NCLEX PATHO QUESTIONS - EXAM 1 Questions and Answers with complete solutions

NCLEX PATHO QUESTIONS - EXAM 1 Questions and Answers with complete solutions • Acid (H+) lost from emesis, diuretics. Retention of HCO3 from medications, hyperaldosteronism. • Increase in HCO3, Increase in pH • Compensation - Respiratory centers are not stimulated, which leads to hypoventilation and CO2 retention. - ANS -Metabolic Alkalosis • Caused by excessive ventilation • Decrease in PCO2, increase in pH • Compensation - Kidneys excrete HCO3. - ANS -Respiratory Alkalosis • Caused by loss of bicarb or build up of acids: lactic acidosis, diarrhea, renal failure, ketones, ammonium intoxication; not caused by respiration. • HCO3 decreases, pH decreases • Compensation - hyperventilation to eliminate CO2 - ANS -Metabolic Acidosis • Respiratory system is the cause • Increase in PCO2, decrease in pH • Compensation - Kidneys reabsorb Bicarb (HCO3). - ANS -Respiratory acidosis A nurse on a medical unit is assigned patients with acid-base irregularities. While caring for a patient with gastric lavage or prolonged vomiting, the nurse should assess for: A. acidosis B. reduction in hemoglobin C. alkalosis D. loss of osmotic pressure - ANS -C Explanation: • Gastric lavage and persistent vomiting cause removal of hydrochloric acid from the stomach, which may lead to metabolic alkalosis. • The loss of hydrogen ions results in a rise in pH (alkalemia). • B - Incorrect: Gastric lavage and vomiting will not affect hemoglobin levels. • D - Incorrect: Osmotic pressure is disturbed when protein is lost from the body. A patient has been on your telemetry unit because of a diagnosis of chest pain and has been on heparin. On the third day of admission they have a very low platelet count, less than 100,000 (normal is 150,000 - 450,000). They have patches of purple like lesions called purpura and bled from their guns while brushing their teeth. The name for this disease is: A. Thrombocytopenia B. Polycythemia Vera C. Mononucleosis D. Creutzfeldt-Jakob disease - ANS -A A patient you are taking care of requires a blood transfusion of red blood cells. You know that all of the following are true about red blood cells EXCEPT: A. They carry oxygen to the cells and tissues of the body B. They contain multiple nuclei to aid in replication in the bloodstream C. They release nitric oxide to help relax constricted blood vessels D. They are biconcave in shape in order to increase their surface area - ANS -B According to the Br∅nsted-Lowry acid-base theory, the following is a characteristic of a strong acid. A. No dissociation in water B. Complete dissociation in water C. No reaction in water D. Become proton acceptors in water - ANS -B Activation of complement is one of the responses of the innate immune system. The classic pathway is a response to: A. A reaction to endotoxins produced by antigens B. A binding to the mannose residues on antigens C. The breakdown of fibrinogen D. The activation of antibodies - ANS -D Chronic hypertension requires that the heart pumps harder with each contraction. This means that the left ventricle experiences more stretch than usual. This can result in ________ of the cells of the ventricle: A. Metaplasia B. Dysplasia C. Atrophy D. Hypertrophy - ANS -D Flipases and flopases are enzymes involved in the asymmetry of the cell membrane. Which of these is a function of membrane asymmetry? A. Marking the cell for apoptosis B. Allows for selective permeability of the membrane C. Manufacture of integral proteins D. Involved in endocytosis of nutrients - ANS -A In diabetes inspidus, patients excrete a large volume of dilute urine. Diabetes inspidus is a disease involving the mutation of proteins that are involved in the movement of water in and out of the cell. What are these proteins? A. Aquaporins B. Actins C. Bradykinins D. Histamines - ANS -A Keith Richards presented into the emergency department because of swelling in his legs, a process known as edema. He has a history of liver failure, and as a result has a decreased capacity to produce proteins such as albumin. The edema is likely a result of: A. Increased oncotic pressure in the capillary B. Decreased capillary permeability C. Decreased oncotic pressure in the capillary D. A build-up of cytotoxins from the liver - ANS -C Mr. Pasteur had his arm in a cast for six weeks. After the cast was removed, his arm was noticeably smaller. This is an example of: A. Metaplasia B. Dysplasia C. Atrophy D. Hypertrophy - ANS -C Opsonization is a process by which: A. Mast cells are degranulated to release histamine B. Antigens are identified by special protein tags C. Collagen is exposed, allowing for platelet interaction D. Proteins bind to antigens to negate the negative charge, allowing for phagocytic interactions - ANS -B Polycythemia Vera is a disease process in which the bone marrow: A. Isn't making any red blood cells B. Isn't making any platelets C. Is making too many red blood cells