HESI RN
RN Pathophysiology NGN Exam Questions
Question 1 of 5
At 0800, the client has ______ metabolic acidosis ______ related to ______ increase in metabolic acid ______
Correct Answer: B,C,D
Rationale: The incomplete statement requires selecting the most likely options to fill the blanks accurately. Lactated Ringer's (LR) is the fluid of choice in metabolic acidosis because it is alkalinizing (contains lactate, which is metabolized to bicarbonate). Starting LR at 100 mL/hr addresses fluid resuscitation and helps correct acidosis. ABG every 4 hours is essential to monitor pH, PaCO₂, and HCO₃⁻ trends. Vital signs every 4 hours detect hemodynamic instability. Option A (admit to medical unit) is a location, not a direct intervention for acidosis.
Question 2 of 5
The nurse is caring for a client who is admitted to the renal unit with pyelonephritis. The client is experiencing flank pain and fever upon admission. Which laboratory result supports the underlying pathophysiological mechanism that explains these findings? Reference Range: White blood cells (WBC) 5,000 to 10,000/mm³ (5 to 10 x 10â¹/L)
Correct Answer: D
Rationale: Pyelonephritis is a bacterial infection of the renal pelvis and parenchyma. Classic signs are flank pain, fever, and urinary symptoms. Urinalysis showing hematuria (blood) and pyuria (pus/WBCs) directly confirms inflammation/infection in the urinary tract. Option shows a normal WBcount, which does not support systemic infection. IVP and sandlike granules are unrelated to acute pyelonephritis symptoms.
Question 3 of 5
The nurse administers lactated Ringer's to a client with burns. For which reason is lactated Ringer's (LR) solution the IV infusion of choice for a client in the emergent phase of a burn injury?
Correct Answer: A
Rationale: In the emergent (resuscitative) phase of burns, massive capillary permeability causes fluid to shift from intravascular to interstitial space, leading to hypovolemia. LR is isotonic and replaces lost volume without causing RBhemolysis (unlike hypotonic fluids). It also provides electrolytes and lactate (converted to bicarbonate) to combat metabolic acidosis from tissue hypoxia. Options B, C, and are incorrect: LR is isotonic, not hypotonic; dextrose is not primary; whole blood is not routine in early burn resuscitation.
Question 4 of 5
Which is the pathophysiological basis for Parkinson's disease?
Correct Answer: A
Rationale: Parkinson's disease results from degeneration of dopamine-producing neurons in the substantia nigra, leading to dopamine deficiency in the basal ganglia. This causes bradykinesia, rigidity, and tremor. Myelin disruption is seen in multiple sclerosis. Serotonin imbalance is linked to mood disorders. Acetylcholine decrease is more relevant in Alzheimer's.
Question 5 of 5
An older adult client with type 2 diabetes mellitus presents to the emergency department (ED) with a respiratory infection. The nurse recognizes that the client is at risk for hyperosmolar hyperglycemic state (HHS) as a result of which process?
Correct Answer: A
Rationale: Infection acts as a stressor, triggering counter-regulatory hormones (cortisol, glucagon, epinephrine) that raise blood glucose. In type 2 DM, this can precipitate HHS (severe hyperglycemia >600 mg/dL, hyperosmolarity, dehydration without significant ketoacidosis). Fever, elevated WBC, and antibiotics are present but not the primary mechanism driving HHS.