PATHO FINAL EXAM

Which intervention has been found to retard the advancement of chronic kidney disease? -Calcium supplementation -Erythropoietin -Insulin -ACE inhibitors

ACE inhibitors

Which is indicative of a left tension pneumothorax? -Course crackles throughout the left chest -Tracheal deviation to the left -Absent breath sounds on the left -Respiratory acidosis

Absent breath sounds on the left

Which clinical finding is indicative of compartment syndrome? -Peripheral edema -Absent peripheral pulses -Redness and swelling -Atrophy of distal tissues

Absent peripheral pulses

A diagnostic laboratory finding in myeloma is -Bence Jones proteins in the urine. -decreased platelet count. -increased IgM antibody titer. -elevated blood glucose levels.

Bence Jones proteins in the urine.

Retroviruses are associated with human cancers, including -Burkitt lymphoma. -Hodgkin's lymphoma. -pancreatic cancer. -hepatic cancer.

Burkitt lymphoma.

Which group is at the highest risk for urinary tract infection? -Infants and children -Sexually active women -Adult males -Patients taking diuretics

Sexually active women

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100? -Sitting BP 88/60, HR 118 -Sitting BP 108/68, HR 102 -Sitting BP 110/78, HR 98 -Sitting BP 120/80, HR 100

Sitting BP 88/60, HR 118

Pain is thought of as -a subjective experience that is difficult to measure objectively. -associated with changes in vital signs reflecting its intensity. -experienced in the same way by all individuals. -always the result of tissue damage that activates nociceptors.

a subjective experience that is difficult to measure objectively.

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is -anticoagulant therapy. -chemotherapy. -activity restriction. -isolation.

activity restriction

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is -bone infection. -fat emboli. -air embolus. -compartment syndrome.

air embolus

All the following stress-induced hormones increase blood glucose except -aldosterone. -cortisol. -norepinephrine. -epinephrine.

aldosterone.

Selye's three phases of the stress response include all the following except -allostasis. -resistance. -alarm. -exhaustion.

allostasis

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with -cardiac catheterization. -antiplatelet drugs. -acute reperfusion therapy. -cardiac biomarkers only.

antiplatelet drugs.

Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of -appendicitis. -peritonitis. -cholecystitis. -gastritis.

appendicitis

A fracture in which bone breaks into two or more fragments is referred to as -comminuted. -open. -greenstick. -stress.

comminuted.

Hypernatremia may be caused by -decreased aldosterone secretion. -decreased antidiuretic hormone secretion. -compulsive water drinking. -excessive dietary potassium.

decreased antidiuretic hormone secretion.

Total body water in older adults is -increased because of decreased adipose tissue and decreased bone mass. -increased because of decreased renal function and hormonal fluctuations. -decreased because of increased adipose tissue and decreased muscle mass. -decreased because of renal changes that cause diuresis with sodium excretion.

decreased because of increased adipose tissue and decreased muscle mass.

The primary effect of aging on all body systems is -decreased functional reserve. -diseased function. -programmed senescence. -senility.

decreased functional reserve

Clinical manifestations of severe symptomatic hypophosphatemia are caused by -excess proteins. -renal damage. -deficiency of ATP. -hypocalcemia.

deficiency of ATP.

A major modifiable risk factor for nephrolithiasis is -positive family history. -dehydration. -smoking. -drinking alcohol.

dehydration.

Widespread activation of the clotting cascade secondary to massive trauma is called -hemophilia B. -disseminated intravascular coagulation (DIC). -Hageman disease. -idiopathic thrombocytopenia purpura.

disseminated intravascular coagulation (DIC).

A common characteristic of viral pneumonia is -high fever. -alveolar infiltrates on a chest x-ray. -increased white blood cell count. -dry cough.

dry cough

A 32-year-old female complaining of severe pain with menstruation and inability to participate in her routine household activities is likely experiencing -dysmenorrhea. -menorrhagia. -amenorrhea -metrorrhagia.

dysmenorrhea.

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is -elevated total iron-binding capacity. -elevated MCHC and MCV. -elevated total and indirect bilirubin. -positive direct or indirect Coombs test.

elevated total iron-binding capacity.

