Patho Exam 3
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke A. impairs α1-antitrypsin, allowing elastase to predominate B. paralyzes the cilia, causing impaired mucociliary clearance. C. predisposes to respiratory infections. D. introduces carcinogens into the lungs
a
Type 2 diabetes mellitus is often associated with A. Non-ketotic hyperosmolality B. childhood. C. autoimmune destruction of the pancreas. D. ketoacidosis.
a
What type of cells make up the alveoli and are involved in gas exchange? A. Type I pneumocytes B. Type II pneumocytes C. Alveolar macrophages D. Goblet cells
a
Ketoacidosis results in which of the following? (Select all that apply.) A. Increase in hormonal levels of cortisol B. Continued insulin deficiency C. Accumulation of fatty acids D. Impaired lipolysis E. Increased pH
a,b,c
Which are clinical findings usually associated with type 1 diabetes mellitus? (Select all that apply.) A. Polyuria B. Polydipsia C. Polyphagia D. Obesity E. Weight gain
a,b,c
Which condition presents a problem with lung diffusion? (Select all that apply.) A. Pneumonia B. Pulmonary edema C. Interstitial lung disease D. Small cell (oat cell) carcinoma E. Squamous cell epidermoid carcinoma
a,b,c
Secondary pulmonary hypertension is most often caused by A. increased pulmonary blood flow. B. increased pulmonary vascular resistance. C. increased left atrial pressure. D. decreased alveolar compliance
b
A patient diagnosed with hormonal resistance can present with which assessment datum? (Select all that apply.) A. No response to exogenous hormone replacement B. Lack of normal hormonal action C. Normal hormone levels D. Elevated hormone levels E. Decreased hormone levels
a,b,c,d
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
a,b,c,d
An acute asthma attack is associated with (Select all that apply.) A. bronchoconstriction B. bronchial mucosal edema C. hypersecretion of mucus D. alveolar collapse. E. hypoxemia.
a,b,c,e
Which is true about lung compliance? (Select all that apply.) A. Represents lung expandability B. Decreases in the elderly C. Can be decreased by obesity, abdominal distention, pregnancy D. Is decreased in emphysema E. Is affected by body position
a,b,c,e
Individuals with diabetes mellitus are particularly susceptible to infections of which of the following? (Select all that apply.) A. Skin B. Vagina C. Esophagus D. Urinary tract E. Respiratory passages
a,b,d
The role of iodine in proper thyroid gland function relates to which of the following? (Select all that apply.) A. Oxidation to iodide B. Coupling to molecular tyrosine C. Retention of iodide in renal tubules D. Trapping of dietary iodine in thyroid cells E. The ability of iodine to neutralize dietary salt
a,b,d
The secretion of the appropriate amount of free thyroid hormones in circulating body fluid is regulated by the feedback interaction between which hormone sources? (Select all that apply.) A. Pituitary B. Hypothalamus C. Adrenal medulla D. Thyroid E. Parathyroid
a,b,d
Which type of shock is characterized by generalized vasodilation and peripheral pooling of blood? (Select all that apply.) A. Septic B. Neurogenic C. Cardiogenic D. Anaphylactic E. Hypovolemic
a,b,d
Structure(s) that engage in exchange of respiratory gases include(s) the (Select all that apply.) A. trachea. B. bronchi. C. pulmonary artery. D. pulmonary capillaries. E. alveoli.
a,b,d,e
Steroids dissolve poorly in blood and require a transport protein (globulin) to convey them through the circulation because they A. have a high pH. B. are lipid-soluble molecules. C. are water-soluble molecules. D. require a high osmotic pressure for transport.
b
Surgical removal of a gland may result in A. hypersecretion. B. hyposecretion C. hyporesponsiveness. D. tissue resistance
b
The anatomic center of coordination and communication between nervous system and endocrine system is the A. adrenal cortex. B. hypothalamus. C. thyroid gland. D. adrenal medulla
b
The central chemoreceptors for respiratory control are A. located in the carotid artery. B. responsive primarily to changes in pH and CO2. C. responsive primarily to hypoxemia. D. less important than the peripheral chemoreceptors in maintaining respiration.
b
The formation of active vitamin D A. occurs in the skin. B. is impaired in renal failure C. is dependent on oral intake of vitamin D. D. is necessary for normal potassium metabolism.
b
The most common mechanism regulating hormone production and secretion is A. positive feedback. B. negative feedback C. positive reinforcement. D. negative reinforcement.
b
The pathophysiology of gestational diabetes mellitus most closely resembles that of A. type 1 diabetes. B. type 2 diabetes C. genetic defects of β-cells. D. chemical-induced diabets.
b
The tightness of the hormone-receptor bond is known as A. specificity. B. affinity C. half-life. D. set-point.
b
The underlying pathogenic mechanism for type 2 diabetes is A. pancreatic β-cell destruction. B. insulin resistance and β-cell dysfunction C. lack of exercise and chronic overeating. D. impaired glucose transport into cells.
