NURS 5315 Final Exam with Complete Solutions

NURS 5315 Final Exam with Complete Solutions 1. A patient in respiratory distress and is breath - A patient who is breathing 33 breaths per minute is hyperventilating and blowing off CO2; there - ing 33 breaths per minute. fore the PCO2 level will be low. The patient will Which ABG value is con- sistent with the clinical scenario? PCO2 15 pH 7.30 pH 7.45 O2 sat 100% 2. A patient has a sodi - um level of 115 mEq/L and is disoriented and lethargic. Which patholog - most likely experience a respiratory alkalosis and the two pH values provided are not consis - tent with this diagnosis. b. The cause of neurologic symptoms associated with a sodium imbalance is directly related to fluid shifting into or out of the neurons of the brain. With a serum sodium of 115 mEq/L, water ical process best explains shifts into the neurons and causes them to swell. this patient's symptoms? a. The action potential has become hyperpolarized. b. Water has shifted into the neurons and caused them to swell. c. Water has shifted into the vascular space and dehydrated the neurons. d. The action potential has become hypopolarized. 3. A patient experiencing de- hydration should be moni - tored for which electrolyte imbalance? a. Hyperkalemia b. Hypocalcemia c. Hypercalcemia d. Hyponatermia 4. A married couple pre - sents to your office for ge- Hypernatremia causes water to shift out of the cell into the intravascular space and causes the neurons to become dehydrated. An alteration in the action potential is not seen with sodium imbalances. a. Serum osmolality is increased during times of dehydration. An elevated serum osmolality will pull potassium into the intravascular space from the intracellular space and cause a rise in serum potassium. A chromosome is a package of material located inside the cell nucleus which is made of proteins NURS 5315 Final Exam with Complete Solutions netic counseling. The hus- band has an autosomal and a single molecule of DNA. There are 23 pairs of chromosomes in each human cell for recessive disease and his a total of 46 chromosomes. Chromosomes are wife has a heterozygous genotype for the disease. They ask you, What is the chance that our baby will have the disease? Which of the following answers is correct? 25% 50% 75% 100% separated into two identical sets during mitosis or meiosis. This provides a set of chromosomes to each daughter cell which results from cell division. This process is responsible for the trans - fer of genetic information to the daughter cells. The first 22 pairs of chromosomes are known as autosomes. The 23rd pair of chromosomes is the pair which contains the genetic information for gender. This pair contains the genetic infor - mation which delineates between the male and female genders. Females have two X chromo - somes (XX) and males have an XY chromosome pair. Autosomal chromosomes are said to be autologous. This means they do not carry genetic information pertaining to gender. Autosomal ge - netic diseases are carried on the first 22 pairs of chromosomes. 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 reces - sive, or they both may be dominant or both reces - sive. The dominant alleles' genetic code will al - ways 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 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 NURS 5315 Final Exam with Complete Solutions use the same letter for the genotype - for exam - ple, "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 homozygous 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 com - pensate 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 dis- ease 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 phe- notype. The father's genotype is written across the top line and the mother's genotype is writ - ten 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