Pathophysiology Chapter 12- Test Bank

A compensation for shock would include: A) increased heart rate and oliguria. B) lethargy and decreased responsiveness. C) warm, dry, flushed skin. D) weak, thready pulse.

A

A modifiable factor that increases the risk for atherosclerosis is: A) leading a sedentary lifestyle. B) being female and older than 40 years of age. C) excluding saturated fats from the diet. D) familial hypercholesterolemia.

A

A prolonged period of shock is likely to cause: A) damage to, and increased permeability of, pulmonary capillaries. B) increased permeability of the glomerular capillaries of the kidneys. C) increased pH of blood and body fluids. D) increased systemic vasoconstriction.

A

Common signs of rheumatic fever include all of the following EXCEPT: A) arthritis, causing deformity of the small joints in the hands and feet. B) erythematous skin rash and subcutaneous nodules. C) epistaxis, tachycardia, and fever. D) elevated ASO titer and leukocytosis.

A

In the period immediately following a myocardial infarction, the manifestations of pallor and diaphoresis, rapid pulse, and anxiety result from: A) onset of circulatory shock. B) the inflammatory response. C) release of enzymes from necrotic tissue. D) heart failure.

A

Low-density lipoproteins (LDL): A) promote atheroma development. B) contain only small amounts of cholesterol. C) transport cholesterol from cells to the liver for excretion. D) are associated with low intake of saturated fats.

A

Paroxysmal nocturnal dyspnea is marked by: A) hemoptysis and rales. B) distended neck veins and flushed face. C) bradycardia and weak pulse. D) cardiomegaly.

A

Septic emboli, a common complication of infective endocarditis, are a result of the fact that: A) vegetations are loosely attached and fragile. B) the valves are no longer competent. C) cardiac output is reduced. D) heart contractions are irregular.

A

The most common cause of death immediately following a myocardial infarction is: A) cardiac arrhythmias and fibrillation. B) ruptured ventricle or aorta. C) congestive heart failure. D) cerebrovascular accident.

A

The term preload refers to: A) volume of venous return. B) peripheral resistance. C) stroke volume. D) cardiac output.

A

Uncontrolled hypertension is most likely to cause ischemia and loss of function in the: A) kidneys, brain, and retinas of the eye. B) peripheral arteries in the legs. C) aorta and coronary arteries. D) liver, spleen, and stomach.

A

When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals? A) Blood pressure remains consistently above 140/90 B) Blood pressure fluctuates between 130/85 and 180/105 C) Blood pressure increases rapidly and is unresponsive to medication D) Chronic kidney disease leads to consistently elevated blood pressure

A

Which factor predisposes to varicose veins during pregnancy? A) Compressed pelvic veins B) Stenotic valves in leg veins C) Thrombus formation D) Insufficient muscle support for veins

A

Which of the following actions causes the atrioventricular (AV) valves to close? A) Increased intraventricular pressure B) Depolarization at the AV node C) Ventricular relaxation and backflow of blood D) Contraction of the atria

A

Which of the following applies to subacute infective endocarditis? A) A microbe of low virulence attacks abnormal or damaged heart valves. B) Virulent microbes invade normal heart valves. C) No permanent damage occurs to the valves. D) Prophylactic medication does not prevent infection.

A

Which of the following describes the blood flow occurring with a ventricular septal defect? A) From the left ventricle to the right ventricle B) From the right ventricle to the left ventricle C) Increased cardiac output from the left ventricle D) Mixed oxygenated and unoxygenated blood in the systemic circulation

A

Which of the following is a result of increased secretion of epinephrine? A) Increased heart rate and force of contraction B) Decreased stimulation of the SA node and ventricles C) Vasoconstriction in skeletal muscles and kidneys D) Vasodilation of cutaneous blood vessels

A

An atheroma develops from: A) a torn arterial wall and blood clots. B) accumulated lipids, cells, and fibrin where endothelial injury has occurred. C) thrombus forming on damaged walls of veins. D) repeated vasospasms.

B

An echocardiogram is used to demonstrate any abnormal: A) activity in the conduction system. B) movement of the heart valves. C) change in central venous pressure. D) blood flow in coronary arteries.

B

Aortic stenosis means the aortic valve: A) allows blood to leak back into the left ventricle during diastole. B) cannot fully open during systole. C) functions to increase stroke volume. D) does not respond to the cardiac cycle.

B

Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following? 1. Gangrenous ulcers in the legs 2. Strong rapid pulses in the legs 3. Intermittent claudication 4. Red, swollen legs A) 1, 2 B) 1, 3 C) 2, 3 D) 2, 4

B

Cardiac output refers to: A) the amount of blood passing through either of the atria. B) the volume of blood ejected by a ventricle in one minute. C) the volume of blood ejected by each ventricle in a single contraction. D) the total number of heartbeats in one minute.

