UTA NURS3366 2021 October All Quizzes Latest

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 1 Quiz

Question 1A 55-year-old man with emphysema (a type of lung disease) who has smoked 2 packs of cigarettes per day for 40 years is hospitalized for acute onset of cough with bloody sputum. After a few days of testing and treatment, the patient’s nurse reads a physician’s note on the chart: “I have told the patient that the etiologies of his presenting problem are: 1) exacerbation of his chronic emphysema and 2) the new diagnosis of lung cancer.  The onset of both was contributed to by his longstanding smoking.”  The patient asks the nurse for morecinformation about his illness.  Which explanation, by the nurse, indicates a full understanding of the patient’s situation?

  “You have a disease process that was iatrogenically caused by cigarette smoking.”

  “You have a sudden onset of a chronic lung disease that was brought on by lung cancer.”

  “The coughing up of blood is caused by a worsening of a disease you’ve had for a long time plus a new problem-- lung cancer.”

  “These diseases have been creeping up on you for probably 20 years; it just goes to show that you should never have taken up smoking.”

 Question 2A 55-year-old man with emphysema (a type of lung disease) who has smoked 2 packs of cigarettes per day for 40 years is hospitalized for acute onset of cough with bloody sputum. After a few days of testing and treatment, the patient’s nurse reads a physician’s note on the chart: “I have told the patient that the etiologies of his presenting problem are: 1) exacerbation of his chronic emphysema and 2) the new diagnosis of lung cancer.  The onset of both was contributed to by his longstanding smoking.”  The patient asks the nurse for more information about his illness.  Based on all the information you have on the patient, which statement is most likely correct? 

  The patient has a poor prognosis because of the comorbidities of lung cancer and cigarette smoking.

  Lung cancer was a sequela of the bloody sputum.

  A precipitating factor for the acute hospitalization was overexertion when the patient started an exercise class.

  Heavy cigarette smoking was a risk factor in the patient’s developing emphysema and lung cancer.

 Question 3An 80-year-old patient has experienced a massive blood loss following an accident.  His vital signs are: Blood pressure/BP 80/50 (normal ~ 120/80), heart rate/HR 120 (norm = 60-100), respiratory rate/RR 20 (norm = 12 to 20), temperature/T 98.6° (norm ~ 98.6°).  In assessing this patient, the nurse understands that the abnormal HR is

  probably the etiology for the patient’s low BP.

  due to the patient’s heart compensating for low blood volume by pumping faster.

  the normal compensatory response of shunting blood volume to the periphery.

  due to multiple risk factors.

 Question 4An 80-year-old patient has experienced a massive blood loss following an accident.  His vital signs are: Blood pressure/BP 80/50 (normal ~ 120/80), heart rate/HR 120 (norm = 60-100), respiratory rate/RR 20 (norm = 12 to 20), temperature/T 98.6° (norm ~ 98.6°). The patient would also most likely have all of the following EXCEPT

  S&S of cool feet and hands from the body’s compensatory response to blood loss.

  S&S of feeling faint and weak from blood loss.

  a risk factor of shock.

  a more guarded (ie, “poorer”) prognosis because of his age.

 Question 5A young, otherwise healthy patient is admitted to the hospital with a diagnosis of heart  failure of unknown cause. The etiology of the heart failure would be termed

  iatrogenic.

   idiopathic.

   nosocomial.

  acute.

 Question 6A busy student, with very few financial resources, has body aches, a fever, cough and nasal congestions and difficulty breathing through their nose. The direct pathophysiologic etiology of these symptoms is most likely related to

  not eating green vegetables.

  lung failure.

  lack of oxygen.

  exposure to a microbe.

 Question 7

A busy student, with very few financial resources, has body aches, a fever, cough and nasal congestions and difficulty breathing through their nose. The precipitating factors related to the illness include all options EXCEPT

  having few financial resources.

  having a cough and nasal congestion.

  has poor hand hygiene.

  is sleep deprived.

 Question 8Which mini concept map best describes thermoregulation? 

  Body temperature decreases --> hypothalamus sends a signal --> vasoconstriction of superficial arteries --> blood stays "warm" in the center of the body (core).

  Body temperature rises --> hypothalamus sends a signal --> vasoconstriction of superficial arteries --> blood stays "cool" in the center of the body (core).

