PORTAGE LEARNING PATHOPHYSIOLOGY NURS 231
BIOD 331 FINAL EXAM & MODULE 1-10 EXAMS ALL
VERSIONS LATEST UPDATE A+ GRADED
The nurse is caring for patients on a cardiac unit. Which patient should
the nurse assess first?
a) The patient diagnosed with Heart Failure who has bilateral 3+
peripheral edema.
b) The patient diagnosed with mitral valve regurgitation who has dyspnea
on exertion.
c) The patient diagnosed with angina who is reporting chest pain.
d) The patient diagnosed with pericarditis who has a temperature of 100
degrees F.
c) The patient diagnosed with angina who is reporting chest pain.
*A patient with a history of angina should be pain-free. If he/she is not,
then there may be myocardial ischemia occurring. All of the other choices
represent expected, but non-lifethreatening findings for the diagnosis.
The nurse is caring for a patient with Diabetic Ketoacidosis. Which of the
following is the most concerning assessment finding?
a) Blood pressure is 103/78.
b) Blood sugar is 565.
c) Urine is dark and cloudy.
d) Patient is confused and agitated.
d) Patient is confused and agitated.
*A patient in DKA is at risk for impaired central perfusion, secondary to
hypovolemia. Confused and agitated is an indicator of poor perfusion to
the brain and is the priority issue. Blood pressure is acceptable, but note
the narrowed pulse pressure indicating compensatory vasoconstriction.
,You are monitoring the patient undergoing exercise EKG (stress test).
Which of the following criteria would indicate that the test should be
stopped prematurely?
a) If the patient's respiratory rate exceeds 24 breaths/minute
b) When the incline of the treadmill reaches 10% elevation
c) If the patient's EKG indicates significant ST segment depression
d) When the patient's heart rate reaches 120 beats/minute
c) If the patient's EKG indicates significant ST segment depression
*ST depression may indicate cardiac ischemia. All other choices are
expected.
A patient is admitted to the intensive care unit for treatment of shock.
The prescriber orders norepinephring (Levophed). The nurse expects this
drug to increase tissue perfusion in this patient by primarily activating:
a) alpha1 receptors to cause vasodilation.
b) beta2 receptors to cause bronchodilation.
c) beta1 receptors to cause a positive inotropic effect.
d) alpha1 receptors to increase blood pressure.
d) alpha1 receptors to increase blood pressure.
A patient comes into the emergency department with extensive bleeding
from face, arm, and chest wounds. What is the earliest manifestation of
hypovolemic shock likely to be detected in this patient?
a) Increased respiratory rate.
b) Increased heart rate.
c) Decreased blood pressure.
d) Cool, pale skin.
b) Increased heart rate.
Your patient had sudden, sharp chest pain and is breathing rapidly. The
provisional diagnosis is acute pulmonary embolism. Which of the following
arterial blood gas results would you expect to see during the first 20
minutes after the start of this episode?
a) pH 7.30 HCO3 22 PCO2 60 PO2 66
,b) pH 7.46 HCO3 28 PCO2 65 PO2 75
c) pH 7.38 HCO3 22 PCO2 45 PO2 96
d) pH 7.47 HCO3 22 PCO2 25 PO2 70
d) pH 7.47 HCO3 22 PCO2 25 PO2 70
*Remember that a patient with a PE will be tachypneic, which leads to an
increased excretion (blowing off) of CO2, which causes a respiratory
alkalosis. Additionally, hypoxemia would be expected.
The patient is diagnosed with heart failure. The nurse finds the patient
lying in bed, short of breath, unable to talk, and with buccal cyanosis.
Which intervention should the nurse implement first?
a) Call Rapid Response Team.
b) Assist the patient to a sitting position.
c) Assess the patient's vital signs.
d) Asuscultate the patient's lung sounds.
b) Assist the patient to a sitting position.
