PATHO 370 CYU Wk 4 - Ch 22,23,24,25

The characteristic x-ray findings in tuberculosis include a.Ghon tubercles. b.bibasilar infiltrates. c.diffuse white-out. d.tracheal deviation.

a.Ghon tubercles.

When exposed to inhaled allergens, a patient with asthma produces large quantities of a.IgE. b.IgM. c.IgA. d.IgG.

a.IgE. During an allergic response, plasma cells produce large quantities of IgE. IgG, IgA, and IgM are not part of the pathophysiology of asthma.

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

a.bronchiectasis Copious, foul-smelling respiratory secretions are associated with bronchiectasis. Copious, foul-smelling respiratory secretions are not associated with emphysema, epiglottitis, or pulmonary edema.

Total body water in older adults is a.decreased because of increased adipose tissue and decreased muscle mass. b.decreased because of renal changes that cause diuresis with sodium excretion. c.increased because of decreased adipose tissue and decreased bone mass. d.increased because of decreased renal function and hormonal fluctuations.

a.decreased because of increased adipose tissue and decreased muscle mass Older adults have decreased total body water because of increased adipose tissue and decreased muscle mass. Older adults have increased adipose tissue. Hormonal fluctuations and diuresis with sodium excretion are not characteristic of older adults.

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

a.deficiency of ATP. Clinical manifestations of severe symptomatic hypophosphatemia are caused by a deficiency of ATP. Phosphate is an important component of ATP, which is the major source of energy for many cellular substances. Severe symptomatic hypophosphatemia does not cause excess protein accumulation, damage the kidneys, or cause hypocalcemia.

Lack of α-antitrypsin in emphysema causes a.destruction of alveolar tissue. b.pulmonary edema and increased alveolar compliance. c.chronic mucous secretion and airway fibrosis. d.bronchoconstriction and airway edema.

a.destruction of alveolar tissue.

Early manifestations of a developing metabolic acidosis include a.headache. b.coma. c.muscle cramps. d.short and shallow respirations.

a.headache.

Decreased neuromuscular excitability is often the result of a.hypercalcemia and hypermagnesemia. b.hypernatremia and hypomagnesemia. c.hypomagnesemia and hyperkalemia. d.hypocalcemia and hypokalemia.

a.hypercalcemia and hypermagnesemia. Hypercalcemia and hypermagnesemia result in decreased neuromuscular excitability. Hypomagnesemia, hypocalcemia, and hypomagnesemia result in increased neuromuscular excitability.

A person who has hyperparathyroidism is likely to develop a.hypercalcemia. b.hypokalemia. c.hyperkalemia. d.hypocalcemia.

a.hypercalcemia.

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

a.low expiratory flow rates. Obstructive disorders are associated with low expiratory flow rates. Obstructive disorders are associated with high residual volume. Increased expiratory reserve volume and decreased total lung capacity are not characteristic of obstructive disorders.

A major cause of treatment failure in tuberculosis is a.noncompliance. b.resistant organism. c.immunosuppression. d.allergy to drugs used.

a.noncompliance. The major cause of treatment failure in tuberculosis is non-adherence to drug therapy. The major cause of treatment failure in tuberculosis is not a resistant organism, drug allergy, or immunosuppression.

A person who experiences a panic attack and develops hyperventilation symptoms may experience a.numbness and tingling in the extremities. b.acute compensatory metabolic acidosis. c.neuromuscular depression. d.anxiety acidosis.

a.numbness and tingling in the extremities

The fraction of total body water (TBW) volume contained in the intracellular space in adults is a.two thirds. b.three fourths. c.one half .d.one third.

a.two thirds.

When a parent of a toddler recently diagnosed with pneumococcal pneumonia asks why their child is so much sicker than a classmate was when they were diagnosed with pneumonia, the nurse replies a."It sounds as if the classmate was just lucky and less exposed at daycare." b."It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia." c."It sounds as if your child has a case of viral pneumonia, while the classmate had bacterial pneumonia." d."It sounds as if your child is having a severe reaction to bacterial pneumonia. It hits some children harder than others."

b."It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia."

