Pathophysiology of Altered Health States Q & A w/ Rationales, Exams of Nursing

Download Pathophysiology of Altered Health States Q & A w/ Rationales and more Exams Nursing in PDF only on Docsity! NURSING 7450 Pathophysiology of Altered Health States Q & A w/ Rationales 2024 1. Which of the following best describes the pathophysiological mechanism of type 1 diabetes mellitus? a. Insulin resistance b. Antibodies destroying pancreatic beta cells c. Increased production of glucagon d. Kidney dysfunction impairing glucose reabsorption Answer: b. Antibodies destroying pancreatic beta cells Rationale: Type 1 diabetes mellitus is an autoimmune disorder in which the body's immune system mistakenly attacks and destroys pancreatic beta cells, resulting in little to no insulin production. 2. Which of the following occurs as a result of an impaired function of the sinoatrial (SA) node? a. Increased heart rate b. Decreased cardiac contractility c. Irregular heart rhythm d. Vasoconstriction Answer: c. Irregular heart rhythm Rationale: The SA node is responsible for initiating the electrical impulses that regulate the heart's rhythm. If there is an impairment in its function, it can lead to irregular heart rhythms, such as atrial fibrillation or bradycardia. 3. Which statement accurately describes the pathophysiology of asthma? Rationale: Diabetes mellitus is a leading cause of chronic kidney disease. Persistent high blood glucose levels damage the small blood vessels in the kidneys, impairing their function over time. 7. Which of the following occurs as a compensatory mechanism during respiratory acidosis? a. Increased depth and rate of breathing b. Increased retention of bicarbonate ions by the kidneys c. Decreased excretion of carbon dioxide by the kidneys d. Increased production of respiratory enzymes Answer: a. Increased depth and rate of breathing Rationale: To compensate for respiratory acidosis (excess carbon dioxide in the blood), the body increases the depth and rate of breathing to eliminate more carbon dioxide and restore a more balanced pH. 8. Which of the following is a characteristic feature of rheumatoid arthritis? a. Inflammation and destruction of joint cartilage b. Impaired neuromuscular transmission c. Degeneration of bone tissue due to calcium loss d. Inadequate production of growth hormone Answer: a. Inflammation and destruction of joint cartilage Rationale: Rheumatoid arthritis is an autoimmune disease that primarily affects the joints. It is characterized by chronic inflammation, which leads to damage and destruction of joint cartilage, resulting in pain, stiffness, and impaired mobility. 9. Which process describes the pathophysiological mechanism underlying neoplasia? a. Uncontrolled cellular proliferation b. Excessive hormone production c. Impaired immune response d. Inflammatory response to tissue injury Answer: a. Uncontrolled cellular proliferation Rationale: Neoplasia refers to the abnormal and uncontrolled growth of cells. This process leads to the formation of tumors or cancerous masses, resulting from genetic mutations that disrupt the normal regulation of cell proliferation. 10. Which of the following is a common complication of uncontrolled hypertension? a. Hypotension b. Stroke c. Hypothyroidism d. Hyperglycemia Answer: b. Stroke Rationale: Uncontrolled hypertension (persistently high blood pressure) places excessive strain on blood vessels, increasing the risk of artery rupture or blockage, leading to a stroke. 11. Why does hyperthyroidism often result in unintended weight loss? a. Increased metabolic rate b. Impaired absorption of nutrients c. Decreased insulin production d. Decreased appetite Answer: a. Increased metabolic rate Rationale: Hyperthyroidism is characterized by excessive production of thyroid hormones, which can significantly increase the body's metabolic rate. This increased metabolism leads to unintended weight loss, despite maintaining adequate nutrition intake. 12. Which of the following best describes the underlying pathophysiology of multiple sclerosis? a. Autoimmune destruction of myelin sheaths in the central nervous system b. Vascular occlusion impairing cerebral blood flow c. Abnormal aggregation of amyloid plaques in the brain d. Degeneration of dopaminergic neurons in the substantia nigra Answer: a. Autoimmune destruction of myelin sheaths in the central nervous system B: Question: A 45-year-old male patient presents with shortness of breath, chest pain, and elevated troponin levels. Which of the following pathophysiological processes is most likely occurring in this patient? A) Chronic obstructive pulmonary disease (COPD) B) Myocardial infarction (MI) C) Pneumonia D) Pulmonary embolism (PE) Answer: B) Myocardial infarction (MI) Rationale: The symptoms and elevated troponin levels indicate myocardial damage, which is characteristic of an MI. Question: A 60-year-old female patient is diagnosed with Type 2 diabetes mellitus. Which of the following pathophysiological mechanisms is primarily responsible for the development of hyperglycemia in this patient? A) Insulin resistance and impaired insulin secretion B) Autoimmune