TESTED QUESTIONS AND FULL SOLUTION
◉ A 43-year-old male who is 5 feet 10 inches tall and weighs 216
pounds has been informed by his nurse practitioner that his body
mass index (BMI) is 31. Which of the following clinical conclusions
based on these data would his nurse be most justified in rejecting?
Answer: The patient is borderline obese but is not yet at the point of
significantly increased risks to health.
◉ A nurse practitioner is providing care for a male patient with a
long-standing hiatal hernia. Which of the following statements most
accurately captures an aspect of the pathophysiology of hiatal
hernias? Answer: If esophageal acid clearance is impaired,
esophagitis can result.
◉ Which of the following patients on a hospital medical unit is most
clearly demonstrating the signs and symptoms of liver failure?
Answer: A 44-year-old man with low hemoglobin levels, low platelet
levels, and spider angiomas
◉ A 42-year-old female patient with a long-standing history of
chronic nausea and vomiting but a near-insatiable appetite has had
her symptoms attributed to an enzyme deficiency. Further
diagnostic testing indicates that she has inadequate pancreatic
,enzyme levels and that her large appetite is due to a lack of enzyme
control of food intake inhibition. In which of the following enzymes
is the woman most likely deficient? Answer: Cholecystokinin
◉ Which of the following measures would likely be rejected as part
of a first-line weight loss plan for a patient with a BMI of 30.2, type 2
diabetes, and hypertension? Answer: Gastric bypass
◉ While on tour, a 32-year-old male musician has presented to the
emergency department of a hospital after a concert complaining of
severe and sudden abdominal pain. He admits to a history of copious
alcohol use in recent years, and his vital signs include a temperature
of 38.8°C (101.8°F), blood pressure of 89/48 mm Hg, and heart rate
of 116 beats per minute. Blood work indicates that his serum levels
of C-reactive protein, amylase, and lipase are all elevated. Which of
the following diagnoses would the care team first suspect? Answer:
Acute pancreatitis
◉ A 55-year-old man has been diagnosed with a hiatal hernia, in
which the function of the lower esophageal sphincter is
compromised. Which of the following consequences of this condition
is most likely? Answer: Protrusion of the stomach or regurgitation of
stomach contents into the esophagus
◉ A 51-year-old male professional is in the habit of consuming six to
eight rum and cokes each evening after work. He assures the nurse
practitioner, who is performing his regular physical exam, that his
,drinking is under control and does not have negative implications
for his work or family life. How could the nurse best respond to the
patient's statement? Answer: "When your body has to regularly
break down that much alcohol, your blood and the functional cells in
your liver accumulate a lot of potentially damaging toxic
byproducts."
◉ A 20-year-old male college student has recently finished a
Thanksgiving dinner of heroic proportions while home for the
holiday weekend. Which of the following phenomena would most
likely have produced his sensation of satiety? Answer:
Cholecystokinin and glucagon-like peptide-1 suppress the hunger
impulse.
◉ After several months of persistent heartburn, a 57-year-old
female patient has been diagnosed with gastroesophageal reflux
disease (GERD). Which of the following treatment regimens is likely
to best address the woman's health problem? Answer: Proton pump
inhibitors, avoiding large meals, and remaining upright after meals
◉ A 32-year-old man is complaining of burning, itching,
photophobia, and severe pain in his right eye after swimming in the
ocean. To determine that the eye condition is corneal rather than a
conjunctival disease, which of the following would be the
distinguishing symptom? Answer: Severe pain
, ◉ A woman with a diagnosis of type 2 diabetes has been ordered by
her primary care provider to have a hemoglobin A1C test for the first
time. The woman states, "I don't see why you want to test my blood
cells when it's sugar that's the problem." What aspect of physiology
will underlie the care provider's response to the patient? Answer:
The amount of glucose attached to A1C cells reflects the average
blood glucose levels over the life of the cell.
◉ A 29-year-old woman has been diagnosed with otosclerosis after
several years of progressive hearing loss. What pathophysiologic
process has characterized her diagnosis? Answer: New, sclerotic
bone has been formed around her stapes and oval window.
◉ A 30 year old man with a diagnosis of type 1 diabetes is aware of
the multiple effects that insulin has on his metabolism. Which of the
following physiological processes are actions of insulin? Answer:
Facilitating triglycerides from glucose in fat cells
◉ An endocrinologist is providing care for a 30-year-old male who
has lived with the effects of increased levels of GH. Which of the
following teaching points about the patient's future health risks is
most accurate? Answer: "When your pituitary gland is enlarged,
there's a real risk that you'll develop some sight deficiencies.
◉ A three-year-old girl has just been diagnosed with type 1A
diabetes and her parents are currently receiving education from the
diabetes education nurse at the hospital where their daughter is