B

Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include: A) slow cardiac contractions. B) increased renin and aldosterone secretions. C) decreased erythropoietin secretion. D) fatigue and cold intolerance.

B

Confirmation of the diagnosis of a myocardial infarction would include: 1. specific changes in the ECG. 2. marked leukocytosis and increased erythrocyte sedimentation rate (ESR). 3. elevation of cardiac isoenzymes in serum. 4. a pattern of pain. A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4

B

Cyanosis occurs in children with tetralogy of Fallot because: A) more carbon dioxide is present in the circulating blood. B) a large amount of hemoglobin in the general circulation is unoxygenated. C) the pulmonary circulation is overloaded and congested. D) the circulation is sluggish (slow) throughout the system.

B

In a child with acute rheumatic fever, arrhythmias may develop due to the presence of: A) endocarditis. B) myocarditis. C) pericarditis. D) congestive heart failure.

B

In an infant, the initial indication of congestive heart failure is often: A) distended neck veins. B) feeding problems. C) low-grade fever and lethargy. D) frequent vomiting.

B

More extensive permanent damage is likely when a myocardial infarction is caused by: A) a hemorrhage. B) an embolus. C) a thrombus. D) an arrhythmia.

B

Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because: A) platelets attach to the inflamed wall. B) thrombus forms in a vein and is less firmly attached. C) leg cramps require massage. D) systemic signs of inflammation require treatment.

B

Rheumatic heart disease usually manifests in later years as: A) swollen heart valves and fever. B) cardiac arrhythmias and heart murmurs. C) thrombus formation and septic emboli. D) petechial hemorrhages of the skin and mucosa.

B

Significant signs of right-sided congestive heart failure include: A) severe chest pain and tachycardia. B) edematous feet and legs with hepatomegaly. C) frequent cough with blood-streaked frothy sputum. D) orthopnea, fatigue, increased blood pressure.

B

The definition of congestive heart failure is: A) cessation of all cardiac activity. B) inability of the heart to pump enough blood to meet the metabolic needs of the body. C) insufficient circulating blood in the body. D) the demand for oxygen by the heart is greater than the supply.

B

Typical early signs or symptoms of myocardial infarction include: A) brief, substernal pain radiating to the right arm, with labored breathing. B) persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse. C) bradycardia, increased blood pressure, and severe dyspnea. D) flushed face, rapid respirations, left-side weakness, and numbness.

B

What are the early signs of circulatory shock? 1. Pale moist skin 2. Loss of consciousness 3. Anxiety and restlessness 4. Rapid strong pulse A) 1, 2 B) 1, 3 C) 1, 4 D) 3, 4

B

When stroke volume decreases, which of the following could maintain cardiac output? A) Decreased peripheral resistance B) Increased heart rate C) Decreased venous return D) General vasodilation

B

Which of the following describes the pericardial cavity? A) It contains sufficient fluid to provide a protective cushion for the heart. B) It is a potential space containing a very small amount of serous fluid. C) It is lined by the endocardium. D) It is located between the double-walled pericardium and the epicardium.

B

Why does anaphylactic shock cause severe hypoxia very quickly? A) Generalized vasoconstriction reduces venous return. B) Bronchoconstriction and bronchial edema reduce airflow. C) Heart rate and contractility are reduced. D) Metabolic rate is greatly increased.

B

Why does ventricular fibrillation result in cardiac arrest? A) Delayed conduction through the AV node blocks ventricular stimulation. B) Insufficient blood is supplied to the myocardium. C) The ventricles contract before the atria. D) Parasympathetic stimulation depresses the SA node.

B

With shock, anaerobic cell metabolism and decreased renal blood flow cause: A) metabolic alkalosis. B) metabolic acidosis. C) decreased serum potassium. D) increased serum bicarbonate.

B

A friction rub is associated with: A) infectious endocarditis. B) arrhythmias. C) pericarditis. D) an incompetent aortic valve.

C

A partial obstruction in a coronary artery will likely cause: A) pulmonary embolus. B) hypertension. C) angina attacks. D) myocardial infarction.

C

A source of an embolus causing an obstruction in the brain could be the: A) femoral vein. B) pulmonary vein. C) carotid artery. D) coronary artery.

C

An incompetent mitral valve would cause: A) increased blood to remain in the right atrium. B) hypertrophy of the right ventricle. C) decreased output from the left ventricle. D) decreased pressure in the left atrium.

C

Cigarette smoking is a risk factor in coronary artery disease because smoking: A) reduces vasoconstriction and peripheral resistance. B) decreases serum lipid levels. C) promotes platelet adhesion. D) increases serum HDL levels.

