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NUR 8022 EXAM 3 (2025-2026) QUESTIONS AND
CORRECT ANSWERS GRADED A+
Which of the following disorders can lead to a low V/Q mismatch? A. Pulmonary edema B. Pulmonary Embolism C. Pulmonary Hypertension D. Hypercapnia A. Pulmonary edema
Nitric oxide, which is released by the glomerular endothelial cells, causes which physiological process to occur? A. Vasoconstriction B. Vasodilation B. Vasodilation
What would be a normal physiological response in regard to osmosis be in a patient with hyperglycemia? The patient's serum is hypertonic and the fluid will move out of the cell
How does the parasympathetic nervous system decrease heart rate? Release of ACH from the parasympathetic system increases the permeability of K+ ions and leads to hyperpolarization of the cell.
A patient is in renal failure. The patient reports a history of severe diarrhea for several days. They also report they have not been able to eat or drink anything for the last 24 hours due to not feeling well. The NP would suspect that this patient's renal failure is a (pre/intral/post renal) and is due to (dehydration/ischemia/urinary obstruction).
Prerenal; dehydration
Which of the following cardiac alterations could lead to left sided hypertrophic cardiomyopathy? A. Aortic stenosis B. Pulmonary hypertension C. Cardiac dilation D. Amyloidosis A. Aortic stenosis
Natriuretic peptides increase the of sodium? excretion
A patient presents with right sided heart failure, what is the most likely cause? Left sided heart failure
If a patient's BP was 200/120 what would you expect to occur physiologically in the kidneys?
Which nerve innervates the diaphragm? Phrenic nerve
Which lipid carried cholesterol to the tissues? LDL
What three areas does gas exchange occur? Bronchioles Alveolar ducts Alveoli
Gas exchange airways are served by the A. Cardiac circulation B. Venous circulation C. Pulmonary circulation C. Pulmonary circulation
Bronchi and other lung structures are served by the
A. Cardiac circulation B. Systemic circulation C. Pulmonary circulation B. Pulmonary circulation
Pulmonary circulation functions Facilitate gas exchange Deliver nutrients to lung tissue Act as blood reservoir for L ventricle Filtering system
pH range 7.35-7.
Which of the following represents ventricular systole on the ECG? A. PR interval B. QRS C. ST interval D. QT interval QT interval
HCO3 range 22-26 mEq/L
Base excess -2 to +
A person has atherosclerosis. Which pathophysiologic process has occurred? Macrophages release enzymes and toxic oxygen radicals that create oxidative stress.
Why do we give patient's ACE inhibitors if they have had an MI? To stop the conversion of angiotensin I to angiotensin II to further protect the heart
What is Dressler syndrome? When does it occur? Delayed form of pericarditis; thought to be antigen-antibody response to necrotic myocardium Occurs 1 week to several months later
A person with an MI is releasing angiotensin II. How should the nurse interpret this finding? Releasing angiotensin II is beneficial or counterproductive and why? Counterproductive; it causes the heart to work harder.
How does angiotensin II affect the heart during an MI? It contributes to the pathogenesis of the MI. Results in systemic effects which causes peripheral vasoconstriction and fluid retention. It's returning more blood flow to the heart and increasing peripheral vascular resistance making the heart work harder
6 P's of PVD Pallor, pulselessness, pain, paresthesia, paralysis and poikilothermia
AD
What can vascular regurgitation lead to? Dilation and hypertrophy (Increased volume leads to dilation; increased workload leads to hypertrophy)
Kussmaul's sign
Some causes of diastolic heart failure Hypertrophy Ischemia Diabetes Valve problems
Systolic heart failure Ejection problem Decreased EF of the L ventricle
Diastolic heart failure Filling problem Pulm congestion despite normal EF
Understand orthopnea with heart failure
Person lays down making it easier for blood to flow back to the heart, thus increasing preload and workload. A failing heart cannot handle this. Blood flows back into the lungs causing the shortness of breath.
Where is left heart failure edema? Pulmonary
AD
Where is right heart failure edema? Peripheral
Clinical manifestations of L heart failure Dyspnea, orthopnea, cough of frothy sputum
Clinical manifestations of R heart failure Jugular vein distention and hepatosplenomegaly
- Parasympathetic nervous system
- Hypothalamic pituitary adrenal axis
- Renin-angiotensin-aldosterone system (RAAS)
- Antidiuretic hormone (ADH) vasopressin aldosterone system
- Renin-angiotensin-aldosterone system (RAAS)
Atrial flutter vs atrial fibrillation Flutter p rate 251- Fib >
AD
Four types of heart block First degree Second degree Mobitz I (Wenckebacke) Second degree Mobitz II Third degree (complete)
Where does first degree heart block occur? Delay at the level of AV node
Where does second degree Mobitz I heart block occur? Level of the AV node
Where does second degree Mobitz II heart block occur? In the bundle of His or lower in the AV conduction system
Where does third degree (complete) heart block occur? AV node or bundle of His or purkinje fibers
Acyanotic heart defects Left to right shunting with pulmonary congestion. CHF
Cyanotic heart defects Right to left shunting
In a child with ventricular septal defect (VSD), blood flow is shunted from the:
- Hypercyanotic spells
- High BP in the arms with decreased pedal pulses
- Syncopal episodes with chest pain
- High BP in the arms with decreased pedal pulses
Kawasaki disease cause Mostly unknown; ~immunologic response to infectious toxin or antigen
What is Kawasaki disease? Acute self limiting febrile illness of early childhood characterized by vasculitis of the medium sized arteries, most noticeable in the coronary vessels
Kawasaki Stage 1 0-12 days: capillaries, venues, arterioles and heart become inflamed
Kawasaki stage 2 12-35 days: larger vessels become inflamed. Coronary aneurysms appear
Kawasaki stage 3 26-40 days: Medium sized arteries begin granulation process. Small vessel inflammation decreases
Kawasaki stage 4 40+ days: scarring of vessels. Thickening of tunica intima. Calcification. Coronary artery stenosis
Kawasaki's disease: clinical manifestations Acute Fever, conjunctivitis, strawberry tongue, rash and lymphadenopathy
Kawasaki's disease: clinical manifestations Subacute Begins when fever ends; Coronary artery aneurysm development, desquamation of palms and soles, marked thrombocytosis
Kawasaki's disease: clinical manifestation Convalescent
Hairlike structures
Alveoli Primary gas exchange units
Type I alveolar cells alveolar structure
Type II alveolar cells surfactant production
What is surfactant? A detergent like complex, reduces surface tension and helps keep the alveoli from collapsing.
Acinus contains
- Ciliated cells
- Goblet cells
- Alveolar ducts
- Alveolar ducts
Pulmonary circulation functions (1) facilitates gas exchange (2) delivers nutrients to lung tissues (3) acts as a blood reservoir for the left ventricle (4) serves as a filtering system that removes clots, air, and other debris from the circulation
Pulmonary circulation has (higher/lower) pressure than systemic circulation? Lower
What two circulatory systems make up the pulmonary circulation? Bronchial (high pressure) and pulmonary (low pressure)
Two factors that keep the lungs from collapsing surfactant and pleural pressure
