Pathophysiology: Check Your Understanding: Final

Croup is characterized by a. an inability to cough. b. drooling, sore throat, and difficulty swallowing. c. a barking cough. d. a productive cough.

a barking cough

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of a. amyotrophic lateral sclerosis. b. hydrocephalus. c. Guillain-Barré syndrome. d. Parkinson disease.

amyotrophic lateral sclerosis

A patient has ureteral colic. The manifestation that requires immediate notification of the physician is a. chills and fever. b. vomiting. c. pink-tinged urine. d. severe flank pain.

chills and fever

The definitive treatment for cholecystitis is a. antibiotics and anti-inflammatories. b. cholecystectomy. c. lithotripsy of stones. d. chemical dissolution of stoes.

cholecystectomy

Which clinical manifestation is not likely the result of a tuberculosis infection? a. Productive cough b. Night sweats c. Cyanosis d. Low-grade fever

Cyanosis

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.

clot retraction

The type of glomerulonephritis which is most likely to result in a swift decline in renal function that then progresses to acute kidney injury is a. post-streptococcal glomerulonephritis. b. crescentic glomerulonephritis. c. acute glomerulonephritis. d. chronic glomerulonephritis.

crescentic glomerulonephritis

Hypernatremia may be caused by a. decreased antidiuretic hormone secretion. b. excessive dietary potassium. c. decreased aldosterone secretion. d. compulsive water drinking.

decreased antidiuretic hormone secretion

Signs and symptoms of clinical dehydration include a. decreased heart rate. b. increased blood pressure. c. increased skin turgor. d. decreased urine output.

decreased urine output

Clinical manifestations of severe symptomatic hypophosphatemia are caused by a. deficiency of ATP. b. hypocalcemia. c. renal damage. d. excess proteins.

deficiency of ATP

Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia. a. True b. False

False

A tool used to assess levels of consciousness is a. magnetic resonance imaging (MRI). b. central perfusion pressure (CPP). c. intracranial pressure (ICP) monitoring. d. Glasgow Coma Scale (GCS).

Glasgow Coma Scale (GCS)

In patients with polycystic kidney disease, renal failure is expected to progress over time as the cystic process destroys more nephrons. At what point will a patient reach end-stage renal disease? a. Greater than 90% nephron loss b. Greater than 50% nephron loss c. Greater than 25% nephron loss d. Greater than 15%

Greater than 90% nephron loss

Which disorder is considered a primary immunodeficiency disease? a. Malnutrition immunodeficiency b. Cancer immunodeficiency c. Radiation immunodeficiency d. HIV/AIDS

HIV/AIDS

Which symptom suggests the presence of a hiatal hernia? a. Nausea b. Heartburn c. Diarrhea d. Abdominal cramps

Heartburn

Allergic (extrinsic) asthma is associated with a. IgE-mediated airway inflammation. b. hyporesponsiveness of airways. c. unknown precipitating factors. d. irreversible airway obstruction.

IgE-mediated airway inflammation

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct? a. "Lung cancer has about a 15% survival rate." b. "Lung cancer death rate has decreased significantly, as with all other cancers." c. "Lung cancer is always fatal." d. "Lung cancer is highly curable when diagnosed early."

"Lung cancer has about a 15% survival rate."

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

Inflammation, mucosal edema, and bronchoconstriction

Retroviruses are associated with human cancers, including a. hepatic cancer. b. Burkitt lymphoma. c. Hodgkin's lymphoma. d. pancreatic cancer.

Burkitt lymphoma

A patient, age 3, has vesicoureteral reflux. "Why does that make him have so many bladder infections?" asks his mother. The nurse's best response is a. "When he urinates, urine stays in his bladder and the normal bacteria that live in the bladder have a chance to grow and cause a bladder infection." b. "When he urinates, urine leaks into his bowel and bacteria from the bowel leak into the bladder, where they grow and make a bladder infection." c. "When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder." d. "When he urinates, the urine makes a fluid trail to the bladder, and if he does not clean himself well, bacteria will enter and make a bladder infection."

