NUR 2063 ESSENTIALS OF PATHOPHYSIOLOGY EXAM 2 version 1 2024 (50 Questions with Answers).p, Exams of Nursing

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NUR 2063 ESSENTIALS OF PATHOPHYSIOLOGY

EXAM 2 version 1 2024

Questions with Answers)

1. Which is the correct term for the prolapse of a portion of the bladder into the vaginal canal? A. Urethrocele B. Cystocele C. Uterine prolapse D. Rectocele
2. A sexually active male reports unilateral pain the scrotum. Assessment finding include a red and swollen, tender area on the scrotum. Which diagnosis is supported by this data? A. Paraphimosis B. Epididymis C. Benign prostate hypertrophy D. Balanitis
3. Which clinical diagnosis is associated with hirsutism amenorrhea, and infertility? A. Pelvic inflammatory disease PID B. Primary amenorrhea C. Polycystic ovary syndrome PCOS D. Premenstrual syndrome PMS
4. Which of the following is a clinical manifestation of hypothyroidism? A. Insomnia B. Weight gain C. Tachycardia D. Diarrhea
5. Tachycardia and anxiety are often experienced by clients with the following endocrine disorder? A. Hypothyroidism B. Grave’s disease C. Myxedema D. Hashimoto’s thyroiditis
6. The client with diabetes insipidus will present with which of the following physical findings? A. Increased urine glucose level B. Increased urination C. Increased blood glucose level D. Increased sweat production
7. Which of the following are clinical manifestations of hypoparathyroidism?

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A. Hypertension and bradycardia B. Hypocalcemia and seizures C. Constipation and amenorrhea D. Renal calculi and osteoporosis

8. Which disorder is related to breaking down fats for energy in clients with type 1 diabetes? A. Hyperglycemic lipid syndrome B. Nonketotic hyperglycemic hyperosmolar syndrome NHHS C. Diabetic ketoacidosis DKA D. Lipidosis hyperosmolar ketosis
9. Which of the following would the nurse expect to find in an individual with hypopituitarism A. Syndrome of inappropriate antidiuretic hormone B. Dwarfism Acromegaly Hyperthyroidism
10. The client reports experiencing episodes of palpitations with a higher heart rate, restlessness, weight loss, amenorrhea, and an intolerance to heat. She also presents with eyes that appear to be bulging. The nurse suspects that the provider may test for which of the following conditions? A. Hyperparathyroidism B. Hyperthyroidism C. Hypoparathyroidism D. Hypothyroidism
11. Which of the following is caused by helicobacter pylori (H. Pylori)?

A. Colon cancer B. Hiatal hernia C. Peptic ulcer disease D. Esophageal varices

12. Which of the following explains why individuals may experience diarrhea when taking antibiotics? A. Destruction of the normal gut flora B. Reduced intestinal motility C. Decreased gastric secretions D. Activation of the parasympathetic nervous system
13. Which of the following describes the cause of infant presenting with cleft lip and palate? A. Injury during birth B. Eating solid foods too soon

C. D.

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C. Congenital birth defect D. Bacterial infection

14. The pituitary gland produces which of the following hormone that acts as a potent anabolic agent for the development of all tissues of the body? A. Thyroid stimulating hormone TSH B. Follicle-stimulating hormone FSH C. Luteinizing hormone LH D. Growth hormone GH
15. Which of the following is the most common cause of Cushing Syndrome?

A. Renal tumor B. Ingestion of glucocorticoids C. Thyroid gland removal D. Insulin resistance

16. Which of the following results from increased water retention caused by excessive ADH Levels A. Syndrome of inappropriate antidiuretic hormone (SIADH)? B. Diabetes Mellitus C. Cushing syndrome D. Diabetes Insipidus
17. The most common form of hypothyroidism can be attributed to which of the following? A. An autoimmune condition called Hashimoto thyroiditis B. An autoimmune condition called systemic lupus erythematosus C. A sexual assault in early life D. A car accident in early life
18. Which of the following is caused by chronic high levels of glucocorticoids, usually cortisol? A. Gestational diabetes B. Cushing syndrome C. Hyperparathyroidism D. Addison’s disease
19. Which is the primary cause of type 1 diabetes?

