NR 507 Final Study (Latest 2024 / 2025) Questions and Answers (Verified Answers)

SUBSCRIBE NR 507 Final Study 1. BPH Answer Becomes problematic when prostatic tissue compresses urethra - in- creased frequency of lower UTIs. - Does not always cause bladder outflow obstruction - Urge to urinate often, delay in starting urination, decreased forced of urinary stream - Bladder unable to empty all of the urine - Overflow incontinence with increase in intra abdominal pressure -Common complications Answer hematuria, bladder/kidney infections, bladder calculi, acute urinary retention (hydroureter), hydronephrosis, and renal insufficiency - Some have signs of uremia and renal failure 40-70% of men with BP related LUTI symptoms have chronic inflammation. 2. Prostate Cancer Answer Total fat intake, animal and saturated fat, red meats, and dairy products associated with increased risk. - dietary fat may increase androgen, oxidative stress, and reactive oxygen species - Obesity linked to advanced and aggressive prostate cancer - High BMI associated with higher aggression and worse outcomes - High calorie and carb intake may increase risk - Monosaturated fats may DECREASE risk - Vit. D. and E. and selenium aid in prevention - Soy has anticancer properties - Tomato/products reduce risk - Broccoli, cabbage, cauliflower, brussel sprouts, chinese cabbage, and turnips may be protective - Green tea associated with decreased incidence - Curcumin has anticarcinogenic potential High linoleic acid (corn oil) act as proinflammatory eicosanoid (promotes cell prolif - eration and angiogenesis) - Western diet has increased omega 6 to 3 ratios (proinflammatory) Cooking meat at high temps produces heterocyclic amines and aromatic hydrocar - bons (carcinogenic) SUBSCRIBE NO support for strong role of fruits/vegetables in slowing progression Carcinogenic nitrosamines formed after consumption of processed meat that con- tains nitrites. 3. Blood glucose in Shock Answer Compensatory mechanisms activated by shock con- tribute to decreased glucose uptake and use -cells shift to glycogenolysis, gluconeogenesis, and lipolysis to generate fuel for survival -Total body stores can only fuel metabolism for 10 hours - High serum levels of cortisol, growth hormone, and catecholamines account for hyperglycemia and insulin resistance, tachycardia, increased SVR and increased cardiac contractility 4. Hypovolemic Shock Answer Causes Answer loss of whole blood, plasma, or interstitial fluid in large amounts such as - hemorrhage, burns, diaphoresis, DM, DI, emesis, diuresis Loss of whole blood/plasma - direct cause Loss of intersitital fluid - indirect (relative) cause -promotes diffusion of plasma from the intravascular to extravascular space -Begins to develop when intravascular volume decreases by 15%. Eventually results in extreme vasoconstriction and increased systemic vascular resistance (SVR) and afterload. 5. Respiratory Alkalosis Answer Occurs when there is alveolar hyperventilation and de- creased concentration of plasma carbon dioxide (hypocapnia) - increasing ratio of HCO3 to PCO2 Ventilation precipitated by hypoxemia and hypermetabolic states - high altitudes - fever, anemia, thyrotoxicosis - early salicylate intoxication - anxiety/panic disorder Improper use of mechanical ventilators causes iatrogenic respiratory alkalosis Secondary respiratory alkalosis may develop from hyperventilation stimulated by metabolic acidosis - mixed AB disorder SUBSCRIBE 6. Buffer in Blood Answer Most important plasma buffer systems are bicarbonate -carbonic acid and hemoglobin Intracellular Answer protein and phosphate (1st line of defense) Hemoglobin has the ability to bind with H+ (HHb) and carbon dioxide (HHbCO2) Hb with H+ is a weak acid Less oxygen saturated Hb (venous blood) is better than oxygen saturated Hb (arterial blood) Intracellular and extracellular proteins have negative charges - serve as buffer for H+ - primarily intracellular because most proteins are inside the cell. 7. DVT Pathophysiology Answer Blood clot that remains attached to a vessel wall (usually single side of lower extremity) Triad of Virchow promotes DVT - Venous stasis -immobility, obesity, prolonged leg dependency, age, CHF - Venous intimal damage - trauma, venipuncture, IV meds - Hypercoagulable state- inherited disorders, smoking, malignancy, liver disease, pregnancy, oral contraceptives, hormone replacement, hyperchromocysteinemia, antiphospholipid syndrome Accumulation of clotting factors and platelets leads to thrombus formation in the vein (often near a valve) - abnormal factor V leiden and prothrombin gene variant 202010A are heritable and cause a predisposition Inflammation around the thrombus promotes further platelet aggregation and it grows proximally 8. Contractures Answer Excessive wound contraction Burn wounds are susceptible Internal contractures common in cirrhosis - Constricts blood flow- portal hypertesnion and esophageal varices 9. Deep Pressure Ulcer Healing SUBSCRIBE Answer Requires tissue replacement so epithelialization, scar formation, and contraction take longer, and healing occurs through secondary intention. -Not completely resorted by healing -Regains 80% of original strength 10. Phases of deep pressure healing Answer Phase 1 Answer inflammation -Coagulation and infiltration of cells (platelets, neutrophils, and macrophages) -Platelets - clot formation, degranulate and release growth factors that initiate proliferation -Neutrophils and macrophages clear wound of debris (debridement) Phase 2 Answer proliferation and new tissue formation (reconstruction) -Macrophage invasion of the dissolving clot ad recruitment and proliferation of fibroblasts -Fibroblast collagen synthesis, epithelialization, contraction, and cellular differentia - tion -Collagen secreted by fibroblasts Phase 3 Answer remodeling and maturation -Continuation of cellular differentiation, scar formation, and scar remodeling -Fibroblast is major cell of tissue remodeling -Deposition of collagen into organized matrix 11. Contraction Answer Calcium binds to troponin Answer Calcium ions bind with troponin -Overcomes inhibitory function of troponin -tropomyosin system -Thin filament (actin) slides toward thick filament (myosin) -Two ends of myofibril shorten after contraction when myosin heads attach to actin forming cross -bridge (actin -myosin complex) -ATP released when cross -bridges attach 12. Growth of Long bones in Children Answer