PATHO exam 2 test questions

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Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria? a. 118/78 b. 128/82 c. 140/88 d. 138/94

128/82

T or F: New-organ damage is a function the stage of hypertension and its duration.

False

The primary adaptive purpose of the substances produced in the alarm stage is a. energy and repair. b. invoke resting state. c. produce exhaustion. d. set a new baseline steady-state.

energy and repair

The spleen is an important defense against infection, because it a. activates the complement cascade. b. initiates inflammation. c. controls phagocytosis. d. filters the blood.

filters the blood

Atherosclerosis puts a patient at risk for (Select all that apply.) a. ischemic stroke. b. hemorrhagic stroke. c. retinal injury. d. renal impairment. e. liver disease.

ischemic stroke retinal injury renal impairment

The primary function of eosinophils is to a. kill parasitic helminths (worms). b. kill bacteria. c. stop viral replication. d. phagocytize fungi.

kill parasitic helminths (worms)

Which vessel normally demonstrates the most rapid blood flow? a. An arteriole b. A capillary c. A venule d. The vena cava

the vena cava

What is the effect on resistance if the radius of a vessel is halved? a. Resistance doubles. b. Resistance decreases by a factor of 16. c. Resistance decreases by half d. Resistance increases by a factor of 16.

Resistance increases by a factor of 16

The prevalence of high blood pressure is higher in a. non-Hispanic white adults. b. Mexican-American adults. c. non-Hispanic black adults. d. Asian children.

non-Hispanic black adults

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by a. norepinephrine. b. cortisol. c. glucagon. d. ACTH.

norepinephrine

Which causes vasoconstriction? a. Norepinephrine b. Calcium channel blocker c. alpha Adrenergic antagonist d. Acetylcholine

norepinephrine

Velocity of blood flow is measured in a. centimeters per second. b. millimeters per minute. c. yards per hour. d. kilometers per minute.

centimeters per second

The goal of long term heparin for the management of a deep vein thrombosis is to a. relieve edema. b. prevent clot dislodgement. c. dissolve the thrombus. d. prevent further clot formation.

prevent further clot formation

Blood is transported from the right ventricle to the lungs by the a. pulmonary veins. b. aorta. c. pulmonary artery. d. bronchial arteries.

pulmonary artery

A serious complication of deep vein thrombosis is a. stroke. b. hypertensive crisis. c. extremity necrosis. d. pulmonary embolus.

pulmonary embolus

Indicators that an individual is experiencing high stress include all the following except a. tachycardia. b. diaphoresis. c. increased peripheral resistance. d. pupil constriction.

pupil constriction

Which is not a manifestation of acute arterial obstruction? a. Pain b. Purpura c. Pallor d. Pulselessness

purpura

The most common method of disease transmission is a. airborne. b. droplet. c. vector. d. inoculant.

Droplet

Which is true about blood flow from the atria? a. Occurs primarily during systole, because perfusion pressure is high b. Is controlled primarily by the autonomic nervous system c. Is increased with elevated right atrial pressure d. Occurs primarily during ventricular diastole

Occurs primarily during ventricular diastole

When systemic vascular resistance is decreased, blood flow a. increases. b. decreases. c. stays the same. d. moves to the extremities.

decreases

Leukocytosis with a "shift to the left" refers to a. elevated segmented neutrophils. b. elevated immature neutrophils. c. decreased monocytes. d. decreased immature neutrophils.

elevated immature neutrophils

An infectious disease that is common in a community is termed a. endemic. b. epidemic. c. pandemic. d. partdemic.

endemic

When a patient is struck in the eye by a baseball, the result is redness and swelling. This increase in blood flow to a localized area is called a. autoregulation. b. edema. c. hyperemia. d. hypoxia.

hyperemia

The effects of excessive cortisol production include a. immune suppression. b. hypoglycemia. c. anorexia. d. inflammatory reactions.

immune suppression

Which clinical finding is most indicative of an acute bacterial infection? a. Increased (band) neutrophils b. Elevated temperature c. Elevated erythrocyte sedimentation rate d. Elevated WBC count

increased band neutrophils

Pulse pressure is defined as a. two thirds of systolic pressure + diastolic pressure. b. systolic pressure + diastolic pressure. c. systolic pressure - diastolic pressure. d. systolic pressure x systemic resistance.

systolic pressure - diastolic pressure

Peripheral edema is a result of a. arterial insufficiency. b. venous thrombosis. c. hypertension. d. atherosclerosis

venous thrombosis

Cardiac myosin has a high affinity for actin when the myosin has what molecule(s) bound to it? a. Calcium b. ATP c. ADP and phosphate d. Creatine phosphate

ADP and phosphate

At very high heart rates, cardiac output a. decreases. b. increases. c. stays the same. d. reverses.

