NURS 5315 Advanced Pathophysiology Final Exam with complete solutions
UTA.
1. A patient in respiratory A patient who is breathing 33 breaths per minute
distress and is breath- is hyperventilating and blowing off CO2; there-
ing 33 breaths per minute. fore the PCO2 level will be low. The patient will
Which ABG value is con- most likely experience a respiratory alkalosis
sistent with the clinical and the two pH values provided are not consis-
scenario? tent with this diagnosis.
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%
2. A patient has a sodi- b. The cause of neurologic symptoms associated
um level of 115 mEq/L with a sodium imbalance is directly related to
and is disoriented and fluid shifting into or out of the neurons of the
lethargic. Which patholog- brain. With a serum sodium of 115 mEq/L, water
ical process best explains shifts into the neurons and causes them to swell.
this patient's symptoms? Hypernatremia causes water to shift out of the
a. The action potential has cell into the intravascular space and causes the
become hyperpolarized. neurons to become dehydrated. An alteration
b. Water has shifted into in the action potential is not seen with sodium
the neurons and caused imbalances.
them to swell.
c. Water has shifted into
the vascular space and
dehydrated the neurons.
d. The action potential has
become hypopolarized.
3. A patient experiencing de- a. Serum osmolality is increased during times of
hydration should be moni- dehydration. An elevated serum osmolality will
tored for which electrolyte pull potassium into the intravascular space from
imbalance? the intracellular space and cause a rise in serum
a. Hyperkalemia potassium.
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia
4. A married couple pre- A chromosome is a package of material located
sents to your office for ge- inside the cell nucleus which is made of proteins
,NURS 5315 Advanced Pathophysiology Final Exam with complete solutions
UTA.
netic counseling. The hus- and a single molecule of DNA. There are 23
band has an autosomal pairs of chromosomes in each human cell for
recessive disease and his a total of 46 chromosomes. Chromosomes are
wife has a heterozygous separated into two identical sets during mitosis
genotype for the disease. or meiosis. This provides a set of chromosomes
They ask you, What is the to each daughter cell which results from cell
chance that our baby will division. This process is responsible for the trans-
have the disease? Which fer of genetic information to the daughter cells.
of the following answers The first 22 pairs of chromosomes are known
is correct? as autosomes. The 23rd pair of chromosomes is
25% the pair which contains the genetic information
50% for gender. This pair contains the genetic infor-
75% mation which delineates between the male and
100% female genders. Females have two X chromo-
somes (XX) and males have an XY chromosome
pair. Autosomal chromosomes are said to be
autologous. This means they do not carry genetic
information pertaining to gender. Autosomal ge-
netic diseases are 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 chromosome in a
pair carries identical genes. These two genes are
known as alleles. The alleles occupy the same
site on each partner of the chromosome pair and
code for the same genetic trait or physiologic
function. Alleles can be dominant or recessive.
One allele may be dominant and the other reces-
sive, or they both may be dominant or both reces-
sive. The dominant alleles' genetic code will al-
ways 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 assigned a lower case
letter. Any letter is okay to use but make sure you
, NURS 5315 Advanced Pathophysiology Final Exam with complete solutions
UTA.
use the same letter for the genotype - for exam-
ple, "Bb or aa." The term homozygous refers to a
pair of alleles which are either both dominant or
recessive. For example, "BB or bb" are said to be
homozygous because the alleles are either both
dominant or recessive. An allele pair in which one
is dominant and one is recessive is said to be
heterozygous. In autosomal recessive disorders
both alleles on the chromosome are affected by
the genetic aberration. If only one recessive gene
is affected by the genetic aberration then the
person is said to be a carrier and will not have
the phenotypic expression of the disease. The
healthy, recessive allele will compensate for the
allele which is affected by the genetic aberration.
The carrier can pass the trait but does not have
the genetic disease. In an autosomal dominant
disorder the dominant gene is the only gene that
has to be affected by the genetic aberration in
order to have the phenotypic expression of the
disease. A healthy recessive allele cannot com-
pensate for a diseased dominant allele. In order
to answer this question one must understand the
above information and draw a Punnett Square.
The husband has an autosomal recessive dis-
ease which means his genotype must be aa.
The wife has a heterozygous genotype for the
disease which means her genotype is Aa. The
capital A reflects a healthy gene so she is merely
a carrier and does not express the disease phe-
notype. The father's genotype is written across
the top line and the mother's genotype is writ-
ten in the boxes to the left. The four boxes in
the middle are the possible genotypes of their
offspring. Each box represents a 25% chance
for the offspring to have that particular genotype.
