Rasmussen College NUR 2063 Pathophysiology exams final, Exams of Nursing

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Patho Final exam

1. What is a characteristic of coronary artery disease (CAD) o The build-up of infectious by-products in the lymph nodes o Insufficient delivery of oxygenated bold to the myocardium o Insufficient delivery of carbon dioxide to the lungs o The build-up of bile in the stomach and gall bladder 2. (a) Which of the following are normal arterial blood gas values? o PH 7.25, PaCO2 52mm Hg, PA02 75 mm Hg, HCO3 18 mEq/L o PH 7.50, PaCo2 30 mm Hg, Pa02 80 mm Hg, HCO3 28 mEq/L o PH 7.40, PaCO2 40 mm Hg, Pa02 90 mm Hg, HCO3 24 mEq/L o PH 7.15, PaCO2 30 mm Hg, Pa02 50 mm Hg, HCO3 24 mEq/L (b) Identify the normal arterial blood gas values o PH 7.26; PaCO2 55 mmHg; HCO3 18 MEq/L ; Pa02 75 mmHg o PH 7.37; PaCO2 42 mmHg; HCO3 24 mEq/L; PaO2 90 mmHg o pH 7.32; PaCO2 48 mmHg; HCO3 18 mEq/L; PaO2 82 mm Hg o pH 7.50; PaCO2 32 mmHg; HCO3 28 mEq/L; PaO2 80 mm Hg

3.. What happens to a client with polycythemia? o Deficient plasma in the blood o Increased lymphatic fluid being produced o Increased red blood cells being produced o Deficient number of red blood cells 4.. What condition can be caused by excessive amount of growth hormone (GH)released by the pituitary gland in childhood before epiphyseal plates of the long bones have. o Acromegaly o Gigantism o Syndrome of inappropriate antidiuretic hormone o Dwarfism 5. Which of the following describes the damage to the brain that results in cerebral palsy? o Reversible with cognitive therapy with the infant client o Transient and resolves in adulthood from physical therapy

o Manifested as an adult after normal childhood activities o Irreversible and occurs before, during or after birth or infancy

6. What is reperfusion injury? o Healing bone tissue after fracture o Skin wound tunneling and shear o Secondary injury after reestablishing blood flow o Injury after blood transfusion 7.. Intracellular fluid contains higher concentration of which of the following? o Magnesium o Sodium o Chloride o Bicarbonate

o Deficient number of red blood cells

8. Which of the following stores electrolytes and acts as an electrolyte pool? o Brain - Kidneys o Bone - Nails 9. Which of the following imbalances is found in clients with syndrome of inappropriate antidiuretic hormone (SIADH)? o Decreased insulin production o Decreased antidiuretic hormone (ADH) production o increased secretion of antidiuretic home (ADH) o Increased production of insulin 10.. What causes secondary brain injury after head trauma? o Brain injury resulting from the body’s response to tissue damage o Brain injury resulting from initial trauma o Injury as a result of medical therapy o Focal areas of bleeding

11. Which of the following steps happens first during hemostasis? o Vascular spasm o Platelet plug o Coagulation o Dissolving of the clot 12. What is the treatment for clients with hemophilia A? o Chemotherapy o Factor VIII replacement o Heparin administration o Bone marrow transplant 13.. Which of the following organs are primarily affected by poorly managed hypertension? o The bladder and urethra o The brain and skin o The heart and kidneys o The stomach and intestines

14.(a) What is the distinguishing feature of Hodgkin disease noted on histologic exam? Need to know o Reed-Sternberg cells o Red-stained cells o Human Papillomavirus o B-cells and T-cells (b) A client has Reed-Sternberg cells noted on a lab histologic study. What condition presents in this manner? o Chronic myeloid leukemia o Infectious mononucleosis o Non-Hodgkin’s lymphoma o Hodgkin’s lymphoma

15. Which of the following described what is occurring in the body of clients experiencing hypovolemia?

o Increased urine retention o Insufficient circulating blood volume o Bounding peripheral pulses o Crackles auscultated in the lungs

16. What is the common denominator of all forms of heart failure? o pulmonary edema o Jugular venous distention o Peripheral edema o Reduced cardiac output 17.. What is the most sensitive indicator of altered brain function? o The ability to perform complex mathematics o Altered level of consciousness o The lack of cerebrospinal fluid production o Intact cranial nerve functions

