Prn 1520 Pathophysiology

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Sample questions from Prn 1520 Pathophysiology

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.Which cellular change is most directly associated with reversible injury caused by early hypoxia?

   • A.Enzymatic digestion of the cell by lysosomal enzymes
   • B.Replacement of injured cells by fibrous scar tissue
   • C.Nuclear fragmentation with loss of membrane integrity
   • D.Cellular swelling from failure of the sodium-potassium pump

   Rationale: Early hypoxia reduces ATP production, impairing the sodium-potassium pump and allowing sodium and water to accumulate inside the cell. Nuclear fragmentation and lysosomal digestion are features of irreversible injury and cell death, not an early reversible change. Fibrous scar formation is a later repair response when damaged tissue cannot be fully regenerated.

2. 2.A toddler has a temperature of 38.4 C (101.1 F) during a viral illness. Which explanation best describes how the fever develops?

   • A.Pyrogens stimulate prostaglandin production that raises the hypothalamic temperature set point
   • B.The hypothalamus lowers its set point, causing the body to retain heat
   • C.Histamine directly increases the temperature set point in the hypothalamus
   • D.Tissue injury prevents the body from releasing heat through the skin

   Rationale: Exogenous or endogenous pyrogens promote prostaglandin E2 production, which raises the hypothalamic set point and triggers heat-conserving responses. A lowered set point would promote heat loss rather than fever. Histamine contributes to vascular changes in inflammation but is not the primary mediator that resets the hypothalamic set point, and impaired heat loss alone does not explain the typical infectious fever response.

3. 3.Refer to the client's chart. Which findings support progression from localized inflammation to a systemic inflammatory response? Select all that apply.

   • A.The wound has localized redness and warmth
   • B.White blood cell count is 15,200/mm3
   • C.The wound is tender when palpated
   • D.Heart rate increased from 92/min to 116/min
   • E.Temperature increased from 37.2 C to 38.6 C

   Rationale: The rising temperature, increasing heart rate, and elevated white blood cell count support a systemic response, as documented by the changes from 0800 to 1000 and the laboratory result. Local redness, warmth, and tenderness are classic local inflammatory findings, but by themselves do not establish a systemic response. The exam distinction is between local vascular and sensory changes at an injury site and whole-body responses such as fever, tachycardia, and leukocytosis.

4. 4.Refer to the client's chart. Which change is the most concerning evidence of worsening tissue perfusion?

   • A.The client reports pain rated 6 of 10 in the affected foot
   • B.The client has a small area of bruising around the ankle
   • C.The affected foot has become cool and pale, with capillary refill of 5 seconds
   • D.The foot is mildly swollen near the injury

   Answer and rationale are in the full material.

5. 5.During a home visit, a client asks why adequate protein intake matters while a pressure injury is healing. Which response is best?

   • A.Protein directly increases oxygen delivery by widening local blood vessels
   • B.Protein supplies amino acids needed for collagen formation and tissue repair
   • C.Protein prevents all inflammatory responses at the wound site
   • D.Protein replaces the need for adequate calories and micronutrients

   Answer and rationale are in the full material.