2023-2024 NURS611 Pathophysiology Exam 4 Version Test Bank With Answers (104 Solved Questions)

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l OM o A Rc P S D |2 4 9 3 9 8 2 91lO M o AR cP S D| 2 4 9 3 9 8 2 9NURS611EXAM4PATHO2LATESTVERSIONACTUAL EXAM TEST BANK2023-2024NURS 611 EXAM 4 PATHO ACTUAL EXAM COMPLETE 100QUESTIONS AND CORRECT DETAILED ANSWERS1.Exposure to which substance protects the mucosal barrier of the stomach?a.Prostaglandinsb.Helicobacter pyloric.Aspirind.Regurgitated bileProstaglandins. Prostaglandins and enterogastrones, such as gastric inhibitorypeptide, somatostatin, and secretin, inhibit acid secretion.2.Glucose transport enhances the absorption of which electrolyte?a.Sodiumb.Potassiumc.Phosphated.ChlorideSodium. Sodium passes through the tight junctions and is actively transportedacross cell membranes. Sodium and glucose share a common active transportcarrier (sodium-glucose ligand transporter 1 [SGLT1]).3.What is the cause of gastroesophageal reflux disease?a.Excessive production of hydrochloric acidb.Zone of low pressure of the lower esophageal sphincterc.Presence ofHelicobacter pyloriin the esophagusd.Reverse muscular peristalsis of the esophagusZone of low pressure of the lower esophageal sphincter. Normally, the restingtone of the lower esophageal sphincter maintains a zone of high pressure thatprevents gastroesophageal reflux. In individuals who develop reflux esophagitis,this pressure tends to be lower than normal from either transient relaxation or aweakness of the sphincter.4.By what mechanism does intussusception cause an intestinal obstruction?a.Telescoping of part of the intestine into another section of intestine,usually causing strangulation of the blood supplyb.Twisting the intestine on its mesenteric pedicle, causing occlusion of theblood supplyc.Loss of peristaltic motor activity in the intestine, causing an adynamic ileus

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l OM o A Rc P S D |2 4 9 3 9 8 2 92d.Forming fibrin and scar tissue that attach to the intestinal omentum,causing obstructionA. Intussusception is the telescoping of part of the intestine into another sectionof intestine, usually causing strangulation of the blood supply.5.What is the most immediate result of a small intestinal obstruction?a.Vomitingb.Electrolyte imbalances

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l OM o A Rc P S D |2 4 9 3 9 8 2 93c.Dehydrationd.DistentionDistention begins almost immediately, as gases and fluids accumulate proximalto the obstruction. Within 24 hours, up to 8 L of fluid and electrolytesenters the lumen in the form of saliva, gastric juice, bile, pancreatic juice, and intestinalsecretions. Copious vomiting or sequestration of fluids in the intestinal lumenprevents theirreabsorption and produces severe fluid and electrolyte disturbances.6.An intestinal obstruction at the pylorus or high in the small intestine causes metabolicalkalosis by causing which outcome?a.Gain of bicarbonate from pancreatic secretions that cannot be absorbedb.Excessive loss of hydrogen ions normally absorbed from gastric juicesc.Excessive loss of potassium, promoting atony of the intestinal walld.Loss of bile acid secretions that cannot be absorbedExcessive loss of hydrogen ions. If the obstruction is at the pylorus or high in thesmall intestine, then metabolic alkalosis initially develops as a result ofExcessive loss of hydrogen ions that normally would be reabsorbed from thegastric juices.7.What are the cardinal symptoms of small intestinal obstruction?a.Constant, dull pain in the lower abdomen relieved by defecationb.Acute, intermittent pain 30 minutes to 2 hours after eatingc.Colicky pain caused by distention, followed by vomitingd.Excruciating pain in the hypogastric area caused by ischemiaColicky pain caused by distention followed by vomiting.8.What is the primary cause of peptic ulcers?a.Hypersecretion of gastric acidb.Helicobacter pyloric.Hyposecretion of pepsind.Escherichia coliHelicobacter pylori.9.A peptic ulcer may occur in all of the following areasexceptthe:a.Stomachb.Jejunumc.Duodenumd.EsophagusJejunum10.After a partial gastrectomy or pyloroplasty, clinical manifestations that include increasedpulse, hypotension, weakness, pallor, sweating, and dizziness are the results of whichmechanism?

