PATHO HESI EXIT LATEST ACTUAL EXAM TEST BANK 500 QUESTINS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

PATHO HESI EXIT LATEST 2023-2024 ACTUAL

EXAM TEST BANK 500 QUESTINS AND

CORRECT DETAILED ANSWERS WITH

RATIONALES (VERIFIED ANSWERS) |ALREADY

GRADED A+

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

B) Excessive blood cell production

C) Diarrhea

D) Increased cardiac contractility - ANSWER- Ans: C

Feedback:

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

Feedback:

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.

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

Feedback:

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.

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

Feedback:

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

Feedback:

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. Manifestations (rather

than causes) of heart failure reflect the physiologic effects of the

impaired pumping ability of the heart, including decreased renal

blood flow.

Assessment of an elderly female client reveals the presence of bilateral

pitting edema of the client's feet and ankles and pedal pulses that are

difficult to palpate. Auscultation of the client's lungs reveals clear air

entry to bases, and the client's oxygen saturation level is 93%, and vital

signs are within reference ranges. What is this client's most likely health

problem?

A) Right-sided heart failure

B) Pericarditis