Which alterations can lead to edema? a.Increased capillary colloid osmotic pressure b.Decreased lymphatic flow c.Decreased capillary hydrostatic pressure d.Decreased capillary membrane permeability

b.Decreased lymphatic flow Lymphatic obstruction prevents the drainage of accumulated interstitial fluid and proteins, which can lead to severe edema. Decreased capillary hydrostatic pressure would push less fluid into the interstitial space. Increased capillary colloid osmotic pressure would remove fluid from the interstitial space. Decreased capillary membrane permeability would allow less fluid movement into the interstitial space.

What age group has a larger volume of extracellular fluid than intracellular fluid? a.Older adults b.Infants c.Adolescents d.Young adults

b.Infants

Which complication of asthma is life threatening? a.Exercise-induced asthma b.Status asthmaticus c.Mast cell degranulation d.Late phase response

b.Status asthmaticus Status asthmaticus is a severe attack unresponsive to routine therapy and can be life threatening if not reversed. Exercise-induced asthma is a form of asthma, rather than a complication of it. The late phase response is part of the pathophysiology of asthma and is not always life threatening. Mast cell degranulation is part of the pathophysiology of asthma and in itself is not life threatening.

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 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 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 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. Hypermagnesemia causes decreased neuromuscular excitability and testing the patellar reflex can detect that. Hypermagnesemia causes decreased, not increased, neuromuscular excitability. If the patellar reflex stays the same, the infusion rate is therapeutic. Watching for seizure activity is a dangerous course of action. Hypermagnesemia can cause respiratory depression and cardiac arrest, so you need to assess for its development.

Metabolic alkalosis is often accompanied by a.hyperkalemia. b.hypokalemia. c.hyponatremia. d.hypernatremia.

b.hypokalemia

Diarrhea and other lower intestinal fluid losses will contribute to a.respiratory acidosis. b.metabolic acidosis. c.metabolic alkalosis. d.mixed acid-base disorders.

b.metabolic acidosis. Diarrhea results in loss of bicarbonate and leads to metabolic acidosis. Loss of bicarbonate (a base) would not lead to metabolic alkalosis. Respiratory conditions lead to respiratory acid and base disturbances; diarrhea is not a respiratory condition. Bicarbonate loss through diarrhea would not lead to any respiratory acid/base disturbance.

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 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."If he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated."

c."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."

How do clinical conditions that increase vascular permeability cause edema? a.Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure b.Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment c.By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure d.By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling

c.By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure Clinical conditions that increase vascular permeability cause edema by allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure. The capillary basement membrane does not change its charge with increased vascular permeability. Increased vascular permeability does not move water into the cells. Increasing the interstitial fluid osmotic pressure would not cause edema.

Hyperaldosteronism causes a.excessive water reabsorption without affecting sodium concentration. b.ECV deficit and hyperkalemia. c.ECV excess and hypokalemia. d.hyponatremia and hyperkalemia.

c.ECV excess and hypokalemia

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.Mast cell degranulation that causes decreased surfactant c.Inflammation, mucosal edema, and bronchoconstriction d.Pulmonary edema and decreased alveolar compliance

c.Inflammation, mucosal edema, and bronchoconstriction In asthma, exposure to an allergen causes mast cell degranulation and release of inflammatory mediators that trigger airway inflammation, mucosal edema, and bronchoconstriction. In asthma, exposure to an allergen does not cause loss of alveolar elastin, pulmonary edema and decreased alveolar compliance, or decreased surfactant.

