NURS 5315 Final Exam Questions and
Answers
1. A patient in respiratory distress and is breathing 33 breaths
per minute. Which ABG value is consistent with the clinical
scenario?
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%: A patient who is breathing 33 breaths per minute is hyperventilating and blowing ott
CO2; therefore the PCO2 level will be low. The patient will most likely experience a respiratory alkalosis
and the two pH values provided are not consistent with this diagnosis.
2. A patient has a sodium level of 115 mEq/L and is disoriented and
lethargic. Which pathological process best explains this patient's
symptoms?
a. The action potential has become hyperpolarized.
b. Water has shifted into the neurons and caused them to swell.
c. Water has shifted into the vascular space and dehydrated the
neurons.
d. The action potential has become hypopolarized.: b. The cause of neurologic
symptoms associated with a sodium imbalance is directly related to fluid shifting into or out of the
neurons of the brain. With a serum sodium of 115 mEq/L, water shifts into the neurons and causes them
,to swell. Hypernatremia causes water to shift out of the cell into the intravascular space and causes the
neurons to become dehydrated. An alteration in the action potential is not seen with sodium
imbalances.
3. A patient experiencing dehydration should be monitored for
which elec- trolyte imbalance?
a. Hyperkalemia
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia: a. Serum osmolality is increased during times of dehydration. An elevated
serum osmolality will pull potassium into the intravascular space from the intracellular space and
cause a rise in serum potassium.
4. A married couple presents to your office for genetic counseling.
The husband has an autosomal recessive disease and his wife has a
heterozygous genotype for the disease. They ask you, What is the
chance that our baby will have the disease? Which of the following
answers is correct?
25%
50%
75%
100%: A chromosome is a package of material located inside the cell nucleus which is made of
proteins and a single molecule of DNA. There are 23 pairs of chromosomes in each human cell for a
total of 46 chromosomes. Chromosomes are separated into two identical sets during mitosis or
,meiosis. This provides a set of chromosomes to each daughter cell which results from cell division. This
process is responsible for the transfer of genetic information to the daughter cells. The first 22 pairs of
chromosomes are known as autosomes. The 23rd pair of chromosomes is the pair which contains the
genetic information for gender. This pair contains the genetic information which delineates between the
male and female genders. Females have two X chromosomes (XX) and males have an XY chromosome
pair. Autosomal chromosomes are said to be autologous. This means they do not carry genetic
information pertaining to gender.
Autosomal genetic diseases are carried on the first 22 pairs of chromosomes. Sex-linked diseases are
only carried on the 23rd pair of chromosomes. The autosomal chromosomes are nearly identical to one
another and are considered homologous to one another. Each autosomal chromosome in a pair carries
identical genes. These two genes are known as alleles. The alleles occupy the same site on each partner
of the chromosome pair and code for the same genetic trait or physiologic function. Alleles can be
dominant or recessive. One allele may be dominant and the other recessive, or they both may be
dominant or both recessive. The dominant alleles' genetic code will always manifest in the individual's
phenotype. The information in the recessive allele is typically not expressed in the phenotype unless
both alleles are recessive. For the purpose of clarity in use, the dominant gene is assigned a capital
letter and the recessive gene is assigned a lower case letter. Any letter is okay to use but make sure
you use the same letter for the genotype - for example, "Bb or aa." The term homozygous refers to a
pair of alleles which are either both dominant or recessive.
For example, "BB or bb" are said to be homozygous because the alleles are either both dominant or
recessive. An allele pair in which one is dominant and one is recessive is said to be heterozygous. In
autosomal recessive disorders both alleles on the chromosome are attected by the genetic aberration. If
only one recessive gene is attected by the genetic aberration then the person is said to be a carrier and
will not have the phenotypic expression of the disease. The healthy, recessive allele will compensate for
the allele which is attected by the genetic aberration. The carrier can pass the trait but does not have the
, genetic disease. In an autosomal dominant disorder the dominant gene is the only gene that has to be
attected by the genetic aberration in order to have the phenotypic expression of the disease. A healthy
recessive allele cannot compensate for a diseased dominant allele. In order to answer this question one
must understand the above information and draw a Punnett Square.
The husband has an autosomal recessive disease which means his genotype must be aa. The wife has
a heterozygous genotype for the disease which means her genotype is Aa. The capital A reflects a healthy
gene so she is merely a carrier and does not express the disease phenotype. The father's genotype is
written across the top line and the mother's genotype is written in the boxes to the left. The four boxes
in the middle are the possible genotypes of their ottspring.
Each box represents a 25% chance for the ottspring to have that particular genotype. The question asks you to
determine the chances the ottspring will have the autosomal recessive disease or in other words,
express the phenotype for the disease. The genotype which will result in the disease is "aa." Therefore,
there is a 50% chance that their ottspring will have the autosomal recessive disease.
5. A child is diagnosed with hemophilia. This is an example of
which genetic concept?
Phenotype
Genotype
Autosomal transmission of the disease
Transcription: The expression of a genetic disease is an example of a phenotype. A genotype is
a gene's programming. Hemophilia is transmitted on the x-chromosome and is not transmitted via the
autosomes. This is not an example of transcription.
