Patho exam 4 questions
Cerebral aneurysm and ateriovenous malformation are the two most common causes of subarachnoid hemorrhage. A. True B. False
A. TRUE
Following a head injury, changes in pupil size, shape and reactivity (often asymmetrical reactions) may indicate impending herniation of the brain. A. True B. False
A. TRUE
Unless contraindicated, a patient who experiences signs and symptoms of transient ischemic attack should immediately ingest an aspirin. A. True B. False
A. TRUE
Elevated serum lipase and amylase levels are indicative of A. gallbladder disease. B. appendicitis. C. pancreatitis. D. Peritonitis
C. pancreatitis.
Esophageal varices represent a complication of ________ hypertension. A. primary B. pregnancy-induced C. portal D. secondary
C. portal
The capillaries of the liver are more commonly known as hepatic: A. canaliculi. B. ducts. C. sinusoids. D. papillae.
C. sinusoids.
Which information indicates the nurse understands digestion? During the cephalic and gastric phases of digestion, gallbladder contraction is mediated by branches of the: A. sympathetic nervous system. B. somatic nervous system. C. vagus nerve. D. glossopharyngeal nerve.
C. vagus nerve.
Parasympathetic stimulation to the pancreas will cause which of the following reactions? A. Hormonal inhibition B. Enzyme secretion C. Vasoconstriction D. Decreased bicarbonate production
B. Enzyme secretion
A patient with a Glasgow Coma Scale score of 10 is classified as having a mild degree of coma. A. True B. False
B. False
Which of the following liver cells are phagocytic? A. Glisson B. Kupffer C. Meissner D. Lieberkühn
B. Kupffer
A patient who presents with a high fever, nausea and vomiting, chills, photophobia, and nuchal rigidity most likely has A. Encephalitis. B. Meningitis. C. A negative Kernig's sign. D. Intracranial pressure reading of 1 mmHg.
B. Meningitis.
Which cells of the gastric glands secrete hydrochloric acid? A. Chief B. Parietal C. Zymogenic D. Surface epithelial
B. Parietal
Epigastric pain that is relieved by food is suggestive of A. pancreatitis. B. peptic ulcer disease. C. gastritis. D. dysphagia.
B. Peptic Ulcer disease
Which sphincter, when it relaxes, allows bile to flow into the duodenum? A. Pyloric sphincter B. Sphincter of Oddi C. Ampulla of Vater D. Ileocecal valve
B. Sphincter of Oddi
The blood supply of the large intestine is derived from which vessel(s)? A. Celiac B. Superior and inferior mesenteric C. Hepatic and portal D. Omental
B. Superior and inferior mesenteric
The most common causes of acute pancreatitis include A. gallstones and hyperlipidemia B. alcohol abuse and gallstones C. hyperlipidemia and hypercalcemia D. surgery and thiazide diuretics
B. alcohol abuse and gallstones
The most important preventative measure for hemorrhagic stroke is A. anticoagulation. B. blood pressure control. C. thrombolytics. D. management of dysrhythmias.
B. blood pressure control.
Most gallstones are composed of A. bile. B. cholesterol. C. calcium. D. uric acid salts.
B. cholesterol.
The function of the acinar cells of the pancreas is to secrete: A. bicarbonate. B. enzymes. C. mucus. D. electrolytes.
B. enzymes
A patient who is at risk for peptic ulcer disease is one who A. has been taking 6 to 8 tablets of acetaminophen per day for 3 weeks. B. has been taking ibuprofen daily for 6 months. C. is experiencing chronic diarrhea. D. routinely drinks alcoholic beverages.
B. has been taking ibuprofen daily for 6 months.
Which of the following situations can contribute to development of peptic ulcer disease? (select all that apply) A. frequent use of acetaminophen. B. infection with Helicobacter Pylori. C. frequent use of ibuprofen. D. smoking
B. infection with Helicobacter Pylori. C. frequent use of ibuprofen. D. smoking
Inflammatory Bowel Disease (IBD) A. is an autoimmune disorder B. is characterized by periods of remission interspersed with periods of exacerbation C. is caused by infection with H. pylori D. is characterized by abnormal gastrointestinal motility and secretion
B. is characterized by periods of remission interspersed with periods of exacerbation
John is a college student living in a dormitory. He comes to the clinic complaining of a headache and confusion. John is found to have a fever of 102° F. This information is most consistent with A. encephalitis. B. meningitis. C. skull fracture. D. cerebral ischemia.