The question asks you to determine the chances
the offspring will have the autosomal recessive
UTA.
1. A patient in respiratory A patient who is breathing 33 breaths per minute
distress and is breath- is hyperventilating and blowing off CO2; there-
ing 33 breaths per minute. fore the PCO2 level will be low. The patient will
Which ABG value is con- most likely experience a respiratory alkalosis
sistent with the clinical and the two pH values provided are not consis-
scenario? tent with this diagnosis.
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%
2. A patient has a sodi- b. The cause of neurologic symptoms associated
um level of 115 mEq/L with a sodium imbalance is directly related to
and is disoriented and fluid shifting into or out of the neurons of the
lethargic. Which patholog- brain. With a serum sodium of 115 mEq/L, water
ical process best explains shifts into the neurons and causes them to swell.
this patient's symptoms? Hypernatremia causes water to shift out of the
a. The action potential has cell into the intravascular space and causes the
become hyperpolarized. neurons to become dehydrated. An alteration
b. Water has shifted into in the action potential is not seen with sodium
the neurons and caused imbalances.
them to swell.
c. Water has shifted into
the vascular space and
dehydrated the neurons.
d. The action potential has
become hypopolarized.
3. A patient experiencing de- a. Serum osmolality is increased during times of
hydration should be moni- dehydration. An elevated serum osmolality will
tored for which electrolyte pull potassium into the intravascular space from
imbalance? the intracellular space and cause a rise in serum
a. Hyperkalemia potassium.
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia
4. A married couple pre- A chromosome is a package of material located
sents to your office for ge- inside the cell nucleus which is made of proteins
,NURS 5315 Advanced Pathophysiology Final Exam with complete solutions
UTA.
netic counseling. The hus- and a single molecule of DNA. There are 23
band has an autosomal pairs of chromosomes in each human cell for
recessive disease and his a total of 46 chromosomes. Chromosomes are
wife has a heterozygous separated into two identical sets during mitosis
genotype for the disease. or meiosis. This provides a set of chromosomes
They ask you, What is the to each daughter cell which results from cell
chance that our baby will division. This process is responsible for the trans-
have the disease? Which fer of genetic information to the daughter cells.
of the following answers The first 22 pairs of chromosomes are known
is correct? as autosomes. The 23rd pair of chromosomes is
25% the pair which contains the genetic information
50% for gender. This pair contains the genetic infor-
75% mation which delineates between the male and
100% female genders. Females have two X chromo-
somes (XX) and males have an XY chromosome
pair. Autosomal chromosomes are said to be
autologous. This means they do not carry genetic
information pertaining to gender. Autosomal ge-
netic diseases are 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 chromosome in a
pair carries identical genes. These two genes are
known as alleles. The alleles occupy the same
site on each partner of the chromosome pair and
code for the same genetic trait or physiologic
function. Alleles can be dominant or recessive.
One allele may be dominant and the other reces-
sive, or they both may be dominant or both reces-
sive. The dominant alleles' genetic code will al-
ways 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 assigned a lower case
letter. Any letter is okay to use but make sure you
, NURS 5315 Advanced Pathophysiology Final Exam with complete solutions
UTA.
use the same letter for the genotype - for exam-
ple, "Bb or aa." The term homozygous refers to a
pair of alleles which are either both dominant or
recessive. For example, "BB or bb" are said to be
homozygous because the alleles are either both
dominant or recessive. An allele pair in which one
is dominant and one is recessive is said to be
heterozygous. In autosomal recessive disorders
both alleles on the chromosome are affected by
the genetic aberration. If only one recessive gene
is affected by the genetic aberration then the
person is said to be a carrier and will not have
the phenotypic expression of the disease. The
healthy, recessive allele will compensate for the
allele which is affected by the genetic aberration.
The carrier can pass the trait but does not have
the genetic disease. In an autosomal dominant
disorder the dominant gene is the only gene that
has to be affected by the genetic aberration in
order to have the phenotypic expression of the
disease. A healthy recessive allele cannot com-
pensate for a diseased dominant allele. In order
to answer this question one must understand the
above information and draw a Punnett Square.
The husband has an autosomal recessive dis-
ease which means his genotype must be aa.
The wife has a heterozygous genotype for the
disease which means her genotype is Aa. The
capital A reflects a healthy gene so she is merely
a carrier and does not express the disease phe-
notype. The father's genotype is written across
the top line and the mother's genotype is writ-
ten in the boxes to the left. The four boxes in
the middle are the possible genotypes of their
offspring. Each box represents a 25% chance
for the offspring to have that particular genotype.
The question asks you to determine the chances
the offspring will have the autosomal recessive