Decreases

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is a. afterload reduction. b. beta antagonist agents. c. preload reduction. d. digitalis.

Digitalis

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

Elevated CK-MB, troponin I, and troponin T

Right-sided heart failure is usually a consequence of (Select all that apply.) a. elevated right ventricular afterload. b. right ventricular infarction. c. tricuspid valve defects. d. congenital anomalies.

Elevated Right Ventricular Afterload Right Ventricular Infarction

T or F: A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.

False

T or F: A requirement for rhythmicity is that the cell membrane has channels that automatically open during phase 3.

False

T or F: A standard ECG has 13 leads.

False

T or F: A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.

False

T or F: Chronic elevation of myocardial wall tension results in atrophy.

False

Characteristics of immunization include which of the following? (Select all that apply.) a. Giving injections of preformed antibodies provides immediate immunity. b. Immunization provides life-long immunity. c. Immunization with killed vaccines may lead to infection from the agent. d. Herd immunity controls disease without immunizing everyone in the population. e. Lack of immunization may lead to an epidemic.

Giving injections of preformed antibodies provides immediate immunity Herd immunity controls disease without immunizing everyone in the population Lack of immunization may lead to an epidemic

Which statement is true about the incidence of heart failure? (Select all that apply.) a. Heart failure affects about 2 million Americans. b. Heart failure is the fastest-growing cardiac disorder. c. There are more than 400,000 new cases of heart failure diagnosed each year in the United States. d. The increasing incidence and hospitalization rates of heart failure reflect the aging population in the United States. e. The incidence of heart failure is 10 per 1000 population after age 65.

Heart failure is the fastest-growing cardiac disorder The increasing incidence and hospitalization rates of heart failure reflect the aging population in the United States The incidence of heart failure is 10 per 1000 population after age 65

A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient? (Select all that apply.) a. Stupor b. Hypotension c. Urticaria d. Angioedema e. Wheezing

Hypotension Urticaria Angioedema Wheezing

Which dysrhythmia is thought to be associated with reentrant mechanisms? a. Second-degree AV block b. Sinus bradycardia c. Junctional escape d. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

IPreexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

A patient with forward effects of heart failure may present with which symptoms? (Select all that apply.) a. Impaired memory b. Mental fatigue c. Stupor d. Confusion e. Aggression

Impaired memory Mental Fatigue Confusion

Angina caused by coronary artery spasm is called _____ angina. a. stable b. classic c. unstable d. Prinzmetal variant

Prinzmetal variant

A patient has heart failure with a normal ejection fraction. Which findings are most likely found in this patient? (Select all that apply.) a. High cardiac output b. Pulmonary congestion c. Edema d. Ejection fraction greater than 50% e. Ejection fraction less than 45%

Pulmonary Congestion Edema Ejection fraction greater than 50%

A vessel that normally contains desaturated (venous) blood is the a. bronchial artery. b. pulmonary artery. c. pulmonary vein. d. coronary artery.

Pulmonary artery

Which causes of shock are considered to be obstructive? (Select all that apply.) a. Ventricular rupture b. Pulmonary embolus c. Cardiac tamponade d. Tension pneumothorax e. Acute hemorrhage

Pulmonary embolus Cardiac tamponade Tension pneumothorax

A patient experiencing shock may exhibit which signs and symptoms? (Select all that apply.) a. Warm, flushed skin b. Pinpoint pupils c. Pulse of more than 100 beats/minute d. Increased urinary output e. Fast and deep respirations

Pulse of more than 100 beats/minute Fast and deep respirations

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of a. arterial obstruction. b. isolated left-sided heart failure. c. right-sided heart failure. d. peripheral vascular disease

Right-sided heart failure

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is a. severe, crushing chest pain. b. ST-segment elevation. c. dysrhythmias. d. pain radiating to the lower legs.

ST segment elevation

In lead II of a normal electrocardiogram (ECG), the Q wave is a downward deflection resulting from ________ depolarization. a. atrial b. apical c. lateral wall d. septal

Septal

A laboratory test that should be routinely monitored in patients receiving digitalis therapy is a. serum sodium. b. albumin level. c. serum potassium. d. serum calcium.

Serum potassium

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? a. Sitting BP 88/60, HR 118 b. Sitting BP 108/68, HR 102 c. Sitting BP 110/78, HR 98 d. Sitting BP 120/80, HR 100

Sitting BP 88/60, HR 118

Restriction of which electrolytes is recommended in the management of high blood pressure? a. Calcium b. Potassium c. Sodium d. Magnesium

Sodium

A patient with significant aortic stenosis is likely to experience syncope. hypertension. increased pulse pressure. peripheral edema.

