patho test 3
Which of the following measures is most effective for preventing pulmonary emboli in patients who are recovering from a major surgery? A) Ambulate patients frequently to prevent blood clot formation. B) Ensure that patients use supplemental oxygen. C) Prevent the development of anemia. D) Promote aggressive fluid intake.
A) Ambulate patients frequently to prevent blood clot formation.
Individuals who have recently developed chronic bronchitis most often present with: A) productive cough. B) wheezing. C) a barrel chest. D) severe dyspnea.
A) productive cough.
Air that enters the pleural space during inspiration and is unable to exit during expiration creates a condition called: A) tension pneumothorax. B) open pneumothorax. C) pleural effusion. D) empyema.
A) tension pneumothorax.
Airway obstruction in chronic bronchitis is generally the result of: A) thick mucous secretions and smooth muscle hypertrophy. B) loss of alveolar elastin. C) the accumulation of pulmonary edema. D) hyperplasia of bronchial cartilage.
A) thick mucous secretions and smooth muscle hypertrophy.
Pulmonary emphysema is characterized by a number of derangements of pulmonary structure and function. Which of the following is NOT a feature of pulmonary emphysema? A. Chronic inflammation of bronchioles leads to trapping of air in the lungs. B. Flow of air in and out of the lungs is greatly increased. C. Nonuniform ventilation of alveoli reduces the efficiency of ventilation. D. Enlargement of air spaces and reduction of capillary surface area within the lungs reduces the efficiency of gas exchange. E. A loss of lung elasticity requires active expiratory effort.
B. Flow of air in and out of the lungs is greatly increased.
Which of the following lab tests will the nurse check to help diagnose heart failure and provide insight into its severity?
Brain na triuretic
Which of the following characteristics is not typical of asthma? A) Asthma is a chronic inflammatory disorder. B) Asthma is caused by bronchial hyperresponsiveness. C) Asthma causes alveolar collapse. D) Genetic susceptibility plays a role in the development of asthma.
C) Asthma causes alveolar collapse.
Primary pulmonary hypertension usually is caused by: A) chronic pulmonary disease. B) right-sided heart failure. C) hereditary traits. D) pulmonary emboli.
C) hereditary traits.
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by: A) increased pulmonary blood flow. B) increased expiratory flow rates. C) increased residual lung volumes. D) decreased chest wall compliance.
C) increased residual lung volumes.
A life-threatening complication of asthma is: A) exercise-induced asthma. B) chronic obstructive pulmonary disease. C) status asthmaticus. D) bronchiectasis.
C) status asthmaticus.
Pneumonia leads to hypoxemia due to: A) cardiogenic pulmonary edema. B) upper airway obstruction. C) the accumulation of exudates and fibrin deposition. D) the decreased fraction of inspired oxygen.
C) the accumulation of exudates and fibrin deposition.
A 56-year-old male is diagnosed with CAD. Which of the following modifiable factors would most likely influence development of the disease?
Cigarette smoking
______ atelectasis is the collapse of lung tissue caused by external pressure exerted by a tumor, fluid, or air.
Compression
_____ is a term that signifies right-sided heart failure secondary to pulmonary hypertension.
Cor pulmonale
A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease is caused by:
Correct Answer: Abnormal thickening and hardening of vessel walls Response Feedback: Atherosclerosis is a form of arteriosclerosis characterized by thickening and hardening of the vessel wall.
A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the nurse determines the patient is experiencing:
Correct Answer: Acute pericarditis Response Feedback: Severe chest pain that worsens with respirations or lying down in a patient with fever, tachycardia, and a friction rub is characteristic of acute pericarditis.
A 49-year-old male presents to his primary care provider reporting chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?
Correct Answer: Apply oxygen to increase myocardial oxygen supply. Response Feedback: Increase myocardial oxygen supply is indicated to treat ischemia.
When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response? The most common cause of myocardial ischemia is:
Correct Answer: Atherosclerosis Response Feedback: The most common cause of myocardial ischemia is atherosclerosis.
