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NURS 611 EXAM 1 PATHO ACTUAL EXAM AND TEST BANK, Exams of Pathophysiology

A comprehensive study guide or exam preparation material for a nursing pathophysiology course, specifically nurs 611 at maryville university. It covers a wide range of topics related to cellular biology, including apoptosis, necrosis, cellular organelles, cellular processes, and various types of cellular changes such as atrophy, hypertrophy, and hyperplasia. The document also delves into topics related to fluid and electrolyte balance, acid-base homeostasis, and the pathophysiology of conditions like hypernatremia, hyponatremia, hyperkalemia, and metabolic acidosis. The level of detail and the comprehensive nature of the content suggest that this document could be highly valuable for nursing students preparing for exams, seeking in-depth understanding of pathophysiology concepts, or needing a comprehensive reference for their studies.

Typology: Exams

2024/2025

Available from 09/17/2024

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Download NURS 611 EXAM 1 PATHO ACTUAL EXAM AND TEST BANK and more Exams Pathophysiology in PDF only on Docsity! NURS 611 EXAM 1 PATHO ACTUAL EXAM AND TEST BANK 2024-2025 COMPLETE COMPREHENSIVE QUESTIONS AND CORRECT ANSWERS WITH RATIONALES GRADED A+ (MARYVILLE UNIVERSITY) Apoptosis - ANSWER A programmed cell death that is regulated or programmed. Cellular self- destruction for elimination or unwanted cell populations Necrosis - ANSWER Rapid loss of the plasma membrane structure, organelle swelling, mitochondria dysfunction What is the #1 cause of cellular injury leading to necrosis (especially the kidney and heart) - ANSWER hypoxia What is the #1 cause of hypoxia? - ANSWER ischemia Main component of a cell - ANSWER nucleus What does the nucleus contain? - ANSWER nucleolus What is the nucleolus composed of? - ANSWER RNA, most of cellular DNA, DNA binding proteins, and histones Why are histone important? - ANSWER histones bind to DNA and fold it into chromosomes (chromatin) which is essential for cell division What are ribosomes? - ANSWER RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus and secreted into the cytoplasm through pores in the nuclear envelope called nuclear pore complexes (NPCs) Where can ribosomes be found? - ANSWER cytoplasm and rough ER what are ribosomes chief function? - ANSWER provides sits for cellular protein synthesis What is the Golgi apparatus (complex)? - ANSWER a network of flatten, smooth membranes and vesicles frequently located near the nucleus of the cell What does the Golgi apparatus do? - ANSWER takes proteins from the ER and processes/packages them into small membrane-bound vesicles called "secretory vesicles, and refines and directs traffic in the cell What are lysosomes and what do they do? - ANSWER maintain cellular health by removal of toxic cellular components, removal of useless organelles, termination of signal transduction, and signals cellular adaption How does aging affect lysosomes? - ANSWER leads to progressive loss of lysosomal efficiency which declines the regenerative capacity of orgANSWER and tissue What functions do lysosomal components integrate? - ANSWER nutrient abundance, energy levels, and cell stressors and will translate them into instructions that regulate cellular metabolism toward either proliferation or inactivity What is mitochondria responsible for? - ANSWER cellular respiration, cellular metabolism , and energy production What does the inner membrane of mitochondria contain? - ANSWER enzymes of the respiratory chain and are essential to the process of oxidative phosphorylation that generates most of the cell's ATP The mitochondrial matrix contains what kind of pathways (1), involve what two things (2), and metabolizes what three things (3)? - ANSWER 1- metabolic 2- urea and heme synthesis 3- carbs, proteins, and lipids What can accumulate intracellularly caused by stresses form metabolic dearangements? - ANSWER carbs, proteins, and lipids What is physiologic