NURS 5315 Final
1. A patient in respiratory A patient who is breathing 33 breaths per minute is hyperventilating
distress and is breathing and blowing off CO2; therefore the PCO2 level will be low. The patient
33 breaths per minute. will most likely experience a respiratory alkalosis and the two pH
Which ABG value is consis- values provided are not consistent with this diagnosis.
tent with the clinical sce-
nario?
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%
2. A patient has a sodium b. The cause of neurologic symptoms associated with a sodium im-
level of 115 mEq/L and balance is directly related to fluid shifting into or out of the neurons
is disoriented and lethar- of the brain. With a serum sodium of 115 mEq/L, water shifts into
gic. Which pathological the neurons and causes them to swell. Hypernatremia causes water
process best explains this to shift out of the cell into the intravascular space and causes the
patient's symptoms? neurons to become dehydrated. An alteration in the action potential
a. The action potential has is not seen with sodium imbalances.
become hyperpolarized.
b. Water has shifted into
the neurons and caused
them to swell.
c. Water has shifted into
the vascular space and de-
hydrated the neurons.
d. The action potential has
become hypopolarized.
3. A patient experiencing de- a. Serum osmolality is increased during times of dehydration. An
hydration should be moni- elevated serum osmolality will pull potassium into the intravascular
tored for which electrolyte space from the intracellular space and cause a rise in serum potassi-
imbalance? um.
, NURS 5315 Final
a. Hyperkalemia
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia
4. A married couple presents A chromosome is a package of material located inside the cell nucleus
to your office for genet- which is made of proteins and a single molecule of DNA. There
ic counseling. The hus- are 23 pairs of chromosomes in each human cell for a total of 46
band has an autosomal chromosomes. Chromosomes are separated into two identical sets
recessive disease and his during mitosis or meiosis. This provides a set of chromosomes to
wife has a heterozygous each daughter cell which results from cell division. This process is
genotype for the disease. responsible for the transfer of genetic information to the daughter
They ask you, What is the cells. The first 22 pairs of chromosomes are known as autosomes.
chance that our baby will The 23rd pair of chromosomes is the pair which contains the genetic
have the disease? Which information for gender. This pair contains the genetic information
of the following answers is which delineates between the male and female genders. Females
correct? have two X chromosomes (XX) and males have an XY chromosome
25% pair. Autosomal chromosomes are said to be autologous. This means
50% they do not carry genetic information pertaining to gender. Auto-
75% somal genetic diseases are carried on the first 22 pairs of chro-
100% mosomes. 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
, NURS 5315 Final
dominant gene is assigned a capital letter and the recessive gene is
assigned a lower case letter. Any letter is okay to use but make sure
you use the same letter for the genotype - for example, "Bb or aa."
The term homozygous refers to a pair of alleles which are either both
dominant or recessive. For example, "BB or bb" are said to be ho-
mozygous because the alleles are either both dominant or recessive.
An allele pair in which one is dominant and one is recessive is said
to be heterozygous. In autosomal recessive disorders both alleles on
the chromosome are affected by the genetic aberration. If only one
recessive gene is affected by the genetic aberration then the person
is said to be a carrier and will not have the phenotypic expression of
the disease. The healthy, recessive allele will compensate for the allele
which is affected by the genetic aberration. The carrier can pass the
trait but does not have the genetic disease. In an autosomal dominant
disorder the dominant gene is the only gene that has to be affected
by the genetic aberration in order to have the phenotypic expression
of the disease. A healthy recessive allele cannot compensate for a
diseased dominant allele. In order to answer this question one must
understand the above information and draw a Punnett Square.
The husband has an autosomal recessive disease which means his
genotype must be aa. The wife has a heterozygous genotype for
the disease which means her genotype is Aa. The capital A reflects
a healthy gene so she is merely a carrier and does not express the
disease phenotype. The father's genotype is written across the top
line and the mother's genotype is written in the boxes to the left.
