Advanced Pathophysiology Exam 3
1. A 2000 ml blood loss will produce which assessment finding? (Select all
that apply.)
a. Air hunger
b. Normal blood pressure in the supine position
c. Rapid thready pulse
d. Cold clammy skin
e. lactic acidosis - CORRECT ANSWER-A, C, D. With a 2000 ml loss of
blood, central venous pressure, cardiac output, and arterial blood pressure are
below normal, even when at rest and in the supine position. The person
commonly has air hunger; a rapid, thready pulse; and cold, clammy skin. With
a 1500 ml loss of blood, supine blood pressure and pulse can still be normal.
Lactic acidosis is observed with a blood loss of 2500 ml or more.
1. A chronic complication of diabetes mellitus is likely to result in
microvascular complications in which areas? (Select all that apply.)
a. Eyes x
b. Coronary arteries
c. Renal system x
d. Peripheral vascular system
e. Nerves x - CORRECT ANSWER-The areas most often affected are the
retina, kidneys, and nerves.
1. A deficiency of which chemical may result in hypothyroidism?
a. Iron
b. Zinc
c. Iodine
d. Magnesium - CORRECT ANSWER-Iodine. The only cause of
hypothyroidism from among the provided options is a deficiency of endemic
iodine.
1. A disproportionate thickening of the interventricular septum is the hallmark
of which form of cardiomyopathy?
a. Dystrophic
b. Restrictive
c. Hypertrophic
d. Dilated - CORRECT ANSWER-Hypertrophic. Only hypertrophic
cardiomyopathy is characterized by a thickening of the septal wall, which may
cause outflow obstruction to the left ventricle outflow tract.
,1. A patient diagnosed with diabetic ketoacidosis (DKA) has the following
laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; positive urine
glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+)
130 mEq/L. The patient reports that he has been sick with the "flu" for 1 week.
What relationship do these values have to his insulin deficiency?
a. Increased glucose use causes the shift of fluid from the intravascular to the
intracellular space.
b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic
acidosis, and osmotic diuresis.
c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss,
and metabolic alkalosis.
d. Decreased glucose use results in protein catabolism, tissue wasting,
respiratory acidosis, and electrolyte loss. - CORRECT ANSWER-Decreased
glucose causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic
diuresis, which have resulted in the symptoms listed in the question.
1. A patient is diagnosed with pulmonary disease and elevated pulmonary
vascular resistance. Which form of heart failure may result from pulmonary
disease and elevated pulmonary vascular resistance?
a. Right heart failure
b. Low-output failure
c. Left heart failure
d. High-output failure - CORRECT ANSWER-Right heart failure. Right heart
failure is defined as the inability of the right ventricle to provide adequate
blood flow into the pulmonary circulation at a normal central venous pressure.
This condition is often a result of pulmonary disease and the resulting
elevated pulmonary vascular resistance.
1. A patient reports sudden onset of severe chest pain that radiates to the
back and worsens with respiratory movement and when lying down. These
clinical manifestations describe:
a. Myocardial infarction (MI)
b. Restrictive pericarditis
c. Pericardial effusion
d. Acute pericarditis - CORRECT ANSWER-Acute pericarditis. Most
individuals with acute pericarditis describe several days of fever, myalgias,
and malaise, followed by the sudden onset of severe chest pain that worsens
with respiratory movements and with lying down. Although the pain may
radiate to the back, it is generally felt in the anterior chest and may be initially
,confused with the pain of an acute MI. Individuals with acute pericarditis also
may report dysphagia, restlessness, irritability, anxiety, and weakness.
1. A patient who is diagnosed with a closed head injury has a urine output of 6
to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone
(ADH) level is low. Although he has had no intake for 4 hours, no change in
his polyuria level has occurred. These symptoms support a diagnosis of:
a. Neurogenic diabetes insipidus
b. Syndrome of inappropriate antidiuretic hormone
c. Psychogenic polydipsia
d. Osmotically induced diuresis - CORRECT ANSWER-Neurogenic diabetes
insipidus. Remember, sodium has to be below 135 to meet the requirement for
SIADH.
1. A person diagnosed with type 1 diabetes experiences hunger,
lightheadedness, tachycardia, pallor, headache, and confusion. The most
probable cause of these symptoms is:
a. Hyperglycemia caused by incorrect insulin administration
b. Dawn phenomenon from eating a snack before bedtime
c. Hypoglycemia caused by increased exercise
d. Somogyi effect from insulin sensitivity - CORRECT
ANSWER-Hypoglycemia caused by increased exercise. The most likely cause
of these symptoms is hypoglycemia, which is often caused by a lack of
systemic glucose as a result of muscular activity.
