1
Portage Learning NURS 231 Pathophysiology Final Exam 2022 100%VERIFIED | QUESTIONS AND
ANSWERS | GRADED A+.
___ ____ is diagnosed by hyperglycemia, low serum bicarbonate, and low pH, with ketonemia
and moderate ketonuria. - ansDiabetic ketoacidosis (DKA)
____ disorders occur when the immune system fails to differentiate self from non-self. -
ansautoimmune
_____ is the flow of gases into and out of the alveoli of the lungs. - ansVentilation
______ is defined as a blood glucose of <60 mg/dL, with associated cognitive impairment. -
ansHypoglycemia
______ measures expiratory volume in a given time. - ansForced expiratory volume (FEV)
_______ failure is caused by conditions that damage the structures within the kidney. -
ansIntrarenal
_______ is sleep disordered breathing due to the brain not properly signaling the respiratory
muscles. - ansCentral sleep apnea
________ utilizes electric impulses to inhibit or stop the abnormal nerve activity that causes
tremor and other unwanted movement patterns associated with Parkinson's disease. -
ansDeep brain stimulation
. Left ventricular hypertrophy is a major risk factor for what other diseases? Name at least
2. - anscoronary heart disease, cardiac dysrhythmias, congestive heart failure, and sudden
death.
1. ______ is a systemic treatment that enables drugs to reach the site of the tumor as well as
other distant sites. - anschemotherapy
1. The three major determinants of myocardial oxygen demand (MVO2) include each of the
following except: - ansa. Diastolic pressure
2. ______ is the most important factor in myocardial oxygen demand. As this increases,
myocardial oxygen consumption or demand also increases. - ansheart rate
3. What is the most common cause of cardiogenic shock? - ansmyocardial infarction
4. Which does NOT occur during cardiogenic shock? - ansdecreased systemic vascular
resistance
A 12-year-old female presents with itchy eyes, nasal congestion and drainage, and sneezing
every spring when the pollen count is high. (1) Explain the immunologic mechanisms that
are responsible for her symptoms. (2) What type(s) of treatment might be used to relieve her
symptoms? - ans1) Mast cells, basophils, and eosinophils play an important role in the
development of type I reactions because they contain the chemical mediator histamine. A
primary or initial-phase response is vasodilation, vascular leakage, and smooth muscle
contraction. A secondary or late-phase response is characterized by more intense
infiltration of tissues with eosinophils and other acute and chronic inflammatory cells, as
well as tissue damage. (2) Antihistamines and intranasal corticosteroids are the mainstay of
treatment.
A 22-year-old competitive gymnast has experienced amenorrhea for the past 5 years. Her
PCP is suspecting that she may have premature osteoporosis. Would you expect her RANKL
levels to be high, normal, or low? Explain why her levels would be at this level. - ansHer
, 2
Portage Learning NURS 231 Pathophysiology Final Exam 2022 100%VERIFIED | QUESTIONS AND
ANSWERS | GRADED A+.
RANKL levels would be higher than normal. Amenorrhea results in lower estrogen levels.
Estrogen increases the production of OPG which inhibits RANKL. Lower estrogen levels
would lead to lower OPG levels in turn increasing RANKL and osteoclast activity.
A 30-year-old man is brought to the ER with a knife wound to the chest. On visual inspection,
asymmetry of chest movement during inspiration, displacement of the trachea, and absence
of breath sounds on the side of the wound are noted. His neck veins are distended, and his
pulse is rapid and thready.
What is your initial diagnosis?
What type of emergent treatment is necessary? - ans1) tension pneumothorax
2) chest tube
A 40-year-old man presents with cough and shortness of breath. After an H&P and chest
films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an
HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/µL
and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man
was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+
count and symptomatology, and why - ans(1) Opportunistic infections are those common
organisms that do not produce infection without impaired immune function. (2) The last
phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/µL or
exhibits an AIDS-defining illness. The risk of opportunistic infections and death increases
significantly when the CD4+ cell count falls below 200 cells/µL.
A 40-year-old woman has experienced heavy menstrual bleeding. She was told she has a
uterine tumor called a leiomyoma. She is worried she has cancer. What do you tell her?
Explain at least 2 differences between a benign and malignant tumor - ansi would explain to
her that it is a benign tumor, and that there is nothing to worry about
1 benign tumors grow by expansion and are usually encapsulated; while malignant tumors
grow by invading and taking over tissue
2: benign tissue is well differentiated and looks like the tissue of origin, while malignant
cells are undifferentiated and are atypical and do not look like the tissues of origin.