B. meningitis.
The pain associated with acute pancreatitis is generally described as ________ in nature. A. sharp and constant. B. steady and boring C. intermittent and burning D. intermittent and stabbing
B. steady and boring
Cerebral aneurysm is most frequently the etiology of A. embolic stroke. B. subarachnoid hemorrhage. C. subdural hemorrhage. D. meningitis.
B. subarachnoid hemorrhage.
Manifestations of acute brain ischemia (Cushing reflex) are due primarily to A. parasympathetic nervous system activation. B. sympathetic nervous system activation. C. autoregulation. D. loss of brainstem reflexes.
B. sympathetic nervous system activation.
The most common cause of mechanical bowel obstruction is A. Volvulus B. Intussusception C. Adhesions D. Fecal impaction
C. Adhesions
What finding would rule out a diagnosis of irritable bowel syndrome in a patient with chronic diarrhea? A. Negative stool leukocytes B. Intermittent constipation C. Abdominal pain and distention D. Bloody stools
D. Bloody stools
Which immunoglobulin is found in normal saliva? A. IgG B. IgD C. IgE D. IgA
D. IgA
Which sphincter prevents reflux of digested material from the colon into the small intestine? A. Haustral B. Lower esophageal C. Pyloric D. Ileocecal valve
D. Ileocecal valve
The pancreas produces which substance to prevent the premature activation of proteolytic enzymes in the pancreas? A. Bicarbonate B. Carboxypeptidase C. Secretin D. Trypsin inhibitor
D. Trypsin inhibitor
Rupture of a cerebral aneurysm should be suspected if the patient reports A. ringing in the ears. B. transient episodes of numbness. C. transient episodes of vertigo. D. a sudden, severe headache.
D. a sudden, severe headache.
A viral hepatitis screen with positive hepatitis B surface antigen (HBsAg) should be interpreted as ________ hepatitis B. A. recovered from B. immunity to C. chronic active D. Acute
D. acute
Epidural bleeding is A. associated with widespread vascular disruption. B. located between the arachnoid and the dura mater. C. usually due to venous leakage. D. characterized by a lucid interval immediately after injury.
D. characterized by a lucid interval immediately after injury.
The definitive treatment for cholecystitis is A. lithotripsy of stones. B. chemical dissolution of stones. C. antibiotics and anti-inflammatories. D. cholecystectomy.
D. cholecystectomy
A patient with peptic ulcer disease may have anemia because of either blood loss or insufficient intrinsic factor. True False
TRUE
Cholecystitis is almost always associated with cholelithiasis and obstruction of the cystic duct related to stasis of bile. True False
TRUE
Cortical spreading depression is thought to trigger the trigeminal vascular system that leads to vasodilation, inflammation, and sensitization of pain receptors in the etiology of migraine headaches. True False
TRUE
Migraine aura is associated with cortical spreading depression. True False
TRUE
Celiac disease is an immune-mediated disorder triggered by ingestion of gluten-containing grains such as wheat, barley, and rye. True False
True
In liver cirrhosis, portal hypertension is caused by fibrosis in the blood vessels leading to resistance of blood flow. True False
True
Acute right lower quadrant pain (McBurney's point) associated with rebound tenderness and systemic signs of inflammation are indicative of a. Appendicitis b. Peritonitis c. Cholecystitis d. Gastritis
a. Appendicitis
Chief cells secrete __, while parietal cells secrete __. ' a. Pepsinogen, hydrogen chloride b. Hydrogen chloride, pepsinogen c. Gastrin, intrinsic factor d. Gastrin, intrinsic factor
a. Pepsinogen, hydrogen chloride
Which of the following symptoms suggests the presence of hiatal hernia? a. Flatus b. Heartburn c. Diarrhea d. Abdominal cramps
b. Heartburn
Epigastric pain that is relieved by food is suggestive of a. Pancreatitis b. Peptic ulcer disease c. Gastritis d. dysphagia
b. Peptic ulcer disease
Barrett esophagus is a a. Gastrin secreting lesion b. Preneoplastic lesion c. Benign condition d. Gastrin-secreting tumor
b. Preneoplastic lesion
The _____ reflex initiates propulsion in the entire colon, usually during or immediately after eating. A. gastrocolic B. ileocolic C. duodenocolic D. cephalocolic
A. gastrocolic
Which of the following signs and symptoms can be related to complications of cirrhosis? (select all that apply) A. . bruising and bleeding B. splenomegaly C. edema and ascites D. encephalopathy
ALL of the above
In the acute phase of stroke, treatment is aimed at A. stabilization of respiratory and cardiovascular function. B. risk factor modification. C. prevention of bedsores and contractures. D. neurologic rehabilitation.
