Basic Concepts of Pathophysiology & Implications for Nursing
Questions 1 & 2 below refer to the following situation:
A 55-year-old man with emphysema (a ... [Show More] type of chronic lung disease) who has smoked 2 packs of
cigarettes per day for 40 years is hospitalized for acute onset of cough productive of bloody
sputum (sputum=secretions from deep in the lungs). After a few days of testing and treatment,
the patient’s nurse reads a physician’s note on the chart: “I have told the patient that the
etiologies of his hemoptysis are: 1) exacerbation of his chronic emphysema and 2) the new
diagnosis of lung cancer. The onsets of both were contributed to by his longstanding smoking.”
1. The patient asks the nurse for more information. Which of the following explanations to
the patient best indicates a full understanding of the patient’s situation?
a. “You have a disease process that was iatrogenically caused by cigarette smoking.”
Incorrect: “iatrogenically” means caused by a medical person.
b. “You have a sudden onset of a chronic lung disease that was brought on by lung
cancer.” Incorrect: the chronic lung disease was part of the medical history of the
patient; the term “chronic” means a long-standing disease, not a “sudden onset.”
c. “The coughing up of blood is caused by a worsening of a disease you’ve had for a
long time plus a new problem-- lung cancer.”
d. “These diseases have been creeping up on you for probably 20 years; it just goes to
show that you should never have taken up smoking.” Incorrect: no evidence in the
scenario to support this sentence. (Besides, it sounds very judgmental.)
2. Based on all the information you have on the patient, which statement is most likely
a. The patient has a poor prognosis because of the comorbidities of lung cancer and
cigarette smoking. Incorrect: Smoking is a risk factor not a disease that would fit
the term “comorbidity.”
b. Lung cancer was a sequela of the bloody sputum. Incorrect: the bloody sputum
was part of the S&S of cancer; this answer implies the bloody sputum caused the
c. A precipitating factor for the acute hospitalization was overexertion when the patient
started an exercise class. Incorrect: no evidence in the scenario to support this
d. Heavy cigarette smoking was a risk factor in the patient’s developing emphysema
and lung cancer.
ANSWERS & RATIONALES to ASSIGNMENT #1
(Basic Concepts of Pathophysiology & Implications for Nursing, Genetic Influence, Intracellular Functions)
Academic honesty reminder: It is ok to discuss the assignments with other students as a learning tool, but it is
considered a breach of academic honesty to copy answers directly from each other.
Also, when taking a test, do not have this or any other informational document visible.
Questions 3 & 4 refer to the following situation: An 80-year-old patient is in shock from loss of
blood following an accident. His vital signs are: BP 80/50 (normal ~ 120/80), HR 120 (norm =
60-100), RR 20 (norm = 12 to 20), T 98.6 (norm ~ 98.6).
3. In assessing this patient, the nurse understands that the abnormal HR is
a. probably the etiology for the patient’s low BP. Incorrect: the shock is due to the
“loss of blood.” A state of shock has a “big picture” of low BP, high HR, cool hands,
weakness, feeling faint, and/or passing out. In this context the high HR doesn’t
CAUSE the low BP.
b. due to the patient’s heart compensating for low blood volume by pumping faster.
c. the normal compensatory response of shunting blood volume to the periphery.
Incorrect: shunting blood to the periphery IS a compensatory response, but it is a
“co-response” with high HR; one doesn’t cause the other.
d. due to multiple risk factors. Incorrect: no evidence in the scenario to support this
sentence. (TIP: when you are deciding on answers, plug them each into the stem
of the question & ask yourself if it makes sense. Ex—does this sentence make
sense? “In assessing this patient, the nurse understands that the abnormal HR is
due to multiple risk factors.” Hopefully you see that no, it doesn’t make sense.) [Show Less]