symptoms of cervical cancer?
Diet high in fat and low in fiber
What is the primary modifiable risk factor of colorectal cancer?
Arterial rectal bleeding, fatigue, weight loss
What are the signs and symptoms of colorectal cancer?
What are the two main modifiable risk factors for lung cancer?
Cough, dyspnea, adventitious breath sounds, chest pain, and hemoptysis
What are the signs and symptoms of lung cancer?
Painless lump, fever, chills, and fatigue
What are the signs and symptoms of both Hodgkin and non-Hodgkin lymphoma?
What are the signs and symptoms of pancreatic cancer?
What are the signs and symptoms of prostate cancer?
What are the signs and symptoms of basal cell carcinoma?
What are the signs and symptoms of malignant melanoma?
A change in a cell from one type to another; may be normal or abnormal
A group of disorders characterized by the patient exhibiting fear and maladaptive strategies in dealing with stressful or everyday stimuli. Pts. typically do not have psychosis or delusions, and usually realize that they have a problem. Examples: anxiety disorder, obsessive-compulsive disorder, and phobia disorder.
Obsessive-compulsive disorder (OCD)
the study of aging and the elderly
What are some effects of aging on the musculoskeletal system?
What are some effects of aging on the nervous system?
What are some effects of aging on the cardiopulmonary system?
What are some effects of aging on the integumentary system?
What are some effects of aging on the endocrine system?
What are some effects of aging on the GI system?
Increased incontinent, decreased kidney rate and function, decreased bladder capacity
What are some effects of aging on the genitourinary system?
The study of what happens to the drug once it enters the body
The study of how a drug exerts its therapeutic effects on the body at the cellular or organ level
The use of multiple medications on a regular basis
What is the difference between palliative care and hospice care?
An ulcer caused by inadequate perfusion of oxygenated blood in the affected tissue. Over time this results in cell death and tissue necrosis. Typically caused by peripheral artery disease which is linked to atherosclerosis, HTN, obesity, diabetes mellitus, and smoking. Most common site is distal 1/3 of LEs. Minimal bleeding, deep but smooth defined wound edges, surrounding skin may be cool, shiny, and hairless. Distal pulses diminished or absent. Significant pain with non-dependent positioning or activity. ABI of <0.80 is indicative of moderate arterial blockage. Complications include gangrene and sepsis. Treatment includes surgical debridement of necrotic tissue, possible grafting, potential amputation if normal circulation can’t be restored. PT emphasizes skin protection and wound healing interventions. Similar condition: venous insufficiency ulcers. This condition presents with shallow, irregular wounds with moderate to heavy exudate, mild pain that’s relieved with elevation, brown flaky skin, and intact pedal pulses.
A painless mass within the breast tissue. Linked to age, young menarche, late menopause, family history, high alcohol intake, high fat diet, and past history of cancer. Medical management depends on size and stage of the mass and can include surgery, chemotherapy, radiation, and hormone therapy. PT may be indicated for lymphedema management, strengthening, endurance, and range of motion exercises. Similar condition: fibrocystic breast disease (mammary dysplasia). Usually bilateral, nodular lumps which become tender immediately prior to menstruation.
A multi-system disease with both biochemical and anatomical consequences. Persistent hyperglycemia due to diminished or absent insulin production, due to beta cell destruction in the pancrease. Exogenous insulin is required to reverse symptoms (prevent ketosis, decrease hyperglycemia, and normalize lipid/protein metabolism. Symptoms include polyuria, polydipsia, polyphagia, nausea, weight loss, fatigue, and blurred vision. PT may be indicated for HEP and education on self-monitoring. Similar condition: diabetes mellitus type 2. This is usually diagnosed in pts. older than 40yo and is characterized by a resistance to insulin due to impairment of receptor sites in peripheral tissue. Symptoms are similar but can also include inadequate wound healing, paresthesias, and cold extremities.
A chronic disease characterized by an inappropriate or diminished cellular response to insulin, preventing adequate absorption of blood glucose, resulting in persistent hyperglycemia. Excess body fat interferes with ability to metabolize insulin and is often a key characteristic. Sedentary lifestyle and being of African, Asian, Hispanic, or American Indian also increases risk. Symptoms include polydipsia, polyuria, polyphagia, blurred vision, delayed healing, and peripheral neuropathy. Treatment is mostly symptom management and, in some cases, exogenous insulin. Lifestyle changes, such as weight loss, proper nutrition, excercise, and stress management, can significantly impact insulin sensitivity. Similar condition: diabetes mellitus type 1. Less common in the US and characterized by a diminished or absent endogenous production of insulin. Similar symptoms, though a pt. with Type 1 is much more likely to experience diabetic ketoacidosis.
