NCLEX PATHO QUESTIONS - EXAM 1 questions and answers, Exams of Pathophysiology

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NCLEX PATHO QUESTIONS - EXAM 1

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The plasma membrane in human cells is comprised of: A. A single layer of phospholipids and proteins B. A capsid made up of lipids and polysaccharides C. A phopholipid bilayer including cholesterol and proteins D. Cellulose - Correct Answers: C The primary function of the mitochondria is: A. Catalyze protein translation B. Package proteins for transport C. Manufacture of ATP D. Management of genetic material - Correct Answers: C Chronic hypertension requires that the heart pumps harder with each contraction. This means that the left ventricle experiences more stretch than usual. This can result in ________ of the cells of the ventricle: A. Metaplasia B. Dysplasia C. Atrophy D. Hypertrophy - Correct Answers: D Flipases and flopases are enzymes involved in the asymmetry of the cell membrane. Which of these is a function of membrane asymmetry? A. Marking the cell for apoptosis B. Allows for selective permeability of the membrane C. Manufacture of integral proteins D. Involved in endocytosis of nutrients - Correct Answers: A

D. Magic - Correct Answers: B Keith Richards presented into the emergency department because of swelling in his legs, a process known as edema. He has a history of liver failure, and as a result has a decreased capacity to produce proteins such as albumin. The edema is likely a result of: A. Increased oncotic pressure in the capillary B. Decreased capillary permeability C. Decreased oncotic pressure in the capillary D. A build-up of cytotoxins from the liver - Correct Answers: C According to the Br∅nsted-Lowry acid-base theory, the following is a characteristic of a strong acid. A. No dissociation in water B. Complete dissociation in water C. No reaction in water D. Become proton acceptors in water - Correct Answers: B Opsonization is a process by which: A. Mast cells are degranulated to release histamine B. Antigens are identified by special protein tags C. Collagen is exposed, allowing for platelet interaction D. Proteins bind to antigens to negate the negative charge, allowing for phagocytic interactions - Correct Answers: B Activation of complement is one of the responses of the innate immune system. The classic pathway is a response to: A. A reaction to endotoxins produced by antigens

B. A binding to the mannose residues on antigens C. The breakdown of fibrinogen D. The activation of antibodies - Correct Answers: D The first phagocytic cells to respond to exposure to an antigen are the: A. Neutrophils B. Monocytes C. Macrophages D. Eosinophils - Correct Answers: A This is an example of an endothelial-derived antimicrobial peptide: A. Lectin B. Complement C. Interleukin D. Defensin - Correct Answers: D A patient you are taking care of requires a blood transfusion of red blood cells. You know that all of the following are true about red blood cells EXCEPT: A. They carry oxygen to the cells and tissues of the body B. They contain multiple nuclei to aid in replication in the bloodstream C. They release nitric oxide to help relax constricted blood vessels D. They are biconcave in shape in order to increase their surface area - Correct Answers: B This component of the hematologic system is a disc-shaped cytoplasmic fragment that can change its shape from a sphere to that containing pseudopods. It is active in the formation of clots and contains dense granules that can secrete ADP, serotonin and thromboxane.

The nurse draws a blood sample on an anxious patient that is hyperventilating. The arterial blood gas will most likely show A. respiratory acidosis B. metabolic acidosis C. metabolic alkalosis D .respiratory alkalosis - Correct Answers: D Explanation

• Hyperventilation is an increase in respiratory rate and/or volume which causes a decrease in PCO2. This in turn raises the pH to cause respiratory alkalosis.
• Hyperventilation is often a response to hypoxia, increased metabolic demands from fever or illness, to pain, anxiety, or as part of a compensatory mechanism to when a patient has metabolic acidosis.
• Though hyperventilation is seen in some cases of metabolic acidosis, this answer is incorrect. On the NCLEX, only consider the information given. Unless information is presented to support other possible conditions (e.g. "three day hx of diarrhea and now hyperventilation), don't "read into" the question.
• Respiratory system is the cause
• Increase in PCO2, decrease in pH
• Compensation - Kidneys reabsorb Bicarb (HCO3). - Correct Answers: Respiratory acidosis
• Caused by loss of bicarb or build up of acids: lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication; not caused by respiration.
• HCO3 decreases, pH decreases
• Compensation - hyperventilation to eliminate CO2 - Correct Answers: Metabolic Acidosis
• Caused by excessive ventilation
• Decrease in PCO2, increase in pH
• Compensation - Kidneys excrete HCO3. - Correct Answers: Respiratory Alkalosis

• Acid (H+) lost from emesis, diuretics. Retention of HCO3 from medications, hyperaldosteronism.
• Increase in HCO3, Increase in pH
• Compensation - Respiratory centers are not stimulated, which leads to hypoventilation and CO retention. - Correct Answers: Metabolic Alkalosis The nurse preceptor is reviewing acid-base imbalances with a new nurse and identifies which of the following clients as the most likely to have respiratory acidosis? A. A client with stage 3 chronic kidney disease B. A client on morphine with decreased respirations C. A client with a 2 day history of vomiting D. A client with diabetic ketoacidosis (DKA) - Correct Answers: B Explanation: Hypoventilation will retain CO2 that would normally be expired during respiration. PCO2 will become elevated, causing respiratory acidosis. The nurse is caring for a patient with metabolic alkalosis who was transferred without lab data or the H&P. Which of the following is a potential cause of metabolic alkalosis? A. Hyperaldosteronism B. Hyperventilation C. Ingestion of ammonia D. Diarrhea - Correct Answers: A Explanation: Hyperaldosteronism increases renal loss of hydrogen ions and increases sodium-hydrogen exchange in the kidney. Sodium retention causes excess fluid volume and the hydrogen ion loss leads to metabolic alkalosis.

• The PC02 will be normal only until respiratory compensation begins, at which time the lungs will begin to attempt to balance the pH by increasing respirations to blow off excess C02, which will lowers the PC02.
• Initial laboratory evaluation of acid-base disorders include ABG, serum electrolytes, and calculation of the anion gap.