NU 606 EXAM 3 ADVANCED PATHOPHYSIOLOGY PRACTICE TEST 2025/2026 ACCURATE QUESTIONS AND VERIFIED CORRECT SOLUTIONS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION

NU 606 EXAM 3 ADVANCED PATHOPHYSIOLOGY PRACTICE TEST 2025/2026 ACCURATE QUESTIONS AND VERIFIED CORRECT SOLUTIONS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION 1. Describe four general treatment measures for cardiac disorders. - ANSWER dietary modification; exercise program; cessation of smoking; drug therapy 2. Identify ten risk factors for developing atherosclerosis. Indicate which ones are modifiable and which ones are not. Note that these are the same risk factors for heart disease. - ANSWER • age—cannot be changed • gender—cannot be changed • genetic or familial factors—cannot be changed • obesity—modifiable • cigarette smoking—modifiable • sedentary lifestyle—modifiable • diabetes mellitus—modifiable • poorly controlled hypertension—modifiable • oral contraceptives and smoking in combination— modifiable • high cholesterol and hypertension—modifiable 3. List factors that may contribute to the development of congenital heart defects - ANSWER Most defects are multifactorial and reflect both genetic and environmental influences (e.g., chromosomal abnormalities in Down syndrome). Environmental factors include viral infections such as rubella and maternal alcoholism (fetal alcohol syndrome [FAS]) and maternal diabetes. 4. Septal defect - ANSWER a hole or defect in the atrial or ventricular septa 5. Valvular incompetence - ANSWER Failure of a valve to close completely allowing blood to regurgitate or leak backward. 6. Stenosis - ANSWER narrowing of a valve 7. Regurgitation - ANSWER backward flow or leaking of blood due to valvular incompetence 8. Prolapse - ANSWER abnormally enlarged and floppy valve leaflets that balloon backward with pressure or posterior displacement of the valve cusp 9. Heart murmur - ANSWER abnormal heart sounds due to leaky valves 10. How are most congenital heart defects detected? - ANSWER by presence of a heart murmur 11. "Right-to-left shunt." - ANSWER Right- to-left shunt means that unoxygenated blood from the right side of the heart bypasses the lung directly and enters the left side of the heart and hence the systemic circulation, producing varying degrees of cyanosis; death may occur in infancy in severe cases. 12. "Left-to-right shunt" - ANSWER Left-to-right shunt means that blood from the left side of the heart is recycled to the right side and to the lungs, resulting in increased volume in the pulmonary circulation, decreased cardiac output, and an inefficient system-an acyanotic condition. 13. Outline the signs and symptoms of large congenital heart defects. - ANSWER • pallor and cyanosis • tachycardia, with very rapid sleeping pulse, frequently a pulse deficit • dyspnea on exertion and tachypnea • in toddlers and older children, frequently assuming a squatting position to modify blood flow • clubbed fingers developed in time • marked intolerance for exercise and exposure to cold • delayed growth and development 14. Explain the consequences of a large ventricular septal defect, including the complications that develop if the defect is not surgically corrected. - ANSWER Ventricular septal defect is the most common congenital heart defect—"hole in the heart." Large openings: left-to-right shunt, reducing the flow of blood from the left ventricle, reducing stroke volume and cardiac output in the systemic circulation. More blood enters the pulmonary circulation, compromising its efficiency, and in time, overloads and irreversibly damages the pulmonary vessels, causing pulmonary hypertension. This complication, if untreated, would lead to abnormally high pressure in the right ventricle and reversal of the shunt to a right-to-left shunt, leading to cyanosis 15. Mitral stenosis - ANSWER left atrial dilation hypertrophy - atrial fibrillation, thrombus, pulmonary edema, RHF 16. Mitral regurgitation - ANSWER mitral insufficiency; incompetent mitral valve allows regurgitation of blood back into left atrium during systole 17. Aortic stenosis - ANSWER calcification of aortic valve cusps that restricts forward flow