C

Excessive fluid in the pericardial space causes: A) increased cardiac output. B) myocardial infarction. C) reduced venous return. D) friction rub.

C

Factors that may precipitate an angina attack include all of the following EXCEPT: A) eating a large meal. B) engaging in an angry argument. C) taking a nap. D) shoveling snow on a cold, windy day.

C

In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure? A) Veins of the legs and feet B) Jugular veins C) Pulmonary capillaries D) Blood vessels of the liver and spleen

C

Pericarditis causes a reduction in cardiac output as a result of which of the following? A) Delays in the conduction system, interfering with cardiac rhythm B) Weak myocardial contractions due to friction rub C) Excess fluid in the pericardial cavity, which decreases ventricular filling D) Incompetent valves, which allow regurgitation of blood

C

Shock is defined as: A) failure of the heart to supply sufficient blood to body cells. B) general hypoxia, causing damage to various organs. C) decreased circulating blood and tissue perfusion. D) loss of blood, causing severe hypoxia.

C

The basic pathophysiology of myocardial infarction is best described as: A) cardiac output that is insufficient to meet the needs of the heart and body. B) temporary vasospasm that occurs in a coronary artery. C) total obstruction of a coronary artery, which causes myocardial necrosis. D) irregular heart rate and force, reducing blood supply to coronary arteries.

C

The classic early manifestation(s) of left-sided congestive heart failure is/are ____, whereas the early indicator(s) of right-sided failure is/are _______. A) palpitations and periodic chest pain; shortness of breath on exertion B) swelling of the ankles and abdomen; chest pain C) shortness of breath on exertion or lying down; swelling of the ankles D) coughing up frothy sputum; hepatomegaly and splenomegaly

C

The most common cause of a myocardial infarction is: A) an imbalance in calcium ions. B) an infection of the heart muscle. C) atherosclerosis involving an attached thrombus. D) a disruption of the heart conduction system.

C

The outcome for many aortic aneurysms is: A) early diagnosis and repair. B) thrombus formation and pulmonary embolus. C) rupture and hemorrhage. D) pressure on adjacent organs or structures.

C

The term arteriosclerosis specifically refers to: A) development of atheromas in large arteries. B) intermittent vasospasm in coronary arteries. C) degeneration with loss of elasticity and obstruction in small arteries. D) ischemia and necrosis in the brain, kidneys, and heart.

C

The term intermittent claudication refers to: A) sensory deficit in the legs due to damage to nerves. B) chest pain related to ischemia. C) ischemic muscle pain in the legs, particularly with exercise. D) dry, cyanotic skin with superficial ulcers.

C

Vasodilation in the skin and viscera results directly from: A) decreased blood pressure. B) increased parasympathetic stimulation. C) relaxation of smooth muscle in the arterioles. D) increased stimulation of alpha-adrenergic receptors.

C

What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease? A) It promotes more rapid healing of ulcerated areas. B) It improves circulation to other areas. C) It prevents spread of infection and reduces pain. D) It reduces swelling in the peripheral areas.

C

What would indicate decompensated acidosis related to shock? A) Serum bicarbonate level below normal B) PCO2 above normal C) Serum pH below normal range D) Urine pH of 4.5

C

Which of the following confirms the presence of a myocardial infarction? A) A full description of the pain, including the sequence of development B) The presence of elevated serum cholesterol and triglycerides C) Serum isoenzymes released from necrotic cells and an ECG D) Leukocytosis and elevated C-reactive protein

C

Which of the following factors greatly improves venous return to the heart during strenuous exercise? A) Rapid emptying of the right side of the heart B) Forceful action of the valves in the veins C) Contraction and relaxation of skeletal muscle D) Peristalsis in the large veins

C

Which of the following is considered to be the most dangerous arrhythmia? A) Tachycardia B) Bradycardia C) Ventricular fibrillation D) Second-degree heart block

C

Which of the following statements regarding aneurysms is true? A) Aneurysms are always caused by congenital malformations. B) The greatest danger with aneurysms is thrombus formation. C) Manifestations of aneurysms result from compression of adjacent structures. D) Aneurysms involve a defect in the tunica media of veins.

C

Which statement applies to paroxysmal nocturnal dyspnea? A) It indicates decreased CO2 diffusion in the lungs. B) It indicates swelling in the bronchioles and bronchi. C) It is caused by increased blood in the lungs when lying in a supine position. D) It results from pleural effusion.

C

A dissecting aortic aneurysm develops as: A) a dilation or bulge that develops at one point on the aortic wall. B) a thrombus that accumulates at a point in the aortic wall. C) a section of the aorta that weakens and dilates in all directions. D) a tear in the intimal lining, which allows blood flow between layers of the aortic wall.