A. stabilization of respiratory and cardiovascular function.
Patients who may be at risk for development of cholesterol gallstones include (Select all that apply.) A. high spinal cord injuries. B. patients receiving total parenteral nutrition. C. patients receiving chemotherapy. D. patients with rapid weight loss. E. pregnant women.
A. high spinal cord injuries. B. patients receiving total parenteral nutrition. D. patients with rapid weight loss. E. pregnant women.
The stroke etiology with the highest morbidity and mortality is A. intracranial hemorrhage. B. thrombosis. C. embolization. D. cardiac arrest
A. intracranial hemorrhage.
Ulcerative colitis is commonly associated with A. Bloody diarrhea B. Malabsorption of nutrients C. Fistula formation between loops of bowel D. Inflammation and scarring of the submucosal layer of bowel
A. Bloody diarrhea
Which of the following hematomas are often associated with skull fractures and results in rapid development? A. Epidural B. Subdural C. Subarachnoid D. Arachnoid
A. Epidural
Following an acceleration-deceleration injury, which of the following findings would result in a classification of a mild head injury? A. Glascow Coma Scale score of 14 with no abnormality noted on the CT scan. B. Glascow Coma Scale score of 10 with no abnormality noted on the CT scan. C. Glascow Coma Scale score of 5 with amnesia for 3 hours. D. Glascow Coma Scale score of 3 with amnesia for 30 minutes
A. Glascow Coma Scale score of 14 with no abnormality noted on the CT scan.
Food is moved down the esophagus via what process? A. Peristalsis B. Retropulsion C. Haustral segmentation D. Defecation
A. Peristalsis
Portal hypertension can lead to which of the following signs and symptoms? (select all that apply) A. Splenomegaly B. Ascites C. Decreased bilirubin D. Esophageal varices
A. Splenomegaly B. Ascites D. Esophageal varices
Portal hypertension can lead to which of the following signs and symptoms? (select all that apply) A. spenomegaly B. ascites C. decreased bilirubin D. esophageal varices
A. Splenomegaly B. Ascites D. esophageal varices
Which of the following statements are true regarding cerebral vascular events? (select all that apply) A. Thrombotic strokes are associated with atherosclerosis and hypercoagulable states. B. Neurologic symptoms of a transient ischemic attack typically last only minutes and totally resolve without lasting neurologic dysfunction. C. Thromobolytic therapy for hemorrhagic stroke should be initiated within 24 hours in order to provide the best outcome. D. Transient ischemic attacks are a significant risk for an impending stroke
A. Thrombotic strokes are associated with atherosclerosis and hypercoagulable states. B. Neurologic symptoms of a transient ischemic attack typically last only minutes and totally resolve without lasting neurologic dysfunction. D. Transient ischemic attacks are a significant risk for an impending stroke
The two main causes of acute pancreatitis are A. alcohol abuse B. cigarette smoking C. obesity D. gallstone obstruction
A. alcohol abuse D. gallstone obstruction
Acute right lower quadrant pain (McBurney's point) associated with rebound tenderness and systemic signs of inflammation are indicative of A. appendicitis. B. peritonitis. C. cholecystitis. D. gastritis.
A. appendicitis.
The physiologic change most likely to lead to an increase in intracranial pressure is A. cerebral vasodilation. B. hypernatremia. C. respiratory hyperventilation. D. sleep.
