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NUR 3129 Patho Finals Questions 100.
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NUR 3129 Patho Finals Questions 100.
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1NUR 3129 Patho Finals study
guide
Hypodipsia in elderly Ch 8 p. 146-147
1. Recognizing the prevalence and incidence of dehydration among older
adults, a care
aide at a long-term care facility is in the habit of encouraging residents to
drink even
though they may not feel thirsty at the time. Which of the following facts
underlies the
care aide's advice?
A) Older adults often experience a decrease in the sensation of thirst, even
when
serum sodium levels are high.
B) The metabolic needs for both fluid and sodium in older adults differ from
those of
younger individuals.
C) Regulation and maintenance of effective circulating volume by the
kidneys is less
effective in the elderly.
D) The renin–angiotensin–aldosterone system (RAAS) is less able to facilitate
sodium clearance in older adults.
Ans: A
Feedback:
The elderly are prone to hypodipsia even when osmolality and serum sodium
levels are
elevated, a fact that is compounded by sensory and/or neurological deficits.
Hypodipsia
in the elderly is not related to differing metabolic needs, ineffective kidney
function, or
compromise of the RAAS.
2. Indicators of fluid volume overload. p. 150
A client is brought to the emergency department with complaints of
shortness of breath.
Assessment reveals a full, bounding pulse, severe edema, and audible
crackles in lower
lung fields bilaterally. What is the client's most likely diagnosis?
A) Hyponatremia
B) Fluid volume excess
C) Electrolyte imbalance: hypocalcemia
D) Hyperkalemia
Ans: B
Feedback:
Peripheral and pulmonary edema as well as a bounding pulse and dyspnea
P a g e 1 | 35
, 2
are indicators
P a g e 2 | 35
, 3
of fluid volume overload.
Etiology of Hyperparathyroidism Ch 8 p.160-161
3. A 52-year-old patient has just passed a kidney stone and has high levels of
calcium in
her urine. Blood tests show high levels of calcium in her blood as well. What
subsequent lab results would be most likely to distinguish between primary
hyperparathyroidism and hypercalcemia of malignancy?
A) Parathyroid hormone level
B) Bone scan
C) Plasma phosphate levels
D) Serum magnesium level
Ans: A
Feedback:
Hyperparathyroidism, in which parathyroid hormone is secreted in excess,
may be
caused by a parathyroid adenoma. Since parathyroid hormone mobilizes
calcium from
bone and promotes its transfer to the extracellular fluid, excess calcium is
excreted in
the urine (promoting the development of kidney stones) and is evident in the
plasma. In
primary hyperparathyroidism, antibody binding assays of intact PTH would
reveal
either normal or elevated parathyroid hormone in the face of hypercalcemia,
whereas in
hypercalcemia of malignancy, levels of intact PTH are suppressed.
Metabolic alkalosis is manifested ..pg 183-184
Tutoring info: increase PH, increase bicarbonate and increase carbon dioxide levels.
A clients arterial blood gases reveal normal oxygen level, pH 7.50, PCO2 level of 50 mmHg
and HCO3 level of 30. The clients respiratory rate is 12 breaths/min and all other vital
signs within normal range. What is this client's most likely diagnosis:
ANS: Metabolica Alkalosis
Role of neutrophils in inflammation Ch 9 pg. 192
A patient presented to the emergency department of the hospital
with a swollen,
reddened, painful leg wound and has been diagnosed with
methicillin-resistant
Staphylococcus aureus (MRSA) cellulitis. The patient's physician has
ordered a
complete blood count and white cell differential. Which of the
following blood
P a g e 3 | 35
, 4
components would the physician most likely anticipate to be
elevated?
D) Neutrophils
Ans: D
Feedback
Increased neutrophils are associated with inflammation in general and
bacterial
infections in particular. Platelets play a role in inflammation, but their levels
would not
rise to the same extent as would neutrophils'. Eosinophils are not strongly
associated
with bacterial infection, and basophils would not increase to the same degree
as
neutrophils.
Role of histamine Pg 198-199
A deficiency in which of the following would result in an inhibition of the inflammatory
response?
A) Histamine
B) Helper T cells
C) B cells
D) Vitamin K
Ans: A
Feedback:
Histamine is a key mediator in the inflammatory system, unlike helper T cells, B cells,
or vitamin K.
Diabetic patients /wound healing p. 208
Diabetes have negative effects on patients Micro : retinopathy micro aneurysms in the back of the retina
Macro: kidney nephropathy, renal insufficient impaired wound healing. Occurs due to vasoconstriction.
Can lead to things like erectile dysfunction or impaired wound healing.
Which of the following patients is most likely to have impairments to the wound-
healing process? A patient with
A) chronic obstructive pulmonary disease.
B) a diagnosis of multiple sclerosis and consequent impaired mobility.
C) poorly controlled blood sugars with small blood vessel disease.
D) congenital heart defects and anemia.
P a g e 4 | 35
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