A. Increased resistance of body cells by an autoimmune reaction B. Destruction of pancreatic beta cells by an autoimmune reaction C. Chronic obesity D. Increased glucose production in the liver

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20. Which of the following hormones play a role in decreasing blood glucose by facilitating movement of glucose into the cell? A. Glucocorticoids

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1. Difference between a sign and a symptom - Sign - Objective

Symptom - Subjective

2. The two types of cells seen during a Type 1 hypersensitivity - Mast and Basophil cells 3. Mantoux test - PPD - TB test 4. What is the etiology of gout? - High uric acid levels 5. A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of - Primary prevention 6. A disorder of unknown cause → Idiopathic - True 7. Which of the following is a statement about disease pathogenesis? - Strep infection activates immune cells, leading to inflammation

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8. An obese teen is given a prescription for a low-calorie diet and exercise program. This is an example of

• Secondary prevention 9. When potassium intake is less than potassium output (or when potassium shifts from plasma into cells)
• hypokalemia 10. Intake of water and Na is less than output of water and Na
  • ECV deficit 11. Avoid massive vitamin D supplementation and drink lots of fluids to prevent kidney damage

Patient teaching for hypercalcemia

1. Besides immunity, what other function does the lymphatic system serve - fluid balance 2. Compounds released during stress - Catecholamines / cortisol 3. Which of the following statements about interferon is correct? - Interferon binds to surface receptors of cells invaded with a virus 4. Which of the following is associated with specific immunity? - immunoglobulins

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5. Injecting a vaccine of a dead or weakened pathogen imparts which type of immunity?

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Artificial active immunity

6. Normal potassium levels - 3.5-5.5mEq/L 7. What is the purpose of the stress response? - restore balance 8. Holds 1/3 of the body's water - extracellular fluid 9. 135-145 mEq/L - sodium serum range 10. Alarm stage of GAS - increased heart rate 11. Which space does fluid enter to cause edema? - interstitial compartment

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12. Treats hives, pruritis and swelling - histamine and prostaglandin 13. Macrophage is a type of white blood cell which is a phagocyte. True 14. Allergies are associated with elevated - eosinophils 15. What causes edema? - Increase in capillary hydrostatic pressure 16. Oncogene is associated with the initiation of cancer - True 17. Gout is caused by the following: - elevated uric acid 18. Glucocorticoids reduce inflammation by - decreasing the permeability in capillaries

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19. Wound edges that are approximated signify the wound is infected - False 20. Which of these exemplifies habituation? - loud noise no longer causes fight/flight response 21. Ecchymosis means large bruise 22. Purpura means - medium bruise 23. Tumors "new growth" not all are life threatening; benign or malignant- Describes - neoplasm 24. May be Primary Bone Cancer or Metastatic - Clinical manifestation of Chondrosarcoma 25. Shingles is a disorder of herpes zoster and has which of the following clinical manifestations?

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• Psoriasis

Eruption of vesicles along sensory neuron dermatomes

26. Distribution of fluid between interstitial and intracellular compartments occurs by

• osmosis 27. A patient describes nausea. What is this?
  • Symptom 28. A simple lab test which can measure the level of inflammation in an individual is
  • Erythrocyte sedimentation rate (ESR) 29. The process by where we use hormones in the body to regulate equilibrium, when the body changes

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• Homeostasis 30. Negative feedback
• uses hormone to reach homeostasis 31. Positive feedback
• increases hormones to create a reaction to occur 32. What the four different parts of homeostasis
• Etiology, Pathogenesis, Clinical manifestations, Treatment implications 33. What are the levels of prevent?
• Primary - Preventative measure

Secondary - Detection

Tertiary - Reducing effects

34. Mitochondria - Powerhouse of the cell

Produces ATP (Glucose+O2)

35. Osmosis

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• Movement of water across a semipermeable membrane 36. What are the fluid compartments?
• ICF and ECF 37. Sign
• Objective - Rash, erythema 38. Symptom
• Subjective - Fever, nausea 39. How is fluid between interstitial and intracellular compartments distributed?
• Osmosis 40. Main complication of sodium imbalance
• Hyper/Hyponatremia

