CYU #4/ Midterm

Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration. a. increased serum sodium b. increased serum potassium c. decreased serum potassium d. decreased serum sodium

decreased serum sodium

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

decreased urine output.

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

deficiency of ATP.

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

dry cough.

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

has had diarrhea for over a week.

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

hypercalcemia and hypermagnesemia

Respiratory alkalosis is caused by a. pneumonia. b. pulmonary edema. c. chest muscle weakness. d. hyperventilation.

hyperventilation.

The imbalance that occurs with oliguric renal failure is a. hypophosphatemia. b. hyperkalemia. c. hypokalemia. d. metabolic alkalosis.

hypokalemia.

Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with a. hypokalemia. b. hyponatremia. c. hypophosphatemia. d. hypocalcemia.

hypophosphatemia.

The hallmark manifestation of acute respiratory distress syndrome is a. hypotension. b. frothy secretions. c. tachycardia. d. hypoxemia.

hypoxemia

A major risk factor for the development of active pulmonary tuberculosis (TB) disease is a. immunosuppression. b. overuse of antibiotics. c. being a male. d. contaminated water

immunosuppression

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

Ghon tubercles.

Which electrolyte imbalances cause increased neuromuscular excitability? a. Hypercalcemia and hypermagnesemia b. Hyperkalemia and hypophosphatemia c. Hypokalemia and hyperphosphatemia d. Hypocalcemia and hypomagnesemia

Hypocalcemia and hypomagnesemia

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. "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." 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 he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated." d. "Clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, so those are the diagnostic criteria."

"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."

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

IgE-mediated airway inflammation.

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

Infants

COPD leads to a barrel chest, because it causes a. muscle atrophy. b. air trapping. c. pulmonary edema. d. prolonged inspiration.

air trapping.

After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is a. associated with respiratory infections. b. associated with specific allergic triggers. c. induced by psychological factors (stress). d. of unknown pathogenesis.

associated with specific allergic triggers.

A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of a. acute respiratory distress syndrome. b. tuberculosis. c. bacterial pneumonia. d. viral pneumonia.

bacterial pneumonia.

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

bicarbonate

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

bronchiectasis.

Causes of hypomagnesemia include a. clinical dehydration. b. oliguric renal failure. c. chronic alcoholism. d. Hyperphosphatemia.

chronic alcoholism.

****To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke a. introduces carcinogens into the lungs. b. predisposes to respiratory infections. c. paralyzes the cilia, causing impaired mucociliary clearance. d. impairs alpha1-antitrypsin, allowing elastase to predominate

impairs alpha1-antitrypsin, allowing elastase to predominate

When a client diagnosed with COPD type A asks, "Why is my chest so big and round?", the nurse responds that a. "Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round." b. "Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round." c. "Scar tissue in your lungs makes them stiff and more full of air than usual, which makes your chest round." d. "Coughing caused by your condition has changed the structure of your airways, which makes your chest round."

"Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round."

A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is a. "Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling." b. "Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell." c. "Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell." d. "Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling."

"Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."

Which is indicative of a left tension pneumothorax? a. Respiratory acidosis b. Absent breath sounds on the left c. Course crackles throughout the left chest d. Tracheal deviation to the left

Absent breath sounds on the left

ow do clinical conditions that increase vascular permeability cause edema? a. Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment b. 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 d. Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure

By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

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

ECV deficit and hyperkalemia.

What is likely to lead to hyponatremia? a. Frequent nasogastric tube irrigation with water b. Administration of intravenous normal saline c. Insufficient ADH secretion d. Excess aldosterone secretion

Frequent nasogastric tube irrigation with water

The organism that causes pulmonary tuberculosis is a. Mycobacterium tuberculosis. b. Haemophilus tuberculosis. c. Tuberculosis tuberculoci. d. Mycococcidio tuberculosis.

Mycobacterium tuberculosis.

The organism that causes pulmonary tuberculosis is a. Mycobacterium tuberculosis. b. Tuberculosis tuberculoci. c. Haemophilus tuberculosis. d. Mycococcidio tuberculosis.

Mycobacterium tuberculosis.

Obstructive sleep apnea would most likely be found in a patient diagnosed with a. Pickwickian syndrome. b. pneumonia. c. myasthenia gravis. d. poliomyelitis.

