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Herzing University - NU 208 Pathophysiology Final Exam 2023.pdf
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Herzing University - NU 208 Pathophysiology Final Exam
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1. A 52-year-old male enters a sleep study to gather information about his sleep disturbances. He reportsthat his wife will not let him sleep in the bed with her until he stops snoring so loudly. He also reports
feeling tired a lot through the day. When the nurse checks the chart, what is the most likely diagnosis?
Insomnia - Not Selected
Correct answer: Obstructive sleep apnea syndrome (OSAS)
Somnambulism - Not Selected
Jet-lag syndrome - Not Selected
General Feedback
OSAS generally results from upper airway obstruction recurring during sleep with excessive snoring and
multiple apneic episodes that last 10 seconds or longer. Insomnia is the inability to fall or stay asleep and
may be mild, moderate, or severe. It does not involve snoring. Somnambulism is sleep-walking. Jet-lag
syndrome is a disorder of waking and sleeping and does not involve snoring.
2. For legal purposes, brain death is defined as:
Correct answer: cessation of entire brain function.
lack of cortical function - Not Selected
a consistent vegetative state (VS) - Not Selected
death of the brainstem - Not Selected
General Feedback
Brain death occurs when there is cessation of function of the entire brain, including the brainstem and
cerebellum. Lack of cortical function or brainstem death is not enough to define brain death. A VS is
complete unawareness of the self or surrounding environment and complete loss of cognitive function.
3. An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would
the nurse expect to find?
Correct answer: Enlarged ventricles
Decreased cerebrospinal fluid (CSF) production - Not Selected
Increased resorption of CSF - Not Selected
Smaller than average head circumference - Not Selected
General Feedback
Congenital hydrocephalus is characterized by enlargement of the cerebral ventricles. Increased, not
decreased, CSF production would lead to hydrocephalus. Decreased resorption of CSF would lead to
hydrocephalus, not increased CSF. An infant with congenital hydrocephalus would have increased head
circumference.
4. An 11-year-old is newly diagnosed with type 1 DM. Which classic symptoms should the nurse assess
the patient for?
Recurrent infections, visual changes, fatigue, and paresthesia - Not Selected
Correct answer: Polydipsia, polyuria, polyphagia, and weight loss
Vomiting, abdominal pain, sweet, fruity breath, dehydration, and Kussmaul breathing - Not
Selected
Weakness, vomiting, hypotension, and mental confusion - Not Selected
,General Feedback
Classic symptoms of type 1 DM include polydipsia, polyuria, polyphagia, and weight loss. Recurrent
infections and visual changes are complications of diabetes. Vomiting, abdominal pain, and sweet breath
are signs of diabetic ketoacidosis. Weakness, hypotension, and mental confusion are signs of
hypoglycemia.
5. When should the nurse assess for the vomiting and headache that are the classic symptoms of
childhood brain tumors?
Correct answer: Morning
Early afternoon - Not Selected
As the sun goes down and darkness begins - Not Selected
During the middle of the night - Not Selected
General Feedback
Headache and vomiting occur more commonly in the morning.
6. A patient is admitted to the intensive care unit with a closed head injury sustained in a motorcycle
accident. The injury has caused severe damage to the posterior pituitary. Which of the following
complications should the nurse anticipate?
Incorrect answer: Dilutional hyponatremia
Correct Answer: Dehydration from polyuria
Cardiac arrest from hyperkalemia - Not Selected
Metabolic acidosis - Not Selected
General Feedback
Diabetes insipidus is a well-recognized complication of closed head injury and is manifested by polyuria
leading to dehydration. The patient will experience hypernatremia, not hyponatremia. Electrolytes other
than sodium are typically not affected with diabetes insipidus. Acidosis is not associated with diabetes
insipidus.
7. A patient diagnosed with Graves disease is admitted to a medical-surgical unit. Which of the following
symptoms would the nurse expect to find before treatment?
Weight gain, cold intolerance - Not Selected
Slow heart rate, rash - Not Selected
Correct answer: Skin hot and moist, rapid heart rate
Constipation, confusion - Not Selected
General Feedback
Symptoms of Graves disease include heat intolerance and increased tissue sensitivity to stimulation by
the sympathetic division of the autonomic nervous system. Weight loss, rather than weight gain, and
heat intolerance would result. Tachycardia, not slow heart rate, would occur. Diarrhea would occur as
opposed to constipation.