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l OM o A Rc P S D |2 4 9 3 9 8 2 94a.Anaphylactic reaction in which chemical mediators, such as histamine,prostaglandins, and leukotrienes, relax vascular smooth muscles, causingshock.b.Postoperative hemorrhage during which a large volume of blood is lost,causing hypotension with compensatory tachycardia.c.Concentrated bolus that moves from the stomach into the small intestine,causing hyperglycemia and resulting in polyuria and eventuallyhypovolemic shock.d.Rapid gastric emptying and the creation of a high osmotic gradient in thesmall intestine, causing a sudden shift of fluid from the blood vessels tothe intestinal lumen.D. Dumping syndrome occurs with varying severity in 5% to 10% of individualswho have undergone partial gastrectomy or pyloroplasty. Rapid gastricEmptying and the creation of a high osmotic gradient in the small intestine cause asudden shiftof fluid from the vascular compartment to the intestinal lumen. Plasma volume decreases,causing vasomotor responses, such asincreased pulse rate, hypotension, weakness, pallor,sweating, and dizziness.Rapid distention of the intestine produces a feeling of epigastric fullness,cramping, nausea, vomiting, and diarrhea11.Which statement is consistent with dumping syndrome?a.Dumping syndrome usually responds well to dietary management.b.It occurs 1 to 2 hours after eating.c.Constipation is often a result of the dumping syndrome.d.It can result in alkaline reflux gastritis.Usually responds well to dietary management.12.Which statement isfalseregarding the sources of increased ammonia that contribute tohepatic encephalopathy?a.End products of intestinal protein digestion are sources of increasedammonia.b.Digested blood leaking from ruptured varices is a source of increasedammonia.c.Accumulation of short-chain fatty acids that is attached to ammonia is asource of increased ammonia.d.Ammonia-forming bacteria in the colon are sources of increasedammonia.The accumulation of short-chain fatty acids, serotonin, tryptophan, and falseneurotransmitters probably contributes to neural derangement and is notassociated with ammonia levels. The other options provide accurateInformation regarding how the sources of ammonia contribute to hepaticencephalopathy.

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l OM o A Rc P S D |2 4 9 3 9 8 2 9513.Which statement isfalseregarding the pathophysiologic process of acute pancreatitis?a.Bile duct or pancreatic duct obstruction blocks the outflow of pancreaticdigestive enzymes.b.Acute pancreatitis can also result from direct cellular injury from drugs orviral infection.c.Acute pancreatitis is an autoimmune disease in which immunoglobulin G(IgG) coats the pancreatic acinar cells; consequently, the pancreaticenzymes destroy the cells.d.Acute pancreatitis is usually mild and spontaneously resolves.The false answer is C. The backup of pancreatic secretions and the activation andrelease of enzymes (activated trypsin activates chymotrypsin, lipase, andelastase) within the pancreatic acinar cells cause acute pancreatitis, anobstructive disease. The activated enzymes cause autodigestion(e.g.,proteolysis, lipolysis) of the pancreatic cells and tissues, resultingIn inflammation. Acute pancreatitis is usually a mild disease and spontaneously resolves;however, approximately 20% of those with the disease develop a severe acute pancreatitisthat requires hospitalization. Pancreatitis developsbecause of a blockage to the outflow ofpancreatic digestive enzymes caused by bile duct or pancreatic duct obstruction (e.g.,gallstones). Acute pancreatitis can also result from direct cellular injury fromdrugs or viralinfection.14.Obesity is defined as a body mass index (BMI) greater than what measurement?a.22b.28c.25d.30Obesity is an energy imbalance, with caloric intake exceeding energyexpenditure, and is defined as a BMI greater than 30.15.Which are the early (prodromal) clinical manifestations of hepatitis?(Select all thatapply.)a.Fatigueb.Vomitingc.Itchingd.Splenomegalye.HyperalgiaA, B, E. The prodromal (preicteric) phase of hepatitis begins approximately 2weeks after exposure and ends with the appearance of jaundice. Fatigue,anorexia, malaise, nausea, vomiting, headache, hyperalgia, cough,and low-grade fever are prodromal symptoms that precede the onset of jaundice.16.Ulcerative colitis: Inflammation begins at the base of the crypts of Lieberkühn in thelarge intestine, primarily the left colon, with infiltration and release of inflammatory