atrophy? - ANSWER occurs in early development. ex: thymus glad during childhood What is pathologic atrophy? - ANSWER occurs as a result of decreases in workload, use, pressure, blood supply, nutrition, and hormonal stimulation. Ex: Shrinking of gonads in an adolescent pt in response to decreased hormonal stimulation. and an pt immobilized in bed for a prolonged time what is hypertrophy? - ANSWER increase in cell size Example of beneficial physiologic hypertrophy? - ANSWER hypertrophy of myocardial cells from endurance training example of pathologic hypertrophy - ANSWER cardiomegaly in a hypertensive patient What is hyperplasia? - ANSWER increase in the number of cells example of compensatory hyperplasia? - ANSWER regeneration of the liver example of pathological hyperplasia - ANSWER endometrial tissue example of hormonal hyperplasia - ANSWER enlargement of the uterus during pregnancy What is metaplasia? - ANSWER replacement of the cells example of metaplasia - ANSWER normal columnar ciliated epithelial cells of the bronchial lining being replaced by squamous cells. can be reversed if irritant stopped cellular metabolism- what molecule gives us energy? - ANSWER ATP functions as the energy- transferring molecule During ischemia, what effect does the loss of ATP have on the cells? - ANSWER a reduction of ATP levels (ATP needs oxygen) that causes the Na+/K+ pump and Na+/Ca exchange to fail, leading to intracellular accumulation of Sodium and calcium and diffusion of K+ out of the cell . Sodium and water can enter cell freely causing cellular swelling What is a free radical? - ANSWER A molecule that is unstable and highly reactive because it contains unpaired electrons. To stabilize, it gives up or takes a electron making it capable of injurious chemical bond formations with proteins, lipids, or carbs 2- most recessive alleles are maintained in normal carriers; they are able to survive in the populations from one generation to the next What form of gene accounts for approximately 5% of breast cancer? - ANSWER autosomal dominant form Which genes are responsible for this form of breast cancer? - ANSWER BRACA1 (chromosome 17) and BRACA2 (chromosome 13) What is the chance of a lifetime risk of developing breast cancer for women who inherit the BRACA1 or BRACA2 gene? - ANSWER 50-80% What is the risk of developing breast cancer if a woman has 1 affected 1st degree relative? - ANSWER double the risk How common is a given disease in a population? - ANSWER well-established measures are used to answer this question What is the definition of incidence rate? - ANSWER number of new cases of a disease reported during a specific period (typically 1 year) divided by the number of individuals in the population What is the definition of relative risk? - ANSWER a common measure of the effect of a specific risk factor how is relative risk expressed? - ANSWER a ratio of the incidence rate of the disease among individuals exposed to a risk factor divided by the incidence of the disease among individuals not exposed to a risk factor Ex: the incidence of death from lung cancer was 1.66 (per 1000 person-years) in heavy smokers (>25 cigs/day), but it was only 0.07 in the non smokers. The ratio of these two incidence rates is 1.66/0.07, which yields a relative risk of 23.7 deaths. Thus, the risk of dying from lung cancer is increased by 24-fold in heavy smokers vs nonsmokers What are the major characteristics of type 1 DM? - ANSWER 1- T-cell infiltration of the pancreas 2-destruction of the insulin-producing beta cells 3-auto-antibodies are formed against pancreatic cells What does epigenetics do? - ANSWER bridges DNA info and function by modifying gene expression without any alteration in DNA sequence What can epigenetic modification cause individuals with the same DNA (twins) - ANSWER have different disease profiles Ex: the occurrence of asthma in only one pair of the identical twins What is demonstrated when twins age? what does this cause? - ANSWER 1- they demonstrate increasing differences in methylation