Patho Midterm
A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction a. i b. ii c. III d. IV
c
A known cause of hypokalemia is a. oliguric renal failure. b. pancreatitis. c. insulin overdose. d. hyperparathyroidism.
c
A major cause of treatment failure in tuberculosis is a. resistant organism. b. allergy to drugs used. c. noncompliance. d. immunosuppression.
c
A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with a. petechiae. b. purpura. c. telangiectasia. d. thrombocytosis.
c
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop a. hypokalemia. b. hyperkalemia. c. hypophosphatemia. d. hyperphosphatemia.
c
Activation of the extrinsic pathway of coagulation is initiated by a. platelet factors. b. collagen exposure. c. tissue thromboplastin. d. factor VII.
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
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
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
Increased preload of the cardiac chambers may lead to which patient symptom? a. Decreased heart rate b. Decreased respiratory rate c. Edema d. Excitability
c
Of the statements below, the accurate statement regarding nutrition and cellular health is a. the body can generally produce elements essential for nutritional balance. b. obese individuals are generally nutritionally healthy. c. deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types. d. a normal BMI indicates nutritional health.
c
The hallmark manifestation of acute respiratory distress syndrome is a. tachycardia. b. hypotension. c. frothy secretions. d. hypoxemia.
c
The inward-pulling force of particles in the vascular fluid is called _____ pressure. a. capillary hydrostatic b. interstitial osmotic c. capillary osmotic d. interstitial hydrostatic
c
What results when systemic blood pressure is increased? a. Hypovolemia b. Decreased cardiac output c. Vasoconstriction d. Decreased vascular resistance
c
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.
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.
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
Accumulation of fluid in the pleural space is called a. an abscess. b. pleurisy. c. flail chest. d. pleural effusion.
d
An important mediator of a type I hypersensitivity reaction is a. complement. b. antigen-antibody immune complexes. c. T cells. d. histamine.
d
Autologous stem cell transplantation is a procedure in which a. there is a high rejection rate. b. stem cells are transferred to the patient from an HLA-matched donor. c. stem cells are transferred to the patient from an identical twin. d. stem cells are harvested from the patient and then returned to the same patient.
d
Emesis causes a. respiratory acidosis. b. respiratory alkalosis. c. metabolic acidosis d. metabolic alkalosis.
d
How do clinical conditions that increase vascular permeability cause edema? a. Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment b. By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling c. Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
d
Metabolic alkalosis is often accompanied by a. hypernatremia. b. hyponatremia. c. hyperkalemia. d. hypokalemia.
d
The ________ system compensates for metabolic acidosis and alkalosis a. gastrointestinal b. renal c. cardiovascular d. respiratory
d
The hallmark manifestation of acute respiratory distress syndrome is a. tachycardia. b. hypotension. c. frothy secretions. d. hypoxemia.
d
When a parent asks how they will know if their 2-month-old baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse's best response is a. "Clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, so those are the diagnostic criteria." b. "If he doesn't wet his diaper all afternoon and his neck veins look flat when he is lying down, then he is probably dehydrated." c. "If he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated." d. "If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated."
d
Which characteristic is indicative of hemolytic anemia? a. Increased total iron-binding capacity b. Increased heart rate c. Hypovolemia d. Jaundince
d
Which form of leukemia demonstrates the presence of the Philadelphia chromosome? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
d
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is a. contaminated water b. immunosuppression. c. being a male. d. overuse of antibiotics.
B. Immunosuppression
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
B. Increased interstitial fluid colloid osmotic pressure
If an individual has a fully compensated metabolic acidosis, the blood pH is a. high. b. low. c. in the normal range. d. either high or low, depending on the type of compensation.
B. Low, than 7.35. normal is 7.35-7.45
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. Peripheral pooling of blood
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. True False
False
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
Familial retinoblastoma involves the transmission of what from parent to offspring? a. Mutant tumor-suppressor gene b. Cancer-causing virus c. Oncogene d. Extra chromosome
a
First-degree heart block is characterized by a. prolonged PR interval b. absent P waves. c. widened QRS complex. d. variable PR interval.
a
Metaplasia is a. the replacement of one differentiated cell type with another. b. the transformation of a cell type to malignancy. c. an irreversible cellular adaptation. d. the disorganization of cells into various sizes, shapes, and arrangements.
a
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 1 b. class 2 c. class 3 d. class 4
a
Respiratory alkalosis is caused by a. hyperventilation. b. pneumonia. c. chest muscle weakness. d. pulmonary edema.
a
Signs and symptoms of clinical dehydration include a. decreased urine output. b. increased skin turgor. c. increased blood pressure. d. decreased heart rate.
a
The body compensates for metabolic alkalosis by a. hypoventilation. b. decreasing arterial carbon dioxide. c. increasing bicarbonate ion excretion. d. hyperventilation.
a
The effect of nitric oxide on systemic arterioles is a. vasodilation. b. vasoconstriction. c. not significant. d. opposed by nitrate drugs.
a
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
a
What age group has a larger volume of extracellular fluid than intracellular fluid? a. infants b. Adolescents c. Young adults d. Older adults
a
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
The cellular change that is considered preneoplastic is a. anaplasia. b. dysplasia. c. metaplasia. d. hyperplasia.
b
The imbalance that occurs with oliguric renal failure is a. metabolic alkalosis. b. hyperkalemia. c. hypokalemia. d. hypophosphatemia.
b
The stage during which the patient functions normally, although the disease processes are well established, is referred to as a. latent b. subclinical c. prodromal. d. convalescence.
