Walden University Advanced

Pathophysiology Final Exam

What is the link between major depression and cortisol secretion? - ANSWER
Individuals with depression show that persistently elevated plasma cortisol levels can
result in inflammation that is believed to trigger depression

A patient has chronic anemia associated with chronic renal failure. What substance
does the healthcare professional tell the patient is needed to treat this anemia? -
ANSWER Erythropoietin

What is the first indication of nephrotic syndrome in children? - ANSWER

Periorbital edema

A patient is in the Emergency Department with heat stroke. What finding does the
healthcare provider associate with this condition? - ANSWER Absence of sweating
despite a high core temperature

Clinical manifestations that include irregular or heavy bleeding, the

passage of large clots, and the depletion of iron stores support which diagnosis? -
ANSWER Abnormal uterine bleeding

The health care professional is caring for a person who has a pathologic fracture.
The patient asks the professional to explain the condition. What response by the
professional is best? - ANSWER A fracture that happens at the site of an
abnormality already in that bone.

A patient has a temporary displacement of two bones in a joint causing the bone
surfaces to partially lose contact with each other. What treatment does the health
care professional prepare the patient for? - ANSWER Reduction and
immobilization

Cystic fibrosis is characterized by which symptom? - ANSWER Excessive mucus

production

Stroke Volume (SV) - ANSWER measurement of the amount of blood ejected from
a ventricle in one contraction

Multiple Sclerosis (MS) - ANSWER disease of the central nervous system

characterized by the demyelination (deterioration of the myelin sheath) of nerve
fibers, with episodes of neurologic dysfunction (exacerbation) followed by recovery
(remission)

Transient Ischemic Attack (TIA) - ANSWER Minor stroke; where neurological

function is regained quickly with time
Myasthenia Gravis - ANSWER autoimmune neuromuscular disorder characterized
by weakness of voluntary muscles

Headaches - ANSWER pain anywhere in the cranial cavity (a.k.a. cephalalgia)

Seizure Disorders - ANSWER

Head Injury - ANSWER

Spinal Cord Injury - ANSWER the type of paralysis is determined by the level of
the vertebra closest to the injury

Inflammatory disease of the Musculoskeletal System - ANSWER

Osteoporosis - ANSWER A condition in which the body's bones become weak and
break easily.

Osteopenia - ANSWER abnormal reduction of bone mass

Bursitis - ANSWER inflammation of a bursa usually caused by a blow or friction

Tendinitis - ANSWER inflammation of the tendons caused by excessive or unusual

use of the joint

Gout - ANSWER a type of arthritis characterized by deposits of uric acid crystals in

the joints

Lyme Disease - ANSWER Tick-borne disease caused by the spirochete Borrelia

burgdorferi.

Spondylosis - ANSWER a degenerative disorder that can cause the loss of normal
spinal structure and function

Fractures - ANSWER a crack or break in a bone

Parkinson's - ANSWER A disorder of the central nervous system that affects

movement, often including tremors.

Alzheimer's - ANSWER A progressive disease that destroys memory and other

important mental functions.

Osteoblasts - ANSWER Bone building cells

Osteocytes - ANSWER a bone cell, formed when an osteoblast becomes

embedded in the matrix it has secreted.

Osteoclasts - ANSWER large cells that resorb or break down bone matrix
Generalized Anxiety Disorder - ANSWER an anxiety disorder in which a person is
continually tense, apprehensive, and in a state of autonomic nervous system arousal

Depression - ANSWER A prolonged feeling of helplessness, hopelessness, and

sadness

Bipolar Disorders - ANSWER disorders marked by alternating or intermixed

periods of mania and depression

Schizophrenia Delirium and Dementia - ANSWER hallucinations

Obsessive Compulsive Disease - ANSWER OCD

Growth and Development - ANSWER consistent growth and development

controlled by inherited DNA

Normal growth patterns - ANSWER

Scoliosis (ortho) - ANSWER

Kawasaki - ANSWER acute systemic vasculitis

-inflammation of blood vessels

Alterations in children - ANSWER

Congenital (heart syndrome) - ANSWER

PDAs - ANSWER

Sudden Infant Death Syndrome (SIDS) - ANSWER the unexplained death of a

seemingly healthy baby

Asthma - ANSWER A chronic allergic disorder characterized by episodes of severe

breathing difficulty, coughing, and wheezing.

