Path Midterm

In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?

Class II, Compensated Stage

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time?

Continue lifestyle modification only

Administration of which therapy is most appropriate for hypovolemic shock?

Crystalloids

Which clinical manifestation is not likely the result of a tuberculosis infection?

Cyanosis

A patient who reports an intestinal fistula also reports feeling "weak and dizzy" when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician?

Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?

Iron deficiency

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?

Left ventricular workload is increased with high afterload.

Dysfunction of which organ would lead to clotting factor deficiency?

Liver

Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure.

Mean arterial

Which causes vasoconstriction?

Norepinephrine

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?

Pain in long bones, infection, fever, bruising

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)

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

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

Septic

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.

Septic

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

The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.

Sodium

Which complication of asthma is life threatening?

Status asthmaticus

Which disorder is associated with a type III hypersensitivity mechanism of injury?

Systemic lupus erythematosus

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.

TRUE

The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII.

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

Croup is characterized by

a barking cough

A common characteristic of viral pneumonia is

a dry cough

Which clinical finding is indicative of compartment syndrome?

absent peripheral pulses

Bacterial pneumonia leads to hypoxemia caused by

accumulation of alveolar exudates

Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of

acute respiratory distress syndrome

Tachycardia is an early sign of low cardiac output that occurs because of

baroreceptor activity

Malignant neoplasms of epithelial origin are known as

carcinomas

Manifestations from sodium imbalances occur primarily as a result of

cellular fluid shifts

Your patient eats "lots of fat," leads a "stressful" life, and has smoked "about two packs a day for the last 40 years." Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is

cigarette smoking

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.

Apoptosis is a process that results in cellular

death

Extreme cold injures cells by all the following except

decreased blood viscosity

The primary effect of aging on all body systems is

decreased functional reserve

When systemic vascular resistance is decreased, blood flow

decreases

Clinical manifestations of severe symptomatic hypophosphatemia are caused by

deficiency of ATP.

Of the statements below, the accurate statement regarding nutrition and cellular health is

deficient cellular uptake by one cell type may contribute to excess nutrient delivery to other cell types.

Severe combined immunodeficiency (SCID) syndrome is an example of a(n)

deficient immune response

Patients with immunodeficiency disorders are usually first identified because they

develop recurrent infections

Aortic regurgitation is associated with

diastolic murmur.

The major cause of death from leukemic disease is

infection

The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is

infection

Disseminated intravascular coagulation may be treated with heparin therapy to

inhibit clotting factor consumption

Reperfusion injury to cells

involves formation of free radicals

A primary effector cell of the type I hypersensitivity response is

mast cells

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

Thalassemia may be confused with iron-deficiency anemia, because they are both

microcytic

A loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation

The goal of long term heparin for the management of a deep vein thrombosis is to

prevent further clot formation

First-degree heart block is characterized by

prolonged PR interval

Left-sided heart failure is characterized by

pulmonary congestion

A serious complication of deep vein thrombosis is

pulmonary embolism

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

"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."

A 5-year-old patient's parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child's most likely diagnosis is

ALL (Acute Lymphoid Leukemia)

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

Anaphylactic

A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of

Bacterial pneumonia

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

The inward-pulling force of particles in the vascular fluid is called _____ pressure.

Capillary osmotic

Uncompensated metabolic alkalosis would result in

increased pH, increased HCO3-

Hyperaldosteronism causes

ECV excess and hypokalemia

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.

FALSE

Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.

FALSE

The most commonly recognized outcome of hypertension is pulmonary disease.

FALSE

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is

digitalis

The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of

extrinsic pathway

Treatment for hemophilia A includes

factor VIII replacement

The conversion of plasminogen to plasmin results in

fibrinolysis

Red blood cells obtain nearly all their energy from metabolism of

glucose

The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who

has had diarrhea for over a week

Early manifestations of a developing metabolic acidosis include

headache

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with

high cardiac output

Respiratory alkalosis is caused by

hyperventilation

Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with

hypophosphatemia

The body compensates for metabolic alkalosis by

hypoventilation

Myasthenia gravis is a type II hypersensitivity disorder that involves

impaired muscle function

Respiratory acidosis is associated with

increased carbonic acid

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

Fully compensated respiratory acidosis is demonstrated by

pH 7.36, PaCO2 55, HCO3- 36.

Persistence of the alarm stage will ultimately result in

permanent damage and death

A deficiency of von Willebrand factor impairs

platelet adhesion to injured tissue

An erroneously low blood pressure measurement may be caused by

positioning the arm above the heart level

Legionnaires disease is characterized by

presence of systemic illness

Transfusion reactions involve RBC destruction caused by

recipient antibodies

Beta-blockers are advocated in the management of heart failure because they

reduce cardiac output

The majority of tachydysrhythmias are believed to occur because of

reentry mechanisms

The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L demonstrates

respiratory alkalosis

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

Autologous stem cell transplantation is a procedure in which

stem cells are harvested from the patient and then returned to the same patient.

The stage during which the patient functions normally, although the disease processes are well established, is referred to as

subclinical

A patient with significant aortic stenosis is likely to experience

syncope

Metaplasia is

the replacement of one differentiated cell type with another.

The fraction of total body water (TBW) volume contained in the intracellular space in adults is

two thirds

Clinical manifestations of extracellular fluid volume deficit include

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