PRN 1520 -PATHOPHYSIOLOGY COMPREHENSIVE FINAL EXAM SOUTH COLLEGE
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Free PRN 1520 -PATHOPHYSIOLOGY COMPREHENSIVE FINAL EXAM SOUTH COLLEGE Questions
1.
Which of the following signs is associated with the pathophysiology of rheumatoid arthritis (RA)?
- Pain relieved by activity and movement
- Asymmetrical joint involvement
- Heberden's nodes at the interphalangeal joints
- Swan neck finger deformities
Explanation
Explanation
Correct Answer: D) Swan neck finger deformities
RA is a systemic autoimmune disease causing symmetric joint inflammation. Chronic synovial inflammation and destruction of tendons and ligaments in the fingers leads to characteristic deformities including swan neck deformity (hyperextension of the PIP joint with flexion of the DIP joint) and boutonnière deformity. RA pain is typically worse with rest and improved with movement, joint involvement is symmetrical not asymmetrical, and Heberden's nodes are associated with osteoarthritis, not RA.
Correct Answer: D) Swan neck finger deformities
RA is a systemic autoimmune disease causing symmetric joint inflammation. Chronic synovial inflammation and destruction of tendons and ligaments in the fingers leads to characteristic deformities including swan neck deformity (hyperextension of the PIP joint with flexion of the DIP joint) and boutonnière deformity. RA pain is typically worse with rest and improved with movement, joint involvement is symmetrical not asymmetrical, and Heberden's nodes are associated with osteoarthritis, not RA.
2.
Which pathophysiological change occurs with left ventricular hypertrophy?
- Coronary artery plaque reduces oxygen delivery to the myocardium
- Fluid volume overload causes dilation of the ventricular chambers
- Inflammatory mediators destroy myocardial muscle fibers
- Higher vascular resistance forces the left ventricle to work harder
Explanation
Explanation
Correct Answer: D) Higher vascular resistance forces the left ventricle to work harder
Left ventricular hypertrophy occurs when the left ventricle works harder to overcome increased vascular resistance, often due to hypertension or other factors. This increased workload leads to thickening of the myocardial muscle, which may impair heart function over time.
Options A, B, and C describe conditions that affect the heart in different ways, but they do not directly cause the hypertrophy seen in left ventricular hypertrophy.
Correct Answer: D) Higher vascular resistance forces the left ventricle to work harder
Left ventricular hypertrophy occurs when the left ventricle works harder to overcome increased vascular resistance, often due to hypertension or other factors. This increased workload leads to thickening of the myocardial muscle, which may impair heart function over time.
Options A, B, and C describe conditions that affect the heart in different ways, but they do not directly cause the hypertrophy seen in left ventricular hypertrophy.
3.
A nurse is assessing a client with type 2 diabetes. Which finding indicates hyperglycemia?
- Dry skin
- Decreased urination
- Bradycardia
- Excessive thirst
Explanation
Explanation
Correct Answer: D) Excessive thirst
Excessive thirst (polydipsia) is a classic symptom of hyperglycemia. When blood glucose levels are elevated, the kidneys attempt to excrete the excess glucose through urine (glucosuria), drawing large amounts of water with it. This osmotic diuresis leads to dehydration, which triggers the thirst center in the hypothalamus, causing the patient to feel intensely and persistently thirsty.
Correct Answer: D) Excessive thirst
Excessive thirst (polydipsia) is a classic symptom of hyperglycemia. When blood glucose levels are elevated, the kidneys attempt to excrete the excess glucose through urine (glucosuria), drawing large amounts of water with it. This osmotic diuresis leads to dehydration, which triggers the thirst center in the hypothalamus, causing the patient to feel intensely and persistently thirsty.
4.
The term "bradypnea" refers to:
- A normal breathing rate.
- A slow respiratory rate.
- Rapid breathing.
- Cessation of breathing.
Explanation
Explanation
Correct Answer: B) A slow respiratory rate.
Bradypnea is defined as an abnormally slow respiratory rate, typically fewer than 12 breaths per minute in adults. The prefix brady- means slow. It can result from causes such as opioid use, CNS depression, metabolic alkalosis, or increased intracranial pressure. Bradypnea reduces the body's ability to eliminate CO₂, potentially leading to hypercapnia and respiratory acidosis if left untreated.
