Pathophysiology Final Exam Review: Multiple Choice Questions and Answers, Exams of Nursing

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1. What is the best way a nurse can assess if their client has altered brain function? a. Normal cranial nerve assessment b. Asking addition and subtraction questions c. Altered level of consciousness d. Vital signs 2. What hormones help to raise the blood sugar level to help maintain homeostasis? a. Insulin b. Thyroxine c. Renin d. Glucagon 3. What are signs of meningitis? Select all that apply. a. Nuchal rigidity b. Headache c. Photopia d. Weight gain 4. What are the immediate clinical manifestations noted after a spinal cord injury? Select all that apply. a. Loss of deep tendon reflexes b. Headache c. Irritability d. Flaccid paralysis 5. This is a cause of edema. a. Polyuria b. Dehydration c. Hypotension d. Decreased plasma proteins 6. What is the normal range for sodium? 135 - 145 mEq/L 7. What type of seizure will the client have a sudden loss of muscle tone, lasting for seconds, followed by postictal confusion? Atonic Seizure 8. Describe a cerebral aneurysm. Dilation (ballooning) of a portion of a blood vessel 9. What is amyotrophic lateral sclerosis? Involves progressive destruction of motor neurons resulting in muscle atrophy

10. What are the causes of hepatic encephalopathy? Alcoholism Please choose the tool you would use to assess your clients level of consciousness? Glascow coma scale If your client’s toes are pointed downward, and the head and neck are arched backward, we would chart that posture as? Decerebrate What happens in our body during the fight and flight response? Increased heart rate and dilated pupils What is an early symptom of amyotrophic lateral sclerosis (ALS)? Muscle twitching Migraines are periodic severe headaches that may be completely incapacitating? True What manifestations would you see with a client diagnosed with Parkinsons disease? Muscle rigidity, shuffling gait, muscular rigidity, masklike facial expressions What manifestations of Huntington’s chorea? Abrupt, bizarre, involuntary dance like movements, decline in mental functions Does insufficient circulating blood volume describe what is happening in the body that is experiencing hypovolemia? True Myasthenia gravis results in progressive muscle weakness?

What is a pneumothorax? A collapsed lung caused by the escape of air into the pleural cavity. What is the difference between Asthma and Chronic obstructive pulmonary disease (COPD) Airflow obstruction caused by asthma is reversible whereas airflow obstruction in COPD is irreversible. How does hemoglobin affect a client’s respiratory status? Decreased hemoglobin causes reduced oxygen carrying capacity. How doe hypoxia develop with pneumonia? Oxygen diffusion is impaired by the congestion. What causes contact dermatitis? Contact with a skin allergen. What causes a cold sore? Herpes simplex type 1. Describe a partial – thickness burn A burn area in which the epidermis and part of the dermis is destroyed. What would you expect to find if your client is diagnosed with pediculosis? The presence of nits at the base of hair shafts. Which burn extends into the deep tissues and has blackened skin? Third degree burn. What is gout? Overproduction of uric acid

What cause osteoporosis? Bone loss during aging. What causes Osteomalacia? Lack of vitamin D or calcium intake in adults. What is a complication of compartment syndrome? Pain and tissue damage What is ankylosing spondylitis? A type of arthritis that causes the spine to stiffen and possibly fuse. What can be one cause of a pulmonary embolism (PE)? A venous blood clot from the lower extremities Air trapping in the alveoli leads to the appearance of a barrel chest in clients with emphysema True What group of clients would be at the highest risk of pneumonia? Clients who are in the hospital and are immunocomprimised What are the risk factors for respiratory disorders? Asthma, smoking, bedrest Your client has a PH of 7.3 and a pCO2 of 55. What is the acid/base imbalance? Respiratory acidosis Emphysema and chronic bronchitis can lead to which disease? Emphysema and chronic bronchitis

Increased red blood cells are being produced. What is Disseminated intravascular Coagulation (DIC)? A life-threatening condition that can occur when tissue factor is exposed to blood What type of cancer is Leukemia? Leukocytes. Pernicious anemia is a deficiency of which vitamin? Vitamin B- 12 What is polycythemia vera caused by? An over production of erythrocytes. What are risk factors associated with non-Hodgkin’s lymphoma? Autoimmune disorders Exposure to environmental irritants History of solid organ transplant What is Hemophilia A caused by? Factor VIII deficiency Describe Hemostasis. Platelets within the bloodstream begin to aggregate to prevent further blood loss. How would you educate your client diagnosed with Epstein-Barr Virus and mononucleosis? Rest, Take antipyretics if having a fever, Stay hydrated What are symptoms of a sickle cell crisis?