destruction of pancreatic beta cells C) Deficiency of glucagon D) Increased sensitivity of peripheral tissues to insulin Answer: A) Insulin resistance and impaired insulin secretion Rationale: Type 2 diabetes mellitus is characterized by insulin resistance and impaired insulin secretion, leading to elevated blood glucose levels. Question: A 30-year-old male patient presents with joint pain, swelling, and morning stiffness that improves throughout the day. Which of the following pathophysiological processes is most likely contributing to these symptoms? A) Osteoporosis B) Osteoarthritis C) Rheumatoid arthritis D) Gout Answer: C) Rheumatoid arthritis Rationale: The described symptoms are characteristic of rheumatoid arthritis, an autoimmune disease that causes joint inflammation and damage. Question: A 55-year-old male patient is admitted with confusion, headache, and visual disturbances. Imaging reveals a mass in the pituitary gland. Which of the following pathophysiological mechanisms is most likely associated with these findings? A) Excess production of growth hormone B) Deficiency of antidiuretic hormone (ADH) C) Overproduction of thyroid-stimulating hormone (TSH) D) Prolactin deficiency Answer: A) Excess production of growth hormone Rationale: A pituitary tumor leading to excessive growth hormone can cause visual disturbances, headaches, and cognitive changes. Question: A 70-year-old female patient presents with progressive memory loss, confusion, and disorientation. Which of the following pathophysiological processes is most likely occurring in this patient? A) Vascular dementia B) Alzheimer's disease C) Parkinson's disease D) Lewy body dementia Answer: B) Alzheimer's disease Rationale: The symptoms described are characteristic of Alzheimer's disease, the most common cause of dementia. Question: A 35-year-old female patient with a history of systemic lupus erythematosus (SLE) presents with a butterfly-shaped rash on her face, joint pain, and proteinuria. Which of the following pathophysiological processes is most likely contributing to these findings? A) Immune complex deposition B) Deficiency of complement proteins C) Impaired T-cell function D) Defective B-cell maturation Answer: A) Immune complex deposition Rationale: The clinical manifestations are consistent with immune complex deposition seen in SLE. Question: A 50-year-old male patient with chronic hepatitis C infection develops ascites and lower extremity edema. Which of the following pathophysiological mechanisms is primarily responsible for these findings? A) Portal hypertension B) Impaired liver synthesis of albumin Question: A 70-year-old male patient presents with dysphagia, regurgitation, and halitosis. Imaging reveals a dilated esophagus with impaired peristalsis. Which of the following pathophysiological processes is primarily associated with these findings? A) Excessive lower esophageal sphincter tone B) Impaired relaxation of the upper esophageal sphincter C) Deficiency of mucus-secreting cells in the esophagus D) Aperistalsis of the esophageal body Answer: D) Aperistalsis of the esophageal body Rationale: The described symptoms and imaging findings are characteristic of achalasia, which involves impaired esophageal peristalsis. Question: A 60-year-old female patient presents with dyspnea, cough, and clubbing of the fingers. Pulmonary function tests reveal restrictive lung disease. Which of the following pathophysiological mechanisms is primarily associated with these findings? A) Impaired lung compliance B) Decreased airway resistance C) Excessive surfactant production D) Inflammatory destruction of alveolar walls Answer: A) Impaired lung compliance Rationale: Restrictive lung disease is characterized by impaired lung compliance, leading to reduced lung volumes. Question: A 45-year-old male patient presents with sudden- onset severe headache, nausea, and photophobia. Examination reveals nuchal rigidity. Which of the following pathophysiological processes is most likely occurring in this patient? A) Cerebral hemorrhage B) Meningitis C) Migraine headache D) Subarachnoid hemorrhage Answer: D) Subarachnoid hemorrhage Rationale: The symptoms, signs, and clinical presentation are indicative of a subarachnoid hemorrhage. Question: A 50-year-old male patient presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal elevated thyroid-stimulating hormone (TSH) and low free thyroxine (T4) levels. Which of the following pathophysiological mechanisms is primarily responsible for these findings? A) Autoimmune destruction of the thyroid gland B) Excessive iodine intake C) Pituitary adenoma secreting excess TSH D) Deficiency of thyrotropin-releasing hormone (TRH) Answer: A) Autoimmune destruction of the thyroid gland Rationale: The clinical presentation and laboratory findings are consistent with autoimmune hypothyroidism. C: 1. A 65-year-old man with a history of hypertension, diabetes and chronic kidney disease presents to the emergency department with chest pain, dyspnea and diaphoresis. His electrocardiogram shows ST segment elevation in leads V1-V4. He is diagnosed with an acute anterior myocardial