Midterm Check Your Understanding
A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is a.unstable angina. b.coronary vasospasm. c.myocardial infarction. d.stable angina.
d.stable angina.
Administration of a vasodilator to a patient in shock would be expected to a. decrease left ventricular afterload. b. increase tissue perfusion. c. increase contractility. d. decrease vascular resistance.
a. decrease left ventricular afterload.
The effects of excessive cortisol production include a. immune suppression b. hypoglycemia c. hypovolemia d. inflammatory reactions
a. immune suppression
The anemia resulting from a deficiency of either vitamin B 12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts. a. true b. false
a. true
Which clinical manifestation is not likely the result of a tuberculosis infection? a.Cyanosis b.Productive cough c.Night sweats d.Low-grade fever
a.Cyanosis
New-organ damage is a function of both the stage of hypertension and its duration. a.False b.True
a.False
Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions. a.False b.True
a.False
Which condition is associated with an elevated reticulocyte count? a.Hemolytic anemia b.Renal disease c.Hypertension d.Aplastic anemia
a.Hemolytic anemia
What age group has a larger volume of extracellular fluid than intracellular fluid? a.Infants b.Older adults c.Adolescents d.Young adults
a.Infants
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event? a.Inflammation, mucosal edema, and bronchoconstriction b.Mast cell degranulation that causes decreased surfactant c.Loss of alveolar elastin and premature closure of airways d.Pulmonary edema and decreased alveolar compliance
a.Inflammation, mucosal edema, and bronchoconstriction
Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following? a.It is a procedure for determining the extent of tumor spread. b.It is based on exploratory surgery. c.It is biochemical testing of tumor cells to determine the genetic basis of the tumor. d.It is a histologic examination of tissues to determine the degree of tumor differentiation.
a.It is a procedure for determining the extent of tumor spread.
Obstructive sleep apnea would most likely be found in a patient diagnosed with a.Pickwickian syndrome. b.pneumonia. c.myasthenia gravis. d.poliomyelitis.
a.Pickwickian syndrome.
Which pulmonary function test result is consistent with a diagnosis of asthma? a.Reduced forced expiratory volume in 1 second (FEV1) b.Increased FEV1 c.Decreased functional residual capacity d.Reduced total lung volume
a.Reduced forced expiratory volume in 1 second (FEV1)
Which disorder is associated with a type III hypersensitivity mechanism of injury? a.Systemic lupus erythematosus b.Erythroblastosis fetalis c.Graves disease d.Seasonal allergic rhinitis
a.Systemic lupus erythematosus
The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII. a.True b.False
a.True
The nurse is swabbing a patient's throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed sensitivity. a.True b.False
a.True
Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord. a.True b.False
a.True
Viral pneumonia is characterized by a.a dry cough b.significant ventilation-perfusion imbalance. c.a productive cough. d.exudative consolidation.
a.a dry cough
While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is a.activity restriction. b.chemotherapy. c.isolation. d.anticoagulant therapy.
a.activity restriction.
A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing a.acute cardiogenic pulmonary edema. b.cardiomyopathy c.a medication reaction. d.right-sided heart failure.
a.acute cardiogenic pulmonary edema.
All the following stress-induced hormones increase blood glucose except a.aldosterone. b.norepinephrine. c.epinephrine. d.cortisol.
a.aldosterone.
Tachycardia is an early sign of low cardiac output that occurs because of a.baroreceptor activity. b.anxiety. c.tissue hypoxia. d.acidosis.
a.baroreceptor activity.
Excessive red cell lysis can be detected by measuring the serum a.bilirubin. b.hemoglobin. c.methemoglobin. d.erythropoietin.
a.bilirubin.
Signs and symptoms of extracellular fluid volume excess include a.bounding pulse. b.tachycardia. c.increased hematocrit. d.increased serum sodium concentration.
a.bounding pulse.
Manifestations from sodium imbalances occur primarily as a result of a.cellular fluid shifts. b.vascular collapse. c.hyperosmolarity. d.hypervolemia.
a.cellular fluid shifts.
Signs and symptoms of clinical dehydration include a.decreased urine output. b.decreased heart rate. c.increased skin turgor. d.increased blood pressure.
a.decreased urine output.
Aortic regurgitation is associated with a.diastolic murmur. b.elevated systemic diastolic blood pressure. c.elevated left ventricular/aortic systolic pressure gradient. d.shortened ventricular ejection phase.
a.diastolic murmur.
The conversion of plasminogen to plasmin results in a.fibrinolysis. b.clot retraction. c.platelet aggregation. d.activation of thrombin.
a.fibrinolysis
The effects of histamine release include a.increased vascular permeability. b.bronchodilation. c.decreased gut permeability. d.vasoconstriction.
a.increased vascular permeability.
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is a.infection. b.alopecia. c.vomiting. d.anemia.
a.infection.
Reperfusion injury to cells a.involves formation of free radicals. b.occurs following nutritional injury. c.results from calcium deficiency in cells. d.results in very little cellular damage.
a.involves formation of free radicals.
