NR 507 FINAL EXAM ADVANCED PATHOPHYSIOLOGY- WITH 100% VERIFIED QUESTIONS AND ANSWERS-2025, Exams of Pathophysiology

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NR 507 FINAL EXAM

ADVANCED

PATHOPHYSIOLOGY-

WITH 100% VERIFIED

QUESTIONS AND

ANSWERS- 2025

ADVANCED PATHOPHYSIOLOGY

NR-507 Final Study Guide

1. Acid base imbalance ➢ While checking arterial blood gas results, a nurse finds respiratory acidosis. What does the nurse suspect is occurring in the patient? reduced tidal volumes ➢ A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely cause? Hyperventilation ➢ The nurse is assessing a client with suspected respiratory acidosis. Which assessment items are priority for the nurse to collect? Rate and depth of respirations, Skin color and temperature, Appearance of the optic nerve ➢ The nurse is administering sodium bicarbonate to the client with respiratory acidosis. The nurse understands that which is the primary goal of treatment for this client? Removing excess acids in blood ➢ ➢ The student nurse is assisting in the care for a client with acute respiratory acidosis. The nurse explains to the student nurse that the client's blood pH initially falls in the development of acute respiratory acidosis because of which process? Hypoventilation
2. ACTH ➢ The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process 24-hour urine secretion of cortisol Dexamethasone suppression test Plasma levels of ACTH ➢ A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing? Increased levels of ACTH ➢ A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client? Cortisol replacement therapy

tongue out. The nurse recognizes these symptoms as those seen with which of the following disorders? Epiglottitis ➢ The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to: be at risk for respiratory distress. ➢ 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 and symptoms?

• Difficulty speaking • Drooling • Sitting with neck extended • Frightened appearance

4. AIDS ➢ A 36-year-old man enters the hospital in an extremely debilitated condition. He has purple-brown skin lesions (a symptom of Kaposi's sarcoma) and a persistent cough. A physical examination reveals swollen lymph nodes, and laboratory tests find a very low lymphocyte count. Information taken during the personal history reveals that he has multiple sex partners with whom he frequently engages in unprotected sex. What is likely to be the man's problem and what is his prognosis? He is probably suffering from AIDS. His outlook is poor once the disease has progressed to this advanced stage. There is no cure, and drug therapy has had limited short-term success. ➢ Why does nursing care of a patient with acquired immune deficiency syndrome (AIDS) include monitoring of T lymphocyte counts? A decrease in the number of T cells would make the patient more susceptible to infection and unusual cancers. ➢ What is the length of time from infection with the AIDS virus to seroconversion? Up to six months ➢ A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with cytomegalovirus. The nurse explains to the woman that the infection is caused by a common organism that normally does not cause infection in someone with a healthy immune system. This type of infection is called what? Opportunistic infection The nurse is caring for a client who has just been diagnosed with AIDS. The client asks the nurse, "How long will I live?" Which of the following is an appropriate response by the nurse?

"AIDS is considered to be a chronic illness today." ➢ Which of the following clients is at the greatest risk for developing an intracellular pathogen infection? An AIDS client with a decreased CD4+ TH1 count

5. Alveolar ventilation/perfusion ➢ A consequence of alveolar hypoxia is: Pulmonary artery vasoconstriction ➢ The pressure required to inflate an alveolus is inversely related to: Alveolus radius ➢ 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 process? Perfusion ➢ A pulmonologist is discussing the base of the lungs with staff. Which information should be included? At the base of the lungs: Arterial perfusion pressure exceeds alveolar gas pressure 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 indicates the nurse understands this condition? When this occurs in a patient it is called: Alveolar dead space ➢ Which of the following conditions should the nurse monitor for in a patient with hypoventilation? Hypercapnia ➢ A nurse is describing the pathophysiology of emphysema. Which information should the nurse include? Emphysema results in: The destruction of alveolar septa and air trapping.
6. Alzheimer’s disease ➢ A patient is admitted to the unit in the middle stages of Alzheimer's disease. How would the nurse expect to find the patient's state of mind? Unable to perform simple tasks