*Sitting the patient up will decrease venous return, thereby reducing
preload and therefore reducing the workload of the heart. It will also
maximize lung expansion. This hopefully will alleviate some of the
patient's respiratory distress. The nurse may need to call RRT if sitting the
patient up doesn't alleviate the distress, or if further assessment
warrants--but it's not the first action. More assessment is not needed at
this time. There is enough assessment data in the stem of the question to
make a decision.
The nurse is caring for a post-operative patient who suddenly reports
sharp chest pain and dyspnea. She is tachycardic. What is the nurse's
priority action?
a) Stat page the respiratory therapist and call for the intubation kit.
b) Auscultate the lung sounds for changes.
c) Check the patient's blood pressure.
d) Increase the oxygen flow rate and elevate the head of the bed.
, d) Increase the oxygen flow rate and elevate the head of the bed.
*Remember--if the stem of the question includes enough assessment data
to indicate "distress" (patient is in a potentially life-threatening situation)
then do not choose any more assessment.
"When in distress, do not assess".
During the activation of the stress response, there is an increased
secretion of aldosterone. Which finding is not an effect you will see with
the release of this hormone?
a) Water retention
b) Calcium excretion
c) Potassium excretion
d) Sodium retention
b) Calcium excretion
Your patient has fine crackles in bilateral lung bases; CVP = 8 mmHg (CVP
yesterday was 5mmHg); IV of D5%/0.25 NS @ 75 mL/hr; urine output over
last 10 hours =230 ml. Does the data in this case point to FVD (Fluid
volume deficit) or FVE (Fluid volume excess)?
a) fluid volume excess
b) fluid volume deficit
c) neither fluid volume excess or deficit
a) fluid volume excess
The patient had a troponin level drawn 8 hours after the onset of chest
pain and the level is elevated. The nurse correctly interprets this data to
mean which of the following?
a) The patient will need to have a 12-lead ECG to confirm the presence of
cardiac damage.
b) The lab result is only significant if the patient's myoglobin is also
elevated.
c) The patient has sustained injury to the cardiac muscle.
d) This lab test will have to be repeated to know if it is significant or not.
BIOD 331 FINAL EXAM & MODULE 1-10 EXAMS ALL
VERSIONS LATEST UPDATE A+ GRADED
The nurse is caring for patients on a cardiac unit. Which patient should
the nurse assess first?
a) The patient diagnosed with Heart Failure who has bilateral 3+
peripheral edema.
b) The patient diagnosed with mitral valve regurgitation who has dyspnea
on exertion.
c) The patient diagnosed with angina who is reporting chest pain.
d) The patient diagnosed with pericarditis who has a temperature of 100
degrees F.
c) The patient diagnosed with angina who is reporting chest pain.
*A patient with a history of angina should be pain-free. If he/she is not,
then there may be myocardial ischemia occurring. All of the other choices
represent expected, but non-lifethreatening findings for the diagnosis.
The nurse is caring for a patient with Diabetic Ketoacidosis. Which of the
following is the most concerning assessment finding?
a) Blood pressure is 103/78.
b) Blood sugar is 565.
c) Urine is dark and cloudy.
d) Patient is confused and agitated.
d) Patient is confused and agitated.
*A patient in DKA is at risk for impaired central perfusion, secondary to
hypovolemia. Confused and agitated is an indicator of poor perfusion to
the brain and is the priority issue. Blood pressure is acceptable, but note
the narrowed pulse pressure indicating compensatory vasoconstriction.
,You are monitoring the patient undergoing exercise EKG (stress test).
Which of the following criteria would indicate that the test should be
stopped prematurely?
a) If the patient's respiratory rate exceeds 24 breaths/minute
b) When the incline of the treadmill reaches 10% elevation
c) If the patient's EKG indicates significant ST segment depression
d) When the patient's heart rate reaches 120 beats/minute
c) If the patient's EKG indicates significant ST segment depression
*ST depression may indicate cardiac ischemia. All other choices are
expected.
A patient is admitted to the intensive care unit for treatment of shock.