A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?
Correct Answer: Long periods of standing Response Feedback: The probable cause of the patient's varicose veins is gradual venous distention caused by the action of gravity on blood in the legs due to long periods of standing. Varicose veins are most likely due to long periods of standing leading to the action of gravity promoting venous distention. Exercise would help prevent this. Trauma can occur, but usually this affects the more superficial veins. Ischemia affects arteries not veins.
A staff member asks a nurse what foam cells are. What is the nurse's best response? Foam cells in a fatty streak are:
Correct Answer: Macrophages that engulf low-density lipoprotein (LDL) Response Feedback: Foam cells are lipid-laden macrophages that engulf LDL.
A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:
Correct Answer: Myocardial hypertrophy and ventricular remodeling Response Feedback: With hypertension comes increased afterload and resistance to ventricular emptying and more workload for the ventricle, which responds with hypertrophy of the myocardium and ventricular remodeling.
A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of cardiac troponins I and T. Based upon the lab findings, the nurse suspects which of the following has occurred?
Correct Answer: Myocardial infarction (MI) Response Feedback: The diagnosis of acute MI is made on the basis of serial cardiac biomarker alterations. The cardiac troponins (troponins I and T) are the most specific indicators of MI.
A 55-year-old male died of a myocardial infarction. Autopsy would most likely reveal:
Correct Answer: Platelet aggregation within the atherosclerotic coronary artery
Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.
Correct Answer: Primary Response Feedback: Most cases of hypertension are diagnosed as primary hypertension.
A 62-year-old male presents to his primary care provider reporting chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?
Correct Answer: Prinzmetal Response Feedback: Chest pain that occurs at rest and at night is descriptive of Prinzmetal angina. Unstable angina is a form of acute coronary syndrome that results from reversible myocardial ischemia. Stable angina is predictable and occurs with activity. Silent angina has few, if any, symptoms.
When a patient with left heart failure starts to have a cough and dyspnea, which principle should the nurse remember? Pulmonary symptoms, common to left heart failure, are a result of:
Correct Answer: Pulmonary vascular congestion Response Feedback: The clinical manifestations of left heart failure are the result of pulmonary vascular congestion and inadequate perfusion of the systemic circulation.
65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures should the nurse assess for in this patient?
Correct Answer: Right heart failure Response Feedback: Right-sided failure occurs when the patient experiences chronic pulmonary disease and elevated pulmonary vascular resistance because the blood has difficulty overcoming the pressure and blood builds up in the right side of the heart.
A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?
Correct Answer: Significant edema to both lower legs and feet Response Feedback: Right-sided failure allows blood to back up into the systemic circulation, leading to peripheral edema.
A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient change?
Correct Answer: Smoking cigarettes Response Feedback: Cigarette smoking leads to vasoconstriction and should be the first behavior the patient changes.
A 51-year-old male is at the health clinic for an annual physical exam. After walking from the car to the clinic, he developed substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:
Correct Answer: Stable angina Response Feedback: Stable angina is associated with activity and subsides with rest.
When a nurse checks the patient for orthostatic hypotension, what did the nurse have the patient do?
Correct Answer: Stand up Response Feedback: Orthostatic hypotension refers to a drop in blood pressure when standing up.
A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure. The nurse understands this is most likely caused by:
Correct Answer: Sympathetic nervous system compensation for decreased cardiac output Response Feedback: The sympathetic nervous system increases peripheral vascular resistance (PVR) and leads to hypertension.
A 50-year-old male is diagnosed with orthostatic hypotension. Which of the following symptoms would he most likely experience?
Correct Answer: Syncope and fainting Response Feedback: Orthostatic hypotension is often accompanied by dizziness, blurring or loss of vision, and syncope or fainting.
A nurse takes an adult patient's blood pressure and determines it to be normal. What reading did the nurse obtain?
