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Nursing School WCU > midterm review patho 9/17 > Flashcards

midterm review patho 9/17 Flashcards

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1
Q
  1. Which is not normally secreted in response to stress?
A

Which is secreted- cortisol
Not secreted-insulin

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2
Q
  1. Which is fasle about Malignant Tumor?
A

all true:
-Can kill host if untreated
-Confirmed by invasive or metastasizing nature
-Tissue-specific differentiation (does not closely resemble tissue type of origin)
a. Greater degree of anaplasia indicates aggressive malignancy.
-Grows rapidly
-May initiate tumor vessel growth
-Frequently necrotic
-Dysfunctional

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3
Q
  1. Beta-blockers are advocated in the management of heart failure because all of the following except;
A

true:
Decrease heart rate
Reduce myocardial oxygen demand
Inhibit detrimental effects of sympathetic stimulation
Prevent arrhythmias
false:
They increase contractility

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4
Q
  1. A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest X-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is
A

Multiple myeloma or myeloma

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5
Q
  1. An increase in hemoglobin affinity for oxygen occurs with
A

shift to the left

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6
Q
  1. Which disorder is considered a primary immunodeficiency disease? (page 216)
A

Severe combined immunodeficiency (SCID) or HIV/AIDS

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7
Q
  1. The most appropriate treatment for secondary polycythemia is
A

measures to improve oxygenation.

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8
Q
  1. Myasthenia gravis is a type II hypersensitivity disorder that involves
A

impaired muscle function.

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9
Q
  1. Which clinical finding is indicative of compartment syndrome?
A

Absent peripheral pulses

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10
Q
  1. The _________ is the behavioral adaptive response to a stressor using culturally based coping mechanisms.
A

Coping mechanism

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11
Q
  1. Is the term used for a tumor whose origin is (nerve, bone, muscle).
A

Sarcoma

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12
Q
  1. Which of the following is NOT abnormal behavior of cancer cells?
A
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13
Q
  1. The _________ is the probability that a test will be negative when applied to a person without a particular condition.
A

Specificity

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14
Q
  1. A serious complication of deep vein thrombosis is
A

pulmonary embolism

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15
Q
  1. Which is false about Small Cell−Manufactured Peptides?
A

Growth factors are small peptides that are manufactured by cells and secreted into the extracellular space. They diffuse to nearby cells and interact with receptors on the target cell surface. Binding of growth factors to cell surface receptors activates signaling cascades within the cell that enhance proliferation. As a general principle, cells do not independently produce growth factors sufficient to stimulate their own proliferation. The proliferation signals must be produced by the cell’s environment. The cell’s environment also conveys growth-inhibiting signals. Overproduction of stimulatory growth factors by a mutant proto-oncogene can shift the balance of signals and produce excessive self-stimulated growth (autocrine signaling). Examples of tumor-secreted growth factors include platelet-derived growth factor (PDGF), transforming growth factor-α (TGF-α), and epidermal growth factor (EGF). Certain cancer types typically secrete particular growth factors. For example, PDGF is commonly oversecreted in glial cell cancers (brain tumors) and connective tissue cancers (sarcomas).

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16
Q
  1. The coagulation Factors II, VII, IX, X, protein C, and S are dependent on __________ for their synthesis.
A

Vitamin K

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17
Q
  1. What is false about Renin-angiotensin-aldosterone system?
A

Renin-angiotensin-aldosterone system (RAAS) important regulator of BP
a. Juxtaglomerular cells when stimulated by low arterial pressure release renin activates angiotensinogen to angiotensin I.
b. Angiotensin I when in contact with ACE activates angiotensin II, a potent vasoconstrictor and stimulates release of aldosterone.
c. Aldosterone, a hormone, causes reabsorption of sodium and water passively follows.

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18
Q
  1. COPD leads to a barrel chest, because it causes
A

air trapping

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19
Q
  1. Diarrhea causes
A

Metabolic acidosis

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20
Q
  1. Effects of hypernatremia on the central nervous system typically include, which of the following?
A

Confusion

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21
Q
  1. In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiological event?
A

Inflammation, mucosal edema, and bronchoconstriction.

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22
Q
  1. Clinical manifestations of moderate to severe hypokalemia include
A

muscle weakness and cardiac dysrhythmias.

