1
NUR 3129 Patho Finals
study guide
1 HYPODIPSIA IN ELDERLY CH 8 P. 146-147
1. Recognizing the prevalence and incidence of dehydration among older adults, a
care aide at a long-term care facility is in the habit of encouraging residents to drink
even though they may not feel thirsty at the time. Which of the following facts
underlies the care aide's advice?
A) Older adults often experience a decrease in the sensation of thirst, even
when serum sodium levels are high.
B) The metabolic needs for both fluid and sodium in older adults differ from those
of younger individuals.
C) Regulation and maintenance of effective circulating volume by the kidneys is
less effective in the elderly.
D) The renin–angiotensin–aldosterone system (RAAS) is less able to facilitate
sodium clearance in older adults.
Ans: A
2 FEEDBACK:
The elderly are prone to hypodipsia even when osmolality and serum sodium levels are
elevated, a fact that is compounded by sensory and/or neurological deficits. Hypodipsia
in the elderly is not related to differing metabolic needs, ineffective kidney function, or
compromise of the RAAS.
2. INDICATORS OF FLUID VOLUME
OVERLOAD. P. 150
A client is brought to the emergency department with complaints of shortness of breath.
Assessment reveals a full, bounding pulse, severe edema, and audible crackles in lower
lung fields bilaterally. What is the client's most likely diagnosis?
A) Hyponatremia
B) Fluid volume excess
C) Electrolyte imbalance: hypocalcemia
D) Hyperkalemia
Ans: B Feedback:
, 1
Peripheral and pulmonary edema as well as a bounding pulse and dyspnea are indicators
of fluid volume overload.
3 ETIOLOGY OF HYPERPARATHYROIDISM CH 8 P.160-161
3. A 52-year-old patient has just passed a kidney stone and has high levels of calcium
in her urine. Blood tests show high levels of calcium in her blood as well. What
subsequent lab results would be most likely to distinguish between primary
hyperparathyroidism and hypercalcemia of malignancy?
A) Parathyroid hormone level
B) Bone scan
C) Plasma phosphate levels
D) Serum magnesium
level Ans: A
, 1
4 FEEDBACK:
Hyperparathyroidism, in which parathyroid hormone is secreted in excess, may be
caused by a parathyroid adenoma. Since parathyroid hormone mobilizes calcium from
bone and promotes its transfer to the extracellular fluid, excess calcium is excreted in
the urine (promoting the development of kidney stones) and is evident in the plasma. In
primary hyperparathyroidism, antibody binding assays of intact PTH would reveal
either normal or elevated parathyroid hormone in the face of hypercalcemia, whereas in
hypercalcemia of malignancy, levels of intact PTH are suppressed.
Metabolic alkalosis is manifested ..pg 183-184
Tutoring info: increase PH, increase bicarbonate and increase carbon dioxide levels.
5 A CLIENTS ARTERIAL BLOOD GASES REVEAL NORMAL OXYGEN
LEVEL, PH 7.50, PCO2 LEVEL OF 50 MMHG AND HCO3 LEVEL
OF 30. THE CLIENTS RESPIRATORY RATE IS 12 BREATHS/MIN
AND ALL OTHER VITAL SIGNS WITHIN NORMAL RANGE. WHAT IS
THIS CLIENT'S MOST LIKELY DIAGNOSIS:
ANS: Metabolica Alkalosis
6 ROLE OF NEUTROPHILS IN INFLAMMATION CH 9 PG. 192
A patient presented to the emergency department of the hospital with a swollen,
reddened, painful leg wound and has been diagnosed with methicillin-resistant
Staphylococcusaureus(MRSA) cellulitis. The patient's
physician has ordered a complete blood count and white cell differential. Which
of the following blood components would the physician most likely anticipate to
be elevated?
D) Neutrophil
s Ans: D
Feedback
Increased neutrophils are associated with inflammation in general and bacterial
infections in particular. Platelets play a role in inflammation, but their levels would not
rise to the same extent as would neutrophils'. Eosinophils are not strongly associated
with bacterial infection, and basophils would not increase to the same degree as
neutrophils.
, 1
Role of histamine Pg 198-199
A deficiency in which of the following would result in an inhibition of the inflammatory
response?
A) Histamine
B) Helper T cells
C) B cells
D) Vitamin K
An A
s:
7 FEEDBACK:
Histamine is a key mediator in the inflammatory system, unlike helper T cells, B cells, or
vitamin K.