Dyspnea, Bone pain What is Chronic Myeloid Leukemia? Malignant granulocytes that carry a unique chromosomal abnormality. What are clinical manifestations of bleeding? Petechiae, Bruising, Neurologic changes What are clinical manifestations of Hemophilia? Easy bruising, Spontaneous hematuria, Prolonged mucosal bleeding Why are clients with acute leukemia at risk for opportunistic infections? They have many nonfunctional immature leukocytes. What is a cause of mechanical bowel obstruction? Intussusception What can cause acute pancreatitis? A stone lodged in the pancreatic duct. What organ can be associated with esophageal varices? Liver What are signs of esophageal cancer? Hx of GERD, Dysphagia, Weight loss, Chest pain, Bloody emesis What type of stools would you anticipate your client having if they are diagnosed with a bleeding gastric ulcer? Black and Tarry

Upon inspection you see that your male client’s urethral meatus is located on the undersurface of the penis. What is this called? Hypospadias Simultaneous clotting and bleeding is called? Disseminated intravascular coagulation Why is erythropoietin excreted from the kidneys? To increase red blood cell production Hemophilia is an inherited disorder that results in an increased coagulation False Pernicious anemia is considered to be what type of anemia? Macrocytic anemia Hemophilia is an inherited disorder True What intrinsic factor is not being secreted in the gastric mucosa in pernicious anemia? Parietal What is our goal when treating anemia? Tissue oxygenation Increased energy and strength is an example of a clinical manifestion of leukemia False DIC is a severe complication of sepsis

True Which type of leukemia primarily affects children? Acute myeloid leukemia Lack of erythrocyte, leukocytes and platelets describe Pancytopenia Which disease would you see acute chest pain syndrome, coughing, dyspnea, and fever? Sickle cell You would see Reed Sternber cells in non-Hodgkin’s lymphoma False Anemia can be caused by? Hereditary causes, decrease in production of red blood cells, increased red blood cell desctruction Which client population has the greatest risk of liver cancer? Cirrhosis Which population has the greatest risk of developing hepatitis B? Multiple sexual partners Your client presents to the ED with a distended abdomen, yellow skin and sclera, and confusion Liver disease An end stage complication of cirrhosis who presents with bloody emesis Bleeding esophageal varices

True Which type of seizures have neuronal activity in both hemispheres of brain? Generalized Working in emergency room, 19 year old college patient complaining days of severe headache, stiff neck? Meningitis, wear facemasks and eye protection Hockey player comes in and had gotten knocked out on ice? Concussion. Make sure he rests, make sure fully recovered before returning to sports, changes in mnetal status, sleepiness, confusion, pupils, difficulty waking, nausea. Signs of increased cranial pressure. Trauma room, motor vehicle accident patient 18 yrs old. The patient is alert and oriented. Checking lower extremities, find loss of sensory-motor control below waist. Spinal cord injury, partial paralyzation. Paraplegia. Know differences between palegias. Clinical manifestations of parkinsons disease? Tremors (pill roll), shuffle gait, uncoordinated balance, mask like facial expressions, muscle rigidity Trigeminal neuralgia Face pain Guillain-Barre syndrome Ascending paralysis. Starts in the feet and works its way up. Then leaves slowly. Can be caused by Zika virus. Rapidly progressing disease of spinal nerves, total paralysis can last up tpo 22-74 hr period. Support respiratory status closely. The client has diagnosis of cluster headaches, manifestations of cluster headache? Severe unilateral pain and tearing, rhinorrhea

Motor vehicle accident, patient has been in hospital for 2 days. Patient has developed hypertension and bradycardia. Autonomic dysreflexia. Look out for any client with spinal cord injuries Early sign of inter cranial pressure? Headache Advanced dementia, early signs? Inability to problem solve Female, late 20s, complaining of muscle weakness, coordination, getting worse over few months Multiple sclerosis Client has liver disease and increased ammonia levels in bloodstream Hepatic, clients with alcoholism suffer a lot from this Inflammation of our menninges? Meningitis Parkinson’s disease, degenerative disorder, what part of brain? Basal ganglia and substantia nigra Best way to prevent spinal cord injury? Hold the C-spine. Support and keep neck in line as they are moving. What disorder has decreased level of dopamine in brain? Parkinsons Gold standard to diagnose strokes. CAT scan, can tell you what type of stroke Alzheimer’s disease clients, what changes in brain?