In older women, osteoporosis is thought to be primarily because of -dietary inadequacies. -estrogen deficiency. -malabsorption syndrome. -inactivity.

estrogen deficiency

Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease. True False

false

The majority of penile cancer cases are classified as basal cell carcinoma. True False

false

The oliguric phase of acute tubular necrosis is characterized by -fluid excess and electrolyte imbalance. -fever and diminishing cognition. -sodium retention and potassium loss in the urine. -magnesium and phosphorous loss in the urine.

fluid excess and electrolyte imbalance.

A patient who has difficulty walking without assistance is incontinent of urine when help doesn't get to her quickly enough. The term for this type of incontinence is -extraurethral. -functional. -urge. -stress.

functional.

Red blood cells obtain nearly all their energy from metabolism of -glucose. -fats. -proteins. -acetyl coenzyme A.

glucose

The effects of histamine release include -vasoconstriction. -bronchodilation. -increased vascular permeability. -decreased gut permeability.

increased vascular permeability.

Venous obstruction leads to edema because it ________ pressure. -increases capillary oncotic -increases arterial blood -decreases tissue -increases capillary hydrostatic

increases capillary hydrostatic

Constipation in an elderly patient can be best treated by -maintaining a low-fiber diet. -maintaining the current level of activity. -fecal disimpaction. -increasing fiber in the diet.

increasing fiber in the diet.

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 -vomiting. -anemia. -alopecia. -infection.

infection

Hypotension associated with neurogenic and anaphylactic shock is because of -hypovolemia. -peripheral pooling of blood. -poor cardiac contractility. -high afterload.

peripheral pooling of blood.

The most common presenting sign/symptom with rheumatic fever is -cardiac murmur. -polyarthritis. -rash. -painless nodules.

polyarthritis.

A serious complication of deep vein thrombosis is -stroke. -hypertensive crisis. -extremity necrosis. -pulmonary embolus.

pulmonary embolus

Cardiogenic shock is characterized by -hypovolemia. -reduced systemic vascular resistance. -reduced cardiac output. -elevated SvO2.

reduced cardiac output.

Emphysema results from destruction of alveolar walls and capillaries, which is because of -release of proteolytic enzymes from immune cells. -air trapping with resultant excessive alveolar pressure. -excessive α1-antitrypsin. -autoantibodies against pulmonary basement membrane.

release of proteolytic enzymes from immune cells.

The ________ system compensates for metabolic acidosis and alkalosis. -gastrointestinal -renal -cardiovascular -respiratory

respiratory

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells? -Elevated CK-MB, troponin I, and troponin T -Markedly decreased CK-MB and troponin I -Elevated LDL -Prolonged coagulation time

Elevated CK-MB, troponin I, and troponin T

The characteristic x-ray findings in tuberculosis include -diffuse white-out. -Ghon tubercles. -bibasilar infiltrates. -tracheal deviation.

Ghon tubercles.

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction. Group of answer choices I II III IV

III

The hypersensitivity reaction that does not involve antibody production is type -I. -II. -III. -IV.

IV

When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that -"Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round." -"Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round." -"Coughing caused by your condition has changed the structure of your airways, which makes your chest round." -"Scar tissue in your lungs makes them stiff and more full of air than usual, which makes your chest round."

"Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."

Which change in a patient's assessment has the greatest urgency? -Serum potassium concentration is decreasing; abdominal distention, but denies any difficulty breathing -Serum calcium concentration is decreasing; reports constipation; is alert and denies any discomfort -Serum calcium concentration is increasing; reports constipation; is alert and denies any discomfort -Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing

-Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing

Chronic bronchitis often leads to cor pulmonale because of -ventricular hypoxia. -increased pulmonary vascular resistance. -left ventricular strain. -hypervolemia.

-increased pulmonary vascular resistance.

Bone healing may be impaired by -excessive vitamin C. -nicotine use. -a high-protein diet. -immobilization.

-nicotine use.

Osmoreceptors located in the hypothalamus control the release of -angiotensin. -atrial natriuretic peptide. -aldosterone. -vasopressin (antidiuretic hormone, ADH).

-vasopressin (antidiuretic hormone, ADH).