b
The strength of the bond between oxygen and hemoglobin is known as the a. bohr effect b. oxygen-hemoglobin affinity. c. dissociation curve. d. hemoglobin synthesis.
b
Transfusion reactions involve RBC destruction caused by a. donor antigens. b. recipient antibodies. c. donor T cells. d. recipient T cells.
b
What is necessary for red blood cell production? a. phosphate b. iron c. magneuism d. calcium
b
When exposed to inhaled allergens, a patient with asthma produces large quantities of a. IgG. b. IgE. c. IgA. d. IgM.
b
Which clinical finding is indicative of compartment syndrome? a. Peripheral edema b. Absent peripheral pulses c. Redness and swelling d. Atrophy of distal tissues
b
A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is a. elevated total iron-binding capacity. b. elevated MCHC and MCV. c. elevated total and indirect bilirubin. d. positive direct or indirect Coombs test.
a
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing a. vitamin K deficiency bleeding. b. acquired vitamin K deficiency. c. von Willebrand disease. d. disseminated intravascular coagulation.
a
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of a. bacterial pneumonia. b. viral pneumonia. c. tuberculosis. d. acute respiratory distress syndrome.
a
A patient with significant aortic stenosis is likely to experience a. syncope. b. hypertension. c. increased pulse pressure. d. peripheral edema.
a
All obstructive pulmonary disorders are characterized by a. resistance to airflow. b. hyperresponsiveness. c. decreased residual volumes. d. decreased lung compliance.
a
All these cellular responses are potentially reversible except a. necrosis b. metaplasia. c. atrophy. d. hyperplasia.
a
An increase in the resting membrane potential (hyperpolarized) is associated with a. hypokalemia. b. hyperkalemia. c. hypocalcemia. d. hypercalcemia.
a
The arterial oxygen content (CaO2) for a patient with PaO2 100 mm Hg, SaO2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL. a. 19.4 b. 1909.8 c. 210 d. 21.05
A. 19.4
A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis is a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
A. ALL (acute lymphoid leukemia)
Which type of leukemia primarily affects children? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)
A. ALL (acute lymphoid leukemia)
Retroviruses are associated with human cancers, including a. Burkitt lymphoma. b. Hodgkin's lymphoma. c. pancreatic cancer. d. hepatic cancer.
A. Burkitt Lymphoma
Velocity of blood flow is measured in a. centimeters per second. b. millimeters per minute. c. yards per hour. d. kilometers per minute.
A. Centimeters per second
Effects of hypernatremia on the central nervous system typically include a. confusion. b. excitation. c. insomnia. d. hallucinations.
A. Confusion
A patient, who is 8 months pregnant, has developed eclampsia and is receiving intravenous magnesium sulfate to prevent seizures. To determine if her infusion rate is too high, you should regularly a. check the patellar reflex; if it becomes more and more hyperactive, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest. b. check the patellar reflex; if it becomes weak or absent, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest. c. check the patellar reflex; if it stays the same, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest. d. check for seizure activity; if no seizures occur, her infusion rate is correct.
B. Check the patellar reflex; if it becomes weak or absent, her infusion rate is probably to high and she is at risk for respiratory depression or cardiac arrest
Beta-blockers are advocated in the management of heart failure because they a. increase cardiac output b. decrease cardiac output c. enhance sodium absorption. d. reduce blood flow to the kidneys.
B. Decrease cardiac output
Tachycardia is an early sign of low cardiac output that occurs because of a. tissue hypoxia. b. anxiety. c. baroreceptor activity. d. acidosis.
C.
Which is indicative of a left tension pneumothorax? a. Course crackles throughout the left chest b. Tracheal deviation to the left c. Absent breath sounds on the left d. Respiratory acidosis
C. Absent breath sounds on the left
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. Communication between the aorta and the pulmonary artery.
Restriction of which electrolytes is recommended in the management of high blood pressure? a. Calcium b. Potassium c. Sodium d. Magnesium
C. Sodium
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. Systemic vascular resistance
Which clinical manifestation is not likely the result of a tuberculosis infection? a. Productive cough b. Low-grade fever c. Night sweats d. cyanosis
Cyanosis
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. Antibiotics
Copious amounts of foul-smelling sputum are generally associated with a. emphysema. b. epiglottitis. c. pulmonary edema. d. bronchiectasis.
D. Bronchiectasis
The final step in clot formation is a. conversion of prothrombin to thrombin. b. platelet degranulation and adhesion. c. conversion of fibrinogen to fibrin. d. clot retraction.
D. Clot retraction
Diffusion
True
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. True False
True
The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension. True False
True
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
Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following? a. It is a procedure for determining the extent of tumor spread. b. It is a histologic examination of tissues to determine the degree of tumor differentiation. c. It is based on exploratory surgery. d. It is biochemical testing of tumor cells to determine the genetic basis of the tumor.
a
A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is a. leukemia. b. myeloma. c. Hodgkin disease. d. back trauma.
b
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.
b
A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of a. primary prevention. b. secondary prevention. c. tertiary prevention. d. disease treatment.
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
Clinical manifestations of moderate to severe hypokalemia include a. muscle spasms and rapid respirations. b. muscle weakness and cardiac dysrhythmias. c. confusion and irritability. d. vomiting and diarrhea.
b
Hyperaldosteronism causes a. ECV deficit and hyperkalemia. b. ECV excess and hypokalemia. c. hyponatremia and hyperkalemia. d. excessive water reabsorption without affecting sodium concentration.
b
Low cardiac output in association with high preload is characteristic of ________ shock. a. hypovolemic b. cardiogenic c. anaphylactic d. septic
b
The most commonly recognized outcome of hypertension is pulmonary disease. true false
false