UTA NURS3366 2021 October Module 1 Quiz 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.”

 Question 11A patient is diagnosed with sickle cell disease (SSD). Which genetic scenario would result in the inheritance of this disease?

  aa

  a heterozygous pairing

  AA

  Different alleles on a gene locus

 Question 12A child with sickle cell anemia presents with pain all over, especially the joints. Which option best links the patho with S&S?

  Cyst formation in the kidneys leads to blood spillage from the circulation into the urine, thus causing anemia.

  A single-gene mutation causes malfunction of genetic coding for clotting properties, leading to bleeding and ischemic pain of the joints.

  Chromosomal aberrancy causes malformation of RBCs in the blood supply to the  joints and subsequent pain due to lack of oxygen.

  A single-gene mutation causes malfunction in RBC O2-carrying capacity, leading to ischemic pain in the joint tissues.

 Question 13The parents of a new baby with Down’s syndrome ask their nurse what to expect. She bases her answer on her understanding that the child will have

  developmental problems brought on by a sex-linked monosomy.

  developmental problems brought on by the pathologic interaction of 3 chromosomes where there should be only two.

  a phenotype based on defective mitochondrial protein synthesis that created aneuploidy.

  the phenotype of diminished IQ and physical differences that are caused by a single-gene disorder.

 Question 14A child is brought to her healthcare provider. Her parents state that no matter how much she eats, she keeps losing weight. She appears quite thin. Her blood sugar is markedly elevated. She is diagnosed with type I diabetes mellitus (DM 1). Which explanation bests links the pathophysiology with the S&S? In DM 1 the pancreas _____

   quits producing glucagon so that glycogen stores are inaccessible, thus causing weight loss.

  increases insulin production so that glucose stays in the blood, causing hyperglycemia.

   quits producing insulin so that glycogenolysis is stimulated and too much glucose enters the blood.

   quits producing insulin so that glucose cannot be used as energy in the cells, thus causing the body to burn up fat and protein for energy.

 Question 15A child is brought to her healthcare provider. Her parents state that no matter how much she eats, she keeps losing weight. She appears quite thin. Her blood sugar is markedly elevated. She is diagnosed with type I diabetes mellitus (DM 1). If ABGs were done on this patient, you would expect all the following EXCEPT:

   a blood pH of 7.32 because sustained gluconeogenesis causes acidic byproducts to accumulate.

  a HCO3 of 20 because the high numbers of acids in her body “take over” and “overcome” the HCO3, which then diminishes in number.

  a HCO3 of 30 because the low numbers of acids in her body stimulate an increase in HCO3.

  this acid/base imbalance to be called metabolic acidosis because it is an acidotic state caused by a metabolic disorder.

 Question 16A patient is diagnosed with metabolic acidosis.  Which compensatory response would you expect?

  Hyperventilation –increased respiratory rate (RR)– to “blow off” CO2; this is the lungs’ way to get rid of acids.

   Hypoventilation—decreased RR– to “ hold onto” CO2, since CO2 is an alkali that will counteract the acidosis.

   Kidneys will excrete more HCO3 into the urine to get rid of acidic byproducts.

  By hyperventilating and blowing off CO2, the body will bring the pH down to normal range.

 Question 17A child accidentally ingests an insecticide with the ingredient cyanide.  Knowing that cyanide suppresses the actions of cytochrome oxidase in the electron transport chain, what is a likely sign or symptom you would expect and why?

  Ketonuria due to increased glycogenesis.

  Confusion due to glycolysis.

  Mild euphoria due to enhanced production of ATP.

  Shortness of breath due to decreased ATP to use for the work of breathing.

 Question 18A patient with a serum calcium of 6.0 (norm = 8.5- 10.5) is most likely to ______  because_______.  

  be lethargic: the cells are hypopolarized.

  have muscle spasms: more Na+ has entered the cells.

  be weak: more Na+ has left the cells.

  have hyperirritable muscles: the cells are hyperpolarized.

 Question 19A patient has been vomiting copiously for 3 days. He is probably in ___ because _____.

  metabolic acidosis : vomiting often leads to hyperventilation.

  respiratory alkalosis : vomiting often leads to hyperventilation

  metabolic alkalosis : vomiting of the normal acidic digestive secretions of the stomach eventually depletes the body’s acids.

  metabolic acidosis : vomiting of the normal acidic digestive secretions of the stomach eventually depletes the body’s acids.

 Question 20A patient’s ABG results are pH:7.20; HCO3:17.   What might be the cause of this acid base imbalance?

  Large amount of alcohol consumed –> break down of alcohol causes a lot of acid byproducts –> excess acid accumulation in the blood –>  metabolic acidosis

  Hypoxia –> cells must continuously go through aerobic glycolysis –> excess pyruvate accumulation –> less ATP production. 

  Gastrointestinal flu –> diarrhea –> loss of HCO3 in the diarrhea –> HCO3 goes up –> causing the pH to go down.

  Kidney failure –> increased HCO3 production –> body compensates by decreasing the respiratory rate (hypoventilation) –> metabolic alkalosis.

 

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