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23
Q
  1. Common characteristics of sarcoidosis include (Select all that apply.)
A

Presence of CD4+ T cells
A non-productive cough
Granulomas in multiple body systems
Fatigue, weight loss, and fever

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24
Q
  1. Transfusion reactions involve RBC destruction caused by
A

recipient antibodies

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25
Q
  1. It is true that diffuse interstitial lung disease (Select all that apply.)
A

leads to loss of alveolar walls.
may be immunologic in nature.
shows on x-ray as a “honeycomb lung.”

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26
Q
  1. Metaplasia is
A

is the replacement of one differentiated cell type with another.

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27
Q
  1. Which factors are considered intrinsic factors in blood pressure readings? (Select all that apply.)
A

Heart rate
Flow dynamics

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28
Q
  1. Tissue hypoxia is most often caused by ___________
A

Ischemia

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29
Q
  1. Which one is true about Angiogenesis?
A

Process by which cancer tumor forms new blood vessels in order to grow
Usually does not develop until late stages of development
Triggers are not generally understood.
Inhibition of angiogenesis is important therapeutic goal.

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30
Q
  1. Which is false about Vascular Purpura?
A

all true:
Abnormality of the vessels or supportive tissues
Purpura (patches of petechiae) present
Allergic purpura: autoimmune process
Ehles-Danlos syndrome: deficient collagen and elastin
Vitamin C deficiency: defective collagen synthesis
Aging: loss of subcutaneous fat and changes in connective tissue
Location of purpura depends on causative agent.
Diagnosis is one of the exclusions after platelet and coagulation disorders are ruled out.
Tourniquet (Rumpel–Leede) test may be used.
Treatment (Tx): removing and avoiding the causative agent

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31
Q
  1. Which is false about Hereditary Hemorrhagic Telangiectasia (Osler–Weber–Rendu Disease)?
A

all true:
Autosomal dominant trait
Family history in both sexes
Dilated, tortuous small blood vessel that easily bleeds
Vessel wall composed of single layer of endothelium
Multiple telangiectases, repeated episodes of bleeding
Treatment is supportive.
 Humidification
 Topical hemostatic agents
 Cauterization
 Iron replacement
 Laser therapy

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32
Q
  1. Which causes of shock are considered to be obstructive? (Select all that apply.)
A

Pulmonary embolus
Cardiac tamponade
Tension pneumothorax

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33
Q
  1. The Primary cause of death in ARDS ( Acute Respiratory Distress Syndrome ) is _____________.
A

sepsis syndrome

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34
Q
  1. Which is false about the Pathogenesis of Bronchiectasis?
A

all true:
Pathogenesis
Recurrent infection of bronchial walls leads to persistent dilation.
Bronchial wall thickening
Inflammation results in destruction of walls.
Destructive process leads to loss of ciliated epithelium.
Transforms to squamous cell and pus formation
Leads to bronchial obstruction

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35
Q
  1. A commonly ingested substance associated with prolongation of the bleeding time is
A

aspirin

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36
Q
  1. Which one is false about the possible pathogenesis of Bronchiolitis?
A

all true:
Pathogenesis
Proliferation and necrosis of bronchiolar epithelium
Production of thick, tenacious mucus
Airway obstruction
Atelectasis
Hyperinflation
Possible mechanisms of airway obstruction
* Development of inflammatory exudate: displaces surfactant
* Release of chemical mediators: produces bronchiolar constriction
* Inflammation: induces fibrosis and airway narrowing
* Goblet cell metaplasia
* Increased bronchial muscle mass

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37
Q
  1. The markers of increased plaque vulnerability include, all of the following, except
A

all true:
Active inflammation within the plaque
Large lipid core with a thin cap
Endothelial denudation (erosion) with superficial platelet adherence
Fissured or ruptured cap
Severe stenosis predisposing to high shear stress

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38
Q
  1. The Tetralogy of Fallot has the following defining features, except;
A

all true:
Ventricular septal defect
Aorta positioned above the ventricular septal opening
Pulmonary stenosis that obstructs right ventricular outflow
Right ventricular hypertrophy

