NCLEX-RN Pathology Practice Questions (210 Flashcards)

Immobility causes mucus to pool in dependent airways due to gravity and decreased surfactant production. This leads to atelectasis (alveolar collapse), which creates an environment for bacterial growth (hypostatic pneumonia). \n\nNCLEX Strategy: The priority intervention is frequent position changes every 2 hours and incentive spirometry to mobilize secretions and expand alveoli. Distractor: Deep vein thrombosis is a vascular, not respiratory, pathology.

**Cardiogenic shock** is characterized by pump failure. A **low CI (<2.2)** indicates inadequate systemic perfusion. The **high Pulmonary Artery Wedge Pressure (PAWP >18)** reflects blood backing up into the pulmonary vasculature because the left ventricle cannot effectively eject volume. This distinguishes it from hypovolemic shock (where PAWP is low). NCLEX Tip: Treatment focuses on increasing contractility (Dobutamine) and reducing afterload/preload, NOT aggressive fluid boluses which worsen pulmonary edema and gas exchange.

Decorticate Posturing (Flexion). \n\nPathophysiology: Indicates damage to the corticospinal tract or cerebral hemispheres. The Flexor response (pulling toward the Core) suggests the midbrain is still somewhat functional but higher brain centers are compromised. \n\nComparison: Decerebrate Posturing (Extension) involves abduction and external rotation of arms with extension. This indicates more severe damage to the brainstem (midbrain/pons). \n\nNCLEX Key: On the Glasgow Coma Scale (GCS), Decorticate scores 3 for motor, while Decerebrate scores 2. Decerebrate is the worse sign. Changes from decorticate to decerebrate indicate worsening herniation.

NSAIDs inhibit the cyclooxygenase (COX-1) enzyme, which is essential for the synthesis of prostaglandins in the gastric mucosa. Prostaglandins are protective; they stimulate mucus and bicarbonate secretion, maintain mucosal blood flow, and promote cell regeneration. Without these defenses, the gastric lining becomes vulnerable to the corrosive effects of hydrochloric acid and pepsin. Exam Strategy: NCLEX often tests the synergy between NSAIDs and H. pylori; a patient with both has a significantly higher risk of bleeding. Educate patients to take NSAIDs with food, though this doesn't fully eliminate the systemic risk.

Both are associated with Osteoarthritis (OA). Heberden's nodes occur at the Distal Interphalangeal (DIP) joints. Bouchard's nodes occur at the Proximal Interphalangeal (PIP) joints. NCLEX Distractor: These are NOT found in Rheumatoid Arthritis. In RA, you see Boutonnière and Swan-neck deformities and ulnar drift.