A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment? a.Rapid, deep breathing, tremors, elevated blood pressure b.Slow, shallow breathing, belligerence, hyperexcitability c.Rapid, deep breathing, lethargy, abdominal pain d.Slow, shallow breathing, numbness and tingling around his mouth

c.Rapid, deep breathing, lethargy, abdominal pain

What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration? a.Salty soup, because he needs nutrition as well as fluid b.Bottled water, because it will rehydrate his cells c.Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid d.Bottled water, because he is so weak that he might choke on the fluid when he swallows, and water would be less damaging to the lungs than salty soup

c.Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid This man has indicators of clinical dehydration and he needs salt to hold the water in his extracellular compartment. Replacing fluids and electrolytes is more important than meeting his nutritional needs now.

Viral pneumonia is characterized by a.significant ventilation-perfusion imbalance. b.exudative consolidation. c.a dry cough. d.a productive cough.

c.a dry cough.

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

c.bicarbonate

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

c.capillary osmotic

The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who a.has had hypokalemia for over a week. b.is in the diuretic phase of acute renal failure. c.has had diarrhea for over a week. d.has newly diagnosed Cushing syndrome.

c.has had diarrhea for over a week. Diarrhea causes increased excretion of the base bicarbonate, which can lead to metabolic acidosis. Although the oliguric phase of acute renal failure causes metabolic acidosis, the diuretic phase does not, because the kidneys can still excrete metabolic acids. Hypokalemia is associated with metabolic alkalosis. Cushing syndrome is cortisol excess, which can cause metabolic alkalosis from increased renal excretion of hydrogen ions.

The finding of ketones in the blood suggests that a person may have a.respiratory acidosis. b.metabolic alkalosis. c.metabolic acidosis. d.respiratory alkalosis.

c.metabolic acidosis Ketones are produced from breakdown of fat in the body as a result of starvation or lack of ability to utilize glucose in diabetes mellitus. Ketoacids in the blood indicate a very high ketone level in the body, which leads to metabolic acidosis. Ketonuria from high ketones in the blood would not indicate metabolic alkalosis. The respiratory system does not influence ketone level.

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.obstructive pulmonary disorder. Asthma is an obstructive pulmonary disorder. Asthma is not a restrictive pulmonary disorder or a type of tracheobronchial obstruction. Although asthma can be associated with infection, it is not an infective pulmonary disorder.

Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called a.pleural effusion. b.empyema. c.tension pneumothorax. d.open pneumothorax.

c.tension pneumothorax. Air that enters the pleural space during inspiration but is unable to exit during expiration causes a tension pneumothorax. The question does not describe open pneumothorax, pleural effusion, or empyema.

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

c.thick mucus, fibrosis, and smooth muscle hypertrophy.

Cystic fibrosis is associated with a.emphysema. b.chronic bronchitis. c.asthma. d.bronchiectasis.

d.bronchiectasis. Fifty percent of cases of bronchiectasis are associated with cystic fibrosis. Cystic fibrosis is not associated with asthma, chronic bronchitis, or emphysema.

The body compensates for metabolic alkalosis by a.increasing bicarbonate ion excretion. b.hyperventilation. c.decreasing arterial carbon dioxide. d.hypoventilation.

d.hypoventilation.

If an individual has a fully compensated metabolic acidosis, the blood pH is a.either high or low, depending on the type of compensation. b.low. c.high. d.in the normal range.

d.in the normal range.

Chronic bronchitis often leads to cor pulmonale because of a.hypervolemia. b.ventricular hypoxia. c.left ventricular strain. d.increased pulmonary vascular resistance.

d.increased pulmonary vascular resistance.

The primary cause of infant respiratory distress syndrome is a.prematurity. b.umbilical cord compression. c.maternal illegal drug use during pregnancy. d.lack of surfactant.

d.lack of surfactant.

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

d.tissue anoxia. Tissue anoxia can cause metabolic acidosis resulting from lactic acid production during anaerobic metabolism. Hyperventilation causes excretion of too much carbonic acid and respiratory alkalosis. The liver metabolizes the citrate in transfused blood into bicarbonate. Hypoventilation causes CO 2 retention and respiratory acidosis.