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INSTANT PDF DOWNLOAD – NU 518 Exam 3 tested questions and verified answers with rationales for Advanced Pathophysiology at University of South Alabama. Features actual exam questions, detailed answer explanations, practice materials, and proven study resources to strengthen preparation and boost exam performance. Ideal downloadable PDF for review, mastery, and nursing exam success. NU 518 exam 3, NU518 test bank PDF, advanced pathophysiology questions, NU518 exam answers, exam 3 rationales PDF, verified nursing exam questions, nurse practitioner patho exam, South Alabama NU518, advanced patho practice test, actual exam questions answers, nursing study guide PDF, downloadable test bank nursing, docsity exam solutions, studocu nursing notes, coursehero practice questions, NU518 review materials
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Ans: (B) Visceral pain occurs when hollow abdominal organs such as the intestine or biliary tree contract unusually forcefully or are distended or stretched. Solid organs such as the liver can also become painful when their capsules are stretched. Visceral pain may be difficult to localize. It is typically palpable near the midline at levels that vary according to the structure involved. Visceral pain varies in quality and may be gnawing, burning, cramping, or aching. When it becomes severe, it may be associated with sweating, pallor, nausea, vomiting, and restlessness.
Ans: (A) Referred pain is felt in more distant sites that share the same innervations as the source of pain. Referred pain often develops as the initial pain becomes more intense and thus seems to radiate or travel from the initial site. It may be felt superficially or deeply but is usually well localized.
c. Diverticulitis d. Chron disease
Ans: (B) Thin, pencil-like stool occurs in an obstructing "apple core" lesion of the sigmoid colon. The nurse considers colon cancer if the above are accompanied by the following: melena, hematochezia, diarrhea, constipation, feeling of incomplete bowel emptying, bloating, cramps weight loss and fatigue.
Ans: (C) Hematochezia is passing of blood-streaked stools, stools that are bright or dark red in color. This is caused by lower gastrointestinal bleeding. Hematemesis is vomiting of fresh blood or of occult blood of 'coffee- grounds' consistency. Steatorrhea is passing of fatty malodorous stools. Melena is presence of occult blood in the stool.
c. Increased ability of the liver to conjugate bilirubin d. Decreased excretion of bilirubin into the bile, resulting in absorption of conjugated bilirubin back into the blood
Ans: (D) Jaundice or the yellowing of the skin is caused by several factors: increased production of bilirubin, decreased uptake of bilirubin by the hepatocytes, decreased ability of the liver to conjugate bilirubin, decreased excretion of bilirubin into the bile, resulting in absorption of conjugated bilirubin back into the blood
Ans: (B) When excretion of bile into the intestine is completely obstructed, the stools become gray or light colored, or acholic, without bile.
asked to flex thigh at the hip and the knee bent and rotated internally d. (-) cutaneous hyperesthesia - localized pain as the nurse pinches the abdomen
Ans: (C) In appendicitis, pain in the right lower quadrant during left-sided pressure suggests appendicitis (a positive Rovsing sign). There is also - increased abdominal pain when the patient is asked to raise his thigh against the nurse's hand positioned above the knee (psoas sign). If the client is asked to flex thigh at the hip and bend the knee and rotate it internally, and pain is felt in the hypogastric are, the client is positive for obturator sign. The client should also be able to localize pain over the lower left quadrant if the nurse pinches skin in different areas of the abdomen (cutaneous hyperesthesia).
Ans: (D) The nurse hooks her left thumb or the fingers of her right hand under the costal margin at the point where the lateral border of the rectus muscle intersects with the costal margin. Or if the liver is enlarged, the nurse hooks thumb or fingers under the liver edge at a comparable point below then asks the patient to take a deep breath. A sharp increase in tenderness with a sudden stop in inspiratory effort constitutes a positive Murphy sign of acute cholecystitis.
Ans: (A) Colonoscopy is indicated for the following increased risk factors: single small adenoma <1 cm): 3 to 6 years after initial polypectomy, single large adenoma (>1 cm), multiple adenomas, adenoma with highgrade dysplasia or villous change: within 3 years of initial polypectomy, history of resection of colorectal cancer: within 1 year after resection, any first-degree relative younger than 60 years, two or more first degree, relatives with either colorectal cancer or adenomatous polyps: at age 40 or 10 years before youngest case in immediate family, whichever is earlier, familial adenomatous polyposis or nonpolyposis colon cancer, and history of inflammatory bowel disease, chronic ulcerative colitis, or Crohn disease.
