HESI RN ADVANCED PATHOPHYSIOLOGY 2023-2024
ACTUAL EXAM 160 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+(LATEST VERSION)
A child has been diagnosed with marasmus due to the fact that the
parents have both lost their jobs and have very limited funds for food.
Which of the following clinical manifestations would the school nurse
assess that would confirm this diagnosis? Select all that apply.
A) Discolored hair
B) Bradycardia
C) Enlarged liver
D) Pitting edema
E) Stunted growth pattern – ANSWER- Ans: B, E
Rationale:
Inadequate food intake, with equal deficiencies of calories and protein,
is the cause of marasmus, which is characterized by low heart rate, blood
pressure, and body temperature; dull hair; and an emaciated appearance.
Hair discoloration, enlarged liver, and pitting edema are manifestations
of kwashiorkor, which is a severe protein deficiency.
A school nurse has identified a student with noticeable loss of lean
tissues and muscle mass. More than likely, this is caused by proteincalorie malnutrition. The nurse should ask the student if he is
experiencing which of the following clinical manifestations that helps
confirm this diagnosis?
A) Respiratory muscle stimulation<\/p>\n\n\n\n
B) Excessive blood cell production
C) Diarrhea
D) Increased cardiac contractility – ANSWER- Ans: C
Rationale:
Protein-calorie malnutrition results in skeletal muscle loss and diarrhea.
This type of malnutrition is also characterized by respiratory muscle
weakness and blood cell loss that impairs the immune response.
A homeless client asks, “Why can’t I get this wound on my foot to heal?”
Knowing that the client is not receiving good nutrition on a regular
basis, the nurse will reply:
A) “Maybe if you could come to the clinic every day, we can help you
change your dressing.”
B) “Right now your immune system is decreased because you are not
eating a balanced diet.”
C) “Maybe if you could find a place to sleep that is cleaner than where
you usually sleep that will help.”
D) “We just need to make sure you are getting the right antibiotics.” –
ANSWER- Ans: B
Rationale:
As protein is lost from the liver, hepatic synthesis of proteins declines,
and plasma protein levels decrease. There also is a decrease in immune
cells. Wound healing is poor, and the body is unable to fight off
infection because of multiple immunologic malfunctions throughout the
body.<\/p>\n\n\n\n
At the cellular level, cardiac muscle cells respond to an increase in
ventricular volume to the point of overload by: Select all that apply.
A) Elongating the cardiac muscle cells
B) Thickening of the individual myocytes
C) Replicating the myofibrils
D) Decreasing the ventricular wall thickness
E) Symmetrically widening and lengthening the hypertrophy –
ANSWER- Ans: A, D
Rationale:
At the cellular level, cardiac muscle cells respond to stimuli from stress
placed on the ventricular wall by pressure and volume overload by
initiating several different processes that lead to hypertrophy. With
ventricular volume overload, the increase in wall stress leads to
replication of myofibrils in series, elongation of the cardiac muscle cells,
and eccentric hypertrophy. Eccentric hypertrophy leads to a decrease in
ventricular wall thickness or thinning of the wall with an increase in
diastolic volume and wall tension. Production of a symmetric
hypertrophy occurs with a proportionate increase in muscle length and
width, as occurs in athletes; concentric hypertrophy with an increase in
wall thickness, as occurs in hypertension; and eccentric hypertrophy
with a disproportionate increase in muscle length, as occurs in dilated
cardiomyopathy. When the primary stimulus for hypertrophy is pressure
overload, the increase in wall stress leads to parallel replication of
myofibrils, thickening of the individual myocytes, and concentric
hypertrophy. Concentric hypertrophy may preserve systolic function for
a time, but eventually the work performed by the ventricle exceeds the
vascular reserve, predisposing to ischemia.<\/p>\n\n\n\n
From the following clients, who are at high risk for developing heart
failure as a result of diastolic dysfunction? Select all that apply.
A) A 48-year-old client with uncontrolled hypertension
B) A marathon runner with history of chronic bradycardia whose pulse
rate is 46
C) A 57-year-old client with history of ischemic heart disease
D) A 70-year-old with enlarged left ventricle due to myocardial
hypertrophy – ANSWER- Ans: A, D
Rationale:
Conditions that reduce the heart’s ability to adequately fill during
diastole, such as myocardial hypertrophy and tachycardia, can lead to
heart failure. Hypertension remains the leading cause of diastolic
dysfunction. Ischemic heart disease is associated with systolic heart
failure, or impaired contractile performance. It is normal for athletes,
like marathon runners, to have slow pulses.
The most common causes of left-sided heart failure include:
A) Acute myocardial infarction
B) Chronic pulmonary disease
C) Impaired renal blood flow
D)Tricuspid valve regurgitation – ANSWER- Ans: A
Rationale:
The most common causes of left-sided heart failure are acute myocardial
infarction and hypertension. Acute or chronic pulmonary disease can
cause right heart failure, referred to as cor pulmonale. The causes of
right-sided heart failure include stenosis or regurgitation of the tricuspid
or pulmonic valves, right ventricular infarction, and cardiomyopathy.
<\/p>\n","protected":false},"excerpt":{"rendered":"
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