Download NSG 533 Exam 1: Fluid and Electrolyte Balance Practice Questions and more Exams Pharmacology in PDF only on Docsity!
NSG 533 Exam 1 Practice Questions
with Answers | Latest
Version | Verified
If the capillary plasma hydrostatic pressure increases, what happens to the movement of fluid out of the capillary? a. increases b. decreases - ✔✔increases Why would an intravenous infusion of albumin help resolve the edema related to liver failure? a. It would increase the plasma oncotic pressure b. It would increase in tissue oncotic pressure c. It would increase the plasma hydrostatic pressure d. It would increase the tissue hydrostatic pressure - ✔✔It would increase the plasma oncotic pressure Which of the following is the best explanation for the development of non-pitting edema? a. an increase in capillary permeability b. an increase in plasma oncotic pressure c. sodium and water retention d. an increase in tissue hydrostatic pressure - ✔✔an increase in capillary permeability If the lymphatic channels are obstructed, which of the following pressures would increase initially? a. plasma oncotic pressure b. tissue oncotic pressure
c. plasma hydrostatic pressure d. none of the above - ✔✔tissue oncotic pressure A patient has a kidney disease, which results in a loss of protein in the urine. This disease is characterized by edema, which results from which of the following? a. increased plasma hydrostatic pressure b. increased tissue oncotic pressure c. decreased plasma oncotic pressure d. decreased tissue hydrostatic pressure - ✔✔decreased plasma oncotic pressure Your patient has an obstruction of the lymphatic duct, which returns lymph fluid from the legs. This will result in which of the following? a. localized, non-pitting edema b. generalized, non-pitting edema c. localized, pitting edema d. generalized, pitting edema - ✔✔localized, non-pitting edema Your grandmother wears garters (circular bands of elastic) below her knees to keep her stockings from falling down. At the end of the day, her lower legs and feet are swollen. This is due to: a. increased plasma hydrostatic pressure. b. increased plasma oncotic pressure. c. decreased plasma oncotic pressure. d. decreased plasma hydrostatic pressure. - ✔✔increased plasma hydrostatic pressure In which of the following types of fluid volume deficit does water volume remain normal? a. isotonic FVD
b. confusion c. headache d. all of the above - ✔✔all of the above What is the major intracellular (ICF) cation? a. potassium b. sodium c. calcium d. magnesium - ✔✔potassium What is the major intracellular (ICF) anion? a. bicarbonate b. chloride c. phosphate d. protein - ✔✔phosphate What is the major extracellular (ECF) cation? a. potassium b. sodium c. calcium d. magnesium - ✔✔sodium What is the major extracellular (ECF) anion? a. bicarbonate
b. chloride c. phosphate d. protein - ✔✔chloride Primary Adrenocorticotropic Hormone (ACTH) stimulation will result in which of the following? a. sodium reabsorption b. sodium excretion c. potassium reabsorption d. decreased aldosterone release - ✔✔sodium reabsorption A patient with hypernatremia would be expected to show which of the following? a. sodium 135 mEq/L b. moist mucous membranes c. thirst d. hypoactive deep tendon reflexes (DTRs) - ✔✔thirst When ECF sodium is decreased, the adrenal glands send aldosterone to the kidneys to: a. increase sodium reabsorption b. decrease sodium reabsorption c. increase water reabsorption d. decrease water reabsorption - ✔✔increase sodium reabsorption Which of the following is not associated with hypokalemia? a. muscle cramps
a. 145 b. 142 c. 139 d. 133 - ✔✔ 139 You need to calculate a quick serum osmolality for your patient. Na 131, K 4.2, BUN 18, glucose 88. The osmolality is: a. 241 mOsm/L; hypo-osmolar b. 273 mOsm/L; hypo-osmolar c. 298 mOsm/L; iso-osmolar d. 376 mOsm/L; hyperosmolar - ✔✔273 mOsm/L; hypo-osmolar In which type of fluid volume deficit is there an equal decrease in sodium concentration and water volume? a. isotonic FVD b. hypotonic FVD c. hypertonic FVD - ✔✔isotonic FVD In patients with extracellular volume excess and circulatory overload, which of the following is a potential outcome? a. postural hypotension b. weakness c. edema d. cell swelling - ✔✔edema Underlying medical conditions that impair normal fluid excretion and result in hypotonic fluid volume excess include which of the following?