8. Which finding indicates the patient is having complications from heat stroke?
Mild elevation of core body temperatures - Not Selected
Correct answer: Cerebral edema and degeneration of the CNS
, Spasmodic cramping in the abdomen and extremities - Not Selected
Alterations in calcium uptake - Not Selected
General Feedback
Symptoms of heat stroke include high core temperature, absence of sweating, rapid pulse, confusion,
agitation, and coma, and complications include cerebral edema and degeneration of the CNS. Neither
cramping nor alterations in calcium uptake are considered complications of a heat stroke.
9. When a patient has a fever, which of the following thermoregulatory mechanisms is activated?
The body’s thermostat is adjusted to a lower temperature. - Not Selected
Temperature is raised above the set point. - Not Selected
Bacteria directly stimulate peripheral thermogenesis. - Not Selected
Correct answer: The body’s thermostat is reset to a higher level.
General Feedback
Fever (febrile response) is a temporary “resetting of the hypothalamic thermostat” to a higher level in
response to endogenous or exogenous pyrogens. Fever is the result of the body’s attempt to raise
temperature, not adjust it to a lower level. When fever occurs, the temperature is raised, but the rise is
due to a reset of the thermostat. Bacteria do not stimulate peripheral thermogenesis, but their
endotoxins do.
10. What is the main source of bleeding in extradural (epidural) hematomas?
Correct answer: Arterial
Venous - Not Selected
Capillary - Not Selected
Sinus - Not Selected
General Feedback
An artery is the source of bleeding in 85% of extradural hematomas. The bleeding associated with an
extradural hematoma is not a result of damage to a vein, a capillary, or a sinus.
11. What common neurologic disturbances should the nurse assess for in a patient with a pituitary
adenoma?
Coma - Not Selected
Correct answer: Visual disturbances
Confused states - Not Selected
Breathing abnormalities - Not Selected
General Feedback
The clinical manifestations of pituitary adenomas are visual changes including visual field impairments
(often beginning in one eye and progressing to the other) and temporary blindness. Coma, confusion,
and breathing abnormalities are not associated with pituitary adenomas.
12. Spinal shock is characterized by:
loss of voluntary motor function with preservation of reflexes. - Not Selected
Correct answer: cessation of spinal cord function below the lesion.
, loss of spinal cord function at the level of the lesion only. - Not Selected
temporary loss of spinal cord function above the lesion. - Not Selected
General Feedback
Spinal shock is the complete cessation of spinal cord function below the lesion. The reflexes are not
preserved in spinal shock. Spinal shock is the complete cessation of spinal cord function below the
lesion, not at the lesion only.
13. What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test?
Measuring fasting glucose levels. - Not Selected
Correct answer: Monitoring long-term serum glucose control.
Detecting acute complications of diabetes. - Not Selected
Checking for hyperlipidemia. - Not Selected
General Feedback
Glycosylated hemoglobin refers to the permanent attachment of glucose to hemoglobin molecules and
reflects the average plasma glucose exposure over the life of a red blood cell (approximately 120 days).
Glycosylated hemoglobin does not measure fasting, but rather glucose control over time. Glycosylated
hemoglobin does not identify complications but could provide data if the patient is at risk. Glycosylated
hemoglobin does not check for hyperlipidemia.
14. A CT scan reveals that a patient has an open basilar skull fracture. Which major complication should
the nurse observe for in this patient?
Hematoma formation - Not Selected
Correct answer: Meningeal infection
Increased intracranial pressure (ICP) - Not Selected
Cognitive deficits - Not Selected
General Feedback
Individuals with an open basilar skull fractures should be observed for meningitis. Such a basilar skull
fracture does not increase a patient’s risk for hematoma formation, ICP, or cognitive deficits.
15. A newborn child is diagnosed with a vertebral arch defect, spina bifida. This condition would lead the
nurse to suspect the child may have which of the following as well? (select all that apply)
Answer: Type II Chiari malformation
Correct answer: Myelomeningocele
Correct answer: Meningocele
Answer: Acrania
Answer: Craniosynostosis
General Feedback
When meningocele and myelomeningocele occur, they are related to an accompanying vertebral defect
that allows the protrusion of the neural tube contents. Type II Chiari malformation is a complex
malformation of the brainstem and cerebellum in which the cerebellar tonsils are displaced downward
into the cervical spinal canal. This does not occur through a spina bifida. In acrania, the cranial vault is
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