2023 HESI Advanced Pathophysiolog Y Fnp V1 100 Practice Questions And Answers

2022 - 2023 HESI

Advanced

Pathophysiolog FNP

(Ver. 1 ) 100

Practice Q and A

Included

1. According to Walter B. Cannon, homeostasis is a stable

internal environment achieved through a system of:

A) Interdependentsystem-wide adaptive responses

B) Variable internal and external conditioning factors

C) Coordinated physiologic processes that oppose change

D) Compatibility between cells and the internal environment

Ans: C

Feedback:

Walter B. Cannon identified homeostasis, achieved by a

coordinated physiologic processthat opposes change. Claude Bernard

recognized the importance of compatibility between cells and the

internal environment. Hans Selye identified the general (systemic)

adaptive and interdependent responses to stress. According to Selye,

stressors produce different responses due to the influence of adaptive

internal or external factors (conditioning factors).

2. A child has been experiencing hypoglycemic episodes. “How

does the body know when to secrete insulin and when to stop

secreting it?” The best response by the nurse, explaining the

physiologic background, would be:

A) “The body knows that if the blood glucose level falls, it will

inhibit insulin secretion and release glycogen to release glucose from

the liver.”

B) “It'sjust a big guessing game; first we give sugar like orange

juice, and then we withhold the carbohydrates if the blood glucose

level is too high.”

C) “Your pituitary gland in the brain is the 'master gland,' and it

controls and regulates all the hormones.”

D) “Once the child starts getting confused, the brain will send a

message to the pancreas to stop producing insulin.”

Ans: A

Feedback:

In the negative feedback mechanism that controls blood

glucose levels, an increase in blood glucose stimulates an increase in

insulin, which enhances removal of glucose from the blood. When

glucose has been taken up by cells and blood glucose levels fall, insulin

secretion is inhibited and glucagon and other counterregulatory

mechanisms stimulate release of glucose from the liver, which causes

blood glucose levels to return to normal.

3. A client presents to the emergency department following a

major traffic accident. Though outwardly there are no apparent

physical injuries found, the client is experiencing chest pain and

heightened alertness, which the health care worker attributes to the

first stage of general adaptation syndrome (GAS). The health care

worker concludesthe client is experiencing manifestationsrelated to

the release of:

A) Aldosterone, which interferes with sodium absorption

B) Epinephrine

C) Too little cortisol

D) Thyroid-stimulating hormone

.

Ans: B

Feedback:

The general adaptation syndromes hasthree stages—the first

is alarm (fight or flight); second is resistance (fight); and the third is

exhaustion. The alarm stage is characterized by a generalized

stimulation of the sympathetic nervous system (SNS) and the HPA,

resulting in release of catecholamines and cortisol. Increased insulin

release or TSH release is not part of the GAS.

4. Although stress exposure initiates integrated responses by

multiple systems, the functional results are first manifested as: Select

all that apply.

A) Enhanced respiratory rate/depth

B) Cravingsfor high-carbohydrate foods

C) Increased alertness and focus

D) Increased glucose utilization

E) Increased GI peristalsis

Ans: A, C, D

Feedback:

Exposure to stress activates an immediate response by the

neuroendocrine system that plays a role in most of the responses to

stress and attempts to adapt. Results of the coordinated release of

these neurohormones include mobilization of energy, a sharpened

focus and awareness, increased cerebral blood flow and glucose

utilization, enhanced cardiovascular and respiratory functioning,

redistribution of blood flow to the brain and muscles, modulation of

the immune response, inhibition of reproductive function, and a

decrease in appetite.

5. A client is experiencing significantstress while awaiting the

results of her recent lymph node biopsy. Among the hormonal

contributors to this response is a release of aldosterone, resulting in

which of the following physiologic effects?

A) Decreased release of insulin

B) Increased cardiac contractility

C) Potentiating effects of epinephrine

D) Increased sodium absorption

Ans: D

Feedback:

Mineralocorticoidssuch as aldosterone increase sodium

absorption by the kidneys. Changes in insulin release and cardiac

contractility are mediated by catecholamines, whereas cortisol

potentiates the action of epinephrine.

6. While looking at cancer cells under a microscope, the

instructor asks the students to describe the cells. Which of the student

answers are accurate? Select all that apply.

A) The cells are in different sizes and shapes.

B) The nucleoli are larger than normal.

C) The cells are contact inhibited.