A 40-year-old woman is hospitalized with a chronic illness characterized by hepatomegaly,
distended neck veins, and peripheral edema. Which of the following disorders is the most
likely cause of these findings? - ansRight heart failure
A 40-year-old woman presents with amenorrhea and weight loss despite increased appetite.
The history and physical exam show exophthalmos, tachycardia, and warm, moist skin.
Each of the following lab abnormalities are expected EXCEPT: - ansIncreased TSH
A 45-year-old obese, sedentary male has recently been diagnosed with type 2 diabetes. What
are 2 strategies to help him normalize his blood sugars? List 2 other macrovascular
complications he is at risk for and how you would screen for them? - ans(1) Diet, exercise,
and weight loss may be all that they need to control blood glucose levels. Even moderate
weight loss of 5-10% of total body weight has been shown to improve glucose control. (2)
Hypertension and hyperlipidemia - checking blood pressure and screening with a serum lipid
panel.
A 50-year-old woman was diagnosed with breast cancer from tissue biopsy following her
diagnostic mammography. They are determining if it has spread to the lymph nodes. (1)
Explain what the sentinel node is. (2) How will they determine if it has spread to the lymph
system? (3) Would a detailed family history of disease be important to obtain? - ansThe
sentinel node is the first lymph node to which the primary tumor drains. The extent of
disease may be determined through lymphatic mapping and sentinel lymph node biopsy. A
radioactive tracer and/or blue dye is injected into the tumor to determine the first lymph
, 3
Portage Learning NURS 231 Pathophysiology Final Exam 2022 100%VERIFIED | QUESTIONS AND
ANSWERS | GRADED A+.
node. This lymph node is examined for the presence of cancer cells. Yes, heredity can be a
strong risk factor for cancer in some families.
A 60-year-old, obese female works out of her home and rarely walks due to the sedentary
nature of her job. Give 2 reasons why she is at increased risk for developing OA. - ansShe is
a female over the age of 55; she is obese, and she is relatively sedentary which contributes
to the decreased nourishment of the joint that comes with weight bearing and range of
motion. (*Note - student only needs to provide 2 reasons.)
A 68-year-old, white Caucasian female has a DEXA scan at the recommendation of her PCP.
Her scan yielded a T-score of -2.6. Interpret the results of her DEXA scan. Develop a
treatment plan giving a pharmacologic recommendation if applicable (be specific with name
of supplement and/or class of drug), and a non-pharmacologic recommendation. - ansThis T-
score indicates osteoporosis. This patient should take a Calcium and Vitamin D supplement.
In addition, she should be prescribed one of the following: Estrogen, SERMs,
Bisphosphonates, or Calcitonin. She should also participate in regular weight bearing and
resistive exercise being careful to choose activities that would not put her at increased risk
for falling.
A 72-year-old male is said to be in phase 2 of gout. He is obese and has a history of alcohol
abuse. Develop a treatment plan including specific pharmacologic intervention and a non-
pharmacologic recommendation to manage his disease. - ansPhase 2 of gout is acute gout
arthritis. The goal of treatment in this phase is to control inflammation and pain. Colchicine
is a prescription drug that could be used to treat his acute inflammation. NSAIDS can also
be used to treat inflammation and manage pain. This patient should be encouraged to lose
weight and decrease his alcohol consumption. He should also avoid purine rich foods such
as fish, bacon, and liver. (*Note - the student has to provide 1 pharmacologic intervention
and 1 non-pharmacologic recommendation.)
A 75-year-old male is brought to the emergency department by their spouse at 8 pm. The
spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she
noticed that her husband's speech was very unclear. When she asked him what was going
on, he said that he didn't know and that the entire right side of his face felt numb. She
reports that he is very active, but he has a past medical history of atrial fibrillation. Based
upon these symptoms and past medical history, what do you suspect this patient is
experiencing? How would you confirm this diagnosis? What treatment should be
administered? Explain why you chose that treatment. - ansThis patient is more than likely
experiencing an ischemic stroke. A CT scan and MRI would be needed to determine if a clot
was blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. If a clot is
found, this patient should receive tPA drugs as they are within the 3-4.5 hour treatment
window.
A bodybuilder's muscles will display hyperplasia. - ansFalse
A decrease in Na+ reabsorption is achieved through the action of which of the following? -
ansDiuretics
A diabetic's risk of macrovascular diseases is 2-4 times higher and the leading cause of
death among diabetics (50-75%) is from a macrovascular disease. Name 3 of the 4
complications listed: - ansPeripheral vascular disease, coronary artery disease, heart
attack, and stroke
A diagnosis of gout is made through which of the following tests? (mark all that apply) -
ansBlood work to determine uric acid levels, Analysis of synovial fluid,
24-hour urine specimen
Portage Learning NURS 231 Pathophysiology Final Exam 2022 100%VERIFIED | QUESTIONS AND
ANSWERS | GRADED A+.
