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Free NR283 student Practise Exam Chamberlain University Questions
1. What manifestation occurs in a person with fluid deficit due to compensation?
-
Bradycardia
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High blood pressure
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Poor skin turgor
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Decreased urine output
Explanation
Explanation
When the body experiences a fluid deficit, the kidneys compensate by conserving water and reducing urine output. This is mediated by increased ADH secretion and activation of the renin-angiotensin-aldosterone system, both of which promote water and sodium retention to restore circulating volume.
Why the other options are incorrect:
A. Bradycardia — Fluid deficit triggers compensatory tachycardia, not bradycardia, as the heart beats faster to maintain cardiac output despite reduced blood volume.
B. High blood pressure — Fluid deficit typically causes hypotension due to reduced circulating volume. While compensatory vasoconstriction may temporarily maintain blood pressure, hypertension is not an expected finding.
C. Poor skin turgor — This is a sign of the fluid deficit itself, not a compensatory response. The body does not produce poor skin turgor as a mechanism of compensation.
When the body experiences a fluid deficit, the kidneys compensate by conserving water and reducing urine output. This is mediated by increased ADH secretion and activation of the renin-angiotensin-aldosterone system, both of which promote water and sodium retention to restore circulating volume.
Why the other options are incorrect:
A. Bradycardia — Fluid deficit triggers compensatory tachycardia, not bradycardia, as the heart beats faster to maintain cardiac output despite reduced blood volume.
B. High blood pressure — Fluid deficit typically causes hypotension due to reduced circulating volume. While compensatory vasoconstriction may temporarily maintain blood pressure, hypertension is not an expected finding.
C. Poor skin turgor — This is a sign of the fluid deficit itself, not a compensatory response. The body does not produce poor skin turgor as a mechanism of compensation.
2. What can cause hyponatremia?
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Decreased antidiuretic hormone
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Decreased water intake
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Increased aldosterone
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Increased sweating
Explanation
Explanation
Sweat contains sodium, and excessive sweating leads to significant sodium loss from the body. When this sodium loss is not adequately replaced, serum sodium levels drop, resulting in hyponatremia. This is especially common in conditions of heat exposure or intense physical activity.
Why the other options are incorrect:
A. Decreased antidiuretic hormone — Low ADH causes the kidneys to excrete more water, which would concentrate sodium and lead to hypernatremia, not hyponatremia.
B. Decreased water intake — Reduced water intake leads to water deficit and hemoconcentration, raising serum sodium levels and causing hypernatremia, not hyponatremia.
C. Increased aldosterone — Aldosterone promotes sodium reabsorption in the kidneys, which would increase serum sodium levels, not decrease them.
Sweat contains sodium, and excessive sweating leads to significant sodium loss from the body. When this sodium loss is not adequately replaced, serum sodium levels drop, resulting in hyponatremia. This is especially common in conditions of heat exposure or intense physical activity.
Why the other options are incorrect:
A. Decreased antidiuretic hormone — Low ADH causes the kidneys to excrete more water, which would concentrate sodium and lead to hypernatremia, not hyponatremia.
B. Decreased water intake — Reduced water intake leads to water deficit and hemoconcentration, raising serum sodium levels and causing hypernatremia, not hyponatremia.
C. Increased aldosterone — Aldosterone promotes sodium reabsorption in the kidneys, which would increase serum sodium levels, not decrease them.
3.
What condition results in edema due to increased capillary permeability?
- Hyponatremia
- Lymph node obstruction
- Heart failure
- Anaphylactic reaction
Explanation
Explanation
Correct Answer: D) Anaphylactic reaction
Edema caused by increased capillary permeability occurs when the walls of the capillaries become more permeable, allowing fluid and proteins to leak from the bloodstream into the surrounding tissues. This process commonly occurs during inflammatory or allergic reactions.
Anaphylactic reactions trigger the release of substances such as histamine and other inflammatory mediators. These chemicals cause the capillary walls to become more permeable, allowing plasma to move into the interstitial spaces. This leads to rapid swelling and edema, which are characteristic features of severe allergic reactions.
In contrast, lymph node obstruction causes edema due to impaired lymphatic drainage, heart failure causes edema due to increased hydrostatic pressure, and hyponatremia is related to electrolyte imbalance rather than increased capillary permeability.