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39
Q
  1. Which is false about Tricuspid Atresia?
A

all true:
Usually associated with underdevelopment of the right ventricle and an atrial septal defect
Allows blood to bypass right ventricle
A patent ductus arteriosus is required to perfuse lungs.
Cyanosis present at birth, mortality high
Surgery required for survival

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40
Q
  1. Which is false regarding Hypertrophic cardiomyopathy?
A

all true:
Thickened, hyperkinetic ventricular muscle mass
Septum may be affected, leading to idiopathic hypertrophic subaortic stenosis.
Genetic abnormality: autosomal dominant pattern
Clinical course is variable, typically slow progression.
Asymptomatic or dyspnea and angina

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41
Q
  1. Which is incorrect about Chronic Ischemic Cardiomyopathy?
A

all true:
Heart failure develops insidiously because of progressive ischemic myocardial damage.
Typically have history of angina or MI
Appears to be a consequence of slow, progressive apoptotic death of myocytes from chronic ischemia
Scattered throughout the myocardium
More common in older adults
Prognosis: poor

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42
Q
  1. The inflammation of the intima of an artery is called ___________.
A

Vasculitis

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43
Q
  1. Which is false about Hereditary Spherocytosis?
A

all true:
Defective red cell membrane skeleton, altered membrane properties, and altered cell metabolism
Autosomal dominant trait
RBCs are fragile microspherocytes, with increased destruction of spherocytes.
Concentration of Hgb increased.
Treatment
 Splenectomy
Prognosis
 Cured but must watch for infections

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44
Q
  1. The following are the most Common Clinical Manifestations of Leukopenia, except
A

 All true:
Lymphadenopathy
 Joint swelling and pain
 Weight loss
 Anorexia
 Hepatomegaly
 Splenomegaly

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45
Q
  1. The following are the common features in Myeloid Neoplasms except;
A

all true:
Involvement of multipotent hematopoietic progenitor cell
Marrow hypercellularity
Overproduction of functional blood cells
Chromosomal abnormalities
Eventual spontaneous conversion to AML or development of marrow fibrosis

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46
Q
  1. Most carbon dioxide is transported in the bloodstream as
A

Bicarbonate ion (HCO3−)

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47
Q
  1. Which is false about the Pathogenesis and Clinical Manifestations of Hairy Cell Leukemia?
A

all true:
Rare, chronic type of leukemia
2% of adult leukemia but highly treatable
Median age of presentation: 55 years; 5:1 predominance of males
B-cell phenotype
Peculiar cells with hairlike projections on their surface
Hairy cells in peripheral blood
Reduced numbers in granulocytes, platelets, red blood cells
Splenomegaly (90%)

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48
Q
  1. Which is false about Sinus Bradycardia?
A

all true:
Heart rate lower than 60 beats/min
May be normal in physically trained individuals with large resting SVs
Usually from parasympathetic activation
If slow HR precipitates low CO, treatment includes sympathomimetic or parasympatholytic drugs.

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49
Q
  1. In regard the Atrial Dysrhythmias and Premature atrial complexes (PACs), which one is false?
A
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50
Q
  1. Which is fasle about Ventricular Fibrillation?
A

all true:
Rapid, uncoordinated cardiac rhythm resulting in ventricular quivering and lack of effective contraction
ECG is rapid and erratic, with no identifiable QRS complexes.
Results in death if not reversed within minutes
Defibrillation
CPR
Antiarrhythmia drugs

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51
Q
  1. Which is false about Hypertensive emergency?
A

all true:
: sudden increase in either or both systolic or diastolic blood pressure with evidence of end-organ damage
Rapid but controlled reduction of blood pressure using parenteral antihypertensive agents under close monitoring (typically in ICU setting)

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52
Q
  1. The cellular component that is most susceptible to radiation injury is the
A

DNA

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53
Q
  1. The cellular response indicative of injury due to faulty metabolism is
A

intracellular accumulations

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54
Q
  1. Extreme cold injures cells by all the following except
A
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55
Q
  1. Infectious injury often results from (Select all that apply.)
A

Exotoxins
Endotoxins
Enzymes from white blood cells

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56
Q
  1. Characteristics of telomerase include (Select all that apply.)
A

Promoting synthesis of telomere ends
Contributing to cancer cell immortality
Activity allowing a cell to replicate indefinitely

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57
Q
  1. A cause of thrombocytopenia includes
A

bone marrow suppression

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58
Q
  1. Which type of leukemia primarily affects children?
A

Acute Lymphoblastic Leukemia (ALL)

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59
Q
  1. Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?
A

Pain in long bones, infection, fever, bruising

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60
Q
  1. Pernicious anemia is caused by a lack of
A

Intrinsic factor, which leads to Vitamin B12 deficiency.