NUR 3129 Patho Finals
study guide
1 HYPODIPSIA IN ELDERLY CH 8 P. 146-147
1. Recognizing the prevalence and incidence of dehydration among older adults, a
care aide at a long-term care facility is in the habit of encouraging residents to drink
even though they may not feel thirsty at the time. Which of the following facts
underlies the care aide's advice?
A) Older adults often experience a decrease in the sensation of thirst, even
when serum sodium levels are high.
B) The metabolic needs for both fluid and sodium in older adults differ from those
of younger individuals.
C) Regulation and maintenance of effective circulating volume by the kidneys is
less effective in the elderly.
D) The renin–angiotensin–aldosterone system (RAAS) is less able to facilitate
sodium clearance in older adults.
Ans: A
2 FEEDBACK:
The elderly are prone to hypodipsia even when osmolality and serum sodium levels are
elevated, a fact that is compounded by sensory and/or neurological deficits. Hypodipsia
in the elderly is not related to differing metabolic needs, ineffective kidney function, or
compromise of the RAAS.
2. INDICATORS OF FLUID VOLUME
OVERLOAD. P. 150
A client is brought to the emergency department with complaints of shortness of breath.
Assessment reveals a full, bounding pulse, severe edema, and audible crackles in lower
lung fields bilaterally. What is the client's most likely diagnosis?
A) Hyponatremia
B) Fluid volume excess
C) Electrolyte imbalance: hypocalcemia
D) Hyperkalemia
Ans: B Feedback:
, 1
Peripheral and pulmonary edema as well as a bounding pulse and dyspnea are indicators
of fluid volume overload.
3 ETIOLOGY OF HYPERPARATHYROIDISM CH 8 P.160-161
3. A 52-year-old patient has just passed a kidney stone and has high levels of calcium
in her urine. Blood tests show high levels of calcium in her blood as well. What
subsequent lab results would be most likely to distinguish between primary
hyperparathyroidism and hypercalcemia of malignancy?
A) Parathyroid hormone level
B) Bone scan
C) Plasma phosphate levels
D) Serum magnesium
level Ans: A
, 1
4 FEEDBACK:
Hyperparathyroidism, in which parathyroid hormone is secreted in excess, may be
caused by a parathyroid adenoma. Since parathyroid hormone mobilizes calcium from
bone and promotes its transfer to the extracellular fluid, excess calcium is excreted in
the urine (promoting the development of kidney stones) and is evident in the plasma. In
primary hyperparathyroidism, antibody binding assays of intact PTH would reveal
either normal or elevated parathyroid hormone in the face of hypercalcemia, whereas in
hypercalcemia of malignancy, levels of intact PTH are suppressed.
Metabolic alkalosis is manifested ..pg 183-184
Tutoring info: increase PH, increase bicarbonate and increase carbon dioxide levels.
5 A CLIENTS ARTERIAL BLOOD GASES REVEAL NORMAL OXYGEN
LEVEL, PH 7.50, PCO2 LEVEL OF 50 MMHG AND HCO3 LEVEL
OF 30. THE CLIENTS RESPIRATORY RATE IS 12 BREATHS/MIN
AND ALL OTHER VITAL SIGNS WITHIN NORMAL RANGE. WHAT IS
THIS CLIENT'S MOST LIKELY DIAGNOSIS:
ANS: Metabolica Alkalosis
6 ROLE OF NEUTROPHILS IN INFLAMMATION CH 9 PG. 192
A patient presented to the emergency department of the hospital with a swollen,
reddened, painful leg wound and has been diagnosed with methicillin-resistant
Staphylococcusaureus(MRSA) cellulitis. The patient's
physician has ordered a complete blood count and white cell differential. Which
of the following blood components would the physician most likely anticipate to
be elevated?
D) Neutrophil
s Ans: D
Feedback
Increased neutrophils are associated with inflammation in general and bacterial
infections in particular. Platelets play a role in inflammation, but their levels would not
rise to the same extent as would neutrophils'. Eosinophils are not strongly associated
with bacterial infection, and basophils would not increase to the same degree as
neutrophils.
, 1
Role of histamine Pg 198-199
A deficiency in which of the following would result in an inhibition of the inflammatory
response?
A) Histamine
B) Helper T cells
C) B cells
D) Vitamin K
An A
s:
7 FEEDBACK:
Histamine is a key mediator in the inflammatory system, unlike helper T cells, B cells, or
vitamin K.