Syncope

T or F : Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.

True

T or F: Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.

True

T or F: The R wave is responsible for apical depolarization.

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. Third-degree heart block b. Junctional tachycardia c. Ventricular escape rhythm d. Sinus bradycardia

Ventricular escape rhythm

Mitral stenosis is associated with a. a prominent S 4 heart sound. b. a pressure gradient across the mitral valve. c. left ventricular hypertrophy. d. a muffled second heart sound (S2 ).

a pressure gradient across the mitral valve

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

The majority of cardiac cells that die after myocardial infarction do so because of a. cell rupture. b. insufficient glucose. c. thrombus. d. apoptosis.

apoptosis

Tachycardia is an early sign of low cardiac output that occurs because of tissue hypoxia. anxiety. baroreceptor activity. acidosis.

baroreceptor activity

Rheumatic heart disease is most often a consequence of a. chronic intravenous drug abuse. b. viral infection with herpesvirus. c. beta hemolytic streptococcal infection. d. cardiomyopathy.

beta hemolytic streptococcal infection

Dysrhythmias are significant since they (Select all that apply.) are an indicator of life span. can indicate an underlying disorder. can impair venous return. increase the severity of heart murmurs. can impair cardiac output.

can indicate an underlying disorder can impair cardiac output

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of a. myocardial infarction. b. cardiac tamponade. c. congestive heart failure (CHF). d. cardiomyopathy.

cardiac tamponade

Low cardiac output in association with high preload is characteristic of ________ shock. a. hypovolemic b. cardiogenic c. anaphylactic d. septic

cardiogenic

Patent ductus arteriosus is accurately described as a(n) a. opening between the atria. b. impedes flow. stricture of the aorta that blood flow c. communication between the aorta and the pulmonary artery. d. cyanotic heart defect associated with right-to-left shunt.

communication between the aorta and the pulmonary artery

Positive inotropic drugs work by increasing (Select all that apply.) a. contractility. b. cardiac output. c. tissue perfusion. d. myocardial oxygen demand. e. vascular resistance.

contractility cardiac output tissue perfusion myocardial oxygen demand

Administration of which therapy is most appropriate for hypovolemic shock? a. Crystalloids b. Vasoconstrictor agents c. Inotropic agents d. 5% dextrose in water

crystalloids

Increased preload of the cardiac chambers may lead to which patient symptom? a. Decreased heart rate b. Decreased respiratory rate c. Edema d. Excitability

edema

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) a. elderly woman without a previous history of MI. b. middle-aged man with a previous history of MI. c. young female athlete with cardiomegaly. d. young sedentary male with a high-stress job.

elderly woman without a previous history of MI

Diagnostic tests used to diagnose or confirm MI include (Select all that apply.) a. electrocardiogram. b. cardiac catheterization. c. echocardiography. d. radionuclide scintigraphy. e. computed tomography.

electrocardiogram cardiac catheterization echocardiography radionuclide scintigraphy

Myocardial cells are connected by gap junctions enabling them to a. all be stimulated simultaneously. b. function as a coordinated syncytium. c. be affected by the autonomic nervous system. d. share ATP.

function as a coordinated syncytium

Septic shock is commonly associated with Gram-negative infections and Gram-positive organisms that enter the body through the (Select all that apply.) a. eyes. b. genitourinary tract. c. gastrointestinal tract. d. respiratory tract. e. skin.

genitourinary tract gastrointestinal tract respiratory tract skin

Blood flow is slow through capillaries because capillaries a. are so far away from the heart. b. have the largest total cross-sectional area. c. are so narrow. d. have no smooth muscle.

have the largest total cross-sectional area

Echocardiograms are used to help diagnose (Select all that apply.) a. heart enlargement. b. valvular disorders. c. cardiac tumors. d. left ventricular motion abnormalities. e. collection of fluid in lung bases.

heart enlargement valvular disorders cardiac tumors left ventricular motion abnormalities

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with a. high afterload. b. low cardiac output. c. high cardiac output. d. reduced contractility.

high cardiac output

Constrictive pericarditis is associated with impaired cardiac filling. cardiac hypertrophy. increased cardiac preload. elevated myocardial oxygen consumption.

impaired cardiac filling

Lusitropic impairment refers to a. poor contractile force. b. impaired diastolic relaxation. c. altered action potential conduction rate. d. altered automaticity.

