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Patho Final > Chapter 17, 19, 20, 22, 23, 25 > Flashcards

Chapter 17, 19, 20, 22, 23, 25 Flashcards

1
Q
  1. A neurologist is teaching about brain injuries. Which information should the neurologist
    include? The most severe diffuse brain injury caused by rotational acceleration is most likely to
    be located _____ the brainstem.

a. More peripheral to
b. In the central portion of
c. Throughout
d. Distal to

A

ANS: A

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2
Q
  1. A nurse is preparing to teach staff about the most common type of traumatic brain injury.
    Which type of traumatic brain injury should the nurse discuss?

a. Penetrating trauma
b. Diffuse axonal injury
c. Focal brain injury
d. Concussion

A

ANS: D

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3
Q
  1. A 15-year-old male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had
    momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be
    categorized as:

a. Grade I
b. Grade II
c. Grade III
d. A mild concussion

A

ANS: B

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4
Q
  1. A 25-year-old male was in an automobile accident. At impact, his forehead struck the
    windshield. In this situation, a nurse recalls the coup injury would occur in the _____ region.

a. Frontal
b. Temporal
c. Parietal
d. Occipital

A

ANS: A

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5
Q
  1. While planning care for a patient with an extradural hematoma, which principle should the
    nurse remember? The main source of bleeding in extradural (epidural) hematomas is:

a. Arterial
b. Venous
c. Capillary
d. Sinus

A

ANS: A

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6
Q
  1. A 69-year-old male with a history of alcohol abuse presents to the emergency room (ER) after
    a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his
    neurologic symptoms is:

a. Concussion
b. Chronic subdural hematoma
c. Epidural hematoma
d. Subacute subdural hematoma

A

ANS: B

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7
Q
  1. A 15-year-old male was struck by a motor vehicle and suffered a traumatic brain injury.
    Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he
    regained consciousness and was able to maintain a conversation with the medical staff. Upon
    arrival to hospital, he was alert and oriented. Physical exam reveals confusion and impaired
    responsiveness. What is the probable nature of his brain injury based on this history?

a. Mild concussion
b. Subdural hematoma
c. Extradural (epidural) hematoma
d. Mild diffuse axonal injury

A

ANS: C

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8
Q
  1. Which assessment finding by the nurse characterizes a mild concussion?
    a. A brief loss of consciousness
    b. Significant behavioral changes
    c. Retrograde amnesia
    d. Permanent confusion
A

ANS: C

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9
Q
  1. A 39-year-old male suffers a severe brain injury when he falls off a building while working.
    CT scan reveals that he has a basilar skull fracture. Based upon his injuries, what major
    complication should the nurse observe for in this patient?

a. Hematoma formation
b. Meningeal infection
c. Increased intracranial pressure (ICP)
d. Cognitive deficits

A

ANS: B

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10
Q
  1. A 65-year-old female loses her balance while walking in the woods, causing her to fall and
    hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having
    diffuse brain injury. Which of the following would most likely occur in this patient?

a. Complete loss of vision
b. Arrhythmia
c. Blunted affect
d. Meningitis infection

A

ANS: C

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11
Q
  1. A 10-year-old male fell -> climbing on a house -> severe brain injury
    - Glasgow Coma Scale (GCS) was 5 - initially 7 after 1 day
    - unconscious for 2
    weeks
    - confused and suffered from anterograde amnesia.
    Which of the following is he
    most likely experiencing?

a. Mild diffuse brain injury
b. Moderate diffuse brain injury
c. Severe diffuse brain injury
d. Postconcussive syndrome

A

ANS: B

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12
Q
  1. _____ are most at risk of spinal cord injury from minor trauma.

a. Infants
b. Men
c. Women
d. The elderly

A

ANS: D

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13
Q
  1. An initial assessment finding associated with acute spinal cord injury is _____ the injury.

a. Pain below the level of
b. Loss of autonomic reflexes above
c. Loss of voluntary control below
d. Hyperactive spinal reflexes below

A

ANS: C

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14
Q
  1. When a patient asks how bad the injuries will be from a spinal injury, what is the nurses best
    response? It is difficult to know the full extent of the injury because of:

a. Incomplete transection of the spinal cord
b. Swelling within the spinal cord
c. Necrosis of the spinal cord
d. Free radical injury and scarring of the glial cells

A

ANS: B

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15
Q
  1. A 20-year-old male is brought to the emergency room (ER) for treatment of injuries received
    in a motor vehicle accident. A spinal cord injury is suspected. What two regions should the nurse
    assess as they are most likely to be damaged?

a. Cervical and thoracic regions
b. Thoracic and lumbar regions
c. Lumbar and sacral regions
d. Cervical and lumbar regions

A

ANS: D

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16
Q
  1. A 33-year-old male is brought to the ER for treatment of injuries received in a motor vehicle
    accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life
    threatening because:

a. Increased ICP may occur.
b. Reflexes will be disrupted.
c. Diaphragm function may be impaired.
d. Bladder emptying will not occur.

A

ANS: C

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17
Q
  1. A 15-year-old male is brought to the ER for treatment of injuries received in a motor vehicle
    accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The
    most accurate explanation of this phenomenon is that:

a. He developed pneumonia.
b. His sympathetic nervous system has been damaged and thermal control disturbed.
c. He has a brain injury.
d. He has septicemia from an unknown source.

A

ANS: B

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18
Q
  1. Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood
    pressure of 200/120, a severe headache, blurred vision, and bradycardia. What does the nurse
    suspect the patient is experiencing?

a. Extreme spinal shock
b. Acute anxiety
c. Autonomic hyperreflexia
d. Parasympathetic areflexia

A

ANS: C

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19
Q
  1. A 20-year-old female suffered from spinal cord injury that resulted from a motor vehicle
    accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated
    cardiovascular response to sympathetic stimulation. What does the nurse suspect caused this
    condition?

a. Toxic accumulation of free radicals below the level of the injury
b. Pain stimulation above the level of the spinal cord lesion
c. A distended bladder or rectum
d. An abnormal vagal response

A

ANS: C

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20
Q
  1. A 50-year-old male presents with low back pain. He denies trauma and says he just woke up
    and it was hurting. An MRI reveals that the vertebra at L5 slid forward relative to those above
    and below it. Which of the following conditions will be documented on the chart?

a. Degenerative disk disease
b. Spondylolysis
c. Spondylolisthesis
d. Spinal stenosis

A

ANS: C

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21
Q
  1. The majority of intervertebral disk herniations occur between which vertebral levels
    (cervical, C; thoracic, T; lumbar, L; sacral, S)?

a. C1 to C3
b. T1 to T4
c. T12 to L3
d. L4 to S1

A

ANS: D

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22
Q
  1. A 30-year-old white male recently suffered a cerebrovascular accident. Which of the
    following is the most likely factor that contributed to his stroke?

a. Age
b. Gender
c. Diabetes
d. Race

A

ANS: C

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23
Q
  1. Which of the following would increase a patients risk for thrombotic stroke?

