1. A patient in respiratory A patient who is breathing 33 breaths per minute
distress and is breath- is hyperventilating and blowing off CO2; there-
ing 33 breaths per minute. fore the PCO2 level will be low. The patient will
Which ABG value is con- most likely experience a respiratory alkalosis
sistent with the clinical and the two pH values provided are not consis-
scenario? tent with this diagnosis.
PCO2 15
pH 7.30
pH 7.45
O2 sat 100%
2. A patient has a sodi- b. The cause of neurologic symptoms associated
um level of 115 mEq/L with a sodium imbalance is directly related to
and is disoriented and fluid shifting into or out of the neurons of the
lethargic. Which patholog- brain. With a serum sodium of 115 mEq/L, water
ical process best explains shifts into the neurons and causes them to swell.
this patient's symptoms? Hypernatremia causes water to shift out of the
a. The action potential has cell into the intravascular space and causes the
become hyperpolarized. neurons to become dehydrated. An alteration
b. Water has shifted into in the action potential is not seen with sodium
the neurons and caused imbalances.
them to swell.
c. Water has shifted into
the vascular space and
dehydrated the neurons.
d. The action potential has
become hypopolarized.
3. A patient experiencing de- a. Serum osmolality is increased during times of
hydration should be moni- dehydration. An elevated serum osmolality will
tored for which electrolyte pull potassium into the intravascular space from
imbalance? the intracellular space and cause a rise in serum
a. Hyperkalemia potassium.
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia
4. A married couple pre- A chromosome is a package of material located
sents to your office for ge- inside the cell nucleus which is made of proteins
, NURS 5315 Final edition
netic counseling. The hus- and a single molecule of DNA. There are 23
band has an autosomal pairs of chromosomes in each human cell for
recessive disease and his a total of 46 chromosomes. Chromosomes are
wife has a heterozygous separated into two identical sets during mitosis
genotype for the disease. or meiosis. This provides a set of chromosomes
They ask you, What is the to each daughter cell which results from cell
chance that our baby will division. This process is responsible for the trans-
have the disease? Which fer of genetic information to the daughter cells.
of the following answers The first 22 pairs of chromosomes are known
is correct? as autosomes. The 23rd pair of chromosomes is
25% the pair which contains the genetic information
50% for gender. This pair contains the genetic infor-
75% mation which delineates between the male and
100% female genders. Females have two X chromo-
somes (XX) and males have an XY chromosome
pair. Autosomal chromosomes are said to be
autologous. This means they do not carry genetic
information pertaining to gender. Autosomal ge-
netic diseases are carried on the first 22 pairs
of chromosomes. Sex-linked diseases are only
carried on the 23rd pair of chromosomes. The
autosomal chromosomes are nearly identical to
one another and are considered homologous to
one another. Each autosomal chromosome in a
pair carries identical genes. These two genes are
known as alleles. The alleles occupy the same
site on each partner of the chromosome pair and
code for the same genetic trait or physiologic
function. Alleles can be dominant or recessive.
One allele may be dominant and the other re-
cessive, or they both may be dominant or both
recessive. The dominant alleles' genetic code will
always manifest in the individual's phenotype.
The information in the recessive allele is typical-
ly not expressed in the phenotype unless both
alleles are recessive. For the purpose of clarity
in use, the dominant gene is assigned a capital
letter and the recessive gene is a
, NURS 5315 Final edition
5. A child is diagnosed with The expression of a genetic disease is an ex-
hemophilia. This is an ex- ample of a phenotype. A genotype is a gene's
ample of which genetic programming. Hemophilia is transmitted on the
concept? x-chromosome and is not transmitted via the au-
Phenotype tosomes. This is not an example of transcription.
Genotype
Autosomal transmission
of the disease
Transcription
6. Dehydration triggers Dehydration will trigger the release of renin when
which physiologic re- renal perfusion is impaired. The other answers
sponse? are seen during times of fluid volume overload.
Increased secretion of
renin.
Increase secretion of na-
triuretic peptides.
Decreased secretion of
antidiuretic hormone.
Decreased serum osmo-
lality.
7. A patient on hy- The pH value and bicarbonate value are consis-
drochlorothiazide has a tent with a metabolic alkalosis. The most likely
pH of 7.49 and a bicar- cause of the metabolic alkalosis is the use of the
bonate of 30. Which of hydrochlorothiazide (HCTZ). This is a thiazide
the following pathologicaldiuretic which can cause a metabolic alkalosis.
processes best explains The use of a thiazide diuretic will increase the
the abnormal lab values? secretion of aldosterone which stimulates the
reabsorption of Na+ and HCO3- in the proximal
a. An accumulation of tubule of the kidney. This is a response directly
pancreatic bicarbonate related to hypovolemia secondary to the diuretic
secondary to vomiting use. Option A occurs as a result of excessive
and loss of hydrochloric vomiting. Vomiting does cause a metabolic al-
acid kalosis but there is nothing in the question to
b. An increased absorp- suggest that the patient has been vomiting. Op-
tion of Na+ and HCO3- in tion C would result in a respiratory alkalosis, not
the proximal renal tubule a metabolic alkalosis. Option D would cause a
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