b
Thyroid hormones are derived from A. peptides. B. tyrosine amino acids C. globulin. D. catecholamines
b
Uncontrolled massive bleeding causes what type of shock? A. Cardiogenic B. Hypovolemic C. Neurogenic D. Septic
b
What describes an asthma that is common in children and adolescents, with bronchospasm occurring within 3 minutes of physical exertion? A. Occupational-induced B. Exercise-induced C. Cardiac-induced D. Drug-induced
b
What is the name of the structure of long hairs that filter air? A. Cilia B. Vibrissae C. Columnar epithelium D. Convoluted turbinates
b
What is the pathophysiologic phenomenon underlying disseminated intravascular coagulation (DIC)? A. Elevated platelet and fibrinogen levels B. Clotting that leads to bleeding C. Inadequate cardiac output D. Mast cell degranulation
b
What physiologic abnormality is characteristic of emphysema? A. Collapse of the proximal airways B. Trapping of air in the distal air sacs C. Widespread occurrence of bronchial plugs D. Extensive inflammation of the lower airways
b
What suppresses the normal secretion of growth hormone? A. Hypoglycemia B. Somatostatin C. Somatomedin D. Amino acids
b
When exposed to inhaled allergens, a patient with asthma produces large quantities of A. IgG. B. IgE C. IgA. D. IgM
b
Which describes a pathologic manifestation of neurogenic shock? A. Release of vasodilatory mediators such as histamine into the circulation B. Loss of sympathetic activation of arteriolar smooth muscle C. Increased sympathetic nervous stimulation D. Massive immune system activation
b
Which hormone is known for its ability to be stored and synthesized but is bound until it is needed for systemic use? A. Steroid B. Thyroid C. Parathyroid D. Polypeptide
b
Which is a true statement regarding the airways? A. There are three main bronchi. B. Cough receptors lie at the carina C. The carina is in the right mainstem bronchus. D. There are six secondary or lobar branches from the bronchi
b
Which major cartilage structure is often referred to as the Adam's apple? A. Cricoid cartilage B. Thyroid cartilage C. Arytenoid cartilage D. Tracheal cartilage
b
Which results in an increase in lung compliance? A. Pneumonia B. Emphysema C. Pulmonary fibrosis D. Pulmonary edema
b
Which statement is true regarding asthma? A. There is decreased responsiveness to environmental stimuli. B. It is characterized by airway inflammation C. It involves irreversible airway obstruction. D. Extrinsic asthma has adult onset
b
________ is the most powerful predictor of developing type 2 diabetes mellitus. A. Aging B. Obesity C. Sedentary lifestyle D. Cardiovascular disease
b
Which are major classifications of deficiencies in growth hormone secretion? (Select all that apply.) A. Increased IGF-1 B. Decreased GH secretion C. Defective GH action D. Decreased IGG secretion E. Defective IGF-1 generation
b, c, e
When emphysema is a result of a α1-antitrypsin disorder, assessment data is likely to include which of the following? (Select all that apply.) A. Caucasian B. Client age younger than 50 C. Elevated levels of α1-antitrypsin D. History of cigarette smoking E. Enzyme levels that are below normal
b, d, e
Which medication may be required for status asthmaticus? (Select all that apply.) A. β-Blockers B. Epinephrine C. Oral corticosteroids D. Terbutaline (Brethine) E. Aminophylline (Phyllocontin)
b, d, e
Which pathogenetic change is associated with acute bronchitis? (Select all that apply.) A. Mast cell-induced inflammation B. Swelling from exudation of fluid C. Decreased mucous production D. Loss of ciliary function E. Inflamed airways
b, d, e
Which are complications of diabetes mellitus that are microvascular? (Select all that apply.) A. Cardiovascular disease B. Retinopathy C. Nephropathy D. Neuropathy E. Stroke
b,c
Which are hormones that increase serum glucose level? (Select all that apply.) A. Vasopressin B. Glucagon C. Growth hormone D. Catecholamine E. Corticosteroid
b,c,d
Which structures are located within the larynx? (Select all that apply.) A. Acinus B. Cartilage C. Epiglottis D. Vocal cords E. Estachian tube
b,c,d
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
b,c,d,e
Non-ketotic hyperglycemic hyperosmolar coma in type 2 diabetes is characterized by which of the following? (Select all that apply.) A. Mild hyperglycemia B. Striking dehydration C. Mortality rate of 11% D. With no or slight ketosis E. Adolescents being most often affected
b,c,d,e
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.
b,c,d,e
Syndrome of inappropriate antidiuretic hormone (SIAHD) secretion can be attributed to which of the following? (Select all that apply.) A. Renal disorders B. Malignant lung disorders C. An overactive adrenal cortex D. Nonmalignant lung disorders E. A hyperactive posterior pituitary gland
b,d
The urinary signs and symptoms of acute renal failure associated with the progressive stage of shock are (Select all that apply.) A. polyuria. B. oliguria. C. decreased blood urea nitrogen. D. increased serum creatinine. E. tachycardia.
b,d
Which insulin types are most commonly used in the rapid-acting category? (Select all that apply.) A. NPH B. Aspart C. Glargine D. Lispro E. Regular
b,d
For the individual with type 2 diabetes, the immediate problems brought about by hyperglycemia can lead to which of the following? (Select all that apply.) A. Ketoacidosis B. Insulin resistance C. Suppressed lipogenesis D. Polydipsia and polyuria E. Further diminished insulin secretion
b,d,e
The major factors that influence stroke volume are (Select all that apply.) A. pre-ejection. B. preload. C. resistance. D. contractility E. afterload
b,d,e
The purpose of the upper respiratory system is which of the following? (Select all that apply.) A. Filtering of inspired gas B. Warming of inspired gas C. Exchange of inspired gas D. Humidification of inspired gas E. Conduction of air toward the alveoli
a,b,d,e
The therapies that would be appropriate for a patient with type 1 diabetes mellitus include (Select all that apply.) A. carbohydrate counting. B. high-protein diet. C. daily exercise. D. insulin.
a,c,d
Which datum supports a diagnosis of compensatory metabolic alkalosis? (Select all that apply.) A. History of diabetes B. Hypomania behavior C. Presence of an infection D. Deep, labored respirations E. Breath has a "sour" odor
a,c,d
When assessing an individual during an acute asthma episode, you should expect to find (Select all that apply.) A. use of accessory breathing muscles. B. expiratory wheezing C. foul-smelling sputum. D. coughing E. feeling of chest tightness
a,c,d,e
Insulin resistance during pregnancy is precipitated by which hormone? (Select all that apply.) A. Human chorionic somatomammotropin B. Triiodothyronine C. Prolactin D. Estrogen E. Cortisol
a,d,e
The portion of the brain that is responsible for neural control of the respiratory system is which of the following? (Select all that apply.) A. Medulla oblongata B. Cerebellum C. Frontal lobe D. Thalamus E. Pons
a,e
In extrinsic asthma the immune system responds to the presence of allergens by causing A. bronchodilation. B. bronchoconstriction C. decreased cough reflex. D. decreased sputum production.
b
In the United States, nearly ________ people have diabetes mellitus. A. 7 million B. 29.1 million C. 366 million D. 176 billion
b
It is true that Graves disease is A. a secondary endocrine disorder. B. associated with autoantibodies to TSH receptors C. characterized by high serum TSH levels. D. untreatable.
b
Lack of α-antitrypsin in emphysema causes A. chronic mucous secretion and airway fibrosis. B. destruction of alveolar tissue C. pulmonary edema and increased alveolar compliance. D. bronchoconstriction and airway edema
b
Most endocrine hormones are water-soluble and exert their effects on target cells by A. binding to nuclear receptors. B. generating second messengers. C. binding to intracellular receptors. D. stimulating action potentials
b
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 auton
b
Myocytes leak the enzyme creatine kinase (CK) into the bloodstream in response to cell A. growth. B. ischemia. C. maturation. D. reproduction.
b
Obstructive disorders are associated with A. low residual volumes. B. low expiratory flow rates. C. increased expiratory reserve volume. D. decreased total lung capacity.
b
Oral antidiabetic agents have been used with success A. as the only required therapy for diabetes. B. with dietary planning for type 2 diabetes C. equally well for type 1 and type 2 diabetes. D. as a substitute for insulin in type 1 diabetes
b
A severely hypertensive patient presents with the classic triad of headache, tachycardia, and diaphoresis, and laboratory tests show excessive circulating catecholamine levels. Which rare, but treatable, disorder is suspected? A. Pheochromocytoma B. Adrenal cortical hypertension C. Hypertrophy of the adrenal gland D. Hyperplasia of the adrenal gland
a
Airway obstruction in chronic bronchitis is because of A. thick mucus, fibrosis, and smooth muscle hypertrophy. B. loss of alveolar elastin. C. pulmonary edema. D. hyperplasia and deformation of bronchial cartilage
a
All obstructive pulmonary disorders are characterized by A. resistance to airflow B. hyperresponsiveness. C. decreased residual volumes. D. decreased lung compliance.
