PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE SOLUTIONS 2022 UPDATE, Exams of Nursing

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D. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35mmHg and mild CHF. Citing scholarly resources, answer the following questions:

1. What is pulmonary hypertension and how could D. D. have developed PH? In healthy lungs, there is a low arterial resistance and venous resistance, so that contributes to the fact that the left side of the heart is much stronger. Pulmonary Hypertension is caused by an increase in blood pressure in the pulmonary arteries to the lungs. The heart is working much harder than it should to get the blood to the lungs. D.D. most likely developed this issue because of her consistent smoking habit.
2. How does her history fit in with her new diagnosis? Her history of smoking has lent a heavy hand in all of her prior illnesses. For example, the chemicals inhaled by smoking has damaged the membranous layer of her layer, which is how fluid is entering her lungs, causing pulmonary edema. All of these illnesses combined are making it harder for her heart and lungs to do their job properly which is why she now has pulmonary hypertension.
3. What are the three types of bronchodilators, and how do they function to alleviate the symptoms of COPD? What are other possible treatments for COPD? The three types are Beta-adrenergic agonists, anticholinergics, and methylxanthines. The Beta-agonists bind to receptors in the lung and block the trigger to the spasms, allowing the airways to remain open. They can be taken orally or via MDI. Anticholinergics block acetylcholine production, which in turn stop the spasms. These are inhaled. The last type, methylxanthines, are the last resort type of drug. They also alleviate airflow obstruction. Corticosteriods, antibiotics, and even opioids can also be used to treat COPD. Leader, D. (2018) Types of Bronchodilators Used to Treat COPD. VeryWellHealth. https://www.verywellhealth.com/bronchodilators-in-the- treatment-of-copd-

 Question 1

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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0.125 out of 0.125 points

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What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration? Selected Answer: Correct Answer: Response Feedback: a. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid a. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid This man has indicators of clinical dehydration and he needs salt to hold the water in his extracellular compartment. Replacing fluids and electrolytes is more important than meeting his nutritional needs now.

 Question 2

0.125 out of 0.125 points After evaluation, a child’s asthma is characterized as “extrinsic.” This means that the asthma is Selected Answer: (^) d. associated with specific allergic triggers. Correct Answer: (^) d. associated with specific allergic triggers. Response Feedback: Extrinsic asthma is also referred to as allergic asthma, which is triggered by antigens. The underlying pathogenesis of extrinsic asthma is an allergic in nature. Intrinsic asthma is associated with respiratory infections. Intrinsic asthma is associated with psychological factors.

 Question 3

0 out of 0.125 points A known cause of hypokalemia is Selected Answer: (^) c. pancreatitis. Correct Answer: (^) a. insulin overdose. Response Feedback: Insulin overdose causes hypokalemia by shifting potassium into cells. Oliguric renal failure decreases electrolyte excretion. Pancreatitis

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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causes fat malabsorpt ion, which binds calcium and magnesium , but not potassium, in the gastrointest inal tract. Hyperparat hyroidism

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regulates calcium, not potassium.

 Question 4

0.125 out of 0.125 points Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called Selected Answer: (^) c. tension pneumothorax. Correct Answer: (^) c. tension pneumothorax. Response Feedback: Air that enters the pleural space during inspiration but is unable to exit during expiration causes a tension pneumothorax. The question does not describe open pneumothorax, pleural effusion, or empyema.

 Question 5

0.125 out of 0.125 points What is likely to lead to hyponatremia? Selected Answer: (^) b. Frequent nasogastric tube irrigation with water Correct Answer: (^) b. Frequent nasogastric tube irrigation with water Response Feedback: Sodium is lost from gastric secretions when nasogastric tubes are irrigated with water. The sodium diffuses into the irrigating water and is then lost when the aspirate is withdrawn. Excessive ADH would lead to hyponatremia by retention of water in the body, thus diluting the sodium. Excess aldosterone would increase serum sodium. Normal saline is an isotonic solution and will not alter the serum sodium.

 Question 6

0.125 out of 0.125 points COPD leads to a barrel chest, because it causes

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Selected Answer: (^) a. air trapping.

