Hesi Pathophysiology Practice Exam Questions with accurate rationale answers. Graded A+

After talking w/ the HCP, a male pt continues to have questions about the results of a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels become elevated. The nurse should explain which ...

After talking w/ the HCP, a male pt continues to have questions about the results of a prostatic surface antigen (PSA) screening test and asks the nurse how the PSA levels become elevated. The nurse should explain which pathophysiological mechanism? - As the prostate gland enlarges, its cells contribute more PSA in the circulating blood PSA is a glycoprotein found in prostatic epithelial cells, and elevations are used as a specific tumor markers. Elevations in PSA are r/t gland volume, ie. benign BPH, prostatitis, and cancer of the prostate, indicating tumor cell load. PSA levels are also used to monitor response to therapy A 26 yr old male client w/ Hodgkin's disease is scheduled to undergo radiation therapy. The clinet expresses concern about the effect of radiation on his ability to have children. What info should the nurse provide? - Permanent sterility occurs in the male client who receive radiation Low sperm count and loss of motility are seen in males w/ Hodgkin's disease b/f any therapy. Radiotherapy often results in permanent aspermia, or sterility The nurse hears short, high-pitched sounds just b/f the end of inspiration in the right and left lower lobes when auscultating a client's lungs. How should this finding be recorded? - Crackles in the right and left lower lobes Fine crackles - short, high-pitched sounds heard just b/f the end of inspiration that are the result of rapid equalization of pressure when collaped alveoli or terminal bronchioles suddenly snap open Wheezing is a continuous high-pitched squeaking or musical sound caused by rapid vibration of bronchial walls that are 1st evident on expiration and may be audible A client is admitted to the ER w/ a tension pneumothorax. Which assessment should the nurse expect to ID? - A deviation of the trachea toward the side opposite of the pneumothorax Tension pneumothorax is caused by rapid accumulation of air in the pleural space, causing severely high intrapleural pressure. This results in collapse of the lung, and the mediastinum shifts toward the unaffected side, which is subsequently compressed A client who is receiving a whole blood transfusion dv's chills, fever, and a HA 30 min after the transfusion is started. The nurse shold recognize these sx as characteristic of what rxn? - A febrile transfusion reaction Sx of a febrile reaction include sudden chills, fever, HA, flushing, and muscle pain. An allergic rxn is the response of histamine release which is characterized by flushing, itching, and urticaria. It exhibits an exaggerated allergic response that progresses to shock and possible cardiac arrest an acute hemolytic reaction presents w/ fever, chills, but is hallmarked by the onset of low back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria, dark urine, ARF, shock, cardiac arrest, and even death The nurse is analyzing the waveforms of a client's ECG. What finding indicates a disturbance in electrical conduction in the ventricles? - QRS interval of 0.14 second the normal duration of the QRS is 0.04 - 0.12 sec T wave is 0.16 sec; PR is 0.12 - 0.20 sec; QT is 0.31-0.38 sec Several hrs after surgical repair of an AAA, the client dvps left flank pain. the nurse determines the client's urinary output is 20 m.;hr for the past 2 hrs. The nurse should conclude that these findings support which complication? - Renal artery embolization Post-op complications of surgical repair of AAA are r/t the location of resection, graft, or stent placement along the abd'l aorta. Embolization of a fragment of thrombus or plaque from the aorta into a renal artery can compromise blood flow in 1 of the renal arteries, resulting in renal ischemia that precipitates unilateral flank pain A client w/ markedly distended bladder is dx w/ hydronephroosis and left hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a residual urine vol of 1650 ml. this finding supports which pathophysiological cause of the client's urinary tract obstruction? - Obstruction at the urinary bladder neck Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward mvmt of urine from the lower to upper urinary tracts), and hydronephrosis (dilation or enlargement of the renal pelvis and calyces) result from post-renal obstruction which can consequently result in chronic pyelonephritis and renal atrophy. Ascending urinary reflux occurs when normal ureteral peristaltic pressure is met w/ an increase in urinary pressure occurring during bladder filling if the urinary bladder neck is obstructed The nurse is planning care for a client who has a right hemispheric stroke. Which nsg dx should the nurse include in the POC? - Risk for injury r/t denial of deficits and impulsiveness Right-brain damage - a client experience difficulty in judgment and spatial perception and is more likely to be impulsive and move quickly, which placing the client at risk for falls the nurse is teaching a client w/ maple syrup urine disease, an autosomal recessive DO about the inheritance pattern. Which info should the nurse provide? - both genes of a pair must be abnormal for the DO to occur A female client tells the nurse that she does not know which day of the month is best to do breast self exams. Which instruction should the nurse provide? - 5-7 days after menses cease this is because the physiologic alterations in breast size and activity reach their minimal level after menses A client reports unprotected sex 1 wk ago and is worried about HIV exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that seroconversion to HIV positive relies on antibody production by B lymphocytes after exposure to the virus. When should the nurse recommend the client return for repeat blood testing? - 6-12 wks although the HIV antigen is detectable appx 2 wks after exposure, seroconversion to HIV positive may take up to 6-12 wks after exposure A nurse is planning to teach self care measures to a female client about prevention of yeast infections. Which instructions should the nurse provide? - avoid tight fitting clothing and do not use bubble bath or bath salts Which rxn should the nurse ID in a client who is responding to stimulation of the sympathetic nervous system (SNS)? - Increased HR any stressor that is perceived as threatening to homeostasis acts to stimulate the SNS and manifests as a flight or flight response, which includes an increased HR