a. Hyperthyroidism
b. Hypertension
c. Anemia
d. Dehydration

A

ANS: D

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24
Q
  1. Of the following groups, who are at highest risk for a cerebrovascular accident (CVA)?

a. Blacks over 65 years of age
b. Whites over 65 years of age
c. Blacks under 65 years of age
d. Whites under 65 years of age

A

ANS: A

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25
Q
  1. A 72-year-old male demonstrates left-sided weakness of upper and lower extremities. The
    symptoms lasted 4 hours and resolved with no evidence of infarction. The patient most likely
    experienced a(n):

a. Stroke in evolution
b. Arteriovenous malformation
c. Transient ischemic attack
d. Cerebral hemorrhage

A

ANS: C

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26
Q
  1. A major contributing process in CVAs is the development of atheromatous plaques in
    cerebral circulation. These most commonly form:

a. In the larger veins
b. Near capillary sphincters
c. In cerebral arteries
d. In the venous sinuses

A

ANS: C

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27
Q
  1. A 60-year-old female with a recent history of head trauma and a long-term history of
    hypertension presents to the ER for changes in mental status. MRI reveals that she had a
    hemorrhagic stroke. What does the nurse suspect cause this type of stroke?

a. Rheumatic heart disease
b. Thrombi
c. Aneurysm
d. Hypotension

A

ANS: C

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28
Q
  1. A 75-year-old male experienced a lacunar stroke. When looking through the history of the
    patients chart, which of the following would the nurse expect to find?

a. An embolus
b. Hypertension
c. A hemorrhage
d. An aneurysm

A

ANS: B

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29
Q
  1. A 25-year-old male died from a gunshot wound to the heart. Upon autopsy, abnormalities in
    the media of the arterial wall and degenerative changes were detected. Which of the following
    most likely accompanied this finding?

a. Fusiform aneurysm
b. Saccular aneurysm
c. Arteriovenous malformation
d. Thrombotic stroke

A

ANS: B

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30
Q
  1. A 48-year-old female presents at the ER reporting an acute severe headache, nausea,
    photophobia, and nuchal rigidity. What does the nurse suspect caused these signs and symptoms?

a. Diffuse brain injury
b. Subarachnoid hemorrhage
c. Epidural hematoma
d. Classic concussion

A

ANS: B

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31
Q
  1. A cause of hydrocephalus in subarachnoid hemorrhage is:

a. Scarring of meninges and impairment of CSF resorption

b. Choroid plexus injury

c. Impairment of CSF flow through the ventricles

d. Vasoconstriction related to carbon dioxide (CO2) changes in the cerebral
circulation

A

ANS: A

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32
Q
  1. A 65-year-old male suffers a subarachnoid hemorrhage secondary to uncontrolled
    hypertension. He appears drowsy and confused with pronounced focal neurologic deficits. This
    condition is grade:

a. I
b. II
c. III
d. IV

A

ANS: C

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33
Q
  1. A 25-year-old female presents to her primary care provider reporting fever, headache, nuchal
    rigidity, and decreased consciousness. She was previously treated for sinusitis. Which of the
    following is the most likely diagnosis?

a. Aseptic meningitis
b. Bacterial meningitis
c. Fungal meningitis
d. Nonpurulent meningitis

A

ANS: B

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34
Q
  1. A neurologist is teaching about encephalitis. Which information should the neurologist
    include? Most causes of encephalitis are:

a. Bacterial
b. Viral
c. Fungal
d. Toxoid

A

ANS: B

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35
Q
  1. A 15-month-old child from Pennsylvania was brought to the ER for fever, seizure activity,
    cranial palsies, and paralysis. Which of the following diagnosis will be documented in the chart?

a. Eastern equine encephalitis
b. Venezuelan encephalitis
c. St. Louis encephalitis
d. West Nile encephalitis

A

ANS: A

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36
Q
  1. A 23-year-old female begins having problems with tiredness, weakness, and visual changes.
    Her diagnosis is multiple sclerosis (MS). What is occurring in the patients body?

a. Depletion of dopamine in the central nervous system (CNS)
b. Demyelination of nerve fibers in the CNS
c. The development of neurofibril webs in the CNS
d. Reduced amounts of acetylcholine at the neuromuscular junction

A

ANS: B

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37
Q
  1. When a patient asks, What is the cause of multiple sclerosis? how should the nurse reply?
    The cause of MS seems to be an interaction between:

a. Vascular and metabolic factors
b. Bacterial infection and the inflammatory response
c. Autoimmunity and genetic susceptibility
d. Neurotransmitters and inherited genes

A

ANS: C

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38
Q
  1. A patient is admitted with amyotrophic lateral sclerosis (ALS). Which classic assessment
    findings will support the diagnosis of ALS?

a. Progressive dementia
b. Muscle weakness and atrophy
c. Severe paresthesias
d. Autonomic dysfunctions

A

ANS: B

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39
Q
  1. Which statement by a patient indicates teaching was successful regarding myasthenia gravis?
    Myasthenia gravis results from:

a. Viral infection of skeletal muscle
b. Atrophy of motor neurons in the spinal cord
c. Demyelination of skeletal motor neurons
d. Autoimmune injury at the neuromuscular junction

A

ANS: D

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40
Q
  1. A nurse recalls direct stimulation of the insulin-secreting cells of the pancreas by the
    autonomic nervous system is an example of _____ control.

a. Negative feedback
b. Positive feedback
c. Neural
d. Substrate-level dependent

A

ANS: C

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41
Q
  1. A nurse is teaching staff about protein hormones. Which information should the nurse
    include? One of the protein hormones is:

a. Thyroxine (T4)
b. Aldosterone
c. Testosterone
d. Insulin

A

ANS: D

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42
Q
  1. A 45-year-old female has elevated thyroxine production. Which of the following would
    accompany this condition?

a. Increased thyroid-releasing hormone (TRH)
b. Increased anterior pituitary stimulation
c. Decreased T4
d. Decreased thyroid-stimulating hormone (TSH)

A

ANS: D

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43
Q
  1. An endocrinologist isolated a new hormone and found it to be a water-soluble amine. Which
    of the following is most like this new hormone?

a. Growth hormone (GH)
b. Luteinizing hormone (LH)
c. Antidiuretic hormone (ADH)
d. Epinephrine

A

ANS: D

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44
Q
  1. When insulin binds to its receptors on muscle cells, an increase in glucose uptake by the
    muscle cells occurs. This is an example of a _____ effect by a hormone.

a. Pharmacologic
b. Permissive
c. Biphasic
d. Direct

A

ANS: D

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45
Q
  1. A 30-year-old male was diagnosed with hypothyroidism. Synthesis of which of the following
    would decrease in this patient?

a. Corticosteroid B globulin
b. Sex hormone-binding globulin
c. Thyroid-binding globulin
d. Albumin

