Description

PATHOPHYSIOLOGY HESI EXAM TEST EXAMS Q & A LATEST UPDATE GRADED A 23. While the nurse obtains a male client's history, review of systems, and physical examination, the client tells the nurse that his breast drains fluid secretions Four types of cirrhosis include alcoholic, post-necrotic, biliary, and cardiac cirrhosis, which is associated with severe right-sided heart failure (HF), so peripheral edema (C) is most consistent with right-sided HF. Although (A and B) can occur in all types of cirrhosis, the most defining characteristic of cardiac cirrhosis is related to HF. Hepatic engorgement can occur in a client with HF or cirrhosis and cause right upper quadrant pain, not left (D). Oxidative damage to cells is thought to be a causative factor in disease and aging. If free radicals bind to polyunsaturated fatty acids found in the lysosome membrane, the lysosome, nicknamed "suicide bags", leaks its protein catalytic enzymes (B) intracellularly and the cell is destroyed. Inadequate ATP production (A) and defective protein synthesis (C) lead to cell death either as the result of defective chromosomes or production of defective integral proteins (D). In coarctation of the aorta, a congenital constriction is found at the aorta near the ductus arteriosus region that lies past the left subclavian arteries, which perfuses the upper extremities. The child should have higher blood pressures in the upper extremities than in the legs (D). (A, B, and C) are not expected in coarctation. from the nipple. The nurse should seek further evaluation of which endocrine gland function? A. Posterior pituitary and testes. B. Adrenal medulla and adrenal cortex. C. Hypothalamus and anterior pituitary. Correct D. Parathyroid and islets of Langerhans. Awarded 0.0 points out of 1.0 possible points. 24. The nurse is assessing the laboratory results for a client who is admitted with renal failure and osteodystrophy. Which findings are consistent with this client's clinical picture? A. Blood urea nitrogen 40 m and creatinine 1.0. B. Cloudy, amber urine with sediment, specific gravity of 1.040. C. Serum potassium of 5.5 mEq and total calcium of 6 mg/dl. Correct D. Hemoglobin of 10 g and hypophosphatemia. Awarded 0.0 points out of 1.0 possible points. 25. Which healthcare practice is most important for the nurse to teach a postmenopausal client? A. Wear layers of clothes if experiencing hot flashes. B. Use a water-soluble lubricant for vaginal dryness. C. Consume adequate foods rich in calcium. Correct D. Participate in stimulating mental exercises. Bone density loss associated with osteoporosis increases at a more rapid rate when estrogen levels begin to fall, so the most important healthcare practice In renal failure, normal serum electrolyte balance is altered because the kidneys fail to activate vitamin D, calcium absorption is impaired, and serum calcium decreases, which stimulates the release of PTH causing resorption of calcium and phosphate from the bone. A decreased tubular excretion and a decreased glomerular filtration rate results in hypocalcemia, hyperphosphatemia, and hyperkalemia (C). (A) is reflective of a non-renal cause, such as dehydration or liver pathology. (B) is more indicative of infection. Renal failure causes anemia and hyperphosphatemia, not (D). Breast fluid and milk production are induced by the presence of prolactin secreted from the anterior pituitary gland, which is regulated by the hypothalamus' secretion of prolactin-inhibiting hormone in both men and women. Further evaluation of the hypothalamus and the anterior pituitary gland (C) should provide additional information about the secretions or lactation. Evaluation of (A, B, or D) do not support a physiologic mechanism or pathology related to mammary discharge. PSA levels are prescribed to screen for prostatic cancer which is often detected by DRE and manifested as small, hard, or stony, irregularly-shaped nodules on the surface of the prostate (D). Although PSA levels are prescribed for routine screening, the findings suggestive of BPH (A), normal texture (B) or infection (C) do not suggest cancer of the prostate, which requires further evaluation. Awarded 0.0 points out of 1.0 possible points. 26. A middle-aged male client asks the nurse what findings from his digital rectal examination (DRE) prompted the healthcare provider to prescribe a repeat serum prostatic surface antigen (PSA) level. What information should the nurse provide? A. A uniformly enlarged prostate is benign prostatic hypertrophy that occurs with aging. B. The spongy or elastic texture of the prostate is normal and requires no further testing. C. An infection is usually present when the prostate indents when a finger is pressed on it. D. Stony, irregular nodules palpated on the prostate should be further evaluated. Correct Awarded 0.0 points out of 1.0 possible points. 27. Which condition is associated with an oversecretion of renin? A. Hypertension. Correct B. Diabetes mellitus. C. Diabetes insipidus. D. Alzheimer's disease. Awarded 0.0 points out of 1.0 possible points. Renin is an enzyme synthesized and secreted by the juxtaglomerular cells of the kidney in response to renal artery blood volume and pressure changes. Low renal perfusion stimulates the release of renin, which is converted by angiotensinogen into angiotensin I, which causes the secretion of aldosterone, resulting in renal reabsorption of sodium, water, and subsequently increases blood pressure (A). (B, C, and D) are not directly related to renin oversecretion. during menopause is ensuring an adequate calcium (C) intake to help maintain bone density and prevent osteoporosis. Although practices such as (A and B) may reduce some of the discomforts for a postmenopausal female, calcium intake is more important than comfort measures. Although social and mental exercises stimulate thought, there is no scientific evidence that mental exercises (D) prevent dementia or common forgetfulness associated with reduced hormonal levels.