NU 160 Final Spring 2025

Correct Answer A: Vision changes occur when the cloudy lens alters the passage of light through the eye.

Explanation:

 Cataracts develop when the lens of the eye becomes cloudy, often due to aging or long-term exposure to ultraviolet light. This cloudiness scatters or blocks light, leading to blurry or dim vision. It does not involve the retina or intraocular pressure. Cataract-related vision changes are usually gradual and painless.

Why Other Options are Wrong:

B. Vision changes occur when blood vessels leak fluid or blood under a portion of the retina.”

 This describes conditions like diabetic retinopathy or macular degeneration, not cataracts. These disorders involve vascular changes, while cataracts involve changes to the lens.

C. Vision changes occur when retinal tissue pulls away from the blood vessels in the eye.”

 This describes a retinal detachment, a medical emergency unrelated to cataracts.

D. Vision changes occur when pressure in the eye is increased due to a decrease of aqueous humor.”

 This is characteristic of glaucoma, not cataracts. Cataracts do not affect intraocular pressure.

Correct Answer A: Blood flow is altered due to atherosclerosis affecting the tissues' ability to receive oxygen-rich blood.

Explanation:

 Peripheral arterial disease (PAD) is primarily caused by atherosclerosis, which leads to narrowing and hardening of the arteries. This reduces blood flow, especially to the extremities, impairing oxygen and nutrient delivery to tissues. Symptoms often include pain, cramping, and non-healing wounds in the legs due to poor perfusion.

Why Other Options are Wrong:

B. Blood flow is altered and causes blood to pool in the legs.

This describes venous insufficiency, not peripheral arterial disease. In PAD, the issue is restricted flow to the tissues, not pooling of blood. Pooling is typical in venous disorders, leading to varicose veins and edema, not ischemia.

C. Blood flow is altered due to incompetent valves causing increased venous pressure.":

This again refers to a venous condition, such as chronic venous insufficiency. Valvular incompetence leads to backflow and pressure buildup, not reduced arterial supply, which is the hallmark of PAD.

D. Blood flow is altered due to excessive stretching of the ventricles impairing the heart to contract.":

This describes heart failure, particularly dilated cardiomyopathy, not peripheral arterial disease. PAD is a vascular condition, not a direct cardiac muscle problem.

Correct Answers:

A. Hypertension

B. Obesity

C. Smoking

E. Hypercholesterolemia

Explanation:

A. Hypertension

High blood pressure damages arterial walls over time, making them more susceptible to plaque buildup. It is modifiable with medication, diet, and lifestyle changes.

B. Obesity

Excess body weight increases the risk of atherosclerosis by contributing to hypertension, diabetes, and high cholesterol. Weight loss is a modifiable factor.

C. Smoking

Smoking contributes to endothelial damage and promotes plaque buildup. It is a major modifiable risk factor, and cessation significantly reduces risk.

E. Hypercholesterolemia

High levels of cholesterol, particularly LDL, promote plaque formation in arteries. It is modifiable through diet, exercise, and medication.

Why the Other Option Is Incorrect:

D. Genetic predisposition

Family history or inherited traits cannot be changed and are considered non-modifiable risk factors for atherosclerosis.

Correct Answer A: Mental status changes

Explanation:

 Mental status changes, such as confusion or decreased alertness, are a hallmark of severe DKA due to the effects of hyperglycemia and metabolic acidosis on the brain. Elevated ketone levels and dehydration can lead to cerebral edema and altered consciousness. This is a critical finding that suggests worsening DKA and requires urgent intervention.

Why Other Options are Wrong:

B. Dizziness:

 While dizziness may occur in many conditions, it is non-specific and not one of the key diagnostic signs of DKA. It may be present in dehydration, but mental status changes take clinical priority and are more definitive in DKA assessment.

C. Nervousness:

 This symptom is more commonly associated with hypoglycemia, not DKA. Clients with low blood sugar often feel jittery or anxious, which contrasts with the mental dulling or confusion of hyperglycemic crises like DKA.

D. Cool, clammy skin:

 This is a sign of hypoglycemia, not hyperglycemia. DKA is more often associated with dry, warm skin due to dehydration. Cool and clammy skin would not be expected in this hyperglycemic state.

Correct Answer B: Diverticulosis is a common condition that increases the risk for diverticulitis.

Explanation:

Diverticulosis refers to the presence of small, bulging pouches (diverticula) in the colon wall, which are often asymptomatic. While not inherently dangerous, diverticulosis can lead to diverticulitis—an inflammation or infection of these pouches. The condition is common, especially in older adults, and understanding the risk of progression is essential in managing it.

