NRSG 2350 EVALUATION EXAM ACTUAL QUESTIONS
AND SOLUTIONS GRADED A+
✔✔Cellular Response to Injury - ✔✔a severe inflammatory response that ends with
repair to damaged cells/tissue, and is part of the innate immune response. Following
injury, the damaged endothelium releases mediators and stimulates the clotting
cascade. The IR and the damaged endothelium work together.
✔✔Why is fluid balance in the body important? - ✔✔Inadequate fluid intake or
excessive fluid loss can lead to dehydration, which in turn can affect cardiac and renal
function and electrolyte management. Inadequate urine production can lead to volume
overload, renal failure and electrolyte toxicity. Body fluids are mainly water and
electrolytes, and the three main organs that regulate fluid balance are the brain, the
adrenal glands and the kidneys.
✔✔Which body system maintains fluid balance? - ✔✔The lymphatic system helps
maintain fluid balance in the body by collecting excess fluid and particulate matter from
tissues and depositing them in the bloodstream. It also helps defend the body against
infection by supplying disease-fighting cells called lymphocytes.
✔✔What are the 5 electrolytes? - ✔✔sodium, chloride, potassium, magnesium, calcium
✔✔What is acid-base balance in the body? - ✔✔The body's balance between acidity
and alkalinity is referred to as acid-base balance. Acid-base balance refers to the
balance between input (intake and production) and output (elimination) of hydrogen ion.
The blood's acid-base balance is precisely controlled because even a minor deviation
from the normal range can severely affect many organs. The body uses different
mechanisms to control the blood's acid-base balance. These mechanisms involve the
Lungs
Kidneys
Buffer systems
✔✔When does blood acidity increase? - ✔✔Level of acidic compounds in the body rises
(through increased intake or production, or decreased elimination)
Level of basic (alkaline) compounds in the body falls (through decreased intake or
production, or increased elimination)
✔✔When does blood alkalinity increase? - ✔✔when the level of acid in the body
decreases or when the level of base increases
✔✔Acidosis - ✔✔The blood has too much acid (or too little base), resulting in a
decrease in blood pH.
✔✔Alkalosis - ✔✔The blood has too much base (or too little acid), resulting in an
increase in blood pH.
,✔✔metabolic acidosis and alkalosis - ✔✔caused by an imbalance in the production of
acids or bases and their excretion by the kidneys.
✔✔Respitory acidosis and alkalosis - ✔✔caused by changes in carbon dioxide
exhalation due to lung or breathing disorders.
✔✔Apoptosis - ✔✔programmed cell death
✔✔Too much Apoptosis? Examples. - ✔✔MS, Parkingson's, Transplant rejection,
Sarcoidosis
✔✔Too little Apoptosis? Examples. - ✔✔leads to cancer and autoimmune diseases
✔✔Necrosis - ✔✔abnormal condition of tissue death
✔✔Necrosis vs. Apoptosis - ✔✔Necrosis: bad, damage to nearby cells caused by lysis
Apoptosis: good; for normal functioning of cell. Cell shrinkage, caspase activation
✔✔Osmosis - ✔✔diffusion of water across a selectively permeable membrane
✔✔Filtration in cell - ✔✔passive process of moving material through a cell membrane.
While diffusion and osmosis rely on concentration gradients, this uses a pressure
gradient. Molecules will move from an area of higher pressure to an area of lower
pressure
✔✔Diffusion - ✔✔Movement of molecules from an area of higher concentration to an
area of lower concentration. Ie, oxygen moves down a concentration gradient from the
air in the alveoli to the blood. carbon dioxide moves down a concentration gradient from
the blood to the air in the alveoli.
