Pathos Midterm
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of
bacterial pneumonia
Croup is characterized by
barking cough
Tachycardia is an early sign of low cardiac output that occurs because of
baroreceptor activity.
Most carbon dioxide is transported in the bloodstream as
bicarbonate ion
Excessive red cell lysis can be detected by measuring the serum
bilirubin
Signs and symptoms of extracellular fluid volume excess include
bounding pulse.
The inward-pulling force of particles in the vascular fluid is called _____ pressure.
capillary osmotic
Which acid are the kidneys unable to excrete?
carbonic
Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of
cardiac tamponade.
A major cause of treatment failure in tuberculosis is
noncompliance
Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by
norepinephrine
Asthma is categorized as a(n)
obstructive pulmonary disorder.
Breast cancer in women who have the breast cancer gene
occurs at an earlier age.
A patient with flail chest will demonstrate
outward chest movement on expiration.
Fully compensated respiratory acidosis is demonstrated by
pH 7.36, PaCO2 55, HCO3- 36.
A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician?
pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high
Hypotension associated with neurogenic and anaphylactic shock is because of
peripheral pooling of blood.
Persistence of the alarm stage will ultimately result in
permanent damage and death
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.
false -
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV
Red blood cells obtain nearly all their energy from metabolism of
glucose
The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient
has chronic heart failure that is treated with diuretics.
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who
has had diarrhea for over a week.
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles
Early manifestations of a developing metabolic acidosis include
headache
A person who has hyperparathyroidism is likely to develop
hypercalcemia
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia
The imbalance that occurs with oliguric renal failure is
hyperkalemia
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
hypertensive crisis
A deficiency of von Willebrand factor impairs
platelet adhesion to injured tissue.
Accumulation of fluid in the pleural space is called
pleural effusion.
A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for
pneumothorax.
An erroneously low blood pressure measurement may be caused by
positioning the arm above the heart level.
In general, the best prognosis for long-term disease-free survival occurs with
ALL (acute lymphoid leukemia).
The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called
BCR-ABL
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?
Begin antihypertensive drug therapy.
Effects of hypernatremia on the central nervous system typically include
Confusion
Clinical manifestations of hyponatremia include
Confusion, lethargy, coma, and perhaps seizures
Administration of which therapy is most appropriate for hypovolemic shock?
Crystalloids
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
False
Chronic elevation of myocardial wall tension results in atrophy.
False
The most commonly recognized outcome of hypertension is pulmonary disease.
Falsse
What is likely to lead to hyponatremia?
Frequent nasogastric tube irrigation with water
The characteristic x-ray findings in tuberculosis include
Ghon tubercles.
Which disorder is considered a primary immunodeficiency disease?
HIV/AIDS
Certain autoimmune diseases are associated with the presence of specific proteins on a person's cells. These proteins are called ________ proteins.
HLA or MHC
Which condition is associated with an elevated reticulocyte count?
Hemolytic anemia
Which disorder is caused by inhalation of organic substances?
Hypersensitivity pneumonitis
Which electrolyte imbalances cause increased neuromuscular excitability?
Hypocalcemia and hypomagnesemia
When exposed to inhaled allergens, a patient with asthma produces large quantities of
IgE
Allergic (extrinsic) asthma is associated with
IgE-mediated airway inflammation
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?
Inadequate water intake
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?
Inflammation, mucosal edema, and bronchoconstriction
A known cause of hypokalemia is
Insulin overdose
The organism that causes pulmonary tuberculosis is
Mycobacterium tuberculosis
Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of
Nitric Oxide
Which assessment would support a diagnosis of type A COPD rather than type B COPD
Normal PaCO2, scant sputum, accessory muscle use, barrel chest
Obstructive sleep apnea would most likely be found in a patient diagnosed with
Pickwickian syndrome.
A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.
Septic
Bacterial pneumonia leads to hypoxemia caused by
accumulation of alveolar exudates.
A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing
acute cardiogenic pulmonary edema.
The fraction of total body water (TBW) volume contained in the intracellular space in adults is
two thirds
The effect of nitric oxide on systemic arterioles is
vasodilation.
What results when systemic blood pressure is increased?
Vasoconstriction
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
"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."