6. Dehydration triggers which physiologic response?
Answers
1. A patient in respiratory distress and is breathing 33 breaths
per minute. Which ABG value is consistent with the clinical
scenario?
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%: A patient who is breathing 33 breaths per minute is hyperventilating and blowing ott
CO2; therefore the PCO2 level will be low. The patient will most likely experience a respiratory alkalosis
and the two pH values provided are not consistent with this diagnosis.
2. A patient has a sodium level of 115 mEq/L and is disoriented and
lethargic. Which pathological process best explains this patient's
symptoms?
a. The action potential has become hyperpolarized.
b. Water has shifted into the neurons and caused them to swell.
c. Water has shifted into the vascular space and dehydrated the
neurons.
d. The action potential has become hypopolarized.: b. The cause of neurologic
symptoms associated with a sodium imbalance is directly related to fluid shifting into or out of the
neurons of the brain. With a serum sodium of 115 mEq/L, water shifts into the neurons and causes them
,to swell. Hypernatremia causes water to shift out of the cell into the intravascular space and causes the
neurons to become dehydrated. An alteration in the action potential is not seen with sodium
imbalances.
3. A patient experiencing dehydration should be monitored for
which elec- trolyte imbalance?
a. Hyperkalemia
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia: a. Serum osmolality is increased during times of dehydration. An elevated
serum osmolality will pull potassium into the intravascular space from the intracellular space and
cause a rise in serum potassium.
4. A married couple presents to your office for genetic counseling.
The husband has an autosomal recessive disease and his wife has a
heterozygous genotype for the disease. They ask you, What is the
chance that our baby will have the disease? Which of the following
answers is correct?
25%
50%
75%
100%: A chromosome is a package of material located inside the cell nucleus which is made of
proteins and a single molecule of DNA. There are 23 pairs of chromosomes in each human cell for a
total of 46 chromosomes. Chromosomes are separated into two identical sets during mitosis or
,meiosis. This provides a set of chromosomes to each daughter cell which results from cell division. This
process is responsible for the transfer of genetic information to the daughter cells. The first 22 pairs of
chromosomes are known as autosomes. The 23rd pair of chromosomes is the pair which contains the
genetic information for gender. This pair contains the genetic information which delineates between the
male and female genders. Females have two X chromosomes (XX) and males have an XY chromosome
pair. Autosomal chromosomes are said to be autologous. This means they do not carry genetic
information pertaining to gender.
Autosomal genetic diseases are carried on the first 22 pairs of chromosomes. Sex-linked diseases are
only carried on the 23rd pair of chromosomes. The autosomal chromosomes are nearly identical to one
another and are considered homologous to one another. Each autosomal chromosome in a pair carries
identical genes. These two genes are known as alleles. The alleles occupy the same site on each partner
of the chromosome pair and code for the same genetic trait or physiologic function. Alleles can be
dominant or recessive. One allele may be dominant and the other recessive, or they both may be
dominant or both recessive. The dominant alleles' genetic code will always manifest in the individual's
phenotype. The information in the recessive allele is typically not expressed in the phenotype unless
both alleles are recessive. For the purpose of clarity in use, the dominant gene is assigned a capital
letter and the recessive gene is assigned a lower case letter. Any letter is okay to use but make sure
you use the same letter for the genotype - for example, "Bb or aa." The term homozygous refers to a
pair of alleles which are either both dominant or recessive.
For example, "BB or bb" are said to be homozygous because the alleles are either both dominant or
recessive. An allele pair in which one is dominant and one is recessive is said to be heterozygous. In
autosomal recessive disorders both alleles on the chromosome are attected by the genetic aberration. If
only one recessive gene is attected by the genetic aberration then the person is said to be a carrier and
will not have the phenotypic expression of the disease. The healthy, recessive allele will compensate for
the allele which is attected by the genetic aberration. The carrier can pass the trait but does not have the
, genetic disease. In an autosomal dominant disorder the dominant gene is the only gene that has to be
attected by the genetic aberration in order to have the phenotypic expression of the disease. A healthy
recessive allele cannot compensate for a diseased dominant allele. In order to answer this question one
must understand the above information and draw a Punnett Square.
The husband has an autosomal recessive disease which means his genotype must be aa. The wife has
a heterozygous genotype for the disease which means her genotype is Aa. The capital A reflects a healthy
gene so she is merely a carrier and does not express the disease phenotype. The father's genotype is
written across the top line and the mother's genotype is written in the boxes to the left. The four boxes
in the middle are the possible genotypes of their ottspring.
Each box represents a 25% chance for the ottspring to have that particular genotype. The question asks you to
determine the chances the ottspring will have the autosomal recessive disease or in other words,
express the phenotype for the disease. The genotype which will result in the disease is "aa." Therefore,
there is a 50% chance that their ottspring will have the autosomal recessive disease.
5. A child is diagnosed with hemophilia. This is an example of
which genetic concept?
Phenotype
Genotype
Autosomal transmission of the disease
Transcription: The expression of a genetic disease is an example of a phenotype. A genotype is
a gene's programming. Hemophilia is transmitted on the x-chromosome and is not transmitted via the
autosomes. This is not an example of transcription.
6. Dehydration triggers which physiologic response?