D) The cells do not resemble the tissue of origin.

E) The cells are attached to an extracellular matrix.

Ans: A, B, D

Feedback:

Undifferentiated cancer cells are marked by a number of

morphologic changes. Both the cells and nuclei display variations in

size and shape. Their nuclei are variable in size and bizarre in shape,

their chromatin is coarse and clumped, and their nucleoli are often

considerably larger than normal. The cells of malignant tumors are

characterized by wide changes of parenchymal cell differentiation from

well differentiated to completely undifferentiated. Normal cells that

are grown in culture tend to display a feature called cell density–

dependent inhibition, in which they stop dividing after the cell

population reaches a particular density. This is sometimes referred to

as contact inhibition since cells often stop growing when they come

into contact with each other. In contrast to normal cells, cancer cells

often survive in microenvironments different from those of the normal

cells. They frequently remain viable and multiply without normal

attachments to other cells and the extracellular matrix.

7. The angiogenesis process, which allows tumorsto develop

new blood vessels, is triggered and regulated by tumor-secreted:

A) Procoagulants

B) Growth factors

C) Attachmentfactors

D) Proteolytic enzymes

Ans: B

Feedback:

Many tumors secrete growth factors, which trigger and

regulate the angiogenesis process. Tumor cells express various cell

surface attachment factors, for anchoring. Tumor cells secrete

proteolytic enzymes to degrade the basement membrane and migrate

into surrounding tissue. Cancer cells may produce procoagulant

materials that affect clotting mechanisms.

8. Which of the following processes characterizes an epigenetic

contribution to oncogenesis?

A) A DNA repair mechanism is disrupted.

B) A tumor suppressor gene is present, but it is not expressed.

C) Cellslose their normal contact inhibition.

D) Regulation of apoptosis in impaired, resulting in

accumulation of cancer cells.

Ans: B

Feedback:

Epigenetic mechanisms of cancer growth involve changes in

the patterns of gene expression without a change in the DNA.

Epigenetic mechanisms may “silence” genes,such astumorsuppressor

genes, so that even though the gene is present, it is not expressed and

a cancer-suppressing protein is not made. Disruption of DNA repair

may contribute to cancer, but this process is not particular to

epigenetics. Similarly, loss of contact inhibition and impaired apoptosis

are associated with cancer but are not specific manifestations of

epigenetic mechanisms.

9. An oncology nurse is caring for a client with newly diagnosed

B-cell lymphoma. Extensive blood work has been drawn and sent to

the lab. Results reveal an elevated antiapoptotic protein BCL-2 level.

The client/family asks, “What does this mean?” The health care

provider bases his or her response on the fact that:

A) The client's immune system is trying to kill the cancer cell by

sending this protein to engulf it.

B) This is a good result. Normal cells undergo apoptosis if DNA

is damaged in any way.

C) This means the cancer cells have found a way to survive and

grow even with damaged DNA.

D) The client's body istrying to limit the blood supply to the

cancer cells by producing high levels of this protein.

Ans: C

Feedback:

Alterations in apoptotic and antiapoptotic pathways have

been found in many cancers. One example is the high levels of the

antiapoptotic protein BCL-2 that occur secondary to a chromosomal

translocation in certain B-cell lymphomas. The mitochondrial

membrane is a key regulator of the balance between cell death and

survival. Proteinsin the BCL-2 family reside in the inner mitochondrial

membrane and are either proapoptotic or antiapoptotic. Since

apoptosis is considered a normal cellular response to DNA damage,

loss of normal apoptotic pathways may contribute to cancer by

enabling DNA-damaged cells to survive.

10. A farmer's long-term exposure to pesticides has made the

cellsin his alveoli and bronchial tree susceptible to malignancy. Which

of the following processes has taken place in the farmer's lungs?

A) Promotion

B) Progression

C) Initiation

D) Differentiation

Ans: C

Feedback:

Initiation involvesthe exposure of cellsto appropriate doses

of a carcinogenic agent that makes them susceptible to malignant

transformation, whereas promotion involves the induction of

unregulated accelerated growth in already initiated cells. Progression

isthe later process whereby tumor cells acquire malignant phenotypic

changes, and differentiation is the process of specialization whereby

new cells acquire the structural, microscopic, and functional

characteristics of the cells they replace.

11. Which of the following practitionersis most likely to be of

immediate assistance in the first 24 hours following delivery of an

infant with a cleft lip?