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61
Q
  1. Necrotic death of brain tissue usually produces _____ necrosis.
A

Liquefactive necrosis

62
Q
  1. Regarding iron deficiency anemia, what laboratory features are typically decreased? (Select all that apply.)
A
  • MCV (Mean Corpuscular Volume)
  • MCH (Mean Corpuscular Hemoglobin)
  • MCHC (Mean Corpuscular Hemoglobin Concentration)
63
Q
  1. A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.)
A
  • Bones
  • Kidneys
64
Q
  1. Which is false about Lymphatic Structure?
A

all true:
-Thin walled and resemble veins
-Range in size from capillaries to vessels of increased diameter
-Intermittent valves that extend into lumen
-Capillary walls contain contractile fibers that propel lymph along the vessel.

65
Q
  1. This law represents the relationship between distending pressure and wall tension.
A

Laplace’s Law

66
Q
  1. If an embolus leaves the Right ventricle, which consequence is correct?
A

Acute Pulmonary Embolism

67
Q
  1. The Emboli can be produced by all others following causes, except;
A

All true:
Thrombus (blood clot)
Fat emboli
Air emboli
Amniotic fluid emboli

68
Q
  1. Which is false about Raynaud Syndrome?
A

all true:
-Extreme vasoconstriction producing cessation of flow to fingers and toes
-Color changes: white, blue (cyanosis), red (hyperemia); pain, numbness; cold triggers attacks
-Intrinsic structural factors, extrinsic neuroregulation, and locally produced mediators involved
-Treatment: enhancing circulation through biofeedback, relaxation, calcium-channel blockers, sympatholytic drugs, prostaglandins

69
Q
  1. The common denominator in all forms of heart failure is..WHAT?
A

Reduced cardiac output

70
Q
  1. Which is false about Legionnaires disease, that causes Pneumonia?
A

all true:
-Organism lives in H2O
-Transmitted by portable H2O, condensers, cooling towers
-Fever, diarrhea, abdominal pain, liver and kidney failure, pulmonary infiltrates
-Treatment: macrolide antibiotic

71
Q
  1. Which is not correct about the treatment of Croup syndrome? (ALL TRUE)
A

all true
Treatment
 Mist therapy
 Oral hydration
 Avoidance of cough stimulation
 O2 therapy, pulse oximetry (hospitalized)
 Nebulized epinephrine (relieves airway obstruction)
 Endotracheal intubation (respiratory failure)

72
Q
  1. Deficits in immune system function occur in cancer due to (Select all that apply.)
A

chemotherapy
cancer cells
cancer metastasis to bone marrow
malnutrition

73
Q
  1. What is false about the fluid distribution between interstitial and intracellular?
A

all true
The intracellular fluid (ICF) is the fluid within cells. The interstitial fluid (IF) is part of the extracellular fluid (ECF) between the cells.

74
Q
  1. Which of the following is not a buffer of the body fluids?
A

all true: cell and plasma proteins, hemoglobin, phosphates, bicarbonate ions, and carbonic acid

75
Q
  1. This disease is a rare inflammatory condition affecting small- and medium-sized arteries and veins of the upper and lower extremities
A

Thromboangiitis obliterans (Buerger disease)

76
Q
  1. Which is not a major mechanism regulating the acid-base status of the body.
A

all true:
Three major mechanisms regulate the acid–base status of the body: buffers, the respiratory system, and the renal system

77
Q
  1. Which of the following agents, causes Cough, tachypnea, rales, wheezes, and no fever?
A

Chlamydia pneumonia

78
Q
  1. Which of the following is not a common physical finding of Emphysema?
A

all true:
-Thin, wasted individual hunched forward
-Using accessory muscles
-Decreased breath sounds, lack of crackles and rhonchi
-Prolonged expiration
-Decreased heart sounds
-Hyperresonance
-Decreased diaphragmatic excursion
-Chronic morning cough

