NUR 239 Exam 5 Solution Manual Fully Solved Latest Update 2025 Graded A+
Penumbra - Answers ischemic band or area of minimally perfused cells; area of tissue damaged by
ischemia but remains potentially viable for several hours if blood flow is restored
Atelectasis - Answers collapse of alveoli; incomplete expansion - collapsed alveoli are much harder to
reinflate
Parkinson's Disease (patho, CM, Dx, Tx) - Answers · Patho: Chronic progressive degenerative neurologic
condition - neurons are destroyed; affects dopamine neurons of substantia nigra
· Clinical Manifestations: 1st tremor: upper extremities at rest, rigidity, bradykinesia; pill rolling: rolls
fingers like rolling a marble in hand; slow to start walking and difficulty stopping
· Dx: CT or MRI to r/o tumors, DaTScan, Pet Scan
· Tx: Increase dopamine, block acetylcholine; meds do not stop progression of disease, just relieve sx
Early signs of PD - Answers loss of smell, constipation, and sleep disorders
"Off-time" phenomenon - Answers fluctuations in medication effectiveness; conform to pt's at home
schedule
TIA (transient ischemic attack) - Answers · TIA: Warning of impending stroke: "brain angina"
o Lasts < 24 hrs
o Temporary lack of blood flow reverses before infarction occurs
o S&S: changes in speech, vision, and gait, dizziness, weakness, numbness
o Complication: high incidence of stroke w/in 48 hrs
o Meds to prevent further TIA/stroke: aspirin or clopidogrel
Stroke - Answers · syndrome of acute focal neurologic deficit resulting from vascular induced disorder
that injures brain tissue; sudden onset of focal neurologic symptoms
o Lasts > 24 hrs
o Damage/necrosis of brain tissues (cerebral infarction)
o Ischemic - 87%: interruption of blood flow
o Hemorrhagic - 13%: higher fatality rate, spontaneous bleeding
Pneumonia - Mode of Transmission - Answers · acute inflammatory process of bronchioles and alveoli;
, · Mode of transmission: aspiration of oral secretions w/ microbes; inhalation of microbes, toxic
inhalants; spread of microbes from another site
o community acquired: strep. Pneumoniase (pneumococcus) within 48 hrs of admission
o hospital-acquired: staphylococcus, MRSA; ventilator-associated - VAP within over 48 hrs after
admission; lower respiratory tract
Pneumonia - CM and S&S - Answers · Clinical Manifestations: sudden onset of cough (productive or non-
productive), fever, chills, malaise, crackles, watery sputum; rust colored sputum
· S&S: fever, chills, pleural pain, crackles
Aspiration Pneumonia - Answers aspiration of vomitus due to altered state of consciousness, decreased
cough and gag reflex, seizures, etc.
Pneumonia Dx and Tx - Answers · Dx: CXR, WBC and differential, sputum culture, ABGs/pulse ox
· Tx: O2, antibiotics (penicillins, cephalosporins, macrolides); prevention: flu and pneumonia vaccines
TB Patho: Active vs Latent - Answers · Tuberculosis- slow-growing bacteria that requires long-term
treatment; airborne transmission
· Patho: aerobic organism, prefers lung tissue with high O2 level (apex); inflammatory, delayed
hypersensitivity reaction; exudate formation, consolidation; granuloma formation/lesion
Active vs Latent TB - Answers · Active: secondary infection if impaired defense mechanisms; fever, night
sweats, fatigue, wt. loss, weakness, persistent productive cough with hemoptysis
· Latent: in-active but TB microbe is alive in body, but contained by immune system; PPD+,
asymptomatic, noninfectious but treat before sx show because it can become active at anytime (when
immune response is decreased)
TB: assessment and Dx - Answers · Assessment: crackles, bronchial breath sounds, chronic productive
cough, hemoptysis, enlarged lymph nodes
· Dx: CXR and Chest CT; sputum culture and sensitivity
Drug-resistant TB - Answers · Drug-resistant: resistant to one first-line drug
· multi-drug resistant: resistant to INH and Rifampin; rapid progression to death in 4-16 wks; 4-6 drugs
needed to treat (2 yr treatment)
· extensive drug resistant: now resistant to second-line drugs; resistance to as many as 6-7 drugs
Carbidopa/levodopa (Sinemet) - Answers · increases dopamine