Necrotic death of brain tissue usually produces _____ necrosis. a.liquefactive b.caseous c.fat d.coagulative
a.liquefactive
A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock. a.obstructive b.distributive c.hypovolemic d.cardiogenic
a.obstructive
The megakaryocyte is a precursor to a.platelets. b.factor IX. c.red blood cells. d.white blood cells.
a.platelets.
The goal of long term heparin for the management of a deep vein thrombosis is to a.prevent further clot formation. b.relieve edema. c.dissolve the thrombus. d.prevent clot dislodgement.
a.prevent further clot formation.
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing a.disseminated intravascular coagulation. b.von Willebrand disease. c.acquired vitamin K deficiency. d.vitamin K deficiency bleeding.
d.vitamin K deficiency bleeding.
When exposed to inhaled allergens, a patient with asthma produces large quantities of a.IgM. b.IgE. c.IgA. d.IgG.
b.IgE.
Which is not normally secreted in response to stress? a.Cortisol b.Insulin c.Epinephrine d.Norepinephrine
b.Insulin
A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia? a.Vitamin B12 deficiency b.Iron deficiency c.Erythropoietin deficiency d.Folate deficiency
b.Iron deficiency
Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body. a.False b.True
b.True
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. a.False b.True
b.True
A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm? a.Sinus bradycardia b.Ventricular escape rhythm c.Junctional tachycardia d.Third-degree heart block
b.Ventricular escape rhythm
Mitral stenosis is associated with a.left ventricular hypertrophy. b.a pressure gradient across the mitral valve. c.a prominent S4 heart sound. d.a muffled second heart sound (S2).
b.a pressure gradient across the mitral valve.
Selye's three phases of the stress response include all the following except a.resistance. b.allostasis. c.alarm. d.exhaustion.
b.allostasis.
Copious amounts of foul-smelling sputum are generally associated with a.epiglottitis. b.bronchiectasis. c.pulmonary edema. d.emphysema.
b.bronchiectasis.
Clinical manifestations of hyponatremia include a.weak pulse, low blood pressure, and increased heart rate. b.confusion, lethargy, coma, and perhaps seizures. c.cardiac dysrhythmias, paresthesias, and muscle weakness. d.thirst, dry mucous membranes, and diarrhea.
b.confusion, lethargy, coma, and perhaps seizures.
Hypernatremia may be caused by a.excessive dietary potassium. b.decreased antidiuretic hormone secretion. c.compulsive water drinking. d.decreased aldosterone secretion.
b.decreased antidiuretic hormone secretion.
Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration. a.increased serum potassium b.decreased serum sodium c.increased serum sodium d.decreased serum potassium
b.decreased serum sodium
Primary treatment for myocardial infarction (MI) is directed at a.activating the parasympathetic system. b.decreasing myocardial oxygen demands. c.protecting the heart from further ischemia. d.reducing heart rate and blood pressure.
b.decreasing myocardial oxygen demands.
The strength of the bond between oxygen and hemoglobin is known as the a.Bohr effect. b.oxygen-hemoglobin affinity. c.dissociation curve. d.hemoglobin synthesis.
b.oxygen-hemoglobin affinity.
A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for a.pneumonia. b.pneumothorax. c.pulmonary edema. d.pulmonary embolus.
b.pneumothorax.
A patient with pure left-sided heart failure is likely to exhibit a.peripheral edema. b.pulmonary congestion with dyspnea. c.jugular vein distention. d.hepatomegaly.
b.pulmonary congestion with dyspnea.
Left-sided heart failure is characterized by a.jugular vein distention. b.pulmonary congestion. c.decreased systemic vascular resistance. d.peripheral edema.
b.pulmonary congestion.
The ________ system compensates for metabolic acidosis and alkalosis. a.renal b.respiratory c.gastrointestinal d.cardiovascular
b.respiratory
The stage during which the patient functions normally, although the disease processes are well established, is referred to as a.latent. b.subclinical. c.prodromal. d.convalescence.
b.subclinical.
The progressive stage of hypovolemic shock is characterized by a.lactic acidosis. b.tachycardia. c.hypertension. d.cardiac failure.
b.tachycardia.
The activated partial thromboplastin time (aPTT) is a measure of the integrity of a.plasminogen. b.the intrinsic pathway. c.the extrinsic pathway. d.factor VIII synthesis.
b.the intrinsic pathway.
An example of an acyanotic heart defect is a.transposition of the great arteries. b.ventricular septal defect. c.tetralogy of Fallot. d.all right-to-left shunt defects.
b.ventricular septal defect.
Renal insufficiency is a common complication of which disease? a. Chronic myeloid leukemia (CML) b. Chronic lymphoid leukemia (CLL) c. Myeloma d. Hodgkin disease
c. Myeloma
Metabolic alkalosis is often accompanied by a.hyperkalemia. b.hypernatremia. c.hypokalemia. d.hyponatremia.
c.hypokalemia.
The cause of the most common form of anemia is a.protein malnutrition b.chronic disease. c.iron deficiency. d.acute bleeding.
c.iron deficiency.
