patho exam 3
ST-elevated myocardial infarction (STEMI) is accompanied by severe, crushing pain. Morphine is the drug of choice used to treat the pain of STEMI when the pain cannot be relieved with oxygen and nitrates. Why is morphine considered the drug of choice in STEMI? a) Action increases autonomic nervous system activity b) Action decreases metabolic demands of the heart c) Action increases anxiety increasing metabolic demands of the heart d) Action relieves pain and gives a sense of depression
b) Action decreases metabolic demands of the heart
Which of the following is a lower airway disease? a) Epiglottis b) Acute bronchiolitis c) Spasmodic croup d) Laryngotracheobronchitis
b) Acute bronchiolitis
Tuberculosis is a highly destructive disease because the tubercle bacillus activates a tissue hypersensitivity to the tubercular antigens. What does the destructive nature of tuberculosis cause in previously unexposed immunocompetent person? a) Cavitation and rapidly progressing pulmonary lesions b) Caseating necrosis and cavitation c) Rapidly progressing lesions and purulent necrosis d) Caseating necrosis and purulent pulmonary lesions
b) Caseating necrosis and cavitation
One of the many manifestations of left-sided heart failure is_________________. It can be diagnosed by examination of the lips and mucous membranes. a) Valvular insufficiency b) Tamponade c) Fibrillation d) Cyanosis
d) Cyanosis
Many pharmaceutical agents may cause pulmonary damage. The nurse knows the following cardiac medication has been associated with toxic effects in the lungs: a) Amiodarone b) Inderal c) Methotrexate d) Busulfan
a) Amiodarone
Hypertension in the elderly is a common finding. This is because of the age-related rise in systolic blood pressure. Among the aging processes, what is a contributor to hypertension? a) Baroreceptor sensitivity b) Aortic softening c) Decreased peripheral vascular resistance d) Increased renal blood flow
a) Baroreceptor sensitivity
Which of the following is a sign or symptom of heart failure? a) Fluid retention b) Ruddy complexion c) Bradycardia d) Chronic productive cough
a) Fluid retention
Nearly everyone with pericarditis has chest pain. With acute pericarditis, the pain is abrupt in onset, sharp, and radiates to the neck, back, abdomen, or sides. What can be done to ease the pain of acute pericarditis? a) Have the patient sit up and lean forward b) Have the patient change positions to unaffected side c) Have the patient breathe deeply d) Have the patient swallow slowly and frequently
a) Have the patient sit up and lean forward
Acute respiratory failure is commonly signaled by varying degrees of hypoxemia and hypercapnia. Respiratory acidosis develops manifested by what? a) Increased cerebral blood flow b) Arterial vasoconstriction c) Increase in cardiac contractility d) Decreased cerebral spinal fluid pressure
a) Increased cerebral blood flow
Pleuritis, an inflammatory process of the pleura is common in infectious processes that spread to the pleura. Which is the drug of choice for treating pleural pain? a) Indomethacin b) Aspirin c) Acetaminophen d) Inderal
a) Indomethacin
Where in the body are lipoproteins synthesized? a) The Small Intestine b) The Large Intestine c) The Pancreas d) The Gall Bladder
a) The Small Intestine
Pulmonary hypertension is usually caused by long-term exposure to hypoxemia. When pulmonary vessels are exposed to hypoxemia, what is the response? a) Pulmonary vessels dilate b) Pulmonary vessels constrict c) Pulmonary vessels spasm d) Pulmonary vessels infarct
b) Pulmonary vessels constrict
Cardiac tamponade is a serious life-threatening condition that can arise from a number of conditions. What is a key diagnostic finding in cardiac tamponade? a) Increase instroke volume b) Pulsus paradoxus c) Narrowed pulse pressure d) Rise in systolic blood pressure
b) Pulsus paradoxus
The early stages of influenza pass by as if the infection were any other viral infection. What is the distinguishing feature of an influenza viral infection that makes it different from other viral infections? a) Slow onset of upper respiratory symptoms b) Rapid onset of profound malaise c) Slow onset of fever and chills d) Rapid onset of productive cough
b) Rapid onset of profound malaise
A 56-year-old woman presents at the clinic complaining of the unsightliness of her varicose veins and wants to know what can be done about them. The nurse explains that the treatment for varicose veins includes which of the following interventions? a) Surgical or fibro therapy b) Sclerotherapy or surgery c) Trendelenburg therapy or sclerotherapy d) Surgery or Trendelenburg therapy
b) Sclerotherapy or surgery
Community-acquired pneumonia can be categorized according to several indexes. Which of the following is not one of these indexes? a) Radiologic findings b) Serologic findings c) Age d) Presence of coexisting disease
b) Serologic findings
Unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI) is a clinical syndrome that ranges in severity between stable angina and MI. It is classified according to its risk of causing an acute MI and is diagnosed based on what? a) Severity of pain and abruptness of onset b) Serum biomarkers and ECG pattern c) Coexisting chronic conditions d) Blood flow angiography
b) Serum biomarkers and ECG pattern
Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is distinguishable between the two by the extent of hypoxemia involved. What is NOT part of the early clinical presentation of ARDS? a) Rapid Onset b) Signs of respiratory distress c) Increase in respiratory rate d) Hypoxemia refractory to treatment
b) Signs of respiratory distress
Pregnancy-induced hypertension is a serious condition affecting between 5% and 10% of pregnant women. The most serious classification of hypertension in pregnancy is preeclampsia-eclampsia. It is a pregnancy-specific syndrome that can have both maternal and fetal manifestations. What is a life-threatening manifestation of the preeclampsia-eclampsia classification of pregnancy-induced hypertension? a) Hepatocellular necrosis b) Thrombocytopenia c) HELLP syndrome d) Decreased renal filtration rate
c) HELLP syndrome
Coccidioidomycosis is a pulmonary fungal infection resembling tuberculosis. Less severe forms of the infection are treated with oral antifungal medications. For persons with progressive disease, what is the drug of choice? a) IV fluconazole b) IV BCG c) IV amphotericin B d) IV rifampin
c) IV amphotericin B
The renin-angiotensin-aldosterone system is a negative feedback system that plays a central role in blood pressure regulation. How does the end result of this feedback loop regulate blood pressure in the body? a) Vasodilates blood vessels to decrease blood pressure b) Vasoconstricts blood vessels to increase blood pressure c) Increases salt and water retention by the kidney d) Decreases salt and water retention by the kidney
c) Increases salt and water retention by the kidney
A 45-year-old woman with a diagnosis of multiple sclerosis comes to the clinic complaining of coldness and pain in her fingers. She says that her fingers get red, and they throb and tingle. The nurse would expect what diagnosis and treatment for this patient? a) Arterial thrombosis; streptokinase b) Peripheral artery disease; aspirin c) Raynaud phenomenon; stop smoking d) Venous thrombosis; heparin
c) Raynaud phenomenon; stop smoking
When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. Which of the following is NOT a factor that contributes to hypercapnia? a) Alteration in carbon dioxide production b) Abnormalities in respiratory function c) Disturbance in gas exchange function d) Decrease in carbon dioxide production
d) Decrease in carbon dioxide production
Nitroglycerin is the drug of choice in treating angina. What does nitroglycerin release into the vascular smooth muscle of the target tissue? a) Antithrombin Factor b) Platelet-aggregating Factor c) Calcium Channel Blocker d) Nitric Oxide
d) Nitric Oxide
A 37-year-old woman presents to her primary care provider complaining of frequents headache and fatigue. T - 36.5 Celsius; P - 86; RR - 16; BP - 180/100. The client is instructed to return in 3 days for a repeat check of her BP, and if elevated she will be started on medication for hypertension. What is the mechanism of action for the following medications used to lower blood pressure? -Lisinopril -Losartan -Metoprolol -Felodipine -Clonidine
-Lisinopril--blocks angiotensin I from converting to angiotensin II -Losartan--blocks the action of angiotensin II -Metoprolol--blocks the beta-receptors from being stimulated -Felodipine--Blocks the calcium from entering the smooth muscles -Clonidine--Blocks the alpha adrenergic receptors
Sepsis is growing in incidence in the United States. Its pathogenesis includes neutrophil activation, which kills microorganisms. Neutrophils also injure the endothelium, releasing mediators that increase vascular permeability. What else do neutrophils do in sepsis? a) Release Nitric Oxide b) Vasoconstrict the capillary bed c) Cause bradycardia d) Activate erythropoiesis
a) Release nitric oxide
Chronic obstructive pulmonary disease (COPD) is a combination of disease processes. What disease processes have been identified as being part of COPD? a) Emphysema and asthma b) Chronic obstructive bronchitis and emphysema c) Chronic obstructive bronchitis and asthma d) Chronic bronchitis and emphysema
b) Chronic obstructive bronchitis and emphysema
Respiration has both automatic and voluntary components that are sent to the respiratory center of the brain from several sources. Which of the following is not a physiologic force that can exert influence on respiration through the lower brain center? a) Fever b) Cold c) Pain d) Emotion
b) Cold
Heart failure in an infant usually manifests itself as tachypnea or dyspnea, both at rest and on exertion. When does this most commonly occur with an infant? a) During bathing b) During feeding c) During burping d) During sleep
b) During feeding
What is the primary physiologic result of obstructive shock? a) Left ventricular hypertrophy b) Elevated right heart pressure c) Right atrial hypertrophy d) Decreased right heart pressure
b) Elevated right heart pressure
What is the underlying cause of respiratory failure in a child with bronchiolitis? a) Obstructive process b) Impaired gas exchange c) Ischemia d) Metabolic acidosis
b) Impaired gas exchange
Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often accompanies the vascular response in anaphylaxis? a) Uterine smooth muscle relaxation b) Laryngeal edema c) Bronchodilation d) Gastrointestinal relaxation