Diffusion Dehydration leads to.. Hypernatremia Manifestations of metabolic acidosis Diarrhea, diabetic keto acidosis, end stage kidney disease, hyperventilation What is sepsis? Blood infection, severe inflammatory response to a pathogen How can we prevent the transmission of an infectious agent? Hand washing Client comes in with hives, swollen, skin. Works in landscaping and is having a reaction to bee sting Histamines, prostaglandins Client comes in with wound, redness and swelling has gone past outline. What is causing the swelling? Increased tissue perfusion What is one way our body fights off infection – viral of bacterial? Fever What causes atherosclerotic plaques to form in our bodies? High cholerstrol, smoking, obesity, stress What are the risk factors for hypertension? Smoking, increase sodium, obesity, unhealthy diet, lack of exercise What role does renin play in increasing arterial blood pressure? Regulates our blood pressure by increasing BP by peripheral resistance by vasoconstriction

What are the types of cardiomyopathies? Dilated, constricted, hypertrophic, obstructive What is myocarditis? Inflammation of the heart tissue. Uncommon condition poorly understood. Infection that occurs several weeks after initial infection. Happens after infection and have to investigate to find the cause. What is infective endocarditis? Infection that affects the heart valves or myocardium. Caused by bacteria that enters the bloodstream What is coronary artery disease? Narrowing of coronary arteries that supply blood and oxygen to the heart. Plaque build up in the heart and hardens the vessels. Can be caused by plaque, trauma, genetics. What types of shock? Distributive, septic, analphabetic, cardiogenic, hypovolemic Peripheral edema is the backward effect of what type of heart failure? Right sided heart failure What is the difference between stable and unstable pectoris angina? Stable- if person is walking around and then they rest, the pain goes away. Unstable pain would not go away. Stable angina has a regular pattern. Rest and medicines usually help. Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. What is a normal blood pressure? 120/ What is an aortic aneurysm? Weakening in the artery, can form bulge. Overtime, wall becomes thinner and thinner and can rupture.

What are manifestations of Addison’s disease? Fatigue, ACTH levels low, cortisol low What happens inside the body of client experiencing anaphylaxis? Airways are narrowing, constriction, peripheral blood vessels dilating, increased capillary permeability Rheumatoid arthritis - immune or autoimmune? Autoimmune response What is happening if you have an autoimmune disease? Body is attacking itself. Immune system is fighting off normal and abnormal cells. What is the job of the lymphocytes? Contribute to our immune response. White blood cell count, play role in cell mediated immunity and the production of immunoglobulins How do we get active immunity? By getting exposed to disease or vaccination Doctor told you you have a benign tumor, what does that mean? Non-cancerous tumor. It doesn’t change and is encapsulated Early symptom of cancer: Fatigue, low WBC What does anaplasia mean? Lack of differentiation. Doesn’t look like it’s normal self. Lack of differentiated features. Normal cells are becoming malignant.

How do we grade a tumor? TMN, tumor, node, metastasis If client has aspiration pneumonia, cause? Saliva or food, liquids or vomits that gets into lungs. What would be a trigger for exercise induced asthma? Exercise. Usually 30 min after exercise Client has spot on top of nose and has squamous cell carcinoma? Doctor will tell patient to wear sunscreen and wear a hat Changes happen to our skin as we age, is that increase to subcutaneous fat? Thinning of epidermis, decrease elasticity, decreased vascularity in aging What is scleroderma? Skin thickens and becomes hard. Massive clumps of collagen. Can advance to organs What is the most common culprit of bacterial skin infections? Staph

What is Gastritis/Acute Gastritis?

Inflammation of the stomach lining.

Causes include ingestion of alcohol, aspirin, NSAIDs; can also be caused by a virus, bacteria, an

autoimmune disorder

Treatment: Remove the offending agent!

Chronic Gastritis

*H.Pylori is almost always a factor