Path NURS 3366 Exam Questions With Complete Solutions
A patient is hospitalized in renal failure. Because of her kidneys'
inability to excrete water, she has generalized edema & a serum
sodium of 129. Because the kidneys have also lost the ability to
appropriately regulate potassium, she also has a serum
potassium of 5.9. These lab results show:
a. hypernatremia & hypokalemia.
b. hyperkalemia & hyponatremia.
c. hyperosmolality & hypernatremia.
d. hypoosmolality & hypocalcemia. Correct Answers b.
hyperkalemia/hyponatremia = high potassium and low sodium
A - incorrect hypernatremia/hypokalemia = high sodium and
low potassium
C - incorrect hyperkalemia/hyponatremia = high potassium and
low sodium
D - hypoosmolality/hypocalcemia = excess water and low
calcium
(Normal labs: Na+ = 135 to 145; K+ = 3.5 - 5.0; serum
osmolality ("osmo") = 280- 295; HCO3 = 22-28).
In the previous question, the edema is most likely due to fluid
shifting from the intravascular space into interstitial spaces
secondary to all the following EXCEPT:
a. hypertonicity of the plasma space.
b. hypotonicity of the plasma space.
c. hypoosmolality of the blood.
,d. diminished osmotic pressure of the blood. Correct Answers
a. hypertonicity (higher solute/concentration) of the plasma
space would mean that there was no edema as it would pull
excess fluid to the blood and not send it to the tissue.
B - true because hypotonicity means low solute/concentration in
the plasma space
C - true because hypoosmolality (low fluid) in the blood would
mean that the blood is more concentrated
D - true because hypoosmolality (low fluid) in the blood would
reduce osmotic pressure in the blood
A 28-year-old man presents with a low blood pressure due to
blood loss from a gunshot wound. The regulatory
action that will best compensate for this patient's fluid volume
deficit is:
a. increased action of the natriuretic peptide system.
b. increased action of the RAAS.
c. inhibition of renin secretion.
d. conversion of aldosterone into angiotensin II. Correct
Answers b. increased action of the RAAS.
A - incorrect as increased action of the natriuretic peptide
system would decompensate the patient
C - incorrect as inhibition of renin secretion would exacerbate
the low fluid volume
D - Incorrect as the conversion of aldosterone into angiotensin II
wouldn't correct the problem
,A 55 year old male is in the ER having a myocardial infarction
(heart attack, AKA "M.I."), which is caused by coronary arteries
that are clogged with fat and narrowed so that not enough
oxygen-rich blood is getting to his heart. He admits that his daily
nutrition is poor, consisting mainly of high-fat fast food. He has
a family history of cardiac disease-- his father had a heart attack
at age 46. The patient is obese and is a heavy cigarette smoker--
2 PPD (packs per day). The patient said he had decided to take
up jogging today and after a few minutes began having chest
pain, nausea and shortness of breath. He went to the ER and was
noted to have profuse diaphoresis (heavy sweating), tachycardia
(rapid heart rate), and significant changes on his
electrocardiogram (ECG or EKG). The patient recovers from
this acute heart attack but his heart is so damaged that
subsequently he has many episodes of congestive heart fail
Correct Answers A - having to be hospitalized frequently
because of problems associated with damaged heart
B - not correct as this is not indicated as a sequela in the
problem
C - not correct because the MI/heart damage has given the
patient a condition where he is now unable to jog more often
D - not correct because....well duh
A 55 year old male is in the ER having a myocardial infarction
(heart attack, AKA "M.I."), which is caused by coronary arteries
that are clogged with fat and narrowed so that not enough
oxygen-rich blood is getting to his heart. He admits that his daily
nutrition is poor, consisting mainly of high-fat fast food. He has
a family history of cardiac disease-- his father had a heart attack
at age 46. The patient is obese and is a heavy cigarette smoker--
, 2 PPD (packs per day). The patient said he had decided to take
up jogging today and after a few minutes began having chest
pain, nausea and shortness of breath. He went to the ER and was
noted to have profuse diaphoresis (heavy sweating), tachycardia
(rapid heart rate), and significant changes on his
electrocardiogram (ECG or EKG). The patient recovers from
this acute heart attack but his heart is so damaged that
subsequently he has many episodes of congestive heart fail
Correct Answers B - having profuse diaphoresis (excessive
sweating with no apparent cause) ; this is not a risk factor
A - heavy smoker is a risk factor
C -genetic predisposition or family history is a risk factor
D - high-fat diet is a risk factor
A 55 year old male is in the ER having a myocardial infarction
(heart attack, AKA "M.I."), which is caused by coronary arteries
that are clogged with fat and narrowed so that not enough
oxygen-rich blood is getting to his heart. He admits that his daily
nutrition is poor, consisting mainly of high-fat fast food. He has
a family history of cardiac disease-- his father had a heart attack
at age 46. The patient is obese and is a heavy cigarette smoker--
2 PPD (packs per day). The patient said he had decided to take
up jogging today and after a few minutes began having chest
pain, nausea and shortness of breath. He went to the ER and was
noted to have profuse diaphoresis (heavy sweating), tachycardia
(rapid heart rate), and significant changes on his
electrocardiogram (ECG or EKG). The patient recovers from
this acute heart attack but his heart is so damaged that
subsequently he has many episodes of congestive heart fail
Correct Answers C - c. High levels of fat in the blood from
A patient is hospitalized in renal failure. Because of her kidneys'
inability to excrete water, she has generalized edema & a serum
sodium of 129. Because the kidneys have also lost the ability to
appropriately regulate potassium, she also has a serum
potassium of 5.9. These lab results show:
a. hypernatremia & hypokalemia.