Correct Answer: Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg Response Feedback: Normal blood pressure has a systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg. A systolic pressure of 140 mm Hg or more would indicate stage I hypertension. A systolic pressure of less than 100 mm Hg would indicate low blood pressure. A diastolic pressure greater than 90 mm Hg would indicate hypertension.
A 56-year-old male presents to his primary care provider for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is of greatest concern to the nurse?
Correct Answer: Tamponade Response Feedback: Muffled heart sounds is an indication of tamponade, and with tamponade the blood backs up into the venous system, leading to hepatomegaly.
A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
Correct Answer: The myocardial oxygen supply has fallen below demand. Response Feedback: Angina is chest pain caused by myocardial ischemia, which develops if the flow or oxygen content of coronary blood is insufficient to meet the metabolic demands of myocardial cells.
A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived, but now the nurse is providing care for impaired ventricular function because:
Correct Answer: The resulting ischemia leads to hypoxic injury and myocardial cell death. Response Feedback: The patient has impaired ventricular functioning because a portion of the myocardium has died due to ischemia.
A 65-year-old female presents to the emergency department reporting difficulty swallowing and shortness of breath. A CT scan would most likely reveal an aneurysm in the:
Correct Answer: Thoracic aorta Response Feedback: Thoracic aortic aneurysms can cause dysphagia (difficulty swallowing) and dyspnea (breathlessness).
What term should the nurse document for a detached blood clot?
Correct Answer: Thromboembolus Response Feedback: A detached thrombus is a thromboembolus.
A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling. He has an elevated level of low-density lipoprotein (LDL) and a low level of high-density lipoprotein (HDL). Which of the following should the nurse advise him to avoid?
Correct Answer: Trans fats Response Feedback: Trans fats are primarily found in artificially solidified (hydrogenated) oils (e.g., margarine and vegetable shortening). By becoming more solid, they lose essential fatty acids (EFAs). They can raise LDL and lower HDL levels.
A 32-year-old female presents with lower leg pain, with swelling and redness. While obtaining the patient's history, which finding could have caused her condition?
Correct Answer: Venous thrombus Response Feedback: A thrombus formation in the vein leads to inflammation that may cause pain and redness with obstruction. Increased pressure in the vein behind the clot may lead to edema of the extremity.
A 49-year-old male presents to his physician complaining of chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia (inadequate blood flow). Which of the following interventions would be most beneficial?
Increase myocardial oxygen supply
59-year-old female is diagnosed with left ventricular failure. The decrease in kidney perfusion would ultimately cause
Increased systemic vascular resistance*
A 73-year-old female has increased pulmonary pressure resulting in right heart failure. A potential cause for her heart to fail is:
Left heart failure
A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of Creatine phosphate and lactic dehydrogenase. These elevated levels indicate:
Myocardial infarction
A 50-year-old male crushed his hand while working in a sawmill. Long after his injury has healed he still feels burning pain in his hand. This pain is referred to as?
Neuropathic pain
The lowest intensity that of a stimulus that is perceived as painful is termed?
Pain threshold
What is inflammation of the pleura that causes pain on inspiration called?
Pleurisy
An 85-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures generally results from this condition?
Right heart failure ---Right ventricle pumps to the pulmonary veins- resistance making it hard for the flow of blood from the RV→ Lungs
Inflammation in visceral tissues activates?
Silent nociceptors
A 15-year-old female scrapes her knee while playing soccer and complains of sharp and well-localized pain. What would most accurately characterise her pain?
Somatic pain
Which one of the following is an excitatory neuromodulator that enhances pain transmission? Beta endorphin, encephalin, substance P, dynorphin
Substance P
Which of the following findings in the patient with Raynaud disease would indicate a need for further teaching?
The patient smokes cigarettes
A 55 year old male presented to his doctor complaining of severe headache. Investigative tests suggested his pain was psychogenic in nature. Why?