✔✔active transport - ✔✔Energy-requiring process that moves material across a cell
membrane against a concentration difference
✔✔passive transport - ✔✔the movement of substances across a cell membrane without
the use of energy by the cell
✔✔Hypervolemia - ✔✔an excess of total body sodium and water. It can be caused by
several different conditions including heart failure, kidney failure, cirrhosis, or
pregnancy; Long-term corticosteroid therapy 13
✔✔Signs of Hypervolemia include: - ✔✔EDEMA: most often in the feet, ankles, wrists,
and face
discomfort in the body, causing cramping, headache, and stomach bloating
, High BP: caused by excess fluid in the bloodstream
shortness of breath caused by extra fluid entering your lungs and reducing your ability
to breathe normally
Heart Issues: because excess fluid can speed up or slow your heart rate, harm your
heart muscles, and increase the size of your heart
✔✔Hypovolemia - ✔✔a decrease in the volume of circulating blood in the body (as from
traumatic injury or severe dehydration). Sweating, excess urination, vomiting, or
diarrhea can all cause rapid water loss. If the fluid is not adequately replaced through
drinking water, a person can become dehydrated and eventually _________. Bleeding
is the most common cause. Blood helps hold your body temperature steady, forms
blood clots, and moves oxygen and nutrients to all of your cells. If your blood volume
gets too low, your organs won't be able to keep working.
✔✔Signs of Hypovolemia - ✔✔Rapid heartbeat
Quick, shallow breathing
Feeling weak
Being tired
Confusion or wooziness
Having little or no pee
Low blood pressure
Cool, clammy skin
✔✔Types of IV fluids (3) - ✔✔isotonic, hypertonic, hypotonic
✔✔Isotonic IV fluids - ✔✔Most IV fluids are _______meaning they_have the same
concentration of solutes as blood plasma. When infused, ___ solutions expand both the
intracellular fluid and extracellular fluid spaces, equally.
Such fluids do not alter the osmolality of the vascular compartment.
These IV fluids have a total osmolality close to that of the ECF and do not cause red
blood cells to shrink or swell
✔✔Hypertonic IV fluids - ✔✔These IV solutions have a greater concentration of solutes
(375 mEq/L and greater) than plasma and cause fluids to move out of the cells and into
the ECF in order to normalize the concentration of particles between two compartments.
This effect causes cells to shrink and may disrupt their function.
They are also known as volume expanders as they draw water out of the intracellular
space, increasing extracellular fluid volume.
✔✔Hypotonic IV fluids - ✔✔These IV solutions have a lower osmolality and contain
fewer solutes than plasma.
They cause fluid shifts from the ECF into the ICF to achieve homeostasis, therefore,
causing cells to swell and may even rupture.
AND SOLUTIONS GRADED A+
✔✔Cellular Response to Injury - ✔✔a severe inflammatory response that ends with
repair to damaged cells/tissue, and is part of the innate immune response. Following
injury, the damaged endothelium releases mediators and stimulates the clotting
cascade. The IR and the damaged endothelium work together.
✔✔Why is fluid balance in the body important? - ✔✔Inadequate fluid intake or
excessive fluid loss can lead to dehydration, which in turn can affect cardiac and renal
function and electrolyte management. Inadequate urine production can lead to volume
overload, renal failure and electrolyte toxicity. Body fluids are mainly water and
electrolytes, and the three main organs that regulate fluid balance are the brain, the
adrenal glands and the kidneys.
✔✔Which body system maintains fluid balance? - ✔✔The lymphatic system helps
maintain fluid balance in the body by collecting excess fluid and particulate matter from
tissues and depositing them in the bloodstream. It also helps defend the body against
infection by supplying disease-fighting cells called lymphocytes.
✔✔What are the 5 electrolytes? - ✔✔sodium, chloride, potassium, magnesium, calcium
✔✔What is acid-base balance in the body? - ✔✔The body's balance between acidity
and alkalinity is referred to as acid-base balance. Acid-base balance refers to the
balance between input (intake and production) and output (elimination) of hydrogen ion.
The blood's acid-base balance is precisely controlled because even a minor deviation
from the normal range can severely affect many organs. The body uses different
mechanisms to control the blood's acid-base balance. These mechanisms involve the
Lungs
Kidneys
Buffer systems
✔✔When does blood acidity increase? - ✔✔Level of acidic compounds in the body rises
(through increased intake or production, or decreased elimination)
Level of basic (alkaline) compounds in the body falls (through decreased intake or
production, or increased elimination)
✔✔When does blood alkalinity increase? - ✔✔when the level of acid in the body
decreases or when the level of base increases
✔✔Acidosis - ✔✔The blood has too much acid (or too little base), resulting in a
decrease in blood pH.
