NURS 5315 Final COMPLETE QUESTIONS
AND ANSWERS
A .patient .in .respiratory .distress .and .is .breathing .33 .breaths .per .minute. .Which .ABG .value .is .consist
ent .with .the .clinical .scenario?
PCO2 .15
pH .7.30
pH .7.45
O2 .sat .100% .- .(correct .answer) .-
A .patient .who .is .breathing .33 .breaths .per .minute .is .hyperventilating .and .blowing .off .CO2; .therefore
.the .PCO2 .level .will .be .low. .The .patient .will .most .likely .experience .a .respiratory .alkalosis .and .the .tw
o .pH .values .provided .are .not .consistent .with .this .diagnosis.
A .patient .has .a .sodium .level .of .115 .mEq/
L .and .is .disoriented .and .lethargic. .Which .pathological .process .best .explains .this .patient's .symptoms?
a. .The .action .potential .has .become .hyperpolarized.
b. .Water .has .shifted .into .the .neurons .and .caused .them .to .swell.
c. .Water .has .shifted .into .the .vascular .space .and .dehydrated .the .neurons.
d. .The .action .potential .has .become .hypopolarized. .- .(correct .answer) .-
b. .The .cause .of .neurologic .symptoms .associated .with .a .sodium .imbalance .is .directly .related .to .fluid
.shifting .into .or .out .of .the .neurons .of .the .brain. .With .a .serum .sodium .of .115
.mEq/L, .water .shifts .into .the .neurons .and .causes .them .to .swell. .Hypernatremia .causes .water .to .shi
ft .out .of .the .cell .into .the .intravascular .space .and .causes .the .neurons .to .become .dehydrated. .An .alt
eration .in .the .action .potential .is .not .seen .with .sodium .imbalances.
A .patient .experiencing .dehydration .should .be .monitored .for .which .electrolyte .imbalance?
a. .Hyperkalemia
,b. .Hypocalcemia
c. .Hypercalcemia
d. .Hyponatermia .- .(correct .answer) .-
a. .Serum .osmolality .is .increased .during .times .of .dehydration. .An .elevated .serum .osmolality .will .pull
.potassium .into .the .intravascular .space .from .the .intracellular .space .and .cause .a .rise .in .serum .potass
ium.
A .married .couple .presents .to .your .office .for .genetic .counseling. .The .husband .has .an .autosomal .rece
ssive .disease .and .his .wife .has .a .heterozygous .genotype .for .the .disease. .They .ask .you, .What .is .the .c
hance .that .our .baby .will .have .the .disease? .Which .of .the .following .answers .is .correct?
25%
50%
75%
100% .- .(correct .answer) .-
A .chromosome .is .a .package .of .material .located .inside .the .cell .nucleus .which .is .made .of .proteins .an
d .a .single .molecule .of .DNA. .There .are .23 .pairs .of .chromosomes .in .each .human .cell .for .a .total .of .4
6 .chromosomes. .Chromosomes .are .separated .into .two .identical .sets .during .mitosis .or .meiosis. .This .
provides .a .set .of .chromosomes .to .each .daughter .cell .which .results .from .cell .division. .This .process .is
.responsible .for .the .transfer .of .genetic .information .to .the .daughter .cells. .The .first .22 .pairs .of .chrom
osomes .are .known .as .autosomes. .The .23rd .pair .of .chromosomes .is .the .pair .which .contains .the .gen
etic .information .for .gender. .This .pair .contains .the .genetic .information .which .delineates .between .the
.male .and .female .genders. .Females .have .two .X .chromosomes .
(XX) .and .males .have .an .XY .chromosome .pair. .Autosomal .chromosomes .are .said .to .be .autologous. .T
his .means .they .do .not .carry .genetic .information .pertaining .to .gender. .Autosomal .genetic .diseases .a
re .carried .on .the .first .22 .pairs .of .chromosomes. .Sex-
linked .diseases .are .only .carried .on .the .23rd .pair .of .chromosomes. .The .autosomal .chromosomes .are
.nearly .identical .to .one .another .and .are .considered .homologous .to .one .another. .Each .autosomal .ch
romosome .in .a .pair .carries .identical .genes. .These .two .genes .are .known .as .alleles. .The .alleles .occup
y .the .same .site .on .each .partner .of .the .chromosome .pair .and .code .for .the .same .genetic .trait .or .ph
ysiologic .function. .Alleles .can .be .dominant .or .recessive. .One .allele .may .be .dominant .and .the .other .
