Instructions:
1. Read and study RRD #1 and any other documents that are referred to such as concept maps.
2. Fill in this worksheet after you finish your readings. (Not mandatory to fill in worksheet, but it will
help when you are ready to enter your answers into Assignment Submission section.)
3. Click on the Assignment Submission offering when you are ready to enter your answers, and follow the instructions there. Note: the multiple-choice assignment format LOOKS like a test, but you will be able to access the assignment freely UP UNTIL THE DUE DATE. At the due date and time, the assignment submission module will become inaccessible. If you have not submitted your assignment by then you will receive a zero.
4. NOTE: in a nursing course exam, read the question carefully, answer the question, save/submit and then move to the next question. You cannot go back and re-review the question and change your answer once you have moved forward to the next question.
NOTE: You may use your lecture notes to correctly answer the questions BUT it is a good idea to study your lecture notes, then try to independently answer the assignment. Testing yourself will help determine what concepts need more reviewing. The assignment questions mimic your exam format exactly. In your studying, remember to approach material via “front-door” and “back door”—for example, if in a test you are given the name of a disease (front door), be able to answer questions about its pathophysiology & S&S. If you are given the patho or S&S (back door), be able to trace them back to the name of the disease….and so forth. Also, read scenarios and questions carefully. Be SURE you understand what is being asked. Then when you go to choose an answer, first read ALL the offerings & choose the one that fits the scenario, plus fits the reading that you have done—the RRD and concept maps. Do not overthink—that is, do not weave in other ungrounded assumptions. Have a good rationale for why you chose the answer that you did…. AND also, why you DIDN’T choose the other answers.
Basic Concepts of Pathophysiology & Implications for Nursing
a. “You have a disease process that was iatrogenically caused by cigarette smoking.”
b. “You have a sudden onset of a chronic lung disease that was brought on by lung cancer.”
c. “The coughing up of blood is caused by a worsening of a disease you’ve had for a long time, plus a new problem– lung cancer.”
d. “These diseases have been creeping up on you for probably 20 years; it just goes to show that you should never have taken up smoking.”
a. The patient has a poor prognosis because of the comorbidities of lung cancer and cigarette smoking.
b. Lung cancer was a sequela of the bloody sputum.
c. A precipitating factor for the acute hospitalization was overexertion when the patient started an exercise class.
d. Heavy cigarette smoking was a risk factor in the patient’s developing emphysema and lung cancer.
a. probably the etiology for the patient’s low BP.
b. due to the patient’s heart compensating for low blood volume by pumping faster.
c. the normal compensatory response of shunting blood volume to the periphery.
d. due to multiple risk factors.
a. S&S of cool feet and hands from the body’s compensatory response to blood loss.
b. S&S of feeling faint and weak from blood loss.
c. a risk factor of shock.
d. a more guarded (ie, “poorer”) prognosis because of his age.
5. A young, otherwise healthy patient is admitted to the hospital with a diagnosis of heart failure of unknown cause. The etiology of the heart failure would be termed
a. iatrogenic.
b. idiopathic.
c. nosocomial.
d. acute.
6. A busy student, with very few financial resources, has body aches, a fever, cough and nasal congestions and difficulty breathing through their nose. The direct pathophysiologic etiology of these symptoms is most likely related to
a. not eating green vegetables.
b. lung failure.
c. lack of oxygen.
d. exposure to a microbe.
7. A busy student, with very few financial resources, has body aches, a fever, cough and nasal congestions and difficulty breathing through their nose. The precipitating factors related to the illness include all options EXCEPT
a. having few financial resources.
b. having a cough and nasal congestion.
c. has poor hand hygiene.
d. is sleep deprived.
| Note: Any time a question refers to a concept map or a “mini-concept” map, as in question #8, think in a stepwise fashion. The first word or phrase leads to the next, which leads to the next, etc. In some cases an arrow separates the word or phrase, and in other cases there may be a series of dots separating them. The point is, one concept leads to another, in an order that makes sense pathophysiologically. |
8. Which mini concept map best describes thermoregulation?
a. Body temperature decreases à hypothalamus sends a signalà vasoconstriction of superficial arteries à blood stays “warm” in the center of the body (core).
b. Body temperature rises à hypothalamus sends a signal à vasoconstriction of superficial arteries à blood stays “cool” in the center of the body (core).
c. Body temperature rises à brain stem sends a signal à skin produces sweat à heat loss through evaporation.
d. Body temperature rises àthe brain over heats à no compensatory mechanisms existà a heat stroke occurs.
a. A compensatory response called glycogenolysis allowed him to access stored glucose for energy.
b. A decompensatory response occurred, in which adrenalin increased and caused more blood flow to the brain.
c. Since his blood sugar was likely low, the heart underwent a compensatory response
known as hypertrophy in order to increase blood flow to central organs.
d. Using a control mechanism known as hyperventilation, the student was able to
“blow off” excess CO2 and thus have a clearer thinking process.