Ans: (C) Peptic ulcer refers to a mucosal ulceration, usually in the duodenum or stomach. Dyspepsia causes similar symptoms but no ulceration. Infection by Helicobacter pylori is often present. The pain experienced by the client is described as gnawing, burning, boring, aching, pressing, or hunger-like, and may radiate to the back.
nurse notes "currant jelly" looking stools on the child's diaper. Diagnostic tests reveal telescoping of the bowel into itself. The nurse suspects which condition? a. Biliary colic b. Intussusception c. Protrusion of an hernia d. Fecal impaction
Ans: (B) Intussusception is the telescoping of the bowel into itself. The client reports colicky abdominal pain, abdominal distention, and often "currant jelly" looking stools (red blood and mucus).
Ans: (A) Fecal impaction is characterized by the presence of a large, firm and immovable fecal mass in rectum. It is characterized by rectal fullness, abdominal pain, and diarrhea around the impaction. It is common in debilitated, bedridden, and elderly patients. It would be pertinent to ask about last bowel movement in this case.
subjective finding as a. Melena b. Steatorrhea c. Acholic stools d. Hematochezia
Ans: (B) In pancreatic insufficiency, there is defective absorption of fat, including fat- soluble vitamins, with steatorrhea (excessive excretion of fat). The stools are typically bulky, soft, light yellow to gray, mushy, greasy or oily, and sometimes frothy; particularly foul smelling and usually floats in the toilet.
Ans: (A) Separation of the two rectus abdominis muscles, through which abdominal contents form a midline ridge when the patient raises head and shoulder, is called diastasis recti. It is often observed in repeated pregnancies, obesity, and chronic lung disease and it has no clinical significance.
B) Mallory-Weiss tear C) Esophageal varices
Ans: C Chapter: 11 Page and Header: 434, Techniques of Examination Feedback: Varices are often found in alcoholic patients, but only when they have a diagnosis of significant cirrhosis. This patient has symptoms of cirrhosis, including jaundice, ascites, spider hemangiomas, and dilated veins on his abdomen (caput medusa).
Ans: C Chapter: 11 Page and Header: 418, The Health History Feedback: Irritable bowel syndrome will cause loose bowel movements with cramps but no systemic symptoms of fever, weight loss, or malaise. This syndrome is more likely in young women with alternating symptoms of loose stools and constipation. Stress usually makes the symptoms worse, as do certain foods.
Ans: D Chapter: 11 Page and Header: 418, The Health History Feedback: Many metabolic conditions can interfere with bowel motility. In this case the patient has many symptoms of hypothyroidism, including cold intolerance, weight gain, fatigue, constipation, and irregular menstrual cycles. On examination, thyromegaly and delayed reflexes can help to make the diagnosis. Medication will usually correct these symptoms.
drug use. His mother died of colon cancer and his father had a stroke. On examination he appears his stated age and is in no acute distress. His temperature is 100. 9 degrees and his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His rectal examination is unremarkable and his fecal occult blood test is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending. What diagnosis for abdominal pain best describes his symptoms and signs? A) Acute diverticulitis B) Acute cholecystitis C) Acute appendicitis D) Mesenteric ischemia
Ans: A Chapter: 11 Page and Header: 418, The Health History Feedback: Diverticulitis is caused by localized infections within the colonic diverticula. Constipation, fever, and abdominal pain are common. Mesenteric ischemia classically presents in older people with a history of vascular disease elsewhere. The typical pain is unusual in that it is not made worse by examination despite being severe. Some mistake this feature to indicate malingering, with bad results.
