Exam 2(v1): NSG 3850 / NSG3850 (2026 / 2027 Edition) Pathophysiology for Nurses II | 100% Correct Questions & Answers - Galen

Exam 2(v1): NSG 3850 / NSG3850 (2026 / 2027 Edition) Pathophysiology for Nurses II | 100% Correct Questions & Answers - Galen Question: Mr. Brown presents with complaints of a stiff rib cage & is having a hard time breathing. What do you suspect is his diagnosis? Answer : Sarcoidosis Question: This disease has an unknown cause many modifiable risk factors Answer : Primary Hypertension Question: What is the diagnosis for air leaking into tissue Answer : Subcutaneous Emphysema Question: Sharp stabbing pain relieved by rest is classified as what (in regards to vasculature) Answer : Arterial insufficiency Question: Varicose veins pose a patient at risk for Answer : Edema, Increased capillary refill pressure Question: What is the definitive test for pulmonary tuberculosis Answer : Acid Fast Bacilus Sputum Culture Question: A patient presents with a productive cough. The chest xray shows parenchymal infiltrates. What is the diagnosis of this patient? Answer : pneumonia Question: Your patient is working outside near a torn down building. What is this patient at risk for? Answer : Aspergillus Pneumonia Question: Hypercoagulable condition, pump failure, aging, trauma, surgery, vessel injury put patients at risk for this Answer : Thrombus Question: Aching and cramping in legs relieved by elevation is indicative of Answer : Chronic Venous Insufficiency Question: This disease speeds atherosclerotic process by thickening of endothelial tissue of large and small vessels Answer : Diabetes Question: A beefy red superficial wound at or around the ankle what kind of wound? Answer : Venous stasis ulcer Question: What do you hear with patients with mitral regurgitation? Answer : Pansystolic murmur Question: This disease process is Idiopathic in 80-90% of people. It may be congenital or neuromuscular. It causes compression of lung volumes and leads to atelectasis. Answer : Kyphosis Question: What process develops due to imbalances in various pressure systems within the lungs? Answer : Pleural effusion Question: This disease process commonly develops in patients receiving chemotherapy Answer : Thrombocytopenia Question: What is the restrictive and occupational lung disease that affects non smokers? Answer : Hypersensitivity pneumonitis (Hypersensitivity reaction III) Question: What are the clinical manifestations of emphysema? Answer : Barrel chest, dyspnea, thin, Sao2 of 85%, clubbing fingers, pursed lip breathing, decreased breath sounds Question: A patient is diagnosed with buerger's disease the clinical manifestations of this disease closely resemble those of what other disease process? Answer : arterial occlusion Question: This respiratory pattern is a normal human response to altitude, fever, or pain Answer : Hyperventilation Question: Pt has asystole and revived, now in a)______ hypoxia causing b)_______ Answer : a) Circulatory b) Decrease cardiac output Question: What are the clinical manifestations of cardiac tamponade: Answer : Becks triad: Hypotension, distended neck veins, muffled heart sounds Question: A recent onset of a cough is indicative of what? Answer : Acute bronchitis Question: What are the backward effects of right sided heart failure? Answer : Enlarged liver and spleen, anorexia, jugular vein distension , ascites, abdominal distension, & subcutaneous edema Question: A patient has a BMI of 31.8 and has had several upper respiratory infections within the last few years, what is the risk associated with this patient? Answer : Chronic Bronchitis Question: This occurs due to the loss of elasticity in lung tissue Answer : Barrel Chest Question: What is the difference between a hypertension emergency vs urgency? Answer : Hypertensive emergency deals with organ death Question: What substance can cause vasoconstriction of vessels, increase blood pressure, & increase cholesterol? Answer : Nicotine In what disease process do fingers go from white to blue to red? Answer : Raynaud's syndrome What are the clinical manifestations of hypotension? Answer : Fatigue, dizziness, weakness, blurred vision, & syncope A patient reports to the office with the complaints of swelling, redness, & cramping in her right leg. What do you suspect her diagnosis will be? Answer : Deep Vein Thrombosis (DVT) What is missing in hemophilia patients? Answer : Intrinsic Factors (Factor 8 & 9) What lab values do you expect to be abnormal for