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University of Maine at Fort Kent

Division of Nursing
BIO 401: Pathophysiology
Exam 2 (Weeks 6-8 Content)
1. A patient with a diagnosis of schizophrenia has been admitted to the emergency
department after ingesting more than 2 gallons of water. Which of the following
pathophysiologic processes may result from the sudden water gain? (p. 170)
a. Hypernatremia
b. Water movement from the extracellular to intracellular compartment
c. Syndrome of inappropriate secretion of ADH (SIADH)
d. Isotonic fluid excess in the extracellular fluid compartment
2. Primary adrenal insufficiency is manifested by (p. 793)
a. Truncal obesity and edema
b. Hypokalemia and hypervolemia
c. Hyponatremia and hypoglycemia
d. Hypopigmentation and hypertension
3. A patient has developed the facial appearance that is characteristic of myxedema
(an enlarged tongue, bradycardia, and voice changes). Which of the following
treatments is most likely to benefit this patient? (p. 787)
a. Synthetic preparations of T3 and T4
b. Beta adrenergic blocking agents and antithyroid drugs
c. Corticosteroid replacement therapy
d. Oral or IV cortisol replacement
4. A patient with longstanding type 2 diabetes is surprised at his high blood sugar
readings after having emergency surgery. Which of the following factors may have
contributed to the patients elevated blood glucose levels? (p. 804)
a. The tissue trauma of surgery resulted in gluconeogenesis
b. Illness inhibited the release and uptake of glucose
c. The stress of the event caused the release of cortisol
d. Sleep disruption in the hospital precipitated the dawn effect
5. Which of the following assessment findings of a male patient constitutes a criterion
for a diagnosis of metabolic syndrome? (p. 822)
a. The patient states that he does less than 30 minutes of strenuous physical
activity each week
b. The patients resting heart rate is typically 85 to 95 beats per minute
c. The patient has a family history of type 2 diabetes
d. The patients blood pressure is consistently in the range of 140/90 mm Hg

6. A diabetic patients most recent blood work indicated a decreased glomerular

filtration rate and urine testing revealed microalbuminuria. Which of the following
self-care measures should the patients care team suggest to the patient? (p. 822)
a. Use of over-the-counter diuretics
b. Measures to lower blood pressure
c. Increased fluid intake
d. Decreased oral sugar intake
7. Which of the following patients would likely be at highest risk of developing
hyperkalemia? (p. 180)
a. A patient who has been admitted for the treatment of acute renal failure
following a drug overdose
b. A patient who has experienced an ischemic stroke with multiple sensory and
motor losses
c. An elderly patient who is experiencing vomiting and diarrhea as a result of
influenza
d. A patient whose thyroidectomy resulted in the loss of his parathyroid gland
8. A female patient with a history of chronic renal failure has developed hypocalcemia.
Which of the following assessment findings would provide potential confirmation of
this diagnosis? (p. 187)
a. The patient experiences shortness of breath on exertion with decreased
oxygen saturation levels
b. The patient is difficult to arouse and is disoriented to time and place
c. The patients heart rate is 120 beats per minute and she is sweaty
d. The patient has muscle spasms and complains of numbness around her
mouth
9. A 77-year-old woman has been brought to the emergency department by her
daughter because of a sudden onset of confusion. The patient admits to ingesting a
large amount of baking soda (sodium bicarbonate) since this morning to treat
indigestion. How will the womans body attempt to resolve this disruption in acidbase balance? (p. 198)
a. Hyperventilation
b. Increasing renal H+ excretion
c. Hypoventilation
d. Increased renal HCO3 reabsorption
10. Arterial blood gases of a patient with a diagnosis of acute renal failure reveal a pH of
7.25 (low), HCO3 of 21 mEq/L (low), decreased PCO2 accompanied by a respiratory
rate of 32 (high). What disorder of acid-base balance is the patient most likely
experiencing? (p. 199)
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

11. Which of the following patients likely faces the greatest risk of a gastrointestinal
bleed? (p. 691)
a. A man whose hypertension requires him to take a diuretic, an ACE inhibitor,
and a beta adrenergic blocker
b. A patient who is taking a broad spectrum antibiotic to treat a bladder infection
c. A patient with a history of anxiety who takes benzodiazepines twice a day
d. A patient who takes aspirin with each meal to control pain
12. A patients complex and worsening pressure ulcer has necessitated the use of
numerous antibiotics over the last several months. Which of the following
consequences may result from this patients medication regimen? (p. 693)
a. Impaired mucus production
b. Vitamin K deficiency
c. Impaired protein metabolism
d. Excessive release of pepsin
13. The nurse who is providing care for a patient with pancreatic cancer should prioritize
which of the following assessments? (p. 756 Clinical Features)
a. Assessment for ascites and close monitoring of fluid balance
b. Respiratory assessment and monitoring of arterial blood gases
c. Vigilant monitoring of blood glucose levels
d. Assessment for deep vein thrombosis
14. A decrease in the serum level of which of the following substances is suggestive of
liver injury? (p. 736)
a. Y-gluamyltransferase (GGT)
b. Albumin
c. Alanine aminotransferase (ALT)
d. Alkaline phosphatase
15. Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV).
Which of the patients statements suggests that he understands his new diagnosis?
(p. 738)
a. I guess Im an example of why you should always use condoms
b. Im embarrassed that Ill be a carrier of hepatitis from now on
c. Im still trying to deal with the fact that this will forever change my life
d. I dont know why I didnt bother to get vaccinated against this
16. Which of the following individuals most likely faces the highest risk of developing
chronic pancreatitis? (p. 756)
a. A woman who has six to eight drinks each evening
b. A man who has become profoundly ill during a tropical vacation
c. A woman who takes two Tylenol tablets five times a day
d. An obese man who has a high fat diet and has a sedentary lifestyle

17. Short Answer: Worth a total of 10 points

Lets tie up some concepts we have learned so far. In your own words answer the
questions below and include citations for the answers.
You have been assigned three patients:
a. Patient A is in for a sickle cell crisis
b. Patient B is in for an active case of hepatitis A
c. Patient C is in for a blood transfusion due to a low Hgb level of 8
secondary to iron deficiency anemia
Question 1: Worth 6 points
Patient A and patient B both have jaundice. Describe the difference in the etiology for
the jaundice for these two patients. (i.e. Why are they yellow?)
Question 2: Worth 2 points
Of the three patients, which would most likely have abnormal liver enzyme tests? Why?
Question 3: Worth 2 points
Patient A (patient with sickle cell anemia) is given hydroxyurea to aid in reducing the
number of sickle cell crises. Describe how the drug works.
18. A patient experiences profuse diarrhea after ingesting a meal that is high in wheat
products. The careprovider diagnoses the patient with gluten sensitive enteropathy
(formerly celiac disease).
a. In your own words, briefly describe the pathophysiology that is believed to
cause the watery diarrhea associated with gluten sensitive enteropathy.
(Worth 3 points) (included is a great website)
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gast
roenterology/celiac-disease-malabsorptive-disorders/
a. Which acid/base imbalance would the nurse expect to find with a patient who
has profuse diarrhea? (metabolic acidosis or metabolic alkalosis) Why?
(Worth 2 points)
19. If a person had a severe inflammation, which would be a more potent drug to give

the patient, a corticosteroid or an NSAID? Why? (Worth 5 points)