of blood during systole 18. Aortic regurgitation - ANSWER incompetent aortic valve that allows backward flow of blood into left ventricle during diastole 19. Pulmonary stenosis - ANSWER Right ventricular hypertrophy Congestion in right atrium and systemic veins Leads to right-sided heart failure Decreased blood flow through pulmonary circulation, leading to decreased gas exchange and blood to left side of heart Weakness, fatigue, cyanosis Swelling of feet and ankles Symptoms of right-sided heart failure Heart murmur 20. Pulmonary regurgitation - ANSWER Blood flows back into right ventricle 21. Name two conditions that are usually associated with heart murmurs. - ANSWER valvular defect; septal defect 22. Describe the four defects that are present in tetralogy of Fallot. Describe the implications of altered blood flow. - ANSWER i. pulmonary valve stenosis: restricts outflow from the right ventricle, leading to right ventricular hypertrophy and high pressure in the right ventricle leading to the right-to-left shunt ii. ventricular septal defect (VSD): an opening in the ventricular septum allows blood to flow between the ventricles iii. dextroposition of the aorta: promotes blood flow directly from the right ventricle into the general circulation iv. right ventricular hypertrophy: thickening of the ventricular wall because of increased work The most common cyanotic congenital heart disorder, tetralogy of Fallot, is a right-to-left shunt of blood through the VSD with marked systemic effects. This means that unoxygenated blood from the right side of the heart bypasses the lungs and enters the left side of the heart and into the general circulation. The high proportion of unoxygenated blood produces a bluish color in the skin and mucous membranes (cyanosis) and marked systemic effects resulting from hypoxemia. 23. Describe therapeutic interventions used in the treatment of heart defects. - ANSWER Treatments include surgical repair of defect, valve replacement, or drug therapy (those used for heart failure). 24. Identify the most significant symptom of chronic bronchitis. - ANSWER constant productive cough 25. Describe the treatments for chronic bronchitis. - ANSWER Treatments include reducing exposure to irritants, prompt treatment of infections, influenza and pneumonia vaccination, and use of expectorants, bronchodilators, chest therapy, low-flow oxygen, and nutritional supplementation. 26. Asthma - ANSWER episodes of breathing difficulty due to narrowed or obstructed airways 27. Explain why individuals with chronic bronchitis are sometimes referred to as blue bloaters. - ANSWER Hypoxia is characteristic feature, particularly during coughing episodes. This results in poor color or cyanosis. Pulmonary congestion and cor pulmonale also commonly occur with chronic bronchitis, resulting in peripheral edema. Thus, there is a designation as a "blue bloater" as opposed to someone with emphysema, a "pink puffer." 28. Emphysema - ANSWER a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. 29. Chronic Bronchitis - ANSWER a condition in which the bronchi in the lungs are constantly swollen and clogged with mucus 30. Define bronchiectasis, and list two primary conditions/diseases that may cause it. - ANSWER Bronchiectasis is an irreversible abnormal dilation of the bronchi. Dilations can be saccular or elongated. This condition can be caused by cystic fibrosis or COPD. 31. Define pneumoconiosis, and state the usual treatment. - ANSWER Pneumoconioses is a chronic restrictive disease resulting from long-term exposure to irritating particles such as asbestos. Treatment involves identifying and ending exposure to the damaging agent. 32. Identify the causes of pulmonary edema. - ANSWER Causes include inflammation in the lungs, increasing capillary permeability; low plasma protein levels, decreasing plasma osmotic pressure; pulmonary hypertension, increasing hydrostatic pressure 33. Describe the signs and symptoms of pulmonary edema. - ANSWER Signs and symptoms include cough, orthopnea, and rales; hemoptysis as congestion increases; frothy sputum; dyspnea; cyanosis due to increasing hypoxemia. 