When a person has a life-threatening hypersensitivity/allergic reaction to bee stings, which lab result will the nurse check IgE ➢ Which immunity principle should guide the nurse when caring for an infant? At birth, IgG levels in newborn infants are: Near adult levels. ➢ While reviewing a patients' immunological profile, which immunoglobulin does the nurse expect to see elevated if the patient has a type I hypersensitivity reaction? IgE ➢ The antibody that becomes bound to mast cells and basophils and causes the cells to release histamine and other chemicals is IgE ➢ In teaching a patient with SLE about the disorder, the nurse knows that the pathophysiology of SLE includes The production of a variety of autoantibodies directed against components of the cell nucleus ➢ A patient is diagnosed with a hypersensitivity reaction mediated by immunoglobulin E (IgE) antibodies. For which type of hypersensitivity reaction should the nurse plan care for this patient? Type 12

9. Autosomal dominant diseases ➢ A nurse is assessing a patient with an autosomal-dominant inherited condition. When discussing the risk of transmission to the patient's offspring, which of the following would the nurse include? Each child has a 50% risk of inheriting the gene. ➢ A client has an autosomal-dominant disorder. His wife is unaffected. When explaining the risk for inheritance of the disorder in their offspring, which statement by the nurse would be most appropriate? There is a 50% chance that each of your children will have the condition ➢ The daughter of a patient with Huntington disease has requested that she be tested for the disease even though she has no symptoms at this time. What type of test does the nurse anticipate the physician will order? Presymptomatic testing ➢ Which of the following risk factors have been linked to ovarian cancers? Select all that apply. Gene mutations BRCA-1 and BRCA-2, Nulliparity ➢ A late acting dominant disorder is: Huntington's chorea

➢ Huntignton's chorea is characterised by Disordered muscle movement and mental disorientation ➢ Dancing gait and bizarre grimacing are characteristics of: Huntignton's disease ➢ The RN is reading the chart of a new pt. at the genetic clinic. The chart notes that the pt., her brother, and her mother all have inherited a particular condition. The RN plans care for a condition with which of the following type of inheritance pattern? autosomal dominant

10. Bartholin glands ➢ A woman visits her primary care provider with a complaint of pain and swelling in the vagina area. The pain is present when she sits and walks intercourse is painful. The nurse prepares the patient for an examination. The nurse and health care provider suspect that the patient may have an inflammation or infection of the? Bartholin glands ➢ A patient has been diagnosed with a Bartholin gland cyst. The nurse expects the patient may experience which symptoms if this becomes infected? Pain, tenderness, and dyspareunia ➢ The female external genitalia are made up of several components. What is in the vestibule of the female external genitalia? Bartholin glands ➢ When performing a pelvic examination, the nurse observes a red swollen area on the right side of the vaginal orifice. The nurse would document this as enlargement of which of the following? Bartholin's gland
11. Bile salt deficiencies ➢ Clinical manifestations of bile salt deficiencies are related to poor absorption of: Fats and fat-soluble vitamins
12. Candidiasis exacerbation ➢ Samantha Velasquez, a 24-year-old preschool teacher, is being seen by the physician in the primary care group where you practice nursing. Over the past 2 months, she has been receiving treatment for multiple ear infections and tonsillitis. She reports a curdy white vaginal discharge and burning with urination. What is the most likely cause of her symptoms? Candida albicans A nurse is counseling a client about risk factors for yeast infections. Which of the following should the nurse list as a risk factor for an overgrowth of Candida albicans?

Nonmigratory, Specific morphology, Differentiated function ➢ The student nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems? reduced immunity and blood-producing functions, altered GI structure and function, decreased respiratory function, motor and sensory deficits 15. Cervical dysplasia ➢ The nurse is caring for a woman who has dysplasia (disordered growth of abnormal cells). The nurse educates her on dysplasia progression that is high-grade. Which of the following information is important for the nurse to include? With cervical cancer, lesions start as dysplasia and progress over a period of time. Progression of a high-grade dysplasia takes about 2 years to develop into an invasive cancer ➢ Prime etiologic factor in the development of dysplasia Human Papilloma Virus ➢ Cervical dysplasia and cancer is relatively rare before ..... years of age, and the mean age is about ..... years. Rare before 25, mean age is 47. ➢ After speaking with the RN, Mrs. Sailor understands that the endocervical biopsy will be done by cervical conization to allow for microscopic examination of the cervical tissue. She is scheduled for cervical conization in 2 day. How should the RN respond to the client? Ask the client about her understanding of the abnormal pap smear result ➢ How often should a Pap and HPV be done All women begin screening for cervical cancer at 21 ->21-29 Pap test every 3 years, HPV unnecessary unless needed following an abnormal Pap test ->30-65 Pap and HPV every 5 years ->Older than 65 May discontinue testing if regular screenings have been negative, If diagnosed with cervical pre-cancer, continue to screen. 16. Cervical immunoglobulin ➢ A woman who is 22 weeks pregnant has a vaginal infection. She tells the nurse that she is afraid that this infection will hurt the fetus. The nurse knows that which of these statements is true? A thick mucus plug forms that protects the fetus from infection.

