NSG 3850 PATHOPHYSIOLOGY EXAM 2 ACCURATE QUESTIONS WITH DETAILED SOLUTIONS SURE TO PASS 100%

1. Clinical Manifestations for Hiatal Hernia? ANSWER Dysphagia, heartburn, chest pain, predisposed to GERD, ulcerations of the stomach. 2. What is interstitial cystitis? ANSWER Inflammation of the bladder without infection. Normal UA, NO FEVER, persistent pelvic pain, frequency and urgency, bladder pressure. 3. Patient comes into clinic with coffee colored urine they have what? ANSWER Acute post streptococcal glomerulonephritis. 4. Patho associated with a disorder where a kidney disease occurs after infections caused by bacteria called group A Streptococcus (group A strep). The immune system activates due to the strep/ ANSWER Acute post streptococcal glomerulonephritis patient will have no fever but will have pelvic pain due to inflammation in the bladder. 5. How do we normally eliminate bacteria in bladder? ANSWER Urination/ elimination 6. Poor hygiene especially after bowel movement can lead to what? ANSWER UTI 7. UTI in men typically caused by? ANSWER STI or they are immunosuppression 8. Anatomic abnormalities can cause infected urine backflow into the kidneys and cause what? ANSWER Chronic pyelonephritis 9. When diagnosing pyelonephritis with imaging it will show what? ANSWER Atrophy and scarring 10. Obstruction from stones cause stasis which can stasis which leads to bacterial growth which leads to ANSWER Chronic Pyelonephritis 11. Complications of Crohn's ANSWER Perianal fissures, fistulas, and abscesses, and intestinal cancer (screening are essential) 12. Causes of stomatitis ANSWER Pathogenic organisms (bacteria or viruses), trauma, chemical irritants (alcohol, tobacco, and other chemical substances), medications (chemo), radiation, nutritional deficiencies (especially vitamin deficiencies), autoimmune disorders or could be idiopathic. 13. Where is McBurney's Point? ANSWER Right Lower Quadrant 14. What is most serious complication of Ulcerative Colitis? ANSWER Toxic Megacolon 15. Relationship between nephrotic syndrome and hyperlipidemia? ANSWER Hyperlipidemia happens due to hepatocyte failure and how it increases lipid synthesis which will cause hypoalbuminemia. 16. Who is at greater risk for CKD? ANSWER Diabetes and hypertension individuals 17. Additional test to determine difference between autosomal dominant and autosomal recessive polycystic kidney disease? ANSWER Liver Biopsy 18. Glomerular membranes have increased permeability which causes leakage of proteins in which condition? ANSWER Nephrotic Syndrome 19. CKD patients have anemia related to? ANSWER Decrease or lack of erythropoietin production. 20. Biggest risk factor for acute pyelonephritis ANSWER Pregnancy 21. Age related clinical manifestations of cystitis in older patients ANSWER Delirium 22. Difference between stress and urgency incontinences? ANSWER Stress is involuntary urine loss with an increase in intra-abdominal pressure due to weakened pelvic floor muscles. Urgency is the sudden leakage of urine immediately after the sensation of the need to urinate due to the overactive detrusor muscle. 23. How do nephrons compensate in early CKD? ANSWER Remaining nephrons try compensating by enlarging and increasing their clearance capacity until they do not work anymore. 24. Age, bladder infections, prostate enlargement and diuretics deals with what type of incontinence? ANSWER Urgency Incontinences 25. What lab valves do you want to educate fellow RN on CKD patients? ANSWER BUN/creatinine, GFR, H&H, RBC, albumin, potassium, sodium, mag, calcium, and phosphorus, Metabolic Acidosis 26. Why does end stage renal diseases at risk for osteodystrophy and and bone fractures ANSWER Having elevated phosphorus and PTH causes altered bone/mineral metabolism. The kidneys are unable to reabsorb calcium. 27. How do we confirm acute kidney injury? ANSWER Creatinine will increase 0.3 in 48 hours or increase 1.5x baseline in 7 days or the urine output less than 0.5 mg/kg/hr for 6 hours. 28. What will the patient look like of they miss hemodialysis? ANSWER Changes in mental status, lethargic, increase in BUN, metabolic acidosis, deep and rapid RR, skeletal muscle weakness, edema, fluid overload, N/V, dysrhythmias, over all feeling terrible. 29. What are the types of inflammatory bowel disorder? ANSWER Crohn's and Ulcerative Colitis. 