final exam questions
Peripheral edema is a result of a. arterial insufficiency. b. venous thrombosis. c. hypertension. d. atherosclerosis
b
Activation of the complement cascade results in (Select all that apply.) a. antibody production. b. inflammation. c. immunosuppression. d. autoimmunity. e. chemotaxis.
b, e
Venous obstruction leads to edema because it ________ pressure. a. increases capillary oncotic b. increases arterial blood c. decreases tissue d. increases capillary hydrostatic
d
What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume? a. Hypotension b. Bradycardia c. Aortic regurgitation d. Tachycardia
d
A level of ____ on the Glasgow Coma Scale indicates likely fatal damage. a. 3 b. 8 c. 12 d. 15
3
Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by a. norepinephrine. b. cortisol. c. glucagon. d. ACTH.
NE
Which is not considered to be a risk factor for thrombus formation? a. Thrombocytopenia b. Vascular trauma c. Stasis of blood flow d. Circulatory shock
a
Functions of antibodies include (Select all that apply.) a. antigen agglutination. b. antigen precipitation. c. opsonization. d. phagocytosis. e. complement activation.
a, b, c, e
It can be explained to a patient that high blood pressure increases the risk of (Select all that apply.) a. stroke. b. renal disease. c. diabetes. d. ischemic heart disease. e. liver disease.
a, b, d
The therapies that would be appropriate for a patient with type 1 diabetes mellitus include (Select all that apply.) a. carbohydrate counting. b. high-protein diet. c. daily exercise. d. insulin. e. oral hypoglycemic agents.
a, c, d
A person is unaware that his bladder is full of urine, but complains that he is leaking urine almost constantly. The most accurate term for this type of incontinence is a. overflow. b. stress. c. urge. d. mixed.
a
The dementia of Alzheimer disease is associated with structural changes in the brain, including a. deposition of amyloid plaques in the brain. b. degeneration of basal ganglia. b. hypertrophy of frontal lobe neurons. d. significant aluminum deposits in the brain.
a
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of a. tumor necrosis factor. b. angiogenesis. c.loss of ATP production. d. pain medications.
a
The primary function of eosinophils is to a. kill parasitic helminths (worms). b. kill bacteria. c. stop viral replication. d. phagocytize fungi.
a
The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation? a. Q = P/R b. Q = R/P c. R=PQ d. P=Q/R
a
The underlying pathogenic mechanism for type 1 diabetes is a. pancreatic beta-cell destruction. b. lack of insulin receptors. c. lack of exercise and chronic overeating. d. impaired glucose transport into cells.
a
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke a. impairs 1-antitrypsin, allowing elastase to predominate. b. paralyzes the cilia, causing impaired mucociliary clearance. c. predisposes to respiratory infections. d. introduces carcinogens into the lungs.
a
Type 2 diabetes mellitus is often associated with a. nonketotic hyperosmolality. b. childhood. c. autoimmune destruction of the pancreas. d. ketoacidosis.
a
the normal post-void residual urine in the bladder is a. less than 100 mL. b. 150 to 200 mL. c. 250 to 300 mL. d. none of these; no normal residual volume is identified.
a
the physiologic mechanisms involved in the pain phenomenon are termed a. nociception. b. sensitization. c. neurotransmission. d. proprioception.
a
Deficits in immune system function occur in cancer as a result of (Select all that apply.) a. chemotherapy. b. cancer cells. c. cancer metastasis to bone marrow. d. immunotherapy. e. malnutrition.
a, b, c, e
side effects of chemo include (select all that apply): a. anemia. b. nausea. c. leukocytosis. d. bleeding. e. infections.
a, b, d, e
urge incontinence often occurs because of (select all that apply) a. aging. b. bladder infections. c. obesity. d. prostate enlargement. e. diuretics.
a, b, d, e
Manifestations of osteoarthritis include (Select all that apply.) a. nodules on joints of the hands. b. crepitus with joint movement. c. pain that is worse upon arising in the morning. d. stiffness that worsens with joint use. e. narrowing of joint spaces.
a, b, e
Aldosterone may increase during stress, leading to (Select all that apply.) a. decreased urinary output b. increased blood potassium. c. increased sodium retention. d. increased blood volume. e. decreased blood pressure.
