NURS 611 NCLEX 2024 PRACTICE EXAM 1 PATHO QUESTIONS AND CORRECT DETAILED ANSWERS, Exams of Nursing

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NURS 611 NCLEX 2024 PRACTICE EXAM 1 PATHO QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+ Calcium and phosphorus have what kind of relationship> and is influenced by which 3 things? - ANSWER- 1- reciprocal 2- PTH, calcitonin, and vit D causes of hypermagnesemia - ANSWER- 1- renal insufficiency or failure (most common) 2- excessive intake of mag antacids 3- adrenal insufficiency 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 causes of hypocalcemia? - ANSWER- 1- Hypoalbuminemia 2- massive blood administration 3- Decreases in PTH and Vit D levels 4- malnutrition 5-alkalosis 6-elevated calcitonin level 7-pancreatitis 8- inadequate GI absorption causes of hypomagnesemia - ANSWER- 1- malnutrition 2-alcoholism 3-malabsorption syndrome 4- urinary losses Causes of metabolic alkalosis - ANSWER- 1- vomiting 2-NG suctioning 3-Hypokalemia 4-diuretic therapy excess HCO3 intake causes of resp. alkalosis - ANSWER- 1- hyperventilation 2- stroke, septicemia, meningitis, encephalitis, brain injury 3- mechanical hyperventilation cellular metabolism- what molecule gives us energy? - ANSWER- ATP functions as the energy- transferring molecule Cystic fibrosis is caused by what type of gene? - ANSWER- autosomal recessive 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 Example of beneficial physiologic hypertrophy? - ANSWER- hypertrophy of myocardial cells from endurance training example of compensatory hyperplasia? - ANSWER- regeneration of the liver example of hormonal hyperplasia - ANSWER- enlargement of the uterus during pregnancy example of metaplasia - ANSWER- normal columnar ciliated epithelial cells of the bronchial lining being replaced by squamous cells. can be reversed if irritant stopped CO2 uncompensated- normal CO2 compensated- acidic HCO2- basic lab findings of resp alk. - ANSWER- ph- high co2-low hco3 uncompensated- normal hco3 compensated- low Main component of a cell - ANSWER- nucleus 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 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 Necrosis - ANSWER- Rapid loss of the plasma membrane structure, organelle swelling, mitochondria dysfunction normal CO2 range - ANSWER- 35-45 normal HCO3 range - ANSWER- 22-26 normal range of calcium - ANSWER- 8.5-10.5 normal range of magnesium - ANSWER- 1.5-3 normal range of pH level - ANSWER- 7.35-7.45 normal range of potassium? - ANSWER- 3.5-5 mEq/L Normal range of sodium - ANSWER- 135-145 mEq/L 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 Pathophysiology of metabolic alkalosis - ANSWER- loss of strong acid or gain of base compensated by increase CO2 retention by the lungs pathophysiology of resp. alkalosis - ANSWER- increased CO2 excretion from hyperventilation ROME - ANSWER- Resp. Opposite, Metabolic equal SEVERE signs of hypocalcemia - ANSWER- 1- convulsions/tetany 2- prolonged QT interval 3-cardiac arrest Signs and symptoms of hypercalcemia - ANSWER- 1- fatigue/ weakness/ lethargy 2- anorexia, nausea, constipation 3- impaired renal function and kidney stones 4- dysrhythmias, bradycardia, cardiac arrest 5- bone pain. osteoporosis, fractures 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 signs and symptoms of hyperphosphatemia - ANSWER- 1- low serum calcium levels 2- if prolonged-calcification of soft tissues Signs and symptoms of hypocalcemia - ANSWER- 1- increased neuromuscular excitability 2-tingling and muscle spasms 3- hyperactive bowel sounds 4-osteoporosis signs and symptoms of hypomagnesemia - ANSWER- 1- irritability 2- increased reflexes, muscle cramps 3- ataxis, nystagmus, tetany 4- convulsions 5- tachycardia, hypotension 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 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 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 are the signs and symptoms of hypokalemia? - ANSWER- 1- cardiac- flat t-waves, AV block, bradycardia 2- paralytic ileus (N&V) What can accumulate intracellularly caused by stresses form metabolic dearangements? - ANSWER- carbs, proteins, and lipids 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 causes hypercalcemia - ANSWER- 1- hyperparathyroidism 2- bone metastases 3- sarcoidosis 4- excess vit D 5- tumors that produce PTH 6- calcium containing antacids what causes hyperkalemia? - ANSWER- 1- renal failure 2- addison's disease (due to decrease production of aldosterone causes body to hold onto K+) what causes hypernatremia? - ANSWER- 1- inadequate free water intake (elderly) 2- inappropriate hypertonic solution (3% and 5% NS) 3- over