Why Other Options are Wrong:

Diverticulosis is often treated with antibiotics and a liquid diet:

This treatment applies to diverticulitis, not diverticulosis. Diverticulosis typically does not require treatment unless complications arise. The focus is usually on dietary fiber intake and regular bowel habits.

Diverticulosis is inflammation and infection of the bowel mucosa:

This describes diverticulitis, not diverticulosis. The latter is non-inflammatory and non-infectious in nature.

Diverticulosis is characterized by the presence of inflamed pouches in the colon:

Diverticulosis involves non-inflamed pouches. The term “inflamed” refers specifically to the progression into diverticulitis.

Correct Answer A: These tests help determine the degree of damage to the heart tissues.

Explanation:

Cardiac enzyme tests (such as troponin, CK-MB, and myoglobin) are used to detect myocardial cell injury. Elevated enzyme levels confirm that heart muscle damage has occurred and help estimate the severity and timing of the infarction.

Why Other Options are Wrong:

B. Cardiac enzymes will identify the location of the MI.

Cardiac enzymes indicate that an MI has occurred but do not specify its anatomical location. An ECG or imaging studies are needed to determine the specific site of the infarction.

C. Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.

Pulmonary congestion is a symptom of heart failure or fluid overload and is typically evaluated through chest x-rays, physical examination, and BNP levels—not cardiac enzyme levels.

D. These tests will enable the provider to determine the heart structure and mobility of the heart valves.

This is the role of echocardiography or other imaging studies, not cardiac enzyme tests. Enzymes reflect function and damage, not structure or valve movement.

Correct Answer B: Drink 3 L of fluid every day

Explanation:

 High fluid intake dilutes the urine, which helps prevent the concentration and crystallization of calcium and oxalate—key contributors to kidney stone formation. Increasing fluid intake is a primary preventive strategy for clients with a history of calcium oxalate stones.

Why Other Options are Wrong:

A. Restrict calcium intake to one serving per day:

 While it may seem intuitive, excessive calcium restriction can actually increase oxalate absorption in the gut, raising the risk of stone formation. Normal dietary calcium intake is encouraged to bind oxalate in the GI tract and prevent stone development.

B. Eat 12 oz of animal protein daily:

 High animal protein intake can increase the excretion of calcium and uric acid, both of which are risk factors for kidney stones. Clients are advised to limit, not increase, intake of animal proteins.

C. Take 3,000 mg of vitamin C daily:

 High doses of vitamin C can be metabolized into oxalate, which may lead to stone formation. This level of supplementation is excessive and potentially harmful for someone prone to calcium oxalate stones.

Correct Answer C: Excessive daytime sleepiness

Explanation:

 Obstructive sleep apnea (OSA) involves repeated episodes of upper airway obstruction during sleep, leading to interrupted breathing and poor sleep quality. As a result, clients with OSA commonly experience excessive daytime sleepiness, fatigue, difficulty concentrating, and irritability. This is one of the hallmark symptoms and a key reason why clients seek medical evaluation.

Why Other Options are Wrong:

Chest pain:

 While OSA can be associated with cardiovascular complications, chest pain is not a typical presenting symptom. It requires evaluation for other causes.

Elevated mood:

 OSA is more often associated with mood disturbances like depression or irritability—not elevated mood. Sleep disruption tends to worsen emotional stability.

Increased appetite:

 OSA does not directly cause increased appetite. In fact, some people may experience weight gain due to fatigue-related inactivity, but increased appetite is not a direct symptom of the disorder.

Correct Answer A: Confusion

Explanation:

 Older adults with pneumonia often present with atypical symptoms. One of the most common signs is acute confusion or a sudden change in mental status. This occurs due to hypoxia and systemic infection, which may not always present with typical respiratory symptoms in elderly clients. Recognizing confusion as an early indicator of infection is crucial in this population.

Why Other Options are Wrong:

B. Tympany upon chest percussion:

 Tympany is a high-pitched, drum-like sound usually associated with excessive air, such as in pneumothorax—not pneumonia. Pneumonia typically produces dullness over the affected area due to consolidation.

C. Hypertension:

 While some clients may have elevated blood pressure, pneumonia more commonly leads to hypotension, especially if sepsis develops. Hypertension is not a defining or expected symptom.

D. Unequal pupils:

 This is a neurological sign often associated with brain injury, stroke, or increased intracranial pressure—not pneumonia.