  Body temperature rises --> brain stem sends a signal --> skin produces sweat --> heat loss through evaporation.

  Body temperature rises --> the brain over heats --> no compensatory mechanisms exist --> a heat stroke occurs.

 Question 9After not eating since breakfast 6 hours ago, a student taking a test notices a period of hunger and fatigue.  He doesn’t have access to food because he is taking the test.  About 10 minutes later, though, he begins to feel ok again and finishes the test with flying colors.  What has happened in his body?

  A compensatory response called glycogenolysis allowed him to access stored glucose for energy.

  A decompensatory response occurred, in which adrenalin increased and caused more blood flow to the brain.

  Since his blood sugar was likely low, the heart underwent a compensatory response known as hypertrophy in order to increase blood flow to central organs.

  Using a control mechanism known as hyperventilation, the student was able to “blow off” excess CO2 and thus have a clearer thinking process.

 Question 10An RN is taking care of a cocaine addict who has just given birth to a baby with a teratogenic defect.  A student nurse asks him what the probable etiology was.  The RN shows understanding of genetic disorders when he says                   

   “It’s hard to know the exact cause, but it’s likely that fetal chromosomal development was impaired by the mom’s intra-pregnancy cocaine ingestion.”

   “ The baby inherited a structural chromosomal defect that resulted in a problem called aneuploidy.”

  “The baby inherited a gene that caused a defect called trisomy 21.”

  “ Since the little guy was born with the Philadelphia chromosome, he will be a life-long Phillies fan.”

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 2 Quiz

Question 1A patient, diagnosed with cancer, has a poor appetite and has lost 80 pounds. Upon assessment (examination),  the nurse notes generalized edema and a low serum protein level.  Which mini-concept map accurately relates the relationship of the patient’s serum protein level with the presence of edema?

  hypoproteinemia--> concentration in blood is now lower than the normal concentration of fluids inside cells--> fluid goes from B to T.

  hypoproteinemia--> concentration in blood is now higher than the normal concentration of fluids inside cells--> fluid goes from B to T

  hypoproteinemia--> blood is now hyperosmolar compared to the cells --> fluid goes from T to B

  hyperproteinemia-->blood now has lower oncotic pressure than normal--> fluid goes from T to B

 Question 2Which serum osmolar state will NOT cause edema?

  hypertonicity of the plasma space.

  hypotonicity of the plasma space.

  hypoosmolality of the blood.

   diminished osmotic pressure of the blood.

 Question 3A 28-year-old man presents with a low blood pressure due to blood loss from a gunshot wound. The regulatory action that will best compensate for this patient’s fluid volume deficit is

   increased action of the natriuretic peptide system.

  increased action of the RAAS.

  inhibition of renin secretion.

  conversion of aldosterone into angiotensin II.

 Question 4A 28-year-old man presents with a low blood pressure due to blood loss from a gunshot wound.  Which aspect, from expected compensatory mechanisms, will NOT occur?

   the patient’s body will “hang on” to water.

  Na+ will be retained by the kidneys.

   water excretion into the urine will increase.

  arterial vasoconstriction is present.

 Question 5A patient is hospitalized in renal failure.   Because of her kidneys’ inability to excrete water, she has generalized edema & a serum sodium of 129. Because the kidneys have also lost the ability to appropriately regulate potassium, she also has a serum potassium of 5.9.  These lab results show:   

Normal Na+: 135 to 145

 Normal K+:    3.5 – 5.0 

  hypernatremia & hypokalemia.

   hyperkalemia & hyponatremia.

  hyperosmolality & hypernatremia.

  hypoosmolality & hypocalcemia.

 Question 6A patient has advanced liver disease.  Blood tests reveal that his serum albumin (albumin is one of the protein molecules found in the blood) level is very low.  What eventually happens in this patient situation?

  Water would shift from blood (B) to tissue (T) because of decreased plasma oncotic pressure.

  There would be an increased intravascular volume due to increased plasma oncotic pressure.

  There would be dehydrated brain cells due to fluid shifting from T to B.

  Water would shift from T to B because of increased osmolality of the vascular space.

 Question 7A patient has advanced liver disease and is found to have a decreased serum albumin (albumin is one of the protein molecules found in the blood) level and edema.  Identify the physiologic process underlying their edema. 