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
128/82
Which is indicative of a left tension pneumothorax?
Absent breath sounds on the left
High blood pressure increases the workload of the left ventricle, because it increases
Afterload
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?
Anaphylactic
The major buffer in the extracellular fluid is
Bicarbonate
Cystic fibrosis is associated with
Bronchiectasis
Retroviruses are associated with human cancers, including
Burkitt lymphoma.
How do 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
Which form of leukemia demonstrates the presence of the Philadelphia chromosome?
CML (chronic myeloid leukemia)
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
Which alterations can lead to edema?
Decreased lymphatic flow
Hyperaldosteronism causes
ECV excess and hypokalemia
Which clinical manifestation is not likely the result of a tuberculosis infection?
cyanosis
Angina caused by coronary artery spasm is called _____ angina.
Prinzmetal variant
Which is not a manifestation of acute arterial obstruction?
Purpura
A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?
Rapid, deep breathing, lethargy, abdominal pain
Which pulmonary function test result is consistent with a diagnosis of asthma?
Reduced forced expiratory volume in 1 second (FEV1)
Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.
Renin
Atherosclerotic plaques with large lipid cores are prone to
Rupture
What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?
Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance?
Serum calcium, bowel function, level of consciousness
Which change in a patient's assessment has the greatest urgency?
Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing
Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?
Sitting BP 88/60, HR 118
Which vessel normally demonstrates the most rapid blood flow?
The vena cava
Which is not considered to be a risk factor for thrombus formation?
Thrombocytopenia
Hemophilia B is also known as Christmas disease.
True
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
True
The anemia resulting from a deficiency of either vitamin B12 (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.
True
The nurse is swabbing a patient's throat to test for streptococcal pharyngitis. The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed sensitivity.
True
Mitral stenosis is associated with
a pressure gradient across the mitral valve.
Individuals who have chronic bronchitis most often have
a productive cough.
Myocarditis should be suspected in a patient who presents with
acute onset of left ventricular dysfunction.
COPD leads to a barrel chest, because it causes
air trapping.
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
antibiotics
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with
antiplatelet drugs
The majority of cardiac cells that die after myocardial infarction do so because of
apoptosis.
A commonly ingested substance associated with prolongation of the bleeding time is
aspirin
Second-degree heart block type I (Wenckebach) is characterized by
lengthening PR intervals and dropped P wave.
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.
cardiogenic shock
Manifestations from sodium imbalances occur primarily as a result of
cellular fluid shifts
Velocity of blood flow is measured in
centimeters per second
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
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.
Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?
class I
Patent ductus arteriosus is accurately described as a(n)
communication between the aorta and the pulmonary artery.
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload.
Hypernatremia may be caused by
decreased antidiuretic hormone secretion.
Total body water in older adults is
decreased because of increased adipose tissue and decreased muscle mass.
Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.
decreased serum sodium
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
deficiency of ATP
Severe combined immunodeficiency (SCID) syndrome is an example of a(n)
deficient immune response.
Lack of α-antitrypsin in emphysema causes
destruction of alveolar tissue
Patients with immunodeficiency disorders are usually first identified because they
develop recurrent infections.
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is
digitalis
A common characteristic of viral pneumonia is
dry cough
Viral pneumonia is characterized by
dry cough
Renal compensation for respiratory acidosis is evidenced by
elevated bicarbonate ion concentration.
Somatic death refers to death
entire organism
The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of
extrinsic pathway.
An increase in organ size and function caused by increased workload is termed
hypertrophy.
Respiratory alkalosis is caused by
hyperventilation
An increase in the resting membrane potential (hyperpolarized) is associated with
hypokalemia
Metabolic alkalosis is often accompanied by
hypokalemia
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop
hypophosphatemia.
A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to
hypotension
Respiratory acidosis may be caused by
hypoventilation
The body compensates for metabolic alkalosis by
hypoventilation
The hallmark manifestation of acute respiratory distress syndrome is
hypoxemia
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is
immunosuppression.
Constrictive pericarditis is associated with
impaired cardiac filling.
Lusitropic impairment refers to
impaired diastolic relaxation
Myasthenia gravis is a type II hypersensitivity disorder that involves
impaired muscle function.
