Download Nurs 6501 Advanced Pathophysiology Midterm Exam with Answers (Walden University) and more Exams Pathophysiology in PDF only on Docsity!
Nurs 6501 Advanced Pathophysiology Midterm
Exam with Answers (Walden University)
A runner has depleted all the oxygen available for muscle energy. Which of the following will facilitate his continued muscle performance? - Correct Answer Answer: Anaerobic glycolysis What causes the rapid change in the resting membrane potential that initiates an action potential? - Correct Answer Answer: Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive. A 12-year-old male is diagnosed with Klinefelter syndrome. His karyotype would reveal which of the following? - Correct Answer Answer: XXY A nurse is reviewing the pedigree chart. When checking for a proband, what is the nurse looking for? - Correct Answer Answer: The person who is first diagnosed with a genetic disease An aide asks the nurse why people who have neurofibromatosis will show varying degrees of the disease. Which genetic principle should the nurse explain to the aide? - Correct Answer Answer: Expressivity In teaching a patient with cirrhosis, which information should the nurse include regarding cholesterol? - Correct Answer Answer: Cholesterol decreases the membrane fluidity of the erythrocyte, which reduces its ability to carry oxygen.
When a patient asks what causes cystic fibrosis, how should the nurse respond? Cystic fibrosis is caused by an _____ gene - Correct Answer Answer: Autosomal recessive How are potassium and sodium transported across plasma membranes? - Correct Answer Answer: By adenosine triphosphate enzyme (ATPase) The nurse would be correct in identifying the predominant extracellular cation as: - Correct Answer Answer: Sodium The early dilation (swelling) of the cell's endoplasmic reticulum results in: - Correct Answer Answer: Reduced protein synthesis What principle should the nurse remember when trying to distinguish aging from diseases? - Correct Answer Answer: It is difficult to tell the difference because both processes are believed to result from cell injury. What is the diagnosis of a 13-year-old female who has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome present? Her features include a short stature, widely spaced nipples, reduced carrying angle at the elbow, and sparse body hair. - Correct Answer Answer: Turner syndrome A eukaryotic cell is undergoing DNA replication. In which region of the cell would most of the genetic information be contained? - Correct Answer Answer: Nucleolus The nurse is teaching staff about the most common cause of Down syndrome. What is the nurse describing? - Correct Answer Answer: Maternal nondisjunction
Why is potassium able to diffuse easily in and out of cells? - Correct Answer Answer: Because the resting plasma membrane is more permeable to potassium Hypothyroidism - Correct Answer A disorder caused by a thyroid gland that is slower and less productive than normal, does not produce enough T3 and T T3, T4, TSH - Correct Answer Diagnosing hypo/hyperthyroidism T3/T4 = thyroid. TSH = Pituitary. T3/T4 abnormality = problem with THYROID. T3/T4 normal + TSH abnormal = Secondary thyroid problem If too much T3/T4, then TSH will be down. Vice Versa. calcium - Correct Answer parathyroid glands responsible for regulating ___ levels. metabolism, temperature - Correct Answer Thyroid produces hormones T3, T4, and plays big role in __, ___ regulation and growth and development iodine - Correct Answer Brain cannot make T3 and T4 without
slows - Correct Answer hypothyroidism everything ___. stimulates sympathetic nervous system, drowsy, lethargic constipated, food move slows, weight gain body temp decreases Hyperthyroidism - Correct Answer excessive activity of the thyroid gland: increased levels of T3, T4 and TSH loss - Correct Answer Hyperthyroidism:
burning calories at an excessive rate weight ___ stimulates sympathetic nervous system: alert, quick reflexes, increased HR & BP (fight or flight response_ Heat intolerance: increased body temp Active GI: diarrhea anterior pituitary gland - Correct Answer the anterior part of the pituitary gland; an endocrine gland whose secretions are controlled by the hypothalamic hormones produces thyroid stimulating hormone (TSH) Cushing's disease - Correct Answer (Remember: UP, UP, UP, DOWN, UP) HYPERnatremia, HYPERtension, INCREASED blood volume, HYPOkalemia, HYPERglycemia adrenal cortex - Correct Answer outer section of each adrenal gland; secretes cortisol, aldosterone, and sex hormones Aldosterone - Correct Answer Hormone that stimulates the kidney to retain sodium ions and water to regulate BP via angiotensin-aldosterone system, retention of sodium and secretes potassium cortisol - Correct Answer stress hormone released by the adrenal cortex helps the body deal with stress such as illness or injury increases blood glucose
buffalo hump females --> no menstruation males--> ED hyperglycemia d/t high cortisol Addison's - Correct Answer ___ symptoms: brownish hyperpigmentation of skin diarrhea, nausea hyponatremia d/t low aldosterone levels --> hyperkalemia hypoglycemia d/t low cortisol low bp, risk for vascular collapse going into shock Anti-diuretic hormone - Correct Answer aka Vasopressin ADH is a hormone made by the hypothalamus in the brain and stored in the posterior pituitary gland. It tells your kidneys how much water to conserve. ADH constantly regulates and balances the amount of water in your blood. increase - Correct Answer SIADH will have ___ in antidiuretic hormone decrease - Correct Answer Diabetes insipidus will have a __ in ADH posterior pituitary gland - Correct Answer stores and secretes ADH
after hypothalamus produces ADH Pheochromocytoma - Correct Answer a benign tumor of the adrenal medulla that causes the gland to secrete catecholamines (epinephrine, norpinephrine, dopamine, and dopa) leading to high BP, headache, sweating and symptoms of a panic attack. diabetic ketoacidosis - Correct Answer acidity of the blood caused by the presence of ketone bodies produced when the body is unable to burn sugar; thus, it must burn fat (triglycerides and amino acids instead of glucose) for energy hyperglycemia hyperketonemia metabolic acidosis occurs mostly in type 1 diabetes mellitus cerebral, coma - Correct Answer DKA causes nausea, vomiting, and abd pain and can progress to __ edema, __ and death deficiency - Correct Answer DKA: hyperglycemia d/t insulin ___ causes an osmotic diuresis leading to marked urinary losses of water and electrolytes urinary excretion of ketones leads to additional loss of sodium and potassium inflammation - Correct Answer Pericarditis is ___ of the pericardium, often with fluid accumulation in the pericardial space (pericardial effusion)
mitral stenosis - Correct Answer narrowing of the mitral valve orifice that impedes blood flow from the left atrium to the left vetricle mitral valve prolapse - Correct Answer Improper closure of the valve between the heart's upper and lower left chambers. billowing of mitral valve leaflets into the left atrium during systole pulmonic regurgitation - Correct Answer pulmonic insufficiency; backflow of blood through incompetent pulmonic valve into the right ventricle causes blood from from the pulmonary artery into the right ventricle during diastole pulmonic stenosis - Correct Answer narrowing of the opening and valvular area between the pulmonary artery and right ventricle narrowing of the pulmonary outflow tract causing obstruction of blood flow from the right ventricle to the pulmonary artery during systole deep vein thrombosis - Correct Answer blood clot forms in a large vein, usually in a lower limb d/t impaired venous return, endothelial injury or hypercoagulability thrombi - Correct Answer __ consist of thrombin, fibrin, and red blood cells with few platelets and without treatment can travel to the lungs causing PE Hypertension - Correct Answer high blood pressure sustained SBP >
BP= cardiac output x total peripheral vascular resistance (TPR) HTN leads to ↑ CO, ↑ TPR peripheral artery disease - Correct Answer Atherosclerotic disease of the arteries that perfuse the limbs especially the lower extremites. can cause intermittent claudation and may not be painful and can go undetected for years. coronary artery disease - Correct Answer disease of the arteries surrounding the heart. leads to dylipidemia which is abnormal concentrations of serum lipoproteins. an increased serum concentration of LDL is an indicator of coronary risk. other risk factors, age, diabetes and CHD stable angina (angina pectoris) - Correct Answer chest pain caused by myocardial ischemia; pain is usually relieved by nitrates Pain describes the sensation by clenching fist over left sternal border. common sx chest pain, palpitations, sense of unease and severe fatigue myocardial infarction (MI) - Correct Answer heart attack; death of myocardial tissue (infarction) caused by ischemia (loss of blood