A rheumatic condition where pain is the primary symptom, caused by tender points within multiple muscles, tendons, and ligaments. No exact etiology known, but some factors speculated to be linked are diet, sleep dysfunction, viral infection, and psychological distress. Greater incidence in females aged 14 – 68. May affect any part of the body. Commonly misdiagnosed as myofascial pain, lupus erythematosus, and chronic fatigue syndrome, as symptoms are similar and there is no definitive test for this condition. Incurable, though symptoms may be mild or even absent throughout the pt’s lifetime. Medical mgmt is focused on normalizing dysfunctions of the ANS, hormonal imbalances, and metabolic abnormalities. Psychotherapy may be indicated for anxiety, depression, or stress. PT is indicated for relaxation strategies, energy conservation, gentle stretching, moist heat, biofeedback, and exercise within tolerance (especially aquatic therapy). Pt. should NOT work through pain. Similar condition: myofascial pain syndrome (MPS). Differs in that MPS presents with palpable trigger points rather than just tender points, and MPS is localized to a single muscle or muscle group, while this condition is systemic, and MPS is caused by overuse or repetitive motions.
A metabolic bone disorder where the rate of bone resorption accelerates and bone formation slows down, decreasing overall bone density. Primarily affects the trabecular bones (most commonly vertebrae, distal radius/ulna, and femoral neck). Typical pt. is post-menopausal female. Symptoms include fractures and pain with weight-bearing and palpation. Postural deformities may be present, such as kyphosis and Dowager’s hump. Determined via bone mineral density test. Treatment includes vitamin and pharmaceutical supplements, proper nutrition, and exercise with emphasis on weight-bearing. Pt. may require corset or lumbar support if that region is affected. Surgical intervention may be required for fracture stabilization. Similar condition: Paget’s disease, characterized by thickened, spongy, and abnormal bone formation. Symptoms include bone pain, headache, hearing loss, stiffness, and fatigue.
A systemic autoimmune disorder characterized by chronic inflammation within synovial membranes, tendon sheaths, and articular cartilage. Smaller peripheral joints are usually first to be affected, however all connective tissue may become involved. Granulation tissue forms as a result of synovitis, eroding articular cartilage, resulting in destruction, adhesions, and fibrosis within the joint. Typical pt. is between 30-50yo. Symptoms include fatigue, bilateral involvement, small joint tenderness, low-grade fever, prolonged morning stiffness, and pain with motion. Medical mgmt is focused on decreasing inflammation and retarding progression of disease. PT includes pt. education on regular rest, pain relief, relaxation, joint protection techniques, and avoidance of resistive exercise, heating modalities, and active stretching during acute phases of inflammation, as they will exacerbate symptoms. Low-impact conditioning (stationary bicycle or swimming) and gentle stretching may be indicated. Similar condition: osteoarthritis. This develops secondary to trauma, obesity, or disease. Typically unilateral and restricted to weight-bearing/heavy use joints.
Systemic lupus erythematosus (SLE)
Chronic autoimmune disorder of the connective tissue; the body produces destructive antibodies which attack itself, producing a variety of symptoms depending on severity and extent. Exact etiology unknown, though genetic, environmental, viral, and hormonal factors are suspected. Far more common in women, and typical age of onset is 15 – 40. Symptoms include malaise, fatigue, rash, arthralgia, and weight loss and can appear and disappear with cycles of exacerbation/remission. Red butterfly rash across face is hallmark sign. CNS can also become involved, leading to depression, irritability, and seizures. Exposure to UV light can exacerbate symptoms. Medical mgmt focuses on reversing the autoimmune response with corticosteroids and immunosuppressive therapy. PT is indicated for a slow reintroduction to physical activity, energy conservation, and endurance training. Periods of remission may last years and overall prognosis is good, though periods of exacerbation can be severe and even fatal (usually due to kidney failure or secondary infection).
Refers to a noncontagious bacterial skin infection occuring in dermal and subcutaneous layers. Typically presents with visible signs of inflammation including local redness, warmth, tenderness,a nd edema that progressively worsens. Early detection and treatment are vital in reducing complications and systemic infection. Can spread if untreated, causing potentially fatal septicemia.
Complex regional pain syndrome (CRPS)
An increase in sympathetic activity causes a release of norepinephrine in the periphery and subsequent vasoconstriction of blood vessels resulting in pain and an increase in sensitivity to peripheral stimulation. Affects all age groups, but is most likely found in individuals 35-60yo, with females > males. Pts. experience intense burning and chronic pain in the affected extremity that eventually spreads in a proximal direction.