A

ANS: C

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46
Q
  1. A patient has high levels of hormones. To adapt to the high hormone concentrations, the
    patients target cells have the capacity for:

a. Negative feedback
b. Positive feedback
c. Down-regulation
d. Up-regulation

A

ANS: C

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47
Q
  1. A patient has researched lipid-soluble hormones on the Internet. Which information indicates
    the patient has a good understanding? Lipid-soluble hormone receptors cross the plasma
    membrane by:

a. Diffusion
b. Osmosis
c. Active transport
d. Endocytosis

A

ANS: A

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48
Q
  1. When a patient asks about target cell receptors, which is the nurses best response? Target cell
    receptors for most water-soluble hormones are located in the:

a. Cytosol
b. Cell membrane
c. Endoplasmic reticulum
d. Nucleus

A

ANS: B

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49
Q
  1. When the endocrinologist asks the staff how the releasing hormones that are made in the
    hypothalamus travel to the anterior pituitary, how should the staff reply? Via the:

a. Vessels of the zona fasciculata
b. Chromophils
c. Median eminence
d. Hypophysial portal system

A

ANS: D

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50
Q
  1. An aide asks the nurse what activates tyrosine. What is the nurses best response?

a. GH
b. PRL
c. Insulin
d. Estrogen

A

ANS: C

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51
Q
  1. A nurse recalls prolactin-inhibiting factors target tissue is the:

a. Hypothalamus
b. Anterior pituitary
c. Mammary glands
d. Posterior pituitary

A

ANS: B

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52
Q
  1. When a staff member asks the nurse which gland secretes ADH and oxytocin, how should
    the nurse respond?

a. Anterior pituitary
b. Posterior pituitary
c. Hypothalamus
d. Pineal gland

A

ANS: B

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53
Q
  1. If a patients posterior pituitary is removed, which hormone would the nurse expect to
    decrease?

a. PRF
b. ADH
c. ACTH
d. GH

A

ANS: B

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54
Q
  1. Which principle should the nurse include while planning care for a patient with an ADH
    problem? ADH release from the posterior pituitary is stimulated by:

a. Low blood pressure sensed by baroreceptors in the kidneys

b. High serum osmolarity sensed by osmoreceptors in the hypothalamus

c. Low osmolality sensed by osmoreceptors in the kidneys

d. High concentration of potassium sensed by chemoreceptors in the carotid body

A

ANS: B

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55
Q
  1. A patient wants to know why ADH is important in the body. What is the nurses best
    response? ADH is important in:

a. The bodys water balance and urine concentration
b. Maintaining electrolyte levels and concentrations
c. Follicular maturation
d. Regulation of metabolic processes

A

ANS: A

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56
Q
  1. If a patient had a problem with the hypothalamus, which of the following hormones would be
    affected?

a. ACTH
b. Oxytocin
c. ADH
d. TSH

A

ANS: B

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57
Q
  1. A nurse is teaching the staff about oxytocin. Which information should the nurse include?
    Target cells for oxytocin are located in the:

a. Renal tubules
b. Thymus
c. Liver
d. Uterus

A

ANS: D

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58
Q
  1. A 50-year-old male patient is deficient in ADH production. Which of the following
    assessment findings would the nurse expect to find?

a. Increased blood volume
b. Increased urine osmolality
c. Increased urine volume
d. Increased arterial vasoconstriction

A

ANS: C

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59
Q
  1. A 70-year-old female has brittle bones secondary to osteoporosis. Her primary care provider
    prescribes calcitonin to:

a. Activate vitamin D
b. Stimulate osteoclastic activity
c. Inhibit calcium resorption from bones
d. Promote thyroid hormone release

A

ANS: C

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60
Q
  1. Which nutrient would the nurse encourage the patient to consume for thyroid hormone
    synthesis?

a. Zinc
b. Sodium
c. Iodine
d. Calcium

A

ANS: C

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61
Q
  1. A nurse is reviewing lab results. Which of the following lab results would slow down the rate
    of parathyroid hormone secretion?

a. Increased serum calcium levels
b. Decreased serum calcium levels
c. Decreased levels of TSH
d. Increased levels of TSH

A

ANS: A

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62
Q
  1. A 40-year-old male undergoes surgery for a PTH-secreting tumor in which the parathyroid is
    removed. Which of the following would the nurse expect following surgery?

a. Increased serum calcium
b. Decreased bone formation
c. Decreased calcium reabsorption in the kidney
d. Increased calcitonin

A

ANS: C

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63
Q
  1. A nurse is teaching a patient about insulin. Which information should the nurse include?
    Insulin is primarily regulated by:

a. Metabolic rate
b. Serum glucose levels
c. Prostaglandins
d. Enzyme activation

A

ANS: B

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64
Q
  1. A 30-year-old male is diagnosed with a hormone-secreting tumor of the pancreas alpha cells.
    Which of the following would the nurse expect to be most likely increased in this patient?

a. Amylin
b. Glucagon
c. Insulin
d. Somatostatin

A

ANS: B

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65
Q
  1. A nurse recalls insulin has an effect on which of the following groups of electrolytes?

a. Sodium, chloride, phosphate
b. Calcium, magnesium, potassium
c. Hydrogen, bicarbonate, chloride
d. Potassium, magnesium, phosphate

A

ANS: D

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66
Q
  1. A student asks the instructor which of the following is the most potent naturally occurring
    glucocorticoid. How should the instructor respond?

a. Aldosterone
b. Testosterone
c. Cortisol
d. Prolactin

A

ANS: C

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67
Q
  1. A patient wants to know what can cause ACTH to be released. How should the nurse
    respond?
    a. High serum levels of cortisol
    b. Hypotension
    c. Hypoglycemia
    d. Stress
A

ANS: D

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68
Q
  1. A nurse is discussing endocrine system dysfunction with a patient. Which statement indicates
    the patient understood? Endocrine system dysfunction can result from hyposecretion,
    hypersecretion, or from:

a. Abnormal receptor activity
b. Abnormal hormone levels
c. Increased synthesis of second messengers
d. Extracellular electrolyte alterations

A

ANS: A

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69
Q
  1. An aide asks the nurse what is the most common cause of elevated levels of antidiuretic
    hormone (ADH) secretion. How should the nurse respond?

a. Autoimmune disease
b. Cancer
c. Pregnancy
d. Heart failure

A

ANS: B

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70
Q
  1. A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome
    of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would
    be expected in this patient?

a. Hyponatremia
b. Hyperkalemia
c. Hypernatremia
d. Hypokalemia

A

ANS: A

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71
Q
  1. A 44-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for SIADH.
    Which of the following assessment findings would be expected in this patient?

a. Peripheral edema
b. Tachycardia
c. Low blood pressure
d. Concentrated urine

A

ANS: D

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72
Q
  1. A nurse is caring for a patient with SIADH. What severe complication should the nurse assess
    for?

a. Stroke
b. Diabetes insipidus
c. Neurologic damage
d. Renal failure

A

ANS: C

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73
Q
  1. A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in
    a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of
    the following complications should the nurse anticipate?

a. Dilutional hyponatremia
b. Dehydration from polyuria
c. Cardiac arrest from hyperkalemia
d. Metabolic acidosis

