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Pathophysiology exam 2 Study Guide:
Questions & Answers
A 54-year-old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feelings. Lab results reveal decreased pH, increased CO2, and normal bicarbonate ion. These findings help to confirm the diagnosis of: (Ans- respiratory acidosis For a patient with respiratory acidosis, chronic compensation by the body will include: (Ans- Kidney excretion of H+ A 55-year-old female presents to her primary care provider and reports dizziness, confusion, and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2, and slightly decreased HCO3. Which of the following is the most likely diagnosis? (Ans- Respiratory alkalosis with renal compensation Outcomes of laboratory tests include an elevated level of natriuretic peptides. Which organ is the priority assessment? (Ans- heart A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor. Further testing indicates that the tumor secretes ADH. Which of the following assessment findings should the nurse expect? (Select all that apply.) (Ans-
- Confusion
- Weakness
- Nausea
- Muscle twitching
The nurse would anticipate the patient with syndrome of inappropriate ADH (SIADH) to demonstrate which of the following symptoms? (Select all that apply.) (Ans-
- Weakness
- Nausea
- Headache
- Muscle twitching A primary care provider is talking about plasma proteins synthesized by lymphocytes in the lymph nodes. What is the primary care provider describing? (Ans- antibodies While reviewing lab results, the nurse recalls the most abundant cells in the blood are: (Ans- erythrocytes An adult patients blood sample is analyzed in a laboratory. Assuming a normal sample, which type of white blood cell accounts for the highest percentage? (Ans- neutrophils A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm and they show phagocytic activity. Which of the following cells is most similar? A) Monocyte B) Macrophage C) Lymphocyte D) Eosinophils (Ans- eosinophils While planning care for a patient with inflammation, which principle will the nurse remember? The predominant phagocyte of early inflammation is the: (Ans- neutrophil
After birth, red blood cells are normally made only in the: (Ans- bone marrow A nurse is discussing a cell that can differentiate into any tissue type. Which term is the nurse describing? (Ans- pluripotent A hematologist is discussing hematopoiesis. Which information should be included? ________ participate in hematopoiesis. a. Colony-stimulating factors (CSFs) b. Eosinophils c. Basophils d. Neutrophils (Ans- Colony-stimulating factors or CSF An unstable type of hemoglobin that cannot bind with oxygen is termed: A) Deoxyhemoglobin B) Oxyhemoglobin C) Methemoglobin D) Glycosylated hemoglobin (Ans- methemoglobin A staff member wants to know where the greatest proportion of iron is located. How should the nurse respond? The greatest proportion of total body iron is located in the: a. Erythrocytes b. Spleen pulp c. Bone marrow d. Liver tissue (Ans- erythrocytes
A student asks the instructor about recycled iron. What information should the instructor share? Recycled iron from macrophages is delivered to the bone marrow bound to: A) Ferritin B) Hemoglobin C) Hemosiderin D) Transferrin (Ans- transferrin A nurse is preparing to teach about erythropoietin. Which information should the nurse include? Erythropoietin is produced in the: (Ans- kidneys Which condition will cause a patient to secrete erythropoietin? (Ans- hypoxia After erythrocytes have circulated for about 120 days, they are removed by macrophages, which are mainly in the: (Ans- spleen Which electrolyte will the nurse check to ensure normal platelet functioning? (Ans- Calcium Which of the following nutritional components will the nurse encourage a patient to consume as it is needed for erythropoiesis? (Ans- Cobalamin A newborn baby is diagnosed with a blood disorder in which her platelet count is low. Which of the following does the nurse suspect could be the reason? (Ans- Decreased thrombopoietin
When an aide asks a nurse how many oxygen molecules can hemoglobin carry, what is the nurse's best response? Hemoglobin molecules carry _____ oxygen molecules. (Ans- 4 (four) A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be: (Ans- Able to assume various shapes A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart? (Ans- pernicious anemia When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes: (Ans- hypochromic A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has? (Ans- hemolytic anemia After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes? (Ans- Hyperdynamic circulatory state A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations should the nurse expect? (Ans- peripheral vasoconstriction
A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness, and fatigue with exertion. Which of the following respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand? (Ans- increased rate and depth of breathing A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear suggests the deficiency is macrocytic and normochromic. The nurse would expect the hemoglobin to be: (Ans- normal A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is: (Ans- Defective DNA synthesis These anemias are the result of ineffective erythrocyte deoxyribonucleic acid (DNA) synthesis. When a patient wants to know why vitamin B12 and folate deficiencies cause anemia, how should the nurse respond? (Ans- Red blood cells have a shorter life span These deficiencies lead to defective erythrocytes that die prematurely, which decreases their numbers in the circulation, causing anemia A 20-year-old female undergoes lab testing for anemia. Results show high iron, bilirubin, and transferrin and low hemoglobin and hematocrit. Which of the following is the most likely diagnosis to be documented on the chart? (Ans- Sideroblastic anemia Individuals with sideroblastic anemia may show signs of iron overload (hemosiderosis), including mild to moderate enlargement of the liver (hepatomegaly) and spleen (splenomegaly).