Lead poisoning and effects on neurological functioning - ANSWER

Sickle Cell - ANSWER an abnormal red blood cell that has a crescent shape and
an abnormal form of hemoglobin

Hemophilia - ANSWER A hereditary disease where blood does not coagulate to

stop bleeding

A patient has a temporary displacement of two bones in a joint causing the bone
surfaces to partially lose contact with each other. What treatment does the health
care professional prepare the patient for? - ANSWER Reduction and
immobilization

Cystic fibrosis is characterized by which symptom? - ANSWER Excessive mucus

production
An infant has gluten-sensitive enteropathy and the parents ask the
healthcare professional to explain why the baby bruises so easily. The professional
explains that the baby has which deficit? - ANSWER Vitamin K deficiency from fat
malabsorption

A healthcare professional advises a pregnant woman to add supplements of which

nutrient to her diet to prevent birth defects? - ANSWER Folate

A mother reports that her young teens have voracious appetites. The
healthcare professional would explain that which hormone is linked to an increase in
appetite during puberty? - ANSWER Leptin

Why is nasal congestion a serious threat to young infants? - ANSWER Infants are
obligatory nose breathers.

A student studying osteomyelitis and asks for an explanation of the term

sequestrum. What response by the professor is best? - ANSWER An area of DE
vascularized and devitalized bone

Which statement by the healthcare professional accurately describes

childhood asthma? - ANSWER An obstructive airway disease characterized by
reversible airflow obstruction, bronchial hyperreactivity, and inflammation

A patient has a spinal cord injury at C4. What should the healthcare
professional assess as the priority in this patient? - ANSWER Respirations

Which cells function to maintain bone matrix? - ANSWER Osteocytes

What is the effect of low plasma albumin? - ANSWER Osmotic pressure

decreases; thus water moves from
the capillaries to the interstitium

Which immunoglobulin (Ig) is present in childhood asthma? - ANSWER IgE

Which mother does the healthcare professional prepare to administer Rh immune

globulin (Rho-GAM) to? - ANSWER Is Rh-negative and the baby is Rh-positive

A parent brings a 10-year-old child to the clinic and reports a mottled appearance to
the skin and legs cramps when the child is in physical education class. Physical
assessment positive for upper extremity hypertension. What diagnostic testing or
treatment does the healthcare professional prepare the family for? - ANSWER An
echocardiogram

In order to help prevent a preadolescent girl from developing later cervical cancer,
which virus does the healthcare professional recommend vaccination against to the
parent? - ANSWER Human papillomavirus (HPV)
Which pain theory proposes that a balance of impulses conducted from the spinal
cord to the higher centers in the central nervous system (CNS) modulates the
transmission of pain? - ANSWER Gate control theory (GCT)

A newborn baby displays jaundice 20 hours after birth. What action by the healthcare
professional is most appropriate? - ANSWER Draw blood to measure total bilirubin

What causes the vasomotor flushes (hot flashes) that are associated with declining
ovarian function with age? - ANSWER Rapid changes in estrogen levels

In acute hypothermia, what physiologic change shunts blood away from the colder
skin to the body core - ANSWER Peripheral vasoconstriction

How does the epididymis become infected? - ANSWER The pathogenic

microorganisms ascend the vasa deferentia from an already infected urethra or
bladder.

What are the clinical manifestations of testicular cancer? - ANSWER Firm,

nontender testicular mass

A healthcare professional is discussing breast feeding with a pregnant woman.