1. A person has acne, easy bruising, thin extremities, and truncal obesity.
These clinical manifestations are indicative of which endocrine disorder?
a. Hyperthyroidism
b. Diabetes insipidus
c. Hypoaldosteronism
d. Cushing disease - CORRECT ANSWER-These symptoms are
characteristic of Cushing disease and are caused by excessive cortisol
secretion.
1. A person may experience which complications as a result of a reduction in
parathyroid hormone (PTH)? (Select all that apply.)
a. Muscle spasms x
b. Tonic-clonic seizures x
c. Laryngeal spasms x
d. Hyporeflexia
, e. Asphyxiation x - CORRECT ANSWER-Symptoms associated with
hypoparathyroidism are related to hypocalcemia. Hypocalcemia causes a
lowering of the threshold for nerve and muscle excitation so that a slight
stimulus anywhere along the length of a nerve or muscle fiber may initiate a
nerve impulse. This creates tetany manifested as muscle spasms,
hyperreflexia, tonic- clonic convulsions, laryngeal spasms, and, in severe
cases, death from asphyxiation.
1. Aldosterone directly increases the reabsorption of:
a. Magnesium
b. Sodium
c. Calcium
d. Water - CORRECT ANSWER-Sodium. In the kidney, aldosterone primarily
acts on the epithelial cells of the nephron- collecting duct to increase sodium
ion reabsorption.
1. Amenorrhea, galactorrhea, hirsutism, and osteoporosis are each caused
by:
a. Posterior pituitary adenoma
b. Prolactinoma
c. Thymoma
d. Growth hormone adenoma - CORRECT ANSWER-Of the options available,
the hallmark of a prolactinoma is the sustained elevation of serum prolactin
that is responsible for the symptoms listed.
1. Amyloidosis, hemochromatosis, or glycogen storage disease usually
causes which form of cardiomyopathy?
a. Infiltrative
b. Septal
c. Restrictive
d. Hypertrophic - CORRECT ANSWER-Restrictive. Restrictive
cardiomyopathy may occur idiopathically or as a cardiac manifestation of
systemic diseases, such as scleroderma, amyloidosis, sarcoidosis, lymphoma,
and hemochromatosis, or a number of inherited storage diseases.
1. An individual who is demonstrating elevated levels of troponin, creatine
kinase-isoenzyme MB (CK-MB), and lactic dehydrogenase (LDH) is exhibiting
indicators associated with which condition?
a. Myocardial ischemia
b. Myocardial infarction (MI)
1. A 2000 ml blood loss will produce which assessment finding? (Select all
that apply.)
a. Air hunger
b. Normal blood pressure in the supine position
c. Rapid thready pulse
d. Cold clammy skin
e. lactic acidosis - CORRECT ANSWER-A, C, D. With a 2000 ml loss of
blood, central venous pressure, cardiac output, and arterial blood pressure are
below normal, even when at rest and in the supine position. The person
commonly has air hunger; a rapid, thready pulse; and cold, clammy skin. With
a 1500 ml loss of blood, supine blood pressure and pulse can still be normal.
Lactic acidosis is observed with a blood loss of 2500 ml or more.
1. A chronic complication of diabetes mellitus is likely to result in
microvascular complications in which areas? (Select all that apply.)
a. Eyes x
b. Coronary arteries
c. Renal system x
d. Peripheral vascular system
e. Nerves x - CORRECT ANSWER-The areas most often affected are the
retina, kidneys, and nerves.
1. A deficiency of which chemical may result in hypothyroidism?
a. Iron
b. Zinc
c. Iodine
d. Magnesium - CORRECT ANSWER-Iodine. The only cause of
hypothyroidism from among the provided options is a deficiency of endemic
iodine.
1. A disproportionate thickening of the interventricular septum is the hallmark
of which form of cardiomyopathy?
a. Dystrophic
b. Restrictive
c. Hypertrophic
d. Dilated - CORRECT ANSWER-Hypertrophic. Only hypertrophic
cardiomyopathy is characterized by a thickening of the septal wall, which may
cause outflow obstruction to the left ventricle outflow tract.
,1. A patient diagnosed with diabetic ketoacidosis (DKA) has the following
laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; positive urine
glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+)
130 mEq/L. The patient reports that he has been sick with the "flu" for 1 week.
What relationship do these values have to his insulin deficiency?
a. Increased glucose use causes the shift of fluid from the intravascular to the
intracellular space.
b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic
acidosis, and osmotic diuresis.
c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss,
and metabolic alkalosis.
d. Decreased glucose use results in protein catabolism, tissue wasting,
respiratory acidosis, and electrolyte loss. - CORRECT ANSWER-Decreased
glucose causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic
diuresis, which have resulted in the symptoms listed in the question.