Obstructive disorders are associated with a.low residual volumes. b.decreased total lung capacity. c.low expiratory flow rates. d.increased expiratory reserve volume.
c.low expiratory flow rates.
The most effective therapy for anemia associated with kidney failure is a.iron administration. b.vitamin B12 and folate administration. c.high-protein diet. d.erythropoietin administration.
d.erythropoietin administration.
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with a.low cardiac output. b.high afterload. c.reduced contractility. d.high cardiac output.
d.high cardiac output.
Decreased neuromuscular excitability is often the result of a.hypocalcemia and hypokalemia. b.hypernatremia and hypomagnesemia. c.hypomagnesemia and hyperkalemia. d.hypercalcemia and hypermagnesemia.
d.hypercalcemia and hypermagnesemia.
The body compensates for metabolic alkalosis by a.hyperventilation. b.decreasing arterial carbon dioxide. c.increasing bicarbonate ion excretion. d.hypoventilation.
d.hypoventilation.
Pernicious anemia is caused by a lack of a.folate. b.iron. c.erythropoietin. d.intrinsic factor.
d.intrinsic factor.
Clinical manifestations of moderate to severe hypokalemia include a.vomiting and diarrhea. b.confusion and irritability. c.muscle spasms and rapid respirations. d.muscle weakness and cardiac dysrhythmias.
d.muscle weakness and cardiac dysrhythmias.
Breast cancer in women who have the breast cancer gene a.is more likely to be unilateral. b.is more responsive to treatment. c.is more common than non-inherited breast cancer. d.occurs at an earlier age
d.occurs at an earlier age
Somatic death refers to death a.of nerve cells. b.of a body organ. c.secondary to brain damage. d.of the entire organism.
d.of the entire organism.
A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of a.secondary prevention. b.tertiary prevention. c.disease treatment. d.primary prevention.
d.primary prevention.
Hypertrophy of the right ventricle is a compensatory response to a.aortic stenosis. b.tricuspid stenosis. c.aortic regurgitation. d.pulmonary stenosis.
d.pulmonary stenosis
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction. a.I b.III c.IV d.II
b.III
The most common tumor-suppressor gene defect identified in cancer cells is a.DCC. b.P53. c.APC. d.Rb.
b.P53.
The arterial oxygen content (CaO 2) for a patient with PaO 2 100 mm Hg, SaO 2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL. a.21.05 b.210 c.1909.8 d.19.4
d.19.4
A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years. a.6 months and 2 b.25 and 45 c.15 and 18 d.4 and 7
d.4 and 7
Which type of leukemia primarily affects children? a.AML (acute myeloid leukemia) b.CLL (chronic lymphoid leukemia) c.CML (chronic myeloid leukemia) d.ALL (acute lymphoid leukemia)
d.ALL (acute lymphoid leukemia)
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock? a.Cardiogenic b.Hypovolemic c.Neurogenic d.Anaphylactic
d.Anaphylactic
Burkitt lymphoma is most closely associated with a.immunodeficiency syndromes. b.radiation exposure. c.history of cigarette smoking. d.Epstein-Barr virus.
d.Epstein-Barr virus.
Familial retinoblastoma involves the transmission of what from parent to offspring? a.Oncogene b.Extra chromosome c.Cancer-causing virus d.Mutant tumor-suppressor gene
d.Mutant tumor-suppressor gene
Which is not considered to be a risk factor for thrombus formation? a.Vascular trauma b.Stasis of blood flow c.Circulatory shock d.Thrombocytopenia
d.Thrombocytopenia
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called a.p53. b.Rb. c.ARA-c. d.bcr-abl.
d.bcr-abl.
The major buffer in the extracellular fluid is a.hemoglobin. b.albumin. c.phosphate. d.bicarbonate.
d.bicarbonate.
Patent ductus arteriosus is accurately described as a(n) a.opening between the atria. b.cyanotic heart defect associated with right-to-left shunt. c.stricture of the aorta that impedes blood flow. d.communication between the aorta and the pulmonary artery.
d.communication between the aorta and the pulmonary artery.
Apoptosis is a process that results in cellular a.proliferation. b.mutation. c.atrophy. d.death
d.death
Patients with immunodeficiency disorders are usually first identified because they a.develop brain infections. b.have unusually high WBC counts. c.run high fevers. d.develop recurrent infections.
d.develop recurrent infections.
Venous obstruction leads to edema because it ________ pressure. a.decreases tissue b.increases capillary oncotic c.increases arterial blood d.increases capillary hydrostatic
d.increases capillary hydrostatic
Coagulative necrosis is caused by a.trauma or pancreatitis. b.dissolving of dead cells and cyst formation. c.lung tissue damage. d.interrupted blood supply.
d.interrupted blood supply.
Hypertension is closely linked to a.urinary tract infection. b.de Quervain syndrome. c.spinal stenosis. d.obstructive sleep apnea.
d.obstructive sleep apnea
Fully compensated respiratory acidosis is demonstrated by a.pH 7.45, PaCO2 40, HCO3- 28. b.pH 7.40, PaCO2 40, HCO3- 24. c.pH 7.26, PaCO2 60, HCO3- 26. d.pH 7.36, PaCO2 55, HCO3- 36.
d.pH 7.36, PaCO2 55, HCO3- 36.