A

ANS: B

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74
Q
  1. While planning care for a patient from general anesthesia, which principle should the nurse
    remember? A side effect of some general anesthetic agents is _____ diabetes insipidus.

a. Neurogenic
b. Nephrogenic
c. Psychogenic
d. Allogenic

A

ANS: B

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75
Q
  1. Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following
    assessment manifestations?

a. Polyuria
b. Edema
c. Vomiting and abdominal cramping
d. Thirst

A

ANS: D

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76
Q
  1. A 50-year-old male patient presents with polyuria and extreme thirst. He was given exogenous
    ADH. For which of the following conditions would this treatment be effective?

a. Neurogenic diabetes insipidus
b. Psychogenic diabetes insipidus
c. Nephrogenic diabetes insipidus
d. SIADH

A

ANS: A

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77
Q
  1. A 25-year-old male presents with fatigue, constipation, and sexual dysfunction. Tests reveal
    all pituitary hormones are normal, and no masses are present. The nurse suspects the most likely
    cause of his symptoms is a dysfunction in the:

a. Anterior pituitary
b. Posterior pituitary
c. Pars intermedia
d. Pituitary stalk

A

ANS: D

78
Q
  1. A 15-year-old female presents with breast discharge, dysmenorrhea, and excessive
    excitability. Tests reveal that all her pituitary hormones are elevated. What does the nurse
    suspect as the most likely cause for these assessment findings?

a. A pituitary adenoma
b. Hypothalamic hyposecretion
c. Hypothalamic inflammation
d. Pheochromocytoma

A

ANS: A

79
Q
  1. What common neurologic disturbances should the nurse assess for in a patient with a
    pituitary adenoma?

a. Coma
b. Visual disturbances
c. Confused states
d. Breathing abnormalities

A

ANS: B

80
Q
  1. A 35-year-old female with Graves disease is admitted to a medical-surgical unit. While the
    nurse is reviewing the lab tests, which results would the nurse expect to find?

a. High levels of circulating thyroid-stimulating antibodies
b. Ectopic secretion of thyroid-stimulating hormone (TSH)
c. Low circulating levels of thyroid hormones
d. Increased circulation of iodine

A

ANS: A

81
Q
  1. While checking the lab results for a patient with Graves disease, the nurse would check the
    T3 level to be abnormally:

a. Low
b. High
c. Variable
d. Absent

A

ANS: B

82
Q
  1. A 35-year-old female with Graves disease is admitted to a medical-surgical unit. Which of
    the following symptoms would the nurse expect to find before treatment?

a. Weight gain, cold intolerance
b. Slow heart rate, rash
c. Skin hot and moist, rapid heart rate
d. Constipation, confusion

A

ANS: C

83
Q
  1. Visual disturbances are a common occurrence in patients with untreated Graves disease. The
    endocrinologist explains to the patient that the main cause of these complications is:

a. Decreased blood flow to the eye
b. Orbital edema and protrusion of the eyeball
c. TSH neurotoxicity to retinal cells
d. Local lactic acidosis

A

ANS: B

84
Q
  1. A 25-year-old female with Graves disease is admitted to a medical-surgical unit. Palpation of
    her neck would most likely reveal:

a. A normal-sized thyroid
b. A small discrete thyroid nodule
c. Multiple discrete thyroid nodules
d. Diffuse thyroid enlargement

A

ANS: D

85
Q
  1. A 22-year-old female has a low level of TSH. What condition does the nurse expect the
    patient is experiencing?

a. Primary hypothyroidism
b. Secondary hypothyroidism
c. Autoimmune hypothyroidism
d. Atypical hypothyroidism

A

ANS: B

86
Q
  1. While planning care for a patient with hypothyroidism, which principle should the nurse
    remember? The basal metabolic rate is unusually _____ with hypothyroidism.

a. High
b. Low
c. Steady
d. Variable

A

ANS: B

87
Q
  1. A 3-year-old male was diagnosed with congenital hypothyroidism. The parents ask the nurse
    if left untreated what will happen. What is the nurses best response? If left untreated, the child
    would have:

a. Mental retardation and stunted growth
b. Increased risk of childhood thyroid cancer
c. Hyperactivity and attention deficit disorder
d. Liver, kidney, and pancreas failure

A

ANS: A

88
Q
  1. A 30-year-old male was diagnosed with thyroid carcinoma. The lab tests the nurse would
    most likely find are _____ T3 and T4 levels.
    a. High
    b. Low
    c. Normal
    d. Variable
A

ANS: C

89
Q
  1. What problem should the nurse assess for in a patient with chronic hyperparathyroidism?

a. Seizure disorders
b. Vitamin D malabsorption
c. Hyponatremia
d. Osteoporosis and pathologic fractures

A

ANS: D

90
Q
  1. A 45-year-old female with Graves disease underwent surgical removal of her thyroid gland.
    During the postoperative period, her serum calcium was low. The most probable reason for her
    low serum calcium is:

a. Hyperparathyroidism secondary to Graves’ disease

b. Myxedema secondary to surgery

c. Hypoparathyroidism caused by surgical injury to the parathyroid glands

d. Hypothyroidism resulting from lack of thyroid replacement

A

ANS: C

91
Q
  1. A 30-year-old female with Graves disease is admitted to a hospital unit for the surgical
    removal of her thyroid gland. During the postoperative period, the nurse notes that the patients
    serum calcium is low. The nurse should observe the patient for which of the following
    signs/symptoms?

a. Muscle weakness and constipation
b. Laryngeal spasms and hyperreflexia
c. Abdominal pain and fever
d. Anorexia, nausea, and vomiting

A

ANS: B

92
Q
  1. When a patient wants to know what most commonly causes hypoparathyroidism, how should
    the nurse reply? It is most commonly caused by:

a. Pituitary hyposecretion
b. Parathyroid adenoma
c. Parathyroid gland injury
d. Hypothalamic inactivity

A

ANS: C

93
Q
  1. A 25-year-old male presents to his primary care provider reporting changes in facial features.
    CT scan reveals a mass on the anterior pituitary, and lab tests reveal severely elevated growth
    hormone (GH). Which of the following would the nurse also expect to find?

a. Decreased IGF-1
b. Hypotension
c. Sexual dysfunction
d. Height increases

A

ANS: C

94
Q
  1. A 30-year-old male presents to his primary care provider reporting visual disturbances. CT
    reveals a pituitary tumor and lab tests reveal elevated prolactin. He is diagnosed with
    prolactinoma. Which of the following treatments would the nurse help implement?
    Administering:

a. Dopaminergic agonists
b. Calcium
c. Insulin
d. Radiation

A

ANS: A

95
Q
  1. A 12-year-old female is newly diagnosed with type 1 DM. When the parents ask what causes
    this, what is the nurses best response?

a. A familial, autosomal dominant gene defect
b. Obesity and lack of exercise
c. Immune destruction of the pancreas
d. Hyperglycemia from eating too many sweets

A

ANS: C

96
Q
  1. A 12-year-old male is newly diagnosed with type 1 DM. Which of the following tests should
    the nurse prepare the patient to best confirm the diagnosis?