30. What does it mean when you have multiple bloody and pus filled stool? ANSWER Ulcerative Colitis patient will have 30 plus a day. 31. What type of peristaltic action is associated with IBS? ANSWER The bowel will be hyperactive 32. Does IBS have a known cause? ANSWER Idiopathic/unidentified 33. Celiac Disease is trigger by? ANSWER Autoimmune disorder triggered by exposure to gliadin in genetically disposed persons. 34. Atrophy of villi and inflammation are associated with malabsorption of nutrients in which GI disorder? ANSWER Celiac Disease 35. Which GI disorder starts as inflammation of the base of crypts of Lieberkuhn leading to formation of abscesses in the epithelium of the crypts? ANSWER Ulcerative Colitis 36. IBS patients can have what? ANSWER Constipation or diarrhea or BOTH can also have mucous in the stool 37. At what percent of nephrons lost will you see clinical manifestations of CKD? ANSWER 75%-80% 38. When will a patient see hypoglycemia if they have dumping syndrome? ANSWER 1-3 hours after meals. 39. Why does hypovolemia occur in Dumping syndrome? ANSWER Occurs because fluids shifts from the blood to the intestines. 40. Celica's disease affects women more or less than men? ANSWER MORE 41. Ulcerative Colitis patient are at more risk for what? ANSWER Colon Cancer 42. Patient that has Peptic Ulcer Disease what is the priority assessment? ANSWER The patient will have black tarry stool and will have blood in the stool could also be coffee ground in texture. GI bleeds are life-threatening complications. 43. Clinical Manifestations of acute pyelonephritis ANSWER Sudden onset fever, chills, hematuria, CVA tenderness (flank pain), anorexia, N/V, dysuria, urgency, frequency, and fever-induced dehydration. 44. How does edema develop in nephrotic syndrome? ANSWER Increase permeability of glomeruli allowing spillage of protein. Hypoalbuminemia as the albumin is lost, the oncotic pressure decreases. This causes fluid to escape into surrounding tissues and escaping from vessels. 45. Renin angiotensin Aldosterone System works as compensatory mechanism in which type of kidney injury? ANSWER Prerenal Kidney 46. Myocardial infarction can be caused of what type of kidney injury? ANSWER Prerenal, decreased perfusion. 47. Dumping syndrome is seen in patients who have what? ANSWER Gastric bypass patients due to altered gastric emptying. (Gastrectomy) 48. What are the different types of bowel obstruction? ANSWER Mechanical: Caused by blockage of the intestine by adhesions, hernia, tumor, inflammation, stricture, impacted feces, volvulus, or intussusception. Functional: Loss of propulsive ability by the bowel and may occur after abdominal surgery or in association with hypokalemia, peritonitis, severe trauma, spinal fractures, ureteral distention, and the administration of medication such as necrosis. 49. Gastritis common clinical manifestations ANWSWER N/V, diarrhea, abdominal pain, anorexia, postprandial discomfort (paint after eating), and hematemesis. Could also be asymptomatic. 50. Peptic Ulcer Disease most common clinical manifestations ANSWER Mild epigastric burning pain usually relieved by INTAKE of food (especially dairy products). 51. What increases GERD? ANSWER Tight clothing, laying flat at night, obesity, smoking, pregnancy. 52. What causes acute on chronic kidney disease? ANSWER Any type of prerenal injury (hemorrhage, sepsis) 53. What can precipitate kidney stone formation? ANSWER Dehydration-working in the heat and higher levels of solute in urine from excess secretion (calcium and uric acid). 54. What happens in antibiotic-associated colitis in the large intestines (Enterocolitis also known as pseudomembranous colitis)? ANSWER Mucosal necrosis caused by C. Diff and acute inflammation in large intestine. Will have higher WBC. 55. Antibiotic associated colitis is know as what and causes changes in what labs? ANSWER Pseudomembranous Colitis and causes an increase in WBC. 56. Common manifestation of diverticula. ANSWER Constipation and also can be asymptomatic. 57. Why do diverticulum develop? ANSWER Low intake in fiber. 58. What happens in short bowel syndrome? ANSWER Malabsorption due to the bowel not being there. 59. What the priority assessment for patient with esophageal varices? ANSWER Hemorrhage 60. When do you have pain from gastric and duodenum ulcers? ANSWER Gastric pain will occur on an empty stomach or seconds after eating.