  “concentration calls” fluid into hypoosmolar compartments from hyperosmolar ones.

  the principle of diffusion results in albumin molecules going from lower to higher concentration.

  “concentration calls” fluid into compartments with higher oncotic pressure from compartments with lower oncotic pressure.

  the proteinemia means that protein molecules will diffuse throughout the blood and tissue.

 Question 8A patient who just came out of general anesthesia has lab work done. The serum osmolality is 165. The nurse taking care of this patient suspects that the _____ is due to _________.

Normal osmolality = 280- 295 

  hyperosmolality: dehydration.

  hypoosmolality: syndrome of inappropriate ADH (SIADH).

  hypertonicity: SIADH.

  high oncotic pressure: a state of hyperpolarization inside the cells.

 Question 9A patient is admitted to the hospital with a serum osmolality of 165.   As an intervention to return the patient to       normal serum osmolality, the nurse is likely to hang an IV bag of _______ because once the fluid is distributed in the blood it will __________ and help return fluid compartment status to homeostasis.

Normal tonicity = 0.9% (normal saline or NS)

  0.45 NaCl: cause water to shift from tissue (T) to blood (B).

   3% NaCl : cause water to shift from T to B.

  0.25 NaCl : shift water from B to T.

  NS : shift water from B to T.

 Question 10A patient with hyposecretion of ADH (less secretion of antidiuretic hormone) would MOST LIKELY have the following: 

Normal osmo = 280- 295 

  serum osmolality of 270.

  oliguria (low urine output).

   serum osmolality of 300.

   edema.

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 3 & 4 Quiz

Question 1A man presents to an ER with a large laceration sustained at a construction site 3 days before.  The area around the laceration is erythematous, painful, and swollen.  The erythema and swelling can be explained at a cellular level by all the following EXCEPT

  mast cell degranulation and release of histamine.

  pro-inflammatory prostaglandins released.

  increased vasomotor tone (vasoconstriction) of the capillaries in the area.

  local reaction to acute phase reactants.

 Question 2A man presents to an ER with a large laceration sustained at a construction site 3 days before.  He is given a TIG (tetanus immunoglobulin) injection. He doesn’t remember ever having a tetanus vaccination. The purpose of the TIG is to:

  prevent any tetanus bacteria from activating the inflammatory system.

   introduce tetanus bacteria so that the immunocyte system can create antibodies to tetanus.

  give the patient natural active acquired immunity.

  provide tetanus antibodies to fight any tetanus bacteria that might be present.

 Question 3A man presents to an ER with a large laceration sustained at a construction site 3 days before.  He is given a TIG (tetanus immunoglobulin) injection. He doesn’t remember ever having a tetanus vaccination. The patient  ______  (should or should not) also get a tetanus vaccination, because_____.

  should: he needs protection against future tetanus exposure.

  should: the vaccination will provide additional passive immunity.

   should not: the TIG is enough, as it will provide long term active acquired immunity

  should not: the vaccine will do nothing for the current exposure.

 Question 4A microbe invades the body for the first time.  Which statement is most likely true about the processes that follow?         

   Plasma cells (a type of B-lymphocyte) will immediately secrete T-cells specific to that microbe.

  CD4 cells will introduce remnants of the microbe to the plasma cells, which directly phagocytize the   remnants.

  Antigens will be created from the memory cells of immunocytes.

   Immunocytes will begin the process of developing memory to that microbe.

 Question 5A patient has a systemic inflammation.  Which response is unlikely associated with his condition?

  increased acute phase reactants.

  lab results showing a high C-reactive protein (CRP).

  lab results showing leukopenia.

  increased pro-inflammatory prostaglandins.

 Question 6A baby who has received immunoglobulins against the “XYZ” virus via its mother’s milk now has  

  natural active acquired immunity.

  natural passive acquired immunity.

   passive innate immunity.

  active innate immunity.

 Question 7A baby who has received immunoglobulins against the “XYZ” virus via its mother’s milk will __________.

  have lifelong immunity to the XYZ virus because of receiving the immunoglobulins that are specific to that particular microbe.

  develop temporary immunity to the XYZ virus due to receiving Mom’s antibodies that are specific to that particular microbe.

  now have complete 2nd line of defense protection, having received it in the breast milk.

  develop alphabetophobia due overdose of anti-XYZ immunoglobulins.