recessive, .or .they .both .may .be .dominant .or .both .recessive. .The .dominant .alleles' .genetic .code .will .
always .manifest .in .the .individual's .phenotype. .The .information .in .the .recessive .allele .is .typically .not
.expressed .in .the .phenotype .unless .both .alleles .are .recessive. .For .the .purpose .of .clarity .in .use, .the .
dominant .gene .is .assigned .a .capital .letter .and .the .recessive .gene .is .a
A .child .is .diagnosed .with .hemophilia. .This .is .an .example .of .which .genetic .concept?
Phenotype
, Genotype
Autosomal .transmission .of .the .disease
Transcription .- .(correct .answer) .-
The .expression .of .a .genetic .disease .is .an .example .of .a .phenotype. .A .genotype .is .a .gene's .program
ming. .Hemophilia .is .transmitted .on .the .x-
chromosome .and .is .not .transmitted .via .the .autosomes. .This .is .not .an .example .of .transcription.
Dehydration .triggers .which .physiologic .response?
Increased .secretion .of .renin.
Increase .secretion .of .natriuretic .peptides.
Decreased .secretion .of .antidiuretic .hormone.
Decreased .serum .osmolality. .- .(correct .answer) .-
Dehydration .will .trigger .the .release .of .renin .when .renal .perfusion .is .impaired. .The .other .answers .ar
e .seen .during .times .of .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 .al
dosterone .secretion
c .Excessive .exhalation .of .CO2 .secondary .to .hyperventilation
d. .Distal .renal .tubular .dysfunction .causing .an .accumulation .of .hydrogen .ions .- .(correct .answer) .-
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 .diureti
c .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 .t
he .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 .metaboli
c .acidosis .
(not .a .metabolic .alkalosis) .secondary .to .a .renal .tubular .dysfunction .known .as .Renal .Tubular .Acidosis
.(RTA).
AND ANSWERS
A .patient .in .respiratory .distress .and .is .breathing .33 .breaths .per .minute. .Which .ABG .value .is .consist
ent .with .the .clinical .scenario?
PCO2 .15
pH .7.30
pH .7.45
O2 .sat .100% .- .(correct .answer) .-
A .patient .who .is .breathing .33 .breaths .per .minute .is .hyperventilating .and .blowing .off .CO2; .therefore
.the .PCO2 .level .will .be .low. .The .patient .will .most .likely .experience .a .respiratory .alkalosis .and .the .tw
o .pH .values .provided .are .not .consistent .with .this .diagnosis.
A .patient .has .a .sodium .level .of .115 .mEq/
L .and .is .disoriented .and .lethargic. .Which .pathological .process .best .explains .this .patient's .symptoms?
a. .The .action .potential .has .become .hyperpolarized.
b. .Water .has .shifted .into .the .neurons .and .caused .them .to .swell.
c. .Water .has .shifted .into .the .vascular .space .and .dehydrated .the .neurons.
d. .The .action .potential .has .become .hypopolarized. .- .(correct .answer) .-
b. .The .cause .of .neurologic .symptoms .associated .with .a .sodium .imbalance .is .directly .related .to .fluid
.shifting .into .or .out .of .the .neurons .of .the .brain. .With .a .serum .sodium .of .115
.mEq/L, .water .shifts .into .the .neurons .and .causes .them .to .swell. .Hypernatremia .causes .water .to .shi
ft .out .of .the .cell .into .the .intravascular .space .and .causes .the .neurons .to .become .dehydrated. .An .alt
eration .in .the .action .potential .is .not .seen .with .sodium .imbalances.
A .patient .experiencing .dehydration .should .be .monitored .for .which .electrolyte .imbalance?
a. .Hyperkalemia
,b. .Hypocalcemia
c. .Hypercalcemia
d. .Hyponatermia .- .(correct .answer) .-
a. .Serum .osmolality .is .increased .during .times .of .dehydration. .An .elevated .serum .osmolality .will .pull
.potassium .into .the .intravascular .space .from .the .intracellular .space .and .cause .a .rise .in .serum .potass
ium.