34. Describe the pathophysiology of pulmonary edema. - ANSWER Pulmonary edema occurs when excess fluid develops in the alveolar tissue. This fluid interferes with gaseous exchange, leading to severe hypoxemia. This accumulation of fluid interferes with the action of surfactant, leading to difficulty in expansion of lungs, which ultimately collapse. 35. Explain why the sputum of an individual with pulmonary edema might be frothy and possibly pink in color. - ANSWER Sputum becomes frothy when air mixes with secretions and becomes blood-tinged as a result of ruptured capillaries in the lungs. 36. Explain why an individual with mild pulmonary edema will experience dyspnea when placed in a supine position (e.g., for dental treatment). What is the term used to describe this condition? - ANSWER When the individual is placed in a supine position, the fluid that has accumulated in the bases of the lungs starts to shift into the upper lobes. Venous return to the heart and lungs is increased when in a supine position. The individual feels a sense of suffocation. This is called orthopnea. 37. Outline the treatment of pulmonary edema, including medications that might be used. - ANSWER Causative factors must be treated and sup- portive care such as oxygen therapy is provided; positive pressure mechanical ventilation may be necessary in severe cases. Upper body is elevated. Diuretics may be given to reduce fluid. 38. Define pulmonary embolus. - ANSWER a blood clot or mass of material that obstructs the pulmonary artery or a branch of it 39. Where do most pulmonary emboli originate? Identify other potential sources of pulmonary emboli. - ANSWER Most pulmonary emboli originate in the deep veins, primarily in the legs. Other potential sources include fat emboli from the bone marrow (fractures), vegetations resulting from endocarditis, amniotic fluid emboli, and tumor cell emboli. 40. Identify individuals who are at high risk for developing pulmonary emboli. - ANSWER • bedridden patients who have been immobile for long periods (e.g., hospitalized patients) • anyone with leg trauma • mothers during childbirth • patients with congestive heart failure (CHF) • patients with dehydration or increased coagulability of the blood • patients who have cancer • airplane or automobile passengers who remain seated for prolonged periods of time 41. Identify the signs and symptoms of a pulmonary embolus. - ANSWER With a small embolus, symptoms include transient chest pain, cough, or dyspnea. With a larger embolus, symptoms include chest pain that increases with coughing or deep breathing, and tachypnea and dyspnea develop suddenly; later, hemoptysis and fever, anxiety and restlessness, pallor, and tachycardia occur. A massive emboli is characterized by severe crushing chest pain; low blood pressure; rapid, weak pulse; and loss of consciousness. Fat emboli are distinguished by development of acute respiratory distress, petechial rash on the trunk, and neurologic signs such as confusion and disorientation. 42. What drugs may be used to treat pulmonary emboli? - ANSWER heparin or fibrinolytic agent 43. Pleural effusion - ANSWER abnormal accumulation of fluid in the pleural space 44. Describe the pathophysiology of a pulmonary embolus. - ANSWER The effects depend on the size and location of the embolism. Small pulmonary emboli are frequently "silent" or asymptomatic. Multiple small emboli, however, equal the effect of a large embolus. Moderate-sized emboli usually cause respiratory impairment. Large emboli affect the cardiovascular system, causing right-sided heart failure and shock. Sudden death often occurs. 45. Pneumothorax - ANSWER air in the pleural cavity caused by a puncture of the lung or chest wall 46. Explain what is meant by a flail chest injury. - ANSWER Flail chest results from fractures of the thorax (usually from falls and automobile accidents)-usually includes fractures of three to six ribs in two places or fracture of the sternum and a number of consecutive ribs resulting in paradoxical movement during inspiration and mediastinal flutter if injury is extensive. 