Patho exam 4 modules

Which patient is at the greatest risk for aortic aneurysm? A 60-year-old client with diminished oxygen saturation, low red blood cell levels, and pallor A 70-year-old client with jugular venous distention, shortness of breath, and pulmonary edema A 66-year-old client back pain and neck vein distention An 81-year-old client with acute cognitive changes as well as difficulty in speaking and swallowing

A 66-year-old client back pain and neck vein distention

Which description best defines afterload? A. The force that the contracting heart muscle must generate to eject blood from the ventricles B. Contractile performance of the heart C. Volume of blood that stretches the ventricle at end diastole D. Volume of blood ejected from the ventricle with each contraction

A. The force that the contracting heart muscle must generate to eject blood from the ventricles

Which findings are characteristic of emphysema? Select all that apply. Hypersecretion of mucus and chronic productive cough Infection of the lung parenchyma, impairing gas exchange Abnormal permanent enlargement of the acini Destruction of the alveolar walls Limitation of airflow caused by lack of elastic recoil in the lungs

Abnormal permanent enlargement of the acini Destruction of the alveolar walls Limitation of airflow caused by lack of elastic recoil in the lungs

Which are findings associated with asthma? Select all that apply. Airway inflammation Bronchospasm Decreased ability to clear mucus Bradypnea Diaphoresis

Airway inflammation Bronchospasm Decreased ability to clear mucus

Who is at the highest risk for developing community-acquired pneumonia (typical)? An older adult living in an assisted living facility A person with diabetes living at home with a small child A college student living in a fraternity house A healthy 30-year-old living alone

An older adult living in an assisted living facility

Which term describes a pathologic outpouching or sac-like dilation of an artery caused by the weakness of the vessel wall? Dissection Aneurysm Fusiform Infarction

Aneurysm

Which event causes vessel constriction? Angiotensin I conversion to angiotensin II Aldosterone secretion in the bloodstream Increased blood volume Peripheral vascular resistance

Angiotensin I conversion to angiotensin II

Which type of blood vessel is prone to aneurysms because of lack of supporting tissue? Femoral artery Carotid artery Aortic artery Pulmonary artery

Aortic artery

Which statement explains how cholesterol is processed in the body? A. The capillaries in the digestive tract transports dietary cholesterol to the cells. Low-density lipoproteins (LDLs) move cholesterol from the cells to the liver for processing into high-density lipoprotein (HDL) cholesterol. The HDL moves cholesterol in the blood back to the cells, where it accumulates as fat deposits inside the blood vessels. B. Dietary fat is processed in the liver into HDL and LDL. The LDL cholesterol is transported to cells in the body. HDL transports cholesterol back to the liver for reprocessing and excretion as bile salts. Excess cholesterol in the blood accumulates as plaques in the vessel walls.

B. Dietary fat is processed in the liver into HDL and LDL. The LDL cholesterol is transported to cells in the body. HDL transports cholesterol back to the liver for reprocessing and excretion as bile salts. Excess cholesterol in the blood accumulates as plaques in the vessel walls.

A nurse working in the intensive care unit (ICU) knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which clinical manifestation(s)? A. Increased urinary output B. Dyspnea and bilateral crackles C. Petechia and spontaneous bleeding D. Muscle cramping and cyanosis in the feet

B. Dyspnea and bilateral crackles

During a routine physical examination of a 66-year-old patient, the nurse practitioner notes a pulsating abdominal mass and refers the patient for further treatment. The nurse practitioner is educating the patient about aneurysms. Which pathophysiologic aspect of aneurysm would support the patient teaching? A. Aneurysms are commonly a result of poorly controlled diabetes mellitus. B. Hypertension is a frequent modifiable contributor to aneurysms. C. Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures. D. Aneurysms can normally be resolved with lifestyle and diet modifications.