17. Chicken pox ➢ An older adult client tells the nurse that her granddaughter has chickenpox. The client is afraid to visit because she is afraid of getting shingles from her granddaughter. What is the nurse's best response? "If you already had chickenpox, you can safely visit your granddaughter." ➢ The nurse counsels the parent of a 12 year old diagnosed with chickenpox about when the child can return to school. The nurse determines that teaching is effective if the parent makes which statement? My child can return to school when the lesions are crusted ➢ A parent calls the clinic to report that the child has been exposed to varicella zoster (chicken pox). The nurse should tell the parent that the incubation period for chickenpox is which length of time? 2-3 weeks

18. Chronic inflammatory joint disease ➢ In assessing the joints of a patient with rheumatoid arthritis, the nurse understands that the joints are damaged by bony ankylosis following inflammation of the joints invasion of pannus into the joint causing a loss of cartilage ➢ Assessment data in the patient with osteoarthritis commonly include joint pain that worsens with use ➢ The nurse is working with a 73-year-old patient with osteoarthritis (OA). In assessing the patient's understanding of this disorder, the nurse concludes teaching has been effective when the patient describes the condition as which of the following Degeneration of articular cartilage in synovial joints ➢ A 60-year-old woman has pain on motion in her fingers and asks the nurse whether this is just a result of aging. The best response by the nurse includes the information that changes in the cartilage and bones of joints may cause symptoms of pain and loss of function in some people as they age ➢ The basic pathophysiologic process of rheumatoid arthritis (RA) is an immune response that activates complement and produces inflammation of joints and other organ systems ➢ During the physical assessment of the patient with moderate RA, the nurse would expect to find spindle-shaped fingers ➢ After teaching a patient with RA about the prescribed therapeutic regimen, the nurse determines that further instruction is needed when the patient says, I should perform most of my daily chores in the morning when my energy level is highest ➢ A 70-year old patient is being evaluated for symptoms of RA. The nurse recognizes that a major problem in the management of RA in the older adult is that drug interactions and toxicity are more likely to occur with multidrug therapy
19. Clonal selection ➢ When a nurse uses the term clonal diversity, what is the nurse describing? The ability of the population of lymphocytes to recognize almost any antigenic molecule ➢ Which of the following statements indicates the nurse has a good understanding of clonal selection? Lymphocytes that can recognize and react to a specific antigen proliferate. ➢ Cytokines that stimulate bone marrow pluripotent stem and progenitor or precursor cells to produce large numbers of platelets, erythrocytes, lymphocytes, neutrophils, and monocytes, eosinophils, basophils, and dendritic cells are known as: Colony-stimulating factors (CSFs)
20. Complications of gastric resection surgery ➢ Care for the postoperative client after gastric resection should focus on which of the following problems? Nutritional needs

Coarctation of the aorta (COA).

23. Congenital intrinsic factor deficiency ➢ A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart? Pernicious anemia A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in intrinsic factor is the most likely cause.
24. Congenital murmurs ➢ While assessing a newborn with respiratory distress, the nurse auscultates a machine- like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has: Patent ductus arteriosus (PDA). ➢ A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? Heart murmur ➢ A newborn develops a murmur and cyanosis shortly after birth. She is diagnosed with pulmonic stenosis (PS) after an echocardiogram revealed narrowing of the pulmonary: Valve orifice
25. Consanguinity- ➢ most common types of relationships in a family
    1. consanguineous 2. affinal
    2. family of origin ➢ blood relationship: consanguineous ➢ What specific consequences are there for consanguinity
    3. increased risk for AR disorders 2. increased risk of SB 3. increased risk for multifactorial and complex inheritance (ie., birth defects)
26. Croup ➢ The 3-year-old child is seen in the local clinic for croup. The child's parents ask the nurse what to do for the child at home to alleviate symptoms. Which suggestions by the nurse is most appropriate? "Stand with your child in front of an open freezer" ➢ The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate what condition? Complete obstruction ➢ The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which intervention? Provide fluids that the child likes and use comfort measures. ➢ A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup?

