NURS 5315 Final Exam Questions and Answers | Latest Update | 2024/2025 | Already Passed

NURS 5315 Final Exam Questions and Answers | Latest Update | 2024/2025 | Already Passed **Which ABG value is consistent with a patient in respiratory distress breathing at a rate of 33 breaths per minute?** **PCO2 15** A patient with rapid breathing (33 breaths per minute) is hyperventilating and expelling CO2, leading to a low PCO2 level. Respiratory alkalosis is likely, so the provided pH values do not match this condition. **What is the cause of disorientation and lethargy in a patient with a sodium level of 115 mEq/L?** **Water has shifted into the neurons and caused them to swell.** Neurological symptoms in sodium imbalance are due to fluid shifts into or out of brain neurons. With a serum sodium of 115 mEq/L, water moves into neurons causing swelling. Hypernatremia causes water to leave the cell, dehydrating neurons. Changes in action potential are not typically seen with sodium imbalances. **Which electrolyte imbalance should be monitored in a patient experiencing dehydration?** **Hyperkalemia** During dehydration, serum osmolality increases, pulling potassium into the intravascular space from the intracellular space, leading to elevated serum potassium levels. **What is the chance that a baby will inherit an autosomal recessive disease if the husband has the disease and the wife is a carrier?** **50%** In autosomal recessive diseases, the husband's genotype is aa, and the wife's genotype is Aa. Using a Punnett square, there is a 50% chance their offspring will inherit the disease (aa genotype). **Which genetic concept does the diagnosis of hemophilia in a child represent?** **Phenotype** Hemophilia's expression as a genetic disease is an example of phenotype. A genotype refers to the genetic coding, while hemophilia is transmitted on the X-chromosome, not autosomes, and is not an example of transcription. **What physiological response is triggered by dehydration?** **Increased secretion of renin** Dehydration causes the release of renin due to reduced renal perfusion. Other responses, such as increased natriuretic peptides and decreased antidiuretic hormone secretion, occur during fluid volume overload. A patient on hydrochlorothiazide has a pH of 7.49 and a bicarbonate of 30. Which of the following pathological processes best explains the abnormal lab values? a. An accumulation of pancreatic bicarbonate secondary to vomiting and loss of hydrochloric acid b. An increased absorption of Na+ and HCO3- in the proximal renal tubule secondary to increased aldosterone secretion c Excessive exhalation of CO2 secondary to hyperventilation d. Distal renal tubular dysfunction causing an accumulation of hydrogen ions The pH value and bicarbonate value are consistent with a metabolic alkalosis. The most likely cause of the metabolic alkalosis is the use of the hydrochlorothiazide (HCTZ). This is a thiazide diuretic which can cause a metabolic alkalosis. The use of a thiazide diuretic will increase the secretion of aldosterone which stimulates the reabsorption of Na+ and HCO3- in the proximal tubule of the kidney. This is a response directly related to hypovolemia secondary to the diuretic use. Option A occurs as a result of excessive vomiting. Vomiting does cause a metabolic alkalosis but there is nothing in the question to suggest that the patient has been vomiting. Option C would result in a respiratory alkalosis, not a metabolic alkalosis. Option D would cause a metabolic acidosis (not a metabolic alkalosis) secondary to a renal tubular dysfunction known as Renal Tubular Acidosis (RTA).