a
An example of a secondary endocrine disorder is A. pituitary hyposecretion of TSH B. adrenal insufficiency following adrenalectomy. C. congenital adrenal hyperplasia. D. pheochromocytoma
a
An increase in serum osmolality would be expected to ________ secretion. A. increase vasopressin B. decrease vasopressin C. decrease ADH D. decrease aldosterone
a
Areas of the lung that have little ventilation and thus little oxygen will cause the blood vessels of that area to A. vasoconstrict. B. vasodilate. C. stabilize. D. clot off
a
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.
a
Children who have midline craniocerebral defects, nystagmus, retinal abnormalities, and other midline or midfacial abnormalities (e.g., cleft lip or palate) should be evaluated for deficiencies in A. growth hormone. B. T3 and T4 hormones. C. parathyroid hormone. D. corticosteroid hormones
a
Circulatory shock is best defined as A. inadequate tissue perfusion. B. cardiovascular collapse. C. acute pump failure. D. vasodilation.
a
Clinical manifestations of Graves disease may include A. tremor B. cold intolerance. C. lethargy. D. weight gain.
a
Compliance of the lung is the measure of A. the lungs ability to be inflated. B. gas exchange at the alveoli. C. the lungs dead space. D. shunting
a
Diabetes insipidus is a condition that A. results from inadequate ADH secretion B. is characterized by oliguria. C. is associated with anterior pituitary dysfunction. D. leads to glycosuria.
a
Diabetic neuropathy is thought to result from A. decreased myoinositol transport B. elevated HbA1c. C. deficient neuronal insulin receptors. D. neuronal demyelination
a
Elevated glucose levels in individuals with diabetes mellitus greatly influence fluid balance and hydration because A. fluids are lost as the kidneys clear excessive glucose during hyperglycemia. B. osmotic pressure rises within the cells during hyperglycemia. C. fluids are accumulated in tissues as blood glucose rises. D. older individuals have impaired thirst perception.
a
Emphysema results from destruction of alveolar walls and capillaries, which is because of A. release of proteolytic enzymes from immune cells. B. air trapping with resultant excessive alveolar pressure. C. excessive α1-antitrypsin. D. autoantibodies against pulmonary basement membrane.
a
Hypoventilation causes A. hypoxemia. B. respiratory alkalosis. C. increased minute ventilation. D. decreased PaCO2.
a
In primary thyroid hormone deficiency, the TSH levels are A. high. B. low. C. undetectable. D. constantly fluctuating.
a
In type I diabetes, respiratory compensation may occur through a process of A. respiratory alkalosis B. respiratory acidosis. C. metabolic acidosis. D. metabolic alkalosis.
a
Individuals who have chronic bronchitis most often have A. a productive cough. B. normal lung sounds. C. a barrel chest. D. substantial weight loss.
a
It is true that growth hormone excess in adults A. results in the condition of acromegaly. B. leads to abnormally tall stature. C. is associated with hypoglycemia. D. is usually asymptomatic
a
Macrovascular complications of diabetes mellitus include A. ischemic cerebrovascular accidents B. retinopathy and nephropathy. C. capillary basement membrane thickening. D. hemorrhagic cerebrovascular accidents.
a
Microvascular complications of diabetes mellitus are seen in A. retinopathy and nephropathy B. ischemic cerebrovascular accidents. C. hemorrhagic cerebrovascular accidents. D. damage to large blood vessels supplying the brain
a
Most of the carbon dioxide in blood is A. transported as bicarbonate. B. transported on the hemoglobin molecule. C. transported as carbonic acid. D. dissolved in plasma.
a
Myxedema coma is a severe condition associated with A. hypothyroidism. B. hyperthermia. C. acute cortisol insufficiency. D. pheochromocytoma
a
Oversecretion of ACTH occurs in A. Cushing disease B. hyperthyroidism. C. diabetes insipidus. D. hypoglycemia
a
The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes. A. less than 180 B. more than 180 C. 70 D. 130
a
The amount of gas remaining in the lungs after a maximal expiration is called the A. residual volume. B. functional residual capacity. C. expiratory reserve volume. D. vital capacity.
a
The conditions of pituitary gigantism in children and acromegaly in adults are produced by excessive levels of A. growth hormone B. thyroid hormone. C. antidiuretic hormone. D. corticosteroid hormone
a
The endocrine system closely resembles the ________ system because many of their actions are coordinated at the level of the hypothalamus. A. nervous B. immune C. integumentary D. lymphatic
a
The hypersecretion of mucus resulting for chronic bronchitis is the result of A. recurrent infection B. destruction of alveolar septa. C. reduced inflammation. D. barrel chest
a
The most significant regulator of antidiuretic hormone (ADH) release is A. osmotic pressure of plasma B. body mass index. C. serum pH. D. rate pressure product.
a
The phenomenon that occurs when cells decrease their number of receptors when exposed to prolonged periods of high concentrations of a hormone is called A. down-regulation B. permissiveness. C. up-regulation. D. antagonism
a
The pituitary gland produces a hormone that is a potent anabolic agent that causes the development of all tissues of the body that are capable of responding to it. This hormone is called A. growth hormone (GH) B. luteinizing hormone (LH). C. follicle-stimulating hormone (FSH). D. thyroid-stimulating hormone (TSH)
a
The pulmonary structure that has the least pulmonary blood flow is A. lung apex. B. middle lung. C. lower lung. D. zone 4.
a
The release of prolactin is normally inhibited by A. dopamine. B. acetylcholine. C. somatostatin. D. somatomedin.
a
The uncontrolled hormone production in acromegaly and gigantism is most often the result of A. benign somatotropic tumor in the pituitary gland B. pituitary response to excessive calcium intake. C. asymptomatic hypercalcemia. D. hyperparathyroidism.
a
The underlying pathogenic mechanism for type 1 diabetes is A. pancreatic β-cell destruction B. lack of insulin receptors. C. lack of exercise and chronic overeating. D. impaired glucose transport into cells.
a
For the patient in hypovolemic shock, what compensatory mechanism will help preserve adequate circulation? A. Increased activity of the parasympathetic nervous system B. Decreased secretion of antidiuretic hormone (ADH) C. The renin-angiotensin-aldosterone cascade D. Vasodilation
c
Gas exchange occurs in which of the respiratory system's structures? A. Sinuses B. Trachea C. Alveoli D. Bronchi
c
Hypoxic pulmonary vasoconstriction A. diverts blood to hypoxic regions. B. increases blood flow to the base of the lung. C. can lead to secondary pulmonary hypertension. D. is always detrimental to the patient
c
If the cause of hypercortisolism is an adrenal tumor, which option is indicated? A. Adrenalin administration B. Bilateral removal of adrenal glands C. Unilateral removal of the affected gland D. Glucocorticoid, but not mineralocorticoid, hormone replacement
c
Improvement in a patient with septic shock is indicated by an increase in A. cardiac output. B. SvO2. C. systemic vascular resistance. D. serum lactate level.