A level of ____ on the Glasgow Coma Scale indicates likely fatal damage. -3 -8 -12 -15

3

A patient presents to the physician's office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years. -6 months and 2 -4 and 7 -15 and 18 -25 and 45

4 and 7

Cervical cancer can be detected in the early, curable stage by the ________ test. -Papanicolaou -human papillomavirus -gonorrhoeae -vaginal pH

Papanicolaou

What laboratory finding is usually found in aplastic anemia? -Leukocytosis -Thrombocythemia -Neutrophilia -Pancytopenia

Pancytopenia

It is true that Graves disease is -a secondary endocrine disorder. -associated with autoantibodies to TSH receptors. -characterized by high serum TSH levels. -untreatable.

associated with autoantibodies to TSH receptors.

Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to -wear and tear on weight-bearing joints. -septic joint inflammation and necrosis. -unknown etiologic factors. -autoimmune mechanisms.

autoimmune mechanisms.

Excessive red cell lysis can be detected by measuring the serum -hemoglobin. -methemoglobin. -bilirubin. -erythropoietin.

bilirubin.

Congenital adrenal hyperplasia (adrenogenital syndrome) results from -cortisol excess. -testosterone-secreting tumor. -exogenous androgens. -blocked cortisol production.

blocked cortisol production

A severe complication of elevated intracranial pressure is -Cushing reflex. -brain herniation. -burr hole. -hydrocephalus.

brain herniation.

A breast lump that is painless, hard, and unmoving is most likely -fibrocystic breast disease. -fibroadenoma. -papilloma. -carcinoma.

carcinoma.

A cause of thrombocytopenia includes -hypoxemia. -reduced erythropoietin. -chemotherapy. -secondary polycythemia.

chemotherapy

Prosthetic joint infection is most often because of -defective replacement material. -injury to the joint. -hematogenous transfer. -arthritis.

hematogenous transfer.

Respiratory alkalosis is caused by -hyperventilation. -pneumonia. -chest muscle weakness. -pulmonary edema.

hyperventilation.

A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is -hypernatremia. -hyperkalemia. -hypokalemia. -hyperglycemia.

hypokalemia.

A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop -hypokalemia. -hyperkalemia. -hypophosphatemia. -hyperphosphatemia.

hypophosphatemia.

A major risk factor for the development of active pulmonary tuberculosis (TB) disease is -contaminated water. -immunosuppression. -being a male. -overuse of antibiotics.

immunosuppression

Lusitropic impairment refers to -poor contractile force. -impaired diastolic relaxation. -altered action potential conduction rate. -altered automaticity.

impaired diastolic relaxation

Gouty arthritis is a complication of -group A streptococcal infection. -autoimmune destruction of joint collagen. -excessive production of urea. -inadequate renal excretion of uric acid.

inadequate renal excretion of uric acid.

Hepatic encephalopathy is associated with -hyperbilirubinemia. -hyperuricemia. -toxic effects of alcohol on brain cells. -increased blood ammonia levels.

increased blood ammonia levels.

Insulin binding to its receptor on target cells results in -increased active transport of glucose into the cell. -glycogen breakdown within target cells. -increased facilitated cellular diffusion of glucose. -gluconeogenesis.

increased facilitated cellular diffusion of glucose.

A primary laboratory finding in end-stage chronic renal disease is -decreased blood urea nitrogen (BUN). -decreased serum sodium. -metabolic alkalosis. -increased serum creatinine.

increased serum creatinine.

Enteropathic arthritis is associated with -irritable bowel syndrome. -inflammatory bowel disease. -chronic constipation. -chronic diarrhea.

inflammatory bowel disease.

Celiac sprue is a malabsorptive disorder associated with -inflammatory reaction to gluten-containing foods. -megacolon at regions of autonomic denervation. -ulceration of the distal colon and rectum. -deficient production of pancreatic enzymes.

inflammatory reaction to gluten-containing foods.

Propylthiouracil may be used to treat hyperthyroidism, because it -destroys thyroid gland cells. -inhibits the release of TSH. -suppresses production of autoantibodies. -inhibits thyroid hormone synthesis.

inhibits thyroid hormone synthesis.

The difference between stress incontinence and urge incontinence is that stress incontinence -occurs in women, whereas urge incontinence occurs in both men and women. -occurs during sleep, whereas urge incontinence occurs during the waking hours. -is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle. -is caused by a detrusor muscle problem, whereas urge incontinence is caused by a neurologic problem.

is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.

The formation of active vitamin D -occurs in the skin. -is impaired in renal failure. -is dependent on oral intake of vitamin D. -is necessary for normal potassium metabolism.

is impaired in renal failure.

