HESI ADVANCED PATHOPHYSIOLOG V1 1. According to Walter B. Cannon, homeostasis is a stable internal environment
achieved through a system
... [Show More] of:
A) Interdependent system-wide adaptive responses
B) Variable internal and external conditioning factors
C) Coordinated physiologic processes that oppose change
D) Compatibility between cells and the internal environment
Ans: C
Feedback:
Walter B. Cannon identified homeostasis, achieved by a coordinated physiologic
process that opposes change. Claude Bernard recognized the importance of
compatibility between cells and the internal environment. Hans Selye identified the
general (systemic) adaptive and interdependent responses to stress. According to Selye,
stressors produce different responses due to the influence of adaptive internal or
external factors (conditioning factors).
2. A child has been experiencing hypoglycemic episodes. “How does the body
know when to secrete insulin and when to stop secreting it?” The best response by the
nurse, explaining the physiologic background, would be:
A) “The body knows that if the blood glucose level falls, it will inhibit insulin
secretion and release glycogen to release glucose from the liver.”
B) “It's just a big guessing game; first we give sugar like orange juice, and then we
withhold the carbohydrates if the blood glucose level is too high.”
C) “Your pituitary gland in the brain is the 'master gland,' and it controls and
regulates all the hormones.”
D) “Once the child starts getting confused, the brain will send a message to the
pancreas to stop producing insulin.”
Ans: A Feedback:
In the negative feedback mechanism that controls blood glucose levels, an increase in
blood glucose stimulates an increase in insulin, which enhances removal of glucose
from the blood. When glucose has been taken up by cells and blood glucose levels fall,
insulin secretion is inhibited and glucagon and other counterregulatory mechanisms
stimulate release of glucose from the liver, which causes blood glucose levels to return
to normal.
3. A client presents to the emergency department following a major traffic accident.
Though outwardly there are no apparent physical injuries found, the client is
experiencing chest pain and heightened alertness, which the health care worker
attributes to the first stage of general adaptation syndrome (GAS). The health care
worker concludes the client is experiencing manifestations related to the release of:
A) Aldosterone, which interferes with sodium absorption
B) Epinephrine
C) Too little cortisol
D) Thyroid-stimulating hormone
Ans: B
Feedback:
The general adaptation syndromes has three stages—the first is alarm (fight or flight);
second is resistance (fight); and the third is exhaustion. The alarm stage is characterized
by a generalized stimulation of the sympathetic nervous system (SNS) and the HPA,
resulting in release of catecholamines and cortisol. Increased insulin release or TSH
release is not part of the GAS.
4. Although stress exposure initiates integrated responses by multiple systems, the
functional results are first manifested as: Select all that apply.
A) Enhanced respiratory rate/depth
B) Cravings for high-carbohydrate foods
C) Increased alertness and focus
D) Increased glucose utilization
E) Increased GI peristalsis
Ans: A, C, D
Feedback:
Exposure to stress activates an immediate response by the neuroendocrine system that
plays a role in most of the responses to stress and attempts to adapt. Results of the
coordinated release of these neurohormones include mobilization of energy, a
sharpened focus and awareness, increased cerebral blood flow and glucose utilization,
enhanced cardiovascular and respiratory functioning, redistribution of blood flow to
the brain and muscles, modulation of the immune response, inhibition of reproductive
function, and a decrease in appetite.
5. A client is experiencing significant stress while awaiting the results of her recent
lymph node biopsy. Among the hormonal contributors to this response is a release of
aldosterone, resulting in which of the following physiologic effects?
A) Decreased release of insulin
B) Increased cardiac contractility
C) Potentiating effects of epinephrine [Show Less]