c
In adrenocortical insufficiency, such as Addison disease, the most severe manifestations are the result of A. an insufficient amount of T4 and T3. B. deficiencies in the renin-angiotensin system. C. an insufficient amount of circulating cortisol D. decreased levels of all the adrenocortical hormones
c
Insulin binding to its receptor on target cells results in A. increased active transport of glucose into the cell. B. glycogen breakdown within target cells. C. increased facilitated cellular diffusion of glucose D. gluconeogenesis.
c
What situation occurs with hypoventilation? A. The amount of air entering the alveoli increases. B. It is a normal response to high altitude. C. The PaCO2 exceeds 45 mm Hg. D. Hypocapnia occurs.
c
What value is consistent with acute respiratory failure? A. PaO2 of 100 mm Hg B. PaCO2 of 40 mm Hg C. pH less than 7.3 D. PaCO2 of 30 mm Hg
c
When damage occurs to the antidiuretic hormone (ADH)-producing cells in the hypothalamus from head trauma, intracranial tumors, or neurosurgery, what disorder is suggested by a large diuresis of very dilute urine? A. Kidney damage B. Diabetes mellitus C. Diabetes insipidus D. Adrenogenital syndrome
c
When it is necessary for another substance to be produced through intermediate processes to serve as a catalyst for intracellular responses, the new substance is referred to as a A. primary target. B. first messenger. C. second messenger. D. secondary hormone.
c
Which assessment would support a diagnosis of type A COPD rather than type B COPD A. Copious sputum, dyspnea, cor pulmonale B. Noisy breath sounds, fatigue, high PaCO2, overweight C. Normal PaCO2, scant sputum, accessory muscle use, barrel chest D. Barrel chest, productive cough, cyanosis, very decreased PaO2
c
Which complication of asthma is life threatening? A. Exercise-induced asthma B. Late phase response C. Status asthmaticus D. Mast cell degranulation
c
Which hormone is regulated by releasing and inhibiting factors from the hypothalamus? A. Oxytocin B. Vasopressin C. Adrenocorticotropic hormone (ACTH) D. Aldosterone
c
Which is a characteristic of intrinsic (non-allergic) asthma? A. The prognosis is better than that of extrinsic (allergic) asthma. B. The onset is usually in adolescence. C. Attacks are often severe. D. It is IgE-mediated
c
Which lung zone has continuous perfusion throughout the cardiac cycle? A. Zone 1 B. Zone 2 C. Zone 3 D. Zone 4
c
Which statement is true regarding the vagus nerves? A. The left vagus nerve supplies the SA node. B. Parasympathetic nerves innervate all of the ventricles. C. Parasympathetic nerve stimulation reduces the heart rate. D. The right vagus nerve supplies both the SA and AV nodes
c
Which statement regarding oxygen and carbon dioxide is true? A. Carbon dioxide is less soluble than oxygen. B. Oxygen diffuses more quickly than carbon dioxide. C. Carbon dioxide is carried in three forms in the blood. D. The capillary beds do not allow for the exchange of carbon dioxide.
c
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
c
_________ is the hormone which causes uterine and milk duct contractions. A. Vasopressin B. Prolactin C. Oxytocin D. Antidiuretic
c
The pathologic changes that occur in the development of coronary atherosclerotic lesions include cell damage resulting from which of the following? (Select all that apply.) A. A decrease in smooth muscle cells B. A chronic calcium buildup C. The effects of oxidized lipids D. An inflammatory response E. The formation of plaques
c,d,e
Propylthiouracil may be used to treat hyperthyroidism, because it A. destroys thyroid gland cells. B. inhibits the release of TSH. C. suppresses production of autoantibodies. D. inhibits thyroid hormone synthesis
d
Right-sided heart failure secondary to pulmonary hypertension is also called A. diastolic heart failure. B. high output failure. C. coronary disease. D. cor pulmonale
d
Shifts in the oxyhemoglobin dissociation curve represent the A. effect of carbonic anhydrase on the uptake of CO2. B. ability of blood to pick up more CO2 when PaO2 is low. C. amount of hydrogen in solution in the blood. D. changes in hemoglobin affinity for oxygen.
d
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
b
Low cardiac output in association with high preload is characteristic of ________ shock. A. hypovolemic B. cardiogenic C. anaphylactic D. septic
b
Mitral stenosis is associated with A. a prominent S4 heart sound. B. a pressure gradient across the mitral valve C. left ventricular hypertrophy. D. a muffled second heart sound (S2).
b
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
b
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 β receptors on the cell membrane. D. inhibits voltage-gated sodium channels in the membrane.
b
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with A. cardiac catheterization. B. antiplatelet drugs. C. acute reperfusion therapy. D. cardiac biomarkers only.
b
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.
b
The layer of squamous cells that lines the cardiac chambers and valves is called the A. myocardium. B. Endocardium. C. epicardium. D. pericardium.
b
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.
b
The part of the cardiac cycle in which the cardiac muscle obtains oxygen and rids itself of waste products is A. systole. B. diastole. C. ventricular ejection. D. isovolumic contraction.
b
The structure that is composed of six polypeptide chains, two heavy chains, and four light chains is called A. actin. B. myosin. C. troponin. D. tropomyosin
b
What factor causes a congenital heart disease to produce cyanosis? A. Left-to-right shunting of blood B. Right-to-left shunting of blood C. Ventricular septal obstruction D. Atrial septal defect
b
What is the name for the arrangement in which separate cells of the myocardium can function together? A. Autoregulation B. Syncytium C. Ischemia D. Myocyte
b
Which condition may result in chronic pulmonary hypertension, right ventricular hypertrophy, and rightsided heart failure? A. Aortic valve stenosis B. Mitral valve stenosis C. Acute myocarditis D. Aortic insufficiency
b
Which phase of cardiac action potential is caused by closure of the fast sodium channels? A. Phase 0 B. Phase 1 C. Phase 2 D. Phase 3
b
Which terms refers to an increased speed of conduction? A. Inotropic B. Dromotropic C. Chronotropic D. Acetylcholine
b
Which wave corresponds with the AV valve bulging during ventricular contraction? A. A wave B. C wave C. D wave D. V wave
b
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
b,c,d
Inflammatory disorders that may alter endothelial cell function include (Select all that apply.) A. multiple sclerosis. B. lupus erythematosus. C. Kawasaki syndrome. D. rheumatoid arthritis. E. polyarteritis nodosa
b,c,e
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.
c
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
c
Atherosclerosis predisposes to a number of processes that are factors in myocardial ischemia. These processes include A. hemorrhage. B. coronary dilation. C. thrombus formation. D. ventricular dysrhythmia
c
Atherosclerotic plaques with large lipid cores are prone to A. dislodgement. B. binding. C. rupture. D. attachment.
c
Blood is transported from the right ventricle to the lungs by the A. pulmonary veins. B. aorta. C. pulmonary artery. D. bronchial arteries.
c
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
c
Cardiogenic shock is characterized by A. hypovolemia. B. reduced systemic vascular resistance. C. reduced cardiac output. D. elevated SvO2.