47. Identify causes of acute respiratory failure. - ANSWER Causes of acute respiratory failure include chronic conditions such as emphysema, combinationof a chronic with an acute disorder such as emphysema complicated by pneumonia or pneumothorax, acute respiratory disorders such as chest trauma, pulmonary embolus, or acute asthma, and many neuromuscular diseases such as myasthenia gravis, amyotrophic lateral sclerosis (ALS), and muscular dystrophy. 48. Infant Respiratory Distress Syndrome - ANSWER caused by immature lungs -- too little surfactant in the alveoli; lungs collapse with each breath 49. Air in the pleural cavity - ANSWER pneumothorax 50. Abnormal widening of the bronchi - ANSWER bronchiectasis 51. Excessive fluid in the pleural cavity - ANSWER pleural effusion 52. Chronic disorder resulting from continued exposure to irritating particles - ANSWER pneumoconiosis 53. Adult Respiratory Distress Syndrome - ANSWER acute respiratory failure in adults characterized by tachypnea, dyspnea, cyanosis, tachycardia, and hypoxia 54. Fungal infection of the lungs - ANSWER histoplasmosis 55. Collapse of a portion of the lung - ANSWER atelectasis 56. Asthma - ANSWER characterized by episodic bronchospasm: 57. Causes orthopnea - ANSWER pulmonary edema 58. Sputum often frothy and pink or blood-tinged - ANSWER pulmonary edema 59. Loss of alveolar walls and lung elasticity - ANSWER emphysema 60. Caused by an acid-fast bacillus - ANSWER tuberculosis 61. Acute manifestations usually relieved by adrenergic agonists - ANSWER asthma 62. Occurs most commonly in immunosuppressed individuals - ANSWER Pneumocystis carinii pneumonia 63. Deficit of pancreatic digestive enzymes - ANSWER cystic fibrosis 64. Collapse of a lung or portion of a lung - ANSWER atelectasis 65. Characterized by a constant productive cough - ANSWER chronic bronchitis 66. A potential complication of thrombophlebitis in leg veins - ANSWER pulmonary embolus 67. Inadequate production of surfactant - ANSWER adult respiratory distress syndrome 68. Results from rib fractures - ANSWER pneumothorax 69. Defect in chloride ion transport in cell membranes - ANSWER cystic fibrosis 70. Causes malabsorption of nutrients - ANSWER cystic fibrosis 71. May cause cavitation within lungs - ANSWER tuberculosis 72. Abnormal dilation of the bronchi - ANSWER bronchiectasis 73. Accumulation of fluid in the pleural cavity - ANSWER pleurisy 74. Characterized by caseation necrosis - ANSWER tuberculosis 75. Treated with leukotriene receptor antagonists - ANSWER asthma 76. Musculoskeletal effects - ANSWER muscles lose strength, endurance, and mass very quickly, atrophy and develop flaccidity; impaired venous return, development of dependent edema; bone demineralization leading to osteoporosis, shortening and decreased flexibility of connective tissue such as ligaments and tendons 77. Cutaneous effects - ANSWER impaired circulation leads to skin breakdown and reduced regeneration; decubitus ulcers 78. Cardiovascular effects - ANSWER reduced venous return and cardiac output; orthostatic hypotension; blood pooling in dependent areas, resulting in edema; thrombus formation; potential embolism 79. Respiratory effects - ANSWER decreased depth of respirations; diminished gaseous exchange; diminished cough resulting in fluid, secretion accumulation; predisposition to respiratory complications- infection, obstruction, and atelectasis; potential for food and water aspiration 80. Gastrointestinal effects - ANSWER constipation; appetite reduction, malnutrition, fatigue, and depression 81. Urinary effects - ANSWER urinary stasis with potential for calculus formation and urinary tract infection (UTI) 82. Effects on children - ANSWER normal growth delayed; spinal or bony deformities; other developmental disorders 83. Stationary blood clot - ANSWER thrombus 84. Collapse of lung tissue - ANSWER atelectasis 85. Sudden drop in blood pressure when change in position occurs - ANSWER orthostatic hypotension 86. Athetoid movements - ANSWER continuous, slow, wormlike, arrhythmic movements 87. Choreiform movements - ANSWER uncontrollable writhing and twisting of body 88. Causes of hypomagnesemia - ANSWER Insufficient magnesium intake Excessive losses Starvation Diarrhea Laxative abuse Decrease intestinal absorption