Patho/Pharm Exam 1

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Blood plasma is referred to as:

intravascular fluid

A 35-year-old male weights 70 kg. Approximately how much of this weight is intracellular fluid?

28 L

Elderly individuals are at a higher risk for developing dehydration because they have:

a decreased lean body mass.

Which of the following conditions would decrease oncotic pressure in the capillaries?

Liver failure

Water movement between the intracellular and extracellular fluid compartments is determined by:

osmotic forces

An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid movement into the interstitial space?

Increase interstitial oncotic pressure

Water balance is closely related to _____ balance.

sodium

A 70-year-old male with chronic renal failure presents with edema. Which of the following is the most likely cause of this condition?

Increased capillary hydrostatic pressure

A 10-year-old male is brought to the ER because he is incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as:

localized edema.

Secretion of antidiuretic hormone (ADH) is stimulated by:

increased plasma osmolality.

A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor. Further testing indicates that the tumor secretes ADH. Which of the following would be expected to result from this condition?

Increased urine osmolality

Secretion of aldosterone results in:

increased blood volume.

A 25-year-old male is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which of the following would be expected to accompany this condition?

Decreased blood K+ levels

Natriuretic hormones affect the balance of:

Sodium

A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the physician orders fluid replacement. The nurse administers a hypertonic IV solution. Which of the following would be expected?

Intracellular dehydration

Which of the following conditions is the most significant risk factor for developing hypernatremia?

Dehydration

The most common cause of pure water deficit is:

renal water loss

Hyperlipidemia and hyperglycemia are associated with:

hypertonic hyponatremia

A 52-year-old diabetic male presents to the ER with lethargy, confusion, and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Which of the following is most likely to occur?

Hypertonic hyponatremia

Hyperkalemia causes:

A. an increase in resting membrane potential with increased excitability of cardiac muscle.

Which of the following would most likely cause hypochloremia?

increased bicarbonate

Which of the following would result in hyperkalemia?

Acute acidosis

Long-term potassium deficits result in damage to the:

Kidneys

A 42-year-old female presents to her physician complaining of muscle weakness and cardiac abnormalities. Laboratory tests indicate that she is hypokalemic. Which of the following could be the cause of her condition?

Primary hyperaldosteronism

A 19-year-old male presents to his physician complaining of restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemic. Which of the following could have caused his condition?

Acidosis

A 60-year-old female is diagnosed with hyperkalemia. Which of the following would be an expected symptom?

Oliguria

Which of the following buffer pairs is considered the major plasma buffering system?

HCO3/H2CO3

Regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:

lungs

Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of:

20/1

One cause of metabolic alkalosis is:

excessive loss of Cl-.

Which of the following conditions is commonly associated with hyperkalemia and metabolic acidosis?

Renal failure

Acute compensation for metabolic acidosis includes:

hyperventilation

Causes of respiratory acidosis include:

pneumonia

A 54-year-old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feelings. Lab results reveal decreased pH, increased CO2, and normal bicarbonate ion. The most likely diagnosis is:

respiratory acidosis.

Chronic compensation for respiratory acidosis includes:

kidney excretion of H+.

A 55-year-old female presents to her physician complaining of dizziness, confusion, and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2, and slightly decreased HCO3-. Which of the following is the most likely diagnosis?

Respiratory alkalosis with renal compensation

Total body water loss in the adult is

2.8 L

Of the 60% of the body weight made up of water, about two thirds is:

intracellular water

A milliequivalent is a unit of:

a chemical activity

Which statement is true?

D. The positive and negative charges in blood plasma must be equal to each other

The release of ADH is not stimulated by:

hypnatremia

The blood pH is maintained near 7.4 by buffering systems. The sequence from the fastest acting to the slowest acting system is:

Blood buffers, lungs, kidneys

The most common method for increasing fluid excretion includes the use of.

diuretics

Solutions that have a greater osmolality than the intracellular fluid (ICF) are called:

hypertonic

Hyponatremia causes cells to:

swell

When an excess of body fluid exists in the intravascular compartment, all of the following
signs can be expected EXCEPT:

An elevated hematocrit level

When a client's serum sodium level is 128 mEq/L, the priority nursing assessment is to
monitor the status of which body system?

neurological

In reviewing the results of the client's blood work, the nurse recognizes that the unexpected
value that should be reported to the health care provider is:

Potassium 2.9 mEq/L

Which of the following clinical assessment findings is most likely seen in a client experiencing
hypernatremia?

extreme thirst

Of the following clients, the nurse recognizes that the individual who is most at risk for a fluid
volume deficit is:

A 6-month-old learning to drink from a cup

Hydrochlorothiazide has just been prescribed for a patent with hypertension. Which instuctions should the nurse include in the patient's teaching?