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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Correct Answer: (^) a. air trapping. Response Feedback: Destruction of alveolar walls reduces lung elastic recoil, which allows airway collapse during exhalation. Air enters the alveoli during inhalation, but has difficulty escaping during exhalation. When air is trapped in the alveoli, residual volume increases, causing a barrel chest. Destruction of alveolar walls does not cause pulmonary edema, muscle atrophy, or prolonged inspiration.

 Question 7

0.125 out of 0.125 points The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment? Selected Answer: Correct Answer: Response Feedback: a. The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately. a. The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately. The airway inflammation, edema, and bronchoconstriction of acute asthma may occlude small airways completely, so that no air is moving, which requires emergency intervention. Alicia has a history of asthma rather than pneumonia. Asthma can occur without wheezing. This is an emergency situation that requires you to start oxygen and notify the physician.

 Question 8

0.125 out of 0.125 points A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for Selected Answer: (^) c. pneumothorax. Correct Answer: (^) c. pneumothorax. Response Feedback:

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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Pne um oth ora x lea ds to a trac hea l shif t to the sid e opp osit e the pne um oth ora x. Pne um oni a, pul mo nar y ede ma, and pul mo nar y em bol us do not lead to tracheal shift.

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 Question 9

0.125 out of 0.125 points Which change in a patient’s assessment has the greatest urgency? Selected Answer: Correct Answer: Response Feedback: c. Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing c. Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing Cardiac dysrhythmias from hyperkalemia need rapid attention to prevent potentially life-threatening consequences and are therefore the highest priority for reporting. Certainly you will want to report this symptomatic hypokalemia, but it is not your most urgent priority, because abdominal distention is not rapidly life threatening and you have another patient with cardiac dysrhythmias, which can be life threatening. Certainly you will want to report this hypocalcemia, but it is not your most urgent priority, because there are no signs and symptoms of hypocalcemia and you have another patient with cardiac dysrhythmias, which can be life threatening. Certainly you will want to report this symptomatic hypercalcemia, but it is not your most urgent priority, because constipation is not rapidly life threatening and you have another patient with cardiac dysrhythmias, which can be life threatening.

 Question 10

0.125 out of 0.125 points When a parent of a toddler recently diagnosed with pneumococcal pneumonia asks why their child is so much sicker than a classmate was when they were diagnosed with pneumonia, the nurse replies Selected Answer: Correct Answer: Response Feedback: d. “It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia.” d. “It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia.” Viral pneumonia does not produce exudate so the cough is non- productive. In general, symptoms of viral pneumonia are less severe than those of bacterial pneumonia. The uncle’s case of viral

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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pneumon ia has less acute symptom s than the children’ s case of bacterial pneumon ia. Pneumoc occal pneumon ia is not necessari ly

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more severe in children. The children most likely have bacterial pneumonia, which is why their symptoms are more acute than the classmate’s case of viral pneumonia.

 Question 11

0.125 out of 0.125 points A major cause of treatment failure in tuberculosis is Selected Answer: (^) c. noncompliance. Correct Answer: (^) c. noncompliance. Response Feedback: The major cause of treatment failure in tuberculosis is non- adherence to drug therapy. The major cause of treatment failure in tuberculosis is not a resistant organism, drug allergy, or immunosuppression.

 Question 12

0.125 out of 0.125 points The primary cause of infant respiratory distress syndrome is Selected Answer: (^) b. lack of surfactant. Correct Answer: (^) b. lack of surfactant. Response Feedback: The primary cause of this disorder is lack of surfactant. While premature infants may demonstrate this disorder, the actual cause is lack of surfactant. It is a syndrome seen in premature infants. Maternal illegal drug use during pregnancy and umbilical cord compression are not the primary causes of infant respiratory distress syndrome.

 Question 13

0.125 out of 0.125 points Manifestations from sodium imbalances occur primarily as a result of

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Selected Answer: (^) a. cellular fluid shifts.

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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Correct Answer: (^) a. cellular fluid shifts. Response Feedback: Sodium imbalances alter osmolality of fluid compartment leading to osmosis of water from the hypo-osmolar compartment to the hyperosmolar compartment. In brain cells, this leads to swelling or shrinkage of cells, and associated manifestations.

 Question 14

0.125 out of 0.125 points Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of Selected Answer: (^) b. acute respiratory distress syndrome. Correct Answer: (^) b. acute respiratory distress syndrome. Response Feedback: Acute respiratory distress syndrome is characterized by widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates. These findings are not characteristics of chronic obstructive pulmonary disease, asthma, or cor pulmonale.

