Epigenetics
Defects in the encoding of histone-modifying proteins
Housekeeping Genes are vital to the function and maintenance of all the body’s cells. What characteristic is … with these genes?
Mutations in the encoding of histone modifying proteins … shown to influence the development of what congenital condition?
Epigenetics refers to chemical modification that are made to what?
Signals to change or modify epigenetic tags are … from where?
What sort of molecule is responsible for transferring signals into cells to gen regulatory proteins?
Mutations in the encoding of histone-modification proteins … shown to influence the development of what congenial condition?
Epigenetics and its role on human development
Research has provided support for the theory that epigenetic modification can result from deficient in utero nutrition causing?
During which stage of human development does the role of epigenetics have the greatest impact on the development of epigenetic abnormalities?
The difference between DNA sequence mutations and epigenetic modifications is?
Research has provided support for the theory that epigenetic modification can result from deficient in utero nutrition causing which chronic disease?
Totipotent cells and its ability to differentiate into any type of cell
Which embryonic stem cell characteristic is referred to as a totipotent?
Examples of two totipotent cells are?
What is a Totipotent cell?
Are all cells Totipotent cells?
Prader-Willi syndrome and Angelman syndrome?
What characteristic of Prader-Willi syndrome is not a characteristic of Angelman syndrome?
A child with Prader-Willi syndrome has been hospitalized. Which assessment findings does the nurse expect with this syndrome?
The nurse is examining an 8-year-old boy with chromosomal abnormalities. Which sign or symptom suggests the boy has Angelman syndrome?
Cellular Proliferation
5-Azacytidine and the treatment of cancer
What is 5-azacytidine? Nucleoside analog able to … incorporated into RNA & DNA
5- Azactytide has demonstrated promise in the treatment of which form of cancer?
the role of inactive MLH1 in the development of some forms of inherited colon cancer
What is the role of inactive MLH1 in the development of some forms of inherited colon cancer?
Effects of ethanol on neural stem cells ability to differentiate into functional neurons-
Research has demonstrated that neural stem cells have an impaired ability to differentiate into functional neurons when subjected to?
Inflammation as an etiology for cancer-note conditions in which this may occur
What chronic inflammatory conditions can increase risk for cancer?
Cancer
In terms of epigenetic modifications, the role of environmental stressors associated with development of cancer
When considering abnormal epigenetics modifications, what factor is currently being viewed as strongly associated with the development of some cancers?
Defects in Mechanism of Defense
Hemolytic defects in the newborn
To explain hemolytic disorders in the new born to new parents, the nurse who cares for the new born population must … aware of the physiologic characteristics related to these conditions. What is the most common cause of pathologic hyperbilirubinemia?
Which infant is most likely to express Rh incompatibility?
Rh hemolytic disease is suspected in a mother’s second baby, a son. Which factor is important in understanding how this could develop?
The nurse is caring for an infant with hemolytic disease. Which medication should the nurse anticipate to … prescribed to decrease the bilirubin level?
A newborn is found to have hemolytic disease. Which combination would … found related to the blood types of this newborn and the parents of the newborn?
The nurse is caring for a newborn with hemolytic disease of the newborn who is receiving phototherapy. Which nursing intervention would … the most appropriate for the nurse to do?
Understand the meaning of infectivity
Most effective treatment for HIV
A patient … with acute primary HIV infection is in the clinic. What treatment should … initiated for this patient?
Defected cells of HIV
A patient has human immunodeficiency virus (HIV). A nurse realizes the HIV will attack:
The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells?
Signs of T-Lymphocyte deficiency-
T-cell defects
A patient has DiGeorge syndrome. Which assessment findings should the nurse monitor for in this patient?
A nurse is caring for a client who is deficient in T cells. Which result of this T cell deficiency does the nurse anticipate?
Pulmonary Alterations
Pulmonary function tests
Identify purposes for preforming PFT’s?
What is the role of pulmonary function testing?
What do PFT screening do?
A 15-year-old female is … with restrictive lung disease caused by fibrosis. The patient had a pulmonary functions test. Which of the following findings is expected?