Correct Answer: D) Anaphylactic reaction
Edema caused by increased capillary permeability occurs when the walls of the capillaries become more permeable, allowing fluid and proteins to leak from the bloodstream into the surrounding tissues. This process commonly occurs during inflammatory or allergic reactions.
Anaphylactic reactions trigger the release of substances such as histamine and other inflammatory mediators. These chemicals cause the capillary walls to become more permeable, allowing plasma to move into the interstitial spaces. This leads to rapid swelling and edema, which are characteristic features of severe allergic reactions.
In contrast, lymph node obstruction causes edema due to impaired lymphatic drainage, heart failure causes edema due to increased hydrostatic pressure, and hyponatremia is related to electrolyte imbalance rather than increased capillary permeability.
4. What manifestation is common when a person experiences an absence seizure?
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Jerking arm movements
-
Sudden muscle stiffening
-
Brief period of staring
-
Bladder incontinence
Explanation
Explanation
Absence seizures, formerly called petit mal seizures, are characterized by sudden, brief lapses in consciousness during which the person appears to stare blankly into space. These episodes typically last only a few seconds, and the person resumes normal activity immediately after without confusion or postictal state.
Why the other options are incorrect:
A. Jerking arm movements — Repetitive jerking movements are characteristic of myoclonic or tonic-clonic seizures, not absence seizures.
B. Sudden muscle stiffening — Muscle rigidity is associated with tonic seizures or the tonic phase of tonic-clonic seizures, not absence seizures.
D. Bladder incontinence — Loss of bladder control can occur with generalized tonic-clonic seizures due to the widespread muscle involvement, but it is not a feature of absence seizures.
Absence seizures, formerly called petit mal seizures, are characterized by sudden, brief lapses in consciousness during which the person appears to stare blankly into space. These episodes typically last only a few seconds, and the person resumes normal activity immediately after without confusion or postictal state.
Why the other options are incorrect:
A. Jerking arm movements — Repetitive jerking movements are characteristic of myoclonic or tonic-clonic seizures, not absence seizures.
B. Sudden muscle stiffening — Muscle rigidity is associated with tonic seizures or the tonic phase of tonic-clonic seizures, not absence seizures.
D. Bladder incontinence — Loss of bladder control can occur with generalized tonic-clonic seizures due to the widespread muscle involvement, but it is not a feature of absence seizures.
5. What arterial blood gas result is expected in a person experiencing a panic attack?
-
pH 7.32, PaCO2 49 mm Hg, HCO3 26 mEq/L
-
pH 7.46, PaCO2 42 mm Hg, HCO3 28 mEq/L
-
pH 7.49, PaCO2 28 mm Hg, HCO3 24 mEq/L
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pH 7.34, PaCO2 45 mm Hg, HCO3 21 mEq/L
Explanation
Explanation
Correct Answer: (C) pH 7.49, PaCO2 28 mm Hg, HCO3 24 mEq/L
During a panic attack, the person hyperventilates, breathing rapidly and deeply. This causes excessive elimination of carbon dioxide from the body, leading to a decrease in PaCO2. As CO2 drops, carbonic acid in the blood decreases, causing the blood pH to rise above 7.45, resulting in respiratory alkalosis. The HCO3 remains normal or near normal in the acute phase because the kidneys have not yet had time to compensate. A pH of 7.49 (alkalotic), PaCO2 of 28 mm Hg (low), and HCO3 of 24 mEq/L (normal) is the classic ABG pattern of uncompensated respiratory alkalosis caused by hyperventilation during a panic attack.
Why Other Options are Incorrect:
A. pH 7.32, PaCO2 49 mm Hg, HCO3 26 mEq/L represents respiratory acidosis with a low pH, elevated PaCO2, and normal to slightly elevated HCO3. This pattern is seen in hypoventilation states such as COPD exacerbation or respiratory depression, not hyperventilation from a panic attack.
B. pH 7.46, PaCO2 42 mm Hg, HCO3 28 mEq/L represents metabolic alkalosis with a normal to slightly elevated pH, normal PaCO2, and elevated HCO3. This pattern is associated with excessive vomiting, nasogastric suctioning, or diuretic use, not a panic attack.
D. pH 7.34, PaCO2 45 mm Hg, HCO3 21 mEq/L represents metabolic acidosis with a low pH, normal PaCO2, and low HCO3. This pattern is seen in conditions such as diabetic ketoacidosis or diarrhea, not a panic attack.