10. An RN is taking care of a cocaine addict who has just given birth to a baby with a teratogenic defect. A student nurse asks him what the probable etiology was. The RN shows understanding of genetic disorders when he says
a. “It’s hard to know the exact cause, but it’s likely that fetal chromosomal development was impaired by the mom’s intra-pregnancy cocaine ingestion.”
b. “The baby inherited a structural chromosomal defect that resulted in a problem called aneuploidy.”
c. “The baby inherited a gene that caused a defect called trisomy 21.”
d. “Since the little guy was born with the Philadelphia chromosome, he will be a life-long Phillies fan.”
a. aa
b. a heterozygous pairing
c. AA
d. Different alleles on a gene locus
12. A child with sickle cell anemia presents with pain all over, especially the joints. Which option best links the patho with S&S?
| (REMEMBER, WHEN YOU ARE STUDYING ANY MATERIAL IN THIS COURSE, BE SURE TO UNDERSTAND HOW TO LINK S&S TO THE PATHO OF THE DISEASE & VICE VERSA.) |
a. Cyst formation in the kidneys leads to blood spillage from the circulation into the
urine, thus causing anemia.
b. A single-gene mutation causes malfunction of genetic coding for clotting properties, leading
to bleeding and ischemic pain of the joints.
c. Chromosomal aberrancy causes malformation of RBCs in the blood supply to the joints and subsequent pain due to lack of oxygen.
d. A single-gene mutation causes malfunction in RBC O2-carrying capacity, leading to ischemic pain in the joint tissues.
a. developmental problems brought on by a sex-linked monosomy.
b. developmental problems brought on by the pathologic interaction of 3 chromosomes where there should be only two.
c. a phenotype based on defective mitochondrial protein synthesis that created aneuploidy.
d. the phenotype of diminished IQ and physical differences that are caused by a single-gene disorder.
14. A child is brought to her healthcare provider. Her parents state that no matter how much she eats, she keeps losing weight. She appears quite thin. Her blood sugar is markedly elevated. She is diagnosed with type I diabetes mellitus (DM 1). Which explanation bests links the pathophysiology with the S&S? In DM 1 the pancreas _____
a. quits producing glucagon so that glycogen stores are inaccessible, thus causing weight loss.
b. increases insulin production so that glucose stays in the blood, causing hyperglycemia.
c. quits producing insulin so that glycogenolysis is stimulated and too much glucose enters the blood.
d. quits producing insulin so that glucose cannot be used as energy in the cells, thus causing the body to burn up fat and protein for energy.
15. A child is brought to her healthcare provider. Her parents state that no matter how much she eats, she keeps losing weight. She appears quite thin. Her blood sugar is markedly elevated. She is diagnosed with type I diabetes mellitus (DM 1). If ABGs were done on this patient, you would expect all the following EXCEPT:
a. a blood pH of 7.32 because sustained gluconeogenesis causes acidic byproducts to
accumulate.
b. a HCO3 of 20 because the high numbers of acids in her body “take over” and “overcome”
the HCO3, which then diminishes in number.
c. a HCO3 of 30 because the low numbers of acids in her body stimulate an increase in HCO3.
d. this acid/base imbalance to be called metabolic acidosis because it is an acidotic state
caused by a metabolic disorder.
16. A patient is diagnosed with metabolic acidosis. Which compensatory response would you expect?
a. Hyperventilation –increased respiratory rate (RR)– to “blow off” CO2; this is the lungs’ way to get rid of acids.
b. Hypoventilation—decreased RR– to “hold onto” CO2, since CO2 is an alkali that will counteract the acidosis.
c. Kidneys will excrete more HCO3 into the urine to get rid of acidic byproducts.
d. By hyperventilating and blowing off CO2, the body will bring the pH down to normal range.
17. A child accidentally ingests an insecticide with the ingredient cyanide. Knowing that cyanide suppresses the actions of cytochrome oxidase in the electron transport chain, what is a likely sign or symptom you would expect and why? (see page 2 of metabolic pathway concept map and use your critical thinking skills)
a. Ketonuria due to increased glycogenesis.
b. Confusion due to glycolysis.
c. Mild euphoria due to enhanced production of ATP.
d. Shortness of breath due to decreased ATP to use for the work of breathing.
18. A patient with a serum calcium of 6.0 (norm = 8.5- 10.5) is most likely to ______ because_______.
a. be lethargic: the cells are hypopolarized.
b. have muscle spasms: more Na+ has entered the cells.
c. be weak: more Na+ has left the cells.
d. have hyperirritable muscles: the cells are hyperpolarized.
19. A patient has been vomiting copiously for 3 days. He is probably in ___ because _____.
a. metabolic acidosis : vomiting often leads to hyperventilation.
b. respiratory alkalosis : vomiting often leads to hyperventilation
c. metabolic alkalosis : vomiting of the normal acidic digestive secretions of the stomach eventually depletes the body’s acids.
d. metabolic acidosis : vomiting of the normal acidic digestive secretions of the stomach eventually depletes the body’s acids.
20. A patient’s ABG results are pH:7.20; HCO3:17. What might be the cause of this acid base imbalance?
a. Large amount of alcohol consumedà break down of alcohol causes a lot of acid byproducts à excess acid accumulation in the blood à metabolic acidosis
b. Hypoxiaà cells must continuously go through aerobic glycolysisà excess pyruvate accumulation à less ATP production.
c. Gastrointestinal fluà diarrheaà loss of HCO3 in the diarrheaàHCO3 goes upàcausing the pH to go down.
d. Kidney failure àincreased HCO3 productionà body compensates by decreasing respiratory rate (hypoventilation)à metabolic alkalosis.