Concern - Hypovolemia

Kidney failure

41. Main complication of calcium imbalance - Hypercalcemia/Hypocalcemia

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Kidney disease

42. How is fluid lost from the body? - Feces, urine, insensible loss 43. How do we lose fluid from extracellular compartment? - Vomiting, diarrhea, urinating, sweating, diuretics' 44. What is potential and fatal complication of hyponatremia - Can cause pressure in brain d/t fluid volume excess 45. Priority assessment for a patient with a potassium imbalance. - Cardiac - Bradycardia, abnormal EKG, Dysrhythmias, cardiac arrest 46. Symptoms of dehydration - Thirst, hypotension, tachycardia, weak-thready pulse, altered level of consciousness 47. Manifestations of fluid excess - peripheral edema, periorbital edema, anasarca, cerebral edema, dyspnea, bounding pulse, tachycardia, jugular vein distension, hypertension, polyuria, rapid weight gain, crackles, and bulging fontanelles 48. Cause of edema

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• Hydrostatic forces are greater than osmotic fluid - excess fluid in interstitial space 49. Extracellular fluid has higher concentration of which electrolytes/substances
• Sodium, Chloride 50. The energy currency of a cell and role the mitochondrion plays in this currency
• ATP - Aerobic metabolism 51. Three electrolytes that are stored in and impact bone and the relationship they have to each other
• Calcium, Magnesium, Phosphorus (↑Calcium = ↑Magnesium), (↑Calcium = ↓Phosphorus) 52. What happens during the alarm phase of Hans Selye's General Adaptation Syndrome?
• Epinephrine is release / Decreased ability to respond to stressors Reduced resistance to stressors 53. What clinical findings would the patient in the fight or flight stage present with?
• Increased vitals, pupils dilated 54. Signs of inflammation
• Pain, warmth, edema, erythema, loss of function

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55. Type 1 hypersensitivity mediator and its effect on the body - IgE - Hay fever, systemic anaphylaxis, asthma 56. What do histamines do? - Stimulate vasodilation to increase blood flow to dilute toxins 57. A lab test that can measure inflammation - CBC - Erythrocyte sedimentation rate (ESR) & C-reactive protein 58. What is metastasis? - to spread - (Cancer spreading) 59. Cachexia - Muscle wasting 60. What are the properties of cancer cells? - Rapid growing, metastasize quickly, fatal, highly undifferentiated 61. The effects of bone marrow suppression in cancer patients - Anemia - check & replace iron, blood transfusion, erythropoietin injection

Leukopenia - teach pt ways to prevent infection

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Thrombocytopenia - pt at risk for bleeding, unable to clot

62. What are example of benign cells - Edema polyps, moles, skin tag, cysts, fibroid tumor 63. Steps in carcinogenesis - Initiation - introduction of the agent

Promotion - initiation of uncontrolled growth

Progression - permanent malignant changes

64. What are T lymphocytes and B lymphocytes? - T cells recognize antigen, produced in bone marrow, mature in thymus, 2 types (regulator - helper & suppressor, & effector/killer), protect against viruses & cancer, responsible for hypersensitivity reactions & transplant rejections. B cells encounter antigen, produced & mature in bone marrow, differentiate into 2

types (memory & immunoglobulin-secreting [Ig]), antibodies produced 72hrs after initial antigen exposure, subsequent exposure to same antigen leads to quicker response

12. What are macrophages? - Fibrocystic WBC within tissues produced by monocytes; phagocytize (eat) & stimulate lymphocytes & other immune cells to respond to pathogens 13. Where are leukocytes and red blood cells formed - Bone marrow

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14. Best way to prevent the spread of infection - wash hands 15. What compounds does the body release during stress? - Cortisol / Catecholamines 16. Specific type of white blood cell found with type 1 hypersensitivity - Mast cell 17. Type 1 hypersensitivity - -B-Lymphocyte

-IgE

-Mast cells & Basophils

-Histamine, Serotonin, Leukotrienes, Prostaglandins

-Hay Fever, Asthma

18. Type 2 hypersensitivity - -B-Lymphocyte

-IgG, IgM

-RBC & WBC

-Complement

-Transfusion reactions, Hemolytic disease

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19. Type 3 hypersensitivity - -B-Lymphocyte

