D115 ADVANCED PATHOPHYSIOLOGY
COMPLETE QUESTIONS &
SOLUTIONS
An advanced practice registered nurse (APRN) is caring for an adult patient who fell off
a ladder and has a T5 compression and a compound fracture of the femur.
The following assessment data is noted:
Vital signs: BP 102/52
Apical pulse: 48
Weak peripheral pulses
Flaccid lower extremities
Severe bruising of the femur
Which type of shock should the APRN suspect? - ANSWERNeurogenic
An advanced practice registered nurse (APRN) is caring for a patient who experienced
a 20% total body surface area (TBSA) burn injury. Current assessment findings include
massive evaporative water losses, a flux of large amounts of fluid and electrolytes in the
tissues, generalized edema, and circulatory hypovolemia. The APRN needs to take
immediate action to prevent irreversible hypovolemic shock and death.
Which priority action should be taken by the APRN? - ANSWERAdminister up to 30 L of
lactated ringer solution over 24 hours
An adult patient has experienced a third-degree burn. An advanced practice registered
nurse (APRN) is attempting to calculate the total body surface area affected using the
rule of nines. The areas involved include the anterior and posterior right arm and leg
and the groin.
What is the estimated total body surface area that will be assigned by the APRN? -
ANSWER28%
An obese, middle-aged patient presents to an advanced practice registered nurse
(APRN) with complaints of heartburn, chronic cough, frequent wheezing, laryngitis, and
sinusitis.
Which pathological mechanism is associated with the probable diagnosis? -
ANSWERAbnormalities in lower esophageal sphincter function, esophageal motility,
and gastric motility or emptying
An advanced practice registered nurse (APRN) is assessing a patient who is diagnosed
with hepatitis B. The APRN is aware that the patient is in the icteric phase of the
infection.
Which finding led the APRN to this conclusion? - ANSWERJaundice
, A patient is experiencing memory loss, irritability, and a hand tremor. An advanced
practice registered nurse (APRN) is concerned that the patient is experiencing hepatic
encephalopathy.
Which diagnostic lab result should be used to confirm this diagnosis? -
ANSWERAmmonia
A patient experiences numbness and tingling of the feet and hands that has been
associated with loss of appetite, occasional epigastric pain, and a deficiency in vitamin
B12.
Which diagnosis should an advanced practice registered nurse (APRN) suspect for this
patient? - ANSWERChronic gastritis
An advanced practice registered nurse (APRN) is working with a patient who has had
two days of severe nausea and vomiting and is diagnosed with an intestinal obstruction.
Due to this diagnosis, the APRN knows that the patient may have an acute kidney
injury.
Which kidney injury coincides with the symptoms described? - ANSWERPrerenal acute
An advanced practice registered nurse (APRN) is working with a patient who has been
diagnosed with a benign tumor of the hypothalamus, decreasing hormone production.
The APRN is concerned about effects on renal function. Which renal effect should the
APRN anticipate? - ANSWERIncrease in water excretion
An advanced practice registered nurse (APRN) is working with a patient who has a
history of type 1 diabetes and is now experiencing renal failure. The APRN counsels the
patient concerning an increase in the incidence of hypoglycemia.
Which pathological mechanism contributes to this concern? - ANSWERReduced renal
gluconeogenesis
A two-year-old child presents to a clinic with acute pyelonephritis for the third time in
four months. An advanced practice registered nurse (APRN) suspects vesicoureteral
reflux and orders a voiding cystourethrograph scan. Results indicate reflux into dilated
ureter or blunting of calyceal fornices.
Which grade should the APRN document? - ANSWERGrade III
A patient presents with complaints of dark urine and generalized malaise. An advanced
practice registered nurse (APRN) notes the voided urine is frothy.
Assessment:
BP: 154/92 mm Hg
generalized edema
Diagnostics:
Serum albumin: 2.4 g/dL
TSH: 5.2 mU/L
Total T4: 3.6 mcg/dL
Free T4: 1.2 ng/dL
UA large protein
COMPLETE QUESTIONS &
SOLUTIONS
An advanced practice registered nurse (APRN) is caring for an adult patient who fell off
a ladder and has a T5 compression and a compound fracture of the femur.