lung compliance - Correct Answer measure of change in lung volume that occurs with given change in transpulmonary pressure determined by the adequate production of surfactant and the elastic recoil of the lungs and chest wall airway resistance - Correct Answer the increase in pressure that occurs as the diameter of the airways decreases from mouth/nose to alveoli. spirometer - Correct Answer measures volume of air inhaled/exhaled and length of time required for each breath Dyspnea - Correct Answer shortness of breath orthopnea - Correct Answer difficulty breathing when lying down paroxysmal nocturnal dyspnea - Correct Answer awakening from sleep with SOB and needing to be upright to achieve comfort Aspiration - Correct Answer Breathing fluid, food, vomitus, or an object into the lungs atelectasis - Correct Answer collapsed lung; incomplete expansion of alveoli bronchiectasis - Correct Answer dilation of the bronchi usually secondary to infection or chronic inflammation Bronchiolitis - Correct Answer Inflammation of the bronchioles that usually occurs in children younger than 2 years and is often caused by the respiratory syncytial virus.
pulmonary edema - Correct Answer accumulation of fluid in the lungs common cause of LHF ARDS (acute respiratory distress syndrome) - Correct Answer respiratory insufficiency marked by progressive hypoxia Asthma - Correct Answer A chronic allergic disorder characterized by episodes of severe breathing difficulty, coughing, and wheezing. COPD (chronic obstructive pulmonary disease) - Correct Answer A group of lung diseases that block airflow and make it difficult to breathe. consist of bronchitis and emphysema Chronic bronchitis - Correct Answer Chronic inflammation of the bronchi that causes airway obstruction resulting from bronchial smooth muscle hypertrophy. Emphysema - Correct Answer a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. function of kidneys - Correct Answer filter blood and produce urine Renal blood flow - Correct Answer 1000- 1200 ml/min GFR (glomerular filtration rate) - Correct Answer 90-120 mL/min Renal function function of nephron - Correct Answer regulate the concentration of water and soluble substances like sodium salts by filtering the
lupus erythematosus - Correct Answer An autoimmune disease wherein the body produces antibodies against a variety of organs, especially connective tissues of skin and joints. Mild Lupus may involve a distinctive butterfly-shaped rash over the nose and cheeks. Mild lupus may also involve myalgia and arthralgia (remember these words?) Severe or systemic lupus (SLE) involves inflammation of multiple organ systems such as the heart, lungs, or kidneys. By the way, lupus means "wolf" in Latin. Maybe a reference to the facial rash that might give a patient a wolf-like appearance. Acute Kidney Injury - Correct Answer abrupt loss of kidney function resulting in retention of urea and nitrogen. Prerenal=decrease renal blood flow s/s: hypotension, hypoperfusion Intrarenal=injury to renal tissue d/t toxins/ischemia s/s: edema, glomerulonephritis Postrenal=stop/slow urine flow down the urinary tract s/s: hx of obstruction, difficulty voiding Oliguric/anuric=less than 500ml UO in 24 hrs, diuretic phase 24hr UO more than 500ml and no longer rise in BUN/Cr, recovery phase months-year, scar tissue. Rx: no nephrotoxic drugs( aminoglycosides, ACEI, NSAIDS, radiocontrast), give IVF if dehydrated, hemodialysis Complications: infection, arrhythmias (hyperkalemia) electrolyte imbalances, GI bleeding, multiple organ system failure. Nursing: assess, montor I&O, daily weight, regulate protein intake, high carb diet, restrict foods high in K, Phosphorus, Na Chronic Kidney Disease (CKD) - Correct Answer Inability of kidneys to excrete wastes; staged from 1 (mild damage to kidney) to 5 (complete kidney failure requiring either dialysis or a renal transplant). Stage 5 is also called end stage renal disease
