Exam 2 Patho Evolve Questions Flashcards
1
Q
Who would be at highest risk for developing pulmonary embolism (PE)?
A
72 year old male who is recovering from hip replacement surgery in the hospital
2
Q
How soon are ECG changes visible after hypoxia
A
30 to 60 seconds
3
Q
Where do aortic blood flow problems occu?
A
- From the left ventricle to the aorta.
4
Q
This occurs with activity and is often limited and resolves with rest
A
- Stable angina
5
Q
Expiratory stridor
A
a monophonic wheeze
6
Q
A 30 year old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. he experiences respiratory failure. which of the following lab values would the nurse expect
A
elevated PaCO2
7
Q
A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. A nurse recalls this condition is caused by
A
Decreased inspired oxygen
8
Q
Clinical Manifestation of Pulmonary Edema
A
- dyspnea
- crackless
- dullness of percuss at lung bases
- pink frothy sputum
- hypercapnia
9
Q
Which is the MOST common complication of an Acute Myocardial Infarcation (AMI)?
A
arrythmia
10
Q
Arteriosclerosis plaque is caused by
A
collagen over a fatty streak that is composed of a large number of lipid-laden foam cells that deposit on the vessel wall.
11
Q
A 60 year old male undergoes surgery for a bone fracture. what nursing measure would be most effective for preventing pulmonary embolism (PE) in this patient?
A
prevent deep vein thrombosis
12
Q
A 10 year old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. the most likely diagnosis on the chart is
A
Status asthmaticus
13
Q
a blood clot that remains attached to a vessel wall.
A
Thrombus
14
Q
has a rumbling-decrescendo murmur.
A
Mitral stenosis
15
Q
a diffuse, inflammatory obstruction of the small airways or bronchioles
A
Bronchiolitis
16
Q
Airway hyper-responsiveness in asthma is related to
A
exposure to an allergen causing mast cell degranulation
17
Q
what is the most common cause of pulmonary edema?
A
- left sided heart failure
- increasing pressure of left chambers of the heart
18
Q
cause a release on renin
A
- decrease in the amount of sodium delivered to the kidney.
- beta-adrenergic stimuli
- low potassium concentration
19
Q
An 80 year old female is in the hospital for a bone fracture. while there she develops a large, nonlethal pulmonary embolus. What is the result of the obstruction of pulmonary blood flow>
A
pulmonary hypertension
20
Q
A cough in an infant can be a sign of
A
- infection
- foreign body
- obstruction.
21
Q
Define Emphysema
A
- abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
22
Q
while reviewing lab results, the help confirm a diagnosis of cystic fibrosis in a 1-year old child which substance will be present in the child’s sweat
A
sodium chloride
23
Q
A 53 year old male with a 20 year history of smoking is diagnosed with emphysema. Why the patient’s airways are obstructed?
A
Loss of elastic recoil
24
Q
Which structures are considered part of the acinus?
A
- Respiratory bronchioles
- Alveolar ducts
- Alveoli
25
# Define Open Pneumothorax
* air pressure in the pleural space **equals** barometric pressure
* b/c air that is drawn into the pleural space during inspiration is forced back out during expiration
26
Hypoxemia and cyanosis are generally caused by
1. lesions that cause right ventricular outflow tract obstruction
2. defects involving mixing of saturated and unsaturated blood
3. transposition of the great arteries
4. deoxygenated blood flowing into systemic circulation
27
indicates there was trauma to the chest resulting in the collapse of the lung
Secondary pneumothorax
28
caused by cell death and necrosis secondary to trauma or pressure-induced oxygen deficiency
Venous Stasis Ulcers
29
an inflammatory disease of the peripheral arteries that tends to occur in young men who are heavy smokers
Thromboangiitis obliterans
30
Cyanosis definition
* bluish discoloration of the skin & mucous membranes,
* caused by increasing amounts of desaturated or reduced hemglobin in the blood.
31
A 42 year old female presents with dyspnea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance, and hypoxemia. tests reveal a fulminate form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.
Acute Respiratory Distress Syndrome (ARDS)
32
What can commonly occur in an infants airway?