A) Lactation consultant

B) Respiratory therapist

C) Occupational therapist

D) Social worker

Ans: A

Feedback:

Infants with a cleft lip typically have difficulty with feeding,

and the assistance of a lactation consultant may be of help in

establishing feeding patterns. Oxygenation is not a typical problem,

while activities of daily living and assistive devices are not relevant

considerations. While social work is often of assistance when a child is

born with a congenital condition, a cleft lip has fewer implications than

most other inherited disorders.

12. The newborn has been born with distinctive physical features

of trisomy 21, Down syndrome. The mother asks the nurse, “What is

wrong? My baby looks different than his brother.” The nurse assesses

the infant and notes which of the following characteristics that

correlate with trisomy 21? Select all that apply.

A) Upward slanting of eyes

B) Large, protruding ears

C) Large tongue sticking out the mouth

D) Long fingers with extra creases

E) Flat facial profile

Ans: A, C, E

Feedback:

The physical features of a child with Down syndrome are

distinctive, and therefore the condition usually is apparent at birth.

These features include growth failure and a small and rather square

head. There is a flat facial profile, small nose, and somewhat

depressed nasal bridge; upward slanting of the eyes; small, low-set,

and malformed ears; and a large, protruding tongue. The child's hands

usually are short and stubby, with fingers that curl inward, and there

usually is only a single palmar crease (simian crease).

13. A 41-year-old woman has made the recent decision to start a

family and is eager to undergo testing to mitigate the possibility of

having a child with Down syndrome. Which of the following tests is

most likely to provide the data the woman seeks?

A) Genetic testing of the woman

B) Genetic testing of the woman and the father

C) Prenatal blood tests

D) Ultrasonography

Ans: C

Feedback:

Down syndrome is a result of chromosomal abnormality and

is not a single-gene disorder. As a result, genetic testing of the mother

and/or father is not relevant. Ultrasonography does not have

predicative value for Down syndrome, but blood tests such as -

fetoprotein, human chorionic gonadotropin (HCG), unconjugated

estriol, inhibin A, and pregnancy-associated plasma protein A have

helped ascertain the risks.

14. Aneuploidy of the X chromosome can result in a monosomy

or polysomy disorder. The clinical manifestations of a female with

monosomy X include: Select all that apply.

A) A short-stature female individual

B) Difficulty with fine motor skills

C) Large heavy breasts

D) Early-onset (age 8) puberty

E) Nonpitting lymphedema of the feet

Ans: A, B, E

Feedback:

Turner syndrome produces a female individual who is short,

has no secondary sex characteristics, has normal intelligence, and fails

to go through puberty due to an absence of ovaries. Polysomy X is a

XXY male. XXY males have tall slim stature with breast enlargement,

lack ofsperm, and normal intelligence. They may have problems with

visuospatial organization (driving a car, working math problems,

psychomotor skills, etc.). There are variations in the syndrome, with

abnormalities ranging from essentially none to webbing of the neck

with redundant skin folds and nonpitting lymphedema of the hands

and feet.

15. Genetic testing has revealed that a male infant has been born

with an extra X chromosome. What are the most likely implications of

this finding? The child:

A) Is unlikely to survive infancy

B) Islikely to have no manifestations of this chromosomal

abnormality

C) Will have significant neurological and cognitive defects

D) Will be unable to reproduce

Ans: B

Feedback:

An extra X chromosome is associated with Klinefelter

syndrome, but a majority of XXY males do not exhibit visible effects of

this chromosomal abnormality.

16. Although bacterial toxins vary in their activity and effects on

host cells, a small amount of gram-negative bacteria endotoxin:

A) Isreleased during cell growth

B) Inactivates key cellular functions

C) Uses protein to activate enzymes

D) In the cell wall activates inflammation

Ans: D

Feedback:

Endotoxins differfrom exotoxinsin several ways. Endotoxins

are found in the cell wall lipids of gram-negative bacteria and are

potent activators of life-threatening systemic responses such as acute

inflammation with clotting and hypotension. Exotoxins contain

protein, are released during cell growth, inactivate key cell functions,

and have enzymatic activity.

17. A 9-month-old infant has been diagnosed with botulism after

he was fed honey. The child's mother was prompted to seek care

because of this child's sudden onset of neuromuscular deficits, which

were later attributed to the release of substances by Clostridium

botulinum. Which virulence factor contributed to this child's illness?