c
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
c
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
c
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
c
Patent ductus arteriosus is accurately described as a(n) A. opening between the atria. B. stricture of the aorta that impedes blood flow. C. communication between the aorta and the pulmonary artery. D. cyanotic heart defect associated with right-to-left shunt.
c
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
c
Rheumatic heart disease is most often a consequence of A. chronic intravenous drug abuse. B. viral infection with herpesvirus. C. β-hemolytic streptococcal infection. D. cardiomyopathy.
c
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.
c
Tachycardia is an early sign of low cardiac output that occurs because of A. tissue hypoxia. B. anxiety. C. baroreceptor activity. D. acidosis.
c
Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of A. catecholamines. B. clotting factors. C. nitric oxide. D. vasopressin.
c
Which electrolyte is necessary for muscle contraction? A. K+ (potassium) B. Na+ (sodium) C. Ca2 + (calcium) D. Mg2 + (magnesium)
c
Which wave on the ECG is representative of depolarization of the lateral walls? A. Q wave B. R wave C. S wave D. T wave
c
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
c,e
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
d
The primary cause of sudden cardiac death is usually because of A. heart failure. B. cardiomyopathy. C. atherosclerotic plaques. D. ventricular dysrhythmia.
d
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
d
What is the marker of choice for detecting a myocardial infarction? A. Elevated T waves on an ECG B. Elevated serum levels of C-MB C. Elevated serum levels of cardiac myoglobin D. Elevated serum levels of cardiac troponin
d
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
d
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
d
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
d
Which refers to intermittent, spontaneous generation of action potentials? A. Relative refractory B. Antiarrhythmics C. Repolarization D. Rhythmicity
d
Which statement is true regarding muscle contraction? A. Contraction of cardiac muscle results from lengthening of sarcomeres. B. Calcium removal from the cytoplasm causes contraction. C. Calcium entry into the cytoplasm causes relaxation. D. Cardiac myocytes are terminally differentiated.
d
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.
b
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.
b
Hypotension associated with neurogenic and anaphylactic shock is because of A. hypovolemia. B. peripheral pooling of blood. C. poor cardiac contractility. D. high afterload
b
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
b
Dead space includes which of the following dimensions? (Select all that apply.) A. Anatomic B. Alveolar C. Physiologic D. Cartilaginous E. Airway resistance
a,b,c
Growth hormone-deficient infants would display A. low birth length and weight. B. normal birth length and weight C. high birth length and weight. D. normal length and low weight.
b
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis. True/ False
False
A standard ECG has 13 leads. True/ False
False
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. True/ False
False
Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body. True/ False
False
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. True/ False
False
When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that A. "Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round." B. "Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round." C. "Coughing caused by your condition has changed the structure of your airways, which makes your chest round." D. "Scar tissue in your lungs makes them stiff and more full of air than usual, which makes your chest round."
a
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. add a box of surgical masks to the nursing supplies near the door. D. remove the water pitcher to comply with anticipated fluid restrictions
a
Which cellular change is seen with chronic bronchitis? A. Increased eosinophils B. Decreased CD8 T lymphocytes C. Decreased interleukin-8 levels D. Atrophy of bronchial glands
a
Which hormone is highly bound to carrier proteins in the bloodstream? A. Thyroid hormones B. Insulin C. Glucagon D. Parathyroid hormone
a
Which pulmonary function test result is consistent with a diagnosis of asthma? A. Reduced forced expiratory volume in 1 second (FEV1) B. Decreased functional residual capacity C. Increased FEV1 D. Reduced total lung volume
a
Which response to an injection of ACTH indicates a primary adrenal insufficiency? A. No change in serum glucocorticoid level B. An increase in serum glucocorticoid level C. A decrease in serum glucose level D. An increase in serum ACTH level
a
Which statement regarding bronchiectasis is true? A. It is common in cystic fibrosis B. It often leads to lung carcinoma. C. It is classified according to stage of spread. D. The most common bacterial pathogen is Streptococcus pneumoniae.
a
Hormonal cell receptors that influence intracellular activity are specific to hormone types and are located on which of the following parts of the cell? (Select all that apply.) A. Walls B. Nuclei C. Cytoplasm D. Nucleoplasm E. Mitochondria
a, b, c
Which is true about epiglottitis? (Select all that apply.) A. Is usually caused by H. influenzae type B B. Can be caused by bacterial infection C. Usually occurs in children D. Is characterized by pain with swallowing E. Generally resolves without intervention
a, b, c, d
Acute bronchitis can be caused by which of the following? (Select all that apply.) A. Influenza A B. Adenovirus C. Coxsackie virus D. Pseudomonas aeruginosa E. Streptococcus pneumoniae
a, b, c, e
The characteristics of bronchiolitis include which of the following? (Select all that apply.) A. Thick, tenacious mucus B. Wheezing C. Crackles D. Bradypnea E. Ear pain
a, b, c, e
What occurs during an acute asthma attack? (Select all that apply.) A. Sputum is often thick, tenacious, scant, and viscid. B. Bronchoconstriction occurs. C. Residual lung volume increases. D. Tidal volume remains unchanged. E. Forced expiratory volumes decrease
a, b, c, e
Characteristics of asthma include (Select all that apply.) A. chronic inflammatory disorder. B. airway hyperresponsiveness C. alveolar collapse. D. genetic susceptibility. E. airway remodeling
a, b, d ,e
Which are major obstructive airway diseases? (Select all that apply.) A. Asthma B. Bronchitis C. Pneumonia D. Emphysema E. Bronchiectasis
a, b, d, e
Which is a classification of emphysema? (Select all that apply.) A. Centriacinar B. Parenchyma C. Panacinar D. Paraseptal E. Bullae
a, c, d
The biological activity of a particular hormone is based in part on its rate of which of the following? (Select all that apply.) A. Release B. Bonding C. Synthesis D. Excretion E. Metabolism
a, c, d, e
Which clinical manifestation suggests epiglottitis? (Select all that apply.) A. Assumes "sniffing dog" position B. White patches on tonsils C. Throat is "cherry red" D. Reports dysphagia E. Sounds hoarse
a, c, d, e
Hormones that are released from the anterior pituitary gland include (Select all that apply.) A. luteinizing hormone B. vasopressin. C. prolactin. D. oxytocin. E. follicle-stimulating hormone.
a, c, e
A clinical finding consistent with a diagnosis of syndrome of inappropriate ADH secretion (SIADH) is A. hypovolemia. B. hyponatremia C. decreased osmolality. D. dehydration.
b
A clinical finding that is consistent with a diagnosis of adrenocortical insufficiency is A. hypokalemia. B. hypoglycemia. C. hypertension. D. moon face.
b
A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of A. hyperparathyroidism. B. hypoparathyroidism. C. diabetes insipidus. D. SIADH.
b
A tumor which results in excessive production and release of catecholamines is A. goiter. B. pheochromocytoma C. Conn syndrome. D. Cushing disease.
b
Activation of the renin-angiotensin system in shock causes A. vasodilation. B. fluid retention. C. sodium shifts. D. glucogenesis
b
After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is A. of unknown pathogenesis. B. associated with specific allergic triggers. C. associated with respiratory infections. D. induced by psychological factors (stress).
