Answers Graded A - EVOLVE q's) Correct and Verified Answers Graded A

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HESI Pathophysiology (Patho & pharm EVOLVE q's) Correct and Verified Answers Graded A

• Which pathophysiological response supports a client's vomiting experience?

• Sensory input of noxious stimuli relayed to the cognitive centers is associated with disgust and illicits vomiting.• Response of stimulation of the posterior oropharynx results in reverse peristalsis of the gastrointestinal tract.• Spasmodic reflex of respiratory and gastric movements results from stimulation of the chemoreceptor trigger zone.• Increased gastric and colonic pressures move gastrointestinal contents to the orifice of least resistance.Correct Answer: Spasmodic reflex of respiratory and gastric movements results from stimulation of the chemoreceptor trigger zone.Rationale: Vomiting is a reflex of spasmodic respiratory movements against the glottis causing the forceful expulsion of the contents of the stomach through the mouth.Stimulation of the emetic center results from afferent vagal and sympathetic nerve pathways that activate the chemoreceptor trigger zone (CTZ).

• A man who was recently diagnosed with Huntington's disease asks the nurse if his

adolescent son should be tested for the disease. What response is best for the nurse to provide?• Autosomal dominant disorders, such as Huntington's, cannot be inherited from the parent.• Genetic counseling should be obtained prior to undertaking any genetic testing procedure.• Testing is needed in adolescents because of the risk of passing the gene to each offspring.

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• Positive genetic testing may contribute to insurance discrimination that denies coverage.Correct Answer: Genetic counseling should be obtained prior to undertaking any genetic testing procedure.Rationale: Genetic counseling provides clients and families with facts to assist them in making informed decisions before any genetic testing procedure is undertaken. It also ensures that the client has voluntarily opted for the testing and not coerced and is also able to weigh the risks and benefits of knowing the result.

• A mother is crying as she holds and rocks her child with tetanus who is having

muscular spasms and crying. After administering diazepam (Valium) to the child, what action should the nurse implement?• Lay the child down and ask the mother to stay near the child in the crib.• Encourage the mother to take a break and leave the room to stop crying.• Keep all light sources off and close the window blinds to the room.• Use calm, reassurance and understanding to comfort the mother.Correct Answer: Lay the child down and ask the mother to stay near the child in the crib.Rationale: Controlling environmental stimulation such as noise, light, or tactile stimuli helps reduce CNS irritability related to acute tetanus. The mother should be instructed to minimize handling of the child during episodes of muscle spasticity and to stay calmly near the child. The mother's presence with the child provides security and support to the child.

• The nurse reviews the complete blood count (CBC) findings of an adolescent with

acute myelogenous leukemia (AML). The hemoglobin is 13.8 g/dl, hematocrit is 36.7%, white blood cell count is 8,200 mm3, and platelet count is 115,000 mm3. Based on these findings, what is the priority nursing diagnosis for this client's plan of care?• Impaired gas exchange.• Risk for infection.• Risk for injury.• Risk for activity intolerance.

Correct Answer: Risk for injury.

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Rationale: A client with AML is at risk for anemia, neutropenia, and thrombocytopenia.These CBC findings indicate that the platelet count is low (normal 250,000 to 400,000 mm3), which places this client at an increased risk for injury, usually manifested as bruising or bleeding.

• What information should the nurse include in a teaching plan about the onset of

menopause? (Select all that apply).• Smoking.• Oophorectomy with hysterectomy.• Early menarche.• Cardiac disease.• Genetic influence.• Chemotherapy exposure.

Correct Answer:

• Smoking • Early menarche • Genetic influence • Chemotherapy exposure Rationale: Menopausal symptoms are related to the cessation of ovarian function. Factors influencing the onset of menopause include smoking, genetic influences, early menarche, and chemotherapy exposure.

• The nurse is teaching a client with maple syrup urine disease (MSUD), an autosomal

recessive disorder, about the inheritance pattern. Which information should the nurse provide?• This recessive disorder is carried only on the X chromosome.• Occurrences mainly affect males and heterozygous females.• Both genes of a pair must be abnormal for the disorder to occur.• One copy of the abnormal gene is required for this disorder.Correct Answer: Both genes of a pair must be abnormal for the disorder to occur.

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Rationale: Maple syrup urine disease (MSUD) is a type of autosomal recessive inheritance disorder in which both genes of a pair must be abnormal for the disorder to be expressed.

• The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone

(SIADH), which is manifested by which symptoms?• Loss of thirst, weight gain.• Dependent edema, fever.• Polydipsia, polyuria.• Hypernatremia, tachypnea.

Correct Answer: Loss of thirst, weight gain.

Rationale: SIADH occurs when the posterior pituitary gland releases too much ADH, causing water retention, a urine output of less than 20 ml/hour, and dilutional hyponatremia. Other indications of SIADH are loss of thirst, weight gain, irritability, muscle weakness, and decreased level of consciousness.

• The nurse is assessing a postmenopausal woman who is complaining of urinary

urgency and frequency and stress incontinence. She also reports difficulty in emptying her bladder. These complaints are most likely due to which condition?• Cystocele.• Bladder infection.• Pyelonephritis.• Irritable bladder.

Correct Answer: Cystocele.

Rationale: This constellation of signs in a postmenopausal woman are characteristic of a cystocele. These symptoms are not characteristic of the other options.

• The nurse is planning care for a client who has a right hemispheric stroke. Which

nursing diagnosis should the nurse include in the plan of care?• Impaired physical mobility related to right-sided hemiplegia.• Risk for injury related to denial of deficits and impulsiveness.• Impaired verbal communication related to speech-language deficits.• Ineffective coping related to depression and distress about disability.