impaired diastolic relaxation

Tumor necrosis factor alpha and interleukin-1 contribute to shock states because they induce production of a. catecholamines. b. clotting factors. c. nitric oxide. d. vasopressin.

nitric oxide

Cor pulmonale refers to a. biventricular failure. b. left ventricular hypertrophy secondary to lung disease. c. right ventricular hypertrophy secondary to pulmonary hypertension. d. right ventricular failure secondary to right ventricular infarction.

right ventricular hypertrophy secondary to pulmonary hypertension

Atherosclerotic plaques with large lipid cores are prone to a. dislodgement. b. binding. c. rupture. d. attachment.

rupture

Beta-blockers are advocated in the management of heart failure because they a. increase cardiac output. b. reduce cardiac output. c. enhance sodium absorption. d. reduce blood flow to the kidneys.

reduce cardiac output.

Cardiogenic shock is characterized by a. hypovolemia. b. reduced systemic vascular resistance. c. reduced cardiac output. d. elevated SvO2 .

reduced cardiac output

Functions of T cells include (Select all that apply.) a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating of B cells. e. killing virally infected cells.

secreting cytokines killing antigen-presenting cells stimulating of B cells killing virally infected cells

The common denominator in all forms of heart failure is a. poor diastolic filling. b. reduced cardiac output. c. pulmonary edema. d. tissue ischemia.

reduced cardiac output

The majority of tachydysrhythmias are believed to occur because of a. triggered activity. b. enhanced automaticity. c. defective gap junctions. d. reentry mechanisms.

reentry mechanisms.

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. a. aldosterone b. norepinephrine c. angiotensinogen d. renin

renin

Sepsis has been recently redefined as a. a systemic infection with viable organisms in the bloodstream. b. a systemic inflammatory response to ischemia. c. a systemic inflammatory response to infection. d. severe hypotension in an infected patient.

the systemic inflammatory response to infection

Which is not considered to be a risk factor for thrombus formation? a. Thrombocytopenia b. Vascular trauma c. Stasis of blood flow d. Circulatory shock

thrombocytopenia

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. arthrosclerosis. b. angina. c. myocardial infarction. d. hypertensive crisis.

Hypertensive crisis

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to a. hypertension. b. hypotension. c. deep vein thrombosis. d. angina.

Hypotension

Which changes in the circulatory system occur in the older adult? (Select all that apply.) a. Increased baroreceptor function b. Increased response to hypertensive stimuli c. Increased systemic vascular resistance (SVR) d. Decreased afterload e. Decreased elasticity of vessel walls

Increased systemic vascular resistance (SVR) Decreased elasticity of vessel walls

Clinical manifestations of chronic arterial obstruction include a. edema. b. intermittent claudication. c. decreased pressure proximal to the obstruction. d. distal hyperemia.

Intermittent claudication

The v wave of an atrial pressure tracing corresponds to a. atrial filling. b. ventricular systole. c. atrial systole. d. mitral valve closure.

atrial filling

During which phase of the cardiac cycle is the mitral valve normally open? a. Atrial systole b. Isovolumic contraction c. Isovolumic relaxation d. Ventricular ejection

atrial systole

Dietary zinc is an important defense against infection, because it maintains (Select all that apply.) a. natural killer cell function. b. lymphocyte activity. c. antioxidant activity. d. neutrophil activity. e. complement activity.

natural killer cell function lymphocyte activity neutrophil activity complement activity

Hypertension is closely linked to a. obstructive sleep apnea. b. urinary tract infection. c. de Quervain syndrome. d. spinal stenosis.

obstructive sleep apnea

Phase 0 of the cardiac muscle cell action potential is associated with ________ channels. a. opening of slow calcium ion b. opening of fast potassium ion c. opening of fast sodium ion d. closure of sodium leak

opening of fast sodium ion

Hypertension with a specific, identifiable cause is known as _____ hypertension. a. primary b. orthostatic c. secondary d. malignant

secondary

Functions of B cells include a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating B cells. e. killing virally infected cells.

synthesizing antibodies

The primary function of kinins is a. phagocytosis of antigens. b. production of antibodies. c. to limit immune reactions. d. vasodilation to enhance inflammation.

vasodilation to enhance inflammation

Immune function is likely to be most effective in a a. newborn. b. 7-month-old infant. c. 30-year-old. d. 70-year-old.

30-year-old

Risk factors for atherosclerosis include a. female gender. b. hyperlipidemia. c. high-protein diet. d. low-fiber diet.