A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments? (Ans- Intravascular fluid A 35-year-old male weighs 70 kg. Approximately how much of this weight is ICF? (Ans- 42 L- the total volume of body water for a 70 kg person is about 42 L (60%) While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n): (Ans- decreased muscle mass Which of the following patients should the nurse assess for a decreased oncotic pressure in the capillaries? A patient with: (Ans- liver failure Water movement between the ICF and ECF compartments is determined by: (Ans- osmotic forces An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid moving into the interstitial space? (Ans- Increased interstitial oncotic pressure When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to _____ balance. (Ans- Sodium A 70-year-old male with chronic renal failure presents with edema. Which of the following is the most likely cause of this condition? (Ans- Increased capillary hydrostatic pressure
A 10-year-old male is brought to the emergency room (ER) because he is incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as: (Ans- localized edema A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include? Secretion of ADH is stimulated by: (Ans- increased plasma osmolality Which statement by the staff indicates teaching was successful concerning aldosterone? Secretion of aldosterone results in: (Ans- increased blood volume A 25-year-old male is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which finding would the nurse expect to see in the lab results? (Ans- Decreased blood K+ levels A patient has been searching on the Internet about natriuretic hormones. When the patient asks the nurse what do these hormones do, how should the nurse respond? Natriuretic hormones affect the balance of: (Ans- Sodium A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected? (Ans- Intracellular dehydration Which of the following patients is the most at risk for developing hypernatremia? A patient with: (Ans- dehydration The most common cause of pure water deficit is: (Ans- A. renal water loss
A 19-year-old male presents to his primary care provider reporting restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemic. Which of the following could have caused his condition? (Ans- acidosis A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe? (Ans- oliguria Which of the following buffer pairs is considered the major plasma buffering system? (Ans- carbonic acid and bicarbonate A nurse recalls regulation of acid-base balance through removal or retention of volatile acids is accomplished by the: (Ans- lungs Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of: (Ans- 20: Which patient is most prone to metabolic alkalosis? A patient with: (Ans- Excessive loss of chloride (Cl) Which patient should the nurse assess for both hyperkalemia and metabolic acidosis? A patient diagnosed with: (Ans- renal failure For a patient experiencing metabolic acidosis, the body will compensate by: (Ans- hyperventilating Which finding would support the diagnosis of respiratory acidosis? (Ans- pneumonia
A 67-year-old female has chronic gastrointestinal bleeding. A nurse recalls the primary cause of her anemia is: (Ans- iron deficiency anemia A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These assessment findings are consistent with which type of anemia? (Ans- Hemolytic anemia A yellow appearance to the skin and sclera are consistent with hemolytic anemia. A 58-year-old female presents in the clinic presenting with fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit, a high mean corpuscular volume, and normal plasma iron. These assessment findings are consistent with which type of anemia? (Ans- Pernicious anemia Pernicious anemia is manifested by tingling paresthesia’s of feet and fingers. The nurse will check which of the following tests to directly measure iron stores? (Ans- Bone marrow biopsy Iron stores are measured directly by bone marrow biopsy. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit? (Ans- spoon shaped nails
