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NURS 5315 FINAL Questions and Correct Solutions 2024.
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NURS 5315 FINAL Questions and Correct Solutions 2024.
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NURS 5315 Final s sStudysonlinesatshttps://quizlet.com/_czj34v
1. A patient in respiratory distress and is breathing 33 breaths per minute. W
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hich ABG value is consistent with the clinical scenario?
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PCO2 15 s
pH 7.30 s
pH 7.45 s
O2 sat 100%: A patient who is breathing 33 breaths per minute is hyperventilating an
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d blowing off CO2; therefore the PCO2 level will be low. The patient will most likely experi
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ence a respiratory alkalosis and the two pH values provided are not consistent with this
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diagnosis.
2. A patient has a sodium level of 115 mEq/L and is disoriented and lethargic. W
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hich pathological process best explains this patient's symptoms?
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a. The action potential has become hyperpolarized.
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b. Water has shifted into the neurons and caused them to swell.
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c. Water has shifted into the vascular space and dehydrated the neurons.
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d. The action potential has become hypopolarized.: b. The cause of neurologic sy
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mptoms associated with a sodium imbalance is directly related to fluid shifting into or
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out of the neurons of the brain. With a serum sodium of 115 mEq/L, water shifts into th
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e neurons and causes them to swell. Hypernatremia causes water to shift out of the ce
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ll into the intravascular space and causes the neurons to become dehydrated. An alter
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ation in the action potential is not seen with sodium imbalances.
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3. A patient experiencing dehydration should be monitored for which elec-
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strolyte imbalance? s
a. Hyperkalemia
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia: a. Serum osmolality is increased during times of dehydration. An el s s s s s s s s s s s
evated serum osmolality will pull potassium into the intravascular space from the intra
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cellular space and cause a rise in serum potassium.
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4. A married couple presents to your office for genetic counseling. The hus-
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sband has an autosomal recessive disease and his wife has a heterozygous ge
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notype for the disease. They ask you, What is the chance that our baby will have
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the disease? Which of the following answers is correct?
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25%
50%
75%
100%: A chromosome is a package of material located inside the cell nucleus which is
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smade of proteins and a single molecule of DNA. There are 23 pairs of chromosomes i
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n each human cell for a total of 46 chromosomes. Chromosomes are separated into t
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wo identical sets during mitosis or meiosis. This provides a set
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1s/s21
, NURS 5315 Final s s
Studysonlinesatshttps://quizlet.com/_czj34v
of chromosomes to each daughter cell which results from cell division.This process is re
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sponsible for the transfer of genetic information to the daughter cells. The first 22 pairs
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of chromosomes are known as autosomes.The 23rd pair of chromosomes is the pair w
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hich contains the genetic information for gender. This pair contains
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the genetic information which delineates between the male and female genders. Fem
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ales have two X chromosomes (XX) and males have an XY chromosome pair. Autoso
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mal chromosomes are said to be autologous. This means they do not carry genetic inf
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ormation pertaining to gender. Autosomal genetic diseases are carried on the first 22
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pairs of chromosomes. Sex-linked diseases are only carried on
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the 23rd pair of chromosomes. The autosomal chromosomes are nearly identical to o
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ne another and are considered homologous to one another. Each autosomal chromo
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some in a pair carries identical genes.These two genes are known as alleles. The alleles
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soccupy the same site on each partner of the chromosome pair and code for the same
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genetic trait or physiologic function. Alleles can be dominant or recessive. One allele m
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ay be dominant and the other recessive, or they both may be dominant or both recessiv
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e.The dominant alleles' genetic code will always manifest in the individual's phenotype
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. The information in the recessive allele is typically not expressed in the phenotype unl
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ess both alleles are recessive. For the purpose of clarity in use, the dominant gene is a
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ssigned a capital letter and the recessive gene is assigned a lower case letter. Any lett
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er is okay to use but make sure you use the same letter for the genotype -
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for example, "Bb or aa." The term homozygous refers to a pair of alleles which are eith
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er both dominant or recessive. For example, "BB or bb" are said to be homozygous be
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cause the alleles are either both dominant or recessive. An allele pair in which one is d
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ominant and one is recessive is said to be heterozygous. In autosomal recessive disor
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ders both alleles on the chromosome are affected by the genetic aberration. If only on
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e recessive gene is affected by
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the genetic aberration then the person is said to be a carrier and will not have the
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phenotypic expression of the disease.The healthy, recessive allele will compensate for
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he allele which is affected by the genetic aberration. The carrier can pass the trait but d
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oes not have the genetic disease. In an autosomal dominant disorder the dominant ge
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ne is the only gene that has to be affected by the genetic aberration in order to have the
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phenotypic expression of the disease. A healthy recessive allele cannot compensate f
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or a diseased dominant allele. In order to answer this question one must understand the
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sabove information and draw a Punnett Square. s s s s s s
The husband has an autosomal recessive disease which means his genotype must be
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aa. The wife has a heterozygous genotype for the disease which means her genotype
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s Aa. The capital A reflects a healthy gene so she is merely a carrier and does not expre
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s the disease phenotype.The father's genotype is written across the
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2s/s21
, NURS 5315 Final s s
Studysonlinesatshttps://quizlet.com/_czj34v
top line and the mother's genotype is written in the boxes to the left. The four boxes in the
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middle are the possible genotypes of their offspring. Each box represents a 25% chanc
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e for the offspring to have that particular genotype. The question asks you to determin
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e the chances the offspring will have the autosomal recessive disease or in other words,
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sexpress the phenotype for the disease. The genotype which will result in the disease is
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"aa." Therefore, there is a 50% chance that their offspring will have the autosomal rece
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ssive disease. s
5. A child is diagnosed with hemophilia. This is an example of which genetic co
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ncept?
Phenotype s
Genotype
Autosomal transmission of the disease s s s s
Transcription: The expression of a genetic disease is an example of a phenotype. A ge s s s s s s s s s s s s s s
notype is a gene's programming. Hemophilia is transmitted on the x-
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chromosome and is not transmitted via the autosomes. This is not an example of trans s s s s s s s s s s s s s s
cription.
6. Dehydration triggers which physiologic response? s s s s
Increased secretion of renin. s s s
Increase secretion of natriuretic peptides. Decr s s s s s
eased secretion of antidiuretic hormone. s s s s
Decreased serum osmolality.: Dehydration will trigger the release of renin when ren s s s s s s s s s s s
al perfusion is impaired.The other answers are seen during times of fluid volume overloa
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d.
7. A patient on hydrochlorothiazide has a pH of 7.49 and a bicarbonate of 30. W
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hich of the following pathological processes best explains the abnormal lab val
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ues?
a. An accumulation of pancreatic bicarbonate secondary to vomiting and loss o
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f hydrochloric acid
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b. An increased absorption of Na+ and HCO3- s s s s s s
sin the proximal renal tubule secondary to increased aldosterone secretion
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c Excessive exhalation of CO2 secondary to hyperventilation
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d. Distal renal tubular dysfunction causing an accumulation of hydrogen ions:
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The pH value and bicarbonate value are consistent with a metabolic alkalosis. The mos
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t likely cause of the metabolic alkalosis is the use of the hydrochlorothiazide (HCTZ). Thi
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s is a thiazide diuretic which can cause a metabolic alkalosis. The use of a thiazide diur
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etic will increase the secretion of aldosterone which stimulates the reabsorption of Na
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+ and HCO3- s s
sin the proximal tubule of the kidney. This is a response directly related to hypovolemia
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3s/s21
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