patterns of their DNA sequences causing increased numbers in phenotype differences What environmental factors can affect epigenetic modification? - ANSWER diet and exposure to certain chemicals What is the main difference between DNA mutation and epigenetic modification? - ANSWER DNA sequence mutations cannot be altered but epigenetic modifications can be reversed Ex: 5-azacytidin When messenger RNA (mRNA) is over-expressed what does it result in and why? - ANSWER 1-results in metastasis of an already existing cancer 2- hypermethylation is in miRNA genes that bind to the ends of mRNAs, degrading them and preventing their translation, so when mRNA targets are over-expressed it increases metastasis ability to continue. What are the 8 signs and symptoms of dehydration - ANSWER 1-headache 2-thirst 3-dry skin 4-dry mucous membranes 5- elevated temp 6-weight loss (except with edema) 7- decreased/ concentrated urine 8- skin turgor normal or decreased (not great ex) look at tongue What are 4 signs and symptoms of HYPOvolemia - ANSWER 1- tachycardia 2-weak pulse 3- dizziness 4- postural hypotension what receptors cause us to feel thirst? how are they activated? - ANSWER 1- osmoreceptors 2- activated by increase in osmotic pressure of the plasma Name 3 populations vulnerable to fluid volume deficit - ANSWER 1- infants: 75-80% total body water 2- obese: fat is water repelling (BMI >30) 3-elderly: thirst sensation is diminished What is oncotic pressure heavily influenced by? - ANSWER plasma proteins What does low plasma albumin cause? - ANSWER edema as a result of a reduction in plasma oncotic pressure What is oncotic pressure? - ANSWER aka colloidal osmotic pressure- it is pressure exerted by proteins, notably albumin, in the blood vessels plasma that tends to pull water into the circulatory system explain how fluid moves from the intravascular space into the interstitial space. what is it influenced by>? - ANSWER through the arterial end of capillaries and the capillary hydrostatic pressure being higher than the capillary oncotic pressure. It is influenced by the cardiac system (think about the heart getting fluids/nutrients where they need to go) What are natriuretic peptides? - ANSWER hormones name 3 natriuretic peptides and what they produce by/ associated with - ANSWER 1- Artial natriuetric peptide (ANP) produced by the myocardia atria 2- brain natriuretic peptide (BNP) produced by the myocardia ventricles 3- Urodilation within the kidney what 2 things do natriuretic peptides affect? - ANSWER decrease BP and increase sodium and water excretion what are natriuretic peptides an antagonist of? - ANSWER the RAAS system (weak antagonist) What doe RAAS stand for? - ANSWER renin angiotension-aldosterone system What is renin? - ANSWER an enzyme secreted by the juxtaglomerular cells of the kidney that promotes the production of the protein angiotensin. Explain RAAS - ANSWER 1- circulating blood volume/pressure is reduced felt by the kidneys 2- renin is released in response to the sympathetic nerve stimulation and decreased perfusion of the renal vasculature. Angiotension I is converted into Angiotension II. 3- aldosterone is pumped out by the adrenal glANSWER (main hormone released to increase perfusion). aldosterone increased sodium and therefore an increase in storage of water and increases BP what causes the secretion of ADH and the feeling of thirst - ANSWER 1- increase in the plasma osmolality (works with sodium and is released by the posterior pituitary), conserves waters. Think hypovolemia after a stabbing (RASS and ADH work together) Normal range of sodium - ANSWER 135-145 mEq/L What does sodium do? - ANSWER regulates fluids, and maintains neuromuscular irritability for conduction of nerve impulses What are the clinical manifestations of severe hypernatremia (4 C's) - ANSWER confusion, convulsion, cerebral hemorrhage, and coma what causes hypernatremia? - ANSWER 1- inadequate free water intake (elderly) 2- inappropriate hypertonic solution (3% and 5% NS) 3- over secretion of aldosterone how