Obstruction
33
A patient has been diagnosed with a pericardial effusion resulting in the presence of frank blood. Which condition is associated with a bloody effusion?
* Coagulation defect, trauma, and aneurysms
34
A yougn patient is admitted to the pediatric unit with cystic fibrosis (CF) exacerbation. the nurse monitors the patient closely because the main cause of death in a child with CF is
respiratory failure
35
Characteristic associated with hypertension?
1. Family history positive for hypertension
2. High dietary sodium
3. **Glucose intolerance**
4. Obesity
36
Which part of the heart is responsible for electrical impulse stimulation?
SA Node
37
A patient is diagnosed with an antidiuretic hormone-producing lung tumor. What is the most likely diagnosis?
small cell carcinoma
38
when constrictions and dilations destroy the bronchi.
Varicose
39
Airway Obstruction is most likely to occur in which age group?
* in infants.
* This is due to their smaller airway and smaller diameter.
* more cartilage and collapse easily.
* A cough can be a sign of infection, foreign body, or obstruction.
40
Define Paroxysmal Nocturnal Dyspnea
* attacks of SOB & coughing that occur at night.
* Awakens the person from sleep, and may be quite frightening.
41
A 23-year-old patient presents with severe chest pain that worsens with respiratory movements and with lying down. What is the most appropriate intervention?
Administer analgesics
42
a 53 year old male with a 20 year history of smoking is diagnosed with emphysema. when the nurse is asked what causes this, what is the nurse's best response? changes in his lungs are caused by
Alpha-1-antitrypsin deficiency
43
Which statement regarding cellular injury of the myocardium is correct?
Myocardial cells remain viable if blood flow returns within 20 minutes.
44
definition of cardiac preload?
Pressure generated by the end-diastolic volume
45
an increase in parasympathetic nervous stimulation and a decrease in sympathetic nervous stimulation
Vasogenic Shock
46
a harsh, vibratory sound of variable pitch due to turbulent flow through the partially obstructed airway
Stridor
47
This sound is high pitched, monphonic. It is louder in the neck than over the chest wall. Upper airway obstruction- swollen tissues or lodged foreign body.
* Stridor
* *croup, acute epiglottis child, foreign inhalation.*
48
A patient presents with chest pain that occurs at rest. Abnormal vasospasm of the coronary arteries is detected. What is the most likely cause of the chest pain?
* Prinzmetal angina
* produces pain at rest and is common in women
49
What is the appropriate term for the “thick filaments of myosin that constitute a central dark band”?
A Band
50
Which term describes the occlusion of a blood vessel from a bolus of circulating matter in the bloodstream?
Embolus
51
What causes decrease breath sounds?
COPD & mucous
52
This type of shock is due to infection
Septic
53
a decrease in blood volume due to hemorrhage
Hypovolemic Shock
54
a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?
* alveolocapillary membrane injury causing a massive inflammatory response
55
Which structure is the source of nutrients for the blood vessels?
vasa vasorum
56
This reflex facilitates blood pressure changes and heart rate changes.
baroreceptor reflex
57
Which diagnosis finding is characteristically present when the parietal pleura is infected?
Friction Rub
58
Normal Heart Rate for a newborn?
100 - 180
59
What is the process called where carbon dioxide (CO2) is exchanged for oxygen?
Respiration
60
This is a medical condition places a client at a higher risk for developing chronic upper airway obstruction?
* Congenital malformation (present at birth)
* Subglottic stenosis
61
veins have pooled blood.
Varicose
62
What causes increased breath sounds
pneumonia
63
when the bronchi become large and balloon like.
saccular
64
What two factors determine cardiac output?
Heart rate and stroke volume
65
inadequate alveolar ventilation in relation to metabolic demands
Hypoventilation
66
A geneticist is discussing cystic fibrosis (CF). which information should be included? CF is an ____ disease
autosomal recessive
## Footnote
*two copies of an abnormal gene must be present in order for the disease or trait to develop.*
67
a thrombus formation occurring mainly in the lower extremities
Deep Vein Thrombosis
68
chest pain, usually substernal chest discomfort
Angina Pectoris
69
A patient has rheumatic fever. Which valve is most commonly affected?