Relationship of lung compliance and residual volume
A nurse is teaching about the functions of the pulmonary system. Which information should the nurse include? One of the functions of the pulmonary system is the:
An 80-year-old male presents to his primary care provider reporting difficulty breathing. Pulmonary function tests reveal that he has increased residual volume. A nurse suspects the most likely cause of this disorder is _____in lung compliance?
Shifts in the oxyhemoglobin dissociation
In a patient with acidosis or a fever, the nurse would expect the
oxyhemoglobin dissociation curve to shift:
What factors affect oxyhemoglobin dissociation?
In a normal person, as PaO2 drops from 100 to 80 to 60, there is ________ in how tightly Hgb is holding onto its 02 (90-100% saturation). But when the PaO2 approaches 50, the s-curve begins to __drop sharply_, and as it does it means that _
For a right shifted curve, for the same PaO2 there will … a lower ______ when compared to a normal curve
What causes a R shift?
In both healthy and pathological conditions, the signs of a R shift are?
What causes a L shift?
CO2 transport in the blood
Most carbon dioxide in the blood is transported?
If an individual with respiratory difficulty were retaining too much
carbon dioxide, which of the following compensatory responses would the
nurse expect to … initiated?
A patient wants to know how carbon dioxide is transported in the body.
How should the nurse respond? Carbon dioxide (CO2) is mainly transported
in the blood:
Characteristics of alveoli
Air passage between alveoli is collateral and evenly distributed because of?
Changes in the alveoli that cause an increase in alveolar surface tension, alveolar collapse and decreased lung expansion are a result of?
Students in a histology class are assigned to identify regions of the
The slide shows a basement membrane, capillary lumen, and
macrophages. The students are looking at the:
While auscultating a patient’s lungs, a nurse recalls the alveoli in the
apexes of the lungs are _____ than alveoli in the bases.
The nurse is caring for a client who is now 2 days post near-drowning. The focused assessment would involve which of the following areas of the lung involved in gas exchange?
Arterial perfusion pressure and alveolar gas pressure in the lung base
A consequence of alveolar hypoxia is:
The pressure … to inflate an alveolus is inversely … to:
The nurse is describing the movement of blood into and out of the
capillary beds of the lungs to the body organs and tissues. What term
should the nurse use to describe this process?
A pulmonologist is discussing the base of the lungs with staff. Which
information should … included? At the base of the lungs:
When the pulmonologist discusses the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called:
How do determine the partial pressure of oxygen given the percentage of oxygen in the air and the barometric pressure
What is the partial pressure of oxygen in the lung given the following
conditions? Percentage of oxygen in air: 20 Barometric pressure: 700 mm Hg
What would the partial pressure of oxygen equal if the barometric pressure was 600 mm Hg?
Results of increased work of breathing
An 80-year-old male presents to his primary care provider reporting
difficulty breathing. Pulmonary function tests reveal that he has
increased residual volume. A nurse suspects the most likely cause of
this disorder is _____ in lung compliance.
Know terms:
Vital capacity (VC),
While reviewing the results of the pulmonary functions test, the nurse is aware that the maximum amount of gas that can …… from the lung is called:
Vital Capacity
Total lung capacity
What would happen to TLC and VC of your lungs become stiff and less elasticity
Can’t take in as much air because elasticity is reduced
Functional capacity
Residual volume,-
Functional residual capacity (FRC)
Which of the following terms should the nurse use when there is a balance between outward recoil of the chest wall and inward recoil of the lungs at rest?
Renal Alterations
Types of nephrons and their functions
The nephrons that determine the concentration of the urine are _____ nephrons.
Which of the following renal structures is not a component of the nephron?
At which of the following locations in the nephron would a nurse practitioner first expect blood to … largely free of plasma proteins?
Which of the following substances is most likely to … reabsorbed in the tubular segments of the nephron using passive transport mechanisms?
What is the function of nephron?
The nephrons are the functional units of the kidney, responsible for the initial formation of urine. The nurse knows that damage to the area of the kidney where the nephrons are … will affect urine formation. Identify that area.
Overall renal physiology
Substances that are actively secreted by the renal tubules
Which of the following substances are actively secreted by the renal tubules?
Which of the following comprises the kidney’s transport system?