18. Which of the following is NOT an example of clinical manifestations of leukemia and lymphoma? o Fatigue o Increased risk bleeding o Increased risk of infections o Increased energy and strength 19. Right sided heart failure is characterized by: o Immunosuppression o Pulmonary edema o Peripheral edema o Coughing 20. A tension pneumothorax requires a needle thoracotomy and/or chest tube placement as treatment to which component of the pathophysiology of the condition? o An accumulation of blood in the pleural space, which makes it difficult for the lungs to exchange gases. o Extreme pain caused by a fractured rib

o A large accumulation of trapped air in the pleural space affecting both the lungs and heart, o Sudden failure of the respiratory system due to fluid accumulation in the alveoli

21. what typically causes contact dermatitis o Fungal infection o Long term disorder from gout o Contact with a skin allergen o Staphylococcal infection 22. Which of the following are clinical manifestation of left sided heart failure? ( Select all that apply) o Shortness of breath o Crackles auscultated in the lungs o Jugular venous distention o Peripheral edema o Cough with frothy sputum

23. Which of the following are risk factors for hypertension (HTN)? o High sugar, low-fat diet o Increased physical activity o Tobacco use o Low fat diet 24. what causes atherosclerotic plaques to form in the body o Poor dietary modification o Administration of statin medication o Interruption of blood flow to the brain o Injury to the endothelium of the coronary arteries 25. Which of the following is a characteristic of disseminated intravascular coagulation? (DIC)? o Simultaneous stroke and heart attack o Simultaneous clotting and bleeding o Simultaneous clotting and insulin release

o Simultaneous bleeding and vomiting

26.. What of the following best describes sepsis? o An overwhelming allergic reaction o Severe inflammatory response to a pathogen ‘s endotoxins o Unknown causes resulting in hypertension o Poor nursing and health care provider interventions 27. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find? o Alkalosis and hyperventilation o Hypoxemia and hypercapnia o Alkalosis and high potassium o Elevated sodium and acidosis 28.. What is the process of moving air into the lungs with subsequent distribution to the alveoli called? o Ventilation

o Aeration o Enclosure vapor o Residual volume

29. Which of the following can lead to impaired neurological function in clients with increased intracranial pressure? (Select all that apply) o Decreased perfusion of the brain tissue o The ability of the tissue to autoregulate the pressure o Inflammation of the brain o Compression of the brain o Increased tissue oxygenation 30. Which of the following hormones helps to raise the blood sugar level to help maintain homeostasis? o Antidiuretic hormones (ADH) o Insulin o Glucagon

o Thyroxine

31. A client diagnosed with heart failure displays bilateral pitting edema of the lower extremities. Which of the following terms is used to describe this finding? o Contraindication o Sign o Symptom o Subjective data 32. Which of the following is a cause of edema? o Decreased plasma proteins o Hypotension o Dehydration o Polyuria 33. Which clients are at highest for pneumonia? o Those in their 20s and 0s and generally health o Those who exercise regular and not exposed to pathogens

o Those who are hospitalized and immunocompromised o Those who have adequate respiratory function

34. Which of the following is found in clients with Parkinson’s diseases? o Mobility and functioning o The liver and kidneys o Too much dopamine in the brain o Skeletal muscle flaccidity 35. What causes osteoporosis? o Poor nutrition in infancy o Regularly weight bearing exercise o Bone loss, frequently during aging o Cerebral palsy and associated disorders 36. (52) What is the best way to prevent transmission of infection agents? o Take antibiotics daily

o Call the practitioner for herbal supplements o Wash hands o Avoid public areas as much as possible

37. Helicobacter pylori (h. pylori) often causes which of the following? o Colon cancer o Hiatal hernia o Peptic ulcer disease o Esophageal varices 38. (a)Which of the following would the nurse see in a client with thrombocytopenia? o A decreased platelet cell count o Decreased white blood cell count o Increased red blood cell count o An increased platelet cell count

( b) Thrombocytopenia is which disorder below? o Increased blood coagulation o Increased platelet production o Increased number of infections o Decreased platelet production