79
Q
  1. Which of the following groups doesn’t belong to the Myeloid lineage?
A

all true: red blood cells, platelets, monocytes, and granulocytes

80
Q
  1. The following are the most common clinical manifestations of Leukopenia, except;
A

all true:
Lymphadenopathy
Joint swelling and pain
Weight loss
Anorexia
Hepatomegaly
Splenomegaly

81
Q
  1. Which is not a Factor that increases the release of ADH?
A

All true:
Increased osmolality (concentration) of the extracellular fluid
Decreased circulating fluid volume
Pain
Nausea
Physiologic and psychological stressors

82
Q
  1. Which is fasle about the pathogenesis of Hypersensitivity pneumonitis?
A

all true:
-Genetic predisposition
-Antigen combines with serum antibody in alveolar walls; leads to type III hypersensitivity reaction
-Antigen-antibody complexes then elicit granulomatous inflammation leading to lung tissue injury
-Leads to diffuse pulmonary fibrosis in upper lobes (hallmark of disease)

83
Q
  1. In this stage, patient functions normally; disease processes are well-established.
A

Subclinical Stage

84
Q
  1. The following are early clinical manifestations of IRDS (infant respiratory distress syndrome), except;
A

all true:
Shallow respirations, diminished breath sounds
Intercostal, subcostal, or sternal retractions
Flaring of nares
Hypotension, bradycardia
Peripheral edema
Low body temperature
Oliguria
Tachypnea (60 to 120 breaths/min)

85
Q
  1. The most important preventative measure for hemorrhagic stroke is
A

Blood pressure control

86
Q
  1. Cerebral aneurysm is most frequently the result of
A

increasing intracranial pressure and hemorrhagic stroke

87
Q
  1. Which is incorrect about Ischemic Pain? (chapter 44)
A

Pain resulting from a sudden or profound loss of blood flow to the tissues in a particular part of the body may result in ischemic pain. Decreased perfusion leads to tissue hypoxia and injury, with release of inflammatory and pain-producing chemicals. Ischemic pain is described as aching, burning, or prickling (paresthesia). The symptoms of ischemic pain depend on the origin of the ischemia. For example, pain of cardiac origin is visceral and radiates to the arm or jaw. This pain is perceived as being deep, aching, diffuse, and pressing. Ischemia resulting from acute deep venous occlusion is also aching and has a deep quality and gradual onset. Acute arterial occlusion may be felt as either burning or aching, but has a sudden onset. Chronic ischemic pain can occur in atherosclerotic syndromes. Arteriosclerosis obliterans occurs gradually as plaque develops in the intima of the arteries, most often arteries of the lower extremities. In the early stages, the pain, called intermittent claudication, is associated with physical activity, is alleviated with rest, and has a cramping quality. In severe cases, ischemic neuropathy may ensue and cause a more consistent burning, shooting pain in the leg or foot. Management of ischemic pain is directed at improving blood flow and reducing tissue hypoxia. Acute ischemia is usually associated with a thrombus or embolus and can be managed with drugs to dissolve the clot or surgery to remove it. Chronic ischemia is most often associated with atherosclerosis and may be improved through lifestyle changes, including smoking cessation, weight loss, reduction of lipid levels, and regular exercise. Surgical bypass procedures or placement of intravascular stents are other therapeutic modalities.

88
Q
  1. Respiratory acidosis may be caused by
A

Hypoventilation

89
Q
  1. A common characteristic of viral pneumonia is
A

-Upper respiratory prodrome
a.Fever, nonproductive cough, hoarseness, coryza accompanied by wheezing/rales
- managed symptomatically because no effective antibiotic therapy is available.
- does not produce exudative fluids.