o Action
Penumbra - Answers ischemic band or area of minimally perfused cells; area of tissue damaged by
ischemia but remains potentially viable for several hours if blood flow is restored
Atelectasis - Answers collapse of alveoli; incomplete expansion - collapsed alveoli are much harder to
reinflate
Parkinson's Disease (patho, CM, Dx, Tx) - Answers · Patho: Chronic progressive degenerative neurologic
condition - neurons are destroyed; affects dopamine neurons of substantia nigra
· Clinical Manifestations: 1st tremor: upper extremities at rest, rigidity, bradykinesia; pill rolling: rolls
fingers like rolling a marble in hand; slow to start walking and difficulty stopping
· Dx: CT or MRI to r/o tumors, DaTScan, Pet Scan
· Tx: Increase dopamine, block acetylcholine; meds do not stop progression of disease, just relieve sx
Early signs of PD - Answers loss of smell, constipation, and sleep disorders
"Off-time" phenomenon - Answers fluctuations in medication effectiveness; conform to pt's at home
schedule
TIA (transient ischemic attack) - Answers · TIA: Warning of impending stroke: "brain angina"
o Lasts < 24 hrs
o Temporary lack of blood flow reverses before infarction occurs
o S&S: changes in speech, vision, and gait, dizziness, weakness, numbness
o Complication: high incidence of stroke w/in 48 hrs
o Meds to prevent further TIA/stroke: aspirin or clopidogrel
Stroke - Answers · syndrome of acute focal neurologic deficit resulting from vascular induced disorder
that injures brain tissue; sudden onset of focal neurologic symptoms
o Lasts > 24 hrs
o Damage/necrosis of brain tissues (cerebral infarction)
o Ischemic - 87%: interruption of blood flow
o Hemorrhagic - 13%: higher fatality rate, spontaneous bleeding
Pneumonia - Mode of Transmission - Answers · acute inflammatory process of bronchioles and alveoli;
, · Mode of transmission: aspiration of oral secretions w/ microbes; inhalation of microbes, toxic
inhalants; spread of microbes from another site
o community acquired: strep. Pneumoniase (pneumococcus) within 48 hrs of admission
o hospital-acquired: staphylococcus, MRSA; ventilator-associated - VAP within over 48 hrs after
admission; lower respiratory tract
Pneumonia - CM and S&S - Answers · Clinical Manifestations: sudden onset of cough (productive or non-
productive), fever, chills, malaise, crackles, watery sputum; rust colored sputum
· S&S: fever, chills, pleural pain, crackles
Aspiration Pneumonia - Answers aspiration of vomitus due to altered state of consciousness, decreased
cough and gag reflex, seizures, etc.
Pneumonia Dx and Tx - Answers · Dx: CXR, WBC and differential, sputum culture, ABGs/pulse ox
· Tx: O2, antibiotics (penicillins, cephalosporins, macrolides); prevention: flu and pneumonia vaccines
TB Patho: Active vs Latent - Answers · Tuberculosis- slow-growing bacteria that requires long-term
treatment; airborne transmission
· Patho: aerobic organism, prefers lung tissue with high O2 level (apex); inflammatory, delayed
hypersensitivity reaction; exudate formation, consolidation; granuloma formation/lesion
Active vs Latent TB - Answers · Active: secondary infection if impaired defense mechanisms; fever, night
sweats, fatigue, wt. loss, weakness, persistent productive cough with hemoptysis
· Latent: in-active but TB microbe is alive in body, but contained by immune system; PPD+,
asymptomatic, noninfectious but treat before sx show because it can become active at anytime (when
immune response is decreased)
TB: assessment and Dx - Answers · Assessment: crackles, bronchial breath sounds, chronic productive
cough, hemoptysis, enlarged lymph nodes
· Dx: CXR and Chest CT; sputum culture and sensitivity
Drug-resistant TB - Answers · Drug-resistant: resistant to one first-line drug
· multi-drug resistant: resistant to INH and Rifampin; rapid progression to death in 4-16 wks; 4-6 drugs
needed to treat (2 yr treatment)
· extensive drug resistant: now resistant to second-line drugs; resistance to as many as 6-7 drugs
Carbidopa/levodopa (Sinemet) - Answers · increases dopamine
o Action