Which beneficial substance does the professional tell the mother is found in breast
milk? - ANSWER IgA

The disruption in cellular adhesion observed in bullous impetigo is caused by an

exfoliative toxin related to which organism? - ANSWER Staphylococcus aureus

A patient has been exposed to prolonged high environmental temperatures and now
shows signs of dehydration, decreased
plasma volumes, hypotension, decreased cardiac output, and tachycardia. What
treatment does the healthcare professional prepare to administer to this patient? -
ANSWER Give the patient plenty of cool fluids to drink

A woman who is positive for hepatitis B is in labor. What action by the healthcare
professional is most appropriate? - ANSWER Immunize the newborn within 12
hours

A healthcare professional is planning a community event to reduce risk of

cerebrovascular accident (CVA) in high risk groups. Which group would the
professional target as the priority? - ANSWER Hypertension

A pregnant woman is seen for the first time at 6 months' gestation and has not taken
prenatal vitamins. The healthcare professional educates the woman on the need for
a blood test specifically to
assess what substance? - ANSWER a-Fetoprotein

A healthcare professional is seeing a patient with suspected schizophrenia. For

which prenatal occurrence should the professional assess? - ANSWER Viral
infection
What congenital malformation is commonly linked to acute leukemia in children? -
ANSWER Down syndrome

Parents bring their 1-year-old child to the emergency department, reporting that the
child has been irritable and pounding on her head, has projectile vomiting, and
seems very sleepy for most of the last 3 days. What diagnostic testing does the
healthcare professional prepare the child and parents for as the priority? -
ANSWER Lumbar puncture with CSF cultures

A patient in the hospital has been receiving heparin injections. The platelet count on
admission was 222,000/mm 3 and four days later is 113,000/mm 3. What action by
the healthcare professional is best? - ANSWER Switch the heparin to lepirudin

A healthcare professional works with recent refugees. A mother brings in her

children who have been diagnosed with iron deficiency anemia. What action by the
professional is most appropriate? - ANSWER Arrange to test for parasitic
infections.

Which patient finding would lead the health care professional to assess the patient
for inflammatory joint disease? - ANSWER Systemic symptoms of inflammation

A student asks the professor what the most common pathophysiologic process is
that triggers aplastic anemia (AA). What response by the professor is most
accurate? - ANSWER Autoimmune disease against hematopoiesis by activated
cytotoxic T (Tc) cell

A student is learning about pelvic inflammatory disease (PID). What information does
the student clarify with a study partner as being correct? - ANSWER Such an
inflammation may result in permanent changes to the ciliated epithelium of the
fallopian tubes.

A patient in the healthcare clinic reports fatigue, weakness, and dyspnea, as well as
pale conjunctiva of the eyes and brittle, concave nails. What assessment by the
healthcare professional is most appropriate for the suspected anemia? - ANSWER
Oral mucus membranes and tongue

A patient is 8 hours postoperative after a long orthopedic procedure. The student

asks why this patient is at particular risk of developing a thromboembolism. What
response by the healthcare professional is best? - ANSWER Patients tend to have
venous stasis from orthopedic
operations

A healthcare professional suspects a patient is brain dead. How would the

professional assess for brain death? - ANSWER Remove the patient's ventilator to
see if spontaneous breathing occurs.

An adult patient has been hospitalized with thrombocytopenia with a platelet count of
8000/mm 3. What action by the healthcare professional is most appropriate? -
ANSWER Tell the patient not to get out of bed without assistance
A child with acute poststreptococcal glomerulonephritis is voiding smoky, brown-
colored urine and asks the healthcare professional to explain what causes it. What
explanation by the professional is best? - ANSWER Presence of red blood cells

A patient has pernicious anemia and asks the healthcare professional to explain the
disease. Which statement by the professional is most accurate? - ANSWER Your
body cannot absorb vitamin B 12.

In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is

deposited in which location? - ANSWER Glomerulus basement membranes

A child has iron deficiency anemia. In addition to iron supplements, what else does
the healthcare professional educate the parents on giving the child? - ANSWER
Vitamin C

When are childhood cancers most often diagnosed? - ANSWER At peak time of
physical growth

Without prior exposure to an antigen, which cells are able to destroy some types of
tumor cells and some virus-infected cells? - ANSWER Natural killer (NK) cells

A patient has hepatomegaly, bronze-colored skin, and cardiac dysrhythmias. What

condition does the healthcare professional prepare to teach the patient about? -
ANSWER Pernicious anemia

How should the healthcare professional reply when parents question why a
computed tomographic (CT) scan of the head was not ordered for their 5-year-old
child after a minor fall? - ANSWER Research suggests that repeated CT scans can
increase the risk of developing brain cancer

A healthcare professional is trying to lower a patient's body temperature by

convection. What action by the professional will accomplish this? - ANSWER
Obtain a fan and set it to blow over the patient.