The prescriber orders norepinephring (Levophed). The nurse expects this
drug to increase tissue perfusion in this patient by primarily activating:
a) alpha1 receptors to cause vasodilation.
b) beta2 receptors to cause bronchodilation.
c) beta1 receptors to cause a positive inotropic effect.
d) alpha1 receptors to increase blood pressure.
d) alpha1 receptors to increase blood pressure.
A patient comes into the emergency department with extensive bleeding
from face, arm, and chest wounds. What is the earliest manifestation of
hypovolemic shock likely to be detected in this patient?
a) Increased respiratory rate.
b) Increased heart rate.
c) Decreased blood pressure.
d) Cool, pale skin.
b) Increased heart rate.
Your patient had sudden, sharp chest pain and is breathing rapidly. The
provisional diagnosis is acute pulmonary embolism. Which of the following
arterial blood gas results would you expect to see during the first 20
minutes after the start of this episode?
a) pH 7.30 HCO3 22 PCO2 60 PO2 66
,b) pH 7.46 HCO3 28 PCO2 65 PO2 75
c) pH 7.38 HCO3 22 PCO2 45 PO2 96
d) pH 7.47 HCO3 22 PCO2 25 PO2 70
d) pH 7.47 HCO3 22 PCO2 25 PO2 70
*Remember that a patient with a PE will be tachypneic, which leads to an
increased excretion (blowing off) of CO2, which causes a respiratory
alkalosis. Additionally, hypoxemia would be expected.
The patient is diagnosed with heart failure. The nurse finds the patient
lying in bed, short of breath, unable to talk, and with buccal cyanosis.
Which intervention should the nurse implement first?
a) Call Rapid Response Team.
b) Assist the patient to a sitting position.
c) Assess the patient's vital signs.
d) Asuscultate the patient's lung sounds.
b) Assist the patient to a sitting position.
*Sitting the patient up will decrease venous return, thereby reducing
preload and therefore reducing the workload of the heart. It will also
maximize lung expansion. This hopefully will alleviate some of the
patient's respiratory distress. The nurse may need to call RRT if sitting the
patient up doesn't alleviate the distress, or if further assessment
warrants--but it's not the first action. More assessment is not needed at
this time. There is enough assessment data in the stem of the question to
make a decision.
The nurse is caring for a post-operative patient who suddenly reports
sharp chest pain and dyspnea. She is tachycardic. What is the nurse's
priority action?
a) Stat page the respiratory therapist and call for the intubation kit.
b) Auscultate the lung sounds for changes.
c) Check the patient's blood pressure.
d) Increase the oxygen flow rate and elevate the head of the bed.
, d) Increase the oxygen flow rate and elevate the head of the bed.
*Remember--if the stem of the question includes enough assessment data
to indicate "distress" (patient is in a potentially life-threatening situation)
then do not choose any more assessment.
"When in distress, do not assess".
During the activation of the stress response, there is an increased
secretion of aldosterone. Which finding is not an effect you will see with
the release of this hormone?
a) Water retention
b) Calcium excretion
c) Potassium excretion
d) Sodium retention
b) Calcium excretion
Your patient has fine crackles in bilateral lung bases; CVP = 8 mmHg (CVP
yesterday was 5mmHg); IV of D5%/0.25 NS @ 75 mL/hr; urine output over
last 10 hours =230 ml. Does the data in this case point to FVD (Fluid
volume deficit) or FVE (Fluid volume excess)?
a) fluid volume excess
b) fluid volume deficit
c) neither fluid volume excess or deficit
a) fluid volume excess
The patient had a troponin level drawn 8 hours after the onset of chest
pain and the level is elevated. The nurse correctly interprets this data to
mean which of the following?
a) The patient will need to have a 12-lead ECG to confirm the presence of
cardiac damage.
b) The lab result is only significant if the patient's myoglobin is also
elevated.
c) The patient has sustained injury to the cardiac muscle.
d) This lab test will have to be repeated to know if it is significant or not.