90
Q
  1. Clinical manifestations of pleural effusion include (Select all that apply.)
A

Dyspnea
Diminished breath sounds
A tracheal shift, if large

91
Q
  1. An acute asthma attack is associated with (Select all that apply.)
A

Bronchoconstriction
Bronchial mucosal edema
Hypersecretion of mucus
Hypoxemia

92
Q
  1. Individuals who have chronic bronchitis most often have
A

-Sputum-excessive, purulent
-dyspnea- mild to moderate, but may gradually progress to severe exertional dyspnea
-cough- chronic, more severe in the mornings
-patient complaints- Chronic cough with mucopurulent sputum, chills, malaise, -muscle aches, fatigue, insomnia, loss of libido
-auscultation of chest- Wheezes, crackles, rhonchi, depending on severity of disease
-Congested lung fields, increased bronchial vascular markings, enlarged horizontal heart

93
Q
  1. The ________ is the test’s ability to give the same results in repeated measurements.
A

Reliability

94
Q
  1. Osmoreceptors located in the hypothalamus control the release of
A

antidiuretic hormone

95
Q
  1. Fully compensated respiratory acidosis is demonstrated by
A

Normal pH, elevated PaCO2, and elevated HCO3−

96
Q
  1. Two primary acid-base disorders that are present independently are referred to as
A

Mixed acid-base disorder

97
Q
  1. A person with acute hypoxemia may hyperventilate and develop
A

Respiratory alkalosis

98
Q
  1. Which acid are the kidneys unable to excrete?
A

Carbonic

99
Q
  1. Causes of metabolic acidosis include all of the following, except
A

All true
Increase in Metabolic Acid
Ketoacidosis (diabetes mellitus, starvation, alcoholism)
Severe hyperthyroidism
Burns
Circulatory shock
Tissue anoxia (lactic acidosis)
Oliguric acute kidney injury or end-stage chronic kidney disease
Excessive intake of acids or acid precursors (e.g., salicylates, methanol, ethylene glycol)
Decrease in Base (Bicarbonate)
Severe or prolonged diarrhea
Gastrointestinal fistula that drains intestinal or pancreatic secretions
Intestinal decompression (drainage tubes)
Renal tubular acidosis

100
Q
  1. Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
A

Metabolic alkalosis

101
Q
  1. A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician?
A

pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high.

102
Q
  1. A 3 year old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?
A

Rapid, deep breathing, lethargy, abdominal pain

103
Q
  1. What is likely to lead to hyponatremia?
A

diuretics, vomiting, diarrhea, congestive heart failure, renal and liver disease.

104
Q
  1. Raise pain threshold and produce sedation and euphoria. (Select all that apply)
A

Endorphins and Enkephalins

105
Q
  1. A person who has hyperparathyroidism is likely to develop
A

Hypercalcemia

106
Q
  1. Signs and symptoms of clinical dehydration include
A

Sunken fontanel (infants)
Rapid, thready pulse
Sudden weight loss
Postural blood pressure decrease with concurrent increased heart rate
Lightheadedness, dizziness, or syncope on standing
Flat neck veins when supine or neck veins that collapse during inspiration (older children and adults)
Longitudinal furrows in the tongue
Thirst
Increased serum sodium concentration
Confusion, lethargy
Coma
Hypovolemic shock
Oliguria
Decreased skin turgor
Dryness of oral mucus membranes
Hard stools
Soft, sunken eyeballs

107
Q
  1. Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with
A

Hypophosphatemia

108
Q
  1. Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.
A

Hyponatremia

109
Q
  1. The electrolyte imbalance that occurs with oliguric renal failure is
A

Hyperkalemia

110
Q
  1. A patient who reports an intestinal fistula also reports feeling “weak and dizzy” when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician?
A

Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.

111
Q
  1. Clinical manifestations of extracellular fluid volume deficit include
A

Sudden weight loss
Postural blood pressure decrease with concurrent increased heart rate
Flat neck veins (or veins collapsing with inspiration) when a patient is supine
Lightheadedness
Dizziness
Syncope
Oliguria or small volume of concentrated urine (if kidneys are responding normally)
Decreased skin turgor
Dryness of oral mucus membranes
Hard stools
Soft sunken eyeballs
Longitudinal furrows in the tongue
-In infants
 Fontanel may be sunken.
 Neck veins are not reliably assessed in infants.
Sudden weight loss is a sensitive measure of ECV deficit.
 One liter of saline weighs 1 kg.
 A person who loses 1 kg in 24 hours has excreted 1 L of fluid or lost it through an abnormal route.
 Is not a reliable indicator for third spacing
Fluid volume depletion can be detected with shifts in orthostatic blood pressure.
May lead to hypovolemic shock, which can be fatal if not treated effectively (fluid replacement)

112
Q
  1. A known cause of hypokalemia is
A

Hypokalemia is caused by factors that decrease potassium intake, shift potassium from the extracellular fluid into the cells, increase potassium excretion through the normal routes, and cause potassium loss from the body by some abnormal route. Potassium-wasting diuretics and corticosteroids such as prednisone are well-known causes of hypokalemia from increased renal potassium excretion.

