HESI PATHO, Patho Hesi 2020/2021 Practice Questions, Pathophysiology HESI. Graded A+

Which rationale best supports an older client's risk of complications related to a dysrhythmia? - An older client is intolerant of decreased cardiac output which may cause dizziness and falls In an older client, card ...

Which rationale best supports an older client's risk of complications related to a dysrhythmia? - An older client is intolerant of decreased cardiac output which may cause dizziness and falls In an older client, cardiac output is decreased and a loss of contractility and elasticity reduces systemic and cerebral blood flow, so dysrhythmias, such as bradycardia or tachycardia is poorly tolerated, and increases the client's risk for syncope, falls, transient ischemic attacks, and possibly dementia. - The nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding? - Ptosis of the left eyelid Ptosis is the term to describe an eyelid droop that covers a large portion of the iris astigmatism -- distortion of the lens of the eye, causing decreased visual acuity. nystagmus - eye makes uncontrolled movements; oculomotor nerve or eyelid muscle disorder that is characterized by rapid, rhythmic movement of both eyes. exophthalmos - protrusion of the eyeballs that occurs with hyperthyroidism The nurse is measuring blood pressure on all four extremities of a child with coarctation of the aorta. Which blood pressure finding should the nurse expect to obtain? - Lower in the legs than the arms In coarctation of the aorta, a congenital constriction is found at the aorta near the ductus arteriosus region that lies past the left subclavian arteries, which perfuses the upper extremities. the child should have higher blood pressures in the upper extremities than in the legs. The nurse reviews the CBC findings of an adolescent with acute myelogenous leukemia. The hemoglobin is 13.8, hematocrit is 36.7 WBC is 8,200 and platelet count is 115,000., Based on these findings, what is the priority nursing dx for this client's plan of care? - Risk for injury A client with AML is at risk for anemia, neurtropenia, and thrombocytopenia. These CBC findings indicate that the platelet count is low (Normal 250,000-400,000) which places this client at an increased risk for injury, usually manifested as bruising or bleeding. hemoglobin: 12-16 female 14-18 male hematocrit: 37-47 female 42-52 male WBC: 5,000-10,000 Platelets: 250,000-400,000 A nurse is planning to teach self-care measures to a female client about prevention of yeasts infections. Which instructions should the nurse provide? - Avoid-tight fitting clothing do not use bubble-bath or bath salts A common genital tract infection in females is cadidiasis, which is an overgrowth of the normal vaginal flora of Candida albicans that thrives in an environment that is warm and moist and perpetuated by tight-fitting clothing, underwear, or pantyhose made of nonabsorbant materials. The client should wear clothing that is loose fitting and absorbent, such as cotton underwear, and avoid using bubble-bath or bath salts which further irritate sensitive genital tissue A client with asthma receives a rx for high blood pressure during a clinic visit. Which rx should the nurse anticipate the client to receive that is least likely to exacerbate asthma? - Metoprolol tartrate (lopressor) The best antihypertensive agent for clients with asthma is lopressor a beta blocking agent which is also cardioselective and less likely to cause bronchocontriction. Which signs and symptoms are associated with arterial insufficiency? - Pallor, intermittent claudication Pallor and intermittent claudication are signs related to stage II of PVD, which results in arterial insufficiency. Arterial insufficiency causes impaired perfusion resulting in hypoxic pain or intermittent claudication (pain in legs when working out bc not enough blood flow) Pedal edema, brown pigmentation are signs related to venous insufficiency Blanched skin, lower extremity ulcers are not specific to arterial disease Peripheral neuropathy may be related to complications of diabetes mellitus resulting in poor circulation A man who was recently diagnosed with huntington's disease asks the nurse if his adolescent son should be tested for the disease. What response is best for the nurse to provide? - Testing is needed bc there is a 50% risk of passing the gene to each offspring Huntingdon's disease, a progressively incapacitating, fatal neuromuscular disease, is an autosomal dominant inherited disease that has a 50% risk of developing in each child of those who have the disorder. The risk of autosomal dominant inheritance should be explained and emphasized. A client with aortic valve stenosis develops HF. Which pathophysiological finding occurs in the myocardial cells as a result of the increased cardiac workload? - Increase in size Hypertension and incompetent or stenotic heart valves cause an increase in the workload of the heart by increasing afterload which requires an increase in teh force of contraction to pump blood out of the heart. Myocardial hypertrophy results bc the cells increase in surface area or size by increasing the amount of contractile proteins, but the quantity of fibers remains constant. As myocardial hypertrophy progresses, the heart becomes ineffective as a pump bc the ventricular wall cannot develop enough tension to cause effective contraction, which causes myocardial irritability due to hypoxia. While the nurse obtains a male client's history, review of systems, and physical exam, the client tells the nurse that his breasts drain fluid secretions from the nipple. The nurse should seek further evaluation of which endocrine gland function? - Hypothalamus and anterior pituitary Breast fluid and milk production are induced by the presence of prolactin secreted from the anterior pituitary gland, which is regulated by the hypothalamus' secretion of prolactin-inhibiting hormone in both men and women. Further evaluation of the hypothalamus and the anterior pituitary gland should provide additional information about secretions or lactation Several hours after surgical repair of an AAA, the client develops left flank pain. the nurse determines the client's urinary output is 20ml/hr for the past 2 hours. The nurse should conclude that these findings support which complication? - Renal artery embolization Postop complications of surgical repiar of AAA are related to the location of resection, graft, or stent placement along the abdominal aorta. Emobolization of a fragment of thrombus or plaque from the aorta into a renal artery can compromise blood flow in one of the renal arteries, resulting in renal ischemia that precipitates unilateral flank pain. hypovolemia can cause acute renal failure which involves both kidneys and would cause bilateral flank pain A client with a fractured right radius reports severe, diffuse pain that has not responded to the rx analgesics. The pain is greater with passive movement of the limb than the active movement by the client. The nurse recognizes that the client is most likely exhibiting symptoms of which condition? - acute compartment syndrome These signs are specific indications of acute compartment syndrome, and should be treated as an emergency situation. A client with a markedly distended bladder is dx with hydronephrosis and left hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a residual urine volume of 1650 ml. This finding supports with pathophysiological cause of client's urinary tract obstruction? - Obstruction at the urinary bladder neck Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward movement 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 with an increase in urinary pressure occurring during bladder filling if the urinary bladder neck is obstructed. The nurse is teaching a client with maple syrup urine disease MSUD, an autosomal recessive disorder, about the inheritance pattern. Which information should the nurse provide? - Both genes of a pair must be abnormal for the disorder to continue. MSUD is a type of Autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed. MSUD is not an x-linked dominant or recessive disorder or an autosomal dominant inheritance disorder. Which reaction should the nurse ID in a client who is responding to stimulation of the sympathetic nervous system? - Increased heart rate Any stressor that is perceived as threatening to homeostasis acts to stimulate the sympathetic nervous system and manifests as a flight-or-fight response, which includes an increase in heart rate. Pupil constriction, bronchial constriction and decreased blood pressure are responses of the parasympathetic nervous system A 26-y/o male client with Hodgkin's disease is scheduled to undergo radiation therapy. The client expresses concern about the effect of radiation on his ability to have children. What information should the nurse provide? - Permanent sterility occurs in male clients who receive radiation Low sperm count and loss of motility are seen in males with Hodgkin's disease before any therapy. Radiotherapy often results in permanent aspermia, or sterility