___ ____ is diagnosed by hyperglycemia, low serum bicarbonate, and low pH, with ketonemia
and moderate ketonuria. - ansDiabetic ketoacidosis (DKA)
____ disorders occur when the immune system fails to differentiate self from non-self. -
ansautoimmune
_____ is the flow of gases into and out of the alveoli of the lungs. - ansVentilation
______ is defined as a blood glucose of <60 mg/dL, with associated cognitive impairment. -
ansHypoglycemia
______ measures expiratory volume in a given time. - ansForced expiratory volume (FEV)
_______ failure is caused by conditions that damage the structures within the kidney. -
ansIntrarenal
_______ is sleep disordered breathing due to the brain not properly signaling the respiratory
muscles. - ansCentral sleep apnea
________ utilizes electric impulses to inhibit or stop the abnormal nerve activity that causes
tremor and other unwanted movement patterns associated with Parkinson's disease. -
ansDeep brain stimulation
. Left ventricular hypertrophy is a major risk factor for what other diseases? Name at least
2. - anscoronary heart disease, cardiac dysrhythmias, congestive heart failure, and sudden
death.
1. ______ is a systemic treatment that enables drugs to reach the site of the tumor as well as
other distant sites. - anschemotherapy
1. The three major determinants of myocardial oxygen demand (MVO2) include each of the
following except: - ansa. Diastolic pressure
2. ______ is the most important factor in myocardial oxygen demand. As this increases,
myocardial oxygen consumption or demand also increases. - ansheart rate
3. What is the most common cause of cardiogenic shock? - ansmyocardial infarction
4. Which does NOT occur during cardiogenic shock? - ansdecreased systemic vascular
resistance
A 12-year-old female presents with itchy eyes, nasal congestion and drainage, and sneezing
every spring when the pollen count is high. (1) Explain the immunologic mechanisms that
are responsible for her symptoms. (2) What type(s) of treatment might be used to relieve her
symptoms? - ans1) Mast cells, basophils, and eosinophils play an important role in the
development of type I reactions because they contain the chemical mediator histamine. A
primary or initial-phase response is vasodilation, vascular leakage, and smooth muscle
contraction. A secondary or late-phase response is characterized by more intense
infiltration of tissues with eosinophils and other acute and chronic inflammatory cells, as
well as tissue damage. (2) Antihistamines and intranasal corticosteroids are the mainstay of
treatment.
A 22-year-old competitive gymnast has experienced amenorrhea for the past 5 years. Her
PCP is suspecting that she may have premature osteoporosis. Would you expect her RANKL
levels to be high, normal, or low? Explain why her levels would be at this level. - ansHer
, 2
Portage Learning NURS 231 Pathophysiology Final Exam 2022 100%VERIFIED | QUESTIONS AND
ANSWERS | GRADED A+.
RANKL levels would be higher than normal. Amenorrhea results in lower estrogen levels.
Estrogen increases the production of OPG which inhibits RANKL. Lower estrogen levels
would lead to lower OPG levels in turn increasing RANKL and osteoclast activity.
A 30-year-old man is brought to the ER with a knife wound to the chest. On visual inspection,
asymmetry of chest movement during inspiration, displacement of the trachea, and absence
of breath sounds on the side of the wound are noted. His neck veins are distended, and his
pulse is rapid and thready.
What is your initial diagnosis?
What type of emergent treatment is necessary? - ans1) tension pneumothorax
2) chest tube
A 40-year-old man presents with cough and shortness of breath. After an H&P and chest
films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an
HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/µL
and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man
was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+
count and symptomatology, and why - ans(1) Opportunistic infections are those common
organisms that do not produce infection without impaired immune function. (2) The last
phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/µL or
exhibits an AIDS-defining illness. The risk of opportunistic infections and death increases
significantly when the CD4+ cell count falls below 200 cells/µL.
A 40-year-old woman has experienced heavy menstrual bleeding. She was told she has a
uterine tumor called a leiomyoma. She is worried she has cancer. What do you tell her?
Explain at least 2 differences between a benign and malignant tumor - ansi would explain to
her that it is a benign tumor, and that there is nothing to worry about
1 benign tumors grow by expansion and are usually encapsulated; while malignant tumors
grow by invading and taking over tissue
2: benign tissue is well differentiated and looks like the tissue of origin, while malignant
cells are undifferentiated and are atypical and do not look like the tissues of origin.
