d115 advanced pathophysiology
An advanced practice registered nurse (APRN) is caring for an adult patient who fell off a ladder and has
a T5 compression and a compound fracture of the femur.
The following assessment data is noted:
Vital signs: BP 102/52
Apical pulse: 48
Weak peripheral pulses
Flaccid lower extremities
Severe bruising of the femur
Which type of shock should the APRN suspect? - (correct Answer) - Neurogenic
An advanced practice registered nurse (APRN) is caring for a patient who experienced a 20% total body
surface area (TBSA) burn injury. Current assessment findings include massive evaporative water losses, a
flux of large amounts of fluid and electrolytes in the tissues, generalized edema, and circulatory
hypovolemia. The APRN needs to take immediate action to prevent irreversible hypovolemic shock and
death.
Which priority action should be taken by the APRN? - (correct Answer) - Administer up to 30 L of lactated
ringer solution over 24 hours
An adult patient has experienced a third-degree burn. An advanced practice registered nurse (APRN) is
attempting to calculate the total body surface area affected using the rule of nines. The areas involved
include the anterior and posterior right arm and leg and the groin.
What is the estimated total body surface area that will be assigned by the APRN? - (correct Answer) -
28%
An advanced practice registered nurse (APRN) assesses a school-aged child with sepsis who is
experiencing new symptoms of hyperthermia, tachycardia, and tachypnea.
Which additional diagnosis should the APRN consider? - (correct Answer) - Systemic inflammatory
response syndrome
A female patient presents with abnormal hair growth on the face and body and reports that the hair on
her head is receding. An advanced practice registered nurse (APRN) determines that the patient has
hirsutism.
Which other diagnosis associated with this condition should be considered by the APRN? - (correct
Answer) - Polycystic ovarian syndrome
, When discussing sun protection with an older patient, an advanced practice registered nurse
recommends the importance of using sunblock to protect aging skin from ultraviolet exposure when the
patient will be in the sun.
Which pathologic changes due to aging of the integumentary system is this recommendation based on? -
(correct Answer) - Decreased melanocytes and clearance of oxidative substances from the dermis
An advanced practice registered nurse (APRN) is working with a bedbound patient who has an area of
skin tissue obscured by slough or eschar over the left greater trochanter.
Which way should this pressure injury be staged by the APRN for treatment? - (correct Answer) -
Unstageable
A five-year-old child presents to a clinic with right inner thigh and groin pain that radiates to the knee.
The parents report to an advanced practice registered nurse (APRN) that activity aggravates the pain, but
rest relieves it. The APRN notes the child's Trendelenburg gait. Radiographic examination confirms a
diagnosis of Legg-Calvé-Perthes disease (LCPD).
What is the pathologic cause of this disorder? - (correct Answer) - Recurrent interruption of the blood
supply to the femoral head
A patient is discussing symptoms of fibromyalgia with an advanced practice registered nurse (APRN) and
is worried about the effect of the condition on life. The APRN suggests treatment to help control
symptoms.
Which treatment should be recommended to this patient? - (correct Answer) - Antidepressants and
acupuncture
A small-framed, older adult patient is having problems with mobility. The patient is treated at a hospital
after a recent fall. During a follow-up visit, an advanced practice registered nurse (APRN) diagnoses the
patient with a fragility fracture of the femur and would like to assess for additional problems.
Which disease process should the APRN suspect in this patient? - (correct Answer) - Osteoporosis
An obese, middle-aged patient presents to an advanced practice registered nurse (APRN) with
complaints of heartburn, chronic cough, frequent wheezing, laryngitis, and sinusitis.
Which pathological mechanism is associated with the probable diagnosis? - (correct Answer) -
Abnormalities in lower esophageal sphincter function, esophageal motility, and gastric motility or
emptying
An advanced practice registered nurse (APRN) is assessing a patient who is diagnosed with hepatitis B.
The APRN is aware that the patient is in the icteric phase of the infection.
Which finding led the APRN to this conclusion? - (correct Answer) - Jaundice
A patient is experiencing memory loss, irritability, and a hand tremor. An advanced practice registered
nurse (APRN) is concerned that the patient is experiencing hepatic encephalopathy.