A laboratory test that should be routinely monitored in patients receiving digitalis therapy is a.serum sodium. b.serum calcium. c.albumin level. d.serum potassium.
d.serum potassium.
Rheumatic heart disease is most often a consequence of a.cardiomyopathy. b.chronic intravenous drug abuse. c.viral infection with herpesvirus. d.β-hemolytic streptococcal infection.
d.β-hemolytic streptococcal infection.
Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins. a.HLA or MHC b.antibody receptor c.complement d.TCR or BCR
a.HLA or MHC
Which change in a patient's assessment has the greatest urgency? a.Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing b.Serum calcium concentration is increasing; reports constipation; is alert and denies any discomfort c.Serum calcium concentration is decreasing; reports constipation; is alert and denies any discomfort d.Serum potassium concentration is decreasing; abdominal distention, but denies any difficulty breathing
a.Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing
When the cause is unknown, a condition is said to be idiopathic a.True b.False
a.True
Proto-oncogenes a.are normal cellular genes that promote growth. b.are the same as oncogenes. c.result from severe mutational events. d.lead to abnormal tumor-suppressor genes.
a.are normal cellular genes that promote growth.
Your patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is a.cigarette smoking. b.stressful lifestyle. c.urban pollutants. d.high-fat diet.
a.cigarette smoking.
Lack of α-antitrypsin in emphysema causes a.destruction of alveolar tissue. b.bronchoconstriction and airway edema. c.chronic mucous secretion and airway fibrosis. d.pulmonary edema and increased alveolar compliance.
a.destruction of alveolar tissue.
Red blood cells obtain nearly all their energy from metabolism of a.glucose. b.acetyl coenzyme A. c.proteins. d.fats.
a.glucose.
An important mediator of a type I hypersensitivity reaction is a.histamine. b.antigen-antibody immune complexes. c.complement. d.T cells.
a.histamine.
Respiratory alkalosis is caused by a.hyperventilation. b.pulmonary edema. c.chest muscle weakness. d.pneumonia.
a.hyperventilation.
A known cause of hypokalemia is a.insulin overdose. b.oliguric renal failure. c.hyperparathyroidism. d.pancreatitis.
a.insulin overdose.
After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor a.is malignant. b.has spread. c.is secondary to cancer elsewhere in the body. d.is benign.
a.is malignant.
After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will a.kill rapidly dividing cells b.stimulate immune cells to fight the cancer. c.selectively kill tumor cells. d.have minimal side effects.
a.kill rapidly dividing cells
The effect of stress on the immune system a.may involve enhancement or impairment the immune system. b.most often involves enhancement of the immune system. c.is unknown. d.has been demonstrated to be non-existent in studies.
a.may involve enhancement or impairment the immune system.
The finding of ketones in the blood suggests that a person may have a.metabolic acidosis. b.respiratory acidosis. c.respiratory alkalosis. d.metabolic alkalosis.
a.metabolic acidosis.
A loud pansystolic murmur that radiates to the axilla is most likely a result of a.mitral regurgitation. b.mitral stenosis. c.aortic stenosis. d.aortic regurgitation.
a.mitral regurgitation
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an Rh-_____ antibody titer carrying an Rh-_____ fetus. a.negative; negative; positive b.negative; positive; positive c.positive; negative; negative d.negative; negative; negative
a.negative; negative; positive
A person who experiences a panic attack and develops hyperventilation symptoms may experience a.numbness and tingling in the extremities. b.acute compensatory metabolic acidosis. c.neuromuscular depression. d.anxiety acidosis.
a.numbness and tingling in the extremities.
Indicators that an individual is experiencing high stress include all the following except a.pupil constriction. b.diaphoresis. c.tachycardia. d.increased peripheral resistance.
a.pupil constriction
An increase in organ size and function caused by increased workload is termed a.inflammation. b.atrophy. c.hypertrophy. d.metaplasia
c.hypertrophy.
When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will a.put a sputum cup and a box of tissues on the bedside table. b.remove the telephone to reduce myocardial oxygen demand. c.remove the water pitcher to comply with anticipated fluid restrictions. d.add a box of surgical masks to the nursing supplies near the door.
a.put a sputum cup and a box of tissues on the bedside table
The majority of tachydysrhythmias are believed to occur because of a.reentry mechanisms. b.triggered activity. c.enhanced automaticity. d.defective gap junctions.
a.reentry mechanisms.
The most common primary immune deficiency that affects only B cells is a. selective IgA. b. DiGeorge. c. Bruton agammaglobulinemia. d. Wiskott-Aldrich.
a.selective IgA.
C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.'s disease is a.streptococcal infection. b.a sore throat. c.pharyngitis. d.genetic susceptibility.
a.streptococcal infection.
A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with a.telangiectasia. b.purpura. c.petechiae. d.thrombocytosis.
a.telangiectasia.
