HCR 240- Human Systems: Human Pathophysiology at Arizona College of Nursing
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Free HCR 240- Human Systems: Human Pathophysiology at Arizona College of Nursing Questions
1. The nurse is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone is lacking in the client with this condition?
- A. Luteinizing hormone
- B. Antidiuretic hormone
- C. Follicle-stimulating hormone
- D. Thyroid-stimulating hormone
Explanation
Diabetes insipidus (DI) results from a deficiency of antidiuretic hormone (ADH), also called vasopressin, which is produced by the hypothalamus and released by the posterior pituitary gland. ADH helps the kidneys retain water by concentrating urine. When this hormone is lacking, the kidneys excrete excessive amounts of dilute urine, leading to polyuria, polydipsia, and dehydration. Treatment often includes desmopressin (DDAVP), a synthetic form of ADH.
2. Hypovolemia and heart failure can contribute to which type of renal dysfunction?
- A. Intra-renal
- B. Inter-renal
- C. Pre-renal
- D. Post-renal
Explanation
Pre-renal dysfunction occurs when there is a reduction in blood flow to the kidneys, leading to decreased glomerular filtration rate (GFR). Conditions like hypovolemia (low blood volume) and heart failure (reduced cardiac output) both limit renal perfusion. This results in inadequate filtration of blood without intrinsic kidney damage. If untreated, prolonged pre-renal hypoperfusion can progress to ischemic injury, causing intra-renal (acute tubular necrosis) damage. Restoring perfusion is crucial to prevent permanent renal impairment.
3. A term used to describe the loss of fat in stool which develops in Celiac Disease.
- A. Melena
- B. Hematochezia
- C. Steatorrhea
- D. Borborygmi
Explanation
Steatorrhea refers to the presence of excess fat in the stool, making it bulky, pale, foul-smelling, and difficult to flush. It occurs in conditions like Celiac Disease, where damage to the intestinal villi leads to fat malabsorption. Because dietary fats are not properly digested or absorbed, they are excreted in the stool. This symptom is a hallmark of malabsorption syndromes and helps differentiate them from other gastrointestinal disorders.
4. Cushing's triad refers to a set of signs that are indicative of increased intracranial pressure (ICP), or increased pressure in the brain. Which of the following is NOT one of the signs of ICP?
- A. Hypertension
- B. Bradycardia
- C. Bradypnea or irregular respirations
- D. Tachycardia
Explanation
Cushing’s triad is a classic sign of increased intracranial pressure and includes three key findings: hypertension (with widened pulse pressure), bradycardia, and irregular or slowed respirations (bradypnea). These signs result from brainstem compression that activates the Cushing reflex to maintain cerebral perfusion. Tachycardia, however, is not part of Cushing’s triad and usually suggests another cause, such as pain, anxiety, or hypovolemia, rather than elevated intracranial pressure.
5. A patient's MRI imaging shows damage to the cerebellum a week after the patient suffered a stroke. What assessment findings would correlate with this MRI finding?
- A. Vision problems
- B. Impaired short-term memory
- C. Balance impairments
- D. Language difficulty
Explanation
The cerebellum is responsible for coordination, balance, and fine motor control. Damage to this region after a stroke typically results in ataxia, characterized by unsteady gait, difficulty maintaining posture, and impaired coordination of voluntary movements. Other signs may include dizziness and tremors. In contrast, language difficulties are associated with damage to Broca’s or Wernicke’s areas in the cerebrum, and memory issues are linked to temporal lobe dysfunction, not cerebellar injury.
6. A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with?
- A. Diabetes Insipidus
- B. Fluid Volume Deficient
- C. SIADH
- D. Addison’s Disease
Explanation
SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion) is most consistent with this presentation. It causes water retention, hyponatremia (sodium level 90), low urine output, and fluid overload. The link to small cell lung cancer, which often secretes ectopic ADH, strongly supports this diagnosis. The patient’s rapid weight gain, high BP, low sodium, and inability to urinate are hallmark features of SIADH, where excess ADH leads to dilutional hyponatremia and fluid retention.
7. A client is brought into the emergency room with left-sided paralysis, slurred speech, loss of gag reflex, and facial droop. A computed tomography (CT) scan reveals a hematoma in the brain. What is most likely this client’s diagnosis?
- A. Transient Ischemic Attack (TIA)
- B. Ischemic Stroke
- C. Lacunar Infarct
- D. Hemorrhagic Stroke
Explanation
A hemorrhagic stroke occurs when a cerebral blood vessel ruptures, leading to bleeding (hematoma) within the brain tissue. The CT scan confirming a hematoma indicates bleeding, not blockage, which differentiates it from an ischemic event. Common symptoms include sudden paralysis, slurred speech, facial droop, and loss of gag reflex, all caused by increased intracranial pressure and tissue damage from bleeding.
8. This is a viral infection that can be transmitted by blood products, body fluids, or sexual contact. An antibody test is available to test for this infection. A vaccine is available for prevention of this disease. Which viral infection is being described?
- A. Hepatitis C (HCV)
- B. Hepatitis A (HAV)
- C. Hepatitis B (HBV)
- D. Hepatitis D (HDV)
Explanation
Hepatitis B (HBV) is a viral infection transmitted through contact with infected blood, semen, or other body fluids, as well as through sexual contact and perinatal exposure. Laboratory testing can detect hepatitis B surface antigen (HBsAg) or antibodies to confirm infection. A highly effective vaccine is available for prevention, unlike hepatitis C, for which no vaccine exists. Chronic HBV infection can lead to cirrhosis, liver failure, or hepatocellular carcinoma if untreated.
9. The nurse is aware that the following laboratory values support a diagnosis of pyelonephritis?
- A. Low white blood cell (WBC) count
- B. Myoglobinuria
- C. Pyuria
- D. Ketonuria
Explanation
Pyuria, the presence of white blood cells (pus) in the urine, is a key diagnostic indicator of pyelonephritis. It reflects inflammation and infection of the renal pelvis and kidney tissue. Pyuria typically accompanies bacteriuria and is detected through urinalysis or urine culture. This finding confirms an upper urinary tract infection and helps guide antibiotic therapy. Persistent pyuria suggests ongoing infection or incomplete treatment response.
10. A male client is admitted for treatment of glomerulonephritis. On initial assessment, the nurse detects one of the classic signs of acute glomerulonephritis of sudden onset. Such signs include:
- A. Moderate to severe hypotension
- B. Polyuria
- C. Green-tinged urine
- D. Generalized edema, especially of the face and periorbital area
Explanation
Acute glomerulonephritis is an inflammatory condition of the glomeruli often following a streptococcal infection. The inflammation leads to fluid retention due to decreased glomerular filtration rate (GFR), resulting in facial and periorbital edema, especially noticeable in the morning. Other classic symptoms include hematuria (tea-colored urine), mild to moderate hypertension, and oliguria. Polyuria and hypotension are not typical findings, while green-tinged urine is unrelated to this condition.
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