Correct Answer: (C) pH 7.49, PaCO2 28 mm Hg, HCO3 24 mEq/L
During a panic attack, the person hyperventilates, breathing rapidly and deeply. This causes excessive elimination of carbon dioxide from the body, leading to a decrease in PaCO2. As CO2 drops, carbonic acid in the blood decreases, causing the blood pH to rise above 7.45, resulting in respiratory alkalosis. The HCO3 remains normal or near normal in the acute phase because the kidneys have not yet had time to compensate. A pH of 7.49 (alkalotic), PaCO2 of 28 mm Hg (low), and HCO3 of 24 mEq/L (normal) is the classic ABG pattern of uncompensated respiratory alkalosis caused by hyperventilation during a panic attack.
Why Other Options are Incorrect:
A. pH 7.32, PaCO2 49 mm Hg, HCO3 26 mEq/L represents respiratory acidosis with a low pH, elevated PaCO2, and normal to slightly elevated HCO3. This pattern is seen in hypoventilation states such as COPD exacerbation or respiratory depression, not hyperventilation from a panic attack.
B. pH 7.46, PaCO2 42 mm Hg, HCO3 28 mEq/L represents metabolic alkalosis with a normal to slightly elevated pH, normal PaCO2, and elevated HCO3. This pattern is associated with excessive vomiting, nasogastric suctioning, or diuretic use, not a panic attack.
D. pH 7.34, PaCO2 45 mm Hg, HCO3 21 mEq/L represents metabolic acidosis with a low pH, normal PaCO2, and low HCO3. This pattern is seen in conditions such as diabetic ketoacidosis or diarrhea, not a panic attack.
6. When a person has decreased levels of serotonin, what manifestation is expected?
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Salivation
-
Mania
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Depression
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Dehydration
Explanation
Explanation
Correct Answer: (C) Depression
Serotonin is a neurotransmitter that plays a central role in regulating mood, emotion, sleep, and appetite. Decreased levels of serotonin in the brain are strongly associated with the development of depression. This is the neurochemical basis for the use of selective serotonin reuptake inhibitors (SSRIs) as the first-line pharmacological treatment for depression, as they work by increasing the availability of serotonin in the synaptic cleft.
Why the other options are incorrect:
A. Salivation is controlled by the autonomic nervous system and is not a manifestation associated with decreased serotonin levels. It is more related to parasympathetic stimulation and cholinergic activity rather than serotonin levels.
B. Mania is associated with excess dopamine and norepinephrine activity rather than decreased serotonin. Elevated or dysregulated neurotransmitter activity, particularly dopamine, is associated with the manic phase of bipolar disorder.
D. Dehydration is a physiological state related to fluid and electrolyte balance and is not a manifestation of decreased serotonin levels. It has no direct neurochemical relationship to serotonin deficiency.
Correct Answer: (C) Depression
Serotonin is a neurotransmitter that plays a central role in regulating mood, emotion, sleep, and appetite. Decreased levels of serotonin in the brain are strongly associated with the development of depression. This is the neurochemical basis for the use of selective serotonin reuptake inhibitors (SSRIs) as the first-line pharmacological treatment for depression, as they work by increasing the availability of serotonin in the synaptic cleft.
Why the other options are incorrect:
A. Salivation is controlled by the autonomic nervous system and is not a manifestation associated with decreased serotonin levels. It is more related to parasympathetic stimulation and cholinergic activity rather than serotonin levels.
B. Mania is associated with excess dopamine and norepinephrine activity rather than decreased serotonin. Elevated or dysregulated neurotransmitter activity, particularly dopamine, is associated with the manic phase of bipolar disorder.
D. Dehydration is a physiological state related to fluid and electrolyte balance and is not a manifestation of decreased serotonin levels. It has no direct neurochemical relationship to serotonin deficiency.
7.
Which statement describes a brain herniation?
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A condition in which the brain swells and becomes enlarged.
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A type of stroke that occurs when a blood clot blocks blood flow to the brain.
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Pressure inside the skull pushes the brain stem through the foramen magnum.
-
The bones of the skull fuse together, putting pressure on the brain.
Explanation
Explanation
Correct answer: C. Pressure inside the skull pushes the brain stem through the foramen magnum
Brain herniation occurs when increased intracranial pressure forces brain tissue to shift from its normal position. In severe cases, the brain stem is pushed downward through the foramen magnum, the opening at the base of the skull. This condition is life-threatening because the brain stem controls vital functions such as breathing, heart rate, and blood pressure. Common causes include traumatic brain injury, brain tumors, hemorrhage, or severe cerebral edema.