1. A patient is diagnosed with pulmonary disease and elevated pulmonary
vascular resistance. Which form of heart failure may result from pulmonary
disease and elevated pulmonary vascular resistance?
a. Right heart failure
b. Low-output failure
c. Left heart failure
d. High-output failure - CORRECT ANSWER-Right heart failure. Right heart
failure is defined as the inability of the right ventricle to provide adequate
blood flow into the pulmonary circulation at a normal central venous pressure.
This condition is often a result of pulmonary disease and the resulting
elevated pulmonary vascular resistance.
1. A patient reports sudden onset of severe chest pain that radiates to the
back and worsens with respiratory movement and when lying down. These
clinical manifestations describe:
a. Myocardial infarction (MI)
b. Restrictive pericarditis
c. Pericardial effusion
d. Acute pericarditis - CORRECT ANSWER-Acute pericarditis. Most
individuals with acute pericarditis describe several days of fever, myalgias,
and malaise, followed by the sudden onset of severe chest pain that worsens
with respiratory movements and with lying down. Although the pain may
radiate to the back, it is generally felt in the anterior chest and may be initially
,confused with the pain of an acute MI. Individuals with acute pericarditis also
may report dysphagia, restlessness, irritability, anxiety, and weakness.
1. A patient who is diagnosed with a closed head injury has a urine output of 6
to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone
(ADH) level is low. Although he has had no intake for 4 hours, no change in
his polyuria level has occurred. These symptoms support a diagnosis of:
a. Neurogenic diabetes insipidus
b. Syndrome of inappropriate antidiuretic hormone
c. Psychogenic polydipsia
d. Osmotically induced diuresis - CORRECT ANSWER-Neurogenic diabetes
insipidus. Remember, sodium has to be below 135 to meet the requirement for
SIADH.
1. A person diagnosed with type 1 diabetes experiences hunger,
lightheadedness, tachycardia, pallor, headache, and confusion. The most
probable cause of these symptoms is:
a. Hyperglycemia caused by incorrect insulin administration
b. Dawn phenomenon from eating a snack before bedtime
c. Hypoglycemia caused by increased exercise
d. Somogyi effect from insulin sensitivity - CORRECT
ANSWER-Hypoglycemia caused by increased exercise. The most likely cause
of these symptoms is hypoglycemia, which is often caused by a lack of
systemic glucose as a result of muscular activity.
1. A person has acne, easy bruising, thin extremities, and truncal obesity.
These clinical manifestations are indicative of which endocrine disorder?
a. Hyperthyroidism
b. Diabetes insipidus
c. Hypoaldosteronism
d. Cushing disease - CORRECT ANSWER-These symptoms are
characteristic of Cushing disease and are caused by excessive cortisol
secretion.
1. A person may experience which complications as a result of a reduction in
parathyroid hormone (PTH)? (Select all that apply.)
a. Muscle spasms x
b. Tonic-clonic seizures x
c. Laryngeal spasms x
d. Hyporeflexia
, e. Asphyxiation x - CORRECT ANSWER-Symptoms associated with
hypoparathyroidism are related to hypocalcemia. Hypocalcemia causes a
lowering of the threshold for nerve and muscle excitation so that a slight
stimulus anywhere along the length of a nerve or muscle fiber may initiate a
nerve impulse. This creates tetany manifested as muscle spasms,
hyperreflexia, tonic- clonic convulsions, laryngeal spasms, and, in severe
cases, death from asphyxiation.
1. Aldosterone directly increases the reabsorption of:
a. Magnesium
b. Sodium
c. Calcium
d. Water - CORRECT ANSWER-Sodium. In the kidney, aldosterone primarily
acts on the epithelial cells of the nephron- collecting duct to increase sodium
ion reabsorption.
1. Amenorrhea, galactorrhea, hirsutism, and osteoporosis are each caused
by:
a. Posterior pituitary adenoma
b. Prolactinoma
c. Thymoma
d. Growth hormone adenoma - CORRECT ANSWER-Of the options available,
the hallmark of a prolactinoma is the sustained elevation of serum prolactin
that is responsible for the symptoms listed.
1. Amyloidosis, hemochromatosis, or glycogen storage disease usually
causes which form of cardiomyopathy?
a. Infiltrative
b. Septal
c. Restrictive
d. Hypertrophic - CORRECT ANSWER-Restrictive. Restrictive
cardiomyopathy may occur idiopathically or as a cardiac manifestation of
systemic diseases, such as scleroderma, amyloidosis, sarcoidosis, lymphoma,
and hemochromatosis, or a number of inherited storage diseases.
1. An individual who is demonstrating elevated levels of troponin, creatine
kinase-isoenzyme MB (CK-MB), and lactic dehydrogenase (LDH) is exhibiting
indicators associated with which condition?
a. Myocardial ischemia
b. Myocardial infarction (MI)