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke
impairs α1-antitrypsin, allowing elastase to predominate.
Respiratory acidosis is associated with
increased carbonic acid
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
increased neuromuscular excitability.
Uncompensated metabolic alkalosis would result in
increased pH, increased HCO3-.
Chronic bronchitis often leads to cor pulmonale because of
increased pulmonary vascular resistance.
The effects of histamine release include
increased vascular permeability.
What age group has a larger volume of extracellular fluid than intracellular fluid?
infants
The major cause of death from leukemic disease is
infection
Empyema is defined as an
infection in the pleural space.
Which is not normally secreted in response to stress?
insulin
Clinical manifestations of chronic arterial obstruction include
intermittent claudication.
The cellular response indicative of injury because of faulty metabolism is
intracellular accumulations.
After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor
is malignant.
The primary cause of infant respiratory distress syndrome is
lack of surfactant
When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that
loss of elastic tissue in the lungs allows airways to close and trap air, which makes chest round
Obstructive disorders are associated with
low expiratory flow rates
Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure.
mean arterial
The most appropriate treatment for secondary polycythemia is
measured to improve oxygenation.
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
metabolic acid deficit.
Diarrhea and other lower intestinal fluid losses will contribute to
metabolic acidosis
Diarrhea causes
metabolic acidosis
The finding of ketones in the blood suggests that a person may have
metabolic acidosis
Emesis causes
metabolic alkalosis.
Thalassemia may be confused with iron-deficiency anemia, because they are both
microcytic.
Two primary acid-base disorders that are present independently are referred to as
mixed acid-base imbalance.
Clinical manifestations of moderate to severe hypokalemia include
muscle weakness and cardiac dysrhythmias.
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
myeloma.
An abnormally wide (more than 0.10 second) QRS complex is characteristic of
premature ventricular complexes.
Legionnaires disease is characterized by
presence of systemic illness
A patient with pure left-sided heart failure is likely to exhibit
pulmonary congestion with dyspnea.
Left-sided heart failure is characterized by
pulmonary congestion.
Hypertrophy of the right ventricle is a compensatory response to
pulmonary stenosis.
When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will
put a sputum cup and a box of tissues on the bedside table
The person at highest risk for developing hypernatremia is a person who
receives tube feedings because he or she is comatose after a stroke.
Transfusion reactions involve RBC destruction caused by
recipient antibodies
The hypersecretion of mucus resulting for chronic bronchitis is the result of
recurrent infection.
Causes of metabolic acidosis include
tissue anoxia
Cardiogenic shock is characterized by
reduced cardiac output
Carbon monoxide injures cells by
reducing oxygen level on hemoglobin
A person with acute hypoxemia may hyperventilate and develop.
respiratory alkalosis.
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L demonstrates
respiratory alkalosis.
Hypertension with a specific, identifiable cause is known as _____ hypertension.
secondary
An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of
secondary prevention
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
septic
A laboratory test that should be routinely monitored in patients receiving digitalis therapy is
serum potassium.
The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.
sodium
A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest. The likely cause of this pain is
stable angina
Activation of the extrinsic pathway of coagulation is initiated by
tissue thromboplastin
Which complication of asthma is life threatening?
status asthmaticus
Autologous stem cell transplantation is a procedure in which
stem cells are harvested from the patient and then returned to the same patient.
Improvement in a patient with septic shock is indicated by an increase in
systemic vascular resistance.
The progressive stage of hypovolemic shock is characterized by
tachycardia.
A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with
telangiectasia
Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called
tension pneumothorax
After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of
tertiary prevention.
The activated partial thromboplastin time (aPTT) is a measure of the integrity of
the intrinsic pathway.
Metaplasia is
the replacement of one differentiated cell type with another.
Osmoreceptors located in the hypothalamus control the release of
vasopressin (antidiuretic hormone, ADH).
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?
ventricular escape rhythm
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing
vitamin K deficiency bleeding.
A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of
vitamin K deficiency.
Neuromuscular disorders impair lung function primarily because of
weak muscles of respiration.
Clinical manifestations of extracellular fluid volume deficit include
weak pulse, low blood pressure, and increased heart rate.