A .married .couple .presents .to .your .office .for .genetic .counseling. .The .husband .has .an .autosomal .rece
ssive .disease .and .his .wife .has .a .heterozygous .genotype .for .the .disease. .They .ask .you, .What .is .the .c
hance .that .our .baby .will .have .the .disease? .Which .of .the .following .answers .is .correct?
25%
50%
75%
100% .- .(correct .answer) .-
A .chromosome .is .a .package .of .material .located .inside .the .cell .nucleus .which .is .made .of .proteins .an
d .a .single .molecule .of .DNA. .There .are .23 .pairs .of .chromosomes .in .each .human .cell .for .a .total .of .4
6 .chromosomes. .Chromosomes .are .separated .into .two .identical .sets .during .mitosis .or .meiosis. .This .
provides .a .set .of .chromosomes .to .each .daughter .cell .which .results .from .cell .division. .This .process .is
.responsible .for .the .transfer .of .genetic .information .to .the .daughter .cells. .The .first .22 .pairs .of .chrom
osomes .are .known .as .autosomes. .The .23rd .pair .of .chromosomes .is .the .pair .which .contains .the .gen
etic .information .for .gender. .This .pair .contains .the .genetic .information .which .delineates .between .the
.male .and .female .genders. .Females .have .two .X .chromosomes .
(XX) .and .males .have .an .XY .chromosome .pair. .Autosomal .chromosomes .are .said .to .be .autologous. .T
his .means .they .do .not .carry .genetic .information .pertaining .to .gender. .Autosomal .genetic .diseases .a
re .carried .on .the .first .22 .pairs .of .chromosomes. .Sex-
linked .diseases .are .only .carried .on .the .23rd .pair .of .chromosomes. .The .autosomal .chromosomes .are
.nearly .identical .to .one .another .and .are .considered .homologous .to .one .another. .Each .autosomal .ch
romosome .in .a .pair .carries .identical .genes. .These .two .genes .are .known .as .alleles. .The .alleles .occup
y .the .same .site .on .each .partner .of .the .chromosome .pair .and .code .for .the .same .genetic .trait .or .ph
ysiologic .function. .Alleles .can .be .dominant .or .recessive. .One .allele .may .be .dominant .and .the .other .
recessive, .or .they .both .may .be .dominant .or .both .recessive. .The .dominant .alleles' .genetic .code .will .
always .manifest .in .the .individual's .phenotype. .The .information .in .the .recessive .allele .is .typically .not
.expressed .in .the .phenotype .unless .both .alleles .are .recessive. .For .the .purpose .of .clarity .in .use, .the .
dominant .gene .is .assigned .a .capital .letter .and .the .recessive .gene .is .a
A .child .is .diagnosed .with .hemophilia. .This .is .an .example .of .which .genetic .concept?
Phenotype
, Genotype
Autosomal .transmission .of .the .disease
Transcription .- .(correct .answer) .-
The .expression .of .a .genetic .disease .is .an .example .of .a .phenotype. .A .genotype .is .a .gene's .program
ming. .Hemophilia .is .transmitted .on .the .x-
chromosome .and .is .not .transmitted .via .the .autosomes. .This .is .not .an .example .of .transcription.
Dehydration .triggers .which .physiologic .response?
Increased .secretion .of .renin.
Increase .secretion .of .natriuretic .peptides.
Decreased .secretion .of .antidiuretic .hormone.
Decreased .serum .osmolality. .- .(correct .answer) .-
Dehydration .will .trigger .the .release .of .renin .when .renal .perfusion .is .impaired. .The .other .answers .ar
e .seen .during .times .of .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 .al
dosterone .secretion
c .Excessive .exhalation .of .CO2 .secondary .to .hyperventilation
d. .Distal .renal .tubular .dysfunction .causing .an .accumulation .of .hydrogen .ions .- .(correct .answer) .-
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 .diureti
c .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 .t
he .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 .metaboli
c .acidosis .
(not .a .metabolic .alkalosis) .secondary .to .a .renal .tubular .dysfunction .known .as .Renal .Tubular .Acidosis
.(RTA).
