Pathophysiology HESI Practice Exam Questions & Answers 100% Correct

A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse should monitor the client closely for a. Loss of thirst, weight gain b. Dependent edema, fever c. Polydipsia, polyuria d. Hypernatremia, tachypnea - ANSWER-a SIADH is caused by the excessive release of an antidiuretic hormonr (ADH). As a result of the excess ADH, the client retains water creating a dilutional hyponatremia. SIADH causes hyponatremia, not D. A client with a markedly distended bladder is diagnosed with hydronephrosis and left hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a residual urine volume of 1650 ml. This finding supports which pathophysiological cause of the client's urinary tract obstruction? a. Obstruction at the urinary bladder neck. b. Ureteral calculi obstruction. c. Ureteropelvic junction stricture. d. Partial post-renal obstruction due to ureteral stricture. - ANSWER-a Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward movement of urine from the lower to upper urinary tracts), and hydronephrosis (dilation or enlargement of the renal pelvis and calyces) result from post-renal obstruction which can consequently result in chronic pyelonephritis and renal atrophy. Ascending urinary reflux occurs when normal ureteral peristaltic pressure is met with an increase in urinary pressure occurring during bladder filling if the urinary bladder neck is obstructed (A). A large residual urine does not occur with (B, C, and D) because the urine can not get to the bladder. Physical examination of a comatose client reveals decorticate posturing. Which statement is accurate regarding this client's status based upon this finding? a. A cerebral infectious process is causing the posturing. b. Severe dysfunction of the cerebral cortex has occurred. c. There is a probable dysfunction of the midbrain. d. The client is exhibiting signs of a brain tumor. - ANSWER-B Decorticate posturing (adduction of arms at shoulders, flexion of arms on chest with wrists flexed and hands fisted and extension and adduction of extremities) is seen with severe dysfunction of the cerebral cortex (B). (A) is characteristic of meningitis. (C) is characterized by decerebrate posturing (rigid extension and pronation of arms and legs). A client with (D) may exhibit decorticate posturing, depending on the position of the tumor and the condition of the client.