Correct Answer: B) A slow respiratory rate.
Bradypnea is defined as an abnormally slow respiratory rate, typically fewer than 12 breaths per minute in adults. The prefix brady- means slow. It can result from causes such as opioid use, CNS depression, metabolic alkalosis, or increased intracranial pressure. Bradypnea reduces the body's ability to eliminate CO₂, potentially leading to hypercapnia and respiratory acidosis if left untreated.
5.
Which hormonal imbalance is responsible for diabetes insipidus?
- Increased insulin
- Deficit of antidiuretic hormone (ADH)
- Deficit of triiodothyronine (T₃) and thyroxine (T₄)
- Decreased glucocorticoids
Explanation
Explanation
Correct Answer: B) Deficit of antidiuretic hormone (ADH)
Diabetes insipidus results from a deficiency of ADH (vasopressin), which is normally responsible for signaling the kidneys to reabsorb water. Without sufficient ADH, the kidneys cannot concentrate urine, leading to the excretion of massive amounts of dilute urine (polyuria) and intense thirst (polydipsia).
Correct Answer: B) Deficit of antidiuretic hormone (ADH)
Diabetes insipidus results from a deficiency of ADH (vasopressin), which is normally responsible for signaling the kidneys to reabsorb water. Without sufficient ADH, the kidneys cannot concentrate urine, leading to the excretion of massive amounts of dilute urine (polyuria) and intense thirst (polydipsia).
6.
One manifestation of HYPOglycemia is:
- Frequent urination.
- Shakiness.
- Extreme thirst.
- Fruity odor to breath.
Explanation
Explanation
Correct Answer: B) Shakiness.
Shakiness (tremors) is a classic manifestation of hypoglycemia, occurring because low blood glucose triggers the sympathetic nervous system to release epinephrine (adrenaline) as a compensatory response. This produces classic adrenergic symptoms including shakiness, diaphoresis, anxiety, tachycardia, and pallor.
Option A is incorrect because frequent urination (polyuria) is a hallmark sign of hyperglycemia, as excess glucose spills into the urine drawing water with it. Option C is incorrect because extreme thirst (polydipsia) is also a classic sign of hyperglycemia, resulting from cellular dehydration and fluid shifts. Option D is incorrect because a fruity odor to breath is a sign of diabetic ketoacidosis (DKA) — a hyperglycemic complication caused by ketone buildup from fat metabolism, not hypoglycemia.
Correct Answer: B) Shakiness.
Shakiness (tremors) is a classic manifestation of hypoglycemia, occurring because low blood glucose triggers the sympathetic nervous system to release epinephrine (adrenaline) as a compensatory response. This produces classic adrenergic symptoms including shakiness, diaphoresis, anxiety, tachycardia, and pallor.
Option A is incorrect because frequent urination (polyuria) is a hallmark sign of hyperglycemia, as excess glucose spills into the urine drawing water with it. Option C is incorrect because extreme thirst (polydipsia) is also a classic sign of hyperglycemia, resulting from cellular dehydration and fluid shifts. Option D is incorrect because a fruity odor to breath is a sign of diabetic ketoacidosis (DKA) — a hyperglycemic complication caused by ketone buildup from fat metabolism, not hypoglycemia.
7.
Which symptom indicates peripheral neuropathy in a client with diabetes?
- Persistent low-grade fever
- Increased deep tendon reflexes
- Sudden onset of severe chest pain
- Numbness and tingling in extremities
Explanation
Explanation
Correct Answer: D) Numbness and tingling in extremities
Diabetic peripheral neuropathy results from chronic hyperglycemia damaging the peripheral nerves, particularly in a "stocking-and-glove" distribution. Patients typically experience numbness, tingling, burning, or loss of sensation beginning in the feet and hands. This loss of protective sensation is a major contributing factor to undetected injuries and diabetic foot ulcers.
Correct Answer: D) Numbness and tingling in extremities
Diabetic peripheral neuropathy results from chronic hyperglycemia damaging the peripheral nerves, particularly in a "stocking-and-glove" distribution. Patients typically experience numbness, tingling, burning, or loss of sensation beginning in the feet and hands. This loss of protective sensation is a major contributing factor to undetected injuries and diabetic foot ulcers.
8.
Why might a client with poorly controlled diabetes require leg amputation?
