NR283 Final Exam Actual Exam Style V1 |
NR 283 Pathophysiology | Chamberlain
1. A patient presents with peripheral edema, jugular venous distention, and weight gain.
Which condition is the most likely cause of these symptoms?
A. Left-sided heart failure
B. Pulmonary edema
C. Right-sided heart failure
D. Myocardial infarction
Answer: C
Rationale: Right-sided heart failure leads to a backup of blood into the systemic
circulation, which causes systemic symptoms like peripheral edema and jugular venous
distention. In contrast, left-sided heart failure primarily affects the pulmonary system,
leading to crackles and shortness of breath. Nurses must monitor daily weights to track
fluid retention in these patients.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with
untreated Type 1 Diabetes and Kussmaul respirations?
A. pH 7.30, HCO3 18, PaCO2 32
B. pH 7.50, HCO3 28, PaCO2 48
C. pH 7.25, HCO3 24, PaCO2 55
,D. pH 7.45, HCO3 22, PaCO2 40
Answer: A
Rationale: Diabetic Ketoacidosis (DKA) results in metabolic acidosis due to the
accumulation of ketones, which are acidic. The body attempts to compensate by using
Kussmaul respirations to blow off CO2, which is an acid. A pH below 7.35 with a low
bicarbonate level confirms metabolic acidosis with partial respiratory compensation.
3. A patient with chronic kidney disease (CKD) has a low hemoglobin level. What is the
primary cause of anemia in this patient?
A. Inadequate production of erythropoietin
B. Iron deficiency from diet
C. Blood loss during dialysis
D. Shortened life span of red blood cells
Answer: A
Rationale: The kidneys are responsible for secreting erythropoietin, a hormone that
stimulates the bone marrow to produce red blood cells. In chronic kidney disease, the
damaged kidneys cannot produce enough of this hormone. This lack of stimulation leads to
a decrease in RBC production and subsequent anemia.
4. What is the primary pathophysiology behind the development of Type 2 Diabetes Mellitus?
A. Absolute insulin deficiency
, B. Autoimmune destruction of beta cells
C. Excessive glucagon secretion
D. Insulin resistance and relative insulin deficiency
Answer: D
Rationale: Type 2 Diabetes is characterized by the body’s cells becoming resistant to the
effects of insulin. Over time, the pancreas may also fail to secrete enough insulin to
overcome this resistance. This differs from Type 1 Diabetes, where there is an absolute lack
of insulin due to autoimmune processes.
5. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which electrolyte imbalance should the nurse monitor for?
A. Hypernatremia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: B
Rationale: SIADH involves the excessive release of antidiuretic hormone, which causes the
kidneys to reabsorb too much water. This excess water dilutes the sodium in the blood,
leading to dilutional hyponatremia. Patients with this condition are often placed on fluid
restrictions to prevent worsening of the imbalance.
NR 283 Pathophysiology | Chamberlain
1. A patient presents with peripheral edema, jugular venous distention, and weight gain.
Which condition is the most likely cause of these symptoms?
A. Left-sided heart failure
B. Pulmonary edema
C. Right-sided heart failure
D. Myocardial infarction
Answer: C
Rationale: Right-sided heart failure leads to a backup of blood into the systemic
circulation, which causes systemic symptoms like peripheral edema and jugular venous
distention. In contrast, left-sided heart failure primarily affects the pulmonary system,
leading to crackles and shortness of breath. Nurses must monitor daily weights to track
fluid retention in these patients.
2. Which arterial blood gas (ABG) result would the nurse expect to see in a patient with
untreated Type 1 Diabetes and Kussmaul respirations?
A. pH 7.30, HCO3 18, PaCO2 32
B. pH 7.50, HCO3 28, PaCO2 48
C. pH 7.25, HCO3 24, PaCO2 55
,D. pH 7.45, HCO3 22, PaCO2 40
Answer: A
Rationale: Diabetic Ketoacidosis (DKA) results in metabolic acidosis due to the
accumulation of ketones, which are acidic. The body attempts to compensate by using
Kussmaul respirations to blow off CO2, which is an acid. A pH below 7.35 with a low
bicarbonate level confirms metabolic acidosis with partial respiratory compensation.
3. A patient with chronic kidney disease (CKD) has a low hemoglobin level. What is the
primary cause of anemia in this patient?
A. Inadequate production of erythropoietin
B. Iron deficiency from diet
C. Blood loss during dialysis
D. Shortened life span of red blood cells
Answer: A
Rationale: The kidneys are responsible for secreting erythropoietin, a hormone that
stimulates the bone marrow to produce red blood cells. In chronic kidney disease, the
damaged kidneys cannot produce enough of this hormone. This lack of stimulation leads to
a decrease in RBC production and subsequent anemia.
4. What is the primary pathophysiology behind the development of Type 2 Diabetes Mellitus?
A. Absolute insulin deficiency
, B. Autoimmune destruction of beta cells
C. Excessive glucagon secretion
D. Insulin resistance and relative insulin deficiency
Answer: D
Rationale: Type 2 Diabetes is characterized by the body’s cells becoming resistant to the
effects of insulin. Over time, the pancreas may also fail to secrete enough insulin to
overcome this resistance. This differs from Type 1 Diabetes, where there is an absolute lack
of insulin due to autoimmune processes.
5. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which electrolyte imbalance should the nurse monitor for?
A. Hypernatremia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
Answer: B
Rationale: SIADH involves the excessive release of antidiuretic hormone, which causes the
kidneys to reabsorb too much water. This excess water dilutes the sodium in the blood,
leading to dilutional hyponatremia. Patients with this condition are often placed on fluid
restrictions to prevent worsening of the imbalance.
