NURS 6620 FINAL EXAM LATEST /NURS 6620 ADVANCED HEALTH ASSESSMENT FINAL ALL
85 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED
A+
During cell injury caused by hypoxia, why does an increase in the osmotic pressure within the
cell occur? - (ANSWERS)b.Sodium chloride enters the cell.
In hypoxic injury, movement of fluid and ions into the cell is associated with acute failure of
metabolism and a loss of ATP production. Normally, the pump that transports sodium ions out
of the cell is maintained by the presence of ATP and ATPase, the active transport enzyme. In
metabolic failure caused by hypoxia, reduced ATP and ATPase levels permit sodium to
accumulate in the cell, whereas potassium diffuses outward. The increase of intracellular
sodium increases osmotic pressure, which draws more water into the cell. (Transport
mechanisms are described in Chapter 1.) The remaining options do not accurately describe the
cell injury that results in increased osmotic pressure caused by hypoxia.
A healthcare professional is caring for four patients. Which patient should the professional
assess for hyperkalemia or hypermagnesmia? - (ANSWERS)c.Renal failure
Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin
deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists.
Hyperparathyroidism might lead to hyperphosphatemia. Vomiting is frequently associated with
potassium depletion. Hyperaldosteronism also can lead to potassium wasting.
Renal failure usually causes hypermagnesemia, in which magnesium concentration is greater
than 2.5 mEq/L. Hypermagnesemia is not a result of the other options.
A major determinant of the resting membrane potential necessary for the transmission of nerve
impulses is the ratio between what? - (ANSWERS)Intracellular and extracellular K+
The ratio of K+ in theICF to K+ in the ECF is the major determinant of the resting membrane
potential, which is necessary for the transmission and conduction of nerve impulses, for the
maintenance of normal cardiac rhythms, and for the skeletal and smooth muscle contraction.
This is not true of the other options.
How do free radicals cause cell damage? - (ANSWERS)a.Giving up an electron, which causes
injury to the chemical bonds of the cell membrane
A free radical is an electrically uncharged atom or group of atoms having an unpaired electron.
Having one unpaired electron makes the molecule unstable; thus to stabilize, the molecule
gives up an electron to another molecule or steals one. Therefore it is capable of forming
injurious chemical bonds with proteins, lipids, or carbohydrates-key molecules in membranes
and nucleic acids. Free radical damage is not caused by hypoxia, lysosomal enzymes, or
transferring atoms.
Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic
acid (H2CO3) exist in what ratio? - (ANSWERS)b.20:1
The relationship between HCO3 and H2CO3 is usually expressed as a ratio. When the pH is 7.4,
this ratio is 20:1 (HCO3:H2CO3). The other options do not accurately identify physiologic pH by
the correct ratio of HCO3 and H2CO3.
, NURS 6620 FINAL EXAM LATEST /NURS 6620 ADVANCED HEALTH ASSESSMENT FINAL ALL
85 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED
A+
Removal of part of the liver leads to the remaining liver cells undergoing which compensatory
process? - (ANSWERS)c.Hyperplasia
Compensatory hyperplasia is an adaptive mechanism that enables certain organs to
regenerate. For example, the removal of part of the liver leads to hyperplasia of the remaining
liver cells (hepatocytes) to compensate for the loss. The other options do not accurately identify
the compensatory process described in the question.
What causes the rapid change in the resting membrane potential to initiate an action potential?
- (ANSWERS)Sodium gates open, and sodium rushes into the cell, changing the membrane
potential from negative to positive.
When a resting cell is stimulated through voltage-regulated channels, the cell membranes
become more permeable to Na+. As Na+ moves into the cell the membrane potential
decreases, or moves forward, from a negative value (in millivolts) to zero. The Na+ gates open,
and Na+ rushes into the cell, causing the membrane potential to reduce to zero and then
become positive (depolarization).
What does the loss of the adenosine triphosphate (ATP) during ischemia cause cells to do? -
(ANSWERS)Swell because of the influx of sodium chloride (NaCl)
A reduction in ATP levels causes the plasma membrane's sodium-potassium (Na+-K+) pump
and sodium-calcium exchange to fail, which leads to an intracellular accumulation of sodium
and calcium and diffusion of potassium out of the cell. (The Na+-K+ pump is discussed in
Chapter 1.) Sodium and water can then freely enter the cell, and cellular swelling results. The
other options do not accurately describe the result of ATP at the cellular level.
What is the most common site of lipid accumulation? - (ANSWERS)Liver
Although lipids sometimes accumulate in heart and kidney cells, the most common site of
intracellular lipid accumulation, or fatty change, is liver cells. Subcutaneous tissue is not a
common site of lipid accumulation.
What occurs during exocytosis? - (ANSWERS)Macromolecules can be secreted across
eukaryotic cell membranes.
In eukaryotic cells, secretion of macromolecules almost always occurs by exocytosis. The
remaining options do not correctly describe exocytosis.
Which form of cell communication is used to communicate within the cell itself and with other
cells in direct physical contact? - (ANSWERS)Plasma membrane-bound signaling molecules
Cells communicate in three main ways; they display plasma membrane-bound signaling
molecules that affect the cell itself and other cells in direct physical contact with it, they affect
receptor proteins inside the target cell, and they form protein channels (gap junctions) that
directly coordinate the activities of adjacent cells. Neurotransmitters are released by neurons
and cross the synaptic cleft to communicate with the cells they innervate. Ligands are involved
in binding processes.
