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Exam (elaborations) pathophysiology
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Newest nurs 5315 advanced pathophysiology final exam questions and correct answers ()
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NURS 5315 Final1. A patient in respiratory distress and is breathing 33 breaths per minute.
Which ABG value is consistent with the clinical scenario? PCO2 15 pH
7.30 pH 7.45
O2 sat 100%: A patient who is breathing 33 breaths per minute is hyperventilating
and blowing off CO2; therefore the PCO2 level will be low. The patient will most
likely experience a respiratory alkalosis and the two pH values provided are not
consistent with this diagnosis.
2. A patient has a sodium level of 115 mEq/L and is disoriented and
lethargic.
Which pathological process best explains this patient's symptoms?
a. The action potential has become hyperpolarized.
b. Water has shifted into the neurons and caused them to swell.
c. Water has shifted into the vascular space and dehydrated the neurons.
The action potential has become hypopolarized.: b. The cause of neurologic
symptoms associated with a sodium imbalance is directly related to fluid shifting
into or out of the neurons of the brain. With a serum sodium of 115 mEq/L,
water shifts into the neurons and causes them to swell. Hypernatremia causes
water to shift out of the cell into the intravascular space and causes the neurons
to become dehydrated. An alteration in the action potential is not seen with
sodium imbalances.
3. A patient experiencing dehydration should be monitored for which
electrolyte imbalance?
a. Hyperkalemia
b. Hypocalcemia
c. Hypercalcemia
d. Hyponatermia: a. Serum osmolality is increased during times of dehydration.
An elevated serum osmolality will pull potassium into the intravascular space
from the intracellular space and cause a rise in serum potassium.
4. A married couple presents to your office for genetic counseling. The
husband has an autosomal recessive disease and his wife has a
heterozygous genotype for the disease. They ask you, What is the chance
that our baby will have the disease? Which of the following answers is
correct?
25%
50%
, NURS 5315 Final
75%
100%: A chromosome is a package of material located inside the cell nucleus
which is made of proteins and a single molecule of DNA. There are 23 pairs of
chromosomes in each human cell for a total of 46 chromosomes. Chromosomes
are separated into two identical sets during mitosis or meiosis. This provides a set
of chromosomes to each daughter cell which results from cell division. This
process is responsible for the transfer of genetic information to the daughter cells.
The first 22 pairs of chromosomes are known as autosomes. The 23rd pair of
chromosomes is the pair which contains the genetic information for gender. This
pair contains the genetic information which delineates between the male and
female genders. Females have two X chromosomes (XX) and males have an XY
chromosome pair. Autosomal chromosomes are said to be autologous. This
means they do not carry genetic information pertaining to gender. Autosomal
genetic diseases are carried on the first 22 pairs of chromosomes. Sex-linked
diseases are only carried on the 23rd pair of chromosomes. The autosomal
chromosomes are nearly identical to one another and are considered homologous
to one another. Each autosomal chromosome in a pair carries identical genes.
These two genes are known as alleles. The alleles occupy the same site on each
partner of the chromosome pair and code for the same genetic trait or physiologic
function. Alleles can be dominant or recessive. One allele may be dominant and
the other recessive, or they both may be dominant or both recessive. The
dominant alleles' genetic code will always manifest in the individual's phenotype.
The information in the recessive allele is typically not expressed in the phenotype
unless both alleles are recessive. For the purpose of clarity in use, the dominant
gene is assigned a capital letter and the recessive gene is assigned a lower case
letter. Any letter is okay to use but make sure you use the same letter for the
genotype - for example, "Bb or aa." The term homozygous refers to a pair of
alleles which are either both dominant or recessive. For example, "BB or bb" are
said to be homozygous because the alleles are either both dominant or recessive.
An allele pair in which one is dominant and one is recessive is said to be
heterozygous. In autosomal recessive disorders both alleles on the chromosome
are affected by the genetic aberration. If only one recessive gene is affected by
the genetic aberration then the person is said to be a carrier and will not have the
phenotypic expression of the disease. The healthy, recessive allele will
compensate for the allele which is affected by the genetic aberration. The carrier
can pass the trait but does not have the genetic disease. In an autosomal
dominant disorder the dominant gene is the only gene that has to be affected by
, NURS 5315 Final
the genetic aberration in order to have the phenotypic expression of the disease.
A healthy recessive allele cannot compensate for a diseased dominant allele. In
order to answer this question one must understand the above information and
draw a Punnett Square.
The husband has an autosomal recessive disease which means his genotype must
be aa. The wife has a heterozygous genotype for the disease which means her
genotype is Aa. The capital A reflects a healthy gene so she is merely a carrier and
does not express the disease phenotype. The father's genotype is written across
the top line and the mother's genotype is written in the boxes to the left. The four
boxes in the middle are the possible genotypes of their offspring. Each box
represents a 25% chance for the offspring to have that particular genotype. The
question asks you to determine the chances the offspring will have the autosomal
recessive disease or in other words, express the phenotype for the disease. The
genotype which will result in the disease is "aa." Therefore, there is a 50% chance
that their offspring will have the autosomal recessive disease.
5. A child is diagnosed with hemophilia. This is an example of which genetic
concept? Phenotype
Genotype
Autosomal transmission of the disease
Transcription: The expression of a genetic disease is an example of a phenotype.
A genotype is a gene's programming. Hemophilia is transmitted on the x-
chromosome and is not transmitted via the autosomes. This is not an example of
transcription.
6. Dehydration triggers which physiologic response?
Increased secretion of renin.
Increase secretion of natriuretic peptides.
Decreased secretion of antidiuretic hormone.
Decreased serum osmolality.: Dehydration will trigger the release of renin when
renal perfusion is impaired. The other answers are seen during times of fluid volume
overload.
7. A patient on hydrochlorothiazide has a pH of 7.49 and a bicarbonate of 30.
Which of the following pathological processes best explains the abnormal
lab values?
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