b
An enlarged thyroid gland produces a colloid goiter when A. lack of iodine prevents formation of thyroid-stimulating hormone without stopping T4 and T3 production. B. lack of iodine prevents T4 and T3 but without stopping thyroglobulin formation C. excessive iodine suppresses thyroid-stimulating hormone, T4, and T3 formation. D. dietary iodine is insufficient and replaced with iodized salt.
b
An example of a lipid-soluble hormone is A. catecholamine. B. thyroid hormone C. peptide hormone. D. pituitary hormone
b
An increase in ADH secretion occurs in response to A. decreased serum osmolality. B. dehydration. C. hypervolemia. D. hyponatremia.
b
An increase in filtration of fluid from the pulmonary capillaries into the interstitium occurs with ________ pressure. A. increased capillary colloid B. increased capillary hydrostatic C. decreased capillary hydrostatic D. decreased interstitial colloid
b
Chronic bronchitis often leads to cor pulmonale because of A. ventricular hypoxia. B. increased pulmonary vascular resistance C. left ventricular strain. D. hypervolemia.
b
Croup is characterized by A. a productive cough. B. a barking cough. C. an inability to cough. D. drooling, sore throat, and difficulty swallowing
b
Growth hormone has several effects on the body, including A. decreasing plasma glucose level. B. increasing lean body mass. C. enhancing deposition of fat. D. depressing immune function.
b
"My doctor said I have cor pul-something, which is a heart problem," says Mr. Garabedian. "I thought I just had these bad lungs that can't be fixed. How can that make my heart go bad?" Which mechanism leads to the development of cor pulmonale, which should serve as the basis for your response to Mr. Garabedian? A. Left ventricular failure causes pulmonary venous congestion and pulmonary edema. B. Pneumothorax causes compression atelectasis, decreased alveolar ventilation, and impaired oxygenation. C. Increased resistance to pulmonary arterial flow leads to compensatory right ventricular hypertrophy. D. Impaired ventilation causes decreased PaO2, which precipitates cardiac dysrhythmias
c
A clinical finding consistent with a hypoglycemic reaction is A. acetone breath. B. warm, dry skin. C. tremors D. hyperventilation.
c
A laboratory finding that would help confirm the diagnosis of hyperaldosteronism is A. hypernatremia. B. hyperkalemia. C. hypokalemia D. hyperglycemia
c
A patient experiencing an acute myocardial infarction (MI) is given a drug to lyse the clot in the coronary artery. What is the best explanation for the sudden development of a serious arrhythmia once circulation is restored? A. The patient has developed cardiogenic shock. B. An increase in oxygen demand once circulation is restored C. The return of oxygen perfusion resulted in reperfusion injury. D. Resuscitation drugs did not circulate to the heart until the clot was lysed
c
A thyroid gland that grows larger than normal is known as A. cretinism. B. myxedema. C. goiter. D. colloidosis
c
A type of insulin that would be most appropriate for acute management of hyperglycemia is A. NPH. B. Semilente. C. regular. D. Ultralente.
c
Allergic (extrinsic) asthma is associated with A. hyporesponsiveness of airways. B. unknown precipitating factors. C. IgE-mediated airway inflammation. D. irreversible airway obstruction.
c
Antidiuretic hormone (ADH) increases A. sodium reabsorption in the distal tubule of the kidney. B. potassium secretion in the distal tubule of the kidney. C. water reabsorption in the collecting tubule of the kidney D. urinary output
c
Asthma is categorized as a(n) A. restrictive pulmonary disorder. B. infective pulmonary disorder. C. obstructive pulmonary disorder D. type of acute tracheobronchial obstruction
c
Autonomic nervous system stimulation effects on the respiratory system include A. parasympathetic stimulation dilates airways. B. sympathetic stimulation constricts airways. C. sympathetic stimulation relaxes bronchial smooth muscle. D. the autonomic system has no effect on the respiratory system.
c
COPD type A is referred to as A. chronic bronchitis. B. bronchiectasis. C. emphysema. D. asthma.
c
Cells can increase their number of receptors in response to chronically low hormone concentrations, so that they are more sensitive to the hormone despite a lower than normal hormone concentration. This phenomenon is called A. down-regulation. B. permissiveness. C. up-regulation D. antagonism
c
Cortisol is produced in the zona ________ of the adrenal cortex. A. glomerulosa B. reticularis C. fasciculata D. medulla
c
Current views about the target group and frequency of screening for diabetes are based on concern for the high prevalence in the adult population of A. unreported HbA1c levels. B. asymptomatic low-risk individuals. C. undiagnosed type 2 diabetes mellitus. D. undiagnosed type 1 diabetes mellitus
c
Cushing syndrome differs from Cushing disease in that the term Cushing syndrome is used only to describe A. hypercortisolism caused by prolonged use of corticosteroid drugs. B. hypercortisolism caused by ectopic nonpituitary tumors. C. hypercortisolism manifestations, regardless of cause D. hypercortisolism that is pituitary dependent.
c
Cystic fibrosis is associated with A. asthma. B. chronic bronchitis. C. bronchiectasis D. emphysema.
c
Destruction of bronchial walls from dilation of airway sacs is a result of A. Aspergillus fumigatus. B. cor pulmonale. C. bronchiectasis. D. cyanosis.
c
Early compensation for hypovolemic shock includes A. decreased heart rate. B. decreased systemic vascular resistance. C. release of epinephrine from adrenal glands. D. shunting of blood from the brain to the extremities
c
Intracellular activation of hormones by secondary signal amplification refers to which process? A. Amplification of secondary signals is artificially induced by hormone administration. B. Administration of one hormone amplifies its presence and diminishes the feedback mechanisms. C. Tiny amounts of circulating hormones cause a cascade effect of progressively larger number of chemical reactions at each step D. Originating hormone release is amplified, while each successive step in metabolism degrades the strength of the secondary signals.
c
It is true that lipid-soluble hormones are A. transported in a free state in the bloodstream. B. bound to receptors on the plasma membranes of target cells. C. diffused through cell membranes to activate intracellular receptors D. activated by second-messenger cascades within the target cell.
c
Radioactive iodine treatment is the therapy of choice in patients with Graves disease. The patient should be expected to A. achieve full recovery after treatment. B. need short-term thyroid replacement therapy. C. need lifelong thyroid replacement therapy D. receive lifelong iodine treatment.
c
Surfactant is a phospholipid that reduces A. pulmonary vascular capacitance. B. elastic recoil force. C. alveolar surface tension. D. pulmonary capillary fragility
c
The breakdown of stored glycogen in the liver and muscles is called A. glycolysis. B. glycogenesis. C. glycogenolysis D. gluconeogenesis
c
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by A. increased pulmonary blood flow. B. increased expiratory flow rates. C. increased residual lung volumes D. decreased chest wall compliance
c
The lungs are normally fully developed by what year of age? A. 15 B. 10 C. 8 D. 5
c
The major risk factor for the development of lung cancer is A. age. B. heredity. C. cigarette smoking. D. asbestos exposure.
