patho exam 1 practice questions
which cell does HIV directly attack?
CD4 Th cell
which immunodeficiency affects B and T cells?
Severe Combined Immunodeficiency (SCID)
A nurse is caring for a patient with excessive vomiting and diarrhea. What complications does the nurse expect? a) hypokalemia b) decreased serum osmolality c) decreased urine osmolality d) hyperkalemia
a) hypokalemia
A patient experiencing a severe anxiety attack with an excessive respiratory rate (tachypnea) is at risk for which acid-base imbalance? a) respiratory alkalosis b) metabolic acidosis c) metabolic alkalosis d) respiratory acidosis
a) respiratory alkalosis
A patient with weight gain, decreased serum osmolality, and increased urine osmolality. The nurse suspects which underlying pathophysiologic cause of these clinical manifestations? a) there is a decrease ADH secretion b) the kidneys are eliminating more water than normal c) there is an increase in ADH secretion d) the kidneys are eliminating more sodium than normal
c) there is an increase in ADH secretion
A client overdosed on heroin and has a respiratory rate of 8 breaths/min and is unresponsive. Which arterial blood gas result does the nurse anticipate? a) pH: 7.49, PaCO2: 45 mmHg, HCO3: 33 mEq/L b) pH: 7.28, PaCO2: 60 mmHg, HCO3: 26 mEq/L c) pH: 7.31, PaCO2: 41 mmHg, HCO3: 18 mEq/L d) pH: 7.38, PCO2: 45 mmHg, HCO3: 26 mEq/L
b) pH: 7.28, PaCO2: 60 mmHg, HCO3: 26 mEq/L
The nurse cares for a client with an acid-base imbalance who has required prolonged gastric suctioning. Which arterial blood gas (ABG) results does the nurse expect? a) pH: 7.31, PaCO2: 60 mmHg, HCO3: 29 mEq/L b) pH: 7.48, PaCO2: 45 mmHg, HCO3: 38 mEq/L c) pH: 7.49, PaCO2: 30 mmHg, HCO3: 22 mEq/L d) pH: 7.28, PaCO2: 40 mmHg, HCO3: 16 mEq/L
b) pH: 7.48, PaCO2: 45 mmHg, HCO3: 38 mEq/L (metabolic alkalosis)
The ABG of a patient is the following: pH= 7.49, PaCO2= 30 mmHg, HCO3= 18 mEq/L How should the nurse interpret these results? a) fully compensated metabolic alkalosis b) partially compensated respiratory alkalosis c) fully compensated respiratory alkalosis d) uncompensated metabolic alkalosis
b) partially compensated respiratory alkalosis
A nurse is caring for a patient who is experiencing hyponatremia, decreased urine output, and edema. The nurse anticipates which diagnosis for this patient? a) parathyroid hormone imbalance b) syndrome of inappropriate antidiuretic hormone (SIADH) c) diabetes insipidus d) diabetes mellitus
b) syndrome of inappropriate antidiuretic hormone (SIADH)
A nurse is caring for a patient with a serum sodium of 132 mEq/L. What does the nurse expect to see? a) cellular shrinkage b) alkalosis c) cellular swelling d) acidosis
c) cellular swelling
Which of the following situations would be most likely to result in hyponatremia? a) increased salt substitute intake b) excess aldosterone secretion c) excess water intake d) decreased ADH secretion
c) excess water intake
The ABG of a patient is the following: pH= 7.38, PaCO2= 52 mmHg, HCO3= 35 mEq/L. How should the nurse interpret these results? a) metabolic acidosis, fully compensated b) respiratory alkalosis, fully compensated c) respiratory acidosis, fully compensated d) metabolic alkalosis, fully compensated
c) respiratory acidosis, fully compensated
A client's arterial blood gas results reveal a serum pH of 7.49, a PaCO2 of 41 mmHg, and a HCO3 level of 38 mEq/L. How does the nurse interpret these results? a) Compensated metabolic alkalosis b) Uncompensated metabolic acidosis c) Compensated respiratory acidosis d) Uncompensated metabolic alkalosis
d) Uncompensated metabolic alkalosis
which of the following is NOT an underlying cause of hyponatremia? a) increased ADH secretion b) diaphoresis c) decreased aldosterone secretion d) dehydration
d) dehydration
Hyperkalemia EKG changes
tall, peaked T waves, widened QRS, flat P wave, ectopic beats and/or abnormal rhythms
Hypokalemia EKG changes
ST depression, inverted T waves, abnormal rhythms, u wave
what causes increased hydrostatic pressure
-CHF -kidney disease -Na retention w/ PMS -pregnancy -pulmonary edema -deep vein thrombosis -portal vein obstruction
what are the causes of decreased capillary colloidal osmotic pressure
-burns -glomerular kidney disease -liver disease -starvation/malnutrition
what are the causes of increased capillary permeability?
-burns -tissue injury -inflammation -allergic Rxn
what are the causes of hypernatremia
-cushings syndrome -hyperaldosteronism -renal failure -diarrhea -burns -fever -infection -diabetes insipidus -dehydration
what are the causes of hyponatremia
-diaphoresis -vomiting -Addisons disease -diuretics -wounds -SIADH -CHF -cirrhosis -acute renal failure -hyperglycemia
in the treatment of AIDS, there is an effort to limit viral replication by targeting what 4 things
-reverse transcriptase -protease -integrase -transcription of viral DNA from host DNA
causes of hyperkalemia
-salt substitutes -k supplements -ACE inhibitors -ARBs -K sparing diuretics -adrenal insufficiency -renal failure -seizures -burns -injuries -extreme exercise
what are the causes of hypokalemia
-vomit -diarrhea -gastric suctioning -diaphoresis -diuretics and RAAS -renal artery stenosis -Cushings -corticosteroids with mineralocorticoid activity -hyperinsulinemia
how will the body compensate for fluid imbalance?