The following assessment data is noted:
Vital signs: BP 102/52
Apical pulse: 48
Weak peripheral pulses
Flaccid lower extremities
Severe bruising of the femur
Which type of shock should the APRN suspect? - ANSWERNeurogenic
An advanced practice registered nurse (APRN) is caring for a patient who experienced
a 20% total body surface area (TBSA) burn injury. Current assessment findings include
massive evaporative water losses, a flux of large amounts of fluid and electrolytes in the
tissues, generalized edema, and circulatory hypovolemia. The APRN needs to take
immediate action to prevent irreversible hypovolemic shock and death.
Which priority action should be taken by the APRN? - ANSWERAdminister up to 30 L of
lactated ringer solution over 24 hours
An adult patient has experienced a third-degree burn. An advanced practice registered
nurse (APRN) is attempting to calculate the total body surface area affected using the
rule of nines. The areas involved include the anterior and posterior right arm and leg
and the groin.
What is the estimated total body surface area that will be assigned by the APRN? -
ANSWER28%
An obese, middle-aged patient presents to an advanced practice registered nurse
(APRN) with complaints of heartburn, chronic cough, frequent wheezing, laryngitis, and
sinusitis.
Which pathological mechanism is associated with the probable diagnosis? -
ANSWERAbnormalities in lower esophageal sphincter function, esophageal motility,
and gastric motility or emptying
An advanced practice registered nurse (APRN) is assessing a patient who is diagnosed
with hepatitis B. The APRN is aware that the patient is in the icteric phase of the
infection.
Which finding led the APRN to this conclusion? - ANSWERJaundice
, A patient is experiencing memory loss, irritability, and a hand tremor. An advanced
practice registered nurse (APRN) is concerned that the patient is experiencing hepatic
encephalopathy.
Which diagnostic lab result should be used to confirm this diagnosis? -
ANSWERAmmonia
A patient experiences numbness and tingling of the feet and hands that has been
associated with loss of appetite, occasional epigastric pain, and a deficiency in vitamin
B12.
Which diagnosis should an advanced practice registered nurse (APRN) suspect for this
patient? - ANSWERChronic gastritis
An advanced practice registered nurse (APRN) is working with a patient who has had
two days of severe nausea and vomiting and is diagnosed with an intestinal obstruction.
Due to this diagnosis, the APRN knows that the patient may have an acute kidney
injury.
Which kidney injury coincides with the symptoms described? - ANSWERPrerenal acute
An advanced practice registered nurse (APRN) is working with a patient who has been
diagnosed with a benign tumor of the hypothalamus, decreasing hormone production.
The APRN is concerned about effects on renal function. Which renal effect should the
APRN anticipate? - ANSWERIncrease in water excretion
An advanced practice registered nurse (APRN) is working with a patient who has a
history of type 1 diabetes and is now experiencing renal failure. The APRN counsels the
patient concerning an increase in the incidence of hypoglycemia.
Which pathological mechanism contributes to this concern? - ANSWERReduced renal
gluconeogenesis
A two-year-old child presents to a clinic with acute pyelonephritis for the third time in
four months. An advanced practice registered nurse (APRN) suspects vesicoureteral
reflux and orders a voiding cystourethrograph scan. Results indicate reflux into dilated
ureter or blunting of calyceal fornices.
Which grade should the APRN document? - ANSWERGrade III
A patient presents with complaints of dark urine and generalized malaise. An advanced
practice registered nurse (APRN) notes the voided urine is frothy.
Assessment:
BP: 154/92 mm Hg
generalized edema
Diagnostics:
Serum albumin: 2.4 g/dL
TSH: 5.2 mU/L
Total T4: 3.6 mcg/dL
Free T4: 1.2 ng/dL
UA large protein