A patient has primary immune thrombocytopenic purpura (ITP) and is

hospitalized after a bleeding episode. What treatment does the healthcare provider
anticipate being ordered for this patient? - ANSWER Infusion of IVIG

A student
reads in a chart that a child has been diagnosed with mixed precocious puberty and
asks for an explanation. What explanation by the healthcare professional is most
accurate? - ANSWER What early puberty has signs of physical and hormonal
abnormalities

A woman attempting to conceive tells the healthcare professional that she and her
partner have intercourse when her basal body temperature (BBT) is around 37˚C
(98˚F) without getting pregnant. What information does the professional give the
woman? - ANSWER Temperature alone is not the most accurate way to predict
ovulation
A student reads in a chart that a baby was born with an encephalocele. The student
asks the healthcare professional to explain this condition. What explanation by the
healthcare professional is best? - ANSWER A herniation or protrusion of brain and
meninges through a defect in the skull

A student asks the healthcare professional why researchers are trying to link specific
genes to specific asthma phenotypes. What response by the professional is best? -
ANSWER It can lead to personalized approaches to treatment.

A health care professional is teaching a group of college women about increasing

calcium in the diet to prevent osteoporosis. A participant asks at what age is peak
bone mass is reached in women. What response is best? - ANSWER 30 years

The student wants to know how the clinical manifestations and onset of juvenile
idiopathic arthritis (JIA) differ from those of rheumatoid
arthritis (RA) in adults. What answer by the healthcare professional is best? -
ANSWER JIA predominantly affects large joints.

A child has Duchenne muscular dystrophy. What complication does the healthcare
professional teach the parents is most important to control? - ANSWER
Respiratory infection

A 9-year-old child has a blood pressure of 112/72 mmHg in the school nurse's office.
What action by the school nurse is most appropriate? - ANSWER Note the normal
finding in the child's records.

An infant is brought to the emergency department by parents who report that the
baby's fontanels seem to be bulging outward. What action by the healthcare provider
is most appropriate? - ANSWER Determine how much fluid the baby
had in the last 24 hours.

What diagnosis is given to parents when their infant's hip maintains contact with the
acetabulum but is not well seated within the hip joint? - ANSWER Subluxated hip

The student asks the professor for a definition of orexigenic neurons. What
description by the professor is most accurate? - ANSWER Promote appetite and
stimulate eating

A patient is in the intensive care unit and has intercranial pressure (ICP) monitoring.
The patient's ICP is 17 mmHg. The healthcare professional notes that the chart
indicates the patient is now in stage 1 intracranial hypertension. What assessment
finding does the professional associate with this condition? - ANSWER No
significant change in ICP readings upil changes

A preschool teacher notices a child who has burrows on the hands that are several
millimeters to 1 cm long, papules, and vesicular lesions. What other assessment
finding would help the teacher determine the type of infestation the child has? -
ANSWER Ask the child if itching occurs at night.
A man has balanitis. What action by the healthcare professional is most appropriate?
- ANSWER Perform a finger stick for a blood glucose reading.

Which condition is consistent with the cardiac defect of transposition of the great
vessels? - ANSWER The aorta arises from the right ventricle.

