NUR-555: Advanced Clinical Pathophysiology
Study Guide for HESI Final Exam
The final exam in this course covers the FNP Domains and is divided into body systems and tests across
the lifespan (pediatrics, adolescent, young adults, adults, women’s health, older adults, and geriatrics).
The general breakdown by area of focus is as follows:
• Pathogenesis and etiology of altered health states (physiologic or psychological)
• Clinical manifestations (signs, symptoms, & laboratory values)
• Differences between normal and abnormal physiological changes across the lifespan
• Physiological responses to illness and treatment (i.e., the expected changes in the body) – learn
more by reviewing: https://www.ncbi.nlm.nih.gov/books/NBK541120/
• Key patient education concerning commonly seen diseases (Diabetes Mellitus Types I & II, COPD,
Asthma, Hypertension, Coronary Artery Disease, & Thyroid Disease
A list of definitive areas to review is in the table below. Keep in mind this list is not all inclusive and is
meant to serve as a guide. You may be asked questions on the final exam outside of these suggested
areas to review. The last page offers some recommended resources as you prepare for the final exam.
Table One: Body Systems and Suggested Areas to Review
Body System Suggested Areas to Review
HEENT • Review infant fontanels – expected time
frame for closure and potentially what it
means if not closed.
fontanelles close by the time your
baby is 18 months old. The posterior
fontanelle usually closes first —
within 2 months of birth. The anterior
fontanelle closes between 7 and 18
months.
Increased intracranial pressure,
hypothyroidism, and skeletal
anomalies are common etiologic
factors.
congenital hypothyroidism is known
to cause fontanelles to remain open.
• Cough and common cold
Cold symptoms are due to the host's
response to the virus rather than to
destruction of the nasal mucosa. Viral
infection of a very limited portion of
the nasal epithelium results in an
influx of polymorphonuclear
leukocytes, cytokine release, and a
vascular leak. Colds are self-limited
Revised 09-13-23
, illnesses.
Cough is a protective reflex to
prevent aspiration and can be
triggered by a multitude of stimuli.
The commonest form of cough is
caused by upper respiratory tract
infection and has no benefit to the
host. The virus hijacks this natural
defence mechanism in order to
propagate itself through the
population.
Cause by Rhinoviruses
• Otitis Media-
An ear infection is caused by
inflammation or infection in
the middle
ear. The pathophysiology of acute
otitis media (AOM) is due to
inflammation in the eustachian
tube, which prevents fluid from
draining from the middle ear
cavity. This fluid retention eventually
turns into purulent effusion, which is
characteristic of AOM.
• Otitis Externa- The term external
otitis (also known as otitis externa or
swimmer's ear) refers to
inflammation of the external auditory
canal. Infectious, allergic, and
dermatologic disease may all lead to
external otitis. Acute bacterial
infection is the most common cause
of external otitis.
Streptococcus pneumoniae,
Moraxella catarrhalis, and non-
typeable Haemophilus
influenzae. These three organisms are
responsible for more than 95% of all
otitis media cases with a bacterial
etiology.
• Possible causes of Sore Throat – think types
of organism (bacteria and virus) causing
Revised 09-13-23
, symptoms
Group A Streptococcus: This bacteria
causes strep throat, which is an
infection in the throat and tonsils
Rhinovirus: This virus causes sore
throats
coronavirus: This virus causes sore
throats
Respiratory syncytial virus: This virus
causes sore throats
Metapneumovirus: This virus causes
sore throats
Epstein-Barr(Herpes type 4): This
virus causes sore throats
• RSV – clinical symptoms
Fever.
Severe cough.
Wheezing — a high-pitched noise
that's usually heard on breathing out
(exhaling)
Rapid breathing or difficulty
breathing — the person may prefer to
sit up rather than lie down.
Bluish color of the skin due to lack of
oxygen (cyanosis)
Poor appetite
Flaring of the nostrils or straining
of the chest or stomach while
breathing.
Nervous • Difference between a HA and a migraine
Migraine typically includes throbbing on one
side of the head that frequently gets worse
with activity. Unlike a headache, other
symptoms, such as nausea, vomiting, vision
difficulties (seeing flashing lights, for
example), light or sound sensitivity, and
tingling often accompany a migraine.
