NURS 611 EXAM 4 PATHO EXAM 100 REVIEW QUESTIONS WITH ANSWERS

NURS 611 EXAM 4 PATHO EXAM 100 REVIEW QUESTIONS WITH ANSWERS

• Exposure to which substance protects the mucosal barrier of the stomach?

Prostaglandins Prostaglandins. Prostaglandins and enterogastrones, such as gastric inhibitory peptide, somatostatin, and secretin, inhibit acid secretion.

• Glucose transport enhances the absorption of which electrolyte?

Sodium Sodium. Sodium passes through the tight junctions and is actively transported across cell membranes. Sodium and glucose share a common active transport carrier (sodium- glucose ligand transporter 1 [SGLT1]).

• What is the cause of gastroesophageal reflux disease?

Zone of low pressure of the lower esophageal sphincter Zone of low pressure of the lower esophageal sphincter. Normally, the resting tone of the lower esophageal sphincter maintains a zone of high pressure that prevents gastroesophageal reflux. In individuals who develop reflux esophagitis, this pressure tends to be lower than normal from either transient relaxation or a weakness of the sphincter.

• By what mechanism does intussusception cause an intestinal obstruction?
• Telescoping of part of the intestine into another section of intestine,

usually causing strangulation of the blood supply Intussusception is the telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply.

• What is the most immediate result of a small intestinal obstruction?

Distention Distention begins almost immediately, as gases and fluids accumulate proximal to the obstruction. Within 24 hours, up to 8 L of fluid and electrolytes enters the lumen in the form of saliva, gastric juice, bile, pancreatic juice, and intestinal secretions. Copious vomiting or sequestration of fluids in the intestinal lumen prevents their reabsorption and produces severe fluid and electrolyte disturbances.

• An intestinal obstruction at the pylorus or high in the small intestine causes metabolic

alkalosis by causing which outcome?Excessive loss of hydrogen ions normally absorbed from gastric juices Excessive loss of hydrogen ions. If the obstruction is at the pylorus or high in the small intestine, then metabolic alkalosis initially develops as a result of excessive loss of hydrogen ions that normally would be reabsorbed from the gastric juices.

• What are the cardinal symptoms of small intestinal obstruction?

Colicky pain caused by distention, followed by vomiting Colicky pain caused by distention followed by vomiting.

• What is the primary cause of peptic ulcers?

Helicobacter pylori

9. A peptic ulcer may occur in all of the following areas except the:

Jejunum 1 / 3

• After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased

pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen.Dumping syndrome occurs with varying severity in 5% to 10% of individuals who have undergone partial gastrectomy or pyloroplasty. Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine cause a sudden shift of fluid from the vascular compartment to the intestinal lumen. Plasma volume decreases, causing vasomotor responses, such as increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness. Rapid distention of the intestine produces a feeling of epigastric fullness, cramping, nausea, vomiting, and diarrhea

• Which statement is consistent with dumping syndrome?

Dumping syndrome usually responds well to dietary management.

• Which statement is false regarding the sources of increased ammonia that contribute to

hepatic encephalopathy?Accumulation of short-chain fatty acids that is attached to ammonia is a source of increased ammonia.The accumulation of short-chain fatty acids, serotonin, tryptophan, and false neurotransmitters probably contributes to neural derangement and is not associated with ammonia levels.

• Which statement is false regarding the pathophysiologic process of acute pancreatitis?

Acute pancreatitis is an autoimmune disease in which immunoglobulin G (IgG) coats the pancreatic acinar cells; consequently, the pancreatic enzymes destroy the cells.The backup of pancreatic secretions and the activation and release of enzymes (activated trypsin activates chymotrypsin, lipase, and elastase) within the pancreatic acinar cells cause acute pancreatitis, an obstructive disease. The activated enzymes cause autodigestion (e.g., proteolysis, lipolysis) of the pancreatic cells and tissues, resulting in inflammation. Acute pancreatitis is usually a mild disease and spontaneously resolves; however, approximately 20% of those with the disease develop a severe acute pancreatitis that requires hospitalization.Pancreatitis develops because of a blockage to the outflow of pancreatic digestive enzymes caused by bile duct or pancreatic duct obstruction (e.g., gallstones). Acute pancreatitis can also result from direct cellular injury from drugs or viral infection.

• Obesity is defined as a body mass index (BMI) greater than what measurement?

30

• Which are the early (prodromal) clinical manifestations of hepatitis? (Select all that

apply.)

• Fatigue X
• Vomiting X
• Itching
• Splenomegaly
• Hyperalgia X 2 / 3

Fatigue, anorexia, malaise, nausea, vomiting, headache, hyperalgia, cough, and low-grade fever are prodromal symptoms that precede the onset of jaundice.

• Ulcerative colitis: Inflammation begins at the base of the crypts of Lieberkühn in the

large intestine, primarily the left colon, with infiltration and release of inflammatory cytokines from neutrophils, lymphocytes, plasma cells, macrophages, eosinophils, and mast cells.

• Crohn disease: In Crohn disease, elevations in IgG are associated with the severity of the

disease.

• Kidney stones in the upper part of the ureter would produce pain referred to which

anatomical area?Umbilicus Kidney stones in the upper part of the ureter would produce pain in the umbilicus. Sensory innervation for the upper part of the ureter arises from the tenth thoracic nerve roots with referred pain to the umbilicus.

• The glomerular filtration rate is directly related to which factor?
• Perfusion pressure in the glomerular capillaries

The filtration of the plasma per unit of time is known as the glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries.

• When renin is released, it is capable of which action?

Formation of angiotensin I

• How high does the plasma glucose have to be before the threshold for glucose is

achieved?180 mg/dl When the plasma glucose reaches 180 mg/dl, as occurs in the individual with uncontrolled diabetes mellitus, the threshold for glucose is achieved.

• What is the end-product of protein metabolism that is excreted in urine?

Urea

• What provides the best estimate of the functioning of renal tissue?

Glomerular filtration rate

• Which renal change is found in older adults?

Decrease in the number of nephrons

• Compared with a younger individual, how is the specific gravity of urine in older adults

affected?Specific gravity of urine in older adults is considered low normal.

• How does progressive nephrons injury affect angiotensin II activity?

It is elevated.It’s elevated. Angiotensin II activity is elevated with progressive nephron injury.

• Which mineral accounts for the most common type of renal stone?

Calcium oxalate Calcium stones (calcium phosphate or calcium oxalate) account for 70% to 80% of all stones requiring treatment.

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