✔✔Alkalosis - ✔✔The blood has too much base (or too little acid), resulting in an
increase in blood pH.
,✔✔metabolic acidosis and alkalosis - ✔✔caused by an imbalance in the production of
acids or bases and their excretion by the kidneys.
✔✔Respitory acidosis and alkalosis - ✔✔caused by changes in carbon dioxide
exhalation due to lung or breathing disorders.
✔✔Apoptosis - ✔✔programmed cell death
✔✔Too much Apoptosis? Examples. - ✔✔MS, Parkingson's, Transplant rejection,
Sarcoidosis
✔✔Too little Apoptosis? Examples. - ✔✔leads to cancer and autoimmune diseases
✔✔Necrosis - ✔✔abnormal condition of tissue death
✔✔Necrosis vs. Apoptosis - ✔✔Necrosis: bad, damage to nearby cells caused by lysis
Apoptosis: good; for normal functioning of cell. Cell shrinkage, caspase activation
✔✔Osmosis - ✔✔diffusion of water across a selectively permeable membrane
✔✔Filtration in cell - ✔✔passive process of moving material through a cell membrane.
While diffusion and osmosis rely on concentration gradients, this uses a pressure
gradient. Molecules will move from an area of higher pressure to an area of lower
pressure
✔✔Diffusion - ✔✔Movement of molecules from an area of higher concentration to an
area of lower concentration. Ie, oxygen moves down a concentration gradient from the
air in the alveoli to the blood. carbon dioxide moves down a concentration gradient from
the blood to the air in the alveoli.
✔✔active transport - ✔✔Energy-requiring process that moves material across a cell
membrane against a concentration difference
✔✔passive transport - ✔✔the movement of substances across a cell membrane without
the use of energy by the cell
✔✔Hypervolemia - ✔✔an excess of total body sodium and water. It can be caused by
several different conditions including heart failure, kidney failure, cirrhosis, or
pregnancy; Long-term corticosteroid therapy 13
✔✔Signs of Hypervolemia include: - ✔✔EDEMA: most often in the feet, ankles, wrists,
and face
discomfort in the body, causing cramping, headache, and stomach bloating
, High BP: caused by excess fluid in the bloodstream
shortness of breath caused by extra fluid entering your lungs and reducing your ability
to breathe normally
Heart Issues: because excess fluid can speed up or slow your heart rate, harm your
heart muscles, and increase the size of your heart
✔✔Hypovolemia - ✔✔a decrease in the volume of circulating blood in the body (as from
traumatic injury or severe dehydration). Sweating, excess urination, vomiting, or
diarrhea can all cause rapid water loss. If the fluid is not adequately replaced through
drinking water, a person can become dehydrated and eventually _________. Bleeding
is the most common cause. Blood helps hold your body temperature steady, forms
blood clots, and moves oxygen and nutrients to all of your cells. If your blood volume
gets too low, your organs won't be able to keep working.
✔✔Signs of Hypovolemia - ✔✔Rapid heartbeat
Quick, shallow breathing
Feeling weak
Being tired
Confusion or wooziness
Having little or no pee
Low blood pressure
Cool, clammy skin
✔✔Types of IV fluids (3) - ✔✔isotonic, hypertonic, hypotonic
✔✔Isotonic IV fluids - ✔✔Most IV fluids are _______meaning they_have the same
concentration of solutes as blood plasma. When infused, ___ solutions expand both the
intracellular fluid and extracellular fluid spaces, equally.
Such fluids do not alter the osmolality of the vascular compartment.
These IV fluids have a total osmolality close to that of the ECF and do not cause red
blood cells to shrink or swell
✔✔Hypertonic IV fluids - ✔✔These IV solutions have a greater concentration of solutes
(375 mEq/L and greater) than plasma and cause fluids to move out of the cells and into
the ECF in order to normalize the concentration of particles between two compartments.
This effect causes cells to shrink and may disrupt their function.
They are also known as volume expanders as they draw water out of the intracellular
space, increasing extracellular fluid volume.
✔✔Hypotonic IV fluids - ✔✔These IV solutions have a lower osmolality and contain
fewer solutes than plasma.
They cause fluid shifts from the ECF into the ICF to achieve homeostasis, therefore,
causing cells to swell and may even rupture.