A newborn has meconium ileus. What diagnostic test does the healthcare
professional advise the parents about? - ANSWER A sweat test

Which condition is considered a clinical cause of amenorrhea? - ANSWER Failure

to ovulate

The healthcare professional directs a student to assess a teen who has Osgood-
Schlatter disease. What assessment finding does the student anticipate for this
disorder? - ANSWER Tendinitis of the anterior patellar tendon

A healthcare professional is educating a community men's group on symptoms of

benign prostatic hyperplasia (BPH). The professional relates that most symptoms
are a result of which pathophysiologic condition? - ANSWER Compression of the
urethra

A patient has been diagnosed with acute lymphocytic leukemia (ALL) and asks the
healthcare professional to describe it. What description by the professional is most
accurate? - ANSWER ALL is a progressive neoplasm defined by the presence of
greater than 30% lymphoblasts in the bone marrow or blood

A child has cystic fibrosis (CF). Which medication does the healthcare professional
teach the parents about? - ANSWER Pancreatic enzymes

A woman diagnosed with trichomoniasis asks if her sexual partner should be treated
as well. What is the appropriate response by the healthcare professional? -
ANSWER Sexual partners should be treated even if they are asymptomatic

A healthcare professional is caring for a patient diagnosed with aphasia. What action
by the professional would be best in working with this patient? - ANSWER Provide
speech therapy.

In which stage of syphilis would the following clinical manifestations be found:

destructive skin, bone and soft tissue lesions, aneurysms, heart failure, and
neurosyphilis? - ANSWER Tertiary

What is the most abundant class of plasma protein? - ANSWER Albumin

A baby is born with a myelomeningocele and needs urgent surgery to repair the
defect. The parents want to take the baby home instead. What does the healthcare
professional tell the parents about the purpose of this surgery? - ANSWER
1cAdditional nervous system damage will occur the longer we wait 1b
A student asks the health care professional why obese people are at higher risk for
hypertension than non-obese individuals. What response by the professional is best?
- ANSWER They produce more angiotensinogen.

In the majority of children experiencing delayed puberty, what is the problem caused
by? - ANSWER Physiologic delays in maturation

A patient has been diagnosed with lithium toxicity. Which electrolyte imbalance does
the healthcare professional correlate with this condition? - ANSWER Hyponatremia

A healthcare professional has educated a student on folic acid. Which statement by

the student indicates that more teaching is needed? - ANSWER Folic acid is stored
in the liver.

A patient had a seizure that consisted of impaired consciousness and the

appearance of a dreamlike state. How does the healthcare professional chart this
episode? - ANSWER Complex focal seizure

A health care professional is caring for a patient admitted to the hospital with severe
anorexia. What action by the health care professional would be most important? -
ANSWER Ensuring the patient is on a cardiac monitor

Parents report their 3-week-old infant who eats well and has gained weight began to
have projectile vomiting for no apparent reason. What treatment option does the
healthcare professional prepare to educate the parents on? - ANSWER Corrective
surgery

Prenatal exposure to diethylstilbestrol (DES) can result in which type of cancer? -

ANSWER Vaginal cancer

An infant has been diagnosed with intussusception and the student asks the
healthcare professional to explain the condition. What explanation by the
professional is most accurate? - ANSWER One part of the intestine telescopes into
another section of the intestine

Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result

of what? - ANSWER Pressure and obstruction

A woman has been diagnosed with polycystic ovary syndrome but is confused
because her pelvic ultrasound (US) was read as normal and did not show cysts.
What response by the health care professional is most appropriate? - ANSWER
You do not need to have cysts on your ovaries to have this condition.

A healthcare professional wants to volunteer for a community education project to

help prevent spinal cord injury. What activity would the professional most likely
volunteer for? - ANSWER Teaching older adults how to prevent trip-and-fall events

A person has abnormally severe tooth decay and erosion of the tooth enamel. What
problem should the health care professional assess the person for? - ANSWER
Bulimia
What is the consequence of a splenectomy? - ANSWER The number of defective
cells in circulation increases

A patient is admitted to the hospital with multiple myeloma (MM). Which diagnostic
test should the healthcare professional assess as the priority? - ANSWER Serum
calcium level

A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient
asks how this could have occurred. What response by the healthcare professional is
best? - ANSWER It is often preceded by a viral illness.

A parent asks the healthcare professional to explain why a child diagnosed with
Tetralogy of Fallot squats frequently. What explanation by the professional is best? -
ANSWER Relieves hypoxia

A patient is in status epilepticus. In addition to giving medication to stop the seizures,

what would the healthcare professional place highest priority on? - ANSWER
Providing oxygen