1|Page
Final Exam - NURS 3366 Questions
and Answers with 100% Complete
Solutions
,2|Page
Stats to memorize
pH
CO2
HCO3
PaO2
blood glucose
normal capillary refill
7.35-7.45
35-45
22-28
80-100
70-99
<2 seconds
Your patient comes in with diabetes insipidus. Explain the
pathophysiology behind their fluid volume deficit.
- under-secretion of ADH
- polyuria, dilute urine
- serum osmolality increase
- sunken eyes, dry membranes, poor skin turgor
A patient with brain damage comes into the ER. They have a
sudden onset of peripheral edema and crackling in the lungs.
What could be the possible cause, and why?
- SIADH
- large, over-secretion of ADH
,3|Page
- causes body to hold on to a ton of water (oliguria)
- fluid volume overload, causes water to shift into tissues
A patient comes in exhibiting signs and symptoms of Grave's.
What signs and symptoms would lead you to believe they have
entered crisis state?
thyroid storm
- extreme tachycardia, HF, shock, 103-105, agitation, delirium,
seizures
- due to very high metabolism
Lab: T4 high, TSH low
What are the two main causes of hhpothyroidism?
Hashimoto's thyroiditis and endemic iodine deficieny
A comatose patient comes into the ER. Their medical record
states that they have hypothyroidism. Explain why they are
likely in a coma.
myxedema crisis
-hypotension, hypoventilation, extremely low metabolism
- face is very bloated due to fat buildup behind the eyes
Lab: low T4, high TSH
When is PTH secreted and what cells in the bone does it affect?
hypocalcemia (low Ca), osteoclasts (to break up bone for
calcium resorption)
, 4|Page
When is calcitonin secreted and what cells in the bone does it
affect?
hypercalcemia (too much calcium), osteoblasts (to build more
bone, bring Ca out of blood into bone)
A patient comes into the ER feeling lethargic and weak. You run
a blood test and find that their serum calcium levels are
extremely high. What might be the pathophysiological
reasoning behind their symptoms?
hypercalcemia = hyperpolarized
- muscles take longer to contract, making the person feel weak
and lethargic
- might be hypercalcemic due to over secretion of PTH, which
normally increases Ca in the blood
- could also be undersecretion of calcitonin, not bringing in
enough Ca into the bone
A patient comes into the ER experiencing tetany and muscle
spasms. You run a blood test and their labs come back with very
low levels of calcium. You check for a Chvostek's sign, and they
are positive. What is the most likely cause of these symptoms?
hypocalcemia = hypopolarized
- muscles take less time to contract, makes person spasm easily
- might be hypocalcemia due to oversecretion of calcitonin,
which normally decreases the Ca in the blood
Final Exam - NURS 3366 Questions
and Answers with 100% Complete
Solutions
,2|Page
Stats to memorize
pH
CO2
HCO3
PaO2
blood glucose
normal capillary refill
7.35-7.45
35-45
22-28
80-100
70-99
<2 seconds
Your patient comes in with diabetes insipidus. Explain the
pathophysiology behind their fluid volume deficit.
- under-secretion of ADH
- polyuria, dilute urine
- serum osmolality increase
- sunken eyes, dry membranes, poor skin turgor
A patient with brain damage comes into the ER. They have a
sudden onset of peripheral edema and crackling in the lungs.
What could be the possible cause, and why?
- SIADH
- large, over-secretion of ADH
,3|Page
- causes body to hold on to a ton of water (oliguria)
- fluid volume overload, causes water to shift into tissues
A patient comes in exhibiting signs and symptoms of Grave's.
What signs and symptoms would lead you to believe they have
entered crisis state?
thyroid storm
- extreme tachycardia, HF, shock, 103-105, agitation, delirium,
seizures
- due to very high metabolism
Lab: T4 high, TSH low
What are the two main causes of hhpothyroidism?
Hashimoto's thyroiditis and endemic iodine deficieny
A comatose patient comes into the ER. Their medical record
states that they have hypothyroidism. Explain why they are
likely in a coma.
myxedema crisis
-hypotension, hypoventilation, extremely low metabolism
- face is very bloated due to fat buildup behind the eyes
Lab: low T4, high TSH
When is PTH secreted and what cells in the bone does it affect?
hypocalcemia (low Ca), osteoclasts (to break up bone for
calcium resorption)
, 4|Page
When is calcitonin secreted and what cells in the bone does it
affect?
hypercalcemia (too much calcium), osteoblasts (to build more
bone, bring Ca out of blood into bone)
A patient comes into the ER feeling lethargic and weak. You run
a blood test and find that their serum calcium levels are
extremely high. What might be the pathophysiological
reasoning behind their symptoms?
hypercalcemia = hyperpolarized
- muscles take longer to contract, making the person feel weak
and lethargic
- might be hypercalcemic due to over secretion of PTH, which
normally increases Ca in the blood
- could also be undersecretion of calcitonin, not bringing in
enough Ca into the bone
A patient comes into the ER experiencing tetany and muscle
spasms. You run a blood test and their labs come back with very
low levels of calcium. You check for a Chvostek's sign, and they
are positive. What is the most likely cause of these symptoms?
hypocalcemia = hypopolarized
- muscles take less time to contract, makes person spasm easily
- might be hypocalcemia due to oversecretion of calcitonin,
which normally decreases the Ca in the blood