hemophilia patients? Answer : PTT (increased), normal or slightly increased bleeding time What disease causes an increase in capillary hydrostatic pressure causing fluid to leak? Answer : Venous Obstruction Pulmonary hypertension, progressive fatigue, hempyphis, & dyspnea are all clinical manifestations of what disease? Mitral valve stenosis What type of stenosis is due to aging and calcification on the aortic cusp? Aortic stenosis Mitral stenosis can lead to what within the atrium of the heart? Atrial Fibrillation A patient with aortic valve stenosis reports complaints of what? Palpitations, chest pains, fatigue, & syncope Platelets and fibrins clump and collect on valve leaflets in which valve disorder? Rheumatic heart disease A patient with acute infective endocarditis can develop valvular insufficiency & stroke A patient with chronic pericarditis presents with weakness and fatigue. From what occurrence do these clinical manifestations come from? Adhesion of the heart and surrounding mediastinum tissue A patient develops edema after sitting in chair, what type of heart failure is present? Right sided heart failure What are the backwards effects of left sided heart failure? Pulmonary congestion, dyspnea, orthopnea, cough, crackles in lungs, pulmonary edema Why does a patient develop cor pulmonale? Increased resistance in pulmonary arteries leads the right side of the heart to compensate A patient is diagnosed with a pneumothorax. What is the pathogenesis of this disease process? Air is trapped in the pleural space and cannot escape & causes the lung to collapse. Patients with varicose veins are at risk for developing Increased capillary pressure A patient with aortic stenosis may report feeling syncopal Why does a lung patient develop cor pulmonale? Right ventricular hypertrophy secondary to pulmonary hypertension What should be taught to a patient with ankylosing spondylitis? Respiratory function will become limited, fibrosis or hardening will occur in the upper lobes of the lungs, & muscles in the chest wall can atrophy What are the common clinical manifestations for asthma? Airway edema, mucous secretions, bronchoconstriction, & wheezing What is a common clinical manifestation of a tension pneumothorax? A tracheal shift occurs to the opposite side of the the pneumothorax What is commonly seen with a pleural effusion? Tracheal shift The patient asks why lung problems caused a heart problem, cor pulmonale. What response is best? - Increased resistance to pulmonary arterial flow leads to compensatory right ventricular hypertrophy - Cor pulmonale is right ventricular hypertrophy that occurs as a compensatory response to chronically increased resistance to pulmonary arterial flow What is the amount of gas remaining within the lungs after MAXIMAL respiration Residual volume What is a common characteristic of viral pneumonia? Dry Cough What are the clinical manifestations associated with chronic bronchitis? Productive cough for 3 months, abnormal lung sounds, & hypersecretion of mucous What does mucus supply a hospitable environment for in a patient with chronic bronchitis? Bacterial colonization and recurrent infections What are the clinical manifestations associated with legionnaires disease? Fever, diarrhea, abdominal pain, & pneumonia What is the route of transportation that legionnaires disease is found in? An organism within contaminated water What kind of treatment does legionnaires require? Antimicrobial A deficiency of Von Willebrand Factor impairs what? Platelet adhesion to injure tissues What is the #1 symptom associated with Von Willebrand disease? Bleeding Atherosclerosis puts a patient at risk for which of the following problems? Ischemic stroke from the weakening of the blood vessels in the brain Renal impairment because of changes in the microcirculation Retinal injury because of changes in the microcirculation While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of lowdensity lipoproteins (LDLs). What is the significance of this finding? Increased LDL levels are associated with increased risk of coronary artery disease A high-fat diet can overwhelm the liver's ability to clear LDL cholesterol from the circulation and result in Hyperlipidemia Angina cause by artery spasms is called ____ or ____ Variant // Prinzmetal Pt.s presenting with symptoms of unstable angina and no ST segment elevation are treated with... Percutaneous coronary intervention Cor pulmonale refers to Right ventricular hypertrophy secondary to