HESI PATHOPHYSIOLOGY PRACTICE EXAM WITH CORRECT ANSWERS

HESI PATHOPHYSIOLOGY PRACTICE EXAM WITH CORRECT ANSWERS After talking w/ the HCP, a male pt 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? - CORRECT ANSWER-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 r/t gland volume, ie. benign BPH, prostatitis, and cancer of the prostate, indicating tumor cell load. PSA levels are also used to monitor response to therapy A 26 yr old male client w/ Hodgkin's disease is scheduled to undergo radiation therapy. The clinet expresses concern about the effect of radiation on his ability to have children. What info should the nurse provide? - CORRECT ANSWER-Permanent sterility occurs in the male client who receive radiation Low sperm count and loss of motility are seen in males w/ Hodgkin's disease b/f any therapy. Radiotherapy often results in permanent aspermia, or sterility The nurse hears short, high-pitched sounds just b/f the end of inspiration in the right and left lower lobes when auscultating a client's lungs. How should this finding be recorded? - CORRECT ANSWER-Crackles in the right and left lower lobes Fine crackles - short, high-pitched sounds heard just b/f the end of inspiration that are the result of rapid equalization of pressure when collaped alveoli or terminal bronchioles suddenly snap open Wheezing is a continuous high-pitched squeaking or musical sound caused by rapid vibration of bronchial walls that are 1st evident on expiration and may be audible A client is admitted to the ER w/ a tension pneumothorax. Which assessment should the nurse expect to ID? - CORRECT ANSWER-A deviation of the trachea toward the side opposite of 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 A client who is receiving a whole blood transfusion dv's chills, fever, and a HA 30 min after the transfusion is started. The nurse shold recognize these sx as characteristic of what rxn? - CORRECT ANSWER-A febrile transfusion reaction Sx of a febrile reaction include sudden chills, fever, HA, flushing, and muscle pain. An allergic rxn is the response of histamine release which is characterized by flushing, itching, and urticaria. It exhibits an exaggerated allergic response that progresses to shock and possible cardiac arrest an acute hemolytic reaction presents w/ fever, chills, but is hallmarked by the onset of low back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria, dark urine, ARF, shock, cardiac arrest, and even death The nurse is analyzing the waveforms of a client's ECG. What finding indicates a disturbance in electrical conduction in the ventricles? - CORRECT ANSWER-QRS interval of 0.14 second the normal duration of the QRS is 0.04 - 0.12 sec T wave is 0.16 sec; PR is 0.12 - 0.20 sec; QT is 0.31-0.38 sec Several hrs after surgical repair of an AAA, the client dvps left flank pain. the nurse determines the client's urinary output is 20 m.;hr for the past 2 hrs. The nurse should conclude that these findings support which complication? - CORRECT ANSWER-Renal artery embolization Post-op complications of surgical repair of AAA are r/t the location of resection, graft, or stent placement along the abd'l aorta. Embolization of a fragment of thrombus or plaque from the aorta into a renal artery can compromise blood flow in 1 of the renal arteries, resulting in renal ischemia that precipitates unilateral flank pain A client w/ markedly distended bladder is dx w/ hydronephroosis and left hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a residual urine vol of 1650 ml. this finding supports which pathophysiological cause of the client's urinary tract obstruction? - CORRECT ANSWER-Obstruction at the urinary bladder neck Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward mvmt of urine from the lower to upper urinary tracts), and hydronephrosis (dilation or enlargement of the renal pelvis and calyces) result from post-renal obstruction which can consequently