ELECTIVE 1 b.

Isotonic dehydration
c. Hypotonic dehydration
FINAL EXAM d. None of the above

NAME: ____________________________________ 6. Signs and Symptoms of Hyponatremic Dehydration include the

following, except?
SECTION: _____________ a. Nausea and vomiting
b. Diminished skin turgor
Multiple Choice Questions: c. Increased sodium
d. Dry mucous membranes
1. The maintenance of hydration depends on a balance 7. Alternative routes of hydration when the oral route Is no
between intake and output, which is regulated by longer reliable are the following, except?
neuroendocrine influences. Which one of the following a. Rehydration by proctoclysis
refers to this parallel neuroendocrine activity? b. SC Hypodermoclysis
a. Homeostasis
c. IV Peripheral & IV Central
b. Renal excretion
d. None of the above
c. Antidiuretic hormone (ADH)
d. Thirst
8. Malnutrition is a common problem in patients with
2. Which of the following is the prime stimulus for thirst chronic, advanced, debilitating illnesses such as
stimulating the release of vasopressin, an antidiuretic acquired immunodeficiency syndrome (AIDS) or cancer.
hormone (ADH): A complex syndrome characterized by loss of appetite,
a. Increased osmotic pressure; generalized tissue wasting, skeletal muscle atrophy,
b. Hypertonicity; immune dysfunction, and a variety of metabolic
c. Depletion of the extracellular fluid compartment alterations is known as?
arising from vomiting, diarrhea, or hemorrhage; a. Anorexia
d. Renal failure, in which plasma sodium is low but b. Cancer cachexia
plasma renin levels are high. c. Asthenia
d. Fatigue
3. This types of dehydration results from a balanced loss of Situation no. 1.
water and sodium. Dehydration and rehydration at the end of life have expected
potential effects depending on the body system being assessed.
a. Hypertonic dehydration
9. As to the general appearance, which of the following is the
b. Isotonic dehydration expected effect of dehydration?
c. Hypotonic dehydration a. Edema
d. None of the above b. Improved appearance
c. Sunken eyes
4. If water losses are greater than sodium losses. This type d. Decreased saliva
of dehydration is known as?
a. Hypertonic dehydration 10. As with the gastrointistinal tract involvement, the following are
b. Isotonic dehydration the expected effects of dehydration, except ?
c. Hypotonic dehydration a. More normal bowel function
d. None of the above b. Constipation
c. Decreased secretions
d. Less vomiting

11. As with the urinary tract involvement, the following are the
expected effects of rehydration, except ?
Date: ____________ a. Improved renal drug clearance
Ratings: ___________ b. Reduced toxic metabolites
c. Reduced renal function
d. May need more drug administration

5. When sodium loss exceeds water loss. This typically 12. As with the pulmonary involvement, the following are the
occurs when water is consumed but food is not. This type expected effects of dehydration, except ?
of dehydration is known as? a. Dry airway, viscous secretions
a. Hypertonic dehydration
 b. Reduced congestion, wheezing, dyspnea, pleural 18. Which one of the following nerves,carries sensory
effusions information from the lungs that initiates the cough reflex.
c. Facilitates productive cough a. Vagus
d. Reduced secretions, cough b. Hypoglossal
c. Glossopharyngeal
Situation no. 2 d. None of the above
Management of patients with dyspnea requires an
understanding of its multidimensional nature and the 19. Cough is considered chronic when it last?
pathophysiologic mechanisms that cause this distressing a. 2 weeks
symptom. The following questions have reference to the b. 4 weeks
Pathophysiologic Mechanisms of Dyspnea.
c. 6 weeks
d. 8 weeks
13. Which one of the following is the rationale for an
Increased Ventilatory Demand of patients with dyspnea?
20. when the sputum contains blood, hemoptysis occurs.
a. Increased physiological dead space
Massive hemoptysis is expectoration of at least how many
b. Restrictive ventilatory deficit mL of blood in 24 hours?
c. Obstructive ventilatory deficit a. 50 to 100 mL
d. None of the above b. 100 to 150 mL
c. 100 to 200 mL
d. 100 to 600 mL

Situation no. 4
14. Causes of Increased Ventilatory Demand of patients with The following questions deal with neurological
dyspnea are the following, except? disturbances.
a. Thromboemboli
b. Vascular obstruction 21. This neurological disturbance consists of sudden,
c. Emphysema uncontrollable, nonrhythmic jerking, usually of the
d. Chronic obstructive pulmonary disease extremities and is frequently seen in the palliative care
15. Causes of Restrictive ventilatory deficit of patients with setting which is known as ...
dyspnea are the following, except? a. Seizure
a. Cachexia b. Spasticity
b. Electrolyte imbalances c. Headache
c. Peripheral muscle weakness d. Myoclonus
d. Chronic obstructive pulmonary disease
22. Of the many neurological disorders that occur in
16. Causes of Obstructive ventilatory deficit of patients with advanced disease, which one is the most frightening.
a. Seizure
dyspnea are the following, except?
b. Spasticity
a. Asthma
c. Headache
b. Tumor obstruction
d. Myoclonus
c. Electrolyte imbalances
d. Chronic obstructive pulmonary disease 23. A movement disorder that results in a partial or complete
loss of supraspinal control of spinal cord function is
17. Which one of the following describes the noise produced which one of the following?
by the turbulent movements of secretions in the upper a. Seizure
airways that occur with the inspiratory and expiratory b. Spasticity
phases of respiration in patients who are dying? c. Headache
a. Dyspneic rattle d. Myoclonus
b. Pleural Effusion rattle Situation no. 5
Delirium, confusion, agitation and restlessness are common
c. Death rattle symptoms in the palliative care setting and are extremely distressing
d. None of the above to both patient and family. The following questions deal with these
symptoms.
Situation no. 3
Cough is a natural defense of the body to prevent entry of 24. It is a common neuropsychiatric disorder seen in all
foreign material into the respiratory tract. In people with health care settings, and is frequently under-diagnosed,
advanced disease, it can be very debilitating, leading to misdiagnosed, and poorly managed. Often, patients are labeled
sleepless nights, fatigue, pain and, at times, pathological as “confused” and no further evaluation is performed to
fractures. determine the cause of this confusion. This refers to which one
of the following?
 a. Delirium
b. Confusion
c. Agitation
d. Restlessness

25. A common, observable syndrome often seen in the

final days of life. It is characterized by (1) frequent,
nonpurposeful motor activity, (2) inability to concentrate
or relax, (3) disturbances in sleep/rest patterns, (4)
fluctuating levels of consciousness, cognitive failure,
and/or anxiety, and (5) potential progression to agitation.
This refers to which one of the following?
a. Delirium
b. Confusion
c. Agitation
d. Restlessness