a, c, d
Atherosclerosis puts a patient at risk for (Select all that apply.) a. ischemic stroke. b. hemorrhagic stroke. c. retinal injury. d. renal impairment. e. liver disease.
a, c, d
A restrictive respiratory disorder is characterized by a. increased total lung capacity. b. decreased residual volume. c. inspiratory wheezing. d. expiratory wheezing.
b
Activation of parasympathetic nerves to the bladder will cause a. bladder contraction. b. bladder relaxation. c. sphincter contraction. d. urine reflux.
b
The spleen is an important defense against infection, because it a. activates the complement cascade. b. initiates inflammation. c. controls phagocytosis. d. filters the blood.
d
The effects of excessive cortisol production include a. immune suppression. b. hypoglycemia. c. anorexia. d. inflammatory reactions.
immune suppression
The mononuclear phagocyte system consists of (Select all that apply.) a. monocytes and tissue macrophages. b. dendritic cells. c. bone marrow stem cells. d. antibody-secreting plasma cells. e. basophils.
a, b
Acute coronary syndrome in the presence of thrombosis may present as (Select all that apply.) a. unstable angina. b. MI. c. sudden cardiac arrest. d. bleeding. e. hypovolemia.
a, b, c
Orthostatic hypotension is a risk factor for (Select all that apply.) a. stroke. b. cognitive impairment. c. death. d. myocardial infarction. e. urinary retention.
a, b, c
The pain characteristics of chronic venous insufficiency include (Select all that apply.) a. aching and cramping in the affected area. b. relief with elevation to the area. c. relief with ambulation if pain is in the legs. d. burning and prickling in the affected area. e. relief with massage to the area.
a, b, c
Which are clinical findings usually associated with type 1 diabetes mellitus? (Select all that apply.) a. Polyuria b. Polydipsia c. Polyphagia d. Obesity e. Weight gain
a, b, c
Blood pressure is regulated on a short-term basis through (Select all that apply.) a. interaction of carotid and aortic baroreceptors. b. vasomotor center in the brainstem. c. activation of SNS. d. inhibition of PSNS. e. activation of RAAS.
a, b, c, d
Chronic activation of stress hormones can lead to (Select all that apply.) a. cardiovascular disease. b. depression. c. impaired cognitive function. d. autoimmune disease. e. overactive immune function.
a, b, c, d
Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.) a. catecholamines. b. ACTH. c. glucocorticoids. d. immune cytokines. e. TSH.
a, b, c, d
An acute asthma attack is associated with (select all that apply): a. bronchoconstriction. b. bronchial mucosal edema. c. hypersecretion of mucus. d. alveolar collapse. e. hypoxemia.
a, b, c, e
Characteristics of asthma include (Select all that apply.) a. chronic inflammatory disorder. b. airway hyperresponsiveness. c. alveolar collapse. d. genetic susceptibility. e. airway remodeling.
a, b, d, e
When assessing an individual during an acute asthma episode, you should expect to find (Select all that apply.) a. use of accessory breathing muscles. b. expiratory wheezing. c. foul-smelling sputum. d. coughing. e. feeling of chest tightness
a, b, d, e
After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is a. of unknown pathogenesis. b. associated with specific allergic triggers. c. associated with respiratory infections. d. induced by psychological factors (stress).
b
An elderly patient's blood pressure is measured at 160/98. How would the patient's left ventricular function be affected by this level of blood pressure? a. This is an expected blood pressure in the elderly and has little effect on left ventricular function. b. Left ventricular workload is increased with high afterload. c. High blood pressure enhances left ventricular perfusion during systole. d. High-pressure workload leads to left ventricular atrophy.
b
Blood flow throughout the periphery is regulated by a. cardiac output. b. the autonomic nervous system. c. velocity. d. hemodynamics.
b
Chronic bronchitis often leads to cor pulmonale because of a. ventricular hypoxia. b. increased pulmonary vascular resistance. c. left ventricular strain. d. hypervolemia.
b
Clinical manifestations of chronic arterial obstruction include a. edema. b. intermittent claudication. c. decreased pressure proximal to the obstruction. d. distal hyperemia.