pulmonary hypertension A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relived by rest, the likely cause of his pain is Stable angina Is myocardial infarction pain relieved by rest? No Mitral stenosis is associated with A pressure gradient across the mitral valve A loud pansystolic murmur that radiates to the axilla is the result of Mitral regurgitation Increase of air entering the alveoli leads to hypocapnia (PaCO2 35 mm Hg) Hyperventilation Cause of hyperventilation Pain fever anxiety obstructive and restrictive lung diseases sepsis high altitude brainstem injury PaO2 is low despite normal O2-carrying capacity Causes include high altitude, hypoventilation, obstruction Hypoxic hypoxia A decrease in O2 carrying capacity Low Hgb Anemic hypoxia Low cardiac output; SHOCK, cardiac arrest, severe blood loss, CHF, thyrotoxicosis O2-carrying capacity is normal but blood flow is reduced Circulatory hypoxia Decreased O2 carrying capacity from a toxic substance; cyanide poisoning Histotoxic hypoxia Manifestations of acute bronchitis Usually mild and self-limiting Cough (productive or non-productive) Recent onset Low-grade fever Substernal chest discomfort Sore throat Postnasal drip Fatigue Cause of chronic bronchitis Cigarette smoking (90%) Repeated airway infections Overweight Genetic predisposition Inhalation of physical or chemical irritants Chronic or recurrent productive cough 3months and 2+ successive years Testing for chronic bronchitis Chest x-ray PFTs ABGs ECG Secondary polycythemia Typical patient is overweight Commonly associated with emphysema SOB on exertion Excessive sputum Chronic cough (more severe in mornings) Evidence of excess body fluids (edema, hypervolemia) Cyanosis (late sign) Crackles, rhonchi, and wheezes; use of accessory muscles to breathe; JVD; clubbing; and pedal/ankle edema Manifestations of chronic bronchitis Pathogenesis of emphysema (1) Release of proteolytic enzymes from neutrophils and macrophages leading to alveolar damage (2) α1-Antitrypsin deficiency (3) Smoking causes alveolar damage (4) Inflammation leads to release of proteolytic enzymes (5) Inactivates α1-antitrypsin (normally protects lung parenchyma) (6) Reduction in pulmonary capillary bed (7) Loss of elastic tissue in lung (8) Air becomes trapped in distal alveoli (9) Loss of alveolar wall and air trapping leads to bullae (large, thin-walled cysts in the lung) formation A common feature of sarcoidosis is the presence of CD4+ T cells. Commonly effects lungs and lymph nodes (and multiple organ systems) Immunologic basis is most likely cause Activation of alveolar macrophage to unknown trigger First degree relative increases risk 5-fold Cause of sarcoidosis Manifestation of sarcoidosis Malaise, fatigue Weight loss Fever Dyspnea of insidious onset Dry, nonproductive cough Erythema nodosum Macules, papules, hyperpigmentation, and subcutaneous nodules Hepatosplenomegaly, lymphadenopathy Liver enzymes tested Swollen lymph nodes Known as extrinsic allergic alveolitis Restrictive and occupational disease Inhaled organic agents are responsible for the inflammatory process Predominant in nonsmokers (80% to 95%) Cause of hypersensitivity pneumonitis Results from buildup of air under pressure in pleural space Can occur from a penetrating lung injury This is like a one way valve- air comes in the puncture wound, but can't move out. No way for the air to escape Tension pneumothorax Air enters pleural space during inspiration but cannot escape during expiration "sucking" chest wound that is open, BUT can't let the air out. Lung on ipsilateral (same) side collapses and forces mediastinum toward contralateral (opposite) side All of this above - Decreases venous return and cardiac output Tension pneumothorax Pathologic collection of fluid or pus in pleural cavity as result of another disease process Constant movement of pleural fluid from parietal pleural capillaries to pleural space, reabsorbed into parietal lymphatics Changes in pleural capillary hydrostatic pressure, colloid oncotic pressure, or intrapleural pressure Imbalance in pressure associated with fluid formation exceeding fluid removal Causes of pleural effusion Causes of kyphoscoliosis Muscular dystrophy Marfan syndrome Idiopathic - Unknown Congenital - @Birth ankylosing spondylitis manifestations Low- to mid-back pain and stiffness increased with prolonged rest Pain and stiffness decrease with exercise Restrictive lung dysfunction Rib cage movement reduction Chest wall muscular atrophy Don't use it - you lose it Breathing by excursion of diaphragm with rib cage immobilization Increase abdominal size can force abdominal contents upward into the chest cavity decreasing _________________________________ lung expansion and diaphragmatic shortening Immunocompromised patients (HIV-AIDS) Pneumocystis jiroveci OR PCP Pneumonia Opportunistic fungal infection Common in patients with cancer or HIV Aspergillus Opportunistic fungal infection Released from walls of old buildings under reconstruction Special care in construction in old hospital buildings. Move patients at risk. Opportunistic pneumonias Viral pneumonia symptoms Fever, nonproductive cough, hoarseness, coryza (Inflammation of the mucous membrane in the nose) Accompanied by wheezing/rales TB cause Acid-fast aerobic bacillus Infects lungs and lymph nodes Can infect any organ, but lungs/lymph are most common M. tuberculosis organisms prefer lung apices because of the higher concentration of oxygen in this area Manifestations of TB Parenchymal complex Well-circumscribed necrotic nodule that becomes fibrotic and calcified Lymph components How to test for TB Sputum culture (definitive diagnosis) Three consecutive morning specimens Identify slow-growing acid-fast bacillus How to collect a sputum specimen Clear mouth Inhale and exhale deeply 3 times Spit in cup _________ will result in increased LDL lipoprotein cholesterol & triglycerides Nicotine Smoking affects the lining of blood vessels in a way that increases the risk of ____________________ thrombus formation Myocardial oxygen supply is decreased r/t _____________ that occur r/t smoking/nicotine Vasospasms Hypertensive emergency manifestations None/Silent killer If uncontrolled, can lead to CAD, renal failure, stroke, angina, MI Warning S/S Headache Persistent nosebleed Chest pain Palpitation People at risk for hypertensive emergencies African Americans Males Compensatory mechanisms for low blood pressure CO will increase and redistribute volume Vasoconstriction of peripheral vessels to increase BP White fingertips - cyanosis - red from reactive hyperemia Pain and numbness caused by affects local nerve function At increased capillary pressure & edema Manifestation of raynauds syndrome Manifestations of Buerger's disease Cool to touch, decreased hair growth, dry, thin, glossy skin, diminished or absent pulses, sharp stabbing pain, ulcer Manifestations of acute peripheral arterial occlusion Cool or cold to touch Decreased or absent hair growth Dry, thin, glossy appearance Thickened nails Pallor when elevated, rubor when dependent Diminished or absent pulses Pain associated with acute peripheral arterial occlusion Sharp and stabbing Intensified with activity Relieved by rest or dependency Ulcer characteristics of acute peripheral arterial occlusion Severely painful Pale, gray base Well-defined edges Located on heels, lateral malleolus, between distal portions of phalanges, pretibial area Impaired venous return Pooling of blood in the extremity Increased capillary pressure and the involved limb becomes edematous Venous ulcers causes Clinical manifestations of venous ulcers Aching Heavy discomfort Darkened raised tortuous veins "Red Beefy" "wet" Commonly found around medial part of ankle Venous stasis ulcer, warm, tough and thickened skin, areas of dark pigmentation, aching, cramping, edema Pain relief with ambulation - Why? - improves the circulation Relief of swelling and related symptoms when area elevated Chronic venous insufficiency Cause of thrombocytopenia due to suppression or destruction of red bone marrow from cancer or chemotherapy Factor VIII or IX deficiency Factor deficiency or the abnormal function of factor VIII. A deficiency or malfunction in either factor interferes with the normal sequence of events in the intrinsic pathway of coagulation and, in turn, the eventual production of a fibrin clot. Inability to form a fibrin clot results in bleeding. Hemophilia Left sided heart failure BACKWARDS EFFECTS: _________ ejection fraction __________ pulmonary hypertension ___________ congestion ____________ ventricular hypertrophy Can lead to right sided heart failure Decreased Increased pulmonary Right Right sided heart failure FORWARDS EFFECT: ____________ cardiac output _____________ tissue perfusion Decreased tissue perfusion especially to the ____________ Decreased Decreased Brain Dyspnea on exertion Orthopnea Cough Paroxysmal nocturnal dyspnea Cyanosis Basilar crackles Backward effects of left sided heart failure Fatigue