Which diagnostic lab result should be used to confirm this diagnosis? - (correct Answer) - Ammonia
An advanced practice registered nurse (APRN) is caring for an adult patient who fell off a ladder and has
a T5 compression and a compound fracture of the femur.
The following assessment data is noted:
Vital signs: BP 102/52
Apical pulse: 48
Weak peripheral pulses
Flaccid lower extremities
Severe bruising of the femur
Which type of shock should the APRN suspect? - (correct Answer) - Neurogenic
An advanced practice registered nurse (APRN) is caring for a patient who experienced a 20% total body
surface area (TBSA) burn injury. Current assessment findings include massive evaporative water losses, a
flux of large amounts of fluid and electrolytes in the tissues, generalized edema, and circulatory
hypovolemia. The APRN needs to take immediate action to prevent irreversible hypovolemic shock and
death.
Which priority action should be taken by the APRN? - (correct Answer) - Administer up to 30 L of lactated
ringer solution over 24 hours
An adult patient has experienced a third-degree burn. An advanced practice registered nurse (APRN) is
attempting to calculate the total body surface area affected using the rule of nines. The areas involved
include the anterior and posterior right arm and leg and the groin.
What is the estimated total body surface area that will be assigned by the APRN? - (correct Answer) -
28%
An advanced practice registered nurse (APRN) assesses a school-aged child with sepsis who is
experiencing new symptoms of hyperthermia, tachycardia, and tachypnea.
Which additional diagnosis should the APRN consider? - (correct Answer) - Systemic inflammatory
response syndrome
A female patient presents with abnormal hair growth on the face and body and reports that the hair on
her head is receding. An advanced practice registered nurse (APRN) determines that the patient has
hirsutism.
Which other diagnosis associated with this condition should be considered by the APRN? - (correct
Answer) - Polycystic ovarian syndrome
, When discussing sun protection with an older patient, an advanced practice registered nurse
recommends the importance of using sunblock to protect aging skin from ultraviolet exposure when the
patient will be in the sun.
Which pathologic changes due to aging of the integumentary system is this recommendation based on? -
(correct Answer) - Decreased melanocytes and clearance of oxidative substances from the dermis
An advanced practice registered nurse (APRN) is working with a bedbound patient who has an area of
skin tissue obscured by slough or eschar over the left greater trochanter.
Which way should this pressure injury be staged by the APRN for treatment? - (correct Answer) -
Unstageable
A five-year-old child presents to a clinic with right inner thigh and groin pain that radiates to the knee.
The parents report to an advanced practice registered nurse (APRN) that activity aggravates the pain, but
rest relieves it. The APRN notes the child's Trendelenburg gait. Radiographic examination confirms a
diagnosis of Legg-Calvé-Perthes disease (LCPD).
What is the pathologic cause of this disorder? - (correct Answer) - Recurrent interruption of the blood
supply to the femoral head
A patient is discussing symptoms of fibromyalgia with an advanced practice registered nurse (APRN) and
is worried about the effect of the condition on life. The APRN suggests treatment to help control
symptoms.
Which treatment should be recommended to this patient? - (correct Answer) - Antidepressants and
acupuncture
A small-framed, older adult patient is having problems with mobility. The patient is treated at a hospital
after a recent fall. During a follow-up visit, an advanced practice registered nurse (APRN) diagnoses the
patient with a fragility fracture of the femur and would like to assess for additional problems.
Which disease process should the APRN suspect in this patient? - (correct Answer) - Osteoporosis
An obese, middle-aged patient presents to an advanced practice registered nurse (APRN) with
complaints of heartburn, chronic cough, frequent wheezing, laryngitis, and sinusitis.
Which pathological mechanism is associated with the probable diagnosis? - (correct Answer) -
Abnormalities in lower esophageal sphincter function, esophageal motility, and gastric motility or
emptying
An advanced practice registered nurse (APRN) is assessing a patient who is diagnosed with hepatitis B.
The APRN is aware that the patient is in the icteric phase of the infection.
Which finding led the APRN to this conclusion? - (correct Answer) - Jaundice
A patient is experiencing memory loss, irritability, and a hand tremor. An advanced practice registered
nurse (APRN) is concerned that the patient is experiencing hepatic encephalopathy.
Which diagnostic lab result should be used to confirm this diagnosis? - (correct Answer) - Ammonia