1. increase vasoconstriction and heart rate -redistributes volume -occurs in minutes 2. alter Na and H2O retention -increases volume -takes hours
patient comes in with CD4 count of <200. what do you suspect for diagnosis
AIDS
which immunodeficiency affects T cells?
DiGeorge Syndrome
which immunodeficiency affects B cells?
X linked agammaglobulinemia
A nurse assesses a client with hyperaldosteronism and subsequent acid-base imbalance. Which client statement does the nurse expect? a) "My mouth and toes feel tingly." b) "My heart beat feels slow and weak." c) "I can't seem to catch my breath." d) "I have swelling in my feet."
a) "My mouth and toes feel tingly." Parathesias around the mouth and on the toes are a hallmark symptom of alkalosis. This would be an expected finding in an uncompensated metabolic alkalosis that would be caused by hyperaldosteronism.
which patient is least likely to develop edema? a) 44 year old with decreased ADH secretion b) 88 year old with chronic renal failure c) 18 year old with a bee allergy who was just stung d) 22 year old with burns to 50% of his body
a) 44 year old with decreased ADH secretion
The nurse cares for a group of clients with acid-base imbalances. Which client does the nurse assess closely for risk of respiratory acidosis? a) Post-operative client with decreased respirations. b) Older adult client with stage 3 chronic kidney disease. c) Pediatric client with a 2-day history of vomiting. d) Young adult client with diabetic ketoacidosis.
a) Post-operative client with decreased respirations.
Which patient would have the most difficulty compensating for a state of metabolic acidosis? a) a patient with lung disease b) a patient with diabetes c) a patient with diarrhea d) a patient with renal failure
a) a patient with lung disease
The nurse is caring for a patient with a serum sodium of 151 mEq/L. What might be a potential cause of this electrolyte disturbance? a) dehydration b) hyperglycemia c) diaphoresis d) vomiting
a) dehydration
The nurse is caring for a patient who reports profound vomiting and diarrhea for the past 4 days. What is the patient at greatest risk for developing? a) respiratory alkalosis b) metabolic acidosis c) metabolic alkalosis d) respiratory acidosis
b) metabolic acidosis
which patient is at greatest risk for developing respiratory acidosis? a) 35 year old who is having a panic attack b) 24 year old who overdosed on heroin c) 54 year old with food poisoning d) 92 year old with chronic renal failure
b) 24 year old who overdosed on heroin
A nurse assesses a client and finds the client somnolent and weak with a respiratory rate of 8 breaths/min. Which acid-base finding does the nurse anticipate when analyzing the client's arterial blood gas results? a) PaO2 98 mmHg b) PaCO2 56 mmHg c) pH 7.41 d) HCO3 18 mmHg
b) PaCO2 56 mmHg
which of the following physiologic changes would be most likely to result in edema? a) decreased blood volume b) decreased capillary osmotic pressure c) increased lymph vessel drainage d) increased dietary intake
b) decreased capillary osmotic pressure
which of the following is an underlying cause of hyperkalemia? a) alkalosis b) high intake of salt substitutes c) prolonged suctioning d) vomiting and diarrhea
b) high intake of salt substitutes
The nurse is caring for a patient whose pH=7.28. Which electrolyte imbalance is the nurse most concerned about the patient developing as a result of the acid-base imbalance? a) hyponatremia b) hyperkalemia c) hypernatremia d) hypokalemia
b) hyperkalemia
which of the following physiologic changes will most likely result in increased hydrostatic pressure in the capillaries, leading to the development of edema? a) malnutrition b) hypervolemia c) liver disease d) inflammation
b) hypervolemia
How will the body compensate in a patient experiencing metabolic acidosis? a) decrease rate and depth of breathing b) increase rate and depth of breathing c) secrete bicarbonate from the kidneys d) excrete hydrogen ions through the kidneys
b) increase rate and depth of breathing
which clinical manifestations is most likely to appear in a patient who has been experiencing significant vomiting and diarrhea for 4 days? a) increased vascular volume b) increased hematocrit c) increased edema d) hypertension
b) increased hematocrit
The nurse is caring for a patient with diabetes insipidus. What is NOT associated with this condition? a) decreased vascular volume b) increased vascular volume c) decreased urine specific gravity d) increased urine output
b) increased vascular volume
How does the body compensate for metabolic alkalosis?
decrease ventilation, increase CO2 levels
patient comes in with: -decreased urine output -tachycardia -postural hypotension what is the diagnoses?
fluid volume deficit
patient comes in with: -bounding pulses -SOB, dyspnea, orthopnea -weight gain -crackles on auscultation what is the diagnoses?
fluid volume excess
which potassium imbalance is associated with acidosis?
hyperkalemia
which imbalance causes cellular shrinkage?
hypernatremia
which potassium imbalance is associated with alkalosis?
hypokalemia
a hyperglycemic patient is at risk for what electrolyte imbalance?
hyponatremia
which imbalance causes cellular swelling?
hyponatremia
How does the body compensate for respiratory alkalosis?
increase H+ excretion, decrease HCO3 reabsorption
How does the body compensate for respiratory acidosis?
increase H+ excretion, increase HCO3 reabsorption
How does the body compensate for metabolic acidosis?
increase ventilation, decrease CO2 levels
which leukocyte is the first to arrive on site of inflammation
neutrophil
what are intracellular electrolytes?
potassium, magnesium, phosphate
what are the extracellular electrolytes?
sodium, chloride, bicarbonate