B. Hypertension is a frequent modifiable contributor to aneurysms.

Which statement defines preload? A. The force that the contracting heart muscle must generate to eject blood from the ventricles B. The amount of blood the heart must pump with each beat C. Volume of blood that stretches the ventricle at end diastole D. Volume of blood ejected from the ventricle with each contraction

B. The amount of blood the heart must pump with each beat

The nurse is teaching the client about medications to manage asthma. Considering the pathophysiology of the disorder, which type of medications will the nurse discuss with the client? Theophylline and bronchodilators Antihistamines and bronchodilators Bronchodilators and antiinflammatory drugs Leukotriene antagonists and antihistamines

Bronchodilators and antiinflammatory drugs

A 3-year-old child with right-sided heart failure has been admitted for worsening of the condition. Which finding would be considered one of the earliest signs of systemic venous congestion in this patient? A, Breathlessness with activity B. Excessive crying C. Enlargement of the liver D. Increased urine output

C. Enlargement of the liver

Which substance contains the most cholesterol? A. VLDL B. HDL C. LDL D. Chylomicron

C. LDL

A nurse will be providing care for a patient who has a diagnosis of heart failure characterized as primarily right-sided. Which description of the patient's presentation would the nurse anticipate? A. Distended bladder, facial edema, and nighttime difficulty breathing B. Dyspnea and adventitious breath sounds on auscultation C. Pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain D. Cyanotic lips and extremities, low urine output, and low blood pressure

C. Pitting edema to the ankles and feet bilaterally, decreased activity tolerance, and occasional upper right quadrant pain

In which layer of the arterial wall can an atheroma form? A. Tunica externa B. Tunica musculara C. Tunica intima D. Tunica media

C. Tunica intima

Which are symptoms of peripheral venous disease? Select all that apply. Numbness Intermittent claudication Diminished pulse in the legs and feet Discoloration

Diminished pulse in the legs and feet Discoloration

Which are clinical manifestations of venous disease? (Select all that apply.) Dull, aching pain Pain when walking Pallor Gangrene Edema

Dull, aching pain Edema

True or false: Reduction of blood flow to the kidneys causes the liver to secrete renin. TRUE FALSE

False

A person's containment and destruction of M. tuberculosis depends on which factor? Bacilli growth time Length of the exposure Health of the immune system Location in the lungs affected

Health of the immune system

Which process causes the primary characteristic of chronic bronchitis? Viral and bacterial infections associated with temperature increases Hypersecretion of mucous with cough Cyanosis and left-sided heart failure A genetically based lack of antitrypsin

Hypersecretion of mucous with cough

Increased sodium and water in the blood results in what? Renin production Arteriolar constriction Rapid blood flow Increased blood volume

Increased blood volume

Which factors make a client most susceptible to a diagnosis of hospital-acquired pneumonia? (Select all that apply.) Infection of lower respiratory tract Evidence of respiratory infection is present on admission Evidence of infection occurs 48 hours after admission Caused by bacterial agents Mechanical ventilation

Infection of lower respiratory tract Evidence of infection occurs 48 hours after admission Caused by bacterial agents Mechanical ventilation

What is the most common cause(s) of traumatic pneumothorax in patients who are critically ill? Select all that apply. Invasive procedure Barotrauma Pneumonia Empyema

Invasive procedure Barotrauma

Mr. D. is 60 years old with a body mass index (BMI) of 32. He comes to the emergency department (ED) with severe chest pain radiating down his left arm. He is sweating, grasping his chest in pain, and complaining of nausea. He says the pain started early this morning, around 7 a.m.; it is now noon. He said he was mowing the lawn when the pain began, so he rested for a while. The pain did not subside.Mr. D.'s blood pressure is 180/100 mm Hg, pulse is 124, respirations are 20 breaths per minute, and temperature is 98.6°F. He has a medical history of coronary artery disease and diabetes mellitus. He smokes two packs of cigarettes per day, enjoys eating fried foods, and does not adhere to any nutritional guidelines. He does not exercise, and his job mostly involves sitting at a desk. Mr. D. is diagnosed with myocardial infarction from atherosclerosis.What makes up the plaque in Mr. D.'s arteries made of? Select all that apply. Lipid debris Collagen Blood cells Fibrous cap Lymphocytes Eosinophils

