UTA NURS3366 2021 October Module 2 Quiz Latest

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.

 Question 11Expected signs and symptoms for a patient with a serum osmolality of 300 would include____.

Normal osmo = 280- 295 

  signs of cerebral edema such as irritability

  signs of cerebral cell dehydration such as confusion

  pitting edema

  crackles in the lungs upon auscultation.

 Question 12A diabetic patient has pathological changes to his arteries that result in narrowing and blockage.  He is diagnosed with gangrene of the toes  (gangrene is when LOTS of cells die)..  Lab work is drawn and shows an elevated CK.  Which pathological process accurately explains this type of occurrence?

  necrosis-->gangrene-->ischemia-->creatine kinase spillage into blood.

  infarct--> cellular differentiation-->release of urea.

  ischemia-->cell injury-->swelling-->spillage of cellular enzymes into blood.

  metastasis-->superoxide dismutase--> release of free radicals.

 Question 13A patient says she has read that free radicals might be partly responsible for the development of her disease process.  She wants to know more information and if there is anything that can counteract free radicals. The nurse’s explanation will be based on understanding that all of the following statements are true EXCEPT    

   an example of a free radical is cytochrome oxide.

  free radical molecules initiate harmful reactions such as lipid peroxidation, which damages the lipids of cell membranes.

  the body’s way to counteract free radicals include enzymes such as superoxide dismutase.

   free radicals are molecules that are in a highly reactive state and can be calmed by taking certain vitamins.

 Question 14A patient who smokes expresses concern to his nurse about the metaplastic changes of the bronchi that were seen during his bronchoscopy. The nurse bases her response on the knowledge that this type of cellular change is __________________

  an irreversible cellular adaptation pattern.

  considered a precancerous cellular change.

  reversible if the change agent is removed.

  due to a physiologic  hyperplasia.

 Question 15Which sets of information are correctly linked?

  a patient with decreased RBC production: erythropoietin injections are needed to counteract overproliferation of red blood cells.

   arterial embolus blocks blood flow: decrease in venous circulation to tissue with resultant hypoxia of cells

   gout: caused by diet high in urea.

   carbon monoxide: binds to Hgb in oxygen’s place.

 Question 16A patient that has been recently diagnosed with a neuroma on the sole of his foot is very anxious.  Of the following, which information shows that the nurse understands the nomenclature of neoplasms when explaining the situation to the patient?

   “You should have the neuroma removed, as this is a cancer that will spread to other parts of the body.”

   “This is most likely a malignancy that will metastasize to your lymph nodes.”

  “Neuromas are benign growths that usually will not spread.”

   “ You will soon have the irresistible urge to put on tap shoes and dance in a Broadway musical.”

 Question 17A family nurse practitioner (FNP) tells a patient that her biopsy shows leiomyosarcoma staged at T2N2M0.  This patient has a 

   benign tumor of the endometrium.

   smooth muscle malignancy that has spread to the lymph nodes.

  a malignancy of the uterus that has spread to distant sites.

  muscle cell tumor that is a carcinoma.

 Question 18Which mini-concept map has correct linkage in describing cancer genesis?

  angiogenesis-->cachexia-->lack of nutrition-->cellular starvation-->cancerous changes

  growth factor signals-->increased cellular differentiation-->anaplasia-->cancer.

  oncogene-->clonal proliferation-->increased cellular differentiation-->cancer.

  oncogene-->clonal proliferation-->anaplasia-->cancer cells.

 Question 19Link the genetic etiology with the S&S of CML (chronic myelocytic leukemia):

  Genes on a defective chromosome malfunction and code for extreme leukocytosis.

  Myelocytic leukocytes attack cells in the blood and cause changes known as The Philadelphia Story.

  A genetic defect causes cancerous changes in the blood vessels, producing hemangiosarcomas.

  Genes on an extra chromosome malfunction and cause defects in leukocyte development, resulting in leukopenia.

 Question 20All of the linkages below are correct EXCEPT 

  cancer-related angiogenesis leaches nutrition from our cells--> cachexia, weakness.

   cancer injures prostate cells--> release into blood of high levels of a tumor marker called PSA (prostate-specific antigen)

  ingestion of foods high in preservatives-->increase genetic “hits”-->increased risk of cancer.

  age-related wear and tear of cells--> increased risk of cancerous lesions such as lipomas.