A cool mist vaporizer at the bedside can help prevent this type of croup.

27. Dermatologic conditions e.g. pityriasis rosea ➢ The physician instructs a mother to take her child out in the sun for approximately an hour or until the skin turns red (not sunburned). This is a common medical treatment for Pityriasis Rosea ➢ The patient has a rash on her back that began about 10 days ago with a raised, scaly border and a pink center. Now she has similar eruptions on both sides of her back. From these signs, the nurse would determine the rash to be Pityriasis Rosea ➢ A 28-year-old client comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. Physical examination reveals that the pattern of eruption is like a Christmas tree and that various erythematous papules and macules are on the cleavage lines of the back. Based on this description, what is the most likely diagnosis? Pityriasis rosea
28. Dermatology terminology-macules, nevi, etc ➢ The nurse's assessment shows that the patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. In the documentation the nurse would chart this as a Papule ➢ While waiting to see the physician, a patient shows the nurse skin areas that are flat, nonpalpable, and have had a change of color. The nurse recognizes that the patient is demonstrating what? macule ➢ A young student comes to the school nurse and shows the nurse a mosquito bite. As the nurse expects, the bite is elevated and has serous fluid contained in the dermis. How would the nurse classify this lesion? A wheal is a primary skin lesion that is elevated and has fluid contained in the dermis
29. Endogenous antigen ➢ When a patient asks what activates the immune response, how should the nurse respond? Molecules that are capable of inducing an immune response are called: antigens. ➢ A nurse is discussing an endogenous antigen. Which example indicates the nurse has a good understanding? The body's own tissue ➢ A nurse recalls the major histocompatibility class I (MHC I) antigens are found on which of the following cells? Red blood cells B lymphocytes and macrophages only Liver, heart, and bone marrow cells only ➢ While the nurse is discussing the immune system, which information should the nurse include? Plasma cells have the capacity to produce antibodies during an immune response. o Which cell is a patient missing if the patient's immune system cannot ingests microorganisms for the purposes of presenting their antigen to the immune system and activating an immune response? Macrophage ➢ A nursing student comes to the nurse with some questions about receptors. The student asks about the location of CD8 receptors. The nurse tells the student that these are located on: cytotoxic T cells.

32. General adaptation syndrome ➢ Increased blood volume, heart rate, blood glucose levels, and increased mental alertness occur during which part of the general adaptation syndrome (GAS)? ALARM STAGE ➢ While assessing a person for effects of the general adaptation syndrome, the nurse should be aware that: Glucose level increases during the alarm reaction stage ➢ A client with cancer has recovered from tumor removal surgery and is now stable while undergoing a chemotherapy treatment schedule. She is not having any symptoms at this time and is continuing to work and enjoy social events. What stage of the general adaptation syndrome (GAS) would you place her in? Resistance
33. Genetic disorders such as Down Syndrome, Turner Syndrome, etc ➢ Which type of genetic test would be used to detect the possibility of Down syndrome? Chromosomal analysis ➢ The nurse is obtaining health history from a client with a genetic disorder. Which of the following would be most appropriate for the nurse to establish the pattern of inheritance? Construct a pedigree of the client's family. ➢ The nurse is assessing a child with Turner syndrome. The nurse anticipates which of the following findings? Short stature ➢ The nurse is working with a mother whose unborn child was diagnosed as having Down syndrome. The nurse explains to the mother that Down syndrome occurs due to which of the following? Chromosome nondisjunction ➢ Parents request that a test be done to determine if the fetus has Down syndrome. What type of test does the nurse anticipate the physician will order? Prenatal screening ➢ Nondisjunction of a chromosome results in which of the following diagnoses? Down syndrome ➢ Match the condition with chromosomal abnormlity or linkage. Klinfelter's syndrome-- 44
    • XXY ➢ Trisomy 21 is otherwise called: Down's syndrome ➢ Down's syndrome is due to: An extra chromosome ➢ In Down's syndrome, the chromosome number in each cell is: 47 ➢ The risk of Down's syndrome in offsprings is high to mothers at the age of: 35 years ➢ Persons with Klinfelter's syndrome have chromosomes: 47 ➢ Turner's syndrome is characterised by chromosomes: 45 ➢ A person having Klinfelter's syndrome is characterised by: Male with some secondary sexual characters of female
34. Genital warts ➢ During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient

states that she is not aware of any problems in that area. The nurse recognizes that these lesions may be: human papillomavirus (HPV), or genital warts. A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for cervical ➢ During a health history, a 22-year old woman asks, "Can I get that vaccine for HPV? I have genital warts and I'd like them to go away!" What is the nurse's best response? "The vaccine cannot protect you if you already have an HPV infection." ➢ a patient with an STD who is most likely to have a nursing diagnosis of disturbed image that hinders future sexual relationships is the patient with genital warts ➢ it is most important for the nurse to teach the female patient with genital warts to have an annual Pap smear ➢ A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually

35. GI symptoms of conditions such as pyloric stenosis, hiatal hernia, ulcerative colitis ➢ The nurse explains to the patient with gastroesophageal reflux disease that this disorder: often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the espophagus ➢ The client with a hiatal hernia chronically experiences heartburn following meals. The nurse planc to teach the client to avoid which action because it is contraindicated with hiatal hernia? Lying recumbent following meals ➢ The client is diagnosed with an acute exacerbation of ulcerative colitis. Which inter- vention should the nurse implement? Monitor intravenous fluids. ➢ Which of the following factors would most likely contribute to the development of a client's hiatal hernia? . ➢ The client asks the nurse whether he will need surgery to correct his hiatal hernia. Which reply by the nurse would be most accurate? "Hiatal hernia symptoms can usually be successfully managed with diet modifications, medications, and lifestyle changes." ➢ A client with ulcerative colitis (UC) has stage 1 of a restorative proctocolectomy with ileo-anal anastomosis (RPC-IPAA) procedure performed. The client asks the nurse, "How long do people with this procedure usually have a temporary ileostomy?" How does the nurse respond?

➢ A patient visits a clinic for an eye examination. He describes his visual changes and mentions a specific diagnostic clinical sign of glaucoma. What is that clinical sign? The presence of halos around lights

38. Glomerulonephritis ➢ A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease? Group A B-hemolytic streptococcus ➢ When a nurse observes post-streptococcal glomerulonephritis as a diagnosis on a patient, which principle will the nurse remember? Acute post-streptococcal glomerulonephritis is primarily caused by? antigen –antibody complex deposition in the glomerular capillaries and inflammatory damage

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is? Acute glomerulonephritis A 15-year-old female presents with flank pain, irritability, malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what could have caused this, how should the nurse respond? Post streptococcal infection ➢ Which of the following clusters of symptoms would make a clinician suspect a child has developed glomerulonephritis? Gross hematuria, flank pain and hypertension ➢ A 5-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 week before the onset of this condition. The infection was most likely located in the Pharynx ➢ A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is? acute glomerulonephritis ➢ A 45-year-old male presents with oliguria. He is diagnosed with chronic glomerulonephritis. The nurse knows oliguria is related to? thickening of the glomerular membrane and decreased renal blood flow ➢ Which assessment finding is most important in determining nursing care for a client with acute glomerulonephritis? Blurred vision. Visual disturbances can be indicative of rising blood pressure in a client with acute glomerulonephritis. ➢ The nurse is assessing a child with acute post streptococcal glomerulonephritis. Which of the following would the nurse expect to assess? fatigue, lethargy, abdominal pain, hypertension, crackles, and anorexia. ➢ A 10-year-old child is diagnosed with glomerulonephritis. Test reveal the disposition of immunonoglobin IgA in the glomerular capillaries. The nurse will monitor for recurrent: Hematuria ➢ Glomerulonephritis is an autoimmune disease that severely impairs renal function. ➢ When reviewing laboratory results, the nurse should immediately notify the health care provider about which finding? Glomerular filtration rate of 20 mL/min

➢ When counseling a woman who is having difficulty conceiving, the nurse will be most concerned about a history of infection with N. gonorrhoeae. Glycoprotein ( this is the only one I COULD NOT FIND!!! Gonococcal disease