b
Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. a. systolic b. mean arterial c. diastolic d. pulse
b
Lack of alpha-antitrypsin in emphysema causes a. chronic mucous secretion and airway fibrosis. b. destruction of alveolar tissue. c. pulmonary edema and increased alveolar compliance. d. bronchoconstriction and airway edema.
b
Leukocytosis with a "shift to the left" refers to a. elevated segmented neutrophils. b. elevated immature neutrophils. c. decreased monocytes. d. decreased immature neutrophils.
b
Obstructive disorders are associated with a. low residual volumes. b. low expiratory flow rates. c. increased expiratory reserve volume. d. decreased total lung capacity.
b
Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with a. cardiac catheterization b. antiplatelet drugs c. acute reperfusion therapy d. cardiac biomarkers only
b
Risk factors for atherosclerosis include a. female gender. b. hyperlipidemia. c. high-protein diet. d. low-fiber diet.
b
The classic manifestations of Parkinson disease include a. intention tremor and akinesia. b. rest tremor and skeletal muscle rigidity. c. ataxia and intention tremor. d. skeletal muscle rigidity and intention tremor.
b
The most important preventive measure for hemorrhagic stroke is a. anticoagulation. b. blood pressure control. c. thrombolytics. d. management of dysrhythmias.
b
The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is a. severe, crushing chest pain. b. ST-segment elevation. c. dysrhythmias. d. pain radiating to the lower legs.
b
The underlying pathogenic mechanism for type 2 diabetes is a. pancreatic beta-cell destruction. b. insulin resistance and beta-cell dysfunction. c. lack of exercise and chronic overeating. d. impaired glucose transport into cells
b
Transfusion reactions involve RBC destruction caused by a. donor antigens. b. recipient antibodies. c. donor T cells. d. recipient T cells.
b
Viral pneumonia is characterized by a. a productive cough. b. a dry cough. c. exudative consolidation. d. significant ventilation-perfusion imbalance.
b
When systemic vascular resistance is decreased, blood flow a. increases. b. decreases. c. stays the same. d. moves to the extremities.
b
Which is not a manifestation of acute arterial obstruction? a. Pain b. Purpura c. Pallor d. Pulselessness
b
Which are complications of diabetes mellitus that are microvascular? (Select all that apply.) a. Cardiovascular disease b. Retinopathy c. Nephropathy d. Neuropathy e. Stroke
b, c
Which are common causes of acquired parkinsonism? (Select all that apply.) a. Degeneration of dopaminergic neurons b. History of infection c. History of intoxication d. History of trauma e. Seizure disorder
b, c, d
Functions of T cells include (Select all that apply.) a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating of B cells. e. killing virally infected cells.
b, c, d, e
Which are hormones that increase serum glucose level? (Select all that apply.) a. Vasopressin b. Glucagon c. Growth hormone d. Catecholamine e. Corticosteroid
b, c, d, e
The "classical pathway" for activation of the complement cascade is triggered by a. activation of C3. b. inflammation. c. first recognition of an antigen. d. antigen-antibody complexes.
d
The effect of stress on the immune system a. is unknown. b. has been demonstrated to be non-existent in studies. c. most often involves enhancement of the immune system. d. may involve enhancement or impairment the immune system.
d
The goal of long term heparin for the management of a deep vein thrombosis is to a. relieve edema. b. prevent clot dislodgement. c. dissolve the thrombus. d. prevent further clot formation.
d
________ edema occurs when ischemic tissue swells because of cellular energy failure. a. Interstitial b. Osmotic c. Vasogenic d. Cytotoxic
d
indicators that an individual is experiencing high stress include all of the following except? a. tachycardia b. diaphoresis c. increased peripheral resistance d. pupil constriction
pupil constriction
Angina caused by coronary artery spasm is called _____ angina. a. stable b. classic c. unstable d. Prinzmetal variant
d
A clinical finding consistent with a hypoglycemic reaction is a. acetone breath. b. warm, dry skin. c. tremors. d. hyperventilation.
c
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 a. artherosclerosis. b. angina. c. myocardial infarction. d. hypertensive crisis.
d
A serious complication of deep vein thrombosis is a. stroke. b. hypertensive crisis. c. extremity necrosis. d. pulmonary embolus.