Lipid debris Collagen Fibrous cap Lymphocytes

Emphysema is a disorder of the lungs involving inflammation of the lungs. What characteristic distinguishes this condition? Obstruction of airflow in the airways Loss of lung elasticity and hyperinflation of the lungs Chronic mucus production and capillary destruction Collapse of the alveoli due to loss of the alveolar wall

Loss of lung elasticity and hyperinflation of the lungs

True or false: Most aortic aneurysms are discovered with no prior symptoms. TRUE FALSE

TRUE

Which process causes the respiratory symptoms of cystic fibrosis? Sodium and chloride secretions decrease or end. Fluid builds up in the air sacs of the lungs and blocks oxygen. Mucus becomes harder to move and hosts microorganisms. Excessive surfactant is produced and becomes trapped.

Mucus becomes harder to move and hosts microorganisms.

A patient being mechanically ventilated with positive end expiratory pressure and pressure support totaling 30 mm Hg has developed unequal chest expansion, absent breath sounds on the right, and tracheal deviation to the right. The patient is increasingly tachycardic, anxious, and agitated, and pulmonary compliance is rapidly decreasing. Which type of pneumothorax has this patient developed? Primary spontaneous pneumothorax Secondary spontaneous pneumothorax Tension pneumothorax Open pneumothorax

Tension pneumothorax

Which are clinical manifestations of arterial disease? (Select all that apply.) Dull, aching pain Pain when walking Pallor Gangrene Edema

Pain when walking Pallor Gangrene

A tall, thin patient in their mid-20s has dyspnea, pleuritic chest pain, and a heart rate of 120 bpm. A chest radiograph shows a contralateral mediastinal shift. Which condition does this patient most likely have? Primary spontaneous pneumothorax Secondary spontaneous pneumothorax Traumatic pneumothorax Transudative pleural effusion

Primary spontaneous pneumothorax

Which processes in the digestive system does cystic fibrosis affect? Select all that apply. Production of bile acid Pancreatic excretion of digestive enzymes Production of insulin Removal of sodium Breakdown of food Absorption of nutrients

Production of bile acid Pancreatic excretion of digestive enzymes Production of insulin Breakdown of food Absorption of nutrients

Which clinical manifestations are present with typical pneumonia but not with atypical pneumonia? Select all that apply. Low white blood cell count Regions of reduced or absent breath sounds Consolidation Nonproductive cough Crackles and dullness to percussion with auscultation Colored sputum Onset greater than 48 hours

Regions of reduced or absent breath sounds Consolidation Crackles and dullness to percussion with auscultation Colored sputum

Which may occur from a myocardial infarction? Select all that apply. Scar tissue Dead tissue Regenerated tissue Weakened tissue

Scar tissue Dead tissue Weakened tissue

Which type of tuberculosis (TB) may occur if a patient becomes immunocompromised? Primary Latent Miliary Secondary

Secondary

Which conditions have symptoms similar to an aortic dissection? Select all that apply. Stroke Heart attack Diabetes Atherosclerosis

Stroke Heart attack

Which characteristics describe progressive primary tuberculosis (TB)? Select all that apply. Symptomatic Aggressive Noncontagious Contained Latent Active

Symptomatic Aggressive Active

Which finding characterizes cystic fibrosis? Development of cholelithiasis and pancreatitis Thick secretions blocking the bronchi Sensitivity to gluten Excessive potassium in the sweat

Thick secretions blocking the bronchi

True or false: With systolic heart failure, an insufficient amount of blood gets pumped out for systemic circulation, eventually causing backup into the pulmonary circulation. TRUE FALSE

True

A patient complains of persistent leg cramps when at rest and has a leg ulcer at the medial malleoli surrounded by bluish-brown skin. The patient has hypertension. What is the cause of the leg ulcer? Arterial insufficiency Diabetes Venous insufficiency Respiratory insufficiency

Venous insufficiency

Which are initial symptoms of an acute asthma attack? Select all that apply. Fatigue Wheezing Dyspnea Chest tightness Cyanosis