Activation of the renin-angiotensin system
Which of the following statements correctly describes a direct end-effect of the renin-angiotensin-aldosterone system?
What does the reduced perfusion of the kidney activate that causes constriction of peripheral arterioles?
Glomerular filtration rate
The glomerular filtration rate (GFR) is directly related to the
A nurse educator is orientating anew nurses to a renal unit of a hospital. Which of the follow teaching points should the nurse include as a part of a review of normal glomerular function?
Mesangial cells
A urologist is discussing the phagocytic cells that lie between the layers of the renal corpuscle
Lying between the layers of the renal corpuscle is a population of phagocytic cells called?
Renal system anatomy
When the renal system secretes rennin, it causes the direct activation of?
Why plasma proteins should … absent from the urine
The fluid formed in the capillary cluster of the nephron is the same as blood plasma except for the absence of?
Which of the following substances does not normally get filtered in the kidneys?
Effects of urinary tract obstruction- hydronephrosis and a decreased glomerular filtration rate
A 25-year-old female is … with urinary tract obstruction. while planning care, the nurse realizes that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate caused by?
Which of the following changes will result in a decreased glomerular filtration rate?
Effect of urinary retention
A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of most concern to the nurse?
A group of students are reviewing information about disorders of the bladder and urethra. The students demonstrate understanding of the material when they identify which of the following as a voiding dysfunction?
A client presents at the clinic with complaints of urinary retention. What question should the nurse ask to obtain additional information about the client’s complaint?
The nurse is teaching a group of nursing students about acute glomerulonephritis genitourinary conditions. A student asks the about a condition that occurs when there is a decreased volume of urine output. The condition the student is referring to is which of the following?
Most common type of renal stone
When a patient asks what the most common type of renal stones is …. of, how should the nurse respond? The most common type of renal stone is … of
The nurse recognizes that a referral for genetic counseling is inappropriate for the client with:
Because a client’s renal stone was found to ….. of uric acid, a low-purine, alkaline-ash diet was ordered. Incorporation of which of the following food items into the home diet would indicate that the client understands the necessary diet modifications?
Epispadias
The optimal time for surgical repair of the Hypospadias and epispadias is
What gender has predominance for exstrophy-epispadias complex?
…. 4 considerations must … addressed when performing the epispadias repair?
What are 2 anomalies noted with epispadias?
List 3 goals of surgical treatment of epispadias
What is the most important indicator of successful continence with epispadias repair?
What are the 3 types of female epispadias?
PIC: A=normal, B=clitoris altered, C and D=varying degree of urethral defect
What are other aspects of female epispadias?
Glomerulonephritis
A 15-year-old male was … with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease?
When a nurse observes post-streptococcal glomerulonephritis as a diagnosis on a patient, which principle will the nurse remember? Acute post-streptococcal glomerulonephritis is primarily caused by?
A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is?
A 15-year-old female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what could have caused this, how should the nurse respond?
Which of the following clusters of symptoms would make a clinician suspect a child has developed glomerulonephritis?
A 5-year-old male was … with glomerulonephritis. History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely … in the
A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is?
A 45-year-old male presents with oliguria. He is … with chronic glomerulonephritis. The nurse knows oliguria is … to?
Which assessment finding is most important in determining nursing care for a client with acute glomerulonephritis?
The nurse is assessing a child with acute poststreptococcal glomerulonephritis. Which of the following would the nurse expect to assess?
Nephrotic syndrome
A urologist is discussing nephritic syndrome. Which information should … included? If nephrotic syndrome is not caused initially by kidney disease, it is termed ____ nephrotic syndrome?
A 4-year-old male is … with nephrotic syndrome. Which of the following assessment findings accompanies this condition?
A 7-year-old female is … with nephrotic syndrome. Which of the following should the nurse ask the parents if they or the child has noticed recently?
Nephrotic syndrome occurs when there is loss of _____ in the urine.
Secondary forms of nephrotic syndrome are … with all of the following conditions except:
Which of the following diseases is a glomerular disorder?
Which assessment finding is common in children …. with nephrotic syndrome?
A child is getting a diagnostic work-up for nephrotic syndrome. Which of the following lab results would the nurse expect to see?