 Question 8After an intensive new exercise routine, a person experiences muscle aches.  The most appropriate self-treatment for this person is to __________, because _______.

  take an NSAID such as Aleve : the drug suppresses phospholipase enzymes in the arachidonic pathway.

  take an NSAID such as Advil : the drug effectively suppresses pro-inflammatory prostaglandin activity.

  make an appointment with their healthcare provider : an assessment of CRP will determine the amount of muscle injury.

  take an antihistamine: it will suppress the effect of the leukotriene inflammatory mediator.

 Question 9An individual, admitted to the hospital after being diagnosed with pneumonia, has developed high fever, altered mental status and low blood pressure.  The cause of his signs are symptoms (S&S) are likely the result of ______________.

  wide-spread systemic inflammatory mediators causing vasodilation

  wide-spread local inflammatory mediators causing vasoconstriction

  chronic inflammation from the development of an autoantibody

  leukopenia and an ineffective chemotactic response from the macrophage

 Question 10Granulating tissue refers to ___________.

  infected and chronically inflamed tissue

  new tissue formed during the healing process

  a defective creation of multiple cells

  a decreased inflammatory response

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 5 Quiz

Question 1A patient presents to the ED with fever, chills, myalgia (muscle pain), and a dry cough.  He says he has recently traveled to China.   He says he got a flu shot a year ago. Which is most likely in this case? 

  This disease is pertussis, probably contracted from an unvaccinated contact when he visited China.

  The disease is probably not influenza, since he had a flu shot during last year’s flu season.

  The diagnosis is influenza, probably contracted via fecal/oral route while in China.

  The diagnosis is influenza, possibly contracted because patient did not have this year’s flu shot.

 Question 2The flu virus has the following characteristics: 

  The causative microbe can also cause a membrane across the pharynx.

  This disease is difficult to treat because of the antigenic drift of its exotoxin.

  Mutations of proteins on the causative organism’s viral cell envelope result in a different version each year.

   A later outbreak may include skin lesions in a dermatome pattern.

 Question 3A commonality of herpetic organisms that cause diseases like chicken pox and shingles is that

  each is caused by a bacterial organism that penetrates the nervous system.

   the causative microbe can remain dormant in the nervous system.

  the causative microbe causes bloody diarrhea.

  each is transmitted via vector. 

 Question 4An otherwise healthy person whose water supply comes from a well is more at risk for _____.

  giardia

  trichinosis

  c-diff

  cysticercosis

 Question 5A 4-year-old patient presents with bloody diarrhea.  Possible causes include _______ because_______

  shigella: the microbe has caused inflammation in the lining of the intestines.        

  pseudomembranous colitis: C. diff has eradicated normal flora.

  giardia: this protozoa invades the intestinal wall and causes necrosis.

  diphtheria: this bacteria causes parotid enlargement.

 Question 6After coming home from an overseas assignment, a young army officer begins complaining of extreme fatigue and arthralgia (joint pain).  He has a very high fever and shaking chills, and he is anemic. The most likely etiology of his S&S is

   infection with rabies virus.

  protozoal invasion of his RBCs

  Staph aureus-related cellulitis.

  Guinea worm infestation.

 Question 7A patient is diagnosed with a staph infection of the skin (cellulitis) and is prescribed a penicillin antibiotic. A week later, there has been no improvement of the symptoms. A specimen of the draining wound is collected by the nurse for culture. The nurse suspects MRSA (methicillin-resistant Staphylococcus aureus).  Which protective personal equipment should the nurse utilize when handling wound exudate?

  a mask

  a mask and gloves

  gloves

  gloves and a gown

 Question 8A patient is diagnosed with a staph infection of the skin (cellulitis) and is prescribed a penicillin antibiotic. A week later, there has been no improvement of the symptoms. The wound culture is positive for MRSA (methicillin-resistant Staphylococcus aureus).  Which option best describes the pathology of MRSA?

  A certain Staphylococcus aureus species developed a special bonding affinity with penicillin.

  The patient likely had a compromised immune system, as evidenced by the cellulitis.

  The Staph microbe mutated and developed beta-lactamase; rendering the antibiotic useless.

  Staphylococcus aureus is a microbe that does not respond to any kind of penicillin antibiotic.

