NURS 6501 Knowledge Check 1 Graded A

Module 2 Knowledge Check Course NURS-6501, Advanced Pathophysiology. Test Module 2 Knowledge Check Status Completed Attempt Score 20 out of 20 points Question 1 Correct CC: “I have been having terrible chest and ...

Module 2 Knowledge Check Course NURS-6501, Advanced Pathophysiology. Test Module 2 Knowledge Check Status Completed Attempt Score 20 out of 20 points Question 1 Correct CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.” HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain. Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl His diagnosis is an acute inferior wall myocardial infarction. 1 of 2 Questions: Why is HDL considered the “good” cholesterol? Selected Answer: HDL is composed of many proteins and lipids whose main function is to transport the other cholesterol lipids from the circulatory system back to the liver. This transportation is known as reverse cholesterol transport (RCT) which aids in the battle with atherosclerosis. In other words, HDL is considered the “good” cholesterol because it helps clean-up the LDL build-up from the artery wall. Question 2 Correct CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.” HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain This study source was downloaded by 100000831988016 from CourseHero.com on 04-12-2022 09:18:44 GMT -05:00 https://www.coursehero.com/file/77513340/Knowledge-Check-1-gradeddocx/ several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain. Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl His diagnosis is an acute inferior wall myocardial infarction. 2 of 2 Questions: Explain the role inflammation has in the development of atherosclerosis. Selected Answer: The inflammatory response plays an important part in the development of atherosclerosis. Atherosclerosis begins with endothelial damage to the arterial wall by comorbidities such as hypercholesterolemia, hyperglycemia, and hypertension. With this damage, the permeability of the tunica intima increases leaving it vulnerable to LDL endocytosis. White blood cells such as monocytes are then called and attached to the endothelial damage in the vessel. These WBC then go through diapedesis in which they release oxygen free radicals and when in contact with LDL, it oxidizes it. This then triggers a vicious circle in which more WBC are then attracted to the site. These WBC then become foam cells which when saturated with LDL particles burst and attract more WBC’s to the site once again. Question 3 Correct A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis. Question: What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub? Selected Answer: Pleural friction rub is the resulting auscultating sound caused by inflammation or infection of the parietal pleura. Upon inspiration, the inflammation causes friction with the visceral and parietal pleura when stretched. The APRN recognizes that the pleural friction rub, along with the fever, and tachycardia can be due to a lung or cardiac disease which in this case was the acute pericarditis. Question 4 This study source was downloaded by 100000831988016 from CourseHero.com on 04-12-2022 09:18:44 GMT -05:00 https://www.coursehero.com/file/77513340/Knowledge-Check-1-gradeddocx/ Correct A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t seem to work. States had a slight sore throat a couple weeks ago and attributed it to the flu. Physical exam revealed thin young man who appears to be uncomfortable but not acutely ill. Posterior pharynx reddened and tonsils 3+ without exudate. + anterior and posterior cervical lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched, crescendo-decrescendo systolic ejection murmur auscultated at the left sternal border. Rapid strep +. The patient was diagnosed with acute rheumatic heart disease (RHD). Question: Explain how a positive strep test has caused the patient’s symptoms. Selected Answer: The patient has experienced symptoms of fever and sore throat for about two weeks. The positive rapid strep test indicates that the patient has a phar