A. cerebral vasodilation.
Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to A. cerebral vasospasm. B. hypotension. C. excessive volume loss. D. increased intracranial pressure. x
A. cerebral vasospasm.
The action of bile is to A. emulsify fats. B. digest cellulose. C. convert sucrose. D. release free amino acids.
A. emulsify fats.
Untreated acute cholecystitis may lead to ________ of the gallbladder wall. A. gangrene B. infection C. distention D. inflammation. x
A. gangrene
Clinical manifestations of gut dysbiosis would include which of the following? (select all that apply) A. Bloating, abdominal pain, and cramping B. Constipation or diarrhea C. Fatigue, brain fog, and lowered mood D. Skin conditions like psoriasis E. Joint pain
ALL of the above A. Bloating, abdominal pain, and cramping B. Constipation or diarrhea C. Fatigue, brain fog, and lowered mood D. Skin conditions like psoriasis E. Joint pain
Clinical manifestations immediately after concussive injury could include which of the following? (select all that apply) A. Alteration of mental status B. Dizziness C. Nausea and vomiting D. Retrograde amnesia
ALL of the above A. Alteration of mental status B. Dizziness C. Nausea and vomiting D. Retrograde amnesia
Signs and symptoms of colon cancer include (select all that apply) A. rectal pain or fullness. B. constipation or diarrhea. C. black, tarry, or pencil-shaped stool D. change in bowel habits.
All of the above A. rectal pain or fullness. B. constipation or diarrhea. C. black, tarry, or pencil-shaped stool D. change in bowel habits.
Which of the following groups of clinical findings indicates the poorest neurologic functioning? A. Spontaneous eye opening, movement to command, oriented to self only B. Eyes open to light touch on shoulder, pupils briskly reactive to light bilaterally C. Assumes decorticate posture with light touch, no verbal response D. No eye opening, responds to painful stimulus by withdrawing
C. Assumes decorticate posture with light touch, no verbal response
Which of the following groups of clinical findings indicates the poorest neurologic functioning? A. Spontaneous eye opening, movement to command, oriented to self only B. Eyes open to light touch on shoulder, pupils briskly reactive to light bilaterally C. Assumes decorticate posture with light touch, no verbal response D. No eye opening, responds to painful stimulus by withdrawing
C. Assumes decorticate posture with light touch, no verbal response
Which of the following statements is FALSE? A. Abdominal pain is generally not caused by cutting or crushing abdominal organs. B. Melena is an indication of blood in the stool. C. Crohn disease and ulcerative colitis are two types of irritable bowel syndrome . D. Patients who have achalasia have difficulty in swallowing both solids and liquids.
C. Crohn disease and ulcerative colitis are two types of irritable bowel syndrome
What clinical finding would suggest an esophageal cause of a client's report of dysphagia? A. Nasal regurgitation and coughing B. Airway obstruction with swallowing C. Heartburn and chest pain during meals D. Coughing when swallowing
C. Heartburn and chest pain during meals
Jaundice is a common manifestation of A. Malabsorption syndromes B. Anemia C. Liver disease D. Cholecystitis
C. Liver disease
An early indicator of colon cancer is A. rectal pain. B. bloody diarrhea. C. a change in bowel habits. D. jaundice.
C. a change in bowel habits.
The exocrine portion of the pancreas contains: A. alpha cells. B. beta cells. C. acinar cells. D. islets of Langerhans.
C. acinar cells.
Risk factors for hemorrhagic stroke include A. atherosclerosis. B. dysrhythmias. C. acute hypertension. D. sedentary lifestyle.
C. acute hypertension.
More than half of the initial cases of pancreatitis are associated with A. trauma. B stones. C. alcoholism. D. high cholesterol
C. alcoholism.
Hepatitis B is usually transmitted by exposure to A. hepatitis vaccine. B. feces. C. blood or semen. D. contaminated food.
C. blood or semen.
Secondary injury after head trauma refers to A. brain injury due to the initial trauma. B. focal areas of bleeding. C. brain injury due to the body's response to tissue damage. D. injury as a result of medical therapy.