A patient being treated for hepatic encephalopathy could be expected to receive a(n) ________ diet. -low-protein and high-fiber -high-protein and high-carbohydrate -high-sodium -unrestricted

low-protein and high-fiber

The most appropriate treatment for secondary polycythemia is -volume expansion with saline. -measured to improve oxygenation. -phlebotomy. -chemotherapy.

measured to improve oxygenation.

A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102°F. This information is most consistent with -encephalitis. -meningitis. -skull fracture. -cerebral ischemia.

meningitis

Diarrhea and other lower intestinal fluid losses will contribute to -metabolic alkalosis. -metabolic acidosis. -respiratory acidosis. -mixed acid-base disorders.

metabolic acidosis.

A loud pansystolic murmur that radiates to the axilla is most likely a result of -aortic regurgitation. -aortic stenosis. -mitral regurgitation. -mitral stenosis.

mitral regurgitation.

It is true that gallstones are -a minimal risk for Native Americans. -more common in women. -more common in men. -at highest risk among Asians.

more common in women.

RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus. -negative; positive; positive -positive; negative; negative -negative; negative; positive -negative; negative; negative

negative; negative; positive

The pain that accompanies kidney disorders is called -nephritic. -nephralgia. -nephrotic. -nephronitis.

nephralgia.

A person who experiences a panic attack and develops hyperventilation symptoms may experience -neuromuscular depression. -anxiety acidosis. -numbness and tingling in the extremities. -acute compensatory metabolic acidosis.

numbness and tingling in the extremities

A malignant bone-forming tumor is referred to as a(n) -rhabdosarcoma. -liposarcoma. -osteosarcoma. -chondrosarcoma.

osteosarcoma

A patient with flail chest will demonstrate -absence of chest movement with breaths. -no inspiratory breath sounds. -fluttering chest movements on expirations. -outward chest movement on expiration.

outward chest movement on expiration.

The disorders characterized by softening and then enlargement of bones is referred to as -osteomyelitis. -osteoporosis. -Paget disease. -rickets.

paget disease

The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions. -sodium -phosphate -magnesium -potassium

sodium

Narcotic administration should be administered carefully in patients with acute pancreatitis related to potential for -respiratory depression. -narcotic dependency. -sphincter of Oddi dysfunction. -allergic reaction.

sphincter of Oddi dysfunction.

The stage during which the patient functions normally, although the disease processes are well established, is referred to as -latent. -subclinical. -prodromal. -convalescence.

subclinical

Manifestations of acute brain ischemia (Cushing reflex) are due primarily to -parasympathetic nervous system activation. -sympathetic nervous system activation. -autoregulation of body systems. -loss of brainstem reflexes.

sympathetic nervous system activation.

The progressive stage of hypovolemic shock is characterized by -tachycardia. -hypertension. -lactic acidosis. -cardiac failure.

tachycardia.

Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called -tension pneumothorax. -open pneumothorax. -pleural effusion. -empyema.

tension pneumothorax.

The activated partial thromboplastin time (aPTT) is a measure of the integrity of -the extrinsic pathway. -the intrinsic pathway. -factor VIII synthesis. -plasminogen.

the intrinsic pathway.

The primary reason that prolonged seizure activity predisposes to ischemic brain damage is that -neurons are unable to transport glucose. -cardiovascular regulation is impaired. -the brainstem is depressed. -the lack of airway maintenance can lead to hypoxia.

the lack of airway maintenance can lead to hypoxia.

The prognosis of penile carcinoma depends upon the stage of the disease. True False

true

Slow pain sensation is transmitted primarily by -group Ia afferents. -α motor neurons. -unmyelinated C fibers. -Aδ fibers.

unmyelinated c fibers

In addition to E. coli, a risk factor for development of pyelonephritis is -urinary retention and reflux. -nephrotic syndrome. -respiratory disease. -glomerulonephritis.

urinary retention and reflux.

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of -vitamin K deficiency. -hemophilia B. -hemophilia A. -idiopathic thrombocytopenia.

vitamin K deficiency

A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing -vitamin K deficiency bleeding. -acquired vitamin K deficiency. -von Willebrand disease. -disseminated intravascular coagulation.

vitamin K deficiency bleeding.