"Your diet should include foods high in potassium."

Which side effect should a patient taking furosemide (Lasix) for hypertension be assessed for?

hearing loss

A nurse is caring for an obese patient who is 3 days postoperative. Upon assessment, the nurse discovers that the patient is short of breath, has respirations of 32/minute, and is coughing up pink, frothy sputum. The nurse should anticipate the administration of which medication?

C. Furosemide (Lasix)

A nurse is caring for a patient with meningitis who is receiving spironolactone (Aldactone). A prescriber writes an order for potassium penicillin. What considerations should the nurse focus on prior to administration?

Obtain the serum potassium level

A patient has 2+ pitting edema of the lower extremities bilaterally; auscultation of the lungs reveals crackles bilaterally; and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question?

Spironolactone (Aldactone)

When giving mannitol (Osmitrol), the nurse is aware that the therapeutic goal of this drug is to

reduce intracranial pressure.

Upon assessment a patient is found to have evidence of respiratory compromise from pulmonary edema. A nurse prepares to administer 40 mg of furosemide (Lasix) IV. How should the nurse administer the drug?

Give it in an IV push over 2 minutes.

A nurse is reviewing laboratory results and discovers a magnesium level of 3.5 mEq/L. The patient complains of muscle weakness and feeling sleepy. The patient has been receiving magnesium sulfate intravenously. The nurse should immediately prepare to administer which of the following medications?

Calcium gluconate

A nurse is stuck in the elevator with an anxious patient who fears that no one will know they are stuck, even though the nurse has pushed the emergency button. The patient becomes hysterical, with respirations of 48 breaths per minute. The nurse attempts to reassure the patient, but the patient is inconsolable. The nurse should anticipate the patient will manifest symptoms of which of the following acid-base alterations?

respiratory alkalosis

A patient is admitted to the unit with extreme fatigue and a history of fluid overload, for which the patient takes furosemide (Lasix). A prescriber orders 10 mEq of potassium chloride intravenously for an adult patient with a potassium level of 2.9 mEq/L. How will the nurse administer the potassium dose?

Diluted and infused over 1 hour

The four processes of pharmacokinetics have which of the following characteristics in common?

movement

What is required for a drug to move through the body?

Ability to cross membranes

The nurse is preparing to give a medication for pain. The drug label states that it is "lipid soluble." What would be the nurse's expectation about how easily this drug could pass through a cell membrane?

rapidly

Which is the most common way for drugs to cross cell membranes?

direct penetration

A nurse prepares to administer an oral medication. Which form of the medication would the nurse expect to have the most rapid onset of action?

liquid

Which factor does NOT improve the rate of drug absorption?

Ionization

Which route of drug administration results in the most rapid absorption?

Intravenous

Which item represents an advantage to using the intravenous (IV) route to deliver medication?

control

What is the minimum amount of time over which an IV drug should be injected in order to minimize risk?

60 seconds

The nurse administers 100 mg of drug X by mouth. After the drug moves through the hepatic system there is very little active drug left in the general circulation. This illustrates which concept below?

First-pass effect

Which of the following items describes the plasma drug level below which therapeutic

MEC

What is meant by a dose-response relationship that is graded?

As the dosage increases, the response becomes progressively greater.

Which is a true statement regarding the maximal efficacy of a drug?

Maximal efficacy is the largest effect that a drug can produce.

Which is a true statement regarding drug-receptor interactions?

Under normal circumstances receptors are regulated by endogenous substances.

Which drug property is most enhanced by the presence of many different types of receptors throughout the body?

Selectivity

The drug atenolol has a strong attraction to beta receptors. Which of the following terms best represents this concept?

Affinity

The nurse prepares to give a drug that will activate receptors for which it has affinity. Which of the following terms would describe this drug?

agonist

Which of the following can result from continuous exposure of cells to antagonists?

Hypersensitivity

Which is the best description of the ED50?

It is the dose that is effective in 50% of the population.

The kidney has several important functions. Which of these functions is most affected by diuretic agents?