Mitral
70
While planning care for a child with asthma, which of the following is characteristic of asthma
Prolonged Expirations
71
the leading cause of death in the first year of life
Congenital Heart Disease
72
what is the most common cause of pulmonary edema?
* left sided heart failure
* increasing pressure of left chambers of the heart
73
This interval is the time when the entire ventricular myocardium is depolarized?
The ST interval
74
Which condition can cause of hypercapnia?
* Disease of the medulla
* Large airway obstruction
* Thoracic cage abnormalities
* Depression of Respiratory Center
75
Which receptor monitors pH, PaCO2, and PaO2 of arterial blood?
Chemoreceptors
76
An irregular shallow pattern of breathing caused by an OD of narcotics, anesthetics or prolonged bed rest.
* Hypoventilation
77
Define Paroxysmal Nocturnal Dyspnea
* attacks of SOB & coughing that occur at night.
* Awakens the person from sleep, and may be quite frightening.
78
often referred to as the cardioinhibitory center
Parasympathetic Excitation
79
A 28 year old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions.
hemoptysis
80
A patient has impaired blood flow from the left atrium to the left ventricle. Which valvular problems does this describe?
Mitral Stenosis
81
This is a loud low pitched bubbling & gurgling. Starts in early inspiration. Sounds like a velcro fastener. Inhaled air is colliding with secretions in the trachea and large bronchi.
* Crackles Course
* *pulmonary edema, pneumonia, depressed cough reflex*
82
Define and embolus
detaches from the wall of a vessel and circulates within the vascular system until it reaches a vessel small enough for it to occlude
83
A newborn has respiratory distress syndrome, what is a predisposing factor
Premature Birth
84
The inflammation caused by a thrombus
Thrombophlebitis
85
What is the effect of angiotensin II?
Vasoconstriction, causes the stimulation of aldosterone
86
A patient with PND is most likely to have
left ventricular failure
87
Arteriosclerosis is:
thickening and hardening of the vessel wall
88
A condition in which blood has pooled, producing distended and palpable vessels, is referred to as a:
Varicose Veins
89
Surfactant
1. a lipid protein mix produced by type II cells.
2. is found in the lining of the alveoli
3. reduces surface tension
90
to prevent sudden infant death syndrome, the nurse should instruct parents to
always lay infants down on their backs to sleep
91
What complication occurs secondary to hypertension?
Congestive heart failure
92
caused by altered hemodynamics
Secondary hypertension
93
caused by an infection of staphylococcus aureus
Infective Endocarditis
94
has a crescendo-decrescendo murmur
Aortic stenosis
95
asthma is thought to be caused by
interactions between genetic and environmental factors
96
This is a very superficial sound that is course and low. Like 2 pieces of leather are being rubbed together. Loss of lubricating fluid. Heard best in anterolateral wall.
* Pleural Friction Rub
* *painful to breathe*
97
The respiratory center characteristics
* located in the brain stem.
* affecting the respiratory muscles’ ability to contract and relax
* transmitting impulses that bring about the physical act of breathing.
* influenced by emotions and pain.
98
most commonly caused by radioactive exposure, rheumatoid arthritis, or uremia
Chronic pericarditis
99
Define Emphysema
* abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
100
Which pathology most commonly results in pulmonary edema?
Increasing pressure in the left chambers of the heart
101
often called the cardioexcitation center
Sympathetic Stimulation
102
Cigarette smoking produces:
* an increased LDL level
* thrombotic/inflammatory state
* decreased HDL
103
Cyanosis definition
* bluish discoloration of the skin & mucous membranes,
* caused by increasing amounts of desaturated or reduced hemglobin in the blood.
