ADVANCED PATHOPHYSIOLOGY HESI RN (Questions and Answers Complete Study Guide) Graded 100% 2023

ADVANCED PATHOPHYSIOLOGY HESI RN (Questions and Answers Complete Study Guide) Graded 100% 2023. A client has been diagnosed with Coxiellaburnetii infection. She asked the health care provider how she could have gotten this disease. The health care provider's best response is: A) “Probably while walking outside without your shoes on.” B) “While swimming in an unsanitary pond.” C) “Drinking contaminated milk.” D) “Eating undercooked fish.” Ans: C Feedbac k: In humans, Coxiella infection produces a disease called Q fever, characterized by a nonspecific febrile illness often accompanied by headache, chills, arthralgias, and mild pneumonia. The organism produces a highly resistant sporelike stage that is transmitted to humans when contaminated animal tissue is aerosolized (e.g., during meat processing) or by ingestion of contaminated milk. 10. A teenage male develops a severe case of “athlete's foot.” He asks, “How did I get this?” The health care worker explains that certain fungi become infectious (called dermatophytes) and exhibit which of the following characteristics? A) Prefer to grow in warm environments like shoes/socks B) Like a moist environment C) Limited to cooler cutaneous surfaces D) Need higher blood flow to survive Ans: C Feedback: Dermatophytes are not able to grow at core body temperature, preferring the cooler surface skin areas instead of moist skin folds. Diseases caused by these organisms, including ringworm, athlete's foot, and jock itch, are collectively called superficial mycoses. 11. A male client with a history of angina has presented to the emergency department with uncharacteristic chest pain, and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle? A) Atrial depolarization B) Ventricular depolarization C) Ventricular repolarization D) Depolarization of the AV node Ans: C Feedback: The T wave on electrocardiography (ECG) corresponds to ventricular repolarization. Atrial depolarization is represented by the P wave and ventricular depolarization by the QRS complex. The isoelectric or zero line between the P wave and the Q wave represents depolarization of the AV node, bundle branches, and Purkinje system. 12. During ventricular systole, closure of the atrioventricular (AV) valves coincides with: and heart rate. Cardiac reserve refers to the maximum percentage of increase in cardiac output that can be achieved above the normal resting level. 14. A client with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveal the following findings: heart rate 80 beats/minute; end-diastolic volume 120 mL; and end-systolic volume 60 mL. What is this client's ejection fraction? A) Atrial chamber filling A) 200 mL B) Aortic valve opening B) 50% C) Isovolumetric contraction C) 0.80 D) Semilunar valves opening D) 180 mL Ans: C Ans: B Feedback: Feedback: Ventricular systole is divided into two parts: Ejection fraction = stroke volume ÷ end-diastolic volume, isovolumetric contraction when the AV valves close and ventricles fill; and the ejection period, when the semilunar valves open and blood is ejected through the aortic valve into circulation. Immediately after closure of the AV valves, there is a 0.02- to 0.03- second period during which the pulmonic and aortic valves remain closed. During this period, the ventricular volume remains the same while the ventricles contract, producing an abrupt increase in pressure. At the end of systole, the ventricles relax, causing a precipitous fall in intraventricular pressures. As this occurs, blood from the large arteries flows back toward the ventricles, causing the aortic and pulmonic valves to snap shut—an event marked by the second heart sound. 13. A heart failure client has an echocardiogram performed revealing an ejection fraction (EF) of 40%. The nurse knows this EF is below normal and explains to the client: A) “This means you have a lot of pressure built-up inside your heart.” B) “This means your heart is not pumping as much blood out of the heart with each beat.” C) “You need to increase the amount of exercise you do to get your heart muscle back in shape.” D) “Your ventricular muscle is getting too stiff to beat normally.” Ans: B Feedback: Ejection fraction is the percentage of diastolic volume ejected from the heart [left ventricle] during systole. Stroke volume is determined by the difference between end-diastolic and endsystolic volumes. Cardiac output is determined by stroke volume whereas stroke volume equals the difference between enddiastolic and end-systolic volume. Therefore, EF = 60 ÷ 120, or 50%. 15. Preload represents the volume work of the heart and is largely determined by: A) Venous blood return B) Vascular resistance C) Force of contraction D) Ventricular emptying Ans: A Feedbac k: Preload represents the amount of blood the heart must pump with each beat and represents the volume of blood stretching the ventricular muscle fibers at the end of diastole. Pressure (resistance), contraction, and ventricular emptying relate to afterload. 16. Which of the following clients coming to a small free clinic are at high risk for malnutrition? Select all that apply. A) An 88-year-old senior citizen on a fixed budg