C. brain injury due to the body's response to tissue damage.
The vermiform appendix is attached to the: A. duodenum. B. ileum. C. cecum. D. sigmoid colon.
C. cecum.
Acute right upper quadrant tenderness and guarding with a positive Murphy's sign is indicative of A. appendicitis. B. peritonitis. C. cholecystitis. D. gastritis.
C. cholecystitis.
The primary bile salts are synthesized from _______ by hepatocytes lining the bile canaliculi. A. lecithin B. fatty acids C. cholesterol D. testosterone
C. cholesterol
In the liver, free bilirubin moves from the plasma in the sinusoids into the hepatocytes, where it is converted into: A. unconjugated bilirubin. B. biliverdin. C. conjugated bilirubin. D. urobilinogen.
C. conjugated bilirubin.
Encephalitis is usually A. due to a bacterial infection in the CNS. B. fatal. C. due to a viral infection in brain cells. D. asymptomatic.
C. due to a viral infection in brain cells.
A common inhibitory central nervous system (CNS) neurotransmitter is A. acetylcholine B. norepinephrine C. gamma- aminobytyric acid (GABA) D. glutamate
C. gamma- aminobytyric acid (GABA)
Epigastric pain that is relieved by food is suggestive of A. pancreatitis. B. cardiac angina. C. gastric ulcer. D. dysphagia.
C. gastric ulcer.
An example of inappropriate treatment for head trauma would be A. head elevation. B. free water restriction. C. hypoventilation. D. bed rest.
C. hypoventilation.
The most important determinant for prescribing therapy for acute stroke is A. location of ischemia. B. thrombotic versus embolic cause. C. ischemic versus hemorrhagic cause. D. age of the patient.
C. ischemic versus hemorrhagic cause.
Brain injury secondary to high serum bilirubin is called A. hepatic encephalopathy. B. hepatic meningitis. C. kernicterus. D. encephalitis.
C. kernicterus
Acceleration-deceleration movements of the head often result in polar injuries in which A. injury is localized to the site of initial impact. B. widespread neuronal damage is incurred. C. bleeding from venules fills the subdural space. D. focal injuries occur in two places at opposite poles.
D. focal injuries occur in two places at opposite poles.
A patient with a history of alcoholism presents with hematemesis and profound anemia. The expected diagnosis is A. ascites. B. cerebral edema. C. hepatic encephalopathy. D. gastroesophageal varices.
D. gastroesophageal varices.
An increased urine bilirubin is associated with A. an increased indirect serum bilirubin. B. hemolytic reactions. C. Gilbert syndrome. D. hepatitis.
D. hepatitis.
Hepatic encephalopathy is associated with A. hyperbilirubinemia .B. hyperuricemia. C. toxic effects of alcohol on brain cells. D. increased blood ammonia levels.
D. increased blood ammonia levels.
Cholecystokinin is secreted by cells in the ____ and stimulates the release of ____. A. pancreas; bicarbonate B. pancreas; secretin C. intestine; bicarbonate D. intestine; bile
D. intestine; bile
irritable bowel syndrome (IBS) A. is an autoimmune disorder B. is characterized by periods of remission interspersed with periods of exacerbation C. is caused by infection with H. pylori D. is characterized by abnormal gastrointestinal motility leading to diarrhea, constipation, or alternating patterns of both.
D. is characterized by abnormal gastrointestinal motility leading to diarrhea, constipation, or alternating patterns of both.
Clinical manifestations of a stroke within the right cerebral hemisphere include A. cortical blindness. B. right visual field blindness. C. expressive and receptive aphasia. D. left-sided muscle weakness and neglect.
D. left-sided muscle weakness and neglect.
Pathophysiologically, esophageal varices can be attributed to A. elevated bilirubin. B. diminished protein metabolism. C. fluid accumulation. D. portal hypertension.
D. portal hypertension.
Rupture of a cerebral aneurysm should be suspected if the patient reports A. ringing in the ears B. transient episodes of numbness. C. transient episodes of vertigo. D. sudden, severe headache.
D. sudden, severe headache.
Mucus production to form the mucosal barrier in the stomach is stimulated by the release of: a. Somatostatin b. Gastrin c. Prostaglandins d. Histamine
c. Prostaglandins