secretion of aldosterone what causes hyponatremia? - ANSWER- 1- sodium deficits (diuretics, vomiting, diarrhea) 2- diseases (kidney, heart and liver failure) 3- hypotonic solutions (D5W) 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 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 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 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) What do most genetic diseases exhibit? - ANSWER- variable expressivity What doe RAAS stand for? - ANSWER- renin angiotension-aldosterone system What does epigenetics do? - ANSWER- bridges DNA info and function by modifying gene expression without any alteration in DNA sequence What does ionizing radiation result in? - ANSWER- the production of negatively charge free elections and positively charged ionized atoms What does low plasma albumin cause? - ANSWER- edema as a result of a reduction in plasma oncotic pressure What does potassium do? - ANSWER- major determinant of the resting membrane potential necessary for transmission of nerve impulses What does sodium do? - ANSWER- regulates fluids, and maintains neuromuscular irritability for conduction of nerve impulses 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 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 What does the nucleus contain? - ANSWER- nucleolus What is hyperplasia? - ANSWER- increase in the number of cells what is hypertrophy? - ANSWER- increase in cell size What is Imcomplete Penetrance? - ANSWER- individuals who have a disease-causing allele may not exhibit that expected phenotype at all, even though the allele and the associated disease may be transmitted to the next generation What is ionizing radiation (IR)? - ANSWER- any form of radiation capable of removing orbital electrons from atoms. What is ionizing radiation emitted from? - ANSWER- x-rays, y-rays, alpha and beta particles, subatomic particles such as neutrons, deuterons, protons, and pions WEAR A LEAD APRON What is metaplasia? - ANSWER- replacement of the cells What is mitochondria responsible for? - ANSWER- cellular respiration, cellular metabolism , and energy production What is oncotic pressure heavily influenced by? - ANSWER- plasma proteins 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 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 physiologic atrophy? - ANSWER- occurs in early development. ex: thymus glad during childhood What is renin? - ANSWER- an enzyme secreted by the juxtaglomerular cells of the kidney that promotes the production of the protein angiotensin. What is sarcopenia? - ANSWER- muscular atrophy: degenerative skeletal muscle loss how fast it happens depends on nature/nurture 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 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 compensatory response of resp acidosis? - ANSWER- increased HCO3 retention by kidneys what is the compensatory response of resp. alkalosis? - ANSWER- increased HCO3 excretion by kidney What is the definition of Expressivity? - ANSWER- the extent of variation in the phenotype associated with a particular genotype 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 penetrance? - ANSWER- The percentage of individuals with a specific genotype who also express the expected phenotype What is the definition of relative risk? - ANSWER- a common measure of the effect of a specific risk factor What is the Golgi apparatus (complex)? - ANSWER- a network of flatten, smooth membranes and vesicles frequently located near the nucleus of the cell 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 What is the main mechanism of damage to DNA by the ionizing radiation? - ANSWER- from generation of reactive oxygen species from reactions with free radicals by radiolysis of water IT HURTS THE DNA THE MOST What is the nucleolus composed of? - ANSWER- RNA, most of cellular DNA, DNA binding proteins, and histones what is the pathophysiology of resp. acidosis - ANSWER- increase CO2 retention from hypoventilation What is the risk of developing breast cancer if a woman has 1 affected 1st degree relative? - ANSWER- double the risk What is trisomy 21 or down syndrome known for? - ANSWER- IQ between 25-70 low nasal bridge protruding tongue flat, low set ears What is wrong with an unpair electron? - ANSWER- causes a chemical imbalance of the cell membrane, making the molecule unstable What makes a trisomic cell? - ANSWER- an aneuploid cell containing three copies of one chromosome (Trisomy 21, 18) what plays a major role in the initiation and progression of disease? - ANSWER- free radicals what receptors cause us to feel thirst? how are they activated? - ANSWER- 1- osmoreceptors