is fluid balance restored with hypernatremia? - ANSWER water is drawn from the intracellular space to the extracellular space What happens to the brain with hypernatremia? - ANSWER blood vessels pull water out of brain cells causing the brain cells to shrink and have micro hemorrhages by stretching and contracting of veins Calcium and phosphorus have what kind of relationship> and is influenced by which 3 things? - ANSWER 1- reciprocal 2- PTH, calcitonin, and vit D what causes hypophosphatemia - ANSWER 1- GI malabsorption r/t Vit D deficiency 2- use of mag/aluminum antacids 3- long term alcohol abuse 4- respiratory alkalosis 5- increased renal excretion of phosphate associated with hyperparathyroidism Signs and symptoms of hypophosphatemia - ANSWER 1- reduced capacity for O2 to be transported by RBC and disturbed energy metabolism 2- leukocyte/platelet dysfunction 3- deranged nerve/muscle function what are 8 severe symptoms of hypophosphatemia - ANSWER 1-irritability 2-confusion 3-numbness 4-coma 5-convulsions 6-resp failure r/t muscle weakness 7- cardiomyopathy 8- bone resorption (rickets and osteomalacia) causes of hyperphosphatemia - ANSWER 1- acute or chronic renal failure 2-treatment of metastatic tumors with chemo that releases large amounts of phosphate 3- long term use of laxatives/enemas 4- hypoparathyroidism signs and symptoms of hyperphosphatemia - ANSWER 1- low serum calcium levels 2- if prolonged-calcification of soft tissues normal range of magnesium - ANSWER 1.5-3 causes of hypomagnesemia - ANSWER 1- malnutrition 2-alcoholism 3-malabsorption syndrome 4- urinary losses signs and symptoms of hypomagnesemia - ANSWER 1- irritability 2- increased reflexes, muscle cramps 3- ataxis, nystagmus, tetany 4- convulsions 5- tachycardia, hypotension causes of hypermagnesemia - ANSWER 1- renal insufficiency or failure (most common) 2- excessive intake of mag antacids 3- adrenal insufficiency signs and symptoms of hypermagnesemia - ANSWER 1- lethargy, drowsiness 2- loss of deep tendon reflexes, muscle weakness 3- N&V 4- resp. distress 5- heart block, cardiac arrest normal range of pH level - ANSWER 7.35-7.45 normal CO2 range - ANSWER 35-45 normal HCO3 range - ANSWER 22-26 what causes resp. acidosis - ANSWER 1- COPD 2- barbs/sedatives OD 3- chest wall abnormality 3-seere pneumonia 4-atelectasis 5-mechanical hypoventilation 6- pulmonary edema what is the pathophysiology of resp. acidosis - ANSWER increase CO2 retention from hypoventilation what is the compensatory response of resp acidosis? - ANSWER increased HCO3 retention by kidneys Lab finding of resp acidosis - ANSWER ph- low CO2- high HCO3- normal (uncompensated) HCO3- high (compensated) ROME - ANSWER Resp. Opposite, Metabolic equal causes of resp. alkalosis - ANSWER 1- hyperventilation 2- stroke, septicemia, meningitis, encephalitis, brain injury 3- mechanical hyperventilation pathophysiology of resp. alkalosis - ANSWER increased CO2 excretion from hyperventilation what is the compensatory response of resp. alkalosis? - ANSWER increased HCO3 excretion by kidney lab findings of resp alk. - ANSWER ph- high co2-low hco3 uncompensated- normal hco3 compensated- low what causes metabolic acidosis, two types - ANSWER type 1: increased non-carbonic acids (elevated anion gap) K-ketones (DKA) I- Ingestion (ingesting antifreeze) L- lactic acid U- uremia/uremic acid type 2: bicarb loss (normal anion gap) 1- diarrhea 2- ureterosigmoidostomy 3- renal failure 4- promimal renal tubule acidosis pathophysiology of metabolic acidosis - ANSWER -Gain of fixed acid ,inability to excrete acid, or loss of base. -Compensatory response of CO2 excretion by the lungs (kussmaul resp) increase RR lab finding of metabolic acidosis - ANSWER ph- acidic co2 uncompensated- normal co2 compensated- basic hco3- acidic Causes of metabolic alkalosis - ANSWER 1- vomiting 2-NG suctioning 3-Hypokalemia 4-diuretic therapy excess HCO3 intake Pathophysiology of metabolic alkalosis - ANSWER loss of strong acid or gain of base compensated by increase CO2 retention by the lungs