a. malnutrition b. SIADH c. sodium retention d. excess intake of hypertonic fluids - ✔✔SIADH Which of the following statements is false? a. Calcium ionizes to a greater extent when pH is low b. Acidosis leads to hypercalcemia c. Metabolic compensation is slower than respiratory compensation d. Alkalosis leads to hyperkalemia - ✔✔Alkalosis leads to hyperkalemia The expected serum osmolality in hypernatremia would be which of the following? a. 300 mOsm/Kg b. 220 mOsm/Kg c. 180 mOsm/Kg d. 50 mOsm/Kg - ✔✔300 mOsm/Kg After three days of IV therapy with D5W, your patient became short of breath and had gained 5 lbs. in 3 days. Her pulse is full and bounding and her neck veins are distended. What is occurring? a. hypernatremia, increasing circulating blood volume b. hyperglycemia c. fluid volume excess, because of excessive hypotonic fluids d. fluid volume deficit, because of water intoxication. - ✔✔fluid volume excess, because of excessive hypotonic fluids
A 20-year-old patient with diabetes mellitus is admitted with lethargy, polydipsia, and polyuria. pH: 7. pCO2: 23 mmHg HCO3: 10 mEq./L Na: 130 mEq./L K: 4.5 mEq./L Cl: 94 mEq./L Glucose: 600 mg/dl - ✔✔Primary (simple) elevated anion gap metabolic acidosis A 72-year-old woman with a brain tumor (diagnosed 3 months ago) presents with an acute change in mental status that began about 1 hour ago. She is currently comatose and exhibits Kussmaul respirations. A CT scan of the head reveals an intracerebral hemorrhage with midline shift. pH: 7. pCO2: 20 mmHg HCO3: 18 mEq./L Na: 136 mEq./L Cl: 103 mEq./L - ✔✔Primary (simple) respiratory alkalosis A 20-year-old man is brought to the emergency department by his sister, who tells you that he swallowed a bottle of pills. pH: 7. pCO2: 15 mmHg HCO3: 8 mEq./L Na: 140 mEq./L K: 3.5 mEq./L Cl: 104 mEq./L - ✔✔Mixed respiratory alkalosis and elevated anion gap metabolic acidosis
A 78-year-old nursing home patient has been vomiting for several days and has rapidly developed a fever and increasing shortness of breath over the past several hours. Her respiratory rate is 35 and she has consolidative signs in the right lung base. pH: 7. pCO2: 20 mmHg HCO3: 28 mEq./L Na: 138 mEq./L Cl: 97 mEq./L - ✔✔Mixed respiratory and metabolic alkalosis A 45-year-old diabetic patient presents with obtundation. pH: 7. pCO2: 80 mmHg HCO3: 20 mEq./L Na: 140 mEq./L K: 5.5 mEq./L Cl: 98 mEq./L - ✔✔Mixed respiratory and elevated anion gap metabolic acidosis A 27-year-old diabetic patient presents with 1 hour of acute shortness of breath. He has been nauseated and has had increased urination over the past 2 days. Because of his nausea, he decided not to take his insulin and has been bedridden for 2 days. In the emergency department, you discover he has a family history of a hypercoagulable disorder. pH: 7. pCO2: 20 mmHg HCO3: 12 mEq./L Na: 136 mEq./L Cl: 102 mEq./L Glucose: 700 mg/dl
a. 6 b. 25 c. 88 d. 116 - ✔✔ 25 What level of prevention is a blood pressure screening program for high school students who are pregnant? a. primary prevention b. secondary prevention c. tertiary prevention - ✔✔secondary prevention Mr. Forbes complains of "indigestion" and becomes sweaty and pale. His wife takes him to the Emergency Department at Northwestern Memorial Hospital. A cardiac catheterization 2 days later shows partial blockage of his right coronary artery (RCA). Blockage of the right coronary artery can lead to myocardial cell injury because it results in which of the following? a. bilirubin accumulation in myocardial cells b. alteration in the genetic material of myocardial cells c. reduced energy production in myocardial cells d. activation of the complement system - ✔✔reduced energy production in myocardial cells When myocardial cells are injured, the function of the Na-K membrane pump may be impaired. Which of the following may then result? a. intracellular sodium will increase b. extracellular potassium will decrease c. cell volume will decrease d. all of the above - ✔✔intracellular sodium will increase
Mr. Forbes is being prepared for open heart surgery when he suffers a myocardial infarction in which a large part of his left ventricle has suffered lethal cell injury. Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, are significantly elevated. What is the best explanation for this? a. It is a sign that necrotic myocardial cells have released their cytoplasmic contents into the blood b. It is a sign of reversible fatty accumulation in the myocardial cells c. It is a sign that the myocardial cells are undergoing hypertrophy d. None of the above - ✔✔It is a sign that necrotic myocardial cells have released their cytoplasmic contents into the blood If a tissue specimen of myocardial cells were obtained for examination from Mr. Forbes, which of the following findings would indicate irreversible cell injury? a. cellular swelling b. decreased ATP production c. decreased intracellular calcium d. dissolution of nuclear material - ✔✔dissolution of nuclear material The accumulation of lactic acid that occurs with impaired energy production results from which of the following? a. increased intracellular glucose b. increased anaerobic metabolism c. decreased metabolic rate d. increased oxidative phosphorylation - ✔✔increased anaerobic metabolism A mountain climber is stranded at 23,000 feet in the Swiss Alps and has lost all his equipment and supplies in an avalanche. Subsequently, he suffers cell injury due to impaired ATP production. The reason for the decrease in ATP is which of the following?