Hyperlipidemia

The movement of blood through the vascular system is opposed by the force of a. viscosity. b. the vessel length. c. the vessel radius. d. resistance.

resistance

Which clinical finding is indicative of compartment syndrome? a. Peripheral edema b. Absent peripheral pulses c. Redness and swelling d. Atrophy of distal tissues

Absent peripheral pulses

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient's blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time? a. Begin lifestyle modifications. b. Begin antihypertensive drug therapy. c. Recheck blood pressure in 4 to 6 weeks. d. Encourage smoking cessation.

Begin antihypertensive drug therapy

T or F: The most commonly recognized outcome of hypertension is pulmonary disease.

False

Chronic activation of stress hormones can lead to (Select all that apply.) a. cardiovascular disease. b. depression. c. impaired cognitive function. d. autoimmune disease. e. overactive immune function.

cardiovascular disease depression impaired cognitive function autoimmune disease

Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.) a. catecholamines. b. ACTH. c. glucocorticoids. d. immune cytokines. e. TSH.

catecholamines ACTH glucocorticoids immune cytokines

A characteristic of some bacteria a. is intracellular parasite. b. is composed of RNA or DNA. c. contains cell wall endotoxin. d. cannot replicate extracellularly.

contains cell wall endotoxin

Angiotensin-converting enzyme (ACE) inhibitors block the a. release of rennin. b. conversion of angiotensin I to angiotensin II. c. conversion of angiotensinogen to angiotensin I. d. effect of aldosterone on the kidney.

conversion of angiotensin I to angiotensin II

Which proteins are associated with the thin filament in the cardiac muscle? (Select all that apply.) a. Actin b. Titin c. Nebulin d. Troponin e. Myosin

Actin Nebulizers Troponin

In which dysrhythmias should treatment be instituted immediately? a. Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute b. Fever-induced tachycardia at 122 beats/minute c. Premature atrial complexes occurring every 20 seconds d. Atrial fibrillation with a ventricular rate of 220 beats/minute

Atrial fibrillation with a ventricular rate of 220 beats/minute

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class? a. Class I b. Class II c. Class III d. Class IV

Class I

In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing? a. Class I, Initial Stage b. Class II, Compensated Stage c. Class III, Progressive Stage d. Class IV, Refractory Stage

Class II, Compensated Stage

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? Increased LDL levels are associated with increased risk of coronary artery disease. Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease. Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain. Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant.

Increased LDL levels are associated with increased risk of coronary artery disea

Which physiologic change increases cardiac work but does not enhance cardiac output? a. Increased preload b. Increased heart rate c. Increased contractility d. Increased afterload

Increased afterload

Which is a true statement about the affect of the Frank-Starling law on the heart? Increased diastolic stretching of myocardial fibers produces increased stroke volume. Sympathetic activation leads to increased myocardial contractility and heart rate. An increase in heart chamber diameter increases myocardial wall tension. An increase in coronary artery diameter results in less rapid coronary blood flow

Increased diastolic stretching of myocardial fibers produces increased stroke volume

Which condition enhances lymphatic flow? a. Increased tissue hydrostatic pressure b. Increased interstitial fluid colloid osmotic pressure c. Decreased capillary hydrostatic pressure d. Increased capillary oncotic pressure

Increased interstitial fluid colloid osmotic pressure

Which is not normally secreted in response to stress? a. Norepinephrine b. Cortisol c. Epinephrine d. Insulin

Insulin

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. This is an expected blood pressure in the elderly and has little effect on left ventricular function. b. Left ventricular workload is increased with high afterload. c. High blood pressure enhances left ventricular perfusion during systole. d. High-pressure workload leads to left ventricular atrophy.

Left ventricular workload is increased with high afterload

A patient's ECG lacks recognizable waveforms and is deemed to be in sinus arrest. The patient's sinus arrest may be a result of (Select all that apply.) a. MI. b. electrical shock. c. electrolyte disturbance. d. acidosis. e. alkalosis.

MI electrical shock electrolyte disturbance acidosis

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

Mitral regurgitation

The most common causes of heart failure are (Select all that apply.) a. myocardial ischemia. b. hypertension. c. dilated cardiomyopathy. d. high-fat diet. e. urinary retention.

Myocardial Ischemia Hypertension

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. cardiogenic b. obstructive c. hypovolemic d. distributive

Obstructive

The urinary signs and symptoms of acute renal failure associated with the progressive stage of shock are (Select all that apply.) polyuria. oliguria. decreased blood urea nitrogen. increased serum creatinine. tachycardia.

Oliguria Increased serum creatinine

The major wave complexes of an ECG include the (Select all that apply.) a. P wave. b. B wave. c. TUV complex. d. QRS complex. e. T wave.

