HESI PATHOPHYSIOLOGY FNP V2 2023 - 2 0 2 4 / PATHOPHYSIOLOGY H E S I FNP R E A L 100 PRACTICE QUESTIONS AND ANSWERS

1. Upon admission assessment, the nurse hears a murmur located at the fifth intercostal space, midclavicular line. The client asks, “What does that mean?” The nurse will base her answer on which of the following physiologic principles?
A) “You have been exposed to an infection that went into your blood stream.”
B) “You have a heart valve that is diseased.”
C) “You heart has been pumping your blood so hard, that the pressure has damaged your valves.”
D) “Your heart has enlarged, so naturally your valves had to enlarge as well.”
Ans: B
Feedback: Turbulence is often accompanied by vibrations of the blood and surrounding cardiovascular structures. Some of these vibrations are in the audible range and can be heard using a stethoscope. For example, a heart murmur results from turbulent flow through a diseased heart valve. The other distractors are not feasible.
2. A client is diagnosed with an abdominal aortic aneurysm that the physician just wants to “watch” for now. When teaching the client about signs/symptoms to watch for, the nurse will base the teaching on which of the following physiological principles?
A) Small diameter of this vessel will cause it to rupture more readily.
B) The larger the aneurysm, the less tension placed on the vessel.
C) As the aneurysm grows, more tension is placed on the vessel wall, which increases the risk for rupture.
D) The primary cause for rupture relates to increase in abdominal pressure such as straining to have a bowel movement.
Ans: C
Feedback: Because the pressure is equal throughout, the tension in the part of the balloon with the smaller radius is less than the tension in the section with the larger radius. The same holds true for an arterial aneurysm in which the tension and risk of rupture increase as the aneurysm grows in size. Wall tension is inversely related to wall thickness, such that the thicker the vessel wall, the lower the tension, and vice versa. Although arteries have a thicker muscular wall than veins, their distensibility allows them to store some of the blood that is ejected from the heart during systole, providing for continuous flow through the capillaries as the heart relaxes during diastole.

3. A client has entered hypovolemic shock after massive blood loss in a car accident. Many of the client's peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon?
A) Blood pressure is no longer able to overcome vessel wall tension.
B) Decreasing vessel radii has caused a decrease in blood pressure.
C) Wall thickness of small vessels has decreased due to hypotension.
D) Decreases in wall tension and blood pressure have caused a sudden increase in vessel radii.
Ans: A
Feedback: In circulatory shock, there is a decrease in blood volume and vessel radii, along with a drop in blood pressure. As a result, many of the small vessels collapse as blood pressure drops to the point where it can no longer overcome the wall tension. Decreases in vessel wall radii do not cause the decrease in blood pressure, and wall thickness generally remains static.
4. Which of the following statements about vascular compliance is accurate?
A) Arteries are much more distensible than veins.
B) Veins can act as a reservoir for storing large quantities of blood.
C) Arteries have thick muscular walls that constrict tightly, thereby ejecting blood without storing it for later use.
D) A continuous flow through the capillaries occurs primarily during systole.
Ans: B