A) Endotoxins

B) Adhesion factors

C) Exotoxins

D) Evasive factors

Ans: C

Feedback:

Exotoxins are proteinsreleased from the bacterial cell during

growth, as in the case of botulism poisoning. Adhesion factors, evasive

factors, and endotoxins are not evident in this release of botulinum

toxin.

18. While explaining evasive factors by microbes to evade

various components of the host'simmune system,the instructor uses

which of the following examples?

A) H. Pylori being able to survive in an acidic environment

B) Enzymes capable of destroying cell membranes

C) S. aureus ability to immobilize IgG

D) An infectious agent's ability to produce toxins

Ans: A

Feedback:

A number of factors produced by microorganisms enhance

virulence by evading various components of the host's immune

system. H. pylori, the infectious cause of gastritis and gastric ulcers,

produces a urease enzyme on its outer cell wall. The urease converts

gastric urea into ammonia, thus neutralizing the acidic environment of

the stomach and allowing the organism to survive in this hostile

environment. Infectious agents also produce invasive factors that

facilitate the penetration of anatomic barriers and host tissue. Most

invasive factors are enzymes capable of destroying cell membranes

(e.g., phospholipases), connective tissue (e.g., elastases, collagenases),

intercellular matrices (e.g., hyaluronidase), and structural protein

complexes (e.g., proteases). The effects of the pathogen's invasive

factors and toxins, combined with the antimicrobial and inflammatory

substances released by host cells, mediate the tissue damage and

pathophysiology of infectious diseases.

19. A client with a long-standing diagnosis of Crohn disease has

developed a perianal abscess. Which of the following treatments will

this client most likely require?

A) Antiviraltherapy

B) Antibiotic therapy

C) Surgical draining

D) Pressure dressing

Ans: C

Feedback:

Although antibiotics are likely to form a component of this

client's treatment, abscesses most often require surgical draining. A

pressure dressing or the use of antivirals is likely unnecessary.

20. In the usual course (stages) after a pathogen has entered the

host body, the stage when the host initially develops the appearance

of signs/symptoms like a mild fever and body aches is:

A) Incubation

B) Prodromal

C) Acute

D) Convalescence

Ans: B

Feedback:

The prodromalstage followsinoculation (the initialstage)

and is identified by the initial onset ofsymptoms in the host. Tissue

inflammation and damage is evident during the acute (3rd) stage.

Pathogen elimination and containment are characteristics of the

convalescent (4th) period, which follows the acute stage.

21. A client who lives with angina pectoris has taken a sublingual

dose of nitroglycerin to treat the chest pain he experiences while

mowing his lawn. This drug facilitatesrelease of nitric oxide, which will

have what physiologic effect?

A) Smooth muscle relaxation of vessels

B) Decreased heart rate and increased stroke volume

C) Increased preload

D) Reduction of cardiac refractory periods

Ans: A

Feedback:

Nitroglycerin produces its effects by releasing nitric oxide in

vascularsmooth muscle of the target tissues, resulting in relaxation of

this muscle and increased blood flow. This drug does not decrease

heartrate. Because it vasodilates, it decreases preload. Nitroglycerine

does not affect cardiac refractory periods.

22. Following a kitchen accident with a knife, the client's cut has

experienced a decrease in the amount of bleeding and has developed a

clot. The nurse knows this is primarily a result of humoral control of

blood flow with the release of:

A) Histamine

B) Bradykinin

C) Serotonin

D) Prostaglandin E2

Ans: C

Feedback:

Serotonin release causes vasoconstriction of blood vessels

and plays a major role in control of bleeding. Histamine, bradykinin,

and prostaglandin E2 cause vasodilation of blood vessels.

23. A client has had a myocardial infarction (MI) that damaged

the right atrium, which has interfered with the SA node. The

compensatory mechanism, the AV node, becomesthe pacemaker of

the heart and beats how many times/minute?

A) 10 to 20 beats/minute

B) 21 to 30 beats/minute

C) 45 to 50 beats/minute

D) 55 to 60 beats/minute

Ans: C

Feedback:

The AV nodal fibers, when not stimulated, discharge at an

intrinsic rate of 45 to 50 times a minute, and the Purkinje fibers

discharge 15 to 40 times/minute. The SA node hasthe fastest intrinsic

rate of firing (60–100 beats/minute) and normally functions as the

pacemaker of the heart. Should the SA node fail to discharge, the AV

node can assume the pacemaker function of the heart, and the

Purkinje system can assume the pacemaker function of the ventricles

should the AV junction fail to conduct impulses from the atria to the

ventricles.