a. Fasting plasma glucose levels
b. Random serum glucose levels
c. Genetic testing
d. Glycosylated hemoglobin measurements

A

ANS: A

97
Q
  1. An 11-year-old male is newly diagnosed with type 1 DM. Which classic symptoms should
    the nurse assess the patient for?

a. Recurrent infections, visual changes, fatigue, and paresthesias
b. Polydipsia, polyuria, polyphagia, and weight loss
c. Vomiting; abdominal pain; sweet, fruity breath; dehydration; and Kussmaul
breathing
d. Weakness, vomiting, hypotension, and mental confusion

A

ANS: B

98
Q
  1. A 19-year-old female with type 1 DM was -> hospital with altered
    consciousness -> lab values: serum glucose 500 mg/dl (high) and serum K+ 2 (low) -> sick with the flu for a week -> dx hyperosmolar hyperglycemia nonketotic syndrome (HHNKS). What relationship do these values have with her insulin deficiency?

a. Increased glucose utilization causes the shift of fluid from the intravascular to the
intracellular space.
b. Decreased insulin causes hyperglycemia and osmotic diuresis.
c. Increased glucose and fatty acid metabolism stimulates renal diuresis and
electrolyte loss.
d. Increased insulin use results in protein catabolism, tissue wasting, and electrolyte
loss.

A

ANS: B

99
Q
  1. A nurse is reviewing lab results for glycosylated hemoglobin (hemoglobin A1c) levels. A
    nurse recalls the purpose of this test is to:

a. Measure fasting glucose levels.
b. Monitor long-term serum glucose control.
c. Detect acute complications of diabetes.
d. Check for hyperlipidemia.

A

ANS: B

100
Q
  1. When a patient asks what causes hyperglycemia in type 2 DM, how should the nurse
    respond? Hyperglycemia is a result of:

a. Insulin deficiency
b. Hyperinsulinemia
c. Glucagon deficiency
d. Liver dysfunction

A

ANS: B

101
Q
  1. A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high), urine glucose and ketones 4+ (high), and arterial pH 7.20 (low). Her parents state that she has been sick with the flu for a week. Which of the
    following statements best explains her acidotic state?

a. Increased insulin levels promote protein breakdown and ketone formation.

b. Her uncontrolled diabetes has led to renal failure.

c. Low serum insulin promotes lipid storage and a corresponding release of ketones.

d. Insulin deficiency promotes lipid metabolism and ketone formation.

A

ANS: D

102
Q
  1. A 13-year-old male who uses insulin to control his type 1 diabetes experiences hunger,
    lightheadedness, tachycardia, pallor, headache, and confusion during gym class. The most
    probable cause of these symptoms is:

a. Hyperglycemia resulting from incorrect insulin administration
b. Dawn phenomenon caused by eating a snack before gym class
c. Hypoglycemia caused by increased exercise
d. Somogyi effect caused by insulin sensitivity

A

ANS: C

103
Q
  1. A 55-year-old female is admitted to the medical unit for complications of long-term, poorly
    controlled type 2 DM. Which of the following would the nurse expect to find in addition to
    elevated glucose?

a. Atherosclerosis
b. Metabolic alkalosis
c. Elevated liver enzymes
d. Anemia

A

ANS: A

104
Q
  1. When a staff member asks the nurse what causes the chronic complications of DM such as
    microvascular and macrovascular disease, how should the nurse respond? These complications
    are primarily related to:

a. Pancreatic changes
b. Hyperglycemia
c. Ketone toxicity
d. Hyperinsulinemia

A

ANS: B

105
Q
  1. A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with
    elevated levels of:

a. ADH
b. Cortisol
c. Adrenocorticotropic hormone (ACTH)
d. Aldosterone

A

ANS: C

106
Q
  1. Which of the following alterations would the nurse expect to find in a patient with untreated
    Cushing disease or syndrome?

a. Bradycardia
b. Tachypnea
c. Hyperkalemia
d. Hypertension

A

ANS: D

107
Q
  1. When a nurse is assessing the physical features of individuals with Cushing syndrome, these
    findings will include:

a. Weight loss and muscle wasting
b. Truncal obesity and moon face
c. Pallor and swollen tongue
d. Depigmented skin and eyelid lag

A

ANS: B

108
Q
  1. A 35-year-old female took corticosteroid therapy for several months. Which of the following
    would the nurse expect to find?

a. Renal toxicity
b. Episodes of hypoglycemia
c. Hypotension
d. Type 2 DM

A

ANS: D

109
Q
  1. A nurse is preparing to teach a patient about Addison disease. Which information should the
    nurse include? The most common cause of Addison disease is:

a. An autoimmune reaction
b. Dietary deficiency of sodium and potassium
c. Cancer
d. Viral infection of the pituitary gland

A

ANS: A

110
Q
  1. A patients anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse
    would recognize the erythrocytes would be:

a. Pale in color
b. Present in various sizes
c. Able to assume various shapes
d. Live only a few days

A

ANS: C

111
Q
  1. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following
    types of anemia will the nurse see documented on the chart?

a. Iron deficiency anemia
b. Pernicious anemia
c. Sideroblastic anemia
d. Hemolytic anemia

A

ANS: B

112
Q
  1. When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally
    low concentration of hemoglobin, the nurse calls these erythrocytes:

a. Hyperchromic
b. Hypochromic
c. Macrocytic
d. Microcytic

A

ANS: B

113
Q
  1. A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the
    following anemias does the nurse suspect the patient has?

a. Sideroblastic anemia
b. Hemolytic anemia
c. Pernicious anemia
d. Iron deficiency anemia

A

ANS: B

114
Q
  1. After initial compensation, what hemodynamic change should the nurse monitor for in a
    patient who has a reduction in the number of circulating erythrocytes?

a. Increased viscosity of blood
b. Decreased cardiac output
c. Altered coagulation
d. Hyperdynamic circulatory state

A

ANS: D

115
Q
  1. A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.
    Which of the following adaptations should the nurse expect?

a. Movement of fluid into the cell
b. Decreased cardiac output
c. Decreased oxygen release from hemoglobin
d. Peripheral vasoconstriction

A

ANS: D

116
Q
  1. A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness,
    and fatigue with exertion. Which of the following respiratory assessment findings indicate the
    respiratory system is compensating for the increased oxygen demand?

a. Bronchoconstriction
b. Increased rate and depth of breathing
c. Dyspnea
d. Activation of the renin-angiotensin response

A

ANS: B

117
Q
  1. A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear
    suggests the deficiency is macrocytic and normochromic. The nurse would expect the
    hemoglobin to be:

a. Normal
b. Sporadic
c. Low
d. High

A

ANS: A

118
Q
  1. A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects
    the most likely cause of this condition is:

a. Defective DNA synthesis
b. Abnormal synthesis of hemoglobin
c. Defective use of vitamin C
d. Blocked protein synthesis

A

ANS: A

119
Q
  1. When a patient wants to know why vitamin B12 and folate deficiencies cause anemia, how
    should the nurse respond?

a. Red blood cells are unable to differentiate into erythrocytes.
b. Red blood cells have malformed hemoglobin molecules.
c. Red blood cells have decreased O2-carrying capacity.
d. Red blood cells have a shorter life span.

