NURS 5315 Final exam 51 complete
solutions.
NURS 5315 Final exam 51 complete
solutions.
A patient in respiratory distress and is breathing 33 breaths per minute. Which ABG value is consistent
with the clinical scenario?
PCO2 15
pH 7.30
pH 7.45
O2 sat 100% - 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 two 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. - 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 shift out of the cell into the intravascular space and causes the neurons
to become dehydrated. An alteration 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 - 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 potassium.
,NURS 5315 Final exam 51 complete
solutions.
A married couple presents to your office for genetic counseling. The husband has an autosomal
recessive disease and his wife has a heterozygous genotype for the disease. They ask you, What is the
chance that our baby will have the disease? Which of the following answers is correct?
25%
50%
75%
100% - ANSWER A chromosome is a package of material located inside the cell nucleus which is made of
proteins and a single molecule of DNA. There are 23 pairs of chromosomes in each human cell for a total
of 46 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
chromosomes are known as autosomes. The 23rd pair of chromosomes is the pair which contains the
genetic 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. This means they do not carry genetic
information pertaining to gender. Autosomal genetic 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 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 - ANSWER The expression of a genetic disease is an example of a phenotype. A genotype is
a gene's programming. Hemophilia is transmitted on the x-chromosome and is not transmitted via the
autosomes. This is not an example of transcription.
, NURS 5315 Final exam 51 complete
solutions.
Dehydration triggers which physiologic response?
Increased secretion of renin.
Increase secretion of natriuretic peptides.
Decreased secretion of antidiuretic hormone.
Decreased serum osmolality. - ANSWER Dehydration will trigger the release of renin when renal
perfusion is impaired. The other answers are 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
aldosterone secretion
c Excessive exhalation of CO2 secondary to hyperventilation
d. Distal renal tubular dysfunction causing an accumulation of hydrogen ions - 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 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).
Which patient may experience a decrease in oncotic pressure?
A patient with cirrhosis.
A patient with dehydration.
A patient with heart failure.
solutions.
NURS 5315 Final exam 51 complete
solutions.
A patient in respiratory distress and is breathing 33 breaths per minute. Which ABG value is consistent
with the clinical scenario?
PCO2 15
pH 7.30
pH 7.45
O2 sat 100% - 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 two 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. - 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 shift out of the cell into the intravascular space and causes the neurons
to become dehydrated. An alteration 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 - 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 potassium.
,NURS 5315 Final exam 51 complete
solutions.
A married couple presents to your office for genetic counseling. The husband has an autosomal
recessive disease and his wife has a heterozygous genotype for the disease. They ask you, What is the
chance that our baby will have the disease? Which of the following answers is correct?
25%
50%
75%
100% - ANSWER A chromosome is a package of material located inside the cell nucleus which is made of
proteins and a single molecule of DNA. There are 23 pairs of chromosomes in each human cell for a total
of 46 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
chromosomes are known as autosomes. The 23rd pair of chromosomes is the pair which contains the
genetic 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. This means they do not carry genetic
information pertaining to gender. Autosomal genetic 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 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 - ANSWER The expression of a genetic disease is an example of a phenotype. A genotype is
a gene's programming. Hemophilia is transmitted on the x-chromosome and is not transmitted via the
autosomes. This is not an example of transcription.
, NURS 5315 Final exam 51 complete
solutions.
Dehydration triggers which physiologic response?
Increased secretion of renin.
Increase secretion of natriuretic peptides.
Decreased secretion of antidiuretic hormone.
Decreased serum osmolality. - ANSWER Dehydration will trigger the release of renin when renal
perfusion is impaired. The other answers are 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
aldosterone secretion
c Excessive exhalation of CO2 secondary to hyperventilation
d. Distal renal tubular dysfunction causing an accumulation of hydrogen ions - 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 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).
Which patient may experience a decrease in oncotic pressure?
A patient with cirrhosis.
A patient with dehydration.
A patient with heart failure.