Blood flow throughout the periphery is regulated by a.the autonomic nervous system. b.hemodynamics. c.velocity. d.cardiac output
a.the autonomic nervous system.
Airway obstruction in chronic bronchitis is because of a.thick mucus, fibrosis, and smooth muscle hypertrophy. b.loss of alveolar elastin. c.hyperplasia and deformation of bronchial cartilage. d.pulmonary edema.
a.thick mucus, fibrosis, and smooth muscle hypertrophy.
The effect of nitric oxide on systemic arterioles is a.vasodilation. b.opposed by nitrate drugs. c.vasoconstriction. d.not significant.
a.vasodilation
Osmoreceptors located in the hypothalamus control the release of a.vasopressin (antidiuretic hormone, ADH). b.aldosterone. c.angiotensin. d.atrial natriuretic peptide.
a.vasopressin (antidiuretic hormone, ADH).
Peripheral edema is a result of a.venous thrombosis. b.arterial insufficiency. c.hypertension. d.atherosclerosis.
a.venous thrombosis.
Neuromuscular disorders impair lung function primarily because of a.weak muscles of respiration. b.secondary pneumonia. c.inactivity secondary to the disorder. d.inflammatory events in the lung.
a.weak muscles of respiration.
In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive. a. true b. false
b. false
A diagnostic laboratory finding in myeloma is a.increased IgM antibody titer. b.Bence Jones proteins in the urine. c.elevated blood glucose levels. d.decreased platelet count.
b.Bence Jones proteins in the urine.
What is the correct definition of complete remission (CR) of leukemia? a.CR is less than 5% leukemic cells in the blood. b.CR is less than 5% blasts in marrow and normal CBC values. c.CR is absence of leukemic cells regardless of CBC values. d.CR is the absence of leukemic cells in the blood.
b.CR is less than 5% blasts in marrow and normal CBC values.
Which serum biomarker(s) are indicative of irreversible damage to myocardial cells? a.Prolonged coagulation time b.Elevated CK-MB, troponin I, and troponin T c.Markedly decreased CK-MB and troponin I d.Elevated LDL
b.Elevated CK-MB, troponin I, and troponin T
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. a.True b.False
b.False
Which disorder is considered a primary immunodeficiency disease? a.Malnutrition immunodeficiency b.HIV/AIDS c.Cancer immunodeficiency d.Radiation immunodeficiency
b.HIV/AIDS
A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) a.young sedentary male with a high-stress job. b.elderly woman without a previous history of MI c.young female athlete with cardiomegaly. d.middle-aged man with a previous history of MI.
b.elderly woman without a previous history of MI
A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is a.elevated MCHC and MCV. b.elevated total iron-binding capacity. c.positive direct or indirect Coombs test. d.elevated total and indirect bilirubin.
b.elevated total iron-binding capacity.
The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of a.platelet function. b.extrinsic pathway. c.fibrinolysis. d.intrinsic pathway.
b.extrinsic pathway.
A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with a.thrombocytopenia. b.hemophilia. c.disseminated intravascular coagulation. d.liver dysfunction.
b.hemophilia.
A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of a.myocardial infarction. b.hypertensive crisis. c.arthrosclerosis. d.angina.
b.hypertensive crisis.
Constrictive pericarditis is associated with a.elevated myocardial oxygen consumption. b.impaired cardiac filling. c.increased cardiac preload. d.cardiac hypertrophy.
b.impaired cardiac filling
Myasthenia gravis is a type II hypersensitivity disorder that involves a.symptoms of hyperthyroidism. b.impaired muscle function. c.symptoms of arthritis or polyarthralgia. d.symptoms of glomerular disease.
b.impaired muscle function.
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke a.introduces carcinogens into the lungs. b.impairs α1-antitrypsin, allowing elastase to predominate. c.predisposes to respiratory infections. d.paralyzes the cilia, causing impaired mucociliary clearance.
b.impairs α1-antitrypsin, allowing elastase to predominate.
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by a.decreased chest wall compliance. b.increased residual lung volumes. c.increased expiratory flow rates. d.increased pulmonary blood flow.
b.increased residual lung volumes.
The primary source of erythropoietin is provided by the a.bone marrow b.kidney. c.lung. d.liver.
b.kidney.
The most appropriate treatment for secondary polycythemia is a.chemotherapy. b.measured to improve oxygenation. c.volume expansion with saline. d.phlebotomy.
b.measured to improve oxygenation.
The prevalence of high blood pressure is higher in a.Mexican-American adults. b.non-Hispanic black adults. c.non-Hispanic white adults. d.Asian children.
b.non-Hispanic black adults.