Oliguria Increased heart rate Faint pulses Restlessness Confusion Anxiety Forward effects of left sided heart failure BACKWARD EFFECTS of right sided heart failure: Increased pulmonary resistance leading to ____________________________. right ventricular hypertrophy FORWARD EFFECTS of right sided heart failure: Reduced cardiac output Hepatomegaly Ascites Splenomegaly Anorexia Subcutaneous edema Jugular vein distention Backward effects of right sided heart failure Fatigue Oliguria Increased heart rate Faint pulses Restlessness Confusion Anxiety Forward effects of right sided heart failure Cause of right sided heart failure Left ventricular failure Cor pulmonale Mitral Valve Stenosis Pulmonary diseases Can occur without Left sided heart failure Atypical angina manifestations Back pain, fatigue, weakness Heavy chest pressure, jaw, neck and arm pain Indigestion or dental pain Burning, crushing, choking, squeezing chest pain Prolonged or severe ischemia can result in cardiac arrest “An elephant is sitting on my chest” or tight fist on the chest. More pronounced during exercise and stress- relief with rest and NTG Dyspnea and chest pain are relieved by rest and NTG. Typical or classic angina manifestation The occlusion is partial or the clot is dissolved before the death of myocardial tissue. Unstable angina The occlusion is complete and the thrombus persists long enough for development of irreversible damage to myocardial cells, resulting in necrosis. MI Women, the elderly, and patients with Diabetic Neuropathies more commonly complain of atypical angina manifestations Blood flow from the left atrium into the left ventricle is impaired leading to increased pressure in the left atrium with possible fibrillation Increased pressure work of the left atrium leads to atrial chamber enlargement and hypertrophy. Metal valve stenosis Causes congestion of blood volume and increased pressure in the left atrium and pulmonary circulation leading to pulmonary venous hypertension: Progressive fatigue exhibited Dyspnea Hemoptysis Manifestations of mitral valve stenosis Decreased stroke volume of ___________ Atrial enlargement and fibrillation predispose to development of _________ exertional dyspnea is a WARNING SIGN left ventricle arterial clots Mitral valve regurgitation is diagnosed with hearing a ____________________________ murmur loud, pansystolic, high pitched blowing Predominant cause if age-related calcifications Calcium deposits on the aortic cusps Post-inflammatory scarring Senile calcific aortic stenosis Calcification of a congenitally deformed valve - Aortic cusp calcifications Aortic Valve stenosis Aortic valve stenosis manifestations Syncope Fatigue Low systolic B/P Faint pulses Angina Endocardial inflammation results in valvular swelling, erosions, and clumping platelets and fibrin on valve leaflets. Scarring and shortening of valvular structures become progressively more severe Rheumatic heart disease Invasion and colonization of endocardial structures by microorganisms Acute and subacute infective endocarditis results in the growth of bacteria-laden vegetations on heart valves. In addition to valvular erosion and scarring, embolization may occur. Infective carditis Beck's triad Hypotension Distended neck veins Muffled heart sounds external compression of the heart chambers such that filling is impaired cardiac tamponade Pericardial sac is destroyed, and external aspect of the heart adheres to surrounding mediastinal structures. Contraction of the heart is constricted Pericardial sac becomes dense, nonelastic, fibrous, and scarred. Diastolic filling restricted as pericardial sack is stiff Chronic pericarditis Acute bronchitis Temporary inflammation of the trachiobrachial tree Caused by inhalation of smoke or some bacterial, fungal, or viral issue RECENT ONSET OF COUGH Hyper secretion of mucus chronic bronchitis CB: desaturation (cyanosis) and edema associated with______________________ in advanced disease or exacerbations right sided heart failure _____ is the persistent narrowing of the airways r/t chronic inflammation, scarring, and excessive mucus production Chronic Bronchitis Chronic Bronchitis can cause secondary polycythemia o Antigen-antibody complexes then elicit granulomatous inflammation leading to lung tissue injury o Leads to diffuse pulmonary fibrosis in upper lobes (hallmark of disease) Hypersensitivity pneumonitis Chronic inflammation at site of ligamentous insertion into spine or sacroiliac joints ankylosing spondylitis