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CYU WEEK 4
Question 1
0 out of 0.125 points
The nurse provides teaching regarding dietary intake of potassium to avoid an
electrolyte imbalance when a patient
Selected Answer:
c. experiences anorexia and chronic oliguric renal failure.
Correct Answer:
a. has chronic heart failure that is treated with diuretics.
Response
Feedback:

Chronic heart failure causes increased secretion of aldosterone, which often causes
hypokalemia by increasing renal excretion of potassium; most diuretics used to treat
heart failure also increase renal excretion of potassium. Vitamin D and malabsorption of
fat decreases absorption of calcium, not potassium. Chronic oliguric renal failure causes
decreased excretion of potassium. An anorexic patient with chronic oliguric renal failure
should not increase dietary potassium.
Question 2
0.125 out of 0.125 points
Which is indicative of a left tension pneumothorax?
Selected Answer:
b. Absent breath sounds on the left
Correct Answer:
b. Absent breath sounds on the left
Response
Feedback:

A left pneumothorax results in absent breath sounds on the affected side. Crackles will
not be heard because breath sounds are not present. Tracheal deviation occurs on the
contralateral side. Pneumothorax results in acute respiratory alkalosis.
Question 3
0 out of 0.125 points
When exposed to inhaled allergens, a patient with asthma produces large
quantities of
Selected Answer:
c. IgG.
Correct Answer:
a. IgE.
Response
Feedback:

During an allergic response, plasma cells produce large quantities of IgE. IgG, IgA, and
IgM are not part of the pathophysiology of asthma.
Question 4
0.125 out of 0.125 points
A person who has hyperparathyroidism is likely to develop
Selected Answer:
d. hypercalcemia.
Correct Answer:
d. hypercalcemia.
Response
Feedback:
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Question 5
A person who has hyperparathyroidism is likely to develop hypercalcemia, because
parathyroid hormone causes calcium to come out of the bones and go to the ECF.
Hypokalemia, hyperkalemia, and hypocalcemia are not the result of
hyperparathyroidism.
0.125 out of 0.125 points
Viral pneumonia is characterized by
Selected Answer:
a. a dry cough.
Correct Answer:
a. a dry cough.
Response
Feedback:
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No exudative fluids are produced. Viral pneumonia does not produce exudates, so the
cough is non-productive. Ventilation-perfusion imbalance does not usually occur in
viral pneumonia.
Question 6
0.125 out of 0.125 points
Pneumocystitis is a term that refers to a
Selected Answer:
b. fungal pneumonia secondary to HIV.
Correct Answer:
b. fungal pneumonia secondary to HIV.
Response
Feedback:
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Pneumocystitis is a fungal pneumonia secondary to HIV. Pneumocystitis is not a viral
pneumonia found in transplant recipients, a non-infectious inflammation of the lung, or
a pneumonia secondary to bladder infection.
Question 7
0.125 out of 0.125 points
Causes of hypomagnesemia include
Selected Answer:
d. chronic alcoholism.
Correct Answer:
d. chronic alcoholism.
Response
Feedback:

Hypomagnesemia is common with chronic alcoholism. Hyperphosphatemia causes
hypocalcemia. Oliguric renal failure and clinical dehydration reduce magnesium
excretion.
Question 8
0.125 out of 0.125 points
Allergic (extrinsic) asthma is associated with
Selected Answer:
d. IgE-mediated airway inflammation.
Correct Answer:
d. IgE-mediated airway inflammation.
Response
Feedback:
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Extrinsic (allergic) asthma is mediated by IgE triggers. Allergic (extrinsic) asthma
involves hyperresponsiveness of the airways. Antigens are the precipitating factors.
Airway obstruction is reversible.
Question 9
0.125 out of 0.125 points
Abnormalities in intracellular regulation of enzyme activity and cellular
production of ATP are associated with
Selected Answer:
d. hypophosphatemia.
Correct Answer:
d. hypophosphatemia.
Response
Feedback:
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Question 10
Phosphate is an important component of ATP. Hypophosphatemia results in decreased
ATP to cells. Hyponatremia, hypocalcemia, and hypokalemia do not affect ATP
production.
0.125 out of 0.125 points
Which electrolyte imbalances cause increased neuromuscular excitability?
Selected Answer:
b. Hypocalcemia and hypomagnesemia
Correct Answer:
b. Hypocalcemia and hypomagnesemia
Response
Feedback:
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Hypocalcemia and hypomagnesemia both cause increased
neuromuscular excitability.
Hypokalemia, hyperkalemia, hypophosphatemia, hypercalcemia,
and hypermagnesemia do not cause increased neuromuscular
excitability.
Question 11
0.125 out of 0.125 points
A patient diagnosed with chronic compensated heart failure reports that, “My
feet swell if I eat salt but I don’t understand why” The nurse’s best response is
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Selected
Answer:
c. “Salt holds water in your blood and makes more pressure against your blood
vessels, so fluid leaks out into your tissues and makes them swell.”
Correct
Answer:
c. “Salt holds water in your blood and makes more pressure against your blood
vessels, so fluid leaks out into your tissues and makes them swell.”
Response
Feedback:
Salt holds water in the ECV, thus increasing capillary hydrostatic pressure. Gravity leads
to feet swelling, but it does not explain what the patient is asking. Salt does not cause
vasodilation, nor does it bind to blood proteins and change osmotic pressure.
Question 12
0.125 out of 0.125 points
Which assessment would support a diagnosis of type A COPD rather than type
B COPD
Selected
Answer:
d.
Normal PaCO 2, scant sputum, accessory muscle use, barrel
chest
Correct Answer:
d.
Normal PaCO2, scant sputum, accessory muscle use, barrel
chest
Response
Feedback:
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Barrel chest and obvious respiratory effort that maintains near
normal blood gases are consistent with type A COPD in the early
stages. Copious sputum, dyspnea, and cor pulmonale are
consistent with type B COPD. Noisy breath sounds, fatigue, high
PaCO 2, and overweight are consistent with type B COPD. Barrel
chest, productive cough, cyanosis, and very decreased PaO 2 are
not consistent with type A COPD.
Question 13
Excessive antidiuretic hormone (ADH) secretion can cause _____
concentration.
0.125 out of 0.125 points
Selected Answer:
b. decreased serum sodium
Correct Answer:
b. decreased serum sodium
Response
Feedback:

Excessive ADH stimulates excessive water reabsorption by the kidneys, which dilutes
the blood, thus decreasing the serum sodium concentration. Excessive ADH secretion
does not cause increased serum sodium or potassium concentrations, or decreased
serum potassium concentration.
Question 14
0 out of 0.125 points
Which is true about epiglottitis? ( Select all that apply.)
Selected Answers:
c. Is characterized by pain with swallowing
d. Can be caused by bacterial infection
e. Usually occurs in children
Correct Answers:
a.
Is usually caused by H. influenzae type B
c. Is characterized by pain with swallowing
d. Can be caused by bacterial infection
e. Usually occurs in children
Response
Feedback:

Epiglottitis is usually caused by H. influenzae type B, but can be
caused by bacteria. It usually occurs in children and is
characterized by pain with swallowing. This condition is a medical
emergency and requires immediate intervention.
Question 15
0.125 out of 0.125 points
The characteristic x-ray findings in tuberculosis include
Selected Answer:
a. Ghon tubercles.
Correct Answer:
a. Ghon tubercles.
Response
Feedback:
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Tuberculosis results in Ghon tubercles that show up as nodules with infiltrates. Diffuse
white-out, basilar infiltrates, and tracheal deviation are not characteristic x-ray
findings in tuberculosis.
Question 16
0.125 out of 0.125 points
What is likely to lead to hyponatremia?
Selected Answer:
b. Frequent nasogastric tube irrigation with water
Correct Answer:
b. Frequent nasogastric tube irrigation with water
Response
Feedback:
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Question 17
Sodium is lost from gastric secretions when nasogastric tubes are irrigated with water.
The sodium diffuses into the irrigating water and is then lost when the aspirate is
withdrawn. Excessive ADH would lead to hyponatremia by retention of water in the
body, thus diluting the sodium. Excess aldosterone would increase serum sodium.
Normal saline is an isotonic solution and will not alter the serum sodium.
0.125 out of 0.125 points
All obstructive pulmonary disorders are characterized by
Selected Answer:
b. resistance to airflow.
Correct Answer:
b. resistance to airflow.
Response
Feedback:

