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NR507 – Advanced Pathophysiology Final Exam – Chamberlain University – 2024/2025 – Questi, Exams of Medicine

Yale UniversityMedicine

This document contains a complete set of final exam questions and 100% accurate answers for the NR507 Advanced Pathophysiology course at Chamberlain University. It comprehensively covers all major body systems including cardiovascular, respiratory, endocrine, neurological, renal, and hematological systems. Designed for graduate nursing students, this resource is perfect for final exam preparation and clinical application review.

Typology: Exams

2024/2025

Available from 06/11/2025

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NR507- ADVANCED PATHOPHYSIOLOGY FINAL
EXAM QUESTIONS WITH 100% ACCURATE
ANSWERS
Acute renal failure - Accurate answers Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are
functioning well
Acute Pyelonephritis - Accurate answers Diagnosing by clinical symptoms alone can be difficult;
can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones) - Accurate answers Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
Chronic Renal Failure - Accurate answers Chronic Kidney Disease (CKD) is a progressive loss of renal
function associated with systemic disease such as hypertension, diabetes mellitus (most significant risk
factor), systemic lupus erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis? - Accurate answers End-stage renal disease (ESRD) is the final stage
of CKD with the number one cause being diabetes mellitus combined with hypertension. At this point,
the patient is completely dependent on dialysis to survive.
CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication for
dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include
salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
Stage I CKD - Accurate answers There is kidney damage with normal or elevated GFR
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NR507- ADVANCED PATHOPHYSIOLOGY FINAL

EXAM QUESTIONS WITH 100% ACCURATE

ANSWERS

Acute renal failure - Accurate answers Reversible Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are functioning well Acute Pyelonephritis - Accurate answers Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis Diagnosis established by: -Urine culture -Urinalysis (WBC casts indicates pyelonephritis, but may not always be present) -Signs/Symptoms -Complicated pyelonephritis requires blood cultures and urinary tract imaging Renal Calculi (Renal Stones) - Accurate answers Goals of Treatment: Manage acute pain Promote passage of stone Reduce size of stone Prevent new stone formation Chronic Renal Failure - Accurate answers Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus erythematosus or intrinsic kidney disease CKD stage is determined by estimates of GFR and albuminuria Who is a candidate for dialysis? - Accurate answers End-stage renal disease (ESRD) is the final stage of CKD with the number one cause being diabetes mellitus combined with hypertension. At this point, the patient is completely dependent on dialysis to survive. CKD is classified into five stages and is based on the patient's GFR rather than symptoms. Patients will need dialysis when the following symptoms are present: --Metabolic acidosis. --Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis. --Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol). --Fluid volume overload that is not responsive to diuretics. --Uremic symptoms due to nitrogenous wastes in the blood stream. Stage I CKD - Accurate answers There is kidney damage with normal or elevated GFR

Stage II CKD - Accurate answers There is kidney damage with mild decrease in GFR 60- Stage III CKD - Accurate answers There is a moderate decrease in GFR 30- Stage IV CKD - Accurate answers There is a severe decrease in GFR 15- Stage V CKD - Accurate answers Kidney failure- End-stage renal disease <15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or kidney transplant Complications of Decreased GFR - Accurate answers Anemia Hypertension Decreased calcium absorption Hyperlipidemia Heart failure Left ventricular hypertrophy Fluid volume overload Hyperkalemia Hyperparathyroidism Hyperphosphatemia Metabolic acidosis Malnutrition (late complication) GERD - Accurate answers Warning signs include: Symptoms over age of 50: -Dysphagia (difficulty swallowing) -Odynophagia (pain on swallowing) -Nausea and vomiting -Weight loss -Melena -Early satiety (feeling full after eating very little food Hiatal Hernia - Accurate answers Often asymptomatic Generally, a wide variety of symptoms develop later in life and are associated with other GI disorders, primarily GERD --Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating small, frequent meals and avoiding the recumbent position after eating. Abdominal supports and tight clothing are avoided and weight control recommended for obese individuals. Duodenal Ulcer - Accurate answers Characteristic manifestation = chronic intermittent pain in epigastric area

More common in women and elderly Hormone replacement therapy with the hormone levothyroxine is the treatment of choice Thyroid-Stimulating Hormone (TSH) - Accurate answers TSH released by anterior pituitary Review hypothalamic-pituitary axis (Picture) Thyroid-releasing hormone (hypothalamus) Hyperthyroidism/ Grave's Disease - Accurate answers Two most distinguishing factors of Grave's disease = pretibial myxedema and exophthalmos Treatment directed at controlling excessive TH production, secretion or action and includes antithyroid drug therapy (methimazole or propylthiouracil), radioactive iodine therapy (absorbed only by thyroid tissue, causing death of cells), and surgery Goal of radioactive iodine ablation for the treatment of Grave's disease is to destroy overactive thyroid tissue Two categories of ophthalmopathy associated with Grave's Disease: - Accurate answers Functional Abnormalities: resulting from hyperactivity of the sympathetic division of the autonomic nervous system (lag of the globe on upward gaze or a lag of the upper lid on downward gaze) Infiltrative Changes: involving the orbital contents with enlargement of the ocular muscles. These changes affect more than half of individuals with Grave's Disease. Increased secretion of hyaluronic acid, adipogenesis, inflammation and edema of the orbital contents results in exophthalmos (protrusion of the eyeball), periorbital edema and extraocular muscle weakness leading to strabismus and diplopia (double vision) Hyperparathyroidism - Accurate answers Characterized by stimulation of parathyroid gland in response to hypocalcemia Hypercalcemia - Accurate answers Hypercalcemia & Hypophosphatemia may be asymptomatic or affected individuals may present with symptoms related to the neuromuscular changes that include paresthesias and muscle cramps Patients with hypercalcemia can have low bone density that is most noted in the distal one-third of the radius Hypoparathyroidism - Accurate answers Hypomagnesemia inhibits PTH secretion Hypomagnesemia may be related to chronic alcoholism, malnutrition, malabsorption, increased renal clearance of magnesium caused by the use of aminoglycoside antibiotics or certain chemotherapeutic agents, or prolonged magnesium-deficient parenteral nutritional therapy Hypocalcemia - Accurate answers Symptoms:

Dry skin Loss of body and scalp hair Hypoplasia of developing teeth Horizontal ridges on nails Cataracts Basal ganglia calcifications Bone deformities Bowing of the long bones Hypercortisolism - Accurate answers Glucose intolerance associated with hypercortisolism --Occurs because of cortisol-induced insulin resistance and increased gluconeogenesis and glycogen storage by the liver Cushing's syndrome characterized by patterns of fat deposition have been described as "truncal obesity", "moon face" and "buffalo hump" Adrenal Crisis- Hypocortisolism - Accurate answers Onset of adrenal crisis is signified by hypotension Hypotension can progress to complete vascular collapse and shock. This is known as adrenal crisis or addisonian crisis and develops with undiagnosed disease, acute withdrawal of glucocorticoid therapy or the occurrence of infection or other comorbid stressful events Primary Hypocortisolism- Adrenal Insufficiency - Accurate answers Lab work that indicates primary hypocortisolism: --Serum and urine levels of cortisol are depressed with primary hypocortisolism, and ACTH levels are increased When prescribing cortisol, the NP should keep in mind: --With acute stressors (infection, surgery, trauma), additional cortisol must be administered to approximate the amount of cortisol that might be expected to be secreted if normal adrenal function were present Type 1 Diabetes - Accurate answers Environmental factors: Viral infections, particularly enteroviruses, coxsackievirus, other infectious microorganisms Helicobacter pylori Exposure to cow's milk proteins Lack of Vitamin D Diagnostic Criteria for Diabetes - Accurate answers According to American Diabetes Association is: Hemoglobin A1C greater than or equal to 6.5% Actions of Insulin - Accurate answers Insulin promotes glucose uptake mostly in the liver, muscle and adipose tissue Autonomic Neuropathy-Complication of Diabetes - Accurate answers Autonomic Neuropathy includes: GI Symptoms:

Diagnosed when any two of the following occur: --Unilateral head pain --Throbbing pain --Pain worsens with activity --Moderate or severe pain intensity And at least one of the following: --Nausea and/or vomiting --Photophobia and phonophobia Migraine with aura with visual, sensory or motor symptoms Migraine without aura (most common) Chronic migraine Tension Headache (Tension Type Headache/TTH) - Accurate answers Most prevalent type of recurrent headache Not vascular or migrainous Average age of onset is during the second decade of life Usually mild to moderate bilateral headache with sensation of a tight band or pressure around head Bell's Palsy - Accurate answers Associated with Cranial Nerve VII paralysis and results in facial asymmetry and inability to close eye, smile or frown on the affected side Bacterial Meningitis - Accurate answers Associated with compression of Cranial nerve V and results in severe and sharp stabbing pain that can worsen with chewing Trigeminal neuralgia - Accurate answers Characterized by clinical manifestations of systemic infection including Characterized by clinical manifestations of systemic infection including --Fever --Tachycardia --Chills And clinical manifestations of meningeal irritation including --Severe throbbing headache --Severe photophobia --Nuchal rigidity --Positive Kernig and Brudzinski signs --Fever

--Tachycardia --Chills And clinical manifestations of meningeal irritation including --Severe throbbing headache --Severe photophobia --Nuchal rigidity --Positive Kernig and Brudzinski signs Cerebrovascular Accident - Accurate answers Review s/s depending on the artery infarcted Example: infarct in the ACA will result in motor: contralateral paralysis or paresis (greater in foot and thigh) Sensory deficits associated with basilar artery infarct include contralateral loss of vibratory sense, sense of position with dysmetria, loss of two-point discrimination, impaired rapid alternating movements Rosacea - Accurate answers Familial tendency, several genes identified Neurovascular dysregulation, infection and factors that trigger altered innate and adaptive immune response involved (ex: chronic sun exposure/damage, heat, drinking alcohol or hot beverages, hormonal fluctuations, Demodex folliculorum/mites colonization, mental stress and anxiety) Melanoma - Accurate answers Most aggressive skin cancer Thickness of lesion impacts prognosis Plaque Psoriasis - Accurate answers Typical lesion is well-demarcated, thick, silery, erythematous plaque surrounded by normal skin that can appear anywhere on the body