A

ANS: D

120
Q
  1. A 20-year-old female undergoes lab testing for anemia. Results show high iron, bilirubin, and
    transferrin and low hemoglobin and hematocrit. Which of the following is the most likely
    diagnosis to be documented on the chart?

a. Pernicious anemia
b. Folate deficiency anemia
c. Iron deficiency anemia
d. Sideroblastic anemia

A

ANS: D

121
Q
  1. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia).
    How should the nurse respond when the patient asks what causes pernicious anemia? A decrease
    in ______ is the most likely cause.

a. Ferritin
b. Gastric enzymes
c. Intrinsic factor
d. Erythropoietin

A

ANS: C

122
Q
  1. Which of the following individuals should the nurse assess first for a vitamin B12 deficiency
    anemia?

a. 3-year-old female who is a fussy eater
b. 26-year-old female in the second trimester of her first pregnancy
c. 47-year-old male who had a gastrectomy procedure (removal of the stomach)
d. 64-year-old male with a history of duodenal ulcers and gastrointestinal bleeding

A

ANS: C

123
Q
  1. A 65-year-old male experienced loss of appetite, weight loss, lemon-yellow skin, liver
    enlargement, and a beefy red tongue shortly before his death. Autopsy suggested pernicious
    anemia, and the cause of death would most likely reveal:

a. Brain hypoxia
b. Liver hypoxia
c. Heart failure
d. Kidney failure

A

ANS: C

124
Q
  1. A 40-year-old male vegetarian is diagnosed with folate deficiency anemia. He reports that he
    is an alcoholic. Which of the following factors put him at greatest risk for developing his
    disease?

a. Being vegetarian
b. Being alcoholic
c. Age
d. Gender

A

ANS: B

125
Q
  1. How should the nurse prepare a patient who is to receive a Schilling test for pernicious
    anemia?

a. Administer radioactive cobalamin and measure its excretion in the urine.
b. Measure antigen-antibody immune complexes.
c. Measure serum ferritin and total iron-binding capacity.
d. Administer folate and evaluate folate content in a blood serum sample.

A

ANS: A

126
Q
  1. A 67-year-old female has chronic gastrointestinal bleeding. A nurse recalls the primary cause
    of her anemia is:

a. Vitamin B12 deficiency
b. Iron deficiency
c. Folate deficiency
d. Bone marrow failure

A

ANS: B

127
Q
  1. A 34-year-old male presents in the emergency room with extreme fatigue and shortness of
    breath. His skin and sclera appear to have a yellowish discoloration. These assessment findings
    are consistent with which type of anemia?

a. Posthemorrhagic anemia
b. Iron deficiency anemia
c. Aplastic anemia
d. Hemolytic anemia

A

ANS: D

128
Q
  1. A 58-year-old female presents in the clinic presenting with fatigue, weight loss, and tingling
    in her fingers. Laboratory findings show low hemoglobin and hematocrit, a high mean
    corpuscular volume, and normal plasma iron. These assessment findings are consistent with
    which type of anemia?

a. Hemolytic anemia
b. Pernicious anemia
c. Iron deficiency anemia
d. Aplastic anemia

A

ANS: B

129
Q
  1. The nurse will check which of the following tests to directly measure iron stores?

a. Serum ferritin
b. Transferrin saturation
c. Bone marrow biopsy
d. Total iron-binding capacity

A

ANS: C

130
Q
  1. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to
    fatigue and weakness, which of the following clinical signs and symptoms would she most likely
    exhibit?

a. Hyperactivity
b. Spoon-shaped nails
c. Gait problems
d. Petechiae

A

ANS: B

131
Q
  1. A 21-year-old woman was recently diagnosed with iron deficiency anemia. Her hematocrit is
    32%. Which of the following treatments would the nurse expect to be prescribed for her?

a. Iron replacement
b. Splenectomy
c. A bone marrow transplant
d. No treatment is necessary

A

ANS: A

132
Q
  1. A 45-year-old male is diagnosed with sideroblastic anemia. When he asks what the most
    likely cause of this disease is, what is the nurses best response?

a. Ineffective iron uptake and abnormal hemoglobin production
b. Misshapen erythrocytes with low hemoglobin
c. Decreased levels of tissue iron with megaloblastic erythrocytes
d. Premature erythrocyte destruction and erythropoietin deficiency

A

ANS: A

133
Q
  1. A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following
    assessment findings would most likely occur?

a. Bronze colored skin
b. Decreased iron
c. Normochromic erythrocytes
d. Aplastic bone marrow

A

ANS: A

134
Q
  1. A nurse is preparing to teach the staff about aplastic anemia. Which information should the
    nurse include? Aplastic anemia is caused by:

a. Iron deficiency
b. Excess levels of erythropoietin
c. Hemolysis
d. Stem cell deficiency

A

ANS: D

135
Q
  1. A nurse recalls posthemorrhagic anemia can result in death when a patients blood loss is in
    excess of:

a. 20% to 29%
b. 30% to 39%
c. 40% to 49%
d. 50% to 59%

A

ANS: C

136
Q
  1. A 57-year-old male presents to his primary care provider for red face, hands, feet, ears, and
    headache and drowsiness. A blood smear reveals an increased number of erythrocytes,
    indicating:

a. Polycythemia vera (PV)
b. Leukemia
c. Sideroblastic anemia
d. Hemosiderosis

A

ANS: A

137
Q
  1. A 67-year-old female is admitted to the emergency department with a diagnosis of
    polycythemia vera. Upon taking the history, the patient will most likely report:

a. Hyperactivity
b. Decreased blood pressure
c. Chest pain
d. A pale skin color

A

ANS: C

138
Q
  1. A 68-year-old female is admitted to the emergency department with a diagnosis of
    polycythemia vera (PV). A nurse realizes the patients symptoms are mainly the result of:

a. A decreased erythrocyte count
b. Rapid blood flow to the major organs
c. Increased blood viscosity
d. Vessel injury

A

ANS: C

139
Q
  1. A 67-year-old female is admitted to the emergency department with a diagnosis of
    polycythemia vera (PV). Which treatment should the nurse discuss with the patient?

a. Therapeutic phlebotomy
b. Restoration of blood volume by plasma expanders
c. Administration of packed red blood cells
d. Iron replacement therapy

A

ANS: A

140
Q
  1. A 70-year-old male is brought to the emergency department, where he dies shortly thereafter.
    Autopsy reveals polycythemia vera (PV). His death was most likely the result of:

a. Acute renal failure
b. Cerebral thrombosis
c. Sepsis
d. Acute leukemia

A

ANS: B

141
Q
  1. A 67-year-old male was diagnosed with polycythemia vera (PV) but refused treatment. His
    condition is at risk for converting to:

a. Chronic lymphocytic leukemia
b. Burkitt lymphoma
c. Multiple myeloma
d. Acute myeloid leukemia