 Question 15

0.125 out of 0.125 points Respiratory alkalosis is caused by Selected Answer: (^) d. hyperventilation. Correct Answer: (^) d. hyperventilation. Response Feedback: Hyperventilation causes respiratory alkalosis as a result of loss of carbonic acid. Pneumonia, chest muscle weakness, and pulmonary edema cause carbonic acid to accumulate in the blood and result in respiratory acidosis.

 Question 16

0 out of 0.125 points

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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causes

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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Selected Answer: (^) b. ECV deficit and hyperkalemia. Correct^ Answer:^ a. ECV excess and hypokalemia. Response Feedback: Hyperaldosteronism causes excessive renal retention of sodium and water and excessive potassium excretion, which lead to ECV excess and hypokalemia. Hyperaldosteronism does not cause ECV deficit, hyperkalemia, hyponatremia, or excessive water reabsorption without affecting sodium concentration.

 Question 17

0.125 out of 0.125 points Metabolic alkalosis is often accompanied by Selected Answer: (^) b. hypokalemia. Correct Answer: (^) b. hypokalemia. Response Feedback: Hypokalemia often accompanies metabolic alkalosis because it can cause metabolic alkalosis or be caused by it. Metabolic alkalosis and hypernatremia, hyponatremia, and hyperkalemia are not often associated with each other.

 Question 18

0.125 out of 0.125 points A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of Selected Answer: (^) b. bacterial pneumonia. Correct Answer: (^) b. bacterial pneumonia. Response Feedback: Bacterial pneumonia produces a productive cough and parenchymal infiltrates (white shadows) on x-ray. Viral pneumonia does not produce a productive cough. Tuberculosis may produce a productive cough but does not show parenchymal infiltrates (white shadows) on x-ray. Acute respiratory distress syndrome produces a non-productive

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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cough.

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 Question 19

0.125 out of 0.125 points Which acid are the kidneys unable to excrete? Selected Answer: (^) c. Carbonic Correct Answer: (^) c. Carbonic Response Feedback: The kidneys can excrete any acid except carbonic acid. The kidneys are able to excrete metabolic acids and ammonia. The kidneys are able to excrete bicarbonate, but bicarbonate is a base, not an acid.

 Question 20

0.125 out of 0.125 points The organism that causes pulmonary tuberculosis is Selected Answer: (^) c. Mycobacterium tuberculosis. Correct Answer: (^) c. Mycobacterium tuberculosis. Response Feedback: Mycobacterium tuberculosis causes pulmonary tuberculosis. Haemophilus tuberculosis , Tuberculosis tuberculoci , and Mycococcidio tuberculosis do not cause pulmonary tuberculosis.

 Question 21

0.125 out of 0.125 points Asthma is categorized as a(n) Selected Answer: (^) b. obstructive pulmonary disorder. Correct^ Answer:^ b. obstructive pulmonary disorder.

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Response Feedback: Asthma is an obstructive pulmonary disorder. Asthma is not a restrictive pulmonary disorder or a type of tracheobronchial obstruction. Although asthma can be associated with infection, it is not an infective pulmonary disorder.

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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 Question 22

0.125 out of 0.125 points Excessive antidiuretic hormone (ADH) secretion can cause concentration. Selected Answer: (^) c. decreased serum sodium Correct Answer: (^) c. decreased serum sodium Response Feedback: Excessive ADH stimulates excessive water reabsorption by the kidneys, which dilutes the blood, thus decreasing the serum sodium concentration. Excessive ADH secretion does not cause increased serum sodium or potassium concentrations, or decreased serum potassium concentration.

 Question 23

0.125 out of 0.125 points The system compensates for metabolic acidosis and alkalosis. Selected Answer: (^) c. respiratory Correct Answer: (^) c. respiratory Response Feedback: When metabolic acids are out of balance, the respiratory system compensates for the altered pH by adjusting the amount of carbon dioxide in the blood. The gastrointestinal system is not a major compensatory mechanism in acid-base imbalances. The kidneys are overwhelmed or dysfunctional in a metabolic acid-base imbalance. The cardiovascular system is not a major compensatory mechanism in acid-base imbalances.