 Question 9After three of weeks of being on strong antibiotics, a patient develops watery diarrhea.  Her stool is cultured. In this question's context, what organism would you expect the stool culture to grow?

  MRSA

  VRE

  Salmonella

  C-diff

 Question 10A school nurse has identified varicella (chicken pox) in a student at an elementary school. Which information about this illness should the school nurse provide to the child’s parents?

  The child can return to school within two days as long as the child does not have a fever.

  Fluid-filled vesicles will be itchy but pose no threat of transmission.

  Varicella can be spread from a sneeze or cough before the vesicles erupt.

  Chicken pox is a deadly disease but can be prevented with a vaccine.

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 6 & 7 Quiz

Question 1A patient has intermittent claudication and a history of atherosclerosis.  What other findings are most likely? 

  pitting edema of the ankles.

  jugular vein distention (JVD).

  cool feet with diminished pulses.

  S&S of increased preload.

 Question 2A patient is diagnosed with venous insufficiency. What treatment is most likely and why?

  a clot-busting medication; used to dissolve arterial clots.

  drop the legs lower than the heart; allows blood to flow around a deep vein thrombosis (DVT).

  complete bedrest; venous stasis reduces the risk of thrombosis.

  elevation of the feet; enhances venous return.

 Question 3A 40-year-old man is undergoing a yearly physical. Everything is fine except that the nurse practitioner hears a murmur. All the following are likely etiologies EXCEPT:

  pulmonic valve insufficiency.

  a heart valve that is ischemic from a coronary artery blockage.

  incompetent venous valves.

  a stenotic mitral valve.

 Question 4A patient has a DVT (deep vein thrombosis) of the right calf.  Which of the following is the LEAST LIKELY to develop?  ­

  Pain at the DVT site.

  Loss of pulse in the right foot.

  Erythema of the right lower leg.

  Shortness of breath.

 Question 5While at a health fair, a man’s blood pressure is measured at 168/100. The registered nurse, instructs the man to see his healthcare provider (HCP). The man asks the nurse “Why; I feel great?”. How should the nurse respond?

  “High blood pressure can cause damage to your kidney or heart even if you feel great.”

  “Unless you have a headache, an elevated blood pressure is not a problem.”

  “An elevated blood pressure indicates less resistance in the artery and less work for your heart.”

  “If you are over 60 years old, this blood pressure measurement is within the normal range.”

 Question 6A man, whose blood pressure is measured at 168/100, is diagnosed with primary hypertension and wants to know more about the reason for the diagnosis. Which response, by the registered nurse (RN), is correct?

  Kidney disease is the likely cause of your high blood pressure.

  High blood pressure is caused by a diet high in fat, salt and cholesterol.

  There is no specific cause for high blood pressure; there are many known contributing factors.

Type-A personality is known to cause high blood pressure.

Question 7A man, whose blood pressure is measured at 168/100, is prescribed an angiotensin-converting enzyme inhibitor (ACEI). Which statement provides an appropriate rationale for the use of this drug?

  ACEI prevent beta receptor stimulation in the heart.

  This medication blocks the action of the sympathetic nervous system.

ACEI prevents vasoconstriction and sodium and water retention.

  This medication reduces the accumulation of LDLs within the arterial intima.

 Question 8A man, diagnosed with essential hypertension, is unable to afford his angiotensin-converting enzyme inhibitor (ACEI). Which complication, from the long-term effect of hypertension, is not expected?

  hematuria and proteinuria

  abdominal aortic aneurysm

  decreased vision

  chronic venous insufficiency

 Question 9A patient with a history of atherosclerosis and HTN (hypertension) is complaining of chest pain, SOB, and pain radiating to his left arm.  He is diagnosed with an MI of his left ventricular wall. Which S&S should the nurse link to a reduced cardiac output?

  varicose veins with ankle edema.

  decreased urine output; cap refill > 4seconds.

  BP of 190/90; awake and alert.

  weak peripheral pulses; warm pink skin.

 Question 10A patient with a history of atherosclerosis and HTN (hypertension) is complaining of chest pain, SOB, and pain radiating to his left arm.  He is diagnosed with an MI of his left ventricular wall. Elevated levels of ______________ confirm the diagnosis.

  troponin.

  B-type natriuretic peptide (BNP).

  histamine.

  inotropes.

