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NR 507 ADVANCED PATHOPHYSIOLOGY FINAL
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EXAM QUESTIONS AND CORECT DETAILED
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ANSWERS LATEST UPDATE CORRECTLY VELIFIED
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The nurse is preparing a client for testing to determine if the client has Cushing
syndrome. What tests are included in the screening process
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24-hour urine secretion of cortisol
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Dexamethasone suppression test
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Plasma levels of ACTH
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A client comes to the clinic with fatigue and muscle weakness. The client also states she
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has been having diarrhea. The nurse observes the skin of the client has a bronze tone and
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when asked, the client says she has not had any sun exposure. The mucous membranes of
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the gums are bluish-black. When reviewing laboratory results from this client, what does
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the nurse anticipate seeing?
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Increased levels of ACTH
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A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to
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begin replacement therapy. Regarding which type of replacement will the nurse educate
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the client? sh
Cortisol replacement therapy
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Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to
stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an
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example of which type of endocrine disorder? Secondary
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The nurse is preparing a client for a test that will measure negative feedback suppression
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of ACTH. Which medication will the nurse administer in conjunction for this test?
Dexamethasone
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ACTH deficiency results in secondary hypocortisolism
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ACTH deficiency is most commonly caused by? glucocorticoid withdrawal
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6 symptoms of an ACTH deficiency tiredness weakness anorexia N/V hypoglycemia
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orthostatic hypotension
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interpretation of ACTH levels requires simultaneous assessment of plasma
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cortisol levels la
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ACTH levels are normal to high in primary adrenal insufficiency
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ACTH levels are low to absent in secondary adrenal insufficiency
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The client has been taking an oral cortisol preparation for 2 years to manage an
autoimmune disease. What effects does the nurse expect this therapy to have on this
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client's circulating levels of ACTH and aldosterone? Decreased ACTH, decreased
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aldosterone
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A nurse checks lab results as both Cushing syndrome and Addison disease can manifest
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with elevated levels of:
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Adrenocorticotropic hormone (ACTH)
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3. Acute epiglottitis
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A caregiver calls the pediatrician's office and reports to the nurse that her 4-year-old, who
was fine the previous day, complained of a sore throat early in the morning and now has
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a temperature of 102.6° F (39.2° C). The caregiver has tried to get the child to nap but the
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child gets panicky, immediately sits back up, and leans forward with her mouth open and
tongue out when the caregiver encourages her to lie down. The nurse suspects the child
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has which of the following conditions? Epiglottitis
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The caregivers of a child report that their child had a cold and complained of a sore
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throat. When interviewed further they report that the child has a high fever, is very
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anxious, and is breathing by sitting up and leaning forward with the mouth open and the
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tongue out. The nurse recognizes these symptoms as those seen with which of the
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following disorders? Epiglottitis
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The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis.
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The nurse recognizes a common complication of the disorder is for the child to: be
at risk for respiratory distress.
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A 5-year-old child is brought to the clinic by his father because the child developed a
high fever over the past 2 to 3 hours. The nurse suspects epiglottitis based on which signs
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and symptoms?
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• Difficulty speaking • Drooling • Sitting with neck extended • Frightened
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appearance
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4. AIDS
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A 36-year-old man enters the hospital in an extremely debilitated condition. He has
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purple-brown skin lesions (a symptom of Kaposi's sarcoma) and a persistent cough. A
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physical examination reveals swollen lymph nodes, and laboratory tests find a very low
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lymphocyte count. Information taken during the personal history reveals that he has
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multiple sex partners with whom he frequently engages in unprotected sex. What is likely
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to be the man's problem and what is his prognosis?
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He is probably suffering from AIDS. His outlook is poor once the disease has
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progressed to this advanced stage. There is no cure, and drug therapy has
had limited short-term success.
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Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS)
include monitoring of T lymphocyte counts?
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A decrease in the number of T cells would make the patient more susceptible
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to infection and unusual cancers.
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What is the length of time from infection with the AIDS virus to seroconversion? Up to
six months
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A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with
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cytomegalovirus. The nurse explains to the woman that the infection is caused by a
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common organism that normally does not cause infection in someone with a healthy
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immune system. This type of infection is called what?
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Opportunistic infection
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The nurse is caring for a client who has just been diagnosed with AIDS. The client asks
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the nurse, "How long will I live?" Which of the following is an appropriate response by
the nurse?
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"AIDS is considered to be a chronic illness today."
Which of the following clients is at the greatest risk for developing an intracellular
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pathogen infection?
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An AIDS client with a decreased CD4+ TH1 count
A consequence of alveolar hypoxia is:
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Pulmonary artery vasoconstriction sh
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The pressure required to inflate an alveolus is inversely related to: Alveolus radius
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The nurse is describing the movement of blood into and out of the capillary beds of the
lungs to the body organs and tissues. What term should the nurse use to describe this
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process? Perfusion
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A pulmonologist is discussing the base of the lungs with staff. Which information should
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be included? At the base of the lungs: Arterial perfusion pressure exceeds alveolar gas
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pressure
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When the pulmonologist discusses the condition in which a series of alveoli in the left lower
lo be receive adequate ventilation but do not have adequate perfusion, which statement
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indicates the nurse understands this condition? When this occurs in a patient it is called: Alveolar
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dead space
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Which of the following conditions should the nurse monitor for in a patient with
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hypoventilation? Hypercapnia
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A nurse is describing the pathophysiology of emphysema. Which information should the
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nurse include? Emphysema results in:
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The destruction of alveolar septa and air trapping.
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6. Alzheimer’s disease
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A patient is admitted to the unit in the middle stages of Alzheimer's disease. How would
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the nurse expect to find the patient's state of mind? Unable to perform simple tasks
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