b) Laryngeal edema
A pulmonary embolism occurs when there is an obstruction in the pulmonary artery blood flow. Classic signs and symptoms of a pulmonary embolism include dyspnea, chest pain, and increased respiratory rate. What is a classic sign of pulmonary infarction? a) Mediastinal shift to the left b) Pleuritic pain c) Tracheal shift to the right d) Pericardial pain
b) Pleuritic pain
What is the primary cause of heart failure in infants and children? a) Idiopathic heart disease b) Structural heart defects c) Hyperkalemia d) Reactions to medications
b) Structural heart defects
When an acute-event occurs, and the circulatory system can no longer provide the body with adequate perfusion of its tissues and organs, cellular hypoxia occurs and body goes into shock. Which of the following is not a cause of shock in the human body? a) Maldistribution of blood flow b) Hypovolemia c) Excessive vasoconstriction d) Obstruction of blood flow
c) Excessive vasoconstriction
The management of cor pulmonale is directed at the underlying lung disease and heart failure. Why is low-flow oxygen therapy part of the management of cor pulmonale? a) Stimulates body to breathe on its own b) Inhibits the respiratory center of the brain from initiating tachypnea c) Reduces pulmonary hypertension and polycythemia associated with chronic lung disease d) Reduces pulmonary hypertension and formation of pulmonary embolism
c) Reduces pulmonary hypertension and polycythemia associated with chronic lung disease
Aortic aneurysms take varied forms and can occur anywhere along the aorta. Which of the following terms involve abdominal aortic aneurysms? a) Berry aneurysms b) Dissecting aneurysms c) Saccular aneurysms d) Bifurcating aneurysms
c) Saccular aneurysms
A group of vascular disorders called vaculitides cause inflammatory injury and necrosis of the blood vessel wall (i.e. vasculitis). These disorders are common pathways for tissue and organ involvement in many different disease conditions. What is the most common of the vasculitides? a) Polyarteritis Nodosa b) Raynaud Disease c) Temporal Arteritis d) Varicose Veins
c) Temporal Arteritis
A 69 year old man is admitted to the hospital following a popliteal embolectomy. He asks the nurse why he had to have surgery on his leg. What is the best response by the nurse? a) The doctor wanted to look into your artery to make sure everything was okay. b) Didn't the doctor explain everything to you before surgery? c) The artery that runs behind your knee was blocked by a blood clot, and the doctor removed it. d) Your upper leg was not getting enough blood, so the doctor had to fix it.
c) The artery that runs behind your knee was blocked by a blood clot, and the doctor removed it.
In hypovolemic shock, the main purpose of treatment is correction or controlling the underlying cause of the hypovolemia and improving the perfusion of the tissues and organs of the body. Which of the following treatments is NOT a primary form of therapy for hypovolemic shock? a) Surgery b) Administration of intravenous fluids and blood c) Vasoconstrictive drugs d) Infusion of blood and blood products
c) Vasoconstrictive drugs
Angina pectoris is a chronic ischemic Coronary Artery Disease (CAD) that is characterized by symptomatic paroxysmal chest pain or pressure sensation associated with transient myocardial ischemia. What precipitates an attack of angina pectoris? a) Exposure to heat b) Sedentary lifestyle c) Abrupt change in position d) Emotional stress
d) Emotional stress
Cystic fibrosis (CF) is an autosomal recessive disorder involving the secretion of fluids in specific exocrine glands. The genetic defect in CF inclines a person to chronic respiratory infections from a small group of organisms. Which organisms create chronic infection in a child with cystic fibrosis? a) Pseudomonas aeruginosa and Escherichia coli b) Staphylococcus aureus and hepatitis C c) Haemoophilus influenzae and influenza A d) Pseudomonas aeruginosa and Staphylococcus aureus
d) Pseudomonas aeruginosa and Staphylococcus aureus
Venous thrombosis most commonly occurs in the lower extremities. Risk factors for venous thrombosis include which of the following? a) Stasis of blood, hypercoagulability, inflammation b) Hypocoagulability, vessel wall injury, increased pressure on deep veins c) Vessel wall injury, hypocoagulability, decreased venous blood flow d) Stasis of blood, hypercoagulability, vessel wall injury
d) Stasis of blood, hypercoagulability, vessel wall injury
Non-small cell lung cancers (NSCLCs) mimic small cell lung cancers (SCLCs) through their abilities to do what? a) Synthesize bioactive products and produce pan-neoplastic syndromes b) Neutralize bioactive products which produce paraneoplastic syndromes c) Produce paraneoplastic syndromes and synthesize aderenocorticotropic hormone (ACTH) d) Synthesize bioactive products and produce paraneoplastic syndromes
d) Synthesize bioactive products and produce paraneoplastic syndromes
A patient with a suspected Myocardial Infarction (MI) is brought to the emergency department by ambulance. As the nurse caring for this patient, what laboratory work would you expect to receive an order for, to confirm a diagnosis of MI? a) Creatine kinase marker b) Complete blood components c) Calcium level d) Troponin level
d) Troponin level