104
When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for
Shock & Death
105
a nurse recalls respiratory distress and hypoxemia in laryngotracheobronchitis are caused by
mucosal edema
106
This reflex causes the heart rate to increase after intravenous infusions of blood or fluid
Bainbridge Reflex
107
Complications of hypertension
* ventricular hypertrophy
* angina pectoris
* congestive heart failure
* coronary artery disease
* myocardial infarction
* sudden death
108
Pneumonia is caused by
viral or bacterial infections
109
characteristic of idiopathic pulmonary arterial hypertension (IPAH)
1. fatigue
2. dyspnea
3. Jugular Vein Distention
110
this is the collapse of lung tissue which tend to develop post op
Atelectasis
111
HDL
* associated with phospholipids and protein
* good
112
Oxygen consumption for newborn
doubles
113
# Define Tension Pneumothorax?
* pleural rupture acts as a one way valve
* air ents on inspiration but preventing its escape by closing during expiration.
* air pressure **exceeds** barometric pressure
* life threatening
114
A 20 year old male presents to his primary health care provider, difficulty breathing when lying down. What term should the nurse use to document this condition?
orthopnea
115
Which of the following would shift the oxyhemoglobin dissociation curve to the left?
Hypocapnia
116
What does a thrill signify?
stenosis or hypertension
117
A 60 year old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. a diagnosis of pleural effusion is made, and a watery fluid is drained. when giving report, the nurse will refer to this fluid as
transudative
118
A 30 year old male prison inmate contracted tuberculosis during an outbreak. while planning interactions, the nurse realizes the patient can transmit this disease through
airborne droplets
119
A patient with PND is most likely to have
left ventricular failure
120
Clinical Manifestation of Pulmonary Edema
* dyspnea
* crackless
* dullness of percuss at lung bases
* pink frothy sputum
* **hyper**capnia
121
Symptoms of acute myocardial infarction (AMI)
* Fever
* Diaphoresis
* Substernal Pain
* Cool, Clammy Skin
122
Functions of the Precardium
* prevents displacement of the heart during gravitational acceleration/deceleration
* physical barrier, protects the heart against infection
* contains pain receptors/mechanoreceptors that affect blood pressure.
* brings about the force required to normalize blood pressure
123
A 60 year old female with emphysema is having difficulty expiring a given volume of air. when giving report, the nurse will relay that the patient is most likely experiencing ___ pulmonary disease
Obstructive Pulmonary Disease
124
A 20 year old male is in acute pain. ABG reveals decreased CO2. What is most likely the cause
hyperventilation
125
Expected assessment findings for someone with a pulmonary embolism
* chest pain
* tachycardia
* tachypnea
* fever
* hemoptysis
126
Reduced oxygenation of arterial blood
* **Hypoxemia**
* Partial Pressure will be below normal value
127
dietary fat package
Chylomicrons
128
A young woman presents with pallor, numbness, and a sensation of cold temperature of her digits. Which condition is the most likely cause for these symptoms?
Raynauds Phenomenon
129
This is when you have prolonged expiration to overcome airway resistance.
* Chronic Obstructive Breathing
* *can cause air trapping (dyspneic episode)*
130
LDL
* associated with cholesterol and protein
* Bad
131
refers to actual blood flow and oxygen delivery
circulation
132
lipid-laden cells that contribute to fatty streaks.
Foam cells
133
This represents the measure of time from the onset of atrial activation to the onset of ventricular activation?
PR interval
134
Asthma affects \_\_\_\_% of children between 5-17 years old
10%
135
a disease of the myocardium.
Cardiomyopathy
136
A nurse remembers bronchiolitis mainly occurs in children under the age of \_\_\_\_\_\_
One
137
A patient experiences an elevated systolic pressure accompanied by normal diastolic pressure (below 90 mmHg). Which is the correct term for this condition?
Isolated systolic hypertension
138
A patient experiences spinal cord damage following a motorcycle accident. What type of shock would most likely result?
Vasogenic
139
Define Alveolar Dead Space
* a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion
140
Which are steps in the process of gas exchange?
1. Ventilation
2. Diffusion
3. Perfusion
141
occlusion of the coronary arteries without pain
Silent ischemia
142
mean pulmonary artery pressure reading will indicate to the nurse that pulmonary hypertension is occurring? Pulmonary artery pressure above _________ mmHg
Above 25
143
This interval represents the sum of all ventricular muscle cell depolarizations.