A

ANS: D

142
Q
  1. A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis
    can be defined as:

a. A normal leukocyte count
b. A high leukocyte count
c. A low leukocyte count
d. Another term for leukopenia

A

ANS: B

143
Q
  1. A 20-year-old female has an increase in eosinophils. When the patient wants to know the
    most likely cause of the eosinophilia. What is the nurses best response?

a. Parasitic invasion and allergic reactions
b. Viral and bacterial infections
c. Stress and anxiety reactions
d. Fungal infections and delayed hypersensitivity

A

ANS: A

144
Q
  1. A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph node
    enlargement. She is diagnosed with infectious mononucleosis. What should the nurse tell the
    patient about the recovery time?

a. 72 hours
b. 3 to 5 days
c. A few weeks
d. Six months

A

ANS: C

145
Q
  1. A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. A
    nurse monitors for which of the following conditions that could result secondary to the
    treatment?

a. Eosinophilia
b. Basophilia
c. Monocytosis
d. Lymphocytosis

A

ANS: B

146
Q
  1. A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how
    he got this disease; how should the nurse respond? The most likely cause is:

a. Adenovirus
b. Epstein-Barr virus (EBV)
c. Cytomegalovirus (CMV)
d. Toxoplasma gondii

A

ANS: B

147
Q
  1. A 15-year-old male with infectious mononucleosis is being given instructions on how to
    prevent the spread of this infection to others. Which statement represents a correct instruction?

a. Wear a surgical mask when others are in the room.
b. Do not share drinking glasses or eating utensils.
c. Avoid all contact with other people.
d. No precautions are necessary.

A

ANS: B

148
Q
  1. A 10-year-old male is diagnosed with leukemia. The nurse assesses for which other condition
    that could be associated with his disease?

a. Down syndrome
b. Hemophilia
c. Hyperthyroidism
d. Pheochromocytoma

A

ANS: A

149
Q
  1. A 5-year-old female is diagnosed with acute leukemia. The nurse will most likely treat this
    patient with:

a. Bone marrow transplant
b. Immunotherapy
c. Chemotherapy
d. Localized radiation therapy

A

ANS: C

150
Q
  1. An oncologist is discussing multiple myeloma. Which information should the oncologist
    include? Multiple myeloma can be defined as a neoplasm of:

a. T cells
b. B cells
c. Immature plasma cells
d. Mature red blood cells

A

ANS: B

151
Q
  1. A 65-year-old male is diagnosed with multiple myeloma. He reports severe pain. This pain
    can be attributed to:

a. Neuropathic infiltrations
b. Destruction of bone tissue
c. Tissue hypoxia
d. Accumulation of toxic proteins

A

ANS: B

152
Q
  1. A 35-year-old female is diagnosed with lymphadenopathy. Which assessment finding will
    help confirm this diagnosis?

a. Small, hard lymph nodes
b. Disordered lymph nodes
c. Nonpalpable, nontender lymph nodes
d. Enlarged lymph nodes

A

ANS: D

153
Q
  1. A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was
    diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse
    expect to find with this disease?

a. Merkel cell
b. Schwann cell
c. Reed-Sternberg cell
d. Kupffer cell

A

ANS: C

154
Q
  1. The people from which country have the lowest risk for Hodgkin lymphoma?

a. United States
b. Japan
c. Denmark
d. Great Britain

A

ANS: B

155
Q
  1. A 62-year-old female tells her health care provider she has been experiencing regular night
    sweats that cause her to wake up drenched. She also remarks that she has been unintentionally
    losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be
    painful. She should be screened for which of the following cancers?

a. Epstein-Barr virus
b. Hodgkin lymphoma
c. Acute leukemia
d. Burkitt lymphoma

A

ANS: B

156
Q
  1. A 10-year-old male presents with abdominal swelling, night sweats, fever, and weight loss.
    He is diagnosed with Burkitt lymphoma. Upon obtaining the history, which of the following is
    the most likely cause?

a. Cytomegalovirus (CMV)
b. Adenovirus
c. Human papillomavirus (HPV)
d. Epstein-Barr virus (EBV)

A

ANS: D

157
Q
  1. For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be:

a. Proliferated
b. Activated
c. Sequestered
d. Infected

A

ANS: C

158
Q
  1. Thrombocytopenia may be:

a. Transient or consistent
b. Normal or abnormal
c. Congenital or acquired
d. Active or inactive

A

ANS: C

159
Q
  1. A 30-year-old female presents with hematuria, menorrhagia, and bleeding gums. She is
    diagnosed with immune thrombocytic purpura (ITP). A nurse realizes the most likely cause is:

a. Allergy-induced platelet lysis
b. An immune response to hypersplenism
c. Antibody destruction of platelets
d. T cell injury to megakaryocytes

A

ANS: C

160
Q
  1. A 50-year-old female is diagnosed with primary thrombocythemia. A nurse would expect the
    blood smear to reveal _____ platelets.

a. Defective
b. Fragmented
c. Consumed
d. Overproduced

A

ANS: D

161
Q
  1. A 52-year-old female is admitted to the cardiac unit with a diagnosis of pericarditis. She asks
    the nurse to explain where the infection is. In providing an accurate description, the nurse states
    that the pericardium is:

a. The outer muscular layer of the heart
b. The innermost layer of the heart chambers
c. A membranous sac that encloses the heart
d. The hearts fibrous skeleton

A

ANS: C

162
Q
  1. A nurse is explaining the function of the heart. Which is a correct response by the nurse? A
    function of the pericardium is to:

a. Provide a barrier against extracardial infections.
b. Improve blood flow through the heart.
c. Play a role in cardiac conduction.
d. Assist in cardiac contraction.

A

ANS: A

163
Q
  1. A 65-year-old male develops blockage in the pulmonary artery. As a result of the blockage,
    blood would first back up into the:

a. Aorta
b. Left ventricle
c. Pulmonary veins
d. Right ventricle

A

ANS: D

164
Q
  1. A nurse is teaching about the heart. Which information should the nurse include? The chamber
    of the heart that generates the highest pressure is the:
    a. Right atrium
    b. Left atrium
    c. Left ventricle
    d. Right ventricle
A

ANS: C

165
Q
  1. A nurse recalls the chamber that receives blood from the systemic circulation is the:

a. Right atrium
b. Right ventricle
c. Left atrium
d. Left ventricle

A

ANS: A

166
Q
  1. Which statement indicates the nurse understands blood flow? Oxygenated blood flows through
    the:
    a. Superior vena cava
    b. Pulmonary veins
    c. Pulmonary artery
    d. Cardiac veins
A

ANS: B

167
Q
  1. A 20-year-old male underwent an echocardiogram to assess chest pain. Results revealed a
    congenital defect in papillary muscles. Which of the following would the nurse expect to occur?

a. Closure of the semilunar valve
b. Backward expulsion of the atrioventricular valves
c. Closure of the atrioventricular valve
d. Backward expulsion of the semilunar valves