This type of pain appears to have no underlying pathology
The pain that occurs to a stimulus such as light stroking that normally does not provoke pain is termed?
allodynia
high output failure occurs with
anemia
The system responsible for an individual's emotional and behavioral responses to pain is the?
motivational/affective system
Pain that is felt in a different body part to the source of the pain is called?
referred pain
A 20 year old female pricked her left hand while sewing: which area in her brain would have received the pain signal s and perceived them as pain?
right somatosensory cortex
50 yo obese male with hypertension and CAD visits nutritionist for food counseling. He is told that ____ fats raise LDL levels and lower HDL levels and should be avoided
trans-fat
A 60-year-old male is diagnosed with cerebral aneurysm. Where does the nurse suspect the cerebral aneurysm is located?
Correct Answer: Circle of Willis Response Feedback: Cerebral aneurysms often occur in the circle of Willis.
Individuals with Raynaud disease need to be counseled to avoid which of the following conditions to prevent severe symptoms?
Correct Answer: Cold exposure Response Feedback: Raynaud disease consists of vasospastic attacks triggered by brief exposure to cold.
A 28-year-old female presents with severe chest pain and shortness of breath. She is diagnosed with pulmonary embolism, which most likely originated from the:
Correct Answer: Deep veins of the leg Response Feedback: The most likely origin of the embolism is from the deep veins of the legs.
A nurse monitors the patient for _____ when rapid onset of malignant hypertension results.
Correct Answer: Encephalopathy Response Feedback: Malignant hypertension leads to cerebral edema and cerebral dysfunction (encephalopathy) and even death.
A patient wants to know what causes atherosclerosis. How should the nurse respond? In general, atherosclerosis is caused by:
Correct Answer: Endothelial injury and inflammation Response Feedback: Atherosclerosis begins with injury to the endothelial cells that line artery walls.
A 30-year-old Caucasian female was recently diagnosed with primary hypertension. She reports that she eats fairly well, usually having red meat and potatoes daily. She also reports that her father has hypertension as well. A nurse determines which of the following risk factors is most likely associated with this diagnosis?
Correct Answer: Genes Response Feedback: Genetic factors, such as family history of hypertension, are the number one factor in the development of hypertension.
A 68-year-old male presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:
Correct Answer: Impending myocardial infarction (MI) Response Feedback: Unstable angina is an indication of impending MI.
A 59-year-old female is diagnosed with left ventricular failure. If a decrease in kidney perfusion occurs, the nurse knows this would ultimately cause:
Correct Answer: Increased systemic vascular resistance Response Feedback: With a decrease in kidney perfusion, renin is released with the ultimate outcome of increased systemic vascular resistance to raise blood pressure to increase blood flow to the kidney.
A 52-year-old female is diagnosed with coronary artery disease. The nurse assesses for myocardial:
Correct Answer: Ischemia Response Feedback: Coronary artery disease leads to myocardial ischemia.
A 73-year-old female has increased pulmonary pressure resulting in right heart failure. The nurse should monitor for a possible complication because a potential cause for her heart to fail is:
Correct Answer: Left heart failure Response Feedback: Right-sided failure often follows left-sided failure when pulmonary congestion forces backward flow of blood into the left ventricle.
Which characteristic changes should the nurse keep in mind while caring for a patient with left heart failure? As left heart failure progresses:
Correct Answer: Left ventricular preload increases. Response Feedback: Left ventricular preload increases in left heart failure because less blood is ejected from the left ventricle.
A nurse recalls acute orthostatic hypotension can be caused by (select all that apply):
- Prolonged immobility - Drug action - Starvation - Volume depletion
A patient has been researching cardiac cells on the internet. Which information indicates the patient has a good understanding? Cardiac cells can withstand ischemic conditions for ___ minutes before irreversible cell injury occurs.
20
Cardiac cells can withstand ischemic conditions for ___ before irreversible injury occurs?
20 minutes
Chronic pain is pain that has lasted longer than?
3 months