A 77 - year-old retired bus driver comes to your clinic for a physical examination at his wife's request. He has recently been losing weight and has felt very fatigued. He has had no chest pain, shortness of breath, nausea, vomiting, or fever. His past medical history includes colon cancer, for which he had surgery, and arthritis. He has been married for over 40 years. He denies any tobacco or drug use and has not drunk alcohol in over 40 years. His parents both died of cancer in their 60 s. On examination his vital signs are normal. His head, cardiac, and pulmonary examinations are unremarkable. On abdominal examination you hear normal bowel sounds, but when you palpate his liver it is abnormal. His rectal examination is
positive for occult blood. What further abnormality of the liver was likely found on examination? A) Smooth, large, nontender liver B) Irregular, large liver C) Smooth, large, tender liver
Ans: B Chapter: 11 Page and Header: 469, Table 11- 12 Feedback: With his past history of colon cancer and with recent weight loss and fatigue, a relapse of his colon cancer would be expected. Colon cancer usually metastasizes to the liver, creating hard, irregular nodules, which can sometimes be palpated on examination. A smooth, large liver which is tender is often seen in hepatitis.
A 26 - year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal pain for 12 hours. He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to be just on the lower right side. He has had some nausea and vomiting but no constipation or diarrhea. His last bowel movement was last night and was normal. He has had no fever or chills. He denies any recent illnesses or injuries. His past medical history is unremarkable. He is engaged. He denies any tobacco or drug use and drinks four to six beers per week. His mother has breast cancer and his father has coronary artery disease. On examination he appears ill and is lying on his right side. His temperature is 100. 4 and his heart rate is 110. His bowel sounds are decreased and he has rebound and involuntary guarding, one third of the way between the anterior superior iliac spine and the umbilicus in the right lower quadrant. His rectal, inguinal, prostate, penile, and testicular examinations are normal. What is the most likely cause of his pain? A) Acute appendicitis B) Acute mechanical intestinal obstruction C) Acute cholecystitis D) Mesenteric ischemia
follows meal ingestion. Crampy abdominal pain, distension, and gas often accompany symptoms. Diarrhea is often provoked by pizza, milkshakes, yogurt, and other lactose-containing foods. This condition is more common in African-Americans, Latinos, Native Americans, and Asians.
A 27 - year-old policewoman comes to your clinic, complaining of severe left- sided back pain radiating down into her groin. It began in the middle of the night and woke her up suddenly. It hurts in her bladder to urinate but she has no burning on the outside. She has had no frequency or urgency with urination but she has seen blood in her urine. She has had nausea with the pain but no vomiting or fever. She denies any other recent illness or injuries. Her past medical history is unremarkable. She denies tobacco or drug use and drinks alcohol rarely. Her mother has high blood pressure and her father is healthy. On examination she looks her stated age and is in obvious pain. She is lying on her left side trying to remain very still. Her cardiac, pulmonary, and abdominal examinations are unremarkable. She has tenderness just inferior to the left costovertebral angle. Her urine pregnancy test is negative and her urine analysis shows red blood cells. What type of urinary tract pain is she most likely to have? A) Kidney pain (from pyelonephritis) B) Ureteral pain (from a kidney stone) C) Musculoskeletal pain D) Ischemic bowel pain
Ans: B Chapter: 11 Page and Header: 418, The Health History Feedback: The pain from a kidney stone causes dramatic, severe, colicky pain at the costovertebral angle that radiates across the flank and down into the groin.
Chris is a 20 - year-old college student who has had abdominal pain for 3 days. It started at his umbilicus and was associated with nausea and vomiting. He was unable to find a comfortable position. Yesterday, the pain became more severe and constant. Now, he hesitates to walk, because any motion makes the pain much worse. It is localized just medial and inferior to his iliac crest on the right. Which of the following is most likely?
A) Peptic ulcer B) Cholecystitis C) Pancreatitis D) Appendicitis
Ans: D Chapter: 11 Page and Header: 418, The Health History Feedback: This is a classic history for appendicitis. Notice that the pain has changed from visceral to parietal. It is well localized to the right lower quadrant, making appendicitis a strong consideration.
Ans: D Chapter: 11 Page and Header: 418, The Health History Feedback: Epigastric pain can have many causes. History and physical will help discern which causes are most likely, but it is important to realize that any of the above, including myocardial ischemia, is always a possibility. Pneumonia and gallbladder pain can also cause pain in this location.
Monique is a 33 - year-old administrative assistant who has had intermittent lower abdominal pain approximately one week a month for the past year. It is not related to her menses. She notes relief with defecation, and a change in form and frequency of her bowel movements with these episodes. Which of the following is most likely? A) Colon cancer B) Cholecystitis C) Inflammatory bowel disease D) Irritable bowel syndrome
