PRN 1520 Pathophysiology EXAM 3 at South College
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Free PRN 1520 Pathophysiology EXAM 3 at South College Questions
A patient arrives at the emergency department with reports of pain in the right upper quadrant of the abdomen after eating a high-fat meal. The patient states that the pain radiates to the back. No changes are noted on the electrocardiogram (ECG) and cardiac enzymes are normal. The nurse suspects this patient is experiencing:
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A myocardial infarction
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Appendicitis
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Gastroesophageal reflux
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Cholecystitis
Explanation
Cholecystitis is the inflammation of the gallbladder, typically caused by the presence of gallstones. The classic symptoms include right upper quadrant pain that is often triggered or worsened after eating a high-fat meal, as fat stimulates the gallbladder to contract. The pain may radiate to the back or right shoulder. The absence of ECG changes and normal cardiac enzymes suggest that the pain is not due to a myocardial infarction (heart attack), making cholecystitis the most likely diagnosis.
A patient presents to the emergency department with a stroke. The patient appears to be having difficulty with hearing and emotional behavior. The nurse would suspect that which lobe of the brain was affected by the stroke?
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Frontal
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Temporal
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Parietal
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Occipital
Explanation
The temporal lobe is primarily responsible for processing auditory information (hearing) and regulating emotions through structures like the amygdala and hippocampus. Damage to the temporal lobe can result in hearing difficulties and changes in emotional behavior, both of which are consistent with the symptoms described in the patient. Additionally, the temporal lobe is involved in memory and language processing.
A client presents to the emergency department with dark, tarry stools. The nurse would document this finding as:
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Hematemesis
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Melena
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Hematochezia
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Thrombocytopenia
Explanation
Melena refers to dark, tarry stools that are the result of blood being digested in the gastrointestinal tract. This typically occurs when there is bleeding from the upper gastrointestinal tract (such as the stomach or duodenum). The blood, after being in the GI tract for some time, turns black and tarry due to digestion.
A nurse working in a neurological unit of a hospital is providing care to a patient who had a seizure 1 hour ago. The patient has been sleeping and is difficult to arouse since having the tonic-clonic seizure. The nurse would document this behavior as:
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The post-ictal phase
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A behavioral disorder
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An absence seizure
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An aura
Explanation
The post-ictal phase refers to the period of recovery following a seizure. During this phase, a patient may experience confusion, lethargy, difficulty arousing, headache, or sleepiness. This phase can last for minutes to hours, depending on the individual and the severity of the seizure. The patient's difficulty in being aroused and sleeping after the tonic-clonic seizure is characteristic of the post-ictal state.
Which of the following correctly lists the order of the electrical conduction system of the heart?
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Purkinje fibers - Bundle of His - AV node - SA node
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SA node - Bundle of His - Purkinje fibers - AV node
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AV node - SA node - Bundle of His - Purkinje fibers
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SA node - AV node - Bundle of His - Purkinje fibers
Explanation
The electrical conduction system of the heart follows this specific order:
1. SA node (Sinoatrial node): The "natural pacemaker" of the heart, located in the right atrium, initiates the electrical impulse.
2. AV node (Atrioventricular node): The impulse then travels to the AV node, located between the atria and ventricles, where it briefly pauses to allow the ventricles time to fill with blood.
3. Bundle of His: From the AV node, the impulse moves down to the Bundle of His, which is a pathway that leads to the right and left bundle branches.
4. Purkinje fibers: Finally, the impulse spreads through the Purkinje fibers in the ventricles, causing them to contract.
This sequence ensures the coordinated contraction of the heart, with the atria contracting first, followed by the ventricles.
The classic triad of Parkinson's disease signs include: (Select All That Apply)
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"Cogwheel" rigidity
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Resting tremor
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Loss of sensation
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Bradykinesia
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Memory loss
Explanation
A. "Cogwheel" rigidity
One of the hallmark signs of Parkinson's disease is rigidity, often described as "cogwheel" rigidity. This type of rigidity presents as jerky, ratchet-like movements when the muscles are passively stretched. It occurs due to the resistance from the muscles when the person moves, which is characteristic of Parkinson's.
B. Resting tremor
A resting tremor is another classic symptom of Parkinson's disease, typically beginning in one hand. It occurs when the hand or fingers are at rest and disappears when the person moves the affected limb. This tremor often starts as a subtle shaking and is a defining feature of the disease.
D. Bradykinesia
Bradykinesia refers to slowness of movement, and it is a core feature of Parkinson's disease. It affects the ability to initiate and complete movements, resulting in a shuffling walk, reduced facial expressions, and difficulty with fine motor tasks such as writing.
Disruption of which neurotransmitter is involved in Parkinson's disease?
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Acetylcholine
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Serotonin
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Norepinephrine
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Dopamine
Explanation
Parkinson's disease is primarily caused by the degeneration of dopamine-producing neurons in the substantia nigra, a part of the brain involved in controlling movement. Dopamine is a neurotransmitter that plays a crucial role in regulating voluntary movements and coordination. The lack of dopamine in Parkinson's disease leads to symptoms such as tremors, rigidity, bradykinesia (slow movements), and postural instability.
A client presents with yellowing of the eyes and skin. Which of the following should the nurse evaluate as a potential cause of this condition?
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Cirrhosis
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Diverticulosis
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Appendicitis
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Ulcerative colitis
Explanation
The yellowing of the eyes and skin is known as jaundice, and it is most commonly caused by the accumulation of bilirubin in the blood. Bilirubin is a byproduct of red blood cell breakdown, and when the liver is unable to process or excrete it properly, it builds up, resulting in jaundice. Cirrhosis, which is scarring of the liver due to chronic liver damage (often from alcohol use, hepatitis, or fatty liver disease), impairs the liver’s ability to filter bilirubin, leading to its accumulation. The liver damage in cirrhosis can obstruct bile flow, further contributing to the development of jaundice.
A nurse is asking a patient about his bowel patterns. Which of the following patient statements may indicate that the patient is experiencing constipation?
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"I feel as though I am able to completely evacuate my bowels when I defecate."
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"My stools are soft."
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"I strain to defecate."
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"I move my bowels at least 7 times a week."
Explanation
Straining to defecate is a common sign of constipation. Constipation is often characterized by infrequent bowel movements, difficulty passing stools, or the need to exert extra effort during defecation. This statement suggests the patient is experiencing difficulty with bowel movements, which is a key symptom of constipation.
A nurse is teaching a patient about risk factors for hypertension. Which of the following should the nurse include as non-modifiable risk factors?
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Obesity
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Gender
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Stress
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Sodium intake
Explanation
Non-modifiable risk factors for hypertension are those that cannot be changed or controlled by lifestyle modifications. Gender is a non-modifiable risk factor because it is determined by biological sex. Men are more likely to develop hypertension at a younger age compared to women, although the risk increases for women after menopause.
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