•
• Types of Seizures
Absence seizures
Also known as petit mal seizures,
Revised 09-13-23
Study Guide for HESI Final Exam
The final exam in this course covers the FNP Domains and is divided into body systems and tests across
the lifespan (pediatrics, adolescent, young adults, adults, women’s health, older adults, and geriatrics).
The general breakdown by area of focus is as follows:
• Pathogenesis and etiology of altered health states (physiologic or psychological)
• Clinical manifestations (signs, symptoms, & laboratory values)
• Differences between normal and abnormal physiological changes across the lifespan
• Physiological responses to illness and treatment (i.e., the expected changes in the body) – learn
more by reviewing: https://www.ncbi.nlm.nih.gov/books/NBK541120/
• Key patient education concerning commonly seen diseases (Diabetes Mellitus Types I & II, COPD,
Asthma, Hypertension, Coronary Artery Disease, & Thyroid Disease
A list of definitive areas to review is in the table below. Keep in mind this list is not all inclusive and is
meant to serve as a guide. You may be asked questions on the final exam outside of these suggested
areas to review. The last page offers some recommended resources as you prepare for the final exam.
Table One: Body Systems and Suggested Areas to Review
Body System Suggested Areas to Review
HEENT • Review infant fontanels – expected time
frame for closure and potentially what it
means if not closed.
fontanelles close by the time your
baby is 18 months old. The posterior
fontanelle usually closes first —
within 2 months of birth. The anterior
fontanelle closes between 7 and 18
months.
Increased intracranial pressure,
hypothyroidism, and skeletal
anomalies are common etiologic
factors.
congenital hypothyroidism is known
to cause fontanelles to remain open.
• Cough and common cold
Cold symptoms are due to the host's
response to the virus rather than to
destruction of the nasal mucosa. Viral
infection of a very limited portion of
the nasal epithelium results in an
influx of polymorphonuclear
leukocytes, cytokine release, and a
vascular leak. Colds are self-limited
Revised 09-13-23
, illnesses.
Cough is a protective reflex to
prevent aspiration and can be
triggered by a multitude of stimuli.
The commonest form of cough is
caused by upper respiratory tract
infection and has no benefit to the
host. The virus hijacks this natural
defence mechanism in order to
propagate itself through the
population.
Cause by Rhinoviruses
• Otitis Media-
An ear infection is caused by
inflammation or infection in
the middle
ear. The pathophysiology of acute
otitis media (AOM) is due to
inflammation in the eustachian
tube, which prevents fluid from
draining from the middle ear
cavity. This fluid retention eventually
turns into purulent effusion, which is
characteristic of AOM.
• Otitis Externa- The term external
otitis (also known as otitis externa or
swimmer's ear) refers to
inflammation of the external auditory
canal. Infectious, allergic, and
dermatologic disease may all lead to
external otitis. Acute bacterial
infection is the most common cause
of external otitis.
Streptococcus pneumoniae,
Moraxella catarrhalis, and non-
typeable Haemophilus
influenzae. These three organisms are
responsible for more than 95% of all
otitis media cases with a bacterial
etiology.
• Possible causes of Sore Throat – think types
of organism (bacteria and virus) causing
Revised 09-13-23
, symptoms
Group A Streptococcus: This bacteria
causes strep throat, which is an
infection in the throat and tonsils
Rhinovirus: This virus causes sore
throats
coronavirus: This virus causes sore
throats
Respiratory syncytial virus: This virus
causes sore throats
Metapneumovirus: This virus causes
sore throats
Epstein-Barr(Herpes type 4): This
virus causes sore throats
• RSV – clinical symptoms
Fever.
Severe cough.
Wheezing — a high-pitched noise
that's usually heard on breathing out
(exhaling)
Rapid breathing or difficulty
breathing — the person may prefer to
sit up rather than lie down.
Bluish color of the skin due to lack of
oxygen (cyanosis)
Poor appetite
Flaring of the nostrils or straining
of the chest or stomach while
breathing.
Nervous • Difference between a HA and a migraine
Migraine typically includes throbbing on one
side of the head that frequently gets worse
with activity. Unlike a headache, other
symptoms, such as nausea, vomiting, vision
difficulties (seeing flashing lights, for
example), light or sound sensitivity, and
tingling often accompany a migraine.
•
• Types of Seizures
Absence seizures
Also known as petit mal seizures,
Revised 09-13-23