24. A client asks why he has not had major heart damage since

his cardiac catheterization revealed he has 98% blockage of the right

coronary artery. The nurse's best response is:

A) “You must have been taking a blood thinner for a long time.”

B) “You have small channels between some of your arteries, so

you can get blood from a patent artery to one severely blocked.”

C) “You are just a lucky person since most people would have

had a massive heart attack by now.”

D) “With this amount of blockage, your red blood cells get

through the vessel one-by-one and supply oxygen to the muscle.”

Ans: B

Feedback:

Collateral circulation is a mechanism for the long-term

regulation of local blood flow. In the heart, anastomotic channels exist

between some of the smaller arteries. These channels permit

perfusion of an area by more than one artery. When one artery

becomes occluded, these anastomotic channels increase in size,

allowing blood from a patent artery to perfuse the area supplied by

the occluded vessel. For example, persons with extensive obstruction

of a coronary blood vessel may rely on collateral circulation to meet

the oxygen needs of the myocardial tissue normally supplied by that

vessel. There is no indication that the client is on a blood thinner.

25. The parasympathetic nervous system causes a slowing of the

heart rate by increasing:

A) Norepinephrine

B) Vessel constriction

C) Cardioinhibitory center

D) Smooth muscle tone

Ans: C

Feedback:

The medullary cardiovascular neurons are grouped into three

distinct pools that lead to sympathetic innervation of the heart and

blood vessels and parasympathetic innervation of the heart. The

cardioinhibitory center controls parasympathetic-mediated slowing of

heart rate. The parasympathetic system has little or no control over

blood vessels (constriction, tone). Norepinephrine is the main

neurotransmitter for sympathetic neurons.

26. The shortness of breath and cyanosis that occur in clients

experiencing acute heart failure syndrome are primarily caused by:

Select all that apply.

A) Accumulation of fluid in the alveoli and airways

B) Lung stiffness

C) Worsening renal failure

D) Myocardial muscle necrosis

E) Impaired gas exchange

Ans: A, B, E

Feedback:

Acute pulmonary edema is the most dramatic symptom of

AHFS. It is a life-threatening condition in which capillary fluid moves

into the alveoli. The accumulated fluid in the alveoli and airways

causes lung stiffness, makes lung expansion more difficult, and impairs

the gas exchange function of the lung. With the decreased ability of

the lungs to oxygenate the blood, the hemoglobin leaves the

pulmonary circulation without being fully oxygenated, resulting in

shortness of breath and cyanosis. Worsening renal failure and MI may

cause volume overload but are more likely secondary causes of chronic

heart failure.

27. While in the ICU, a client's status changes. The health care

providers suspect heart failure. Which of the following diagnostic

procedures would give the staff information about pulmonary capillary

pressures, which will lead to the most appropriate interventions?

A) Echocardiography

B) Radionuclide ventriculography

C) Cardiac magnetic resonance imaging

D) Hemodynamic monitoring

Ans: D

Feedback:

Invasive hemodynamic monitoring may be used for

assessment in acute, life-threatening episodes of heart failure. These

monitoring methods include central venous pressure (CVP), pulmonary

artery pressure monitoring, measurements of cardiac output, and

intra-arterial measurements of blood pressure. Echocardiography plays

a key role in assessing ejection fraction, right and left ventricular wall,

wall thickness, ventricular chamber size, valve function, heart defects,

and pericardial disease. Radionuclide ventriculography is

recommended if there is reason to suspect coronary artery disease or

ischemia as the underlying cause for heart failure. Cardiac magnetic

resonance imaging and cardiac computed tomography are used to

document ejection fraction, ventricular preload, and regional wall

motion.

28. A nurse is performing client health education with a 68-yearold man who has recently been diagnosed with heart failure. Which of

the following statements demonstrates an accurate understanding of

his new diagnosis?

A) “I'll be sure to take my beta blocker whenever I feelshort of

breath.”

B) “I'm going to avoid as much physical activity as I can so that I

preserve my strength.”

C) “I know it's healthy to drink a lot of water, and I'm going to

make sure I do this from now on.”

D) “I'm trying to think of ways that I can cut down the amount

of salt that I usually eat.”

