Pathophysiology: Study Guide for Test 1 (part 1)
Pathophysiology: Study Guide for Test 1 (part 1) HLTHST 300
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This 6 page Study Guide was uploaded by email@example.com Notetaker on Thursday September 15, 2016. The Study Guide belongs to HLTHST 300 at Boise State University taught by Jennifer Legget in Fall 2016. Since its upload, it has received 144 views. For similar materials see Pathophysiology in Biology at Boise State University.
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Date Created: 09/15/16
Practice Quizzes: Unit 2 – Part 1 Chapters 8, 9, and 10 1. A client's primary care provider has recommended biofeedback in an effort to address her chronic stress and reduce the potential for complications. What will be the goal of this intervention? a. Teaching the client to consciously control her own body functioning b. Biofeedback is a technique in which an individual learns to control physiologic functioning. It does not use exercise alone, and it aims to resolve, not simply accommodate, stress. Various types of stimulation are used, but not all are tactile. 2. A student is participating in an extended fast as part of a charitable fundraising effort. Which of the following is an example of the physiologic reserve that will facilitate the student's adaptation to the stress of this sudden change in diet? a. The student's adipose tissue contains large and accessible stores of energy. b. The ability of body systems to increase their function given the need to adapt is known as the physiologic reserve, an example of which is the energy stored in fat tissue. Previous experience, health, and relaxation are all likely to foster the student's ability to adapt, but these are not dimensions of physiologic reserve. 3. Following a school shooting, many of the children want to talk about the traumatic event. The school nurse knows this is very therapeutic and would be called: a. Debriefing b. Debriefing, or talking about the traumatic event at the time it happens, often is an effective therapeutic tool. Crisis teams are often among the first people to attend to the emotional needs of those caught in catastrophic events. Some people may need continued individual or group therapy. Guided imagery is a mind–body technique intended to relieve stress and promote a sense of peace and tranquility during periods of stress or difficulty. The individual is guided to focus on creating a specific mental image designed to bring about positive physical and/or emotional effects. Instructions are given to focus on the present; if possible, it is desirable to tune out all outside thoughts and ideas. Frequently, instructions include going to a “special place” in their minds, such as a secluded beach or a babbling brook. 4. A female client experienced a random assault several months earlier, and her recent vigilance around her own safety is described as “obsessive” by her friends and family. Which of the following aspects of posttraumatic stress disorder (PTSD) characterizes the client's behavior? a. Hyperarousal b. Hyperarousal refers to the presence of increased irritability, difficulty concentrating, an exaggerated startle reflex, and increased vigilance and concern over safety. Avoidance refers to the emotional numbing that accompanies PTSD. Intrusion is characterized by the occurrence of flashbacks, in which the traumatic experience is relived. 5. Which of the following emergency department clients is most likely demonstrating clinical manifestations of acute stress? A client with: a. An acute heightened sense of alertness to surroundings and personnel b. Acute stress is time limited, and reactions are those of the autonomic nervous system—the fight-or-flight response. Acute stress is short term and does not recur. Centrally, there is facilitation of neural pathways mediating arousal, alertness, vigilance, cognition, and focused attention, as well as appropriate aggression. Acute stress situations are controlled by a negative feedback system. When chronic stress continues, components of the system become abnormally active or fatigued and fail. The other distractors may relate to a physical problem and not “acute stress.” 6. When discussing adolescent health with a group of high school teachers, the school nurse shares that each year their student population is becoming increasingly obese. Therefore, the school nurse took the opportunity to educate the teachers about signs and symptoms of which of the following high-risk disease processes? a. Type 2 diabetes mellitus b. Childhood obesity is directly related to the increased incidence of type 2 diabetes. Until recently, type 2 diabetes rarely developed in children. Rheumatoid arthritis, attention deficit disorder, and resistant bacterial infections are unrelated to excessive fat storage (obesity). 7. Which of the following measures should a school nurse prioritize in the treatment and prevention of childhood obesity? a. Education on exercise and nutrition b. Teaching children about the pivotal roles of regular exercise and a healthy diet should be the primary focus of treatment for the majority of obese children. Pharmacologic treatments and cognitive therapy are measures that are likely to be appropriate for only a small minority of obese children. A high-protein, low-carbohydrate diet is a short-term weight loss strategy that is not synonymous with creating lifelong healthy eating habits. 