"When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder."

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

4 and 7

Renal insufficiency occurs when _____ of the nephrons are not functional. a. 25% b. 50% c. 75% to 90% d. more than 90%

75% to 90%

Which treatment is helpful in neuropathic pain but not used for acute pain? a. Anticonvulsants b. Nonsteroidal anti-inflammatory drugs and aspirin c. Narcotic analgesics d. Nonnarcotic analgesics

Anticonvulsants

________ is the most powerful predictor of developing type 2 diabetes mellitus. a. Cardiovascular disease b. Sedentary lifestyle c. Obesity d. Aging

Obesity

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

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

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

Tachycardia

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

Thrombocytopenia

The anemia resulting from a deficiency of either vitamin B 12 (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts. a. False b. True

True

The best intervention for acute kidney injury (AKI) is prevention. a. False b. True

True

The most common cause of urinary obstruction in male newborns and infants is urethral valves. a. False b. True

True

Two of the most serious oncology emergencies associated with non-Hodgkin lymphoma are obstruction of the superior vena cava and compression of the spinal cord. a. True b. False

True

A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm? a. Third-degree heart block b. Sinus bradycardia c. Ventricular escape rhythm d. Junctional tachycardia

Ventricular escape rhythm

A person who is diagnosed with nephrotic syndrome is also experiencing hypoalbuminemia. This happens because a. albumin leaks into the interstitial spaces. b. albumin is excreted in the urine. c. hepatocyte failure decreases albumin synthesis. d. malnutrition is part of nephrotic syndrome.

albumin is excreted in the urine

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

acute onset of left ventricular dysfunction

The major buffer in the extracellular fluid is a. phosphate. b. bicarbonate. c. albumin. d. hemoglobin.

bicarbonate

Activation of parasympathetic nerves to the bladder will cause a. urine reflux. b. sphincter contraction. c. bladder relaxation. d. bladder contraction.

bladder contraction

Copious amounts of foul-smelling sputum are generally associated with a. emphysema. b. bronchiectasis. c. epiglottitis. d. pulmonary edema.

bronchiectasis

The inward-pulling force of particles in the vascular fluid is called _____ pressure. a. capillary osmotic b. interstitial hydrostatic c. interstitial osmotic d. capillary hydrostatic

capillary osmotic

In general, with aging, organ size and function a. remain the same. b. are unknown. c. increase. d. decrease.

decrease

Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because a. demyelination is mediated by immune mechanisms. b. steroids inhibit synaptic degradation of neurotransmitters. c. viral damage can be inhibited. d. steroids reverse the progression of the disease.

demyelination is mediated by immune mechanisms

The dementia of Alzheimer disease is associated with structural changes in the brain, including a. degeneration of basal ganglia. b. deposition of amyloid plaques in the brain. c. significant aluminum deposits in the brain. d. hypertrophy of frontal lobe neurons.

deposition of amyloid plaques in the brain

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

disseminated intravascular coagulation (DIC)

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

dry cough

A risk factor for osteoporosis is a. late menopause. b. early menopause. c. endometriosis. d. ovarian cysts.

early menopause

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

elderly woman without a previous history of MI

A disease that is native to a particular region is called a. pandemic. b. epidemic. c. ethnographic. d. endemic.

endemic

Steatohepatitis is caused by an accumulation of ________ in the liver cells. a. ferritin b. acetaminophen c. fat d. bile

fat

Acceleration-deceleration movements of the head often result in polar injuries in which a. focal injuries occur in two places at opposite poles. b. bleeding from venules fills the subdural space. c. widespread neuronal damage is incurred. d. injury is localized to the site of initial impact.

focal injuries occur in two places at opposite poles

A silent abdomen 3 hours after bowel surgery most likely indicates a. mechanical bowel obstruction. b. functional bowel obstruction. c. perforated bowel. d. peritonitis.