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 8 Quiz

Question 1A patient in the hospital is recovering from hip surgery.  She begins to complain of chest pain and dyspnea.  Her RR (respiratory rate) is 30.  A lung scan is performed and the V/Q ratio is reported to the nurse as “high.” This patient has most likely suffered a(n)  

  MI.

  pulmonary embolus.

  atelectasis

  episode of pulmonary edema.

 Question 2A patient, diagnosed with a high V/Q restrictive disorder, has shortness of breath and chest pain. In the categorization of a restrictive disorder, the pathophysiology student should identify that the patient has problems related to __________ and ____________.

  inhalation and hypoxemia

  inhalation and hypercapnia

  exhalation and hypoxemia

  exhalation and hypercapnia

 Question 3Arterial blood gases (ABGs) are drawn on a patient in the ED (emergency department). The results are: pH:  7.50; PO2: 100; PCO2: 29; HCO3: 26.  This acid base imbalance is called _________________     

  respiratory acidosis

  metabolic acidosis

   respiratory alkalosis.

  metabolic alkalosis.

 Question 4Arterial blood gases (ABGs) are drawn on a patient in the ED (emergency department). The results are: pH:  7.50; PO2: 100; PCO2: 29; HCO3: 26.  What mechanism is likely causing this disturbance?

  Hypoventilation

  Hyperventilation

  Hemoptysis.

   Orthopnea.

 Question 5Arterial blood gases (ABGs) are drawn on a patient in the ED (emergency department). The results are: pH:  7.50; PO2: 100; PCO2: 29; HCO3: 26.  What compensatory mechanism occurs with this acid base imbalance?

  The respiratory rate will increase.

  The respiratory rate will decrease.

  The kidney will make less HCO3.

  The kidney will make more HCO3.

 Question 6A child with laryngotracheobronchitis is likely to 

  have stridor from trying to exhale air from inflamed alveoli.

  develop a walled-off area of viral infection in the laryngeal area.

  have stridor from trying to inhale air through inflamed bronchi.

  have wheezing from trying to exhale through broncho constricted airways.

 Question 7A child is diagnosed with laryngotracheobronchitis. The RN (registered nurse) should provide the parents with instructions related to the________________.

  administration of antibiotics

  use of a cool mist humidifier

  insertion of a chest tube drainage system

  use of a peak flow meter

 Question 8A victim of a stab wound to the chest develops a pneumothorax. Which type of pneumothorax is most likely in his case?

  Consolidative.

  Tension

  Bronchial

  Open

 Question 9A common denominator of a bed-ridden nursing home patient and an unconscious  alcoholic is their high risk for

  aspiration pneumonia.

  bronchogenic carcinoma.

  nosocomial pneumonia.

  strictures in the pulmonary vessels.

 Question 10A patient is diagnosed with community-acquired pneumonia (CAP). Which S&S would the nurse expect to assess in the patient?   

  Hypercapnia and malaise.

  Fever, chills and cough.

  Frothy sputum and edema.

  Bradypnea and jugular vein distension.

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 9 Quiz

Question 1An elderly man develops postrenal acute kidney injury (AKI).  What is the most likely cause? 

  dehydration.

  a positive PSA.

   benign prostatic hyperplasia.

  sepsis.

Question 2Which condition predisposes a patient to developing an intrarenal acute kidney injury?

  Diabetes Mellitus.

  Hypotension.

  Uterine prolapse.

  Antibiotics.

Question 3The RN (registered nurse) is caring for a patient diagnosed with an acute kidney injury. Which laboratory values are most significant for diagnosing an acute kidney injury?

  BUN and creatinine

  Hemoglobin and RBC count.

  Potassium and sodium.

  Potassium and BUN.

 Question 4A patient is found to have hematuria, proteinuria, and an elevated serum creatinine. These findings indicate                                                                                 

  prerenal acute kidney injury

  acute tubular necrosis

  postrenal chronic kidney injury

  glomerulonephritis

 Question 5A patient is admitted with heart failure. Over a 30-hour period the patient develops oliguria.  His serum creatinine (SrCr) is measured at 1.4; the blood urea nitrogen (BUN) is measured at 34.   What type of problem is most likely?    

