HESI RN EVOLVE Pathophysiology Practice Exam
A 26-year-old male client with Hodgkin's disease is scheduled to undergo radiation therapy. The client
expresses concern about the effect of radiation on his ability to have children. What information should
the nurse provide?
A. The radiation therapy causes the inability to have an erection.
B. Radiation therapy with chemotherapy causes temporary infertility.
C. Permanent sterility occurs in male clients who receive radiation.
D. The client should restrict sexual activity during radiotherapy.
C. Permanent sterility occurs in male clients who receive radiation.
-Low sperm count and loss of motility are seen in males with Hodgkin's disease before any therapy.
Radiotherapy often results in permanent aspermia, or sterility (C). (A, B, and D) are inaccurate.
After talking with the healthcare provider, a male client continues to have questions about the results of
a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels become elevated.
The nurse should explain which pathophysiological mechanism?
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
B. The PSA levels normally rise and fall, so multiple testings over time are necessary.
C. Low PSA levels indicate that the prostate gland is not functioning properly.
D. The PSA blood test is used to determine dosage for Viagra prescriptions.
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
-PSA is a glycoprotein found in prostatic epithelial cells, and elevations are used as a specific tumor
markers. Elevations in PSA are related to gland volume, i.e., benign prostatic hypertrophy, prostatitis,
and cancer of the prostate, indicating (tumor) cell load (A). PSA levels are also used to monitor response
to therapy. (B, C, and D) provide incorrect information.
The nurse hears short, high-pitched sounds just before the end of inspiration in the right and left lower
lobes when auscultating a client's lungs. How should this finding be recorded?
,A. Inspiratory wheezes in both lungs.
B. Crackles in the right and left lower lobes.
C. Abnormal lung sounds in the bases of both lungs.
D. Pleural friction rub in the right and left lower lobes.
B. Crackles in the right and left lower lobes.
-Fine crackles (B) are short, high-pitched sounds heard just before the end of inspiration that are the
result of rapid equalization of pressure when collapsed alveoli or terminal bronchioles suddenly snap
open. Wheezing (A) is a continuous high-pitched squeaking or musical sound caused by rapid vibration
of bronchial walls that are first evident on expiration and may be audible. Although (C) describes an
adventitious lung sound, this documentation is vague. (D) is a creaking or grating sound from
roughened, inflamed surfaces of the pleura rubbing together heard during inspiration, expiration, and
with no change during coughing.
A client is admitted to the Emergency Department with a tension pneumothorax. Which assessment
should the nurse expect to identify?
A. An absence of lung sounds on the affected side.
B. An inability to auscultate tracheal breath sounds.
C. A deviation of the trachea toward the side opposite the pneumothorax.
D. A shift of the point of maximal impulse to the left, with bounding pulses.
C. A deviation of the trachea toward the side opposite the pneumothorax.
-Tension pneumothorax is caused by rapid accumulation of air in the pleural space, causing severely high
intrapleural pressure. This results in collapse of the lung, and the mediastinum shifts toward the
unaffected side, which is subsequently compressed (C). (A, B, and D) are not demonstrated with a
tension pneumothorax.
A client who is receiving a whole blood transfusion develops chills, fever, and a headache 30 minutes
after the transfusion is started. The nurse should recognize these symptoms as characteristic of what
reaction?
, A. A mild allergic reaction.
B. A febrile transfusion reaction.
C. An anaphylactic transfusion reaction.
D. An acute hemolytic transfusion reaction.
B. A febrile transfusion reaction.
-Symptoms of a febrile reaction (B) include sudden chills, fever, headache, flushing and muscle pain. An
allergic reaction (A) is the response of histamine release which is characterized by flushing, itching, and
urticaria. An anaphylactic reaction (C) exhibits an exaggerated allergic response that progresses to shock
and possible cardiac arrest. An acute hemolytic reaction (D) presents with fever and chills, but is
hallmarked by the onset of low back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria,
dark urine, acute renal failure, shock, cardiac arrest, and even death.
A nurse is planning to teach self-care measures to a female client about prevention of yeast infections.
Which instructions should the nurse provide?
A. Use a douche preparation no more than once a month.
B. Increase daily intake of fiber and leafy green vegetables.
C. Select nylon underwear that is loose-fitting, white, and comfortable.
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.
-A common genital tract infection in females is candidiasis, which is an overgrowth of the normal vaginal
flora of Candida albicans that thrives in an environment that is warm and moist and is perpetuated by
tight-fitting clothing, underwear, or pantyhose made of nonabsorbent materials. The client should wear
clothing that is loose fitting and absorbent, such as cotton underwear, and avoid using bubble-bath or
bath salts (D) which further irritate sensitive genital tissue. Douching (A) is not recommended because it
can irritate vaginal tissue, alter pH, and contribute to fungal growth. While (B) encourages healthy,
nutritional guidelines, it is not the focus of the teaching. Cotton, not nylon undergarments (C), provide
absorbancy and reduce moisture in the perineal area.
Which reaction should the nurse identify in a client who is responding to stimulation of the sympathetic
nervous system?