P wave QRS complex T wave

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. right-sided heart failure. b. cardiomyopathy. c. a medication reaction. d. acute cardiogenic pulmonary edema.

acute cardiogenic pulmonary edema

Myocarditis should be suspected in a patient who presents with a. chest pain and ST elevation. b. acute onset of left ventricular dysfunction. c. murmur and abnormal valves on echocardiogram. d. family history of cardiomyopathy.

acute onset of left ventricular dysfunction

Proteins that are increased in the bloodstream during acute inflammation are called a. membrane attack complexes. b. selectin receptors. c. acute phase proteins. d. major histocompatibility complexes.

acute phase proteins

One role of ATP in cardiac muscle contraction is a. providing energy to pump calcium into the cell. b. inducing a conformational change in tropomyosin. c. altering myosin affinity for actin-binding sites. d. releasing sequestered calcium from the sarcoplasmic reticulum.

altering myosin affinity for actin-binding sites

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock? a. Cardiogenic b. Hypovolemic c. Anaphylactic d. Neurogenic

anaphylactic

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with a. perfumes. b. incompatible blood products. c. animal proteins or dander. d. antibiotics.

antibiotics

Administration of a vasodilator to a patient in shock would be expected to a. decrease vascular resistance. b. increase contractility. c. decrease left ventricular afterload. d. increase tissue perfusion.

decrease left ventricular afterload

Aldosterone may increase during stress, leading to (Select all that apply.) a. decreased urinary output. b. increased blood potassium. c. increased sodium retention. d. increased blood volume. e. decreased blood pressure.

decreased urinary output. increased sodium retention increased blood volume

Primary treatment for myocardial infarction (MI) is directed at a. protecting the heart from further ischemia. b. decreasing myocardial oxygen demands. c. reducing heart rate and blood pressure. d. activating the parasympathetic system.

decreasing myocardial oxygen demands

Aortic regurgitation is associated with a. diastolic murmur. b. elevated left ventricular/aortic systolic pressure gradient. c. elevated systemic diastolic blood pressure. d. shortened ventricular ejection phase

diastolic murmur

Electrical currents that travel through the heart are called vectors because they include (Select all that apply.) a. direction. b. polarity. c. magnitude. d. vascularity. e. ionic waves.

direction magnitude

Automatic pacemaker cells spontaneously depolarize, because a. leak channels (If ) allow calcium and sodium ions into the cell. b. they lack efficient sodium/potassium pumps. c. voltage-sensitive sodium channels open spontaneously. d. chloride leaks into the cell during rest.

leak channels (If ) allow calcium and sodium ions into the cell.

Second-degree heart block type I (Wenckebach) is characterized by absent P waves. lengthening PR intervals and dropped P wave. constant PR interval and dropped QRS complexes. no correlation between P waves and QRS complexes

lengthening PR intervals and dropped P wave.

Blood flow is measured as a given number of (Select all that apply.) a. liters. b. milliliters. c. nanoliters. d. cubic centimeters. e. cubic millimeters.

liters milliliters nanoliters

Inflammatory disorders that may alter endothelial cell function include (Select all that apply.) multiple sclerosis. lupus erythematosus. Kawasaki syndrome. rheumatoid arthritis. polyarteritis nodosa.

lupus erythematosus Kawasaki syndrome polyarteritis nodosa.

Drug resistance of microbes occurs secondary to a. patient allergy to a drug. b. mutation of the microbe. c. enhance pathogenicity of the microbe. d. using high doses of drugs.

mutation of the microbe

Parasympathetic stimulation of the heart generally leads to a decrease in heart rate, because acetylcholine a. increases intracellular cAMP levels and opens calcium channels. b. opens potassium channels allowing potassium ion efflux. c. binds and blocks beta receptors on the cell membrane. d. inhibits voltage-gated sodium channels in the membrane.

opens potassium channels allowing potassium ion efflux

A patient with heart failure who reports intermittent shortness of breath during the night is experiencing a. orthopnea. b. paroxysmal atrial tachycardia. c. sleep apnea. d. paroxysmal nocturnal dyspnea.

paroxysmal nocturnal dyspnea

The membrane attack complex formed by complement is similar in function to a. CD4+ . b. granzymes. c. CD8. d. perforin.

perforin

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

peripheral pooling of blood

Persistence of the alarm stage will ultimately result in a. stress reduction. b. permanent damage and death. c. movement into the resistance stage. d. exhaustion of the sympathetic nervous system.

permanent damage and death

An erroneously low blood pressure measurement may be caused by a. positioning the arm above the heart level. b. using a cuff that is too small. c. positioning the arm at heart level. d. measuring blood pressure after exercise.