functional bowel obstruction

Epigastric pain that is relieved by food is suggestive of a. pancreatitis. b. gastric ulcer. c. dysphagia. d. cardiac angina.

gastric ulcer

Prosthetic joint infection is most often because of a. hematogenous transfer. b. defective replacement material. c. arthritis. d. injury to the joint.

hematogenous transfer

Hyperlipidemia occurs in nephrotic syndrome because a. body fats are catabolized. b. lipids are not excreted in the urine. c. hepatocytes synthesize excessive lipids. d. muscles stop burning triglycerides for energy.

hepatocytes synthesize excessive lipids

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

high cardiac output

The consequence of an upper urinary tract obstruction in a single ureter is a. hydronephrosis. b. anuria. c. kidney stone formation. d. dilation of the urethra.

hydronephrosis

Autonomic dysreflexia is characterized by a. hypertension and bradycardia. b. hypotension and shock. c. pallor and vasoconstriction above the level of injury. d. extreme pain below the level of injury.

hypertension and bradycardia

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

hypertensive crisis

A patient presenting with muscle cramps, fatigue, anxiety, depression, and prolonged Q-T intervals on EKG may be showing symptoms of a. hypoparathyroidism. b. SIADH. c. diabetes insipidus. d. hyperparathyroidism.

hypoparathyroidism

Myxedema coma is a severe condition associated with a. pheochromocytoma. b. hypothyroidism. c. hyperthermia. d. acute cortisol insufficiency.

hypothyroidism

Individuals diagnosed with systemic lupus erythematosus (SLE) are at risk for developing numerous complications of various organs because of a. excessive production of connective tissue. b. formation of osteophytes in tissues. c. impaired tissue oxygen transport. d. immune injury to basement membranes.

immune injury to basement membranes

Hepatic encephalopathy is associated with a. toxic effects of alcohol on brain cells. b. hyperuricemia. c. increased blood ammonia levels. d. hyperbilirubinemia.

increased blood ammonia levels

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

increased serum creatinine

Enteropathic arthritis is associated with a. irritable bowel syndrome. b. chronic constipation. c. inflammatory bowel disease. d. chronic diarrhea.

inflammatory bowel disease

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for a. education. b. intervention. c. stimulation. d. documentation.

intervention

The cellular response indicative of injury because of faulty metabolism is a. lactate production. b. hydropic swelling. c. metaplasia. d. intracellular accumulations.

intracellular accumulations

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

reduced cardiac output

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will a. selectively kill tumor cells. b. have minimal side effects. c. kill rapidly dividing cells. d. stimulate immune cells to fight the cancer.

kill rapidly dividing cells

The American Diabetes Association recommends a postprandial blood glucose level of ________ mg/dL for adults with diabetes. a. 130 b. more than 180 c. less than 180 d. 70

less than 180

Jaundice is a common manifestation of a. cholecystitis. b. malabsorption syndromes. c. anemia. d. liver disease.

liver disease

Obstructive disorders are associated with a. low residual volumes. b. low expiratory flow rates. c. decreased total lung capacity. d. increased expiratory reserve volume.

low expiratory flow rates

The initial treatment of an individual experiencing a seizure is concentrated on a. obtaining an EEG. b. documenting the seizure pattern. c. administering anticonvulsant medication. d. maintaining an airway.

maintaining an airway

Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of a. carbonic acid deficit. b. metabolic acid deficit. c. carbonic acid excess. d. metabolic acidosis.

metabolic acid deficit

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a ________ headache. a. migraine b. tension c. chronic d. sinus

migraine

The physiologic mechanisms involved in the pain phenomenon are termed a. neurotransmission. b. nociception. c. sensitization. d. proprioception.

nociception

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

non-Hispanic black adults

Type 2 diabetes mellitus is often associated with a. nonketotic hyperosmolality. b. ketoacidosis. c. childhood. d. autoimmune destruction of the pancreas.