8. Which of the following characteristics distinguishes kwashiorkor from marasmus? a. High intake of carbohydrates b. Kwashiorkor is a protein deficiency coupled with a high-carbohydrate diet; marasmus is a deficiency in both calories and protein. Both forms of malnutrition impair immune function and pigment synthesis, and each is normally accompanied by inadequate intake of dietary fats. 9. Protein contains nitrogen. A negative nitrogen balance represents: a. More nitrogen excreted than consumed b. Negative nitrogen balance represents more excretion of nitrogen than consumed as protein. It represents a state of tissue breakdown. Positive nitrogen balance is when more protein (nitrogen) is consumed than is needed or excreted. A normal nitrogen balance is when protein intake is equivalent to nitrogen output. 10.Which of the following statements best conveys the endocrine function of adipose tissue? Adipose tissue: a. Produces leptin, which mediates body weight b. Adipose tissue is now recognized as an endocrine organ that produces several hormones, including leptin, an important mediator of body weight. It does not produce CCK or ghrelin, however, and adipose tissue does not directly antagonize the effects of insulin. 11.A very ill client has been admitted to the hospital for testing for possible septic shock. The client reports light-headedness, dizziness, and tingling/numbness of the fingers and toes. The nurse understands that this is likely due to which physiological phenomenon? a. The sign/symptoms of respiratory alkalosis are associated with hyperexcitability of the nervous system and a decrease in cerebral blood flow. A decrease in the CO2 content of the blood causes constriction of cerebral blood vessels. CO2 crosses the blood–brain barrier rather quickly; the manifestations of acute respiratory alkalosis are usually of sudden onset. The person often experiences light- headedness, dizziness, tingling, and numbness of the fingers and toes. Impaired alveolar ventilation is associated with respiratory acidosis. A gain in bicarbonate is associated with metabolic alkalosis. Inability of the kidney to excrete the body's fixed acids occurs with metabolic acidosis. 12.The most reliable method for measuring body water or fluid volume increase is by assessing: a. Body weight change b. Daily weights are a reliable index of water volume gain (1 L of water weighs 2.2 pounds). Daily weight measurements taken at the same time each day with the same amount of clothing provide a useful index of water gain due to edema. When an unbalanced distribution of body water exists in the tissues and organs, assessment of surface skin tissue turgor will be inaccurate. Measurement of renal output is unreliable because fluid retention may be a compensatory response, or the renal system may be dysfunctional. Serum sodium levels are affected by multiple variables other than body water volume. 13.A female client with a history of chronic renal failure has a total serum calcium level of 7.9 mg/dL. While performing an assessment, the nurse should focus on which of the following clinical manifestations associated with this calcium level? a. Intermittent muscle spasms and complaints of numbness around her mouth b. Spasms and numbness are characteristic of hypocalcemia. Respiratory effects, tachycardia, and diaphoresis are not associated with low calcium levels, whereas decreased level of consciousness can be indicative of hypercalcemia. 14.Of the following clients, which would be at highest risk for developing hyperkalemia? a. A male admitted for acute renal failure following a drug overdose b. There are three main causes of hyperkalemia: (1) decreased renal elimination; (2) a shift in potassium from the ICF to ECF compartment; and (3) excessively rapid rate of administration. The most common cause of serum potassium excess is decreased renal function. Stroke does not typically have a direct influence on potassium levels, whereas vomiting and diarrhea can precipitate hypokalemia. Loss of the parathyroid influences calcium, not potassium, levels. 15.A 2-week-old infant (full-term at birth) is admitted to the pediatrics unit with “spitting up large amounts of formula” and diarrhea. The infant has developed a weak suck reflex. Which of the following statements about total body water (TBW) is accurate in this situation? a. Full-term infants have a TBW of approximately 75% due to their high metabolic rate. b. Infants normally have more TBW than older children or adults. TBW constitutes approximately 75% to 80% of body weight in full-term infants and an even greater percentage in premature infants. In males, the TBW decreases in the elderly population to approximately 52% TBW. Obesity decreases TBW, with levels as low as 30% to 40% of body weight in adults. Infants have more than half of their TBW in their ECF compartment, as compared to adults. 16.A large, high-calorie meal has resulted in the intake of far more energy than a person requires. What will the individual's body do with the excess carbohydrates provided by this meal? a. Convert them into glucose and store them in the liver and muscles b. Dietary carbohydrates are largely converted to glucose, which is stored as glycogen in the liver and skeletal muscle cells. They are not excreted by the kidneys, and carbohydrates cannot be directly converted into amino acids or structural proteins. 17.Following yearly routine physical examination by the health care provider, a client has been diagnosed with upper body obesity along with central fat distribution. The client is at greater risk for developing which of the following disease processes? a. Cardiometabolic disorders b. Upper body obesity, more than other types of obesity, carries a high cardiometabolic risk. Obese people tend to develop joint problems and arthritis, but there is no direct association with osteoporosis. Chronic anemia is associated with malnutrition and starvation. Primary renal disease is unrelated to excessive weight. 