Obstructive lung diseases are characterized by increased resistance to airflow. Only
asthma is characterized by hyperresponsiveness. Increased residual volume is common
in obstructive pulmonary disorders. Emphysema is characterized by increased lung
compliance caused by a loss of alveoli and elastic tissue.
Question 18
0.125 out of 0.125 points
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
Selected Answer:
a. deficiency of ATP.
Correct Answer:
a. deficiency of ATP.
Response
Feedback:
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Clinical manifestations of severe symptomatic hypophosphatemia are caused by a
deficiency of ATP. Phosphate is an important component of ATP, which is the major
source of energy for many cellular substances. Severe symptomatic hypophosphatemia
does not cause excess protein accumulation, damage the kidneys, or cause hypocalcemia.
Question 19
0.125 out of 0.125 points
The primary cause of infant respiratory distress syndrome is
Selected Answer:
c. lack of surfactant.
Correct Answer:
c. lack of surfactant.
Response
Feedback:

The primary cause of this disorder is lack of surfactant. While
premature infants may demonstrate this disorder, the actual cause
is lack of surfactant. It is a syndrome seen in premature infants.
Maternal illegal drug use during pregnancy and umbilical cord
compression are not the primary causes of infant respiratory
distress syndrome.
Question 20
0.125 out of 0.125 points
What age group has a larger volume of extracellular fluid than intracellular fluid?
Selected Answer:
b. Infants
Correct Answer:
b. Infants
Response
Feedback:
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Question 21
Infants have a larger volume of extracellular fluid than intracellular fluid. Adolescents,
young adults, and older adults have a larger volume of intracellular fluid than
extracellular fluid.
0.125 out of 0.125 points
When a parent asks how they will know if their 2-month-old baby, who is
throwing up and has frequent diarrhea, is dehydrated, the nurse’s best response
is
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Selected
Answer:
b. “If the soft spot on the top of his head feels sunken in and his mouth is dry between
his cheek and his gums, then he is probably dehydrated.”
Correct
Answer:
b. “If the soft spot on the top of his head feels sunken in and his mouth is dry between
his cheek and his gums, then he is probably dehydrated.”
Response
Feedback:
Checking whether the head feels sunken and the mouth is dry between check and gums
are useful assessments of ECV deficit in an infant, which is an important part of clinical
dehydration. It is true that clinical dehydration is the combination of extracellular fluid
volume deficit and hypernatremia, but it does not address the question Mr. Worry is
asking. Although the diaper information provides a useful assessment, neck veins are not
a reliable assessment in an infant. Drowsiness and fatigue are not reliable assessments
for dehydration.
Question 22
0.125 out of 0.125 points
When a parent of a toddler recently diagnosed with pneumococcal pneumonia
asks why their child is so much sicker than a classmate was when they were
diagnosed with pneumonia, the nurse replies
Selected
Answer:
c. “It sounds like your child has a case of bacterial pneumonia, while the classmate
had viral pneumonia.”
Correct
Answer:
c. “It sounds like your child has a case of bacterial pneumonia, while the classmate
had viral pneumonia.”
Response
Feedback:

Viral pneumonia does not produce exudate so the cough is non-productive. In general,
symptoms of viral pneumonia are less severe than those of bacterial pneumonia. The
uncle’s case of viral pneumonia has less acute symptoms than the children’s case of
bacterial pneumonia. Pneumococcal pneumonia is not necessarily more severe in
children. The children most likely have bacterial pneumonia, which is why their
symptoms are more acute than the classmate’s case of viral pneumonia.
Question 23
0.125 out of 0.125 points
Clinical manifestations of hyponatremia include
Selected Answer:
a. confusion, lethargy, coma, and perhaps seizures.
Correct Answer:
a. confusion, lethargy, coma, and perhaps seizures.
Response
Feedback:

Clinical manifestations of hyponatremia include confusion, lethargy, coma, and perhaps
seizures, as they are manifestations of CNS dysfunction. Weak pulse, low blood pressure,
and increased heart rate are characteristic of clinical dehydration. Hyponatremia does
not cause thirst, dry mucous membranes, and diarrhea. Cardiac dysrhythmias,
paresthesias, and muscle weakness are manifestations of electrolyte imbalances.
Question 24
0.125 out of 0.125 points
A major risk factor for the development of active pulmonary tuberculosis (TB)
disease is
Selected Answer:
a. immunosuppression.
Correct Answer:
a. immunosuppression.
Response
Feedback:
Immunosuppressed individuals, such as those with HIV, are at high risk for active TB
disease. Contaminated water and gender are not major risk factors for pulmonary
tuberculosis. Excessive use of antibiotics can lead to opportunistic yeast and fungal
infections or cause bacterial resistance to available antibiotics, but it is not a major risk
factor for TB.
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Question 25
0.125 out of 0.125 points
The imbalance that occurs with oliguric renal failure is
Selected Answer:
a. hyperkalemia.
Correct Answer:
a. hyperkalemia.
Response
Feedback:

Oliguric renal failure decreases potassium excretion, which causes hyperkalemia.
Oliguric renal failure decreases acid excretion and causes metabolic acidosis (not
alkalosis). Oliguric renal failure does not cause hypokalemia or hypophosphatemia.
Question 26
0.125 out of 0.125 points
Which alterations can lead to edema?
Selected Answer:
b. Decreased lymphatic flow
Correct Answer:
b. Decreased lymphatic flow
Response
Feedback:

Lymphatic obstruction prevents the drainage of accumulated interstitial fluid and
proteins, which can lead to severe edema. Decreased capillary hydrostatic pressure
would push less fluid into the interstitial space. Increased capillary colloid osmotic
pressure would remove fluid from the interstitial space. Decreased capillary membrane
permeability would allow less fluid movement into the interstitial space.
Question 27
0.125 out of 0.125 points
A patient exhibiting respiratory distress as well as a tracheal shift should be
evaluated for
Selected Answer:
a. pneumothorax.
Correct Answer:
a. pneumothorax.
Response
Feedback:
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Pneumothorax leads to a tracheal shift to the side opposite the pneumothorax.
Pneumonia, pulmonary edema, and pulmonary embolus do not lead to tracheal shift.
Question 28
0.125 out of 0.125 points
The fraction of total body water (TBW) volume contained in the intracellular
space in adults is
Selected Answer:
a. two thirds.
Correct Answer:
a. two thirds.
Response
Feedback:
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Approximately two thirds of TBW is contained inside the cells. Two thirds, not three
fourths, of TBW is contained inside the cells. Two thirds, not one-half, of TBW is
contained inside the cells. One-third of the TBW is extracellular in adults.
Question 29
Signs and symptoms of clinical dehydration include
0.125 out of 0.125 points
Selected Answer:
b. decreased urine output.
Correct Answer:
b. decreased urine output.
Response
Feedback:
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One clinical manifestation of dehydration is decreased urine output. Skin turgor and
blood pressure decrease in clinical dehydration. Heart rate increases in clinical
dehydration.
Question 30
0.125 out of 0.125 points
Airway obstruction in chronic bronchitis is because of
Selected Answer:
a. thick mucus, fibrosis, and smooth muscle hypertrophy.
Correct Answer:
a. thick mucus, fibrosis, and smooth muscle hypertrophy.
Response
Feedback:

Airway obstruction in chronic bronchitis is as a result of thick mucus, fibrosis, and
smooth muscle hypertrophy. Loss of alveolar elastin, pulmonary edema, and hyperplasia
and deformation of bronchial cartilage are not part of the pathophysiology of chronic
bronchitis.
Question 31
0 out of 0.125 points
The inward-pulling force of particles in the vascular fluid is called _____
pressure.
Selected Answer:
d. interstitial osmotic
Correct Answer:
b. capillary osmotic
Response
Feedback:
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Capillary osmotic pressure is the inward-pulling force of particles in the vascular fluid.
Capillary hydrostatic pressure is an outward-pulling. The question pertains to vascular
fluid rather than interstitial fluid. Interstitial hydrostatic pressure is an outward-pulling
force.
Question 32
0.125 out of 0.125 points
Air that enters the pleural space during inspiration but is unable to exit during
expiration creates a condition called
Selected Answer:
c. tension pneumothorax.
Correct Answer:
c. tension pneumothorax.
Response
Feedback:

Air that enters the pleural space during inspiration but is unable to exit during
expiration causes a tension pneumothorax. The question does not describe open
pneumothorax, pleural effusion, or empyema.
Question 33
0.125 out of 0.125 points
The electrolyte that has a higher concentration in the extracellular fluid than in
the intracellular fluid is _____ ions.
Selected Answer:
d. sodium
Correct Answer:
d. sodium
Response
Feedback:

Extracellular fluid has a higher sodium ion concentration than does intracellular fluid.
Intracellular fluid has a higher phosphate, magnesium, and potassium ion
concentration than does extracellular fluid.
Question 34
0.125 out of 0.125 points
After evaluation, a child’s asthma is characterized as “extrinsic.” This means
that the asthma is
Selected Answer:
a. associated with specific allergic triggers.
Correct Answer:
a. associated with specific allergic triggers.
Response
Feedback:

Extrinsic asthma is also referred to as allergic asthma, which is triggered by antigens.
The underlying pathogenesis of extrinsic asthma is an allergic in nature. Intrinsic
asthma is associated with respiratory infections. Intrinsic asthma is associated with
psychological factors.
Question 35
0.125 out of 0.125 points
The hypersecretion of mucus resulting for chronic bronchitis is the result of
Selected Answer:
a. recurrent infection.
Correct Answer:
a. recurrent infection.
Response
Feedback:

Mucus provides a hospitable environment for bacterial colonization and recurrent
infection. Destruction of alveolar septa and reduced inflammation are not complications
of chronic bronchitis. Hypersecretion of mucus does not contribute to barrel chest.
Question 36
0.125 out of 0.125 points
Chronic occupational lung disease is characterized by ( Select all that apply.)
Selected Answers:
b. a progressive cough and dyspnea with exercise.
c. causation from long-term inhalation of inorganic material.
d. possible negative chest x-ray when symptom-free.
e. a latent period before symptoms occur.
Correct Answers:
b. a progressive cough and dyspnea with exercise.
c. causation from long-term inhalation of inorganic material.
d. possible negative chest x-ray when symptom-free.
e. a latent period before symptoms occur.
Response
Feedback:

Chronic occupational lung disease is caused by long-term inhalation of inorganic
material. A latent period of 10 to 20 years may ensue before symptoms occur. One of the
earliest manifestations is a progressive cough and dyspnea on exertion. The disease
cannot be ruled out by a negative chest x-ray. Impairment of macrophage function is the
primary mechanism through which inorganic particles initiate lung disease.
Question 37
0.125 out of 0.125 points
Decreased neuromuscular excitability is often the result of
Selected Answer:
b. hypercalcemia and hypermagnesemia.
Correct Answer:
Response
Feedback:

b. hypercalcemia and hypermagnesemia.
Hypercalcemia and hypermagnesemia result in decreased neuromuscular excitability.
Hypomagnesemia, hypocalcemia, and hypomagnesemia result in increased
neuromuscular excitability.
Question 38
0.125 out of 0.125 points
Osmoreceptors located in the hypothalamus control the release of
Selected Answer:
c. vasopressin (antidiuretic hormone, ADH).
Correct Answer:
c. vasopressin (antidiuretic hormone, ADH).
Response
Feedback:

Factors that increase secretion of ADH into the blood include increased osmolality of the
blood, which is sensed by osmoreceptors in the hypothalamus. Release of angiotensin,
atrial natriuretic peptide, and aldosterone is not controlled by osmoreceptors in the
hypothalamus.
Question 39
0.125 out of 0.125 points
How is a patient hospitalized with a malignant tumor that secretes parathyroid
hormone–related peptide monitored for the resulting electrolyte imbalance?
Selected Answer:
a. Serum calcium, bowel function, level of consciousness
Correct Answer:
a. Serum calcium, bowel function, level of consciousness
Response
Feedback:

Question 40
Parathyroid hormone increases the plasma calcium concentration, and constipation and
lethargy are manifestations of hypercalcemia. Parathyroid hormone increases the plasma
calcium concentration, but these are signs of increased neuromuscular excitability, which
occurs with hypocalcemia. Parathyroid hormone affects plasma concentration of calcium,
not potassium.
0.125 out of 0.125 points
The assessment findings of a 5-year-old with a history of asthma include
extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use
of accessory respiratory muscles. There is no wheezing and the chest is silent
in many areas. How should you interpret your assessment?
Selected
Answer:
c. The child may be having such a severe asthma episode that the airways are closed,
so start oxygen and get the doctor immediately.
Correct
Answer:
c. The child may be having such a severe asthma episode that the airways are closed,
so start oxygen and get the doctor immediately.
Response
Feedback:
The airway inflammation, edema, and bronchoconstriction of acute asthma may occlude
small airways completely, so that no air is moving, which requires emergency
intervention. Alicia has a history of asthma rather than pneumonia. Asthma can occur
without wheezing. This is an emergency situation that requires you to start oxygen and
notify the physician.