A 67-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera. Upon taking the history, the patient will most likely report: (Ans- Chest pain Coronary blood flow may be affected, precipitating angina. A 68-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera (PV). A nurse realizes the patient's symptoms are mainly the result of: (Ans- increased blood viscosity A 67-year-old female is admitted to the emergency department with a diagnosis of polycythemia vera (PV). Which treatment should the nurse discuss with the patient? (Ans- Therapeutic phlebotomy Treatment of PV is phlebotomy to reduce red cell mass and blood volume. A 70-year-old male is brought to the emergency department, where he dies shortly thereafter. Autopsy reveals polycythemia vera (PV). His death was most likely the result of: (Ans- Cerebral thrombosis 50% of individuals with PV die within 18 months of the onset of initial symptoms because of thrombosis or hemorrhage. A 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment. His condition is at risk for converting to: (Ans- acute myeloid leukemia A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as: (Ans- A high leukocyte count
Leukocytosis is present when the count is higher than normal A 20-year-old female has an increase in eosinophils. When the patient wants to know the most likely cause of the eosinophilia. What is the nurses best response? (Ans- Parasitic invasion and allergic reactions Parasitic invasion can lead to eosinophilia. A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph node enlargement. She is diagnosed with infectious mononucleosis. What should the nurse tell the patient about the recovery time? (Ans- A few weeks Infectious mononucleosis (IM) is usually self-limiting, and recovery occurs in a few weeks; severe clinical complications are rare (5%). Fatigue may last for 1 to 2 months after resolution of other symptoms A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. A nurse monitors for which of the following conditions that could result secondary to the treatment? (Ans- Basophilia Basophilia results from antithyroid therapy. A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how he got this disease, how should the nurse respond? The most likely cause is: (Ans- Epstein-Barr virus (EBV) A 15-year-old male with infectious mononucleosis is being given instructions on how to prevent the spread of this infection to others. Which statement represents a correct instruction? (Ans- Do not share drinking glasses or eating utensils.
A 35-year-old female is diagnosed with lymphadenopathy. Which assessment finding will help confirm this diagnosis? (Ans- enlarged lymph nodes A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease? (Ans- Reed-Sternberg cell The people from which country have the lowest risk for Hodgkin lymphoma? (Ans- Japan Japan has the lowest rate of Hodgkin lymphoma. A 62-year-old female tells her health care provider she has been experiencing regular night sweats that cause her to wake up drenched. She also remarks that she has been unintentionally losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful. She should be screened for which of the following cancers? (Ans- Hodgkin lymphoma The patient has symptoms of Hodgkin lymphoma. About a third of individuals will have some degree of systemic symptoms. Intermittent fever, without other symptoms of infection, drenching night sweats, itchy skin (pruritus), and fatigue are relatively common A 10-year-old male presents with abdominal swelling, night sweats, fever, and weight loss. He is diagnosed with Burkitt lymphoma. Upon obtaining the history, which of the following is the most likely cause? (Ans- Epstein-Barr virus (EBV) EBV is associated with almost all cases of Burkitt lymphoma
For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be: (Ans- sequestered Thrombocytopenia may be: (Ans- Congenital or acquired The condition may also be either congenital or acquired and may be either primary or secondary to other conditions. A 30-year-old female presents with hematuria, menorrhagia, and bleeding gums. She is diagnosed with immune thrombocytic purpura (ITP). A nurse realizes the most likely cause is: (Ans- Antibody destruction of platelets The majority of cases of ITP are due to immune driven destruction of platelets. A 50-year-old female is diagnosed with primary thrombocythemia. A nurse would expect the blood smear to reveal _____ platelets. (Ans- Overproduced Thrombocythemia is characterized by a platelet count more than 400, platelets/mm3 of blood and is symptomatic when the count exceeds 1,000,000/ mm3, at which time the risk for intravascular clotting (thrombosis) is high. A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. The nurse suspects a decrease in which of the following vitamins? (Ans- K Lack of vitamin K interferes with clotting.