A 40-year-old woman is hospitalized with a chronic illness characterized by hepatomegaly,
distended neck veins, and peripheral edema. Which of the following disorders is the most
likely cause of these findings? - ansRight heart failure
A 40-year-old woman presents with amenorrhea and weight loss despite increased appetite.
The history and physical exam show exophthalmos, tachycardia, and warm, moist skin.
Each of the following lab abnormalities are expected EXCEPT: - ansIncreased TSH
A 45-year-old obese, sedentary male has recently been diagnosed with type 2 diabetes. What
are 2 strategies to help him normalize his blood sugars? List 2 other macrovascular
complications he is at risk for and how you would screen for them? - ans(1) Diet, exercise,
and weight loss may be all that they need to control blood glucose levels. Even moderate
weight loss of 5-10% of total body weight has been shown to improve glucose control. (2)
Hypertension and hyperlipidemia - checking blood pressure and screening with a serum lipid
panel.
A 50-year-old woman was diagnosed with breast cancer from tissue biopsy following her
diagnostic mammography. They are determining if it has spread to the lymph nodes. (1)
Explain what the sentinel node is. (2) How will they determine if it has spread to the lymph
system? (3) Would a detailed family history of disease be important to obtain? - ansThe
sentinel node is the first lymph node to which the primary tumor drains. The extent of
disease may be determined through lymphatic mapping and sentinel lymph node biopsy. A
radioactive tracer and/or blue dye is injected into the tumor to determine the first lymph
, 3
Portage Learning NURS 231 Pathophysiology Final Exam 2022 100%VERIFIED | QUESTIONS AND
ANSWERS | GRADED A+.
node. This lymph node is examined for the presence of cancer cells. Yes, heredity can be a
strong risk factor for cancer in some families.
A 60-year-old, obese female works out of her home and rarely walks due to the sedentary
nature of her job. Give 2 reasons why she is at increased risk for developing OA. - ansShe is
a female over the age of 55; she is obese, and she is relatively sedentary which contributes
to the decreased nourishment of the joint that comes with weight bearing and range of
motion. (*Note - student only needs to provide 2 reasons.)
A 68-year-old, white Caucasian female has a DEXA scan at the recommendation of her PCP.
Her scan yielded a T-score of -2.6. Interpret the results of her DEXA scan. Develop a
treatment plan giving a pharmacologic recommendation if applicable (be specific with name
of supplement and/or class of drug), and a non-pharmacologic recommendation. - ansThis T-
score indicates osteoporosis. This patient should take a Calcium and Vitamin D supplement.
In addition, she should be prescribed one of the following: Estrogen, SERMs,
Bisphosphonates, or Calcitonin. She should also participate in regular weight bearing and
resistive exercise being careful to choose activities that would not put her at increased risk
for falling.
A 72-year-old male is said to be in phase 2 of gout. He is obese and has a history of alcohol
abuse. Develop a treatment plan including specific pharmacologic intervention and a non-
pharmacologic recommendation to manage his disease. - ansPhase 2 of gout is acute gout
arthritis. The goal of treatment in this phase is to control inflammation and pain. Colchicine
is a prescription drug that could be used to treat his acute inflammation. NSAIDS can also
be used to treat inflammation and manage pain. This patient should be encouraged to lose
weight and decrease his alcohol consumption. He should also avoid purine rich foods such
as fish, bacon, and liver. (*Note - the student has to provide 1 pharmacologic intervention
and 1 non-pharmacologic recommendation.)
A 75-year-old male is brought to the emergency department by their spouse at 8 pm. The
spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she
noticed that her husband's speech was very unclear. When she asked him what was going
on, he said that he didn't know and that the entire right side of his face felt numb. She
reports that he is very active, but he has a past medical history of atrial fibrillation. Based
upon these symptoms and past medical history, what do you suspect this patient is
experiencing? How would you confirm this diagnosis? What treatment should be
administered? Explain why you chose that treatment. - ansThis patient is more than likely
experiencing an ischemic stroke. A CT scan and MRI would be needed to determine if a clot
was blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. If a clot is
found, this patient should receive tPA drugs as they are within the 3-4.5 hour treatment
window.
A bodybuilder's muscles will display hyperplasia. - ansFalse
A decrease in Na+ reabsorption is achieved through the action of which of the following? -
ansDiuretics
A diabetic's risk of macrovascular diseases is 2-4 times higher and the leading cause of
death among diabetics (50-75%) is from a macrovascular disease. Name 3 of the 4
complications listed: - ansPeripheral vascular disease, coronary artery disease, heart
attack, and stroke
A diagnosis of gout is made through which of the following tests? (mark all that apply) -
ansBlood work to determine uric acid levels, Analysis of synovial fluid,
24-hour urine specimen
