2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE QUESTIONS AND ANSWERS
2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE QUESTIONS AND ANSWERS
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2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE QUESTIONS AND ANSWERS
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2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE QUESTIONS AND ANSWERS
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2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE QUESTIONS AND ANSWERS
2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE QUESTIONS AND ANSWERS
1. Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, midclavicular line. The client asks, “What does that mean?” The nurse will base her answer on which of the following physiol...
2020 hesi pathophysiology fnp v2 100 practice questions and answers 1 upon admission assessment
the nurse hears a murmur located at the fifth intercostal space
midclavicular line the client as
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2020 HESI PATHOPHYSIOLOGY FNP V2 100 PRACTICE
QUESTIONS AND ANSWERS
1. Upon admission assessment, the nurse hears a 3. A client has entered hypovolemic shock after
murmur located at the fifth intercostal space, midclavicular massive blood loss in a car accident. Many of the client's
line. The client asks, “What does that mean?” The nurse peripheral blood vessels have consequently collapsed.
will base her answer on which of the following physiologic How does the Laplace law account for this
principles? pathophysiologic phenomenon?
A) “You have been exposed to an infection that A) Blood pressure is no longer able to
went into your blood stream.” overcome vessel wall tension.
B) “You have a heart valve that is diseased.” B) Decreasing vessel radii has caused a decrease
C) “You heart has been pumping your blood so in blood pressure.
hard, that the pressure has damaged your valves.” C) Wall thickness of small vessels has decreased due
D) “Your heart has enlarged, so naturally your to hypotension.
valves had to enlarge as well.” D) Decreases in wall tension and blood pressure
Ans: B have caused a sudden increase in vessel radii.
Feedback: Turbulence is often accompanied by Ans: A
vibrations of the blood and surrounding cardiovascular Feedback: In circulatory shock, there is a decrease
structures. Some of these vibrations are in the audible in blood volume and vessel radii, along with a drop in blood
range and can be heard using a stethoscope. For example, a pressure. As a result, many of the small vessels collapse as
heart murmur results from turbulent flow through a blood pressure drops to the point where it can no longer
diseased heart valve. The other distractors are not feasible. overcome the wall tension. Decreases in vessel wall radii do
not cause the decrease in blood pressure, and wall
2. A client is diagnosed with an abdominal aortic
thickness generally remains static.
aneurysm that the physician just wants to “watch” for now.
When teaching the client about signs/symptoms to watch 4. Which of the following statements about
for, the nurse will base the teaching on which of the vascular compliance is accurate?
following physiological principles? A) Arteries are much more distensible than veins.
A) Small diameter of this vessel will cause it B) Veins can act as a reservoir for storing large
to rupture more readily. quantities of blood.
B) The larger the aneurysm, the less tension C) Arteries have thick muscular walls that
placed on the vessel. constrict tightly, thereby ejecting blood without storing it
C) As the aneurysm grows, more tension is placed for later use.
on the vessel wall, which increases the risk for rupture. D) A continuous flow through the capillaries occurs
D) The primary cause for rupture relates to primarily during systole.
increase in abdominal pressure such as straining to have a Ans: B
bowel movement. Feedback: The most distensible of all vessels are the
Ans: C veins, which can increase their volume with only slight
Feedback: Because the pressure is equal changes in pressure, allowing them to function as a
throughout, the tension in the part of the balloon with the reservoir for storing large quantities of blood that can be
smaller radius is less than the tension in the section with returned to the circulation when it is needed. Although
the larger radius. The same holds true for an arterial arteries have a thicker muscular wall than veins, their
aneurysm in which the tension and risk of rupture increase distensibility allows them to store some of the blood that is
as the aneurysm grows in size. Wall tension is inversely ejected from the heart during systole, providing for
related to wall thickness, such that the thicker the vessel continuous flow through the capillaries as the heart relaxes
wall, the lower the tension, and vice versa. Although during diastole.
arteries have a thicker muscular wall than veins, their
distensibility allows them to store some of the blood that is 5. In the days following a tooth cleaning and root
ejected from the heart during systole, providing for canal, a client has developed an infection of the thin, three-
continuous flow through the capillaries as the heart relaxes layered membrane that lines the heart and covers the
during diastole. valves. What is this client's most likely diagnosis?
,A) Pericarditis conducting its own electrical impulses or action potentials.
These action potentials result in excitation of muscle fibers
B) Endocarditis
throughout the myocardium. Similarities to skeletal muscle
C) Myocarditis include contractility, calcium influx, and actin–myosin
(sarcomeres) binding.
D) Vasculitis
Ans: B
8. When discussing the AV node's role in the
Feedback: electrical conduction of the heart with a client
newly diagnosed with an AV block, which of the
The endocardium is a thin, three-layered membrane that
following statements are accurate? Select all that
lines the heart and covers the valves; infection of this part
apply.
of the heart is consequently referred to as endocarditis.
A) The AV node offers a two-way conduction area
between the atria and the ventricles.
6. Following several weeks of increasing fatigue
B) The velocity of conduction through the AV
and a subsequent diagnostic workup, a client has been
junctional fibers is very fast, which greatly increases
diagnosed with mitral valve regurgitation. Failure of this
impulse transmission.
heart valve would have which of the following
consequences? C) A block at the AV bundle of His interferes with
the normal delay of the impulse, thereby interfering with
A) Backup of blood from the right atrium into
complete ejection of blood from the atria prior to
the superior vena cava
ventricular contraction.
