Advanced Pathophysiology HESI final Exam: Latest
Updated; Questions & Answers
The nurse hears short, high-pitched sounds just before the end of inspiration in the
right and left lower lobes when auscultating a client's lungs. How should this finding
be recorded?
Correct Answer: Fine crackles are short, high pitched sounds heard just before the
end of inspiration that are the result of rapid equalization of pressure when collapsed
alveoli or terminal bronchioles suddenly snap open.
The nurse is assessing an older client and determines that the client's left upper
eyelid droops, covering more of the iris than the right eyelid. Which description
should the nurse use to document this finding?
Correct Answer: Ptosis is the term used to describe an eyelid droop that covers a
large portion of the iris, which may result from oculomotor nerve or eyelid muscle
disorder.
A client's family asks why their mother with heart failure needs a pulmonary artery
catheter now that she is in the ICU. What information should the nurse include in the
explanation to the family?
Correct Answer: Pulmonary artery catheters are used to measure central pressures
and fluid balance. Even though all clients in the ICU require close monitoring, they
do not all need a PA catheter
Several hours after surgical repair of an abdominal aortic aneurysm, the client
develops left flank pain. The nurse determines the client's urinary output is 20 mL/hr
for the past 2 hours.
Correct Answer: Postoperative complications of surgical repair of AAA are related to
the location of resection, graft, or stent placement along the abdominal aorta.
Embolization of a fragment of thrombus or plaque from the aorta into a renal artery
can compromise blood flow in one of the renal arteries, resulting in renal ischemia
that precipitates unilateral flank pain.
The nurse should conclude that these findings support which complication?
Correct Answer: Intraoperative blood loss or rupture of the aorta anastomosis can
cause acute renal failure related to hypovolemia.
The nurse is assessing a postmenopausal woman who is complaining of urinary
urgency and frequency and stress incontinence. She also reports difficulty emptying
her bladder. These complaints are most likely due to which condition?
Correct Answer: This constellation of signs in a postmenopausal woman are
characteristic of cystocele.
A male client who has never smoked by has had COPD is now being assessed for
cancer of the lung. The nurse knows that he is most likely to develop which type of
lung cancer?
Correct Answer: Adenocarcinoma is the only lung cancer not related to cigarette
smoking. It has been found to be directly related to lung scarring and fibrosis from
preexisting pulmonary disease such as TB or COPD.
, Muscular Dystrophy is characterized by which pathophysiological condition?
Correct Answer: Skeletal muscle degeneration is a classic symptom of muscular
dystrophy.
The nurse is preparing to administer atropine, an anticholinergic, to a client who is
scheduled for a cholecystectomy. The client asks the nurse to explain the reason for
the prescribed medication. What is the best response for the nurse to provide?
Correct Answer: Atropine may be prescribed to increase the automaticity of the SA
node and prevent a dangerous reduction in HR during surgical anesthesia.
What information should the nurse include in a teaching plan about the onset of
menopause?
Correct Answer: Smoking, Oophorectomy and hysterotomy, Early menarche,
Genetic influence and Chemotherapy exposure.
A patient with aortic valve stenosis develops heart failure.
Correct Answer: Hypertension and incompetent or stenotic heart valves cause an
increase in the workload of the heart by increasing the afterload which requires an
increase in the force of contraction to pump blood out of the heart.
Which pathophysiological finding occurs in the myocardial cells as a result of the
increased cardiac workload?
Correct Answer: Myocardial hypertrophy results because the cells increase in
surface area or size by increasing the amount of contractile proteins, but the
quantity.
Physical examination of a comatose patient reveals decorticate posturing. Which
statement is accurate regarding this client's status based upon this finding?
Correct Answer: Decorticate posturing adduction of arms and shoulders, flexion of
arms on chest with wrists flexed and hands fisted and extension and adduction of
extremities is seen with severe dysfunction of the cerebral cortex.
Which client is at highest risk for chronic kidney disease secondary to diabetes
mellitus?
Correct Answer: Diabetic retinopathy and nephropathy are related to prolonged
hyperglycemia and hypertension which damage the microvasculature of the eyes
and kidneys, so a client with Type 1 DM and retinopathy is most likely to develop
neuropathy and chronic kidney disease.
A mother is crying as she holds and rocks her child with tetanus who is having
muscular spasms and crying. After administering diazepam (Valium) to the child,
what action should the nurse implement?
Correct Answer: Controlling environmental stimulation such as noise, light, or tactile
stimuli helps reduce CNS irritability related to acute tetanus. The mother should be
instructed to minimize handling of the child during episodes of muscle spasticity and
to stay calmly near the child. The mother's presence with the child provides security
and support,
Updated; Questions & Answers
The nurse hears short, high-pitched sounds just before the end of inspiration in the
right and left lower lobes when auscultating a client's lungs. How should this finding
be recorded?