A 26-year-old male client with Hodgkin's disease is scheduled to undergo radiation therapy. The client
expresses concern about the effect of radiation on his ability to have children. What information should
the nurse provide?
A. The radiation therapy causes the inability to have an erection.
B. Radiation therapy with chemotherapy causes temporary infertility.
C. Permanent sterility occurs in male clients who receive radiation.
D. The client should restrict sexual activity during radiotherapy.
C. Permanent sterility occurs in male clients who receive radiation.
-Low sperm count and loss of motility are seen in males with Hodgkin's disease before any therapy.
Radiotherapy often results in permanent aspermia, or sterility (C). (A, B, and D) are inaccurate.
After talking with the healthcare provider, a male client continues to have questions about the results of
a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels become elevated.
The nurse should explain which pathophysiological mechanism?
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
B. The PSA levels normally rise and fall, so multiple testings over time are necessary.
C. Low PSA levels indicate that the prostate gland is not functioning properly.
D. The PSA blood test is used to determine dosage for Viagra prescriptions.
A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood.
-PSA is a glycoprotein found in prostatic epithelial cells, and elevations are used as a specific tumor
markers. Elevations in PSA are related to gland volume, i.e., benign prostatic hypertrophy, prostatitis,
and cancer of the prostate, indicating (tumor) cell load (A). PSA levels are also used to monitor response
to therapy. (B, C, and D) provide incorrect information.
The nurse hears short, high-pitched sounds just before the end of inspiration in the right and left lower
lobes when auscultating a client's lungs. How should this finding be recorded?
,A. Inspiratory wheezes in both lungs.
B. Crackles in the right and left lower lobes.
C. Abnormal lung sounds in the bases of both lungs.
D. Pleural friction rub in the right and left lower lobes.
B. Crackles in the right and left lower lobes.
-Fine crackles (B) are short, high-pitched sounds heard just before the end of inspiration that are the
result of rapid equalization of pressure when collapsed alveoli or terminal bronchioles suddenly snap
open. Wheezing (A) is a continuous high-pitched squeaking or musical sound caused by rapid vibration
of bronchial walls that are first evident on expiration and may be audible. Although (C) describes an
adventitious lung sound, this documentation is vague. (D) is a creaking or grating sound from
roughened, inflamed surfaces of the pleura rubbing together heard during inspiration, expiration, and
with no change during coughing.
A client is admitted to the Emergency Department with a tension pneumothorax. Which assessment
should the nurse expect to identify?
A. An absence of lung sounds on the affected side.
B. An inability to auscultate tracheal breath sounds.
C. A deviation of the trachea toward the side opposite the pneumothorax.
D. A shift of the point of maximal impulse to the left, with bounding pulses.
C. A deviation of the trachea toward the side opposite the pneumothorax.
-Tension pneumothorax is caused by rapid accumulation of air in the pleural space, causing severely high
intrapleural pressure. This results in collapse of the lung, and the mediastinum shifts toward the
unaffected side, which is subsequently compressed (C). (A, B, and D) are not demonstrated with a
tension pneumothorax.
A client who is receiving a whole blood transfusion develops chills, fever, and a headache 30 minutes
after the transfusion is started. The nurse should recognize these symptoms as characteristic of what
reaction?
, A. A mild allergic reaction.
B. A febrile transfusion reaction.
C. An anaphylactic transfusion reaction.
D. An acute hemolytic transfusion reaction.
B. A febrile transfusion reaction.
-Symptoms of a febrile reaction (B) include sudden chills, fever, headache, flushing and muscle pain. An
allergic reaction (A) is the response of histamine release which is characterized by flushing, itching, and
urticaria. An anaphylactic reaction (C) exhibits an exaggerated allergic response that progresses to shock
and possible cardiac arrest. An acute hemolytic reaction (D) presents with fever and chills, but is
hallmarked by the onset of low back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria,
dark urine, acute renal failure, shock, cardiac arrest, and even death.
A nurse is planning to teach self-care measures to a female client about prevention of yeast infections.
Which instructions should the nurse provide?
A. Use a douche preparation no more than once a month.
B. Increase daily intake of fiber and leafy green vegetables.
C. Select nylon underwear that is loose-fitting, white, and comfortable.
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.
D. Avoid tight-fitting clothing and do not use bubble-bath or bath salts.
-A common genital tract infection in females is candidiasis, which is an overgrowth of the normal vaginal
flora of Candida albicans that thrives in an environment that is warm and moist and is perpetuated by
tight-fitting clothing, underwear, or pantyhose made of nonabsorbent materials. The client should wear
clothing that is loose fitting and absorbent, such as cotton underwear, and avoid using bubble-bath or
bath salts (D) which further irritate sensitive genital tissue. Douching (A) is not recommended because it
can irritate vaginal tissue, alter pH, and contribute to fungal growth. While (B) encourages healthy,
nutritional guidelines, it is not the focus of the teaching. Cotton, not nylon undergarments (C), provide
absorbancy and reduce moisture in the perineal area.
Which reaction should the nurse identify in a client who is responding to stimulation of the sympathetic
nervous system?