BUN (blood urea nitrogen):  8 to 25

Serum creatinine (SrCr):  0.6 to 1.2

  prerenal acute kidney injury

  acute tubular necrosis

  postrenal chronic kidney injury

  glomerulonephritis

 Question 6A patient is admitted with heart failure. Over a 30-hour period the patient develops oliguria and is diagnosed with AKI (acute kidney injury). Which assessment finding is expected in this patient? 

Urine specific gravity:  1.002 to 1.028.

   poor skin turgor.

  urine specific gravity of 1.000.

  urine specific gravity of 1.028.

   hypovolemia.

 Question 7A nurse taking care of a patient diagnosed with heart failure and prerenal AKI (acute kidney injury) notes that “casts” are now present on the patient’s urinalysis report. Which statement best describes the pathophysiologic rational for casts in this patient?

  As kidney tubular cells die, they slough off into the urinary tubules then are reabsorbed into the peritubular capillaries, causing arterial blockages called casts.

  Elevated levels of blood urea nitrogen cause the formation of crystals within the kidney tubular cells. These crystals are known as casts.

  Casts are evidence of dead kidney tubular cells as a result of the low cardiac output and prolonged ischemia from the heart failure problem.

  Oliguria has caused fluid volume overload. With a fluid volume overload, more pressure is exerted on Bowman’s capsule, causing the formation of casts.

 Question 8Drugs that ___________should not be used in chronic renal failure (CKD).

  enhance potassium secretion in the distal collecting tubule (DCT)

  enhance potassium reabsorption in the DCT

  decrease pruritis.

  enhance diuresis.

 Question 9A patient, diagnosed with CKD (chronic kidney disease) has hyperkalemia. Identify the pathophysiologic reason for this abnormality.

  Decreased levels of aldosterone cause increased retention of potassium (K+).

  With CKD, aldosterone pathologically increases K+ excretion into the kidney tubule.

  Increased diuresis has caused the loss of K+.

  Oliguria and a pathological response to aldosterone, cause K+ retention.

 Question 10A patient, diagnosed with CKD (chronic kidney disease) has hyperkalemia. The RN (registered nurse) immediately reports the value to the HCP (healthcare provider) because hyperkalemia can cause_________

  itching from an abnormal deposition on the skin.

  decreased mentation or altered level of consciousness.

  hyperpolarization of the resting membrane potential and bradycardia.

  hypopolarization of the resting membrane potential and tachycardia.

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 10 Quiz

Question 1Which statement, by the patient, supports the diagnosis of multiple sclerosis (MS)?

  “I had a really bad case of the flu a few weeks ago.”

  “I think one of my coworkers was also just diagnosed with MS.”

  “I should have a full recovery from this illness in a few days.”

  “I thought only elderly women got this disease?”

 Question 2Which assessment finding is expected in a patient with multiple sclerosis (MS)?

  Cogwheel rigidity and dysarthria.

  Ascending paralysis of the lower extremities.

  Asymmetric muscle weakness and ataxia.

  Photophobia and phonophobia.

 Question 3The RN (registered nurse) is taking care of a patient with Parkinson's disease (PD). Which assessment data support this diagnosis?

  Paresthesia and ataxia

  Dementia and emotional upset

  Drooping eyelid and muscle weakness

  Shuffling gait and mask-like facial expressions.

 Question 4A nurse reviewing the drug list of a Parkinson’s patient notes that he is on an anticholinergic drug. The nurse understands that the reason for the patient to be on this drug is most likely

  his increased risk of environmental allergies.

   to suppress some of the function of acetylcholine in the brain.

   to stimulate adrenergic receptors in the eyes.

  to decrease dopamine levels of the brain.

 Question 5A patient with myasthenia gravis (MG) is on a drug to block an enzyme called cholinesterase. This drug’s action will help the patient by decreasing the              

  amount of acetylcholine in neuromuscular junctions.

  build-up of senile plaques..

  effect of hypertonia.

   breakdown of acetylcholine in neuromuscular junctions.

 Question 6A patient, diagnosed with myasthenia gravis (MG), is complaining of diplopia and wants to know the reason for this ocular abnormality. The nurse demonstrates understanding of the disease and associated symptoms when he explains that

  “a lack of oxygen to your brain has caused swelling in the area of your optic nerve”.

  “the involuntary movements of your eye are caused by a lack of oxygen to a part of your brain”.

  “there is nothing wrong; you just have temporary pupillary constriction from the bright light”.