Correct Answer: Fine crackles are short, high pitched sounds heard just before the
end of inspiration that are the result of rapid equalization of pressure when collapsed
alveoli or terminal bronchioles suddenly snap open.
The nurse is assessing an older client and determines that the client's left upper
eyelid droops, covering more of the iris than the right eyelid. Which description
should the nurse use to document this finding?
Correct Answer: Ptosis is the term used to describe an eyelid droop that covers a
large portion of the iris, which may result from oculomotor nerve or eyelid muscle
disorder.
A client's family asks why their mother with heart failure needs a pulmonary artery
catheter now that she is in the ICU. What information should the nurse include in the
explanation to the family?
Correct Answer: Pulmonary artery catheters are used to measure central pressures
and fluid balance. Even though all clients in the ICU require close monitoring, they
do not all need a PA catheter
Several hours after surgical repair of an abdominal aortic aneurysm, the client
develops left flank pain. The nurse determines the client's urinary output is 20 mL/hr
for the past 2 hours.
Correct Answer: Postoperative complications of surgical repair of AAA are related to
the location of resection, graft, or stent placement along the abdominal aorta.
Embolization of a fragment of thrombus or plaque from the aorta into a renal artery
can compromise blood flow in one of the renal arteries, resulting in renal ischemia
that precipitates unilateral flank pain.
The nurse should conclude that these findings support which complication?
Correct Answer: Intraoperative blood loss or rupture of the aorta anastomosis can
cause acute renal failure related to hypovolemia.
The nurse is assessing a postmenopausal woman who is complaining of urinary
urgency and frequency and stress incontinence. She also reports difficulty emptying
her bladder. These complaints are most likely due to which condition?
Correct Answer: This constellation of signs in a postmenopausal woman are
characteristic of cystocele.
A male client who has never smoked by has had COPD is now being assessed for
cancer of the lung. The nurse knows that he is most likely to develop which type of
lung cancer?
Correct Answer: Adenocarcinoma is the only lung cancer not related to cigarette
smoking. It has been found to be directly related to lung scarring and fibrosis from
preexisting pulmonary disease such as TB or COPD.
, Muscular Dystrophy is characterized by which pathophysiological condition?
Correct Answer: Skeletal muscle degeneration is a classic symptom of muscular
dystrophy.
The nurse is preparing to administer atropine, an anticholinergic, to a client who is
scheduled for a cholecystectomy. The client asks the nurse to explain the reason for
the prescribed medication. What is the best response for the nurse to provide?
Correct Answer: Atropine may be prescribed to increase the automaticity of the SA
node and prevent a dangerous reduction in HR during surgical anesthesia.
What information should the nurse include in a teaching plan about the onset of
menopause?
Correct Answer: Smoking, Oophorectomy and hysterotomy, Early menarche,
Genetic influence and Chemotherapy exposure.
A patient with aortic valve stenosis develops heart failure.
Correct Answer: Hypertension and incompetent or stenotic heart valves cause an
increase in the workload of the heart by increasing the afterload which requires an
increase in the force of contraction to pump blood out of the heart.
Which pathophysiological finding occurs in the myocardial cells as a result of the
increased cardiac workload?
Correct Answer: Myocardial hypertrophy results because the cells increase in
surface area or size by increasing the amount of contractile proteins, but the
quantity.
Physical examination of a comatose patient reveals decorticate posturing. Which
statement is accurate regarding this client's status based upon this finding?
Correct Answer: Decorticate posturing adduction of arms and shoulders, flexion of
arms on chest with wrists flexed and hands fisted and extension and adduction of
extremities is seen with severe dysfunction of the cerebral cortex.
Which client is at highest risk for chronic kidney disease secondary to diabetes
mellitus?
Correct Answer: Diabetic retinopathy and nephropathy are related to prolonged
hyperglycemia and hypertension which damage the microvasculature of the eyes
and kidneys, so a client with Type 1 DM and retinopathy is most likely to develop
neuropathy and chronic kidney disease.
A mother is crying as she holds and rocks her child with tetanus who is having
muscular spasms and crying. After administering diazepam (Valium) to the child,
what action should the nurse implement?
Correct Answer: Controlling environmental stimulation such as noise, light, or tactile
stimuli helps reduce CNS irritability related to acute tetanus. The mother should be
instructed to minimize handling of the child during episodes of muscle spasticity and
to stay calmly near the child. The mother's presence with the child provides security
and support,