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l OM o A Rc P S D |2 4 9 3 9 8 2 96cytokines from neutrophils, lymphocytes, plasma cells, macrophages, eosinophils, andmast cells.17.Crohn disease: In Crohn disease, elevations in IgG are associated with the severity of thedisease.18.Kidney stones in the upper part of the ureter would produce pain referred to whichanatomical area?a.Vulva or penisb.Thighsc.Umbilicusd.Lower abdomenKidney stones in the upper part of the ureter would produce pain in theumbilicus. Sensory innervation for the upper part of the ureter arisesfrom the tenth thoracic nerve roots with referred pain to the umbilicus.19.The glomerular filtration rate is directly related to which factor?a.Perfusion pressure in the glomerular capillariesb.Diffusion rate in the renal cortexc.Diffusion rate in the renal medullad.Glomerular active transportPerfusion pressure. The filtration of the plasma per unit of time is known as theglomerular filtration rate(GFR), which is directly related to only theperfusion pressure in the glomerular capillaries.20.When renin is released, it is capable of which action?a.Inactivation of autoregulationb.Direct activation of angiotensin IIc.Direct release of antidiuretic hormone (ADH)d.Formation of angiotensin IFormation of angiotensin I.21.How high does the plasma glucose have to be before the threshold for glucose isachieved?a.126 mg/dlb.180 mg/dlc.150 mg/dld.200 mg/dlWhen the plasma glucose reaches 180 mg/dl, as occurs in the individual withuncontrolled diabetes mellitus, the threshold for glucose is achieved.22.What is the end-product of protein metabolism that is excreted in urine?a.Glucoseb.Bilec.Ketones

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l OM o A Rc P S D |2 4 9 3 9 8 2 97d.UreaUrea23.What provides the best estimate of the functioning of renal tissue?a.Glomerular filtration rateb.Hourly urine outputc.Serum blood urea nitrogen and creatinined.The specific gravity of the solute concentration of the urineGFR24.Which renal change is found in older adults?a.Sharp decline in glomerular filtration rateb.Sharp decline in renal blood flowc.Decrease in the number of nephronsd.Decrease in urine outputDecrease in the number of nephrons.25.Compared with a younger individual, how is the specific gravity of urine in older adultsaffected?a.Specific gravity of urine in older adults is increased.b.Specific gravity of urine in older adults is considered high normal.c.Specific gravity of urine in older adults is considered low normal.d.Specific gravity of urine in older adults is decreased.SG in older adults is considered low normal.26.How does progressive nephrons injury affect angiotensin II activity?a.Angiotensin II activity is decreased.b.It is elevated.c.Angiotensin II activity is totally suppressed.d.It is not affected.It’selevated. Angiotensin II activity is elevated with progressive nephron injury.27.Which mineral accounts for the most common type of renal stone?a.Magnesium-ammonium-phosphateb.Calcium oxalatec.Uric acidd.Magnesium phosphateCalcium stones (calcium phosphate or calcium oxalate) account for 70% to 80%of all stones requiring treatment.28.Regarding the formation of renal calculi, what function does pyrophosphate, potassiumcitrate, and magnesium perform?a.They inhibit crystal growth.b.Pyrophosphate, potassium citrate, and magnesium stimulate thesupersaturation of salt.

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l OM o A Rc P S D |2 4 9 3 9 8 2 98c.They facilitate the precipitation of salts from a liquid to a solid state.d.Pyrophosphate, potassium citrate, and magnesium enhancecrystallization of salt crystals to form stones.They inhibit crystal growth.29.What is the most common cause of uncomplicated urinary tract infections?a.Staphylococcusb.Proteusc.Klebsiellad.Escherichia coliE. Coli30.Which differentiating sign is required to make the diagnosis of pyelonephritis from thatof cystitis?a.Difficulty starting the stream of urineb.Spasmodic pain that radiates to the groinc.Increased glomerular filtration rated.Urinalysis confirmation of white blood cell castsUA of WBC casts. Clinical assessment, alone, is difficult to differentiate thesymptoms of cystitis from those of pyelonephritis. Urine culture,urinalysis, and clinical signs and symptoms establish the specific diagnosis. White bloodcell casts indicate pyelonephritis, but they are notalways present in the urine.31.Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual?a.Confusion and poorly localized abdominal discomfortb.Dysuria, frequency, and suprapubic painc.Hematuria and flank paind.Pyuria, urgency, and frequencyOlder adults with cystitis may demonstrate confusion or vague abdominaldiscomfort or otherwise be asymptomatic.32.Pyelonephritis is usually caused by which type of organism?a.Bacteriab.Virusesc.Fungid.ParasitesPyelonephritis is usually caused by the bacteriaEscherichia coli, Proteus,orPseudomonas.33.Which abnormal laboratory value is found in glomerular disorders?a.Elevated creatinine concentrationb.Elevated immunoglobulin A (IgA)

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