Duodenum Function of the Small Intestine - Correct Answer chemical digestion of carbs, proteins, and lipids Bile - Correct Answer a bitter greenish-brown alkaline fluid that aids digestion and is secreted by the liver and stored in the gallbladder. Liver functions - Correct Answer Responsible for: The metabolism of fats, proteins, and carbohydrates. Excretion of bilirubin, cholesterol, hormones, and drugs. Enzyme activation. Storage of glycogen, vitamins, and minerals. Synthesis of plasma proteins, such as albumin, and clotting factors. Blood detoxification and purification. Bile production and secretion. hepatic portal vein - Correct Answer A vein connecting the capillary bed of the intestines with the capillary bed of the liver. This allows amino acids and gluocse absorbed from the intestines to be delivered first to the liver for processing before being transported throughout the circulatory system. Bilirubin - Correct Answer an orange-yellow pigment formed in the liver by the breakdown of hemoglobin and excreted in bile. Gallbladder function - Correct Answer Store & concentrate bile produced by the liver until it is needed in the small intestine Pancreas - Correct Answer An organs in the abdominal cavity with two roles. The first is an exocrine role: to produce digestive enzymes and bicarbonate, which are delivered to the small intestine via the pancreatic duct. The second is an endocrine role: to secrete insulin and glucagon into the bloodstream to help regulate blood glucose levels. anorexia - Correct Answer loss of appetite
Dudoenal Ulcer - Correct Answer Increased number of parietal cells in the stomach increased gastric levels Rapid gastric emptying gastric ulcer - Correct Answer persistent pain in the upper abdomen, often described as burning pain is somewhat or completely relieved by eating bland foods often have hematernesis or melana Zollinger-Ellison syndrome - Correct Answer hypersecretion of gastric acid that produces peptic ulcers as a result of a non-beta- cell tumor of the pancreatic islets stress ulcers - Correct Answer gastric mucosal lesions that develop in patients who are critically ill from trauma, shock, hemorrhage, sepsis, burns, acute respiratory distress syndrome, major surgical procedures, or other severe illnesses Cushing ulcer - Correct Answer increased stimulation of vagus nerve secondary to increased ICP leads to increased acid production, increased vagus stim causes increase of ACh which binds parietal cells and increases acid production Dumping syndrome - Correct Answer increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis. Wait 1 hr after meals to drink ulcerative colitis - Correct Answer a chronic condition of unknown cause in which repeated episodes of inflammation in the rectum and large intestine cause ulcers and irritation Chron's disease - Correct Answer A chronic inflammatory bowel disease that affects the lining of the digestive tract.
irritable bowel syndrome - Correct Answer a common condition of unknown cause with symptoms that can include intermittent cramping, abdominal pain, bloating, constipation, and/or diarrhea Diverticulitis - Correct Answer inflammation of the diverticula appendicitis - Correct Answer inflammation of the appendix portal hypertension - Correct Answer A potential complication of chronic alcoholism resulting in liver damage and obstruction of venous blood flow through the liver. The rising blood pressure in the veins between the gastrointestinal tract and liver causes engorgement of veins around the umbilicus (navel). splenomegaly - Correct Answer enlargement of the spleen Acites - Correct Answer is excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity). Hepatic encephalopathy - Correct Answer impaired ammonia metabolism causes cerebral edema. s/s: change in LOC, memory loss, asterixis (flapping tremor) impaired handwriting, hyperventilation w/ resp alkalosis. Rx: lactulose, low protein, safety, rest Hepatitis - Correct Answer Inflammation of the liver, usually caused by a viral infection, that causes fever, loss of appetite, jaundice, fatigue, and altered liver function. Hepatitis B virus - Correct Answer virus that causes inflammation of the liver; transmitted through any body fluid, including vaginal secretions, semen, and blood
