Knowledge Check #2

When changes in total body water are accompanied by proportional changes in electrolytes, what type of alteration occurs?

Hypotonic

Normotonic

Isotonic

Hypertonic

Isotonic

Isotonic alterations occur when proportional changes in electrolytes and water accompany changes in total body water leaving osmolality unchanged. Hypertonic changes develop when the osmolality of the ECF is elevated higher than normal. Hypotonic changes occur when the osmolality of the ECF is lower than normal. Normotonic is not a description of changes in body water

The pathophysiologic process of edema is related to which mechanism?

Decreased capillary hydrostatic pressure

Increased plasma oncotic pressure

Lymphatic obstruction

Sodium depletion

Lymphatic Obstruction

The pathophysiologic process of edema is related to an increase in the forces favoring fluid filtration from the capillaries or lymphatic channels into the tissues. The most common mechanisms are increased capillary hydrostatic pressure, decreased plasma oncotic pressure, increased capillary membrane permeability and lymphatic obstruction, and sodium retention

During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?

Potassium

Sodium

Magnesium

Oxygen

Potassium

In states of acidosis, hydrogen ions shift into the cells in exchange for intracellular fluid potassium; hyperkalemia and acidosis therefore often occur together. This is not true of the other options

A patient is admitted with hyponatremia. For which clinical manifestations would the healthcare professional assess? (Select all that apply.)

Seizures

Confusion

Headache

Lethargy

Paranoia

Seizures

Confusion

Headache

Lethargy

A third of the body's fluid is contained in the extracellular interstitial fluid spaces that include what? (Select all that apply.)

Blood plasma

Urine

Lymph

Sweat

Intraocular fluids

Urine

Lymph

Sweat

Intraocular fluids

Two thirds of the body's water is in the intracellular fluid (ICF) compartment, and one third is in the extracellular fluid (ECF) compartments. The two main ECF compartments are the interstitial fluid and the intravascular fluid, such as the blood plasma. Interstitial ECF compartments include the lymph and the transcellular fluids, such as the synovial, intestinal, biliary, hepatic, pancreatic, and cerebrospinal fluids; sweat; urine; and pleural, synovial, peritoneal, pericardial, and intraocular fluids

An imbalance of potassium can produce which dysfunctions? (Select all that apply.)

Smooth muscle atony

Hearing loss

Weakness of skeletal muscles

Visual impairment

Cardiac dysrhythmias 

Smooth muscle atony

Weakness of skeletal muscles

Cardiac dysrhythmias 

Symptoms of hyperkalemia vary, but common characteristics are muscle weakness or paralysis and dysrhythmias with changes in the ECG. A wide range of metabolic dysfunctions may result from hypokalemia. Neuromuscular excitability is decreased, causing skeletal muscle weakness, smooth muscle atony, and cardiac dysrhythmias. Potassium imbalances do not produce visual or hearing problems

Which term is used to identify the movement of gas and air into and out of the lungs?

Ventilation

Perfusion

Respiration

Diffusion

Ventilation

Ventilation is the term used to identify the mechanical movement of gas or air into and out of the lungs. Perfusion is the term used to describe blood that reaches the alveoli. Respiration is the exchange of gasses. Diffusion is the movement of particles through a semipermeable membrane from an area of higher concentration to an area of lower concentration

Where in the lung does gas exchange occur?

Main bronchus

Alveolocapillary membrane

Segmental bronchi

Trachea

Alveolocapillary membrane

Which describes the pressure in the pleural space?

Below atmospheric

Atmospheric

Above atmospheric

Variable

Below atmospheric

Pressure in the pleural space is usually negative or subatmospheric (-4 to -10 mmHg)

If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to react in which manner?

Show no change, allowing the O₂ concentration to remain stable

Show dramatic fluctuation, allowing the O₂ concentration to increase

Shift to the left, allowing less O₂ to be released to the cells

Shift to the right, causing more oxygen (O₂) to be released to the cells

Shift to the right, causing more oxygen (O₂) to be released to the cells

A shift to the right depicts hemoglobin's decreased affinity for O2 or an increase in the ease with which oxyhemoglobin dissociates and O2 moves into the cells. The oxyhemoglobin dissociation curve is shifted to the right by acidosis (low pH), hyperthermia, increased 2,3-BPG, and hypercapnia (increased partial pressure of arterial carbon dioxide [PaCO2]). A shift to the left would occur with alkalosis, hypocapnia, hypothermia, and decreased 2,3-BPG

Which action is a purpose of the inflammatory process?

To prevent infection of the injured tissue

To create immunity against subsequent tissue injury

To provide specific responses toward antigens

To lyse cell membranes of microorganisms

To prevent infection of the injured tissue

What is the vascular effect of histamine released from mast cells?

Increased endothelial adhesiveness

Initiation of clotting cascade

Platelet adhesion

Vasodilation

Vasodilation

When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte?

Monocytes

Eosinophils

Neutrophils

Basophils

Neutrophils

What is the primary function of neutrophils during the cellular stage of acute inflammation?

Engulf and destroy pathogens

Produce histamine

Promote scar tissue formation

Stimulate vasodilation

Engulf and destroy pathogens

Neutrophils are the first white blood cells to arrive at the site of acute inflammation. Their main role is phagocytosis—engulfing and destroying pathogens and debris. Histamine is released by mast cells, and scar tissue formation is a later process involving fibroblasts

Which hormone is primarily responsible for regulating sodium balance in the body?

Cortisol

Insulin

Antidiuretic hormone (ADH)

Aldosterone

Aldosterone

Aldosterone, secreted by the adrenal cortex, increases sodium reabsorption in the kidneys, helping regulate sodium balance. ADH primarily controls water reabsorption, insulin regulates glucose, and cortisol influences metabolism and stress response, not sodium balance directly

Under normal circumstances, the neural responses and the hormones that are released during the stress response are not around long enough to cause damage to vital tissues.

T/F

True

The ability of body systems to increase their function, given the need to adapt, is known by what term?

Physiological reserve

Coping strategies

Adaptation

Homeostasis

Physiological reserve

What is the first stage of Selye’s general adaptation syndrome?

Resistance

Adaptation

Alarm

Exhaustion

Alarm

Alarm is the first stage of Selye's general adaptation syndrome and is characterized by a generalized stimulation of the sympathetic nervous system and the HPA axis, resulting in the release of catecholamines and cortisol

What term is used to describe the process by which proliferating cells are transformed into more specialized cell types?

Proliferation

Premitosis

Differentiation

Postmitosis

Differentiation

A student asks the healthcare professional how immunity is decreased by stress. The professional responds that during a stress response, the helper T (Th) 1 response is suppressed by which hormone?

Growth hormone

Cortisol

Prolactin

ACTH

Cortisol

Cortisol acts to suppress the activity of Th1 cells, which leads to a decrease in innate immunity and the proinflammatory response. Cortisol also stimulates the activity of Th2 cells, which increases adaptive immunity and the anti-inflammatory response.

ACTH binds with specific receptors on the adrenal glands which causes the release of the glucocorticoids.

Prolactin is secreted in response to a variety of stressful stimuli and acts as a second messenger for IL-2 and has a positive influence on B-cell activation and differentiation.

Growth hormone affects protein, lipid, and carbohydrate metabolism; counters effects of insulin; and is involved in tissue repair