Exam 3

A 56-year-old woman presents at the clinic complaining of the unsightliness of her varicose veins and wants to know what can be done about them. The nurse explains that the treatment for varicose veins includes which of the following interventions?

Sclerotherapy or surgery

What is the primary cause of heart failure in infants and children?

Structural heart defects

In hypovolemic shock, the main purpose of treatment is correction or controlling the underlying cause of the hypovolemia and improving the perfusion of the tissues and organs of the body. Which of the following treatments is not a primary form of therapy for hypovolemic shock?

Surgery

Hypertension in the elderly is a common finding. This is because of the age-related rise in systolic blood pressure. Among the aging processes, what is a contributor to hypertension?

Baroreceptor sensitivity

ST-elevated myocardial infarction (STEMI) is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI?

Action rapidly onsets after intravenous administration, decreases anxiety which decreases metabolic demands of heart

Which of the following is a lower airway disease?

Acute bronchiolitis

Many pharmaceutical agents may cause pulmonary damage. The nurse knows the following cardiac medication has been associated with toxic effects in the lungs:

Amiodarone

One of the many manifestations of left-sided heart failure is_________________. It can be diagnosed by examination of the lips and mucous membranes.

Breathlessness and Cyanosis

Chronic obstructive pulmonary disease (COPD) is a combination of disease processes. What disease processes have been identified as being part of COPD?

Chronic obstructive bronchitis and emphysema

Respiration has both automatic and voluntary components that are sent to the respiratory center of the brain from several sources. Which of the following is not a physiologic force that can exert influence on respiration through the lower brain center?

Cold

When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. Which of the following is not a factor that contributes to hypercapnia?

Decrease in carbon dioxide production

Aortic aneurysms take varied forms and can occur anywhere along the aorta. Which of the following terms is a false aneurysm?

Dissecting ansurysms

Heart failure in an infant usually manifests itself as tachypnea or dyspnea, both at rest and on exertion. When does this most commonly occur with an infant?

During feeding

What is the primary physiologic result of obstructive shock?

Elevated right heart pressure

Angina pectoris is a chronic ischemic Coronary Artery Disease (CAD) that is characterized by symptomatic paroxysmal chest pain or pressure sensation associated with transient myocardial ischemia. What precipitates an attack of angina pectoris?

Emotional stress

When an acute-event occurs, and the circulatory system can no longer provide the body with adequate perfusion of its tissues and organs, cellular hypoxia occurs and body goes into shock. Which of the following is not a cause of shock in the human body?

Excessive vasoconstriction

Which of the following is a sign or symptom of heart failure?

Fluid retention in extremities

Pregnancy-induced hypertension is a serious condition affecting between 5% and 10% of pregnant women. The most serious classification of hypertension in pregnancy is preeclampsia-eclampsia. It is a pregnancy-specific syndrome that can have both maternal and fetal manifestations. What is a life-threatening manifestation of the preeclampsia-eclampsia classification of pregnancy-induced hypertension?

HELLP syndrome

Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis?

Have the patient sit up and lean forward.

Acute respiratory failure is commonly signaled by varying degrees of hypoxemia and hypercapnia. Respiratory acidosis develops manifested by what?

Increased cerebral blood flow

The renin-angiotensin-aldosterone system is a negative feedback system that plays a central role in blood pressure regulation. How does the end result of this feedback loop regulate blood pressure in the body?

Increases salt and water retention by the kidney

Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often accompanies the vascular response in anaphylaxis?

Laryngeal edema

A 37-year-old woman presents to her primary care provider complaining of frequents headache and fatigue. T - 36.5 Celsius; P - 86; RR - 16; BP - 180/100. The client is instructed to return in 3 days for a repeat check of her BP, and if elevated she will be started on medication for hypertension. What is the mechanism of action for the following medications used to lower blood pressure?

Lisinopril: Blocks angiotensin 1 from converting to angiotensin 2 Losartan: Blocks the actions of angiotensin Metoprolol: Blocks the beta-receptors from being stimulated Felodipine: Blocks the calcium from entering smooth muscle Clonidine: Blocks the alpha adrenergic receptors

Pleuritis, an inflammatory process of the pleura is common in infectious processes that spread to the pleura. Which is the drug of choice for treating pleural pain?

NSAIDS

Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissue?

Nitric oxide

What is the underlying cause of respiratory failure in a child with bronchiolitis?

Obstructive process

A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain, and increased respiratory rate. What is a classic sign of pulmonary infarction?

Pleuritic pain

Cystic fibrosis (CF) is an autosomal recessive disorder involving the secretion of fluids in specific exocrine glands. The genetic defect in CF inclines a person to chronic respiratory infections from a small group of organisms. Which organism can create chronic infection in a child with cystic fibrosis?

Pseudomonas aeruginosa

Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is the response?

Pulmonary vessels constrict

Cardiac tamponade is a serious life-threatening condition that can arise from a number of conditions. What is a key diagnostic finding in cardiac tamponade?

Pulsus paradoxus

The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections?

Rapid onset of profound malaise

A 45-year-old woman with a diagnosis of multiple sclerosis comes to the clinic complaining of coldness and pain in her fingers. She says that her fingers get red, and they throb and tingle. The nurse would expect what diagnosis and treatment for this patient?

Raynaud phenomenon; stop smoking

The management of cor pulmonale is directed at the underlying lung disease and heart failure. Why is low-flow oxygen therapy part of the management of cor pulmonale?

Reduces pulmonary hypertension and polycythemia associated with chronic lung disease

Sepsis is growing in incidence in the United States. Its pathogenesis includes neutrophil activation, which kills microorganisms. Neutrophils also injure the endothelium, releasing mediators that increase vascular permeability. What do activated endothelial cells release?

Release nitric oxide

Unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI) is a clinical syndrome that ranges in severity between stable angina and MI. It is classified according to its risk of causing an acute MI and is diagnosed based on what?

Serum biomarkers and ECG pattern

Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include which of the following?

Stasis of blood, hypercoagulability, vessel wall injury

A 69-year-old man is admitted to the hospital following a popliteal embolectomy. He asks the nurse why he had to have surgery on his leg. What is the best response by the nurse?

The artery that runs behind your knee was blocked by a blood clot, and the doctor removed it.

Where in the body are lipoproteins synthesized?

The small intestine and liver

A patient with a suspected Myocardial Infarction (MI) is brought to the emergency department by ambulance. As the nurse caring for this patient, what laboratory work would you expect to receive an order for, to confirm a diagnosis of MI?

Troponin level

Community-acquired pneumonia is usually diagnosed based on history, physical exam, chest xray and knowledge of microorganisms currently in the community?

True

Non-small cell lung cancers (NSCLCs) mimic small cell lung cancers (SCLCs) through their abilities to do what?

Synthesis bioactive products and produce paraneoplastic syndromes