infarction (MI) and is given aspirin, nitroglycerin, morphine and oxygen. He is also started on a heparin infusion and is scheduled for percutaneous coronary intervention (PCI). Which of the following pathophysiological processes is most likely responsible for his MI? a) Coronary artery spasm b) Coronary artery thrombosis* c) Coronary artery embolism d) Coronary artery dissection Rationale: Coronary artery thrombosis is the most common cause of acute MI, especially in patients with atherosclerosis and risk factors such as hypertension, diabetes and chronic kidney disease. A thrombus forms on a ruptured or eroded plaque, occluding the blood flow to the myocardium and causing ischemia and necrosis. Coronary artery spasm, embolism and dissection are less common causes of MI. 2. A 45-year-old woman with a history of systemic lupus Decreased sodium excretion by the kidneys may also contribute to ascites by increasing water retention, but it is not the primary cause of ascites. 4. A 55-year-old woman with a history of hypertension, hyperlipidemia and smoking presents to the clinic with intermittent claudication, which is pain in her lower extremities that occurs with walking and is relieved by rest. She also has cold, pale and cyanotic feet with diminished pulses. She is diagnosed with peripheral arterial disease (PAD) and is prescribed antiplatelet therapy, statins and cilostazol. She is also advised to quit smoking, control her blood pressure and cholesterol levels, and exercise regularly. Which of the following pathophysiological factors is most likely responsible for her intermittent claudication? a) Ischemia* b) Inflammation c) Infection d) Neuropathy Rationale: Intermittent claudication is a classic symptom of PAD, which is a chronic condition characterized by atherosclerosis of the arteries supplying the lower extremities. Atherosclerosis causes narrowing and occlusion of the arteries, reducing blood flow and oxygen delivery to the muscles. This causes ischemia, which manifests as pain, especially during exercise when the oxygen demand exceeds the supply. Inflammation, infection and neuropathy may also cause pain in the lower extremities, but they are not related to PAD or intermittent claudication. 5. A 25-year-old woman with a history of asthma presents to the emergency department with acute exacerbation of her symptoms. She has wheezes, cough, dyspnea and chest tightness. Her peak expiratory flow rate (PEFR) is 50% of her personal best. She is given albuterol nebulization, ipratropium bromide inhalation, prednisone oral and oxygen therapy. Her symptoms improve after the treatment and her PEFR increases to 80% of her personal best. She is discharged with a prescription for inhaled corticosteroids, long-acting beta-agonists and leukotriene modifiers. Which of the following pathophysiological processes is most likely responsible for her asthma exacerbation? a) Bronchoconstriction* b) Bronchiectasis c) Bronchitis d) Bronchiolitis Rationale: Asthma is a chronic inflammatory disorder of the airways that causes bronchoconstriction, which is the narrowing of the bronchial smooth muscle due to contraction or spasm. Bronchoconstriction reduces the diameter of the airways, increasing airway resistance and decreasing airflow. This causes wheezes, cough, dyspnea and chest tightness, especially during expiration. Bronchoconstriction can be triggered by various factors such as allergens, irritants, infections, exercise or stress. Bronchodilators such as albuterol and ipratropium bromide relax the bronchial smooth muscle and reverse bronchoconstriction. Bronchiectasis is a permanent dilation of the bronchi due to chronic inflammation and infection. Bronchitis is an inflammation of the bronchi due to infection or irritation. Bronchiolitis is an inflammation of the bronchioles due to viral infection. These conditions may cause similar symptoms as asthma, but they are not related to bronchoconstriction. 6. A 75-year-old man with a history of benign prostatic hyperplasia (BPH) presents to the clinic with urinary frequency, urgency, nocturia and hesitancy. He also has a weak urinary stream and incomplete bladder emptying. He is diagnosed with lower urinary tract symptoms (LUTS) due to BPH and is prescribed alpha-blockers and 5-alpha reductase inhibitors. He is also advised to avoid caffeine, alcohol and antihistamines that may worsen his symptoms. Which of the following pathophysiological changes is most likely responsible for his LUTS? a) Increased bladder contractility b) Decreased bladder compliance c) Increased urethral resistance* d) Decreased urethral sensation Rationale: LUTS are common in men with BPH, which is a non-malignant enlargement of the prostate gland due to increased proliferation of epithelial and stromal cells. The enlarged prostate compresses the urethra, causing increased urethral resistance and obstruction to urine flow. This causes urinary frequency, urgency, nocturia and hesitancy, as well as a weak urinary stream and incomplete bladder emptying. Alpha-blockers relax the smooth muscle of the prostate and bladder neck, reducing urethral resistance and