Wheezing Dyspnea Chest tightness

What results from the abnormal production of renin? a. Increased sodium in the bloodstream b. Conversion of angiotensinogen to angiotensin I c. Lung constriction d. Pulmonary dilation

b. Conversion of angiotensinogen to angiotensin I

Which type of cell is associated with endothelial injury related to cholesterol? a. Red blood cells b. Macrophages c. Platelets d. Smooth muscle cells

b. Macrophages

Which processes in the blood vessel precede an atheroma rupture? a. Cholesterol builds up in the blood vessel, causing accumulation of blood clots and slowing blood flow. b. The blood vessel wall narrows from lipoproteins, allowing plaque to dissolve into the blood and thrombus formation. c. A blood vessel wall injury allows lipoprotein infiltration and monocytes migration, causing buildup and protrusion of fatty streaks into the blood vessel. d. Plaque in the blood allows vessel walls to thicken with lipid debris and causes thrombus formation.

c. A blood vessel wall injury allows lipoprotein infiltration and monocytes migration, causing buildup and protrusion of fatty streaks into the blood vessel.

A client who is immunocompromised client is placed in respiratory isolation with suspected tuberculosis (TB) infection. The sputum cultures results read M. tuberculosis mycobacterium. The laboratory result: confirms the diagnosis of active tuberculosis. reflects that the client has been exposed to the TB organism. demonstrates that the client has a unique type of pneumonia. is evidence of the development of latent tuberculosis.

confirms the diagnosis of active tuberculosis.

Essential hypertension is a result of what? a. Reduced oxygen in the bloodstream b. Intra-arterial pressure damaging the blood vessel c. Blood clotting around damaged endothelial cells d. Increased cardiac output and vascular resistance

d. Increased cardiac output and vascular resistance

Mr. D. is 60 years old with a body mass index (BMI) of 32. He comes to the emergency department (ED) with severe chest pain radiating down his left arm. He is sweating, grasping his chest in pain, and complaining of nausea. He says the pain started early this morning, around 7 a.m.; it is now noon. He said he was mowing the lawn when the pain began, so he rested for a while. The pain did not subside.Mr. D.'s blood pressure is 180/100 mm Hg, pulse is 124, respirations are 20 breaths per minute, and temperature is 98.6°F. He has a medical history of coronary artery disease and diabetes mellitus. He smokes two packs of cigarettes per day, enjoys eating fried foods, and does not adhere to any nutritional guidelines. He does not exercise, and his job mostly involves sitting at a desk. Mr. D. is diagnosed with myocardial infarction from atherosclerosis.When Mr. D.'s blood work returns, the nurse notes abnormal cholesterol levels. What imbalance would you expect to see? a. High levels of HDL and LDL b. High levels of HDL and low levels of LDL c. Low levels of LDL and high levels of HDL d. Low levels of HDL and high levels of LDL

d. Low levels of HDL and high levels of LDL

The client diagnosed with emphysema has been diagnosed with a secondary pneumothorax. The client is asking what caused the lung to 'burst.' The nurse understands that secondary pneumothorax is most commonly caused by: ruptured belbs on the lungs. a weakness in the bronchus. an inflamed alveoli that irritate the pleura. damage to lung tissue and the trapping of gases within the chest.

damage to lung tissue and the trapping of gases within the chest.

True or false: Fibrosis of the gallbladder is a symptom of cystic fibrosis. TRUE FALSE

false

Which organ passes along aldosterone causing water and sodium retention? Kidneys Heart Liver Lungs

kidneys

A client comes to the emergency department with shortness of breath. The client reports being generally healthy but felt something 'pop' during a period of coughing while running cross country. The nurse anticipates that the client will be diagnosed with: spontaneous pneumothorax. an allergic reaction. bronchitis. costochrondritis.

spontaneous pneumothorax.

A client was injured in a car accident and is experiencing severe dyspnea. The assessment reveals fractured ribs on the left side of the chest and right-sided tracheal deviation. The chest x-ray confirms a mediastinal shift. The nurse understands that these findings are consistent with: spontaneous pneumothorax tension pneumothorax. hemothorax. atelectasis.

tension pneumothorax.

Secondary tuberculosis (TB) infection occurs from reinfection from inhaled droplet nuclei. TRUE FALSE

true