 Question 24

0.125 out of 0.125 points A person who experiences a panic attack and develops hyperventilation symptoms may experience Selected Answer: (^) b. numbness and tingling in the extremities.

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Correct Answer: (^) b. numbness and tingling in the extremities.

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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Response Feedback:

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE

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Numbness and tingling in the extremities occurs in alkalosis as a result of increased neuromuscular irritability. Numbness and tingling as a result of hyperventilation result from increased neuromuscular irritability, not neuromuscular depression. Acidosis depresses neuromuscular irritability and thus would not cause numbness and tingling, even in compensation.

 Question 25

0.125 out of 0.125 points A restrictive respiratory disorder is characterized by Selected Answer: (^) c. decreased residual volume. Correct Answer: (^) c. decreased residual volume. Response Feedback: Restrictive respiratory disorders are characterized by decreased residual volume. Restrictive respiratory disorders are not characterized by increased residual volume. Inspiratory and expiratory wheezing are not characteristic of restrictive respiratory disorder.

 Question 26

0.125 out of 0.125 points Clinical manifestations of hyponatremia include Selected Answer: (^) b. confusion, lethargy, coma, and perhaps seizures. Correct^ Answer:^ b. confusion, lethargy, coma, and perhaps seizures. Response Feedback: Clinical manifestations of hyponatremia include confusion, lethargy, coma, and perhaps seizures, as they are manifestations of CNS dysfunction. Weak pulse, low blood pressure, and increased heart rate are characteristic of clinical dehydration. Hyponatremia does not cause thirst, dry mucous membranes, and diarrhea. Cardiac dysrhythmias, paresthesias, and muscle weakness are manifestations of electrolyte imbalances.

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 Question 27

0.125 out of 0.125 points Diarrhea and other lower intestinal fluid losses will contribute to Selected Answer: (^) b. metabolic acidosis. Correct Answer: (^) b. metabolic acidosis. Response Feedback: Diarrhea results in loss of bicarbonate and leads to metabolic acidosis. Loss of bicarbonate (a base) would not lead to metabolic alkalosis. Respiratory conditions lead to respiratory acid and base disturbances; diarrhea is not a respiratory condition. Bicarbonate loss through diarrhea would not lead to any respiratory acid/base disturbance.

 Question 28

0 out of 0.125 points Pneumocystitis is a term that refers to a Selected Answer: (^) c. non-infectious inflammation in the lung. Correct Answer: (^) d. fungal pneumonia secondary to HIV. Response Feedback: Pneumocystitis is a fungal pneumonia secondary to HIV. Pneumocystitis is not a viral pneumonia found in transplant recipients, a non-infectious inflammation of the lung, or a pneumonia secondary to bladder infection.

 Question 29

0.125 out of 0.125 points Viral pneumonia is characterized by Selected Answer: (^) a. a dry cough. Correct Answer: (^) a. a dry cough.

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Response Feedback: No exudative fluids are produced. Viral pneumonia does not produce exudates, so the cough is non-productive. Ventilation- perfusion imbalance does not usually occur in viral pneumonia.

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 Question 30

0.125 out of 0.125 points To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke Selected Answer: (^) d. impairs α 1 -antitrypsin, allowing elastase to predominate. Correct Answer: (^) d. impairs α 1 -antitrypsin, allowing elastase to predominate. Response Feedback: Cigarette smoking impairs α 1 -antitrypsin, allowing elastase to predominate and destroy lung tissue, causing emphysema. Although cigarette smoking does paralyze cilia, this action predisposes to respiratory infections rather than to emphysema. Although cigarette smoking does predispose to respiratory infections, that is not the mechanism that causes emphysema. Carcinogens introduced by cigarette smoking increase the risk of developing lung cancer, but they are not responsible for emphysema.

 Question 31

0.125 out of 0.125 points A patient has a positive Chvostek sign. The nurse interprets this as a sign of Selected Answer: (^) c. increased neuromuscular excitability. Correct Answer: (^) c. increased neuromuscular excitability. Response Feedback: Positive Chvostek sign indicates increased neuromuscular excitability, which can be caused by hypocalcemia, hypomagnesemia, or other factors. Hypercalcemia and

PATHO 370 TEST 4 EXAM QUESTIONS WITH COMPLETE