- Elevated blood glucose increases blood viscosity.
- Necrosis and gangrene development in the legs.
- Cells in the legs lack sufficient glucose.
- Severe tissue dehydration occurs.
Explanation
Explanation
Correct Answer: B) Necrosis and gangrene development in the legs.
Poorly controlled diabetes causes progressive peripheral vascular disease (reduced blood flow) and peripheral neuropathy (loss of sensation) in the lower extremities. Reduced circulation impairs wound healing, and loss of sensation means injuries go unnoticed and untreated. This combination leads to chronic, non-healing wounds that become infected, progressing to tissue necrosis and gangrene — ultimately requiring amputation to prevent systemic sepsis and preserve life.
Correct Answer: B) Necrosis and gangrene development in the legs.
Poorly controlled diabetes causes progressive peripheral vascular disease (reduced blood flow) and peripheral neuropathy (loss of sensation) in the lower extremities. Reduced circulation impairs wound healing, and loss of sensation means injuries go unnoticed and untreated. This combination leads to chronic, non-healing wounds that become infected, progressing to tissue necrosis and gangrene — ultimately requiring amputation to prevent systemic sepsis and preserve life.
9.
Blood flows through the heart in which order after leaving the superior and inferior vena cavae?
- Left atrium – bicuspid/mitral valve – left ventricle – aortic valve – aorta – lungs – pulmonary veins – right atrium – tricuspid valve – right ventricle – pulmonic valve – pulmonary artery
- Left atrium – tricuspid valve – left ventricle – pulmonic valve – pulmonary artery – lungs – pulmonary veins – right atrium – bicuspid/mitral valve – right ventricle – aortic valve – aorta
- Right atrium – tricuspid valve – right ventricle – pulmonic valve – pulmonary artery – lungs – pulmonary veins – left atrium – bicuspid/mitral valve – left ventricle – aortic valve – aorta
- Right atrium – bicuspid/mitral valve – right ventricle – pulmonic valve – pulmonary artery – lungs – pulmonary veins – left atrium – tricuspid valve – left ventricle – aortic valve – aorta
Explanation
Explanation
Correct Answer: C) Right atrium – tricuspid valve – right ventricle – pulmonic valve – pulmonary artery – lungs – pulmonary veins – left atrium – bicuspid/mitral valve – left ventricle – aortic valve – aorta
Deoxygenated blood from the body returns via the vena cavae into the right atrium, passes through the tricuspid valve into the right ventricle, exits through the pulmonic valve into the pulmonary artery, travels to the lungs for oxygenation, returns via the pulmonary veins to the left atrium, passes through the mitral valve into the left ventricle, and is pumped out through the aortic valve into the aorta for systemic circulation.
Correct Answer: C) Right atrium – tricuspid valve – right ventricle – pulmonic valve – pulmonary artery – lungs – pulmonary veins – left atrium – bicuspid/mitral valve – left ventricle – aortic valve – aorta
Deoxygenated blood from the body returns via the vena cavae into the right atrium, passes through the tricuspid valve into the right ventricle, exits through the pulmonic valve into the pulmonary artery, travels to the lungs for oxygenation, returns via the pulmonary veins to the left atrium, passes through the mitral valve into the left ventricle, and is pumped out through the aortic valve into the aorta for systemic circulation.
10.
What is the primary reason polyuria occurs in a client who has diabetes mellitus?
- Ketoacidosis
- Elevated glucose levels
- Low blood glucose
- Diabetic nephropathy
Explanation
Explanation
Correct Answer: B) Elevated glucose levels
In diabetes mellitus, persistently elevated blood glucose exceeds the renal threshold for reabsorption (approximately 180 mg/dL). Glucose spills into the urine (glycosuria), creating an osmotic effect that pulls large amounts of water with it into the urine, resulting in polyuria. This osmotic diuresis is the direct and primary cause of excessive urination in diabetic patients.
Correct Answer: B) Elevated glucose levels
In diabetes mellitus, persistently elevated blood glucose exceeds the renal threshold for reabsorption (approximately 180 mg/dL). Glucose spills into the urine (glycosuria), creating an osmotic effect that pulls large amounts of water with it into the urine, resulting in polyuria. This osmotic diuresis is the direct and primary cause of excessive urination in diabetic patients.
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