Human immunodeficiency virus (HIV)
A viral infection. Primary risk factors include unprotected sexual intercourse (anal or vaginal), IV drug use, or mother-to-fetus transmission. Without treatment, advances in three stages: acute infection, clinical latency, and finally AIDS. Leading cause of death for pts. are, in order of prevalance, AIDS-related opportunistic infection, AIDS-defining cancers (e.g., Kaposi sarcoma, non-Hodgkin lympoma, etc.), liver disease, and cardiovascular disease.
Juvenile rheumatoid arthritis (JRA)
Autoimmune disorder found in children <16yo which occurs when the immune cells mistakenly begin to attack the joints and organs causing local and systemic effects. Girls > boys, most commonly diagnosed as toddlers or early adolescence. Clinical symptoms include persistent joint swelling, pain, and stiffness.
An inflammation of the inner lining of the appendix which may spread to other areas. Abdominal pain is most commonly reported with symptoms beginning as either umbilical or gastric pain that migrates to the right lower quadrant. Examination findings typically include abdominal rebound tenderness, pain with percussion, abdominal guarding, and rigidity.
Complex condition with unknown etiology, though potentially includes viral origin, immune response to nervous system inflammation, or combination of lifestyle factors. Best managed using a multidisciplinary approach including education, medical management, cognitive behavioral therapy, and exercise. There is no cure, and symptom presentation, progression, and resolution can be highly variable, making prognosis difficult.
A specific form of inflammatory bowel disease in which the lining of the GI tract becomes abnormally inflamed. Typical signs and symptoms range from mild to debilitating to life-threatening. Symptoms may develop gradually or rapidly and include abdominal pain, cramping, diarrhea, bloody stool, GI tract ulcers, diminished appetite, and weight loss.
Considered a complex form of arthritis resulting from an abnormally high uric acid level (hyperuricemia) in the body. Males > females, with great toe, knee, and ankle being most commonly affected joints. May present as chronic or as a series of acute attackes. Identification of uric acid crystals in synovial fluid, collected via synovial biopsy, may be used to confirm diagnosis.
An inflammatory bowel disease that results in chronic inflammation and the formation of ulcers in the large intestine. Symptoms include abdominal pain, cramping, diarrhea, blood in the stools, defecation urgency, weight loss, fatigue, and fever. Best test to diagnose is endoscopy, which allows for direct visualization of the colon.
Cancer which most commonly affects the endometrium and is thought to occur when an imbalance of hormones causes the endometrium to grow thicker. Unexpected vaginal bleeding is the most common symptom associated with this cancer, especially post-menopausal. The only known method to confirm diagnosis is tissue biopsy.
Which depth of burn exhibits the highest level of pain?
Which symptom is of greatest concern regarding exercise prescription for pts. with hyperthyroidism?
List and describe the two main classifications of vitamins
Complex regional pain syndrome (CRPS)
3) limiting blood’s oxygen carrying capacity
What is the normal range of healthy weight gain during pregnancy?
3) wrist flexion, MCP extension
Which type of wound would be most appropriate for the use of autolytic debridement?
1) a heavily draining wound with 90% granulation tissue in the wound bed
2) an infected wound with a shallow wound bed and 40% necrotic tissue
3) a shallow wound with no necrotic tissue in the wound bed
4) a painful wound with 50% eschar tissue in the wound bed
Adrenal cortex (outer layer) and adrenal medulla (inner portion). The cortex is further sub-divided into three zones.
1) zona glomerulosa – outermost cortex – mineralocorticoids (most common is aldosterone) – regulate salt, electrolyte, and BP balance
2) zona fasciculata – middle of cortex – glucocorticoids (most common is cortisol) – regulation of metabolism
3) zona reticularis – innermost cortex – androgens (sex hormones to be converted to estrogen and testosterone in the gonads) – sexual development and function
4) medulla – catecholamines (epinephrine and norepinephrine) – produce stress responses
2) hip flexion and adduction
This is the expected deformity contracture with burns of the hip
3) presence of an abrasion
A stage 1 pressure ulcer is characterized by intact skin
4.Choose socks without seams to avoid irritating the skin on the foot
A physical therapist assistant works with a patient who has type 2 diabetes and bilateral lower extremity neuropathy. Which of the following instructions is the MOST appropriate for the assistant to use to educate the patient about appropriate foot care?