B) Backflow from the right ventricle to the right
D) When there is an AV block, impulses from the
atrium during systole
atria and ventricles beat independently of each other so,
C) Inhibition of the SA node's normal action potential the heart rhythm is usually chaotic and not regular.
D) Backflow from the left ventricle to the left atrium Ans: C, D
Ans: D Feedback:
Feedback: The AV node connects the atrial and ventricular systems
and normally provides for a one-way conduction between
The mitral valve separates the left ventricle from the left the atria and ventricles. The velocity of conduction through
atrium; failure of this valve would cause backflow from the AV junctional fibers is very slow, which greatly delays
the former to the latter during systole. Valve function does impulse transmission. A further delay occurs as the impulse
not directly affect cardiac contractility. travels through the transitional fibers and into the AV
bundle, known as the bundle of His. This delay provides a
mechanical advantage whereby the atria can complete
7. Heart muscle differs from skeletal muscle tissue by their ejection of blood before ventricular contraction
being able to generate: begins.
Under normal circumstances, the AV node provides the only
A) Contractions connection between the atrial and ventricular conduction
systems. The atria and ventricles would beat independently
B) Calcium influx
of each other if the transmission of impulses through the AV
C) Action potentials node were blocked.
D) Sarcomere binding
Ans: C 9. If the parasympathetic neurotransmitter releases
acetylcholine, the nurse should anticipate observing what
Feedback: changes in the ECG pattern?
Heart muscle, or the myocardium, is unique among A) Heart rate 150 beats/minute, labeled as
other muscles in that it is capable of generating and supraventricular tachycardia
rapidly
B) Disorganized ventricular fibrillation
, C) Complete cardiac standstill 11. As a nurse working in the newborn nursery and
intensive care unit, when an infant has been diagnosed
D) Slowing of heart rate to below 60
with failure to thrive, which of the following statements
beats/minute Ans: D about hormones' effect on the body will the nurse explain
to the family?
Feedback:
A) The catecholamine norepinephrine is
Acetylcholine, the parasympathetic neurotransmitter primarily responsible for the failure to thrive.
released during vagal stimulation of the heart, slows down
the heart rate by decreasing the slope of phase 4. The B) CRF increases somatostatin levels, which
catecholamines, the sympathetic nervous system inhibits secretion of growth hormone.
neurotransmitters epinephrine and norepinephrine,
C) ACTH release from the pituitary causes babies
increase the heart rate by increasing the slope or rate of
to not gain weight.
phase 4 depolarization. Fibrillation is the result of
disorganized current flow within the ventricle (ventricular D) Antidiuretic hormone is involved in the stress
fibrillation). Fibrillation interrupts the normal contraction of response and can increase water retention.
the atria or ventricles. In ventricular fibrillation, the
ventricles quiver but do not contract. Thus, there is no Ans: B
cardiac output, and there are no palpable or audible pulses
Feedback:
(i.e., cardiac standstill).
Although growth hormone is initially elevated with the
onset of stress, prolonged presence of cortisol leads to
10. When explaining a new diagnosis of suppression of growth hormone, insulin-like growth factor
complete heart block to a client/family, the nurse 1 (IGF-1), and other growth factors, exerting a chronically
should include which of the following statements? inhibitory effect on growth. In addition, CRF directly
increases somatostatin, which in turn inhibits growth
A) “This means that your atria are not contracting hormone secretion. Although the connection is speculative,
normally, they are quivering.” effects of stress on growth hormone may provide one of
the vital links to understanding failure to thrive in children.
B) “One consequence of this type of block is a
Angiotensin II enhances CRF formation and release,
very slow heart rate that limits circulation to the brain.”
contributes to the release of ACTH from the pituitary,
C) “This type of arrhythmia requires enhances stress-induced release of vasopressin from the
defibrillation, which will occur in the cardiac catheter lab posterior pituitary, and stimulates release of norepinephrine
later today.” from the locus ceruleus. Antidiuretic hormone (ADH)
released from the posterior pituitary is also involved in the
D) “It's pretty common for everyone to experience stress response, particularly in hypotensive stress or stress
this arrhythmia, especially during times of stress in their due to fluid volume loss.
lives.”
Ans: B
12. A nursing student's current clinical placement has
Feedback: been a source of stress due to high client acuity combined
with interpersonal conflict with some of the unit staff. At
In complete heart block, the atria and ventricles beat
the same time, the student has been fighting a cold for
independently of each other. The most serious effect of
more than 2 weeks and has been unable to regain a normal
some forms of AV block is a slowing of heart rate to the
feeling of health. How might these two phenomena be
extent that circulation to the brain is compromised. Atria
related?
fibrillation is where there is interruption of the normal
contraction of the atria, and the atria are quivering rather A) Epinephrine and norepinephrine inhibit
than contracting. Ventricular fibrillation requires immediate the release and action of lymphocytes.
defibrillation for the client to survive. Complete heart block
is not common. However, PVCs do occur under times of B) Stress and illness lack a statistical correlation,
stress. though they are often thought to coexist.
C) The effects of stress on the cerebellum initiate a
decrease in immunity.
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