c
The peripheral chemoreceptors A. are located in the medulla oblongata. B. lead to hypoventilation when stimulated. C. respond to the arterial oxygen level. D. are unresponsive to pH and CO2 levels
c
The shift to anaerobic metabolism in shock results in A. metabolic alkalosis. B. decreased oxygen utilization. C. increased lactate production. D. decreased hydrogen ion production.
c
The signs and symptoms of adrenocortical hormone excess may occur from either a primary or secondary disorder. A symptom associated with primary Cushing syndrome is A. hyperpigmentation. B. hypotension. C. hyperglycemia D. hyperkalemia.
c
Up-regulation of target cell receptors results in A. decreased target cell sensitivity to hormone. B. reduced production of hormone. C. increased target cell responsiveness to hormone D. an increased hormone half-life.
c
Virchow's triad can result in A. decreased pulmonary arterial pressure. B. alveolar collapse. C. pulmonary embolus. D. bronchoconstriction.
c
What indicator is most helpful in evaluating long-term blood glucose management in patients with diabetes mellitus? A. Blood glucose levels B. Urine glucose levels C. Glycosylated hemoglobin levels (HbA1c) D. Clinical manifestations of hyperglycemia
c
What is the primary cause of airway obstruction in patients with chronic bronchitis? A. Thinning bronchial smooth muscle B. Hyperventilation C. Mucous plugs D. Infection
c
What is the underlying problem common among all types of shock? A. Cardiac failure B. Generalized vasodilation C. Inadequate cellular oxygenation D. Faulty compensatory mechanisms
c
What likelihood is there that gestational diabetes will persist or recur after pregnancy? A. Gestational diabetes markedly increases the development of type 1 diabetes mellitus. B. If glucose tolerance returns after pregnancy, there is low likelihood of recurrence of diabetes mellitus. C. Between 30% to 84%of women with a history of gestational diabetes mellitus will have a recurrence in subsequent pregnancies D. Women with gestational diabetes have about the same incidence of developing type 2 diabetes as women in the general population
c
A description of the feedback mechanism implemented by the thyroid gland would state that A. positive feed-forward occurs when excessive levels of thyroid-stimulating hormone shut down thyroid gland release of hormones but provides similar hormonal action. B. positive feedback occurs when falling levels of the circulating thyroid hormones stimulate the release of thyroid-stimulating hormone from the pituitary gland that then inhibits thyroid hormone secretion. C. negative feedback occurs when falling levels of thyroid-stimulating hormone from the pituitary gland stimulate release of the hormone from the thyroid that then inhibits thyroid-stimulating hormone release. D. negative feedback occurs when low levels of circulating T3 and T4 trigger thyrotropin-releasing hormone to stimulate release of pituitary thyroid-stimulating hormone that then stimulates thyroid secretion of T3 and T4, resulting in rising levels that inhibit thyroid-stimulating hormone release.
d
A patient reporting vision changes, photophobia, and lid lag may be exhibiting signs of A. Addison disease. B. Cushing syndrome. C. myxedema. D. Graves disease.
d
A primary endocrine disorder occurs when A. the pituitary gland oversecretes hormones. B. the pituitary gland undersecretes hormones. C. exogenous hormones suppress endogenous production. D. the target gland is unresponsive to pituitary regulation.
d
Aldosterone secretion is regulated by the presence of ________ in the circulation. A. progesterone B. corticoglobulin C. ACTH D. angiotensin II
d
Aldosterone secretion would be expected to produce which change? A. Decrease sodium reabsorption B. Decrease urine potassium C. Decrease blood pressure D. Increase blood pressure
d
COPD leads to a barrel chest, because it causes A. pulmonary edema. B. muscle atrophy. C. prolonged inspiration. D. air trapping
d
Calcitonin is produced by thyroid parafollicular cells and increases bone formation by A. homeostasis. B. osteoclasts. C. reabsorption. D. osteoblasts
d
Changes in urine osmolality seen in syndrome of inappropriate antidiuretic hormone (SIADH) secretion cause A. increased serum osmolality. B. peripheral and central edema. C. increased water retention with sodium. D. increased water retention without sodium
d
Chronic pulmonary hypertension can eventually cause which complication? A. Pulmonary emboli B. Respiratory acidosis C. Chronic obstructive pulmonary disease D. Right heart failure
d
Clinical manifestations of hypoparathyroidism A. are similar to those occurring with hypermagnesemia. B. result from decreased neuromuscular excitability. C. are similar to those occurring with hypokalemia. D. result from decreased serum ionized calcium
d
Congenital adrenal hyperplasia (adrenogenital syndrome) results from A. cortisol excess. B. testosterone-secreting tumor. C. exogenous androgens. D. blocked cortisol production
d
Copious amounts of foul-smelling sputum are generally associated with A. emphysema. B. epiglottitis. C. pulmonary edema. D. bronchiectasis
d
Diabetes mellitus is most accurately defined as a disorder that affects A. the utilization of fats and glucose. B. glucose metabolism and utilization. C. the metabolism of glycogen stores and glucose. D. the utilization of all energy nutrients
d
Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States. A. first B. second C. fourth D. seventh
d
Growth hormone stimulates the liver to release A. ketones. B. insulin. C. bile. D. IGF-1
d
Hormones are synthesized within an endocrine organ's cell organelles with A. all endocrine organs producing a variety of hormones. B. each endocrine organ source producing a different hormone. C. all of one particular hormone being produced only by one organ. D. hormone synthesis sometimes taking place in other organs or cell types
d
If annual development assessment shows a child to have growth hormone deficiencies, treatment alternatives include A. parathyroid preparations. B. surgical removal of the tumor. C. palliative care because no treatment is known. D. pharmacologic agents that affect growth hormone secretion
d
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event? A. Loss of alveolar elastin and premature closure of airways B. Pulmonary edema and decreased alveolar compliance C. Mast cell degranulation that causes decreased surfactant D. Inflammation, mucosal edema, and bronchoconstriction
d
It is true that the synthesis of thyroid hormones A. is increased by thyrotropin-inhibiting factor. B. occurs in perifollicular C cells. C. is stimulated by ACTH. D. is inhibited by iodine deficiency
d
Low serum levels of which hormone is helpful in differentiating between primary or secondary causes of hypothyroidism? A. T3 B. T4 C. Thyroxine D. Thyroid-stimulating hormone (TSH)
d
Primary pulmonary hypertension is A. more common in men. B. readily treatable. C. caused by genetic mutation. D. rapidly progressive
d
Some hormones are secreted in cyclic patterns. In these cases, which statement is true? A. Hormones controlling menstruation are circadian in nature. B. Circadian rhythms always dominate over systemic needs or stressors. C. Hormones that control reproductive differentiation are controlled by circadian cycles. D. Immediate systemic needs can override cyclic patterns and modify hormone secretion
d
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. The child probably has consolidated pneumonia; oxygen should be started immediately. B. Since there is not wheezing, asthma is the problem, but oxygen should be started immediately anyway. C. The signs and symptoms are consistent with asthma; start oxygen and then check to see that your stethoscope is working properly. D. 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 most common cause of chronic bronchitis is A. bacterial infection. B. chemical irritants. C. viral infection. D. smoking
d
The origin of congenital adrenal hyperplasia occurs when circulating cortisol levels A. are normal but ACTH levels are high. B. are high and stimulate ACTH activity. C. and ACTH levels are normal but adrenal glands proliferate. D. are insufficient to provide negative feedback to the anterior pituitary gland
d
The pathology of syndrome of inappropriate antidiuretic hormone (SIADH) secretion, leading to dilution of serum and an excess of water relative to solute, produces A. shrinking of cells and neuron tissue. B. hypokalemia and cardiac dysrhythmias. C. hemoconcentration and falsely high hemoglobin. D. hyponatremia and swelling of cells and neural compression
d
The vasoactive mediators released in septic shock contribute to increase A. systemic vascular resistance. B. destruction of microemboli. C. systemic vasoconstriction. D. vascular permeability
d
What effect would adrenocortical insufficiency have on an individual's response to surgical stress? A. More prone to hyperglycemia B. Decreased sensitivity to anesthesia C. More susceptible to hypertensive crisis D. More prone to hypotension
d
Which characteristic uniquely belongs to type 2 diabetes mellitus? A. A strong genetic component B. An absolute absence of insulin production C. A lower than normal basal insulin secretion D. An absent first-phase insulin response and diminished second-phase response
d
Which hormone is responsible for regulation of immune and inflammatory reactions? A. Thyrotropin B. Androgen C. Aldosterone D. Cortisol
d
Which is a true statement regarding the mechanics of breathing? A. During inspiration the muscles relax. B. During exhalation the muscles contract. C. Atelectasis occurs when bronchi collapse. D. Functional residual capacity is the air remaining in alveoli.