39. Disturbance in which of the following would cause a client to experience a gout? o Serotonin receptors o Uric acid metabolism o Liver function o Cardiac function 40. which of the following can occur with clients who have hyponatremia? o The loss of more water than salt o A gain of more salt than water o Manifested by thirst

o Potentially fatal due to swelling in the brain

41. Which of the following describes passive immunity? o Vaccination against the disease o Transfer of antibodies from mother to baby o Cuts or wounds which are infected and heal o Having the disease in question 42. Which of the following properties are found in clients with metastatic cancer? o Tumors that are well encapsulated o Tumors with slow, stable growth o Cells that are genetically stable o Cells invading local tissue and overrunning neighboring cells 43. What tool is used to determine a client’s level of consciousness? o Magnetic resonance imaging (MRI) o Glasgow Coma Scale (GCS)

o Central perfusion pressure (CPP) o Intracranial pressure (ICP) monitoring

44. A client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays .. tenderness. What would the nurse anticipate the client to be experiencing? o Pseudomembranous colitis o Peptic ulcer diseases o Appendicitis o Esophageal cancer 45. What physiological reaction happens to the body with the “Fight or flight” response? o Increased heart rate o Constricted pupils o Decreased blood pressure o Decreased heart rate

46. When a client has their “fight or flight” system activated, which below is a manifestation of that? o Decreased blood pressure o Decreased heart rate o Decreased respiration rate o Increased glucose levels 47. Which of the following is a clinical manifestation of hyperthyroidism? o Tachycardia o Constipation o Weight gain o fatigue 48. What is the pathophysiology of type I diabetes o Overproduction of insulin from the beta cells of the pancreas o Destruction of the beta cells within the pancreas, resulting in an inability to produce insulin

o Loss of insulin receptors on the target cells, resulting in insulin resistance o A pituitary tumor in the brain, resulting in increased antidiuretic hormone production

49. What are the major mechanisms of the spinal cord injuries? o Hypoextension, expansion, hyperflexion o Hyperflexion, expansion, hypometabolism o Hypermetabolism, compression, hyperextension o Hyperextension, hyperflexion, compression 50. (a) Virchow’s triad includes which of the following factors (select all that apply.) o Increased blood coagulability o Damage to the arterial wall o Venous blood hypermobility o Damage to the venous wall o Venous blood statis

(b) What are the components of Virchow’s triad, which can lead the client to form blood clots? o Venous stasis, hypercoagulability o Vessel wall injury, hypocoagulability o Vessel wall injury, venous motility o Venous motility, hypercoagulability

51. Signs and symptoms of myocardial infarction include which of the following????? o Persistent chest pain which may radiate to the arm o Brief sternal chest pain on inspiration o Rapid respirations with left sided weakness and numbness o Left upper quadrant abdominal pain which radiates to the back and shoulder 52. what is the phase of acute kidney injury that results in a decrease in urine output?

o Oliguric phase o Diuresis phase o Prodromal/asymptomatic phase o Recovery phase

53. Which of the following clinical findings would be present in clients experiencing shock? (Select all that apply) o Hypertension o Increased mental clarity o Altered level of consciousness o Hypotension o Tachycardia 54 Which of the following conditions results from excessive immune response? o Rheumatoid arthritis o Chronic renal failure o Type II diabetes

o Onychomycosis 55 A client is bleeding. Platelets within the bloodstream begin aggregating to prevent further blood loss. This is one of the first steps of which of the following processes? o Hemokinetics o Homeokinetics o Hemostasis o Homeostasis 56 Which of the following is used to classify seizures? o Clinical symptoms and electrocardiogram (ECG) o Electroencephalogram (EEG) and electrocardiogram (ECG) o Clinical symptoms and completer blood count (CBC) o Clinical symptoms and electroencephalogram (EEF) 57 Hemophilia patients have severe pain in their: o joints o head

o abdomen o chest 58 The client with human papillomavirus is at risk for which? o Lung cancer o Pancreatic cancer o Stomach cancer o Cervical cancer 59 How does unstable angina pectoris differ from stable angina pectoris? o Unstable angina pectoris can only be diagnosed by changes in cardiac biomarkers o Unstable angina pectoris manifests in electrocardiogram (ECG) changes only o Unstable angina pectoris is not relived by periods of rest o Unstable angina pectoris is not as serious as stable angina 60 What is the goal for treating sepsis? o To identify the cause and treat

o Offer antibiotics if the client asks o Restore cognitive functioning o Restore kidney functioning 61 If a patient complains of dizziness, which term below best describes this felling? o Contraindication o Sign o Objective data o Symptom 62 Which of the following hormones do the kidney secrete to increase red blood cell production? o Erythropoietin o Insulin and glycogen o Testosterone o Thyroid stimulating hormone