D

A sign of aortic stenosis is: A) increased cardiac output. B) congestion in the liver, spleen, and legs. C) flushed face and headache. D) a heart murmur.

D

A very rapid heart rate reduces cardiac output because: A) venous return is increased. B) ventricular fibrillation develops immediately. C) conduction through the AV node is impaired. D) ventricular filling is reduced.

D

In a child with ventricular septal defect, altered blood flow: A) leads to increased stroke volume from the left ventricle. B) results in unoxygenated blood in the systemic circulation. C) is called a right-to-left shunt. D) is called a left-to-right shunt.

D

Pericarditis may be caused by: 1. infection. 2. abnormal immune responses. 3. injury. 4. malignant neoplasm. A) 1, 2 B) 3, 4 C) 1, 3, 4 D) 1, 2, 3, 4

D

Shock follows a myocardial infarction when: A) the stress response causes general vasodilation. B )fluid is lost into ischemic tissues. C) heart valves are damaged. D) a large portion of the myocardium is damaged.

D

The basic pathophysiological change associated with essential hypertension is: A) development of lipid plaques in large arteries. B) recurrent inflammation and fibrosis in peripheral arteries. C) degeneration and loss of elasticity in arteries. D) increased systemic vasoconstriction.

D

The cause of essential hypertension is considered to be: A) chronic renal disease. B) excessive intake of saturated fats and salt. C) sedentary lifestyle. D) idiopathic.

D

The function of the baroreceptors is to: A) stimulate the parasympathetic or sympathetic nervous system at the sinoatrial (SA) node as needed. B) adjust blood pressure by changing peripheral resistance. C) sense a change in blood oxygen and carbon dioxide levels. D) signal the cardiovascular control center of changes in systemic blood pressure.

D

The initial effect on the heart in cases of rheumatic fever is: A) infection in the heart by hemolytic streptococci. B) highly virulent microbes causing vegetations on the heart valves. C) septic emboli obstructing coronary arteries. D) acute inflammation in all layers of the heart due to abnormal immune response.

D

The most common factor predisposing to the development of varicose veins is: A) trauma. B) congenital valve defect in the abdominal veins. C) infection. D) increased venous pressure.

D

The normal delay in conduction through the AV node is essential for: A) preventing an excessively rapid heart rate. B) limiting the time for a myocardial contraction. C) allowing the ventricles to contract before the atria. D) completing ventricular filling.

D

The right side of the heart would fail first in the case of: 1. severe mitral valve stenosis. 2. uncontrolled essential hypertension. 3. large infarction in the right ventricle. 4. advanced chronic obstructive pulmonary disease (COPD). A) 1, 2 B) 2, 3 C) 1, 4 D) 3, 4

D

The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following EXCEPT: A) previously established collateral circulation. B) immediate administration of thrombolytic drugs. C) maintaining maximum oxygen supply to the myocardium. D) removing the predisposing factors to atheroma development.

D

The term cardiac arrest refers to which of the following? A) Condition where cardiac output is less than the demand B) A decreased circulating blood volume C) Missing a ventricular contraction D) The cessation of all cardiac function

D

When comparing angina with myocardial infarction (MI), which statement is true? A) Both angina and MI cause tissue necrosis. B) Angina often occurs at rest; MI occurs during a stressful time. C) Pain is more severe and lasts longer with angina than with MI. D) Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is not.

D

Which change results from total heart block? A) A prolonged PR interval B) Periodic omission of a ventricular contraction C) A wide QRS wave D) Spontaneous slow ventricular contractions, not coordinated with atrial contraction

D

Which of the following are predisposing factors to thrombus formation in the circulation? 1. Decreased viscosity of the blood 2. Damaged blood vessel walls 3. Immobility 4. Prosthetic valves A) 1, 3 B) 2, 4 C) 1, 3, 4 D) 2, 3, 4

D

Which of the following causes increased heart rate? A) Stimulation of the vagus nerve B) Increased renin secretion C) Administration of beta-blocking drugs D) Stimulation of the sympathetic nervous system

D

Which of the following is NOT true of the drug nitroglycerin? A) It decreases myocardial workload by causing systemic vasodilation. B) It may be administered sublingually, transdermally, or by oral spray. C) Dizziness or syncope may follow a sublingual dose. D) It strengthens the myocardial contraction.

D

Which of the following is most likely to cause left-sided congestive heart failure? A) Incompetent tricuspid heart valve B) Chronic pulmonary disease C) Infarction in the right atrium D) Uncontrolled essential hypertension

D

Which of the following compensations that develop in patients with congestive heart failure eventually increase the workload of the heart? A) Faster heart rate and cardiomegaly B) Peripheral vasoconstriction C) Increased secretion of renin D) A and C E) A, B, and C

E