NURS 5315: ADVANCED PATHOPHYSIOLOGY 2024 FINAL EXAM QUESTIONS WITH CORECT ANSWERS || ALREADY GRADED A+ <UPDATED VERSION>
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Course
NURS 5315: ADVANCED PATHOPHYSIOLOGY
Institution
NURS 5315: ADVANCED PATHOPHYSIOLOGY
NURS 5315: ADVANCED
PATHOPHYSIOLOGY 2024 FINAL
EXAM QUESTIONS WITH CORECT
ANSWERS || ALREADY GRADED A+
<UPDATED VERSION>
Total Body Weight decreases as we age due to - ANSWER -Increase in body fat
-Decrease in muscle mass
-Decrease in ability to regulate sodium and water balance
-...
NURS 5315: ADVANCED
PATHOPHYSIOLOGY 2024 FINAL
EXAM QUESTIONS WITH CORECT
ANSWERS || ALREADY GRADED A+
<UPDATED VERSION>
Total Body Weight decreases as we age due to - ANSWER ✔ -Increase in body fat
-Decrease in muscle mass
-Decrease in ability to regulate sodium and water balance
-Decrease in renal function
-Elderly are very susceptible to dehydration d/t increased insensible water loss
PCO2 - ANSWER ✔ -Measures the partial pressure of arterial CO2 in the blood
(dissolved in the blood) and reflects ventilation.
-The higher this level is, the faster the respirations are and vice versa.
HCO3 - ANSWER ✔ -Is a direct measurement of the amount of bicarbonate in the
blood.
-It reflects the metabolic component of acid base balances, specifically the kidney.
PaO2 - ANSWER ✔ Is a measure of the partial pressure of arterial O2, which is
the amount of oxygen content that is dissolved in the arterial blood.
Base Excess/Deficit - ANSWER ✔ -Is a value which is calculated from the pH,
PCO2, and the hematocrit.
-It represents the amount of anions available for buffering.
A negative base excess represents - ANSWER ✔ metabolic acidosis
, A positive base excess represents - ANSWER ✔ metabolic alkalosis or
compensation for respiratory acidosis
A-a Gradient - ANSWER ✔ -Measures the differences between the alveolar (A) to
arterial (a) O2.
-It is a calculated value which indicates the difference between alveolar and arterial
O2 content.
An elevated A-a gradient can happen in such diseases such as - ANSWER ✔
pulmonary edema, pulmonary fibrosis, and ARDS.
Roles of the kidney in maintenance of acid base balance - ANSWER ✔
Reabsorption of Bicarbonate
Renal Excretion of Hydrogen
Excretion of Hydrogen as Ammonium
What inhibits HCO3 reabsorption - ANSWER ✔ Acetazolamide (carbonic
anhydrase inhibitor): blocks the action of carbonic anhydrase
Order of RAAS - ANSWER ✔ -release of renin
-renin -> angiotensin
-angiotensin -> angiotensin 1
-ACCE converts angiotensin1-> angiotensin II -> causes art VC -> release of
aldosterone -> stimulates renal Na reabsorption and K excretion
Works opposite of RAAS to decrease blood volume - ANSWER ✔ ANP and BNP
Natriuretic Hormones
-promote urinary excretion of Na and water
may be used interchangeably with osmolality - ANSWER ✔ tonicity
What causes an increase in hydrostatic pressure - ANSWER ✔ venous obstruction
or retention of Na & water
what causes a decrease in oncotic pressure and osmotic pressure - ANSWER ✔
decreased plasma protein production
Reabsorption of bicarbonate occurs with - ANSWER ✔ loop or thiazide diuretics
volume replacement with NaCl
Renal excretion of H+ ions occurs mostly in - ANSWER ✔ distal tubule &
collecting ducts
What assists with renal excretion of H+ ions - ANSWER ✔ inorganic phosphates
Where does excretion of hydrogen as ammonium occur - ANSWER ✔ proximal
tubule, loop of henle, and distal tubules (proximal tubule cells produce NH4+)
What blocks the actions of carbonic anhydrase to inhibit HCO3 reabsorption -
ANSWER ✔ Acetazolamide
High Anion Gap metabolic acidosis is likely caused by - ANSWER ✔ lactic
acidosis
ketoacidosis
acute or chronic renal failure
Normal anion gap metabolic acidosis is likely caused by - ANSWER ✔ GI losses
from diarrhea
large volumes of saline admin
medications such as NSAIDS, ace inhibitors, trimethoprim
Clinical Manifestations of Metabolic Acidosis - ANSWER ✔ Headache and
lethargy, which progresses to confusion and coma in severe, Kussmauls
respirations (form of hyperventilation that are deep and rapid), anorexia, N/V,
diarrhea, abd discomfort
Pathological Consequences of Metabolic Acidosis - ANSWER ✔ decreased
myocardial contractility, decreased CO, and catecholamine resistant hypotension,
and hyperkalemia
, Pathological Mechanisms that cause Metabolic Acidosis - ANSWER ✔ -increased
acid production
-loss of bicarbonate
-diminished renal excretion of hydrogen.
Metabolic Acidosis - ANSWER ✔ Reduction of serum bicarbonate concentration
and a low arterial pH.
Metabolic Alkalosis - ANSWER ✔ Results from an excess of HCO3 or deficiency
of H ions.
High pH, high HCO3
Causes of Metabolic Alkalosis - ANSWER ✔ Gastric stomach contents (vomiting
or gastric suctioning), diuretic use (thiazide diuretics), diarrhea (laxative abuse),
antacid ingestion, excess aldosterone
Clinical Manifestations of Metabolic Alkalosis - ANSWER ✔ Hypokalemia,
hypocalcemia, cardiac arrhythmias from hypokalemia, hypoventilation, and a
elevated PCO2, tetany, paresthesias
Contraction Alkalosis - ANSWER ✔ Results in an increased production of
aldosterone and consequently increased reabsorption of Na+ and HCO3- in the
proximal tubule in response to the hypovolemia and hypokalemia.
-occurs with diuretic use
In order for metabolic alkalosis to occur - ANSWER ✔ a process that causes a rise
in serum bicarbonate and a process which prevents the renal excretion of serum
bicarbonate must both occur.
Respiratory Acidosis - ANSWER ✔ Results from an excess of arterial carbon
dioxide (PaCO2), a decrease in alveolar ventilation in relation to the metabolic
production of carbon dioxide. Lungs aren't blowing off enough CO2.
Causes of Respiratory Acidosis - ANSWER ✔ -Medullary respiratory center
depression from opiates, barbiturates, anesthesia, PCO2 retention, or a head injury
-Impaired respiratory musculature from Guillain-Barre' syndrome, polio,
amyotrophic lateral sclerosis, multiple sclerosis
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