113
Q
  1. A patient, who is 8 months pregnant, has developed eclampsia and is receiving intravenous magnesium sulfate to prevent seizures. To determine if her infusion rate is too high, you should regularly
A

check the patellar reflex; if it becomes weak or absent, her infusion rate probably is too high and she is at risk for respiratory depression or cardiac arrest.

114
Q
  1. How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone–related peptide monitored for the resulting electrolyte imbalance?
A

Serum calcium, bowel function, level of consciousness

115
Q
  1. Effects of stress response influenced by all of the following except;
A

all true-
Effects of stress response influenced by:
a. genetics.
b. socioeconomic status.
c. prior susceptibilities.
d. preexisting health status.
e. allostatic state.
f. ability to manage stress.

116
Q
  1. Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of
A

Acute Respiratory Distress Syndrome (ARDS)

117
Q
  1. Which is indicative of a left tension pneumothorax?
A

Tracheal deviation to the right
Tension pneumothorax results in shifting and compression of mediastinal structures, including the heart, which compromises left ventricular filling. Accumulation of air in the pleural space may occur because of trauma or spontaneous rupture of lung parenchyma. A tension pneumothorax develops when the air in the pleural space begins to exert a positive pressure on lung and mediastinal structures. A deviated trachea and decreased or absent breath sounds may occur. Arterial blood gas values can deteriorate rapidly. Tension pneumothorax is detectable by chest radiography.

118
Q
  1. A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for
A

Tension pneumothorax

119
Q
  1. A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of
A

Bacterial pneumonia

120
Q
  1. Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called
A

Tension Pneumothorax

121
Q
  1. The pH can provide all the following information except;
A

If blood or other body fluids become too acidic or too alkalotic, dysfunction and even death can occur.
Death can occur if
a. pH falls below 6.9.
b. pH rises above 7.8.
Maintenance of acid-base balance reflects homeostatic functions of normal cellular metabolism.

Normal pH of adult blood ranges from 7.35 to 7.45.
Range is somewhat wider in infants and children.
High pH indicates few hydrogen ions.
c. Solution is alkaline (basic).
Low pH indicates a lot of hydrogen ions.
d. Solution is acidic.

122
Q
  1. With too much acid production, all of the following events would happen except;
A
123
Q
  1. The lungs can excrete only_____________
A

carbon dioxide and water from the body (carbonic acid)

124
Q
  1. What is false regarding the decreased HCO3− (bicarbonate)?
A

all true: esults in a low plasma bicarbonate HCO3− concentration, which lowers the pH.

125
Q
  1. Severe metabolic acidosis can produce all of the following, except;
A

all true:
a. Tachycardia
b. Ventricular dysrhythmias (from myocardial intracellular acidity)
c. Decreased cardiac contractility
d. Death from brainstem dysfunction usually occurs if pH falls below 6.9

126
Q
  1. This membrane network is present in all eukaryotic cells and is known as the “gastrointestinal tract” of the cell.
A

Endoplasmic reticulum

127
Q
  1. Inadequate neuromuscular function can produce respiratory acidosis. Which of the following is not an inadequate neuromuscular function impairment?
A

true:
Myasthenia gravis
Guillain-Barré syndrome
Spinal cord injury
Muscular dystrophy

128
Q
  1. In compensated respiratory acidosis, we can observe all of the following except;
A

all true:
Increased PaCO2 (primary imbalance)
Increased bicarbonate concentration (compensation)
Decreased (somewhat low) or even normal pH, depending on degree of compensation

129
Q
  1. Increased preload of the cardiac chambers may lead to which patient symptom?
A

edema

130
Q
  1. Thalassemia may be confused with iron-deficiency anemia, because they are both
A

Microcytic anemias

131
Q
  1. A patient is diagnosed with stage IIA Hodgkin disease. This patient’s clinical stage was most likely determined by (Select all that apply.)
A

patient history.
lymph node biopsy.
CT scan.
physical examination.