85 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED
A+
During cell injury caused by hypoxia, why does an increase in the osmotic pressure within the
cell occur? - (ANSWERS)b.Sodium chloride enters the cell.
In hypoxic injury, movement of fluid and ions into the cell is associated with acute failure of
metabolism and a loss of ATP production. Normally, the pump that transports sodium ions out
of the cell is maintained by the presence of ATP and ATPase, the active transport enzyme. In
metabolic failure caused by hypoxia, reduced ATP and ATPase levels permit sodium to
accumulate in the cell, whereas potassium diffuses outward. The increase of intracellular
sodium increases osmotic pressure, which draws more water into the cell. (Transport
mechanisms are described in Chapter 1.) The remaining options do not accurately describe the
cell injury that results in increased osmotic pressure caused by hypoxia.
A healthcare professional is caring for four patients. Which patient should the professional
assess for hyperkalemia or hypermagnesmia? - (ANSWERS)c.Renal failure
Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin
deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists.
Hyperparathyroidism might lead to hyperphosphatemia. Vomiting is frequently associated with
potassium depletion. Hyperaldosteronism also can lead to potassium wasting.
Renal failure usually causes hypermagnesemia, in which magnesium concentration is greater
than 2.5 mEq/L. Hypermagnesemia is not a result of the other options.
A major determinant of the resting membrane potential necessary for the transmission of nerve
impulses is the ratio between what? - (ANSWERS)Intracellular and extracellular K+
The ratio of K+ in theICF to K+ in the ECF is the major determinant of the resting membrane
potential, which is necessary for the transmission and conduction of nerve impulses, for the
maintenance of normal cardiac rhythms, and for the skeletal and smooth muscle contraction.
This is not true of the other options.
How do free radicals cause cell damage? - (ANSWERS)a.Giving up an electron, which causes
injury to the chemical bonds of the cell membrane
A free radical is an electrically uncharged atom or group of atoms having an unpaired electron.
Having one unpaired electron makes the molecule unstable; thus to stabilize, the molecule
gives up an electron to another molecule or steals one. Therefore it is capable of forming
injurious chemical bonds with proteins, lipids, or carbohydrates-key molecules in membranes
and nucleic acids. Free radical damage is not caused by hypoxia, lysosomal enzymes, or
transferring atoms.
Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic
acid (H2CO3) exist in what ratio? - (ANSWERS)b.20:1
The relationship between HCO3 and H2CO3 is usually expressed as a ratio. When the pH is 7.4,
this ratio is 20:1 (HCO3:H2CO3). The other options do not accurately identify physiologic pH by
the correct ratio of HCO3 and H2CO3.
, NURS 6620 FINAL EXAM LATEST /NURS 6620 ADVANCED HEALTH ASSESSMENT FINAL ALL
85 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED
A+
Removal of part of the liver leads to the remaining liver cells undergoing which compensatory
process? - (ANSWERS)c.Hyperplasia
Compensatory hyperplasia is an adaptive mechanism that enables certain organs to
regenerate. For example, the removal of part of the liver leads to hyperplasia of the remaining
liver cells (hepatocytes) to compensate for the loss. The other options do not accurately identify
the compensatory process described in the question.
What causes the rapid change in the resting membrane potential to initiate an action potential?
- (ANSWERS)Sodium gates open, and sodium rushes into the cell, changing the membrane
potential from negative to positive.
When a resting cell is stimulated through voltage-regulated channels, the cell membranes
become more permeable to Na+. As Na+ moves into the cell the membrane potential
decreases, or moves forward, from a negative value (in millivolts) to zero. The Na+ gates open,
and Na+ rushes into the cell, causing the membrane potential to reduce to zero and then
become positive (depolarization).
What does the loss of the adenosine triphosphate (ATP) during ischemia cause cells to do? -
(ANSWERS)Swell because of the influx of sodium chloride (NaCl)
A reduction in ATP levels causes the plasma membrane's sodium-potassium (Na+-K+) pump
and sodium-calcium exchange to fail, which leads to an intracellular accumulation of sodium
and calcium and diffusion of potassium out of the cell. (The Na+-K+ pump is discussed in
Chapter 1.) Sodium and water can then freely enter the cell, and cellular swelling results. The
other options do not accurately describe the result of ATP at the cellular level.
What is the most common site of lipid accumulation? - (ANSWERS)Liver
Although lipids sometimes accumulate in heart and kidney cells, the most common site of
intracellular lipid accumulation, or fatty change, is liver cells. Subcutaneous tissue is not a
common site of lipid accumulation.
What occurs during exocytosis? - (ANSWERS)Macromolecules can be secreted across
eukaryotic cell membranes.
In eukaryotic cells, secretion of macromolecules almost always occurs by exocytosis. The
remaining options do not correctly describe exocytosis.
Which form of cell communication is used to communicate within the cell itself and with other
cells in direct physical contact? - (ANSWERS)Plasma membrane-bound signaling molecules
Cells communicate in three main ways; they display plasma membrane-bound signaling
molecules that affect the cell itself and other cells in direct physical contact with it, they affect
receptor proteins inside the target cell, and they form protein channels (gap junctions) that
directly coordinate the activities of adjacent cells. Neurotransmitters are released by neurons
and cross the synaptic cleft to communicate with the cells they innervate. Ligands are involved
in binding processes.