d
Which is an upper airway structure? A. Trachea B. Larynx C. Bronchi D. Oropharynx
d
Which person is at greatest risk for developing a pulmonary embolism? A. A 25-year-old man with asthma B. A 28-year-old woman in the first trimester of a normal pregnancy C. A 42-year-old woman with a broken ankle D. A 67-year-old man with a deep vein thrombosis in the femoral vein
d
Which statement is true regarding cystic fibrosis? A. It is autosomal-dominant. B. It affects endocrine glands. C. It is common in African Americans. D. It is the most common genetic disease in the United States
d
Which statement is true regarding the function of hormones? A. Their sole function is to target and influence cell locations distant from the secreting cell. B. Their sole function is to influence cellular function of the secreting cell. C. Their sole function is to target and influence cell locations adjacent to the secreting cell. D. They may act to target and influence either the secreting cell or cells at other locations
d
A requirement for rhythmicity is that the cell membrane has channels that automatically open in phase 3. True/ False
False
The R wave is responsible for apical depolarization. True/ False
False
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? A. Cardiogenic B. Septic C. Anaphylactic D. Neurogenic
b
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
a
A patient with significant aortic stenosis is likely to experience A. syncope. B. hypertension. C. increased pulse pressure. D. peripheral edema.
a
Administration of which therapy is most appropriate for hypovolemic shock? A. Crystalloids B. Vasoconstrictor agents C. Inotropic agents D. 5% dextrose in water
a
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.
a
At very high heart rates, cardiac output A. decreases. B. increases. C. stays the same. D. reverses
a
Constrictive pericarditis is associated with A. impaired cardiac filling. B. cardiac hypertrophy. C. increased cardiac preload. D. elevated myocardial oxygen consumption.
a
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
a
The effect of nitric oxide on systemic arterioles is A. vasodilation. B. vasoconstriction. C. not significant. D. opposed by nitrate drugs
a
The progressive stage of hypovolemic shock is characterized by A. tachycardia. B. hypertension. C. lactic acidosis. D. cardiac failure
a
The v wave of an atrial pressure tracing corresponds to A. atrial filling. B. ventricular systole. C. atrial systole. D. mitral valve closure
a
What valve directs blood flow from the left atrium to the left ventricle? A. Mitral B. Aortic C. Pulmonic D. Tricuspid
a
Which is a true statement about the affect of the Frank-Starling law on the heart? A. Increased diastolic stretching of myocardial fibers produces increased stroke volume B. Sympathetic activation leads to increased myocardial contractility and heart rate. C. An increase in heart chamber diameter increases myocardial wall tension. D. An increase in coronary artery diameter results in less rapid coronary blood flow.
a
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
a
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 associated with increased risk of coronary artery disease. B. Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease. C. Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain. D. Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant.
a
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
a,b,c
What portion(s) of the heart does the left anterior descending branch supply? (Select all that apply.) A. Septal B. Apical C. Anterior D. Lateral E. Posterior
a,b,c
Blood flows in the human body move from which of the following? (Select all that apply.) A. Right atrium to the right ventricle B. Right ventricle to the lungs C. Left ventricle to the body D. Lungs to the left atrium E. Body to the left atrium
a,b,c,d
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.
a,b,c,d
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
a,b,c,d
What is a major determinant of stroke volume? (Select all that apply.) A. Preload B. Afterload C. Heart rate D. Contractility E. Vagus nerve activation
a,b,d
Tetralogy of Fallot is characterized by which of the following? (Select all that apply.) A. A ventricular septal defect B. Right ventricular hypertrophy C. Transposition of the great arteries D. Obstructed right ventricular outflow E. An aorta positioned above the ventricular septal opening
a,b,d,e
Which is a normal excitation pathway? (Select all that apply.) A. AV node B. SA node C. VA node D. Bundle of HIS E. Purkinje Fibers
a,b,d,e
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
a,c
Which clinical manifestation differentiates myocardial infarction (MI) from angina pectoris? (Select all that apply.) A. Radiating chest pain B. Chest pain initiated by exercise C. ST-segment changes on the ECG D. Elevated serum levels of troponin E. Chest pain aggravated by coughing
a,c,d
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
a,c,d
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.
a,d,e
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
b
A vessel that normally contains desaturated (venous) blood is the A. bronchial artery. B. pulmonary artery. C. pulmonary vein. D. coronary artery.
b
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.
b
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
c
. 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
d
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
d
Abnormal vascular regulation by endothelial cells in small vessels of the heart contributes to A. hypertension. B. dysrhythmias. C. truncus arteriosus. D. ischemic heart disease
d
Angina caused by coronary artery spasm is called _____ angina. A. stable B. classic C. unstable D. Prinzmetal variant
d
In a patient with mitral stenosis, cardiac catheterization findings would indicate increased pressure in the A. right ventricle B. left ventricle C. right atria D. left atria
d
The echocardiogram is especially useful in the measurement of the A. coronary blood flow. B. structures of the lungs. C. obstructions to blood flow. D. heart motion within the chest.
d
The majority of cardiac cells that die after myocardial infarction do so because of A. cell rupture. B. insufficient glucose. C. thrombus. D. apoptosis
d