  “your disease decreases the strength of the eye muscles which can cause double vision”.

 Question 7A migraine abortive drug, such as Imitrex, will most likely be given in which situation?

  “I’ve had a migraine for hours—the pain is killing me.”

  “Nurse Ratchet, this patient is post-ictal.”

  “I’m having a pre-migraine aura, but it’s not bad.”

  “My dad’s memory is getting worse and worse.”

 Question 8A person diagnosed with meningitis will be at risk for

  increased intracranial pressure.

  decreased cerebral edema.

  a negative Kernig’s sign.

  motor tract decussation.

 Question 9CSF (cerebral spinal fluid) testing on a patient with fever and neck stiffness shows a high protein level.  This is most likely due to:

  leakage of protein into the CSF from traumatic injury.

  edema from an embolic stroke.

  the presence of bacteria in the CSF.

  the presence of amyloid in the CSF.

 Question 10Upon assessing his patient, a nurse notes hemiparesis of the right arm & leg and dysphasia which the patient states began 2 days ago. The nurse thinks it is most likely that the patient has had

  basal ganglion issues.

  a stroke involving the left hemisphere of the brain.

  a brain attack involving the right hemisphere of the brain.

   a TIA (transient ischemic attack) involving the left hemisphere of the brain.

 

 

NURS3366 Pathophysiologic Processes: Implications for Nursing

Module 11 Quiz

Question 1Following an illness, a patient becomes hypocalcemic.  Which of the following mechanisms will increase the calcium in her blood?

   the pituitary will decrease its secretion of T4.

  the thyroid will increase secretion of calcitonin.

   The pituitary will decrease its secretion of parathyroid hormone (PTH).

  The parathyroid will increase its secretion of PTH.

 Question 2Which statement, by a patient, would cause a registered nurse (RN) to suspect the patient is experiencing hyperthyroidism?

  “I just don’t seem to have an appetite anymore.”

  “My hair is falling out and my skin is always moist.”

  “My skin is really dry and course.”

  “I have not had a bowel movement in 4 days.”

 Question 3Lab work is done on a patient with untreated Grave’s disease.  The expected findings would be a _____TSH and a ___T4.                                

   low; high

   high; low

  normal; high

  high; normal.

 Question 4While examining a patient diagnosed with the extreme state of hyperthyroidism, a nurse notes ___________, which is associated with a(n) _______________.

  hypoventilation; myxedema coma.

  tetany; Addisonian crisis.

  a temperature of 105; thyrotoxic crisis.

  cretinism; adrenal crisis.

 Question 5Osteopenia is likely associated with all the following EXCEPT:

   low dietary calcium.

  hyperparathyroidism.

  high levels of calcitonin.

  increased osteoclastic activity.

 Question 6Drugs that _____________________ should be prescribed for the patient with osteoporosis.

   increase osteoclastic activity.

  increase calcium resorption.

  decrease osteoclastic activity.

   increase osteopenia.

 Question 7A patient is diagnosed with hypothyroidism. Which S&S (signs and symptoms) are expected?

  Complaints of fatigue and hair loss.

  Complaints of nervousness and exophthalmos.

  Tachycardia, increased appetite and diarrhea.

  A goiter and complaints of stiffness of the hands.

 Question 8A patient, diagnosed with hypothyroidism is prescribed a synthetic thyroid hormone (levothyroxine). Which assessment data indicate the medication has been effective?

  A measured heart rate of 48 beats/minute.

  A measured temperature of 98.6°.

  A 3-pound weight gain.

  Hypotension and hypoventilation.

 Question 9A patient who just came out of general anesthesia has lab work done.  The serum osmolality is 165.   The nurse taking care of this patient suspects that his _____ is due to _________.

Normal serum osmolality: 280 to 295

  hyperosmolality: diabetes insipidus (DI).

  hypoosmolality: syndrome of inappropriate ADH (SIADH).

   dry mucus membranes: SIADH.

   shift of calcium into blood: a state of hypopolarization inside the cells.

 Question 10A nurse, caring for a patient who has been diagnosed with diabetes insipidus (DI), would expect to find which sign and symptom (S&S)?   

   signs of cerebral edema such as decreased LOC.

  signs of cerebral cell dehydration such as headache.

   generalized edema

  crackles in the lungs upon auscultation.