QRS complex
144
Define Croup
* an acute laryngotracheobronchitis
* occurs in children between 6 months and 5 years of age, with a peak incidence at 2 years of age
* Almost always caused by a virus
145
Which enzymes are released by damaged myocardial muscle tissue
1. Creatnin Kinase
2. LDH
3. Troponin
146
a 50 year old male is diagnosed with pulmonary embolism (PE). what symptoms most likely occurred before treatment
chest pain and shortness of breath
147
is an accumulation of fluid in the pericardium
Pericardial effusion
148
often associated with ectopic hormone production, especially antidiuretic hormone
Small Cell Carcinoma
149
# Define Open Pneumothorax
* air pressure in the pleural space **equals** barometric pressure
* b/c air that is drawn into the pleural space during inspiration is forced back out during expiration
150
A 60 year old male with a 40 year history of smoking presents with chest pain, cough, sputum production, and pneumonia. tests reveal widespread metastatic cancer, and the primary care provider plans radiation therapy. which of the following is the most likely type of cancer to be documented on the chart
Non Small Cell Carcinoma
151
a hypersensitivity usually due to penicillin, latex, and food allergies
Anaphalactic Shock
152
A patient has a loud pansystolic murmur that radiates to the back and axilla. Which valvular abnormality is this describing?
Mitral regurgitation
153
Which conditions are associated with dyslipidemia?
Very low-density lipoproteins (VLDL) - triglycerides and proteins
154
Asthma related to Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by
mucus secretion, bronchoconstriction, and airway edema
155
SIDS peaks between ____ and ____ months of age
3, 4
156
a result of atherosclerosis
peripheral vascular disease
157
A 20 year old male presents to his primary health care provider, difficulty breathing when lying down. What term should the nurse use to document this condition?
orthopnea
158
the persistent abnormal dilation of the bronchi
Bronchiectasis
159
What is V/Q Ratio
* balance of ventilation/perfusion
160
What is the "v" referring to?
air entering alveoli
161
What is "q" referring to?
amount of blood **perfusing** the capillaries around the alveoli
162
What is low v/q
* shunting
* inadequate **ventilation**
asthma, atelactasis, pulmonary edema
163
What is high v/q
* poor **perfusion **of well ventilated lungs
## Footnote
*PE*
164
What is the difference between V/Q mismatch and shunt when supplemental oxygen is administered?
V/Q mismatch will respond well but **shunts** (Qs/Qt) will not.
165
What do pleural diseases impact?
Ventilation and oxygenation
166
What do chest wall disorders affect?
Tidal wave (compromised ventialtion), results in hypercapnia
167
What is empyema?
presence of microorganizms and cellular debris in pleural space
168
What diseases could be outcomes of pulmonary fibrosis
ARDS, TB, inhalation of asbestos
169
what is fibrosis mean?
scar tissue
170
What is aspiration pneumonia?
enviornmental compounds entering the lung and results in inflammation
171
What is epiglottis in children?
* bacterial invasion,
* inflammation,
* edema,
* obstruction of airway
172
Signs/Symptoms of Epiglottis
* high fever
* irritability
* sore throa
* inspiratory stridor
* respiratory distress
* muffled voice
173
Diseases associated w/ clubbing
* chronic hypoxemia
* bronchiostasi
* cystic fibrosis
* pulmonary fibrosis
174
Kussmaul Breathing
* think exercise, no expiratory pause
* body needs less CO2
* tissues want more 02
175
This breathing pattern is associated with any condition that reduces blood flow to the brain stem
Cheyne Stokes
176
A disorder or medication that raises peripheral vascular resistance or crdiac output will raise bp.
Secondary Hypertension
177
What happens in orthostatic hypotension?
* body fails to compensate, vessels dilate, heart rate drops
* pooling blood
* arterial pressure drops
## Footnote
*meds, hypovolemia, starvation, immobile*
178
What organs are affected from hypertension
* heart
* brain
* kidney
* eyes