Dysfunction of which organ would lead to clotting factor deficiency? a.Pancreas b.Spleen c.Liver d.Kidney
c.Liver
Which dysrhythmia is thought to be associated with reentrant mechanisms? a.Junctional escape b.Second-degree AV block c.Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome) d.Sinus bradycardia
c.Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance? a.Serum potassium, bowel function, level of consciousness b.Serum potassium, Chvostek and Trousseau signs c.Serum calcium, bowel function, level of consciousness d.Serum calcium, Chvostek and Trousseau signs
c.Serum calcium, bowel function, level of consciousness
The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment? a.Since there is not wheezing, asthma is the problem, but oxygen should be started immediately anyway. b.The child probably has consolidated pneumonia; oxygen should be started immediately. c.The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately. d.The signs and symptoms are consistent with asthma; start oxygen and then check to see that your stethoscope is working properly.
c.The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
Which is not considered to be a risk factor for thrombus formation? a.Stasis of blood flow b.Circulatory shock c.Thrombocytopenia d.Vascular trauma
c.Thrombocytopenia
What results when systemic blood pressure is increased? a.Decreased vascular resistance b.Decreased cardiac output c.Vasoconstriction d.Hypovolemia
c.Vasoconstriction
Individuals who have chronic bronchitis most often have a.a barrel chest. b.normal lung sounds. c.a productive cough. d.substantial weight loss.
c.a productive cough
Cancer grading is based on a.metastasis. b.tumor size. c.cell differentiation. d.local invasion.
c.cell differentiation.
Widespread activation of the clotting cascade secondary to massive trauma is called a.hemophilia B. b.Hageman disease. c.disseminated intravascular coagulation (DIC). d.idiopathic thrombocytopenia purpura.
c.disseminated intravascular coagulation (DIC).
Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because a.hypoxia resulting from bronchoconstriction impairs cardiac function. b.anaphylaxis results in large volume losses secondary to sweating. c.massive histamine release from mast cells leads to vasodilation. d.toxins released into the blood interfere with cardiac function.
c.massive histamine release from mast cells leads to vasodilation.
A primary effector cell of the type I hypersensitivity response is a.neutrophils. b.cytotoxic cells. c.mast cells. d.monocytes.
c.mast cells.
Asthma is categorized as a(n) a.infective pulmonary disorder. b.type of acute tracheobronchial obstruction. c.obstructive pulmonary disorder. d.restrictive pulmonary disorder.
c.obstructive pulmonary disorder.
The process responsible for distribution of fluid between the interstitial and intracellular compartments is a.active transport. b.diffusion. c.osmosis. d.filtration
c.osmosis.
Persistence of the alarm stage will ultimately result in a.stress reduction b.exhaustion of the sympathetic nervous system. c.permanent damage and death. d.movement into the resistance stage.
c.permanent damage and death.
First-degree heart block is characterized by a.widened QRS complex. b.absent P waves. c.prolonged PR interval. d.variable PR interval.
c.prolonged PR interval.
The hypersecretion of mucus resulting for chronic bronchitis is the result of a.reduced inflammation. b.barrel chest. c.recurrent infection. d.destruction of alveolar septa.
c.recurrent infection.
Beta-blockers are advocated in the management of heart failure because they a.enhance sodium absorption. b.increase cardiac output. c.reduce cardiac output. d.reduce blood flow to the kidneys.
c.reduce cardiac output.
The common denominator in all forms of heart failure is a.tissue ischemia. b.poor diastolic filling. c.reduced cardiac output. d.pulmonary edema.
c.reduced cardiac output.
A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of a.disease treatment. b.primary prevention. c.secondary prevention. d.tertiary prevention.
c.secondary prevention.
An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of a.disease treatment. b.primary prevention. c.secondary prevention. d.tertiary prevention.
c.secondary prevention.
Improvement in a patient with septic shock is indicated by an increase in a.SvO2. b.serum lactate level. c.systemic vascular resistance. d.cardiac output.
c.systemic vascular resistance.
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of a.angiogenesis. b.loss of ATP production. c.tumor necrosis factor. d.pain medications.
c.tumor necrosis factor.
Tissues are able to autoregulate their rate of blood flow by controlling a.arterial blood pressure. b.perfusion pressure. c.vascular resistance. d.venous return to the heart.
c.vascular resistance.
Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts resulting from cancer paraneoplastic syndromes is a. potassium b. tumor necrosis factor c. insulin d. calcium
d. calcium.
The final step in clot formation is a.conversion of prothrombin to thrombin. b.platelet degranulation and adhesion. c.conversion of fibrinogen to fibrin. d.clot retraction.
d.clot retraction.
A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is a."Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling." b."Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling." c."Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell." d."Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."
d."Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."
Which clinical finding is indicative of compartment syndrome? a.Peripheral edema b.Redness and swelling c.Atrophy of distal tissues d.Absent peripheral pulses
d.Absent peripheral pulses
Which acid are the kidneys unable to excrete? a.Bicarbonate b.Ammonia c.Metabolic d.Carbonic
d.Carbonic
The cellular component that is most susceptible to radiation injury is the a.ribosomes. b.RNA. c.membrane. d.DNA
d.DNA
Which alterations can lead to edema? a.Decreased capillary hydrostatic pressure b.Increased capillary colloid osmotic pressure c.Decreased capillary membrane permeability d.Decreased lymphatic flow
d.Decreased lymphatic flow
Increased preload of the cardiac chambers may lead to which patient symptom? a.Decreased respiratory rate b.Decreased heart rate c.Excitability d.Edema
d.Edema
While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding? a.Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain. b.Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease. c.Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant. d.Increased LDL levels are associated with increased risk of coronary artery disease.
d.Increased LDL levels are associated with increased risk of coronary artery disease.
