NACE Physiological Adaptation 5

Question 1

A patient with cirrhosis develops asterixis, confusion, and elevated ammonia levels. Which physiological process is occurring?

Accepted Answer

Hepatic encephalopathy from impaired ammonia detoxification

Answer

Hepatic encephalopathy results from the failing liver's inability to convert ammonia to urea, allowing ammonia to cross the blood-brain barrier and impair neurological function.

Question 2

A patient on mechanical ventilation has a PaCO2 of 55 mmHg and pH of 7.28. The ventilator rate is 12 breaths/min. What adjustment would correct the respiratory acidosis?

Accepted Answer

Increase the respiratory rate

Answer

Increasing the respiratory rate increases minute ventilation, eliminating more CO2 and correcting respiratory acidosis.

Question 3

A patient develops compartment syndrome in the left leg after a tibial fracture. Which assessment finding is most diagnostic?

Accepted Answer

Pain out of proportion to injury unrelieved by opioids, worsened with passive stretch

Answer

Pain disproportionate to the injury that worsens with passive muscle stretching is the hallmark early sign of compartment syndrome due to elevated intracompartmental pressure.

Question 4

A patient with heart failure is prescribed furosemide. Which electrolyte imbalance is the priority concern?

Accepted Answer

Hypokalemia

Answer

Loop diuretics like furosemide inhibit sodium-potassium-chloride reabsorption in the loop of Henle, causing significant potassium wasting and hypokalemia.

Question 5

A patient with Addison's disease presents with severe hypotension, hyponatremia, and hyperkalemia. Which pathophysiological mechanism explains these findings?

Accepted Answer

Aldosterone deficiency impairing sodium retention and potassium excretion

Answer

Aldosterone deficiency in Addison's disease prevents sodium reabsorption and potassium excretion in the kidney, leading to hyponatremia, hyperkalemia, and volume depletion.

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

NACE Physiological Adaptation 5