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.
