WGU D115 Distributed Formative Assessment 3|2023 LATEST UPDATE|GUARANTEED SUCCESS

A patient presents to an advanced practice registered nurse (APRN) complaining of diarrhea, rectal bleeding, and right lower quadrant tenderness. Diagnostic tests reveal deficiencies in folic acid, vitamin D, and calcium. The APRN suspects Crohn disease. What is the pathological mechanism of this disorder? Neutrophil infiltration of the crypts, which causes destructive abscess formation Destruction of mucosal barrier caused by drugs or Helicobacter pylori infection Acid and pepsin in the duodenum penetrating the mucosal barrier, which causes ulceration Decreased mucosal blood flow and hypersecretion of acid caused by overstimulation of the vagal nuclei Crohn disease can involve any part of the gastrointestinal tract from the oropharynx to the perianal area. Diseased segments frequently are separated by intervening normal bowel, leading to the term "skip areas." Inflammation can be transmural, often extending through to the serosa, resulting in sinus tracts or fistula formation. A patient with a history of prostate cancer is admitted with confusion, thirst, nausea, oliguria, and abdominal cramping. The patient has gained 12 lb in the last two weeks. Diagnostics include potassium: 4.1 mEq/L sodium: 118 mEq/L serum osmolality: 272 mOsm/kg H2O increased urine osmolality Which part of the nephron is affected by this endocrine disorder? Distal tubule and collecting duct Proximal tubule and descending loop Glomerular capsule Bowman capsule Syndrome of inappropriate secretion of antidiuretic hormone (ADH) is an over secretion of ADH by the posterior pituitary gland due to several reasons, including prostate or renal cancers. When there is an over-secretion of ADH, it causes the distal tubules and collecting duct to reabsorb water and hyper-dilute the serum, causing a decreased serum sodium level, low serum osmolality, and high urine osmolality. The patient then gains weight from the excess fluid. An advanced practice registered nurse (APRN) is reviewing orders for a patient who passed a calculi, which relieved the condition of compensatory hypertrophy. The APRN is aware that the patient will need to be monitored closely due to a common condition associated with return to bilateral function. Which condition should the APRN anticipate? Apoptosis Post-obstructive diuresis Renal colic Hyperfunction Patients will have marked polyuria (> 4-5 L per day) after the release of bilateral obstruction. The physiological factors include excess sodium and water retention and accumulation of urea and other non-reabsorbable solutes, resulting in an osmotic diuresis. A patient expresses concern to an advanced practice registered nurse (APRN) about not being able to complete an entire meal without experiencing acid reflux. The patient also reports new symptoms including chest pain and dysphagia. The APRN suspects that the patient might have cancer. Which type of cancer is the APRN concerned about? Pancreatic Colorectal Esophageal Stomach The most common symptom of esophageal cancer is a problem swallowing (dysphagia), with a feeling like the food is stuck in the throat or chest or even choking on food. Some people get a feeling of pressure or burning in the chest. An advanced practice registered nurse (APRN) is working with a patient who has been diagnosed with detrusor hyperreflexia of the bladder without dyssynergia. The APRN is aware that an underlying neurological disorder led to the patient's condition. Which neurological disorder caused this condition? Spinal cord injury Guillain-Barré syndrome Multiple sclerosis Brain tumor Neurogenic bladder is a term applied to urinary bladder malfunction due to neurologic dysfunction emanating from internal or external trauma, disease, or injury. Symptoms of neurogenic bladder range from detrusor underactivity to overactivity, depending on the site of neurologic insult. An advanced practice registered nurse (APRN) is examining a 55-year-old African American male patient who has skin nodules. The APRN performs a physical exam and notes the nodules on his palms are blue-black and irregular. Which diagnosis should the APRN suspect? Primary nodular melanoma Superficial spreading melanoma Acral-lentiginous melanoma Lentigo maligna melanoma Acral-lentiginous melanoma occurs predominantly in men between the ages of 20 and 60 years, with 30-75% in African Americans, Asians, or Hispanics. This is characterized by blue-black irregular macules, papules, or nodules on the palms, soles of the feet, and mucous membranes. An advanced practice registered nurse (APRN) is examining an adult patient for knee pain that increases when climbing stairs or running. The pain decreases with rest, application of local heat, and regular use of ibuprofen. The APRN notes tenderness and inflammation surrounding the knee, but there is no obvious knee deformity. Radiologic evaluation is unremarkable. Which diagnosis should the APRN make for this patient? Osteoporosis Fibrosarcoma Paget disease Bursitis Trauma and overuse injuries can result in inflammation of the bursal sac. The pathophysiology of bursitis is an inflammation that is reactive to overuse or excessive pressure. The inflammation may decrease with rest, heat, and aspiration of the fluid.