Correct answer: C. Pressure inside the skull pushes the brain stem through the foramen magnum
Brain herniation occurs when increased intracranial pressure forces brain tissue to shift from its normal position. In severe cases, the brain stem is pushed downward through the foramen magnum, the opening at the base of the skull. This condition is life-threatening because the brain stem controls vital functions such as breathing, heart rate, and blood pressure. Common causes include traumatic brain injury, brain tumors, hemorrhage, or severe cerebral edema.
8.
Which chemical is involved in the inflammatory response, regulation of body temperature, and regulation of water balance?
- Acetylcholine
- Dopamine
- Histamine
- Serotonin
Explanation
Explanation
Correct answer: C. Histamine
Histamine is an important chemical mediator released by mast cells and basophils during inflammatory and allergic reactions. It contributes to the inflammatory response by causing vasodilation and increasing capillary permeability. Histamine also plays a role in several physiological processes including regulation of body temperature and fluid balance through its actions in the hypothalamus and other body systems.
Correct answer: C. Histamine
Histamine is an important chemical mediator released by mast cells and basophils during inflammatory and allergic reactions. It contributes to the inflammatory response by causing vasodilation and increasing capillary permeability. Histamine also plays a role in several physiological processes including regulation of body temperature and fluid balance through its actions in the hypothalamus and other body systems.
9.
What manifestation is expected with an obstruction of the small intestine?
- Severe diarrhea
- Increased passage of gas
- Abdominal distension
- Decreased heart rate
Explanation
Explanation
Correct answer: C. Abdominal distension
Small intestinal obstruction prevents the normal movement of intestinal contents. As fluid, gas, and intestinal secretions accumulate above the obstruction, the bowel becomes distended. This buildup leads to noticeable abdominal swelling and discomfort, making abdominal distension a common and expected manifestation of small intestinal obstruction.
Correct answer: C. Abdominal distension
Small intestinal obstruction prevents the normal movement of intestinal contents. As fluid, gas, and intestinal secretions accumulate above the obstruction, the bowel becomes distended. This buildup leads to noticeable abdominal swelling and discomfort, making abdominal distension a common and expected manifestation of small intestinal obstruction.
10. Why does a person with liver disease develop esophageal varices?
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Decreased storage of iron
-
Increased ammonia levels
-
Increased portal pressure
-
Decreased bile production
Explanation
Explanation
Correct Answer: (C) Increased portal pressure
In liver disease, particularly cirrhosis, scar tissue replaces healthy liver cells and obstructs blood flow through the liver. This causes blood to back up in the portal venous system, raising portal pressure — a condition called portal hypertension. As blood seeks alternative routes, it is diverted into smaller collateral vessels including those in the esophagus. These vessels become engorged and dilated, forming esophageal varices that are highly prone to rupture and life-threatening bleeding.
Why the other options are incorrect:
A. Decreased storage of iron — Iron storage is a liver function, and its impairment in liver disease contributes to anemia, not esophageal varices. Varices are a vascular consequence of portal hypertension.
B. Increased ammonia levels — Elevated ammonia in liver disease results from impaired detoxification and leads to hepatic encephalopathy. While it is a serious complication of liver disease, it does not cause esophageal varices.
D. Decreased bile production — Reduced bile production affects fat digestion and absorption of fat-soluble vitamins, but it does not contribute to the development of esophageal varices.
Correct Answer: (C) Increased portal pressure
In liver disease, particularly cirrhosis, scar tissue replaces healthy liver cells and obstructs blood flow through the liver. This causes blood to back up in the portal venous system, raising portal pressure — a condition called portal hypertension. As blood seeks alternative routes, it is diverted into smaller collateral vessels including those in the esophagus. These vessels become engorged and dilated, forming esophageal varices that are highly prone to rupture and life-threatening bleeding.
Why the other options are incorrect:
A. Decreased storage of iron — Iron storage is a liver function, and its impairment in liver disease contributes to anemia, not esophageal varices. Varices are a vascular consequence of portal hypertension.
B. Increased ammonia levels — Elevated ammonia in liver disease results from impaired detoxification and leads to hepatic encephalopathy. While it is a serious complication of liver disease, it does not cause esophageal varices.
D. Decreased bile production — Reduced bile production affects fat digestion and absorption of fat-soluble vitamins, but it does not contribute to the development of esophageal varices.
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