Cleansing and maintenance of extracellular fluid volume

Which diuretic agent below will produce the greatest degree of diuresis?

Furosemide (Lasix)

The nurse is caring for a patient taking furosemide (Lasix). Which symptom below is the most indicative of an adverse effect with this drug?

Potassium = 3.2 mEq/L

The nurse is caring for a patient receiving hydrochlorothiazide (HydroDIURIL) who is also taking digoxin (Lanoxin). Which adverse effect may occur as a result of giving these two drugs together?

Digoxin toxicity

The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen since it has been shown to greatly reduce mortality in patients with heart failure?

Spironolactone (Aldactone)

The nurse is teaching a female patient about her new prescription for spironolactone (Aldactone). Which statement indicates the teaching was effective?

"I will call my doctor if I begin having menstrual irregularities."

Which organ has the primary responsibility for maintaining fluid volume and osmolality?

kidneys

Which intravenous (IV) fluid would be the most appropriate for treating isotonic volume contraction?

0.9% sodium chloride

The nurse is caring for a patient receiving IV therapy with 3% sodium chloride infusion at 75 mL/hr. Which finding below indicates an adverse effect of this therapy?

Distended neck veins and ankle edema

The nurse is preparing to administer IV potassium to a patient with hypokalemia. Which prescription below is the most appropriate?

Potassium chloride 10 mEq in 100 mL IV over 1 hour

The nurse is caring for a patient receiving oral magnesium gluconate. Which symptom below may indicate a common adverse effect of this medication?

Loose stools

Pathology

Investigation of structural alterations in cells, tissues, and organs which can help identify the cause of a particular disease

Pathogenesis

Patterns of tissue change associated with the cause of disease

Etiology

Study of the cause of disease

Idiopathic

Diseases that have no identifiable cause

Iatrogenic

Disease that occur as a result of medical treatment

Nosocomial

Disease that are aquired as a consequence of being in a hospital environment

Diagnosis

Naming or identification of a disease

Prognosis

Expected outcome of a disease

Chronic disease

Develops more slowly and signs and symptoms last for a long time

Acute disease

Sudden appearance of of signs and symptoms that last only a short time

Remission

Periods when symptoms disappear or diminish significantly

Exacerbation

Periods when symptoms become worst and severe

Complication

Onset of a disease in a person who is already coping with another existing disease

Sequelae

Unwanted outcomes of having a disease or are the results of trauma

Clinical manifestations

Signs and symptoms or evidence of disease

Signs

Objective alterations that can be observed or measured by another person

Local "signs"

Redness, swelling and other signs are "systemic"- such as fever

Symptoms

Subjective experiences reported by the person with the disease

Prodromal period

Disease is the time during which a person experienced vague symptoms such as fatigue or loss of appetite before the onset of specific signs and symptoms

Insidious symptoms

Vague or nonspecific feelings and an awareness that there is a change in the body

Latent period

Time during which no symptoms are readily apparent inn the affect person, but disease is present

Syndrome

A group of symptoms that occur together and may be cause by several interrelated problems, specific disease

Disorder

Abnormality of function, refer to an illness or particular problem

Epidemiology

Study if tracking patterns or disease occurrence and transmission among population and by geographic areas

Incidence

Disease is the number of new cases occurring in a specific period

Prevalence

Diease is the number of existing cases within a population during a specific period

Risk/predisposing factors

Increase the probability that disease will occur, factor does not cause the disease

Precipitating factors

Condition or event that does cause a pathologic event or disorder

Which of the following is not a clinical manifestation of hypokalemia?

Skeletal muscle contractility is increase

A patient has deep and rapid repirations. Laboratory test revels decrease pH and bicarbonate this patient has:

metabolic acidosis

Which of the following is not one of the four most common causes of edema formation (increased filtration of fluid from capillaries and lymph into surrounding tissues?

Decrease hydrostatic pressure

Which of the following is not a cause of hypernatremia?

Excessive free water intake

Which of the following is true regarding hyponatremia?

It occurs when sodium drops below 135 mEq/L

Which of the following statement is true regarding hyperchloremia?

treats underlying disorders

Which of the following is a true statement regarding Hyperkalemia?

It often occurs in acidosis

Which of the following statement is true?

water moves freely across membrane

Which of the following statement is true?

2/3 of the body's water is intracellular

Which of the following statement regarding aldosterone is true?

it is a hormone that is secreted when sodium are depressed

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