nonketotic hyperosmolality

A person is unaware that his bladder is full of urine, but complains that he is leaking urine almost constantly. The most accurate term for this type of incontinence is a. stress. b. urge. c. overflow. d. mixed.

overflow

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

paroxysmal nocturnal dyspnea

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

permanent damage and death

Treatment of a uterine prolapse may involve the insertion of a(n) ________ to hold the uterus in place. a. IUD. b. catheter. c. pessary. d. endopelvic mesh implant.

pessary

A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for a. pulmonary embolus. b. pulmonary edema. c. pneumothorax. d. pneumonia.

pneumothorax

If acute tubular necrosis (ATN) does not resolve and continued tubular dysfunction ensues, the patient will then experience a. oliguria and sodium retention. b. polyuria and sodium wasting. c. infections and sepsis. d. magnesium and phosphorus loss in urine.

polyuria and sodium wasting

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

positioning the arm above the heart level

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

pulmonary congestion with dyspnea

Vesicoureteral reflux is associated with a. polycystic renal disease. b. proteinuria. c. increased serum creatinine. d. recurrent cystitis.

recurrent cystitis

The classic manifestations of Parkinson disease include a. skeletal muscle rigidity and intention tremor. b. rest tremor and skeletal muscle rigidity. c. intention tremor and akinesia. d. ataxia and intention tremor.

rest tremor and skeletal muscle rigidity

The disease that is similar to osteomalacia and occurs in growing children is a. Paget disease. b. rickets. c. osteopenia. d. osteosarcoma.

rickets

The most helpful laboratory value in monitoring the progression of declining renal function is a. mental status changes. b. serum potassium. c. serum creatinine. d. blood urea nitrogen.

serum creatinine

The pain associated with chronic pancreatitis is generally described as ________ in nature. a. steady and boring b. intermittent and burning c. intermittent and stabbing d. sharp and constant

steady and boring

Autologous stem cell transplantation is a procedure in which a. stem cells are harvested from the patient and then returned to the same patient. 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. there is a high rejection rate.

stem cells are harvested from the patient and then returned to the same patient

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

subclinical

Rupture of a cerebral aneurysm should be suspected if the patient reports a. sudden, severe headache. b. transient episodes of vertigo. c. transient episodes of numbness. d. ringing in the ears.

sudden, severe headache

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

sympathetic nervous system activation

Blood flow throughout the periphery is regulated by a. velocity. b. cardiac output. c. the autonomic nervous system. d. hemodynamics.

the autonomic nervous system

Airway obstruction in chronic bronchitis is because of a. thick mucus, fibrosis, and smooth muscle hypertrophy. b. hyperplasia and deformation of bronchial cartilage. c. loss of alveolar elastin. d. pulmonary edema.

thick mucus, fibrosis, and smooth muscle hypertrophy

Causes of metabolic acidosis include a. hypoventilation. b. tissue anoxia. c. massive blood transfusion. d. hyperventilation.

tissue anoxia

The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of a. angiogenesis. b. pain medications. c. loss of ATP production. d. tumor necrosis factor.

tumor necrosis factor

Slow pain sensation is transmitted primarily by a. unmyelinated C fibers. b. group Ia afferents. c. α motor neurons. d. Aδ fibers.

unmyelinated C fibers

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

vascular resistance

Rickets is characterized by soft, weak bones resulting from a deficiency of a. calcium. b. vitamin D. c. phosphate. d. estrogen.

vitamin D

Clinical manifestations of extracellular fluid volume deficit include a. cardiac dysrhythmias, paresthesias, and muscle weakness. b. confusion, lethargy, coma, and perhaps seizures. c. thirst, dry mucous membranes, and diarrhea. d. weak pulse, low blood pressure, and increased heart rate.

weak pulse, low blood pressure, and increased heart rate