The four boxes in the middle are the possible genotypes of their
offspring. Each box represents a 25% chance for the offspring to
have that particular genotype. The question asks you to determine the
chances the offspring will have the autosomal recessive disease or in
other words, express the phenotype for the disease. The genotype
1. A patient in respiratory A patient who is breathing 33 breaths per minute is hyperventilating
distress and is breathing and blowing off CO2; therefore the PCO2 level will be low. The patient
33 breaths per minute. will most likely experience a respiratory alkalosis and the two pH
Which ABG value is consis- values provided are not consistent with this diagnosis.
tent with the clinical sce-
nario?
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%
2. A patient has a sodium b. The cause of neurologic symptoms associated with a sodium im-
level of 115 mEq/L and balance is directly related to fluid shifting into or out of the neurons
is disoriented and lethar- of the brain. With a serum sodium of 115 mEq/L, water shifts into
gic. Which pathological the neurons and causes them to swell. Hypernatremia causes water
process best explains this to shift out of the cell into the intravascular space and causes the
patient's symptoms? neurons to become dehydrated. An alteration in the action potential
a. The action potential has is not seen with sodium imbalances.
become hyperpolarized.
b. Water has shifted into
the neurons and caused
them to swell.
c. Water has shifted into
the vascular space and de-
hydrated the neurons.
d. The action potential has
become hypopolarized.
3. A patient experiencing de- a. Serum osmolality is increased during times of dehydration. An
hydration should be moni- elevated serum osmolality will pull potassium into the intravascular
tored for which electrolyte space from the intracellular space and cause a rise in serum potassi-
imbalance? um.
, NURS 5315 Final
a. Hyperkalemia
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia
4. A married couple presents A chromosome is a package of material located inside the cell nucleus
to your office for genet- which is made of proteins and a single molecule of DNA. There
ic counseling. The hus- are 23 pairs of chromosomes in each human cell for a total of 46
band has an autosomal chromosomes. Chromosomes are separated into two identical sets
recessive disease and his during mitosis or meiosis. This provides a set of chromosomes to
wife has a heterozygous each daughter cell which results from cell division. This process is
genotype for the disease. responsible for the transfer of genetic information to the daughter
They ask you, What is the cells. The first 22 pairs of chromosomes are known as autosomes.
chance that our baby will The 23rd pair of chromosomes is the pair which contains the genetic
have the disease? Which information for gender. This pair contains the genetic information
of the following answers is which delineates between the male and female genders. Females
correct? have two X chromosomes (XX) and males have an XY chromosome
25% pair. Autosomal chromosomes are said to be autologous. This means
50% they do not carry genetic information pertaining to gender. Auto-
75% somal genetic diseases are carried on the first 22 pairs of chro-
100% mosomes. 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
, NURS 5315 Final
dominant gene is assigned a capital letter and the recessive gene is
assigned a lower case letter. Any letter is okay to use but make sure
you use the same letter for the genotype - for example, "Bb or aa."
The term homozygous refers to a pair of alleles which are either both
dominant or recessive. For example, "BB or bb" are said to be ho-
mozygous because the alleles are either both dominant or recessive.
An allele pair in which one is dominant and one is recessive is said
to be heterozygous. In autosomal recessive disorders both alleles on
the chromosome are affected by the genetic aberration. If only one
recessive gene is affected by the genetic aberration then the person
is said to be a carrier and will not have the phenotypic expression of
the disease. The healthy, recessive allele will compensate for the allele
which is affected by the genetic aberration. The carrier can pass the
trait but does not have the genetic disease. In an autosomal dominant
disorder the dominant gene is the only gene that has to be affected
by the genetic aberration in order to have the phenotypic expression
of the disease. A healthy recessive allele cannot compensate for a
diseased dominant allele. In order to answer this question one must
understand the above information and draw a Punnett Square.
The husband has an autosomal recessive disease which means his
genotype must be aa. The wife has a heterozygous genotype for
the disease which means her genotype is Aa. The capital A reflects
a healthy gene so she is merely a carrier and does not express the
disease phenotype. The father's genotype is written across the top
line and the mother's genotype is written in the boxes to the left.
The four boxes in the middle are the possible genotypes of their
offspring. Each box represents a 25% chance for the offspring to
have that particular genotype. The question asks you to determine the
chances the offspring will have the autosomal recessive disease or in
other words, express the phenotype for the disease. The genotype