132
Q
  1. Malignant neoplasms of epithelial origin are known as
A

Carcinomas

133
Q
  1. Which one is false about Malignant Tumor?
A

Can kill host if untreated
Confirmed by invasive or metastasizing nature
Tissue-specific differentiation (does not closely resemble tissue type of origin)
a. Greater degree of anaplasia indicates aggressive malignancy.
Grows rapidly
May initiate tumor vessel growth
Frequently necrotic
Dysfunctional

134
Q
  1. This tumor marker is associated with carcinomas of the colon, pancreas, lungs, stomach and heart.
A

Carcinoembryonic antigen (CEA)

135
Q
  1. The _______ are peptides produced and secreted by white blood cells.
A

Cytokines

136
Q
  1. Which is NOT a general cause for atrophy?
A

Disuse
Denervation
Ischemia
Nutrient starvation
Interruption of endocrine signals
Persistent cell injury

137
Q
  1. Which is false about the action potential? (page 48 in book)
A

all true:
-The negative value of the resting membrane potential (RMP) is determined by the ratio of intracellular to extracellular K+ ion concentration. Changes in serum K+ concentration can have profound effects on the RMP.
- Cells with voltage-gated ion channels are excitable and can produce and conduct action potentials. An action potential results from the opening of “fast” Na+ channels, which allows Na+ to rush into the cell.
-Repolarization is caused by closure of Na+ channels and efflux of K+ from the cell. In cardiac muscle, repolarization is prolonged as a result of Ca2+ influx through “slow” Ca2+ channels.

138
Q
  1. Which is false about Peroxisomes? Select all that apply
A

which perform the task of intracellular digestion of organic waste; and the mitochondria, which produce cellular energy in the form of ATP.

139
Q
  1. The transport of lipid molecules due their electrochemical gradient and because of differences between intracellular and extracellular charges is called
A

Electrochemical diffusion

140
Q
  1. The first line of treatment for Atherosclerosis, includes the following, except;
A

true: nonpharmacologic interventions such as weight reduction, smoking cessation, exercise, and low-fat diet

141
Q
  1. What is the definitive test for diagnosis of Pulmonary tuberculosis?
A

Sputum culture for Mycobacterium tuberculosis

142
Q
  1. The following are the most clinically important electrolytes, except;
A

all true:
Sodium
Potassium
Calcium
Magnesium
Chloride
Bicarbonate
Phosphate

143
Q
  1. Rupture of a cerebral aneurysm should be suspected if the patient reports
A

Sudden, severe headache (“thunderclap headache”)

144
Q
  1. Patients presenting with symptoms of unstable angina and no ST-segment elevation are treated beside oxygen with____________.
A

Antiplatelet therapy (aspirin)

145
Q
  1. Which disorder is caused by inhalation of organic substances?
A

Hypersensitivity pneumonitis

146
Q
  1. Which condition enhances lymphatic flow?
A

Increased colloid osmotic pressure

147
Q
  1. The effects of histamine release include all of the following, except
A

true
vasodilation, which results in flushed skin and hypotension.
contraction of the smooth muscles of the respiratory system.
increased vascular permeability, which results in tissue edema.
false
increased cardiac contractility, which results in hypertension.

148
Q

Dyspnea
Diminished breath sounds
A tracheal shift, if large

A

-Barrel chest and obvious respiratory effort that maintains near normal blood gases are consistent with type A COPD in the early stages.
-Normal PaCO2, scant sputum, accessory muscle use, barrel chest

149
Q

hich is not correct about the treatment of Croup syndrome? (ALL TRUE)

A

all true
Treatment
 Mist therapy
 Oral hydration
 Avoidance of cough stimulation
 O2 therapy, pulse oximetry (hospitalized)
 Nebulized epinephrine (relieves airway obstruction)
 Endotracheal intubation (respiratory failure)

150
Q

patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.)

A
  • Fatigue
  • Weight loss
  • Abdominal discomfort
  • Sweats

Nursing School WCU (36 decks)

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