Which condition enhances lymphatic flow? a.Increased tissue hydrostatic pressure b.Increased capillary oncotic pressure c.Decreased capillary hydrostatic pressure d.Increased interstitial fluid colloid osmotic pressure
d.Increased interstitial fluid colloid osmotic pressure
Which characteristic is indicative of hemolytic anemia? a.Hypovolemia b.Increased heart rate c.Increased total iron-binding capacity d.Jaundice
d.Jaundice
An elderly patient's blood pressure is measured at 160/98. How would the patient's left ventricular function be affected by this level of blood pressure? a.High-pressure workload leads to left ventricular atrophy. b.This is an expected blood pressure in the elderly and has little effect on left ventricular function. c.High blood pressure enhances left ventricular perfusion during systole. d.Left ventricular workload is increased with high afterload.
d.Left ventricular workload is increased with high afterload.
Which causes vasoconstriction? a.Calcium channel blocker b.α-Adrenergic antagonist c.Acetylcholine d.Norepinephrine
d.Norepinephrine
What laboratory finding is usually found in aplastic anemia? a.Leukocytosis b.Thrombocythemia c.Neutrophilia d.Pancytopenia
d.Pancytopenia
Angina caused by coronary artery spasm is called _____ angina. a.classic b.unstable c.stable d.Prinzmetal variant
d.Prinzmetal variant
The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation? a.P = Q/R b.R = PQ c.Q = R/P d.Q = P/R
d.Q = P/R
Sepsis has been recently redefined as a.a systemic inflammatory response to ischemia. b.a systemic infection with viable organisms in the bloodstream c.severe hypotension in an infected patient. d.a systemic inflammatory response to infection.
d.a systemic inflammatory response to infection.
The majority of cardiac cells that die after myocardial infarction do so because of a.cell rupture. b.thrombus. c.insufficient glucose. d.apoptosis.
d.apoptosis.
A cause of thrombocytopenia includes a.secondary polycythemia. b.hypoxemia. c.reduced erythropoietin. d.chemotherapy.
d.chemotherapy.
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)? a.Painless enlarged cervical lymph node, fever, weight loss b.Pain in long bones, infection, fever, bruising c.Vertebral fracture, hypercalcemia, bone pain d.Elevated WBC count found on routine examination, asymptomatic
b.Pain in long bones, infection, fever, bruising
COPD leads to a barrel chest, because it causes a.prolonged inspiration. b.air trapping. c.muscle atrophy. d.pulmonary edema.
b.air trapping.
A restrictive respiratory disorder is characterized by a.expiratory wheezing. b.decreased residual volume. c.inspiratory wheezing. d.increased total lung capacity.
b.decreased residual volume.
Of the statements below, the accurate statement regarding nutrition and cellular health is a.obese individuals are generally nutritionally healthy. b.deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types. c.a normal BMI indicates nutritional health. d.the body can generally produce elements essential for nutritional balance.
b.deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.
Severe combined immunodeficiency (SCID) syndrome is an example of a(n) a.primary acquired immunodeficiency. b.deficient immune response. c.excessive immune response. d.hypersensitivity reaction.
b.deficient immune response.
A common characteristic of viral pneumonia is a.increased white blood cell count. b.dry cough. c.high fever. d.alveolar infiltrates on a chest x-ray.
b.dry cough
Patients who experience anemic episodes when exposed to certain drugs most likely have a.spherocytosis. b.glucose-6-phosphate dehydrogenase deficiency. c.thalassemia. d.sickle cell anemia.
b.glucose-6-phosphate dehydrogenase deficiency.
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop a.hyperkalemia. b.hypophosphatemia. c.hypokalemia. d.hyperphosphatemia.
b.hypophosphatemia.
Respiratory acidosis may be caused by a.tissue hypoxia. b.hypoventilation. c.massive blood transfusion. d.hyperventilation.
b.hypoventilation.
Respiratory acidosis is associated with a.hypokalemia. b.increased carbonic acid. c.increased pH. d.increased neuromuscular excitability.
b.increased carbonic acid.
The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is a.anemia. b.infection. c.alopecia. d.vomiting.
b.infection
The major cause of death from leukemic disease is a.malnutrition. b.infection. c.hypovolemic shock. d.kidney failure.
b.infection.
Clinical manifestations of chronic arterial obstruction include a.edema. b.intermittent claudication. c.decreased pressure proximal to the obstruction. d.distal hyperemia.
b.intermittent claudication.
The cellular response indicative of injury because of faulty metabolism is a.metaplasia. b.intracellular accumulations. c.lactate production. d.hydropic swelling.
b.intracellular accumulations.
Pernicious anemia is caused by a lack of a.erythropoietin. b.intrinsic factor. c.iron. d.folate.
b.intrinsic factor.