b. hyperkalemia & hyponatremia.
c. hyperosmolality & hypernatremia.
d. hypoosmolality & hypocalcemia. Correct Answers b.
hyperkalemia/hyponatremia = high potassium and low sodium
A - incorrect hypernatremia/hypokalemia = high sodium and
low potassium
C - incorrect hyperkalemia/hyponatremia = high potassium and
low sodium
D - hypoosmolality/hypocalcemia = excess water and low
calcium
(Normal labs: Na+ = 135 to 145; K+ = 3.5 - 5.0; serum
osmolality ("osmo") = 280- 295; HCO3 = 22-28).
In the previous question, the edema is most likely due to fluid
shifting from the intravascular space into interstitial spaces
secondary to all the following EXCEPT:
a. hypertonicity of the plasma space.
b. hypotonicity of the plasma space.
c. hypoosmolality of the blood.
,d. diminished osmotic pressure of the blood. Correct Answers
a. hypertonicity (higher solute/concentration) of the plasma
space would mean that there was no edema as it would pull
excess fluid to the blood and not send it to the tissue.
B - true because hypotonicity means low solute/concentration in
the plasma space
C - true because hypoosmolality (low fluid) in the blood would
mean that the blood is more concentrated
D - true because hypoosmolality (low fluid) in the blood would
reduce osmotic pressure in the blood
A 28-year-old man presents with a low blood pressure due to
blood loss from a gunshot wound. The regulatory
action that will best compensate for this patient's fluid volume
deficit is:
a. increased action of the natriuretic peptide system.
b. increased action of the RAAS.
c. inhibition of renin secretion.
d. conversion of aldosterone into angiotensin II. Correct
Answers b. increased action of the RAAS.
A - incorrect as increased action of the natriuretic peptide
system would decompensate the patient
C - incorrect as inhibition of renin secretion would exacerbate
the low fluid volume
D - Incorrect as the conversion of aldosterone into angiotensin II
wouldn't correct the problem
,A 55 year old male is in the ER having a myocardial infarction
(heart attack, AKA "M.I."), which is caused by coronary arteries
that are clogged with fat and narrowed so that not enough
oxygen-rich blood is getting to his heart. He admits that his daily
nutrition is poor, consisting mainly of high-fat fast food. He has
a family history of cardiac disease-- his father had a heart attack
at age 46. The patient is obese and is a heavy cigarette smoker--
2 PPD (packs per day). The patient said he had decided to take
up jogging today and after a few minutes began having chest
pain, nausea and shortness of breath. He went to the ER and was
noted to have profuse diaphoresis (heavy sweating), tachycardia
(rapid heart rate), and significant changes on his
electrocardiogram (ECG or EKG). The patient recovers from
this acute heart attack but his heart is so damaged that
subsequently he has many episodes of congestive heart fail
Correct Answers A - having to be hospitalized frequently
because of problems associated with damaged heart
B - not correct as this is not indicated as a sequela in the
problem
C - not correct because the MI/heart damage has given the
patient a condition where he is now unable to jog more often
D - not correct because....well duh
A 55 year old male is in the ER having a myocardial infarction
(heart attack, AKA "M.I."), which is caused by coronary arteries
that are clogged with fat and narrowed so that not enough
oxygen-rich blood is getting to his heart. He admits that his daily
nutrition is poor, consisting mainly of high-fat fast food. He has
a family history of cardiac disease-- his father had a heart attack
at age 46. The patient is obese and is a heavy cigarette smoker--
, 2 PPD (packs per day). The patient said he had decided to take
up jogging today and after a few minutes began having chest
pain, nausea and shortness of breath. He went to the ER and was
noted to have profuse diaphoresis (heavy sweating), tachycardia
(rapid heart rate), and significant changes on his
electrocardiogram (ECG or EKG). The patient recovers from
this acute heart attack but his heart is so damaged that
subsequently he has many episodes of congestive heart fail
Correct Answers B - having profuse diaphoresis (excessive
sweating with no apparent cause) ; this is not a risk factor
A - heavy smoker is a risk factor
C -genetic predisposition or family history is a risk factor
D - high-fat diet is a risk factor
A 55 year old male is in the ER having a myocardial infarction
(heart attack, AKA "M.I."), which is caused by coronary arteries
that are clogged with fat and narrowed so that not enough
oxygen-rich blood is getting to his heart. He admits that his daily
nutrition is poor, consisting mainly of high-fat fast food. He has
a family history of cardiac disease-- his father had a heart attack
at age 46. The patient is obese and is a heavy cigarette smoker--
2 PPD (packs per day). The patient said he had decided to take
up jogging today and after a few minutes began having chest
pain, nausea and shortness of breath. He went to the ER and was
noted to have profuse diaphoresis (heavy sweating), tachycardia
(rapid heart rate), and significant changes on his
electrocardiogram (ECG or EKG). The patient recovers from
this acute heart attack but his heart is so damaged that
subsequently he has many episodes of congestive heart fail
Correct Answers C - c. High levels of fat in the blood from