A

ANS: B

168
Q
  1. A cardiologist is discussing valves with the staff. Which information should the cardiologist
    include? _____ are the anchors of the atrioventricular valves.

a. Chordae tendineae cordis
b. Great vessels
c. Coronary ostia
d. Trabeculae carneae

A

ANS: A

169
Q
  1. Which statement indicates the nurse understands coronary ostia? The coronary ostia (the
    openings to the coronary arteries) are found in the:

a. Left ventricle
b. Inferior vena cava
c. Coronary sinus
d. Aorta

A

ANS: D

170
Q
  1. The nurse is planning care for a patient with heart problems. Which information should the
    nurse remember? The _____ artery travels down the interventricular septum and delivers blood
    to portions of the left and right ventricle.

a. Right coronary
b. Circumflex
c. Left anterior descending
d. Cardiac

A

ANS: C

171
Q
  1. A 65-year-old male is transported to the ER for chest pain. An electrocardiogram reveals a
    prolonged QRS interval. What is the nurse monitoring when the nurse observes the QRS
    complex on the electrocardiogram? The QRS complex reflects:

a. Ventricular activity
b. Pulmonary artery closure
c. Mitral valve opening
d. Aortic valve closing

A

ANS: A

172
Q
  1. When a staff member asks where venous blood from the coronary circulation drains into,
    what is the best response by the nurse? The:

a. Superior vena cava
b. Inferior vena cava
c. Right atrium
d. Reft atrium

A

ANS: C

173
Q
  1. While viewing the electrocardiogram, the nurse recalls the _____ conducts action potentials
    down the atrioventricular septum.

a. Bachmann bundle
b. Bundle of His
c. Sinoatrial node
d. Atrioventricular node

A

ANS: B

174
Q
  1. A 13-year-old female took a weight loss drug that activated the sympathetic nervous system.
    Which of the following assessment findings would the nurse expect?

a. Decreased myocardial contraction
b. Decreased heart rate
c. Increased cardiac conduction
d. Increased intranodal conduction time

A

ANS: C

175
Q
  1. A 50-year-old female received trauma to the chest that caused severe impairment of the
    primary pacemaker cells of the heart. Which of the following areas received the greatest
    damage?

a. Atrioventricular (AV) node
b. Sinoatrial (SA) node
c. Bundle of His
d. Ventricles

A

ANS: B

176
Q
  1. A 54-year-old male is diagnosed with left bundle branch block. Which of the following
    structures would not receive an electrical impulse?

a. Atrioventricular (AV) node
b. Sinoatrial (SA) node
c. Bundle of His
d. The left ventricle

A

ANS: D

177
Q
  1. Which information by the nurse indicates a good understanding of depolarization?
    Depolarization of a cardiac muscle cell occurs as the result of:

a. A decrease in the permeability of the cell membrane to ions
b. The rapid movement of ions across the cell membrane
c. A blockade by calcium ions
d. Stimuli instigated during the refractory period

A

ANS: B

178
Q
  1. A cardiologist is teaching about the period that follows depolarization of the myocardium
    and represents a period during which no new cardiac potential can be propagated. What is the
    cardiologist describing?

a. Absolute refractory
b. Hyperpolarization
c. Resting
d. Threshold

A

ANS: A

179
Q
  1. The nurse is reviewing a normal electrocardiogram. The nurse assesses the PR interval
    because it represents:

a. Atrial depolarization
b. Ventricular depolarization
c. Onset of atrial activation to onset of ventricular activity
d. Electrical systole of the ventricles

A

ANS: C

180
Q
  1. The _____ represents the sum of all ventricular muscle cell depolarization.

a. PR interval
b. QRS complex
c. QT interval
d. P wave

A

ANS: B

181
Q
  1. When a student nurse asks the nurse how the cardiac electrical impulse normally begins,
    what is the most correct response? The cardiac electrical impulse normally begins spontaneously
    in the sinoatrial (SA) node because it:

a. Has a superior location in the right atrium
b. Is the only area of the heart capable of spontaneous depolarization
c. Has rich sympathetic innervation via the vagus nerve
d. Depolarizes more rapidly than other automatic cells of the heart

A

ANS: D

182
Q
  1. A 28-year-old female with seizure disorder has a vagus nerve stimulator implanted to help
    control seizure activity. Which of the following would the nurse also expect to occur?

a. Increased speed of cardiac cycle
b. Increased cardiac contractility
c. Decreased vasodilation
d. Decreased cardiac conduction

A

ANS: D

183
Q
  1. A new drug is released to aid in weight loss. It stimulates the sympathetic system. The nurse
    monitors for an increased heart rate. The sympathetic system causes this by:

a. Inhibiting the release of catecholamines
b. Altering the threshold potential
c. Decreasing the conduction time through the atrioventricular (AV) node
d. Increasing the influx of calcium

A

ANS: B

184
Q
  1. A nurse assesses the heart after acetylcholine because the effect of acetylcholine on the heart
    is to:

a. Decrease the refractory period
b. Increase calcium influx
c. Increase the strength of myocardial contraction
d. Decrease the heart rate

A

ANS: D

185
Q
  1. To help a nursing student differentiate cardiac muscle from skeletal muscle, which
    characteristic should the nurse use? One difference between cardiac muscle and skeletal muscle
    is that:

a. Cardiac muscle cells are arranged in branching networks.
b. Skeletal muscle cells have only one nucleus.
c. Cardiac muscle cells appear striped.
d. Skeletal muscle cells contain sarcomeres.

A

ANS: A

186
Q
  1. A cardiologist is teaching about myocardial cells. Which information should the cardiologist
    include? _____ are thickened areas of the sarcolemma of myocardial cells that enable electrical
    impulses to travel in a continuous cell-to-cell fashion.

a. Myosins
b. Intercalated disks
c. Troponin Ts
d. I bands

A

ANS: B

187
Q
  1. _____ is the process by which an action potential in the plasma membrane of a myocardial
    cell triggers the events that directly cause contraction of the myocardial cells.

a. Electrocontraction
b. Intercalated communication
c. Excitation-contraction coupling
d. Myosin communication

A

ANS: C

188
Q
  1. The molecule that aids in bonding of the troponin complex to actin and tropomyosin is
    troponin:

a. C
b. I
c. T
d. M

A

ANS: C

189
Q
  1. A patient has searched on the internet for muscle contractions. Which information indicates a
    good understanding? Muscle contractions occur when there is a decreased:

a. Distance between Z lines
b. A band length
c. Z line length
d. H zone distance

A

ANS: A

190
Q
  1. A nurse is discussing the pressure generated at the end of diastole. Which term is the nurse
    describing?

a. Preload
b. Afterload
c. Systemic vascular resistance
d. Total peripheral resistance

A

ANS: B

191
Q
  1. Which principle should the nurse remember when planning nursing care for a patient with
    heart problems? As stated by the Frank-Starling law, there is a direct relationship between the
    _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next
    systole.

a. Pressure, duration
b. Volume, force
c. Viscosity, force
d. Viscosity, duration

A

ANS: B

Patho Final (4 decks)

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