18.A frail, 87-year-old female client has been admitted to a hospital after a fall and has been diagnosed with failure to thrive. Which of the following laboratory values would suggest that the client may be experiencing malnutrition? a. Low prealbumin b. Prealbumin levels are a reliable indicator of calorie–protein malnutrition. Low blood sugar does not necessarily indicate malnutrition, and neither C-reactive protein nor bilirubin levels are sensitive or specific indicators of nutritional status. 19.A client is experiencing significant stress while awaiting the results of her recent lymph node biopsy. Among the hormonal contributors to this response is a release of aldosterone, resulting in which of the following physiologic effects? a. Increased sodium absorption b. Mineralocorticoids such as aldosterone increase sodium absorption by the kidneys. Changes in insulin release and cardiac contractility are mediated by catecholamines, whereas cortisol potentiates the action of epinephrine. 20.A 70-year-old client admitted to a hospital for a prostatectomy is surprised to learn that his physician has prescribed insulin on a sliding scale, despite the fact that the client successfully manages his type 2 diabetes using diet and oral antihyperglycemics when at home. Which of the following facts may underlie the physician's action? a. Stress-induced hyperglycemia results from numerous factors, including enhanced release of glucose from glycogen stores, increased production of glucose from noncarbohydrate sources such as amino acids, and an accompanying state of insulin resistance that impairs glucose uptake into skeletal muscle. CRF, vasopressin, epinephrine, and norepinephrine do not have direct and pronounced effects on blood glucose levels during times of stress and illness. 21.A client asks, “Why do I keep getting these cold sores on my lips? Am I kissing people too much?” The nurse will base her response by saying: a. “These sores usually develop when you are not sleeping well or are emotionally upset.” b. Herpes simplex virus type 1 infection (i.e., cold sores) often develops during periods of inadequate rest, fever, ultraviolet radiation exposure, and emotional upset. The resident herpes virus is kept in check by body defenses, probably T lymphocytes, until a stressful event occurs that causes suppression of the immune system. You do not catch cold sores by not washing after the restroom. The other responses about going out with a wet head or staying away from crowds have no bearing to the development of cold sores. 22.A nurse caring for a client with a diagnosis of diabetes insipidus (DI) should prioritize the close monitoring of which of the following electrolyte levels? a. Sodium b. The high water intake and high urine output that characterize diabetes insipidus create a risk of sodium imbalance. DI may present with hypernatremia and dehydration, especially in persons without free access to water, or with damage to the hypothalamic thirst center and altered thirst sensation. 23.A client with a diagnosis of liver cirrhosis secondary to alcohol abuse has a distended abdomen as a result of fluid accumulation in his peritoneal cavity (ascites). Which of the following pathophysiologic processes contributes to this third spacing? a. Abnormal increase in transcellular fluid volume b. Third spacing represents the loss or trapping of extracellular fluid (ECF) in the transcellular space and a consequent increase in transcellular fluid volume. The serous cavities are part of the transcellular compartment located in strategic body areas where there is continual movement of body structures—the pericardial sac, the peritoneal cavity, and the pleural cavity. Polydipsia and increased fluid intake alone are insufficient to cause third spacing, and increased capillary colloidal osmotic pressure would result in increased intracellular fluid (ICF). The etiology of third spacing does not normally include alterations in hormonal control of fluid balance. 24.The syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by: a. Low serum sodium level of 122 mEq/L b. SIADH results from a failure of the negative feedback system that regulates the release and inhibition of antidiuretic hormone (ADH). ADH secretion continues even when serum osmolality is decreased, causing water retention and dilutional hyponatremia. Diabetes insipidus, deficiency or decreased response to ADH, is characterized by increased serum osmolality, excessive thirst, and polyuria. Urine output decreases in SIADH despite adequate or increased fluid intake. 25.A client has been receiving intravenous normal saline at a rate of 125 mL/hour since her surgery 2 days earlier. As a result, she has developed an increase in vascular volume and edema. Which of the following phenomena accounts for this client's edema? a. Increased capillary filtration pressure b. An increase in vascular volume results in an increase in capillary filtration pressure. Consequently, movement of vascular fluid into the interstitial spaces increases and edema ensues. An increase in vascular volume does not directly result in obstruction of lymph flow, increased capillary permeability, or decreased capillary colloidal osmotic pressure.
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