There is a disease of the spleen, which results in an excessive destruction of RBCs. This increase in RBC destruction can lead to which of the following? a. hypoxia b. hypobilirubinemia c. an increase in platelets d. all of the above - ✔✔hypoxia Your body has developed an increased demand for thyroid hormones. This will lead to ____________ of the thyroid gland. a. atrophy b. hypertrophy c. dysplasia d. metaplasia - ✔✔hypertrophy You palpate a gangrenous leg and note the presence of crepitus. Crepitus is associated with which of the following? a. wet gangrene b. dry gangrene c. gas gangrene d. all of the above - ✔✔gas gangrene Direct cell membrane destruction may result from which of the following? a. complement activation b. bacterial enzymes c. free radicals
d. all of the above - ✔✔all of the above Which of the following is true regarding apoptosis? a. It occurrence may be physiological or pathological b. It does not stimulate the inflammatory process c. It results in phagocytosis of the apoptotic cell d. all of the above - ✔✔all of the above Insufficient blood flow to a part of the body is defined as: a. hypoxia b. hypoxemia c. necrosis d. ischemia - ✔✔ischemia A cellular change, which is often precancerous, is called: a. hyperplasia b. metaplasia c. dysplasia d. hypertrophy - ✔✔dysplasia Which of the following changes is indicative of irreversible cell injury? a. sodium influx into the cytoplasm b. glycolysis (anaerobic metabolism) c. detachment of ribosomes from rough endoplasmic reticulum
a. Apoptosis is a more rapid process b. Apoptosis is usually initiated by ischemia-induced cell injury c. Apoptosis is genetically controlled d. Apoptosis characteristically involves rupture of the cell membrane. - ✔✔Apoptosis is genetically controlled You are a nurse practitioner working in an outpatient clinic. Your patient's echocardiogram shows moderate aortic stenosis (narrowing of the aortic valve). You know that the stenotic valve creates an increased resistance against which the left ventricle contracts. The cellular adaptation most likely to occur in the left ventricle is which of the following? a. atrophy b. hypertrophy c. hyperplasia d. metaplasia - ✔✔hypertrophy Select the condition that is an example of physiologic hyperplasia. a. breast enlargement during puberty b. endometrial hyperplasia from excessive estrogen stimulation c. prostatic hyperplasia occurring as men age d. none of the above are physiologic - ✔✔breast enlargement during puberty Your patient has a long history of mitral stenosis (narrowing of the mitral valve). As the years go by, the left atrium, which contracts against the increased resistance of the stenotic valve, begins to fail--and output from the left ventricle begins to decline. If the left ventricle were to undergo adaptation, what would it most likely be? a. atrophy b. hypertrophy
c. hyperplasia d. metaplasia - ✔✔atrophy Which of the following is not characteristic of cellular dysplasia? a. variation in size and shape of cells b. small, pale nuclei c. disorderly arrangement of cells d. preneoplastic change - ✔✔small, pale nuclei If a normal individual began to take cortisol 100 mgs. every day as a medication, which of the following would result? a. hypertrophy of the adrenal gland b. hyperplasia of the adrenal gland c. atrophy of the adrenal gland d. hypertrophy and hyperplasia of the adrenal gland - ✔✔atrophy of the adrenal gland If a normal individual began to take thyroid hormone 100 mcgs. every day as a medication, which of the following would result? a. hypertrophy of the thyroid gland b. hyperplasia of the thyroid gland c. atrophy of the thyroid gland d. hypertrophy and hyperplasia of the thyroid gland - ✔✔atrophy of the thyroid gland Chronic alcoholism can result in the development of a fatty liver because it results in which of the following? a. increased production of free fatty acids