Pickwickian syndrome

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

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. 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 b. Salty soup, because he needs nutrition as well as fluid c. Bottled water, because it will rehydrate his cells d. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

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? a. Serum calcium, Chvostek and Trousseau signs b. Serum calcium, bowel function, level of consciousness c. Serum potassium, bowel function, level of consciousness d. Serum potassium, Chvostek and Trousseau signs

Serum calcium, bowel function, level of consciousness

The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment? a. Since there is not wheezing, asthma is the problem, but oxygen should be started immediately anyway. b. The signs and symptoms are consistent with asthma; start oxygen and then check to see that your stethoscope is working properly. c. The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately. d. The child probably has consolidated pneumonia; oxygen should be started immediately.

The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.

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

a barking cough.

Individuals who have chronic bronchitis most often have a. substantial weight loss. b. a productive cough. c. a barrel chest. d. normal lung sounds.

a productive cough.

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

capillary osmotic

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

decreased antidiuretic hormone secretion.

To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke a. predisposes to respiratory infections. b. paralyzes the cilia, causing impaired mucociliary clearance. c. introduces carcinogens into the lungs. d. impairs α1-antitrypsin, allowing elastase to predominate.

impairs α1-antitrypsin, allowing elastase to predominate.

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

in the normal range.

Respiratory acidosis is associated with a. hypokalemia. b. increased neuromuscular excitability. c. increased carbonic acid. d. increased pH.

increased carbonic acid

A patient has a positive Chvostek sign. The nurse interprets this as a sign of a. decreased neuromuscular excitability. b. hypermagnesemia. c. increased neuromuscular excitability. d. hypercalcemia.

increased neuromuscular excitability.

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by a. increased expiratory flow rates. b. increased residual lung volumes. c. decreased chest wall compliance. d. increased pulmonary blood flow.

increased residual lung volumes.

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

lack of surfactant.

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

low expiratory flow rates.

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

metabolic acidosis.

Clinical manifestations of moderate to severe hypokalemia include a. muscle spasms and rapid respirations. b. muscle weakness and cardiac dysrhythmias. c. confusion and irritability. d. vomiting and diarrhea.

muscle weakness and cardiac dysrhythmias.

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

noncompliance

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

numbness and tingling in the extremities.

Asthma is categorized as a(n) a. infective pulmonary disorder. b. type of acute tracheobronchial obstruction. c. obstructive pulmonary disorder. d. restrictive pulmonary disorder.

obstructive pulmonary disorder.

Fully compensated respiratory acidosis is demonstrated by a. pH 7.45, PaCO2 40, HCO3- 28. b. pH 7.26, PaCO2 60, HCO3- 26. c. pH 7.36, PaCO2 55, HCO3- 36. d. pH 7.40, PaCO2 40, HCO3- 24.

pH 7.36, PaCO2 55, HCO3- 36.

Accumulation of fluid in the pleural space is called a. an abscess. b. flail chest. c. pleural effusion. d. pleurisy.

pleural effusion.

When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will a. remove the telephone to reduce myocardial oxygen demand. b. put a sputum cup and a box of tissues on the bedside table. c. add a box of surgical masks to the nursing supplies near the door. d. remove the water pitcher to comply with anticipated fluid restrictions.

put a sputum cup and a box of tissues on the bedside table

Emphysema results from destruction of alveolar walls and capillaries, which is because of a. release of proteolytic enzymes from immune cells. b. air trapping with resultant excessive alveolar pressure. c. excessive α1-antitrypsin. d. autoantibodies against pulmonary basement membrane.

release of proteolytic enzymes from immune cells.

All obstructive pulmonary disorders are characterized by a. resistance to airflow. b. decreased residual volumes. c. hyperresponsiveness. d. decreased lung compliance.

resistance to airflow

A person with acute hypoxemia may hyperventilate and develop a. metabolic alkalosis. b. metabolic acidosis. c. respiratory acidosis. d. respiratory alkalosis.

respiratory alkalosis.

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

tension pneumothorax

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.

two thirds.

Osmoreceptors located in the hypothalamus control the release of a. vasopressin (antidiuretic hormone, ADH). b. aldosterone. c. angiotensin. d. atrial natriuretic peptide.

vasopressin (antidiuretic hormone, ADH).

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

weak pulse, low blood pressure, and increased heart rate.