Ans: D

Feedback:

Salt and fluid restrictions are indicated for most clients with

heart failure (HF). Beta blockers do not address shortness of breath,

and cardiac medications are not normally taken in response to acute

symptoms. Clients should be encouraged to maintain, and increase,

physical activity within the limits of their condition.

29. A client with a diagnosis of heart failure has returned from a

visit with his primary care provider with a prescription for a change in

his daily medication regimen. Which of the following drugs is likely to

improve the client's cardiac function by increasing the force and

strength of ventricular contractions?

A) A -adrenergic blocker

B) A diuretic

C) A cardiac glycoside

D) An ACE inhibitor

Ans: C

Feedback:

Cardiac glycosides improve cardiac function by increasing the

force and strength of ventricular contractions. -Adrenergic blockers

decrease left ventricular dysfunction associated with activation of the

sympathetic nervous system. ACE inhibitors block the conversion of

angiotensin I to II, whereas diuretics promote the excretion of fluid.

30. A client awaiting a heart transplant is experiencing

decompensation of her left ventricle that will not respond to

medications. The physicians suggest placing the client on a ventricular

assist device (VAD). The client asks what this equipment will do. The

health care providers respond:

A) “Pull your blood from the right side of the heart and run it

through a machine to oxygenate it better, and then return it to your

body.”

B) “Measure the pressures inside your heart continuously to

asses pumping ability of your left ventricle.”

C) “Have a probe at the end of a catheter to obtain

thermodilution measures,so cardiac output can be calculated.”

D) “This device will decrease the workload of the myocardium

while maintaining cardiac output and systemic arterial pressure.”

Ans: D

Feedback:

Refractory heart failure reflects deterioration in cardiac

function that is unresponsive to medical or surgical interventions.

Ventricular assist devices (VADs) are mechanical pumps used to

support ventricular function. VADs are used to decrease the workload

of the myocardium while maintaining cardiac output and systemic

arterial pressure. This decreases the workload on the ventricle and

allows it to rest and recover. The rest of the distractors relate to the

monitoring in an ICU of cardiac functioning. Invasive hemodynamic

monitoring may be used for assessment in acute, life-threatening

episodes of heart failure. With the balloon inflated, the catheter

monitors pulmonary capillary pressures (i.e., pulmonary capillary

wedge pressure or pulmonary artery occlusion pressure), which reflect

pressures from the left ventricle. The pulmonary capillary pressures

provide a means of assessing the pumping ability of the left ventricle.

One type of pulmonary artery catheter is equipped with a thermistor

probe to obtain thermodilution measurements of cardiac output.

31. A car accident client is admitted with a chest tube following

pneumothorax. He also has an elevated blood alcohol level. When the

nurse enters his room,she notes the client is dyspneic,short of breath,

and holding his chest tube in his hand. When the nurse pulls the linens

back, she finds a “sucking” chest wound. After calling a “code blue,”

the next priority intervention would be to:

A) Place the client's meal napkin over the wound

B) Observe and wait for the code blue team to bring equipment

C) Try to calm the patient down by maintaining therapeutic

communication

D) Apply a Vaseline gauze (airtight) dressing over the insertion

site

Ans: D

Feedback:

The client has a medical emergency. Sucking chest wounds,

which allow air to pass in and out of the chest cavity,should be treated

by promptly covering the area with an airtight covering. Chest tubes

are inserted as soon as possible. The other interventions will not help

minimize the amount of air entering the pleural space.

32. A client with a history of heart failure and COPD (caused by

60 pack/year smoking) presents to the clinic with the following

complaints: auscultation of breath sounds reveal absent/diminished

breath sounds in the right lower lobe. Which other manifestations lead

the health care provider to suspect the client may have developed

atelectasis? Select all that apply.

A) Respiratory rate—32; pulse rate—122 beats/minute.

B) “Having a hard time catching my breath.”

C) “Seemslike I'm not making much water (decreased urine

production).”

D) Using accessory muscles to help him breathe.

E) Copious amounts of thick, green sputum.

Ans: A, B, D

Feedback:

Atelectasis is caused most commonly by airway obstruction

rather than a vascular obstruction. The clinical manifestations of

atelectasis include tachypnea (respiratory rate of 32), tachycardia

(pulse rate of 122) dyspnea (hard time catching breath), cyanosis, signs

of hypoxemia, diminished chest expansion, absence of breath sounds,

and intercostal retractions (use of accessory muscles). Both chest

expa