d
Beta-blockers are advocated in the management of heart failure because they a. increase cardiac output. b. reduce cardiac output. c. enhance sodium absorption. d. reduce blood flow to the kidneys.
b
Modulation of pain signals is thought to be mediated by the release of a. histamine. b. endorphins. c. cholecystokinin. d. glutamine.
b
The direct cause of stress incontinence is a. the effect of aging. b. pelvic muscle weakness. c. neurologic conditions. d. detrusor muscle overactivity.
b
The gate control theory of pain transmission predicts that activity in touch receptors will a. enhance perception of pain. b. decrease pain signal transmission in the spinal cord. c. activate opioid receptors in the CNS. d. increase secretion of substance P in the spinal cord.
b
a risk factor for osteoporosis is a. endometriosis b. early menopause c. late menopause d. ovarian cysts
b
"Please explain the pathophysiology of osteoarthritis to me," says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best response is a. "Yes; repeated use just wears out the cartilage, until it becomes thin and denuded. That causes pain and will eventually cause joint inflammation." b. "Yes; with increasing age, the inflammation from repeated joint use accumulates and causes the cartilage to get thin and ragged until it disappears." c. "No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone." d. "No; autoimmune cells infiltrate the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage."
c
Allergic (extrinsic) asthma is associated with a. hyporesponsiveness of airways. b. unknown precipitating factors. c. IgE-mediated airway inflammation. d. irreversible airway obstruction.
c
Individuals diagnosed with systemic lupus erythematosus (SLE) are at risk for developing numerous complications of various organs because of a. excessive production of connective tissue. b. formation of osteophytes in tissues. c. immune injury to basement membranes. d. impaired tissue oxygen transport.
c
Pain that waxes and wanes and is exacerbated by physical exertion is likely related to a. neuralgia. b. intermittent claudication. c. fibromyalgia syndrome. d. neuropathy.
c
Pelvic floor muscle training is appropriate for a. overflow incontinence. b. reflux prevention. c. urge incontinence. d. functional incontinence.
c
The chief pathologic features of osteoarthritis are a. stress fractures of the epiphysis, inflammation of the diaphysis, and accumulation of excessive synovial fluid. b. autoimmune damage to the synovium, destruction of articular cartilage by pannus, and thickening of synovial fluid. c. degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium. d. thinning of the joint capsule, resorption of bone, excessive formation of new bone, and formation of bone spurs.
c
Which treatment is helpful in neuropathic pain but not used for acute pain? a. Narcotic analgesics b. Nonsteroidal anti-inflammatory drugs and aspirin c. Anticonvulsants d. Nonnarcotic analgesics
c
Persistence of the alarm stage will ultimately result in a. stress reduction. b. permanent damage and death. c. movement into the resistance stage. d. exhaustion of the sympathetic nervous system.
permanent damage and death
antigen presenting cells function to a. display foreign antigen on their cell surfaces bound to MHC. b. stimulate cytokine production by macrophages. c. phagocytose and degrade foreign antigens. d. initiate the complement cascade by way of the alternative pathway.
a
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 a. stable angina. b. myocardial infarction. c. coronary vasospasm. d. unstable angina.
a
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of a. bacterial pneumonia. b. viral pneumonia. c. tuberculosis. d. acute respiratory distress syndrome.
a
All obstructive pulmonary disorders are characterized by a. resistance to airflow. b. hyperresponsiveness. c. decreased residual volumes. d. decreased lung compliance.
a
Diabetic neuropathy is thought to result from a. decreased myoinositol transport. b. elevated HbA1c. c. deficient neuronal insulin receptors. d. neuronal demyelination.
a
Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they a. increase dopamine activity in the basal ganglia. b. induce regeneration of neurons in the basal ganglia. c. prevent progression of the disease. d. produce excitation of basal ganglia structures.
a
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 1-antitrypsin. d. autoantibodies against pulmonary basement membrane.
a
Functions of B cells include a. synthesizing antibodies. b. secreting cytokines. c. killing antigen-presenting cells. d. stimulating B cells.
a
In the acute phase of stroke, treatment is focused on a. stabilization of respiratory and cardiovascular function. b. risk factor modification. c. prevention of bedsores and contractures. d. neurologic rehabilitation.