1.Soak the feet in warm water daily, then apply petroleum jelly to retain skin moisture
2.Wear shoes which are snug on the toes to prevent blister formation
3.Use alcohol-based creams and lotions to ensure that the foot is thoroughly cleaned
4.Choose socks without seams to avoid irritating the skin on the foot
A physical therapist assistant is treating a patient in an acute care setting who has a hematologic disorder. Which of the following measures would be the MOST appropriate for the assistant to monitor on a daily basis in order to ensure patient safety during treatment?
1.Hemoglobin
2.Complete blood count
3.Arterial blood gas
4.Blood glucose
A patient is scheduled to undergo a transtibial amputation of the left lower extremity. In addition, the patient is one month post right total knee arthroplasty. Given the patient’s past and current surgical history, the physical therapist assistant should expect which of the following activities to be the MOST difficult for the patient following their amputation?
1.Rolling from supine to sidelying
2.Moving from supine to sitting
3.Moving from sitting to standing
4.Ambulating in the parallel bars
A physical therapist assistant hypothesizes that a patient’s burns are best classified as deep partial-thickness after originally hypothesizing that the burns were full-thickness. Which finding would BEST support the assistant’s new hypothesis?
1.Sensation to touch
2.Absence of pain
3.Blanching to pressure
4.Red, glistening appearance
A physical therapist assistant reviews the past medical history of a patient who has recently been diagnosed with adhesive capsulitis. Which of the following medical conditions is MOST associated with an increased incidence of adhesive capsulitis?
1.Diabetes mellitus
2.Hemophilia
3.Peripheral vascular disease
4.Osteomalacia
3.Congestive heart failure
All others would result in weight loss. Addison’s is hypofunction of adrenal cortex resulting in loss of apetite and anorexia. Crohn’s disease decreases appetite and increases caloric need. Graves’ disease is hyperthyroidism which increases metabolism, often leading to weight loss.
A physical therapist assistant treating a patient rehabilitating from spinal surgery four days ago observes the patient’s incision. What type of healing is BEST described by the surgical incision being stitched closed?
1.Primary intention
2.Delayed primary intention
3.Secondary intention
4.Tertiary intention
2.Increase the speed of movement
A physical therapist assistant implements an aquatic program for a patient who has a lower extremity injury. The program requires the patient to run in place using a flotation device while tethered to the side of the pool using an elastic cord. Which of the following actions would be the MOST appropriate to increase resistance?
1.Increase the water temperature
2.Increase the speed of movement
3.Increase the depth of the water
4.Remove the flotation device
A physical therapist assistant reviews a patient’s medical record prior to beginning treatment. The record indicates the patient was recently placed on amitriptyline (Elavil). Which of the following responses is the MOST common side effect associated with this tricyclic antidepressant?
1.Sedation
2.Dysarthria
3.Seizures
4.Blood pressure variability
A patient with diabetes mellitus is scheduled to walk approximately one half mile as part of a community fitness initiative. The physical therapist assistant checks the patient’s blood glucose level before initiating the activity and finds it is 125 mg/dL. This finding indicates that the assistant should make which of the following recommendations?
1.The patient is safe to perform the activity
2.The patient should increase food intake with a fruit or bread exchange
3.The patient should increase food intake with a half sandwich with fruit or milk
4.The patient should not exercise until the blood glucose is under better control
A patient sustained a superficial wound that appears as a moderate abrasion on the anterior surface of their thigh approximately four inches above the superior pole of the patella. Which type of wound dressing would MOST likely be utilized?
1.Calcium alginate dressing
2.Hydrocolloid dressing
3.Hydrogel dressing
4.Transparent film dressing
A patient completing a resistive exercise program following an ankle injury reports to the physical therapist assistant that lifting weights often causes them to void small amounts of urine. Which of the following actions is the MOST appropriate for the assistant to take?
1.Refer the patient to a support group
2.Instruct the patient in pelvic floor muscle strengthening exercises
3.Discontinue resistive exercises as part of the established plan of care
4.Educate the patient about incontinence
A patient four weeks post anterior cruciate ligament reconstruction using a patellar tendon autograft informs a physical therapist assistant that they are going on vacation for a week in a tropical location. What advice should the assistant give to the patient that would be the MOST beneficial to protect their scar from the sun?
1.Keep the scar covered when outside in the sun
2.Apply sunscreen with a minimum of 15 SPF directly to the scar
3.Apply sunscreen with a minimum of 30 SPF directly to the scar
4.Apply sunscreen with a minimum of 50 SPF directly to the scar