Diarrhea causes a.respiratory alkalosis. b.metabolic acidosis. c.respiratory acidosis. d.metabolic alkalosis.
b.metabolic acidosis
Thalassemia may be confused with iron-deficiency anemia, because they are both a.hyperchromic. b.microcytic. c.responsive to iron therapy. d.genetic.
b.microcytic.
All these cellular responses are potentially reversible except a.metaplasia. b.necrosis. c.hyperplasia. d.atrophy
b.necrosis.
Beta-blockers are advocated in the management of heart failure because they a.reduce blood flow to the kidneys. b.reduce cardiac output. c.enhance sodium absorption. d.increase cardiac output.
b.reduce cardiac output.
Cardiogenic shock is characterized by a.hypovolemia. b.reduced cardiac output. c.reduced systemic vascular resistance. d.elevated SvO2.
b.reduced cardiac output.
Cor pulmonale refers to a.biventricular failure. b.right ventricular hypertrophy secondary to pulmonary hypertension. c.left ventricular hypertrophy secondary to lung disease. d.right ventricular failure secondary to right ventricular infarction.
b.right ventricular hypertrophy secondary to pulmonary hypertension.
Pulse pressure is defined as a.systolic pressure × systemic resistance. b.systolic pressure - diastolic pressure. c.systolic pressure + diastolic pressure. d.two thirds of systolic pressure + diastolic pressure.
b.systolic pressure - diastolic pressure.
After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of a.primary prevention. b.tertiary prevention. c.disease treatment. d.secondary prevention.
b.tertiary prevention
The fraction of total body water (TBW) volume contained in the intracellular space in adults is a.three fourths. b.two thirds. c.one third. d.one half.
b.two thirds.
When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that a."Scar tissue in your lungs makes them stiff and more full of air than usual, which makes your chest round." b."Coughing caused by your condition has changed the structure of your airways, which makes your chest round." c."Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round." d."Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round."
c."Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."
How do clinical conditions that increase vascular permeability cause edema? a.Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure b.Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment c.By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure d.By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling
c.By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
Which alterations can lead to edema? a.Decreased capillary membrane permeability b.Decreased capillary hydrostatic pressure c.Decreased lymphatic flow d.Increased capillary colloid osmotic pressure
c.Decreased lymphatic flow
Hyperaldosteronism causes a.ECV deficit and hyperkalemia. b.hyponatremia and hyperkalemia. c.ECV excess and hypokalemia. d.excessive water reabsorption without affecting sodium concentration.
c.ECV excess and hypokalemia.
The hypersensitivity reaction that does not involve antibody production is type a.III. b.II. c.IV. d.I.
c.IV.
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding? a.Excess of feedings b.Too much sodium in the feedings c.Inadequate water intake d.Kidney failure
c.Inadequate water intake
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? a.Cardiogenic b.Neurogenic c.Septic d.Anaphylactic
c.Septic
Restriction of which electrolytes is recommended in the management of high blood pressure? a.Calcium b.Magnesium c.Sodium d.Potassium
c.Sodium
Croup is characterized by a.an inability to cough. b.a productive cough. c.a barking cough. d.drooling, sore throat, and difficulty swallowing.
c.a barking cough.
Myocarditis should be suspected in a patient who presents with a.murmur and abnormal valves on echocardiogram. b.family history of cardiomyopathy. c.acute onset of left ventricular dysfunction. d.chest pain and ST elevation.
c.acute onset of left ventricular dysfunction.
High blood pressure increases the workload of the left ventricle, because it increases a.preload. b.blood volume. c.afterload. d.stroke volume.
c.afterload.
Cystic fibrosis is associated with a.chronic bronchitis. b.asthma. c.bronchiectasis. d.emphysema.
c.bronchiectasis.
Extreme cold injures cells by all the following except a.ischemic injury from vasoconstriction. b.crystallization of cellular components. c.decreased blood viscosity. d.peripheral nerve damage from rebound vasodilation
c.decreased blood viscosity.
The primary effect of aging on all body systems is a.senility. b.programmed senescence. c.decreased functional reserve. d.diseased function.
c.decreased functional reserve.
Renal compensation for respiratory acidosis is evidenced by a.elevated carbon dioxide. b.decreased bicarbonate ion concentration. c.elevated bicarbonate ion concentration. d.decreased carbon dioxide.
c.elevated bicarbonate ion concentration.
Pneumocystitis is a term that refers to a a.viral pneumonia found in transplant recipients. b.non-infectious inflammation in the lung. c.fungal pneumonia secondary to HIV. d.pneumonia secondary to bladder infection.
c.fungal pneumonia secondary to HIV.
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is a.contaminated water. b.overuse of antibiotics. c.immunosuppression. d.being a male.
c.immunosuppression.
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. a.aldosterone b.angiotensinogen c.renin d.norepinephrine
c.renin
The most definitive diagnostic method for active tuberculosis is acquired via a.chest x-ray. b.blood culture. c.sputum culture. d.Mantoux skin test.
c.sputum culture