a
In type I diabetes, respiratory compensation may occur through a process of a. respiratory alkalosis. b. respiratory acidosis. c. metabolic acidosis. d. metabolic alkalosis.
a
Insulin binding to its receptor on target cells results in a. increased active transport of glucose into the cell. b. glycogen breakdown within target cells. c. increased facilitated cellular diffusion of glucose. d. gluconeogenesis.
a
Which clinical finding is most indicative of an acute bacterial infection? a. Increased (band) neutrophils b. Elevated temperature c. Elevated erythrocyte sedimentation rate d. Elevated WBC count
a
Which serum biomarker(s) are indicative of irreversible damage to myocardial cells? a. Elevated CK-MB, troponin I, and troponin T b. Markedly decreased CK-MB and troponin I c. Elevated LDL d. Prolonged coagulation time
a
the stroke etiology with highest morbidity and mortality a. intracranial hemorrhage b. intracranial thrombosis c. intracranial embolization d. cardiac arrest
a
All the following stress-induced hormones increase blood glucose except a. aldosterone. b. cortisol. c. norepinephrine. d. epinephrine.
aldosterone
Selye's three phases of the stress response include all the following except a. allostasis. b. resistance. c. alarm. d. exhaustion.
allostasis
A type of insulin that would be most appropriate for acute management of hyperglycemia is a. NPH. b. Semilente. ' c. regular. d. Ultralente.
c
Bacterial pneumonia leads to hypoxemia caused by a. cardiogenic pulmonary edema. b. upper airway obstruction. c. accumulation of alveolar exudates. d. interstitial edema.
c
Increased preload of the cardiac chambers may lead to which patient symptom? a. Decreased heart rate b. Decreased respiratory rate c. Edema d. Excitability
c
Orthostatic hypotension may be a manifestation of a. Alzheimer disease. b. multiple sclerosis. c. Parkinson disease. d. amyotrophic lateral sclerosis.
c
RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus. a. negative; positive; positive b. positive; negative; negative c. negative; negative; positive d. negative; negative; negative
c
The effects of histamine release include a. vasoconstriction. b. bronchodilation. c. increased vascular permeability. d. decreased gut permeability.
c
The most important determinant for prescribing therapy for acute stroke is a. location of ischemia. b. thrombotic versus embolic cause. c. ischemic versus hemorrhagic cause. d. age of the patient.
c
Tissues are able to autoregulate their rate of blood flow by controlling a. perfusion pressure. b. arterial blood pressure. c. vascular resistance. d. venous return to the heart.
c
Which pulmonary function test result is consistent with a diagnosis of asthma? a. Reduced forced expiratory volume in 1 second (FEV1) b. Decreased functional residual capacity c. Increased FEV1 d. Reduced total lung volume
c
risk factors for hemorrhagic stroke include a. atherosclerosis b. dysrhythmias c. acute HTN d. sedentary lifestyle
c
Which changes in the circulatory system occur in the older adult? (Select all that apply.) a. Increased baroreceptor function b. Increased response to hypertensive stimuli c. Increased systemic vascular resistance (SVR) d. Decreased afterload e. Decreased elasticity of vessel walls
c, e
Clinical manifestations of a stroke within the right cerebral hemisphere include a. cortical blindness. b. right visual field blindness. c. expressive and receptive aphasia. d. left-sided muscle weakness and neglect.
d
High blood pressure increases the workload of the left ventricle, because it increases a. stroke volume. b. blood volume. c. preload. d. afterload.
d
Interleukin-1, interleukin-6, and tumor necrosis factor- are inflammatory cytokines secreted by a. plasma cells. b. neutrophils. c. lymphocytes. d. macrophages.
d
Parkinson disease is associated with a. demyelination of CNS neurons. b. a pyramidal nerve tract lesion. c. insufficient production of acetylcholine in the basal ganglia. d. a deficiency of dopamine in the substantia nigra.
d
The primary adaptive purpose of the substances produced in the alarm stage is a. energy and repair. b. invoke resting state. c. produce exhaustion. d. set a new baseline steady-state.
energy and repair
which is not normally secreted in response to stress? a. NE b. cortisol c. EP d. insulin
insulin