-IgG

-Host tissue cells

-Complement

-Serum sickness, Arthus phenomenon SLE, Rheumatoid arthritis

20. Type 4 hypersensitivity - -T-Lymphocyte

-None

-Host tissue cells

-Cytokines

-Contact dermatitis, Infection allergy

21. Apoptosis - Cell kill themselves

Cancer cells do not go through this

22. Carcinogenesis - Process in which cancer develops 23. Gangrene

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• Severe hypoxic injury 24. Benign cell
• slow, progressive, localized, well defined, resembles host, grows by expansion 25. Malignant
• Rapid growth, spreads quickly, Fatal 26. Cancer complications
• Anemia - Decrease in circulation of blood

Cachexia - Unexplained weight loss and weakness

Leukopenia - Decrease in circulating white blood cells Thrombocytopenia - Decrease

in circulating platelets

27. General adaptation syndrome - Alarm

Resistance

Exhaustion

28. Rheumatoid arthritis

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• Systemic autoimmune condition involving multiple joints. Inflammatory response in rheumatoid joint leads to accumulation of immune cells and infiltration of the synovium 112. Rheumatoid arthritis clinical manifestation
• Low grade fever, malaise, muscle spasms, AM muscle stiffness, bilateral joint pain, fatigue, anorexia, anemia, depression, unsteady gait 113. Conditions which result from excessive immune response
• RA, SLE, Guillain-Barre syndrome 114. What is atopic dermatitis
• Eczema, chronic inflammatory condition most common in infants, usually resolving in early adulthood 115. What is contact dermatitis
• Inflammation of the skin caused by contact with a substance 116. What is psoriatic arthritis
• Inflammatory arthritis associated with psoriasis 117. What causes gout
• Overproduction or underexcretion of uric acid. Factors: overweight/obesity, disease (HTN, DM, renal disease, sickle cell anemia) 118. Osteoporosis etiology

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• Estrogen deficiencies, poor calcium intake, disuse 119. The best prevention for Pressure ulcers/injuries is to perform what intervention
• Frequent turning Q 2hrs, get pt. OOB & into chair, keep vulnerable areas clean & dry, keep bed coverings off feet 120. Complications of compartment syndrome
• Tissue becomes necrotic d/t no oxygen getting to muscles & nerves because of too much pressure from inflammation 121. The 5 P's of compartment syndrome
• Pain

Pallor

Pulseless

Paresthesia

Paralysis

122. What is muscular dystrophy - genetically driven progressive muscle weakness & degeneration; muscle is replaced by fat and fibrous connective tissue 123. What is Fibromyalgia - Widespread muscular pains & fatigue

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124. 1st degree burn - Only the epidermis (red, painful, and edema) 125. 2nd degree burn - epidermis and part of dermis (blistered) 126. 3rd degree burn - Full thickness damage through skin into nerves and muscles 127. Simple fracture - Single break with bone ends keeping alignment 128. Transverse Fracture - Straight across the bone shaft 129. Oblique fracture - at an angle to the bone shaft 130. Spiral fracture - Twists around the bone shaft

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131. Comminuted fracture - Multiple fracture lines and bones pieces 132. Greenstick fracture - Incomplete break in the bone, only slight bend 133. Compression fracture - Bone is crushed or collapses / small pieces 134. Complete fracture - - broken into two or more sperate pieces 135. Incomplete fracture - Partially broken 136. Open fracture / Compound - Skin is broken and bone protrude 137. Closed fracture - Skin is intact 138. Impacted fracture

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• one end of the bone is forced into the adjacent bone 139. Pathologic fracture
• fracture caused by diseased or weakened bone 140. Stress fracture
• repeated excessive stress 141. Depressed fracture
• cranium is fractured inward toward the brain 142. Shingles
• viral disease that affects the peripheral nerves and causes blisters on the skin that follow the course of the affected nerves 143. Scabies
• contagious skin disease transmitted by the itch mite, commonly through sexual contact 144. Complications of fractures
• • Acute compartment syndrome
• Crush syndrome