positioning the arm above the heart level

The major factors that influence stroke volume are (Select all that apply.) a. pre-ejection. b. preload. c. resistance. d. contractility. e. afterload.

preload contractility afterload

An abnormally wide (more than 0.10 second) QRS complex is characteristic of a. paroxysmal atrial tachycardia. b. supraventricular tachycardia. c. junctional escape rhythm. d. premature ventricular complexes.

premature ventricular complexes

First-degree heart block is characterized by a. prolonged PR interval. b. absent P waves. c. widened QRS complex. d. variable PR interval.

prolonged PR interval

Left-sided heart failure is characterized by a. pulmonary congestion. b. decreased systemic vascular resistance. c. jugular vein distention. d. peripheral edema.

pulmonary congestion

A patient with pure left-sided heart failure is likely to exhibit jugular vein distention. pulmonary congestion with dyspnea. peripheral edema. hepatomegaly.

pulmonary congestion with dyspnea

Hypertrophy of the right ventricle is a compensatory response to a. aortic stenosis. b. aortic regurgitation. c. tricuspid stenosis. d. pulmonary stenosis.

pulmonary stenosis

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? Cardiogenic Septic Anaphylactic Neurogenic

septic

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock. a. cardiogenic b. hypovolemic c. obstructive d. septic

septic

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? a. Cardiogenic b. Hypovolemic c. Anaphylactic d. Septic

septic

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. stable angina. b. myocardial infarction. c. coronary vasospasm. d. unstable angina.

stable angina

Characteristics of complement include (Select all that apply.) a. stimulating chemotaxis. b. lysing target cells. c. having multiple plasma proteins. d. being synthesized in the bone marrow. e. enhancing phagocytosis.

stimulating chemotaxis lysing target cells having multiple plasma proteins enhancing phagocytosis

Orthostatic hypotension is a risk factor for (Select all that apply.) a. stroke. b. cognitive impairment. c. death. d. myocardial infarction. e. urinary retention.

stroke cognitive impairment death

It can be explained to a patient that high blood pressure increases the risk of (Select all that apply.) a. stroke. b. renal disease. c. diabetes. d. ischemic heart disease. e. liver disease.

stroke renal disease ischemic heart disease

Creatine phosphate is a. a waste product of cellular metabolism. b. synthesized when ATP levels are high. c. enzymatically degraded to form creatine kinase. d. an indicator of myocardial cell damage.

synthesized when ATP levels are high

Improvement in a patient with septic shock is indicated by an increase in cardiac output SvO2 systemic vascular resistance serum lactate level

systemic vascular resistance

The progressive stage of hypovolemic shock is characterized by a. tachycardia. b. hypertension. c. lactic acidosis. d. cardiac failure.

tachycardia

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume? a. Hypotension b. Bradycardia c. Aortic regurgitation d. Tachycardia

tachycardia

Passive immunity is provided by (Select all that apply.) a. transfer of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies. d. vaccines with dead or altered organisms. e. active infections.

transfer of preformed human antibodies injection of human immune globulin injection with preformed animal antibodies

The primary functions of the circulatory system are (Select all that apply.) a. transport oxygen. b. transport nutrients. c. remove metabolic waste. d. reabsorb leaking fluid. e. return leukocytes to the circulation.

transport oxygen transport nutrients remove metabolic waste

Acute coronary syndrome in the presence of thrombosis may present as (Select all that apply.) a. unstable angina. b. MI. c. sudden cardiac arrest. d. bleeding. e. hypovolemia.

unstable angina MI sudden cardiac arrest

The effect of nitric oxide on systemic arterioles is a. vasodilation. b. vasoconstriction. c. not significant. d. opposed by nitrate drugs.

vasodilation

An example of an acyanotic heart defect is a. tetralogy of Fallot. b. transposition of the great arteries. c. ventricular septal defect. d. all right-to-left shunt defects

ventricular septal defect

Allostasis is best defined as a. steady-state. b. a state of equilibrium, of balance within the organism. c. the process by which the body heals following disease. d. the overall process of adaptive change necessary to maintain survival and well-being.

the overall process of adaptive change necessary to maintain survival and well-being

Risk of infection is increased in (Select all that apply.) a. use of corticosteroids. b. diabetes mellitus. c. spleen removal. d. stomach removal. e. stress.

use of corticosteroids diabetes mellitus spleen removal stress

Active immunity involves (Select all that apply.) a. injection of preformed human antibodies. b. injection of human immune globulin. c. injection with preformed animal antibodies. d. vaccines with dead or altered organisms. e. active infections.

vaccines with dead or altered organisms active infections

Tissues are able to autoregulate their rate of blood flow by controlling a. perfusion pressure. b. arterial blood pressure. c. vascular resistance. d. venous return to the heart.

vascular resistance

What results when systemic blood pressure is increased? a. Hypovolemia b. Decreased cardiac output c. Vasoconstriction d. Decreased vascular resistance

vasoconstriction

Which is true about the mitral valve? a. Opens during ventricular systole b. Is located between the right atrium and right ventricle c. Has three valve leaflets d. Allows blood to flow from the left atrium to the left ventricle

Allows blood to flow from the left atrium to the left ventricle

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time? a. Continue lifestyle modifications only. b. Continue lifestyle modifications plus diuretic therapy. c. Continue lifestyle modifications plus ACE inhibitor therapy. d. Continue lifestyle modifications plus beta blocker therapy

Continue lifestyle modifications only

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation? a. Q = P/R b. Q = R/P c. R = PQ d. P = Q/R

Q = P/R

T or F: The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension.

True

The pain characteristics of chronic venous insufficiency include (Select all that apply.) a. aching and cramping in the affected area. b. relief with elevation to the area. c. relief with ambulation if pain is in the legs. d. burning and prickling in the affected area. e. relief with massage to the area.

aching and cramping in the affected area relief with elevation to the area relief with ambulation if pain is in the legs

High blood pressure increases the workload of the left ventricle, because it increases a. stroke volume. b. blood volume. c. preload. d. afterload.

afterload

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

aldosterone

Selye's three phases of the stress response include all the following except a. allostasis. b. resistance. c. alarm. d. exhaustion.

allostasis

Activation of the complement cascade results in (Select all that apply.) a. antibody production. b. inflammation. c. immunosuppression. d. autoimmunity. e. chemotaxis.

antibody production inflammation chemotaxis

Immunity to a specific organism can be determined by a. active phase protein count. b. antibody titer. c. erythrocyte sedimentation rate. d. WBC count.

antibody titer

Functions of antibodies include (Select all that apply.) a. antigen agglutination. b. antigen precipitation. c. opsonization. d. phagocytosis. e. complement activation.

antigen agglutination antigen precipitation opsonization complement activation

The "classical pathway" for activation of the complement cascade is triggered by a. activation of C3. b. inflammation. c. first recognition of an antigen. d. antigen-antibody complexes.

antigen-antibody complexes

The term used to describe fungal infections is a. sepsis. b. mycoses. c. amebiasis. d. Chlamydia.

myoses

An increase in intracellular calcium ion results in myocardial contraction, because calcium a. activates membrane calcium pumps. b. binds troponin, causing actin-binding sites to be exposed. c. increases affinity of myosin for actin cross-bridge sites. d. promotes ATP synthesis.

binds troponin, causing actin-binding sites to be exposed

While caring for a geriatric patient, the changes in the heart that may be expected include a. increased oxygen consumption. b. increased coronary artery blood flow. c. decreased response to an elevated heart rate. d. cardiomyopathy.

decreased response to an elevated heart rate

Antigen-presenting cells function to a. display foreign antigen on their cell surfaces bound to MHC. b. stimulate cytokine production by macrophages. c. phagocytose and degrade foreign antigens. d. initiate the complement cascade by way of the alternative pathway.

display foreign antigen on their cell surfaces bound to MHC.

Venous obstruction leads to edema because it ________ pressure. a. increases capillary oncotic b. increases arterial blood c. decreases tissue d. increases capillary hydrostatic

increases capillary hydrostatic

Blood pressure is regulated on a short-term basis through (Select all that apply.) interaction of carotid and aortic baroreceptors. vasomotor center in the brainstem. activation of SNS. inhibition of PSNS. activation of RAAS.

interaction of carotid and aortic baroreceptors vasomotor center in the brainstem activation of SNS inhibition of PSNS

Interleukin-1, interleukin-6, and tumor necrosis factor- are inflammatory cytokines secreted by a. plasma cells. b. neutrophils. c. lymphocytes. d. macrophages.

macrophages

The effect of stress on the immune system a. is unknown. b. has been demonstrated to be non-existent in studies. c. most often involves enhancement of the immune system. d. may involve enhancement or impairment the immune system.

may involve enhancement or impairment the immune system

Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. a. systolic b. mean arterial c. diastolic d. pulse

mean arterial

The mononuclear phagocyte system consists of (Select all that apply.) a. monocytes and tissue macrophages. b. dendritic cells. c. bone marrow stem cells. d. antibody-secreting plasma cells. e. basophils.

monocytes and tissue macrophages dendritic cells


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