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Ane Class Practice > Pathopharm Exam 3-S4 > Flashcards

Pathopharm Exam 3-S4 Flashcards

1
Q

Which intracerebral disease process is capable of producing diffuse dysfunction?
a. Closed-head trauma with bleeding
b. Subdural pus collections
c. Neoplasm
d. Embolic infarct

A

d. Embolic infarct

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2
Q

Cognitive operations cannot occur without the effective functioning of what part of the brain?
a. Pons
b. Medulla oblongata
c. Reticular activating system
d. Cingulate gyrus

A

c. Reticular activating system

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3
Q

What is the most common infratentorial brain disease process that results in the direct destruction of the reticulating activation system (RAS)?
a. Cerebrovascular disease
b. Demyelinating disease
c. Neoplasms
d. Abscesses

A

a. Cerebrovascular disease

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4
Q

What stimulus causes posthyperventilation apnea (PHVA)?
a. Changes in PaO2 levels
b. Changes in PaCO2 levels
c. Damage to the forebrain
d. Any arrhythmic breathing pattern

A

b. Changes in PaCO2 levels

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5
Q

A healthcare professional reads in the patient’s chart and notes the patient has Cheyne-Stokes respirations. What clinical finding would the professional correlate with this condition?
a. Sustained deep rapid but regular pattern of breathing
b. Crescendo-decrescendo pattern of breathing, followed by a period of apnea
c. Prolonged pause after the inspiratory period with occasional end-expiratory pause
d. Completely random, irregular breathing pattern with pauses

A

b. Crescendo-decrescendo pattern of breathing, followed by a period of apnea

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6
Q

Vomiting is associated with central nervous system (CNS) injuries that compress which of the brain’s anatomic locations?
a. Vestibular nuclei in the lower brainstem
b. Floor of the third ventricle
c. Any area in the midbrain
d. Diencephalon

A

a. Vestibular nuclei in the lower brainstem

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7
Q

Which midbrain dysfunction causes pupils to be pinpoint size and fixed in position?
a. Diencephalon dysfunction
b. Oculomotor cranial nerve dysfunction
c. Dysfunction of the tectum
d. Pontine dysfunction

A

d. Pontine dysfunction

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8
Q

A healthcare professional suspects a patient is brain dead. How would the professional assess for brain death?
a. Determine if the patient can make voluntary movements.
b. Perform tests to assess if the patient is in a coma.
c. Remove the patient’s ventilator to see if spontaneous breathing occurs.
d. Monitor the patient for eye movements that seem purposeful.

A

c. Remove the patient’s ventilator to see if spontaneous breathing occurs.

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9
Q

A patient has damage to the lower pons and medulla. What finding does the healthcare professional associate with this injury?
a. Flexion with or without extensor response of the lower extremities
b. Extension response of the upper and lower extremities
c. Extension response of the upper extremities and flexion response of the lower extremities
d. Flaccid response in the upper and lower extremities

A

d. Flaccid response in the upper and lower extremities

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10
Q

Which hospitalized patient does the healthcare professional assess as a priority for the development of delirium?
a. An individual with diabetes celebrating a 70th birthday
b. A depressed Hispanic woman
c. An elderly male on the second day after hip replacement
d. A man diagnosed with schizophrenia

A

c. An elderly male on the second day after hip replacement

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11
Q

A patient suffered a seizure for the first time. The spouse asks the healthcare professional to explain what a seizure is. What response by the professional is best?
a. Actions that occur without conscious thought because of a stimulus
b. A sudden, explosive, disorderly discharge of brain cells
c. A disease where a person has frequent seizures like this one
d. A series of excessive, purposeless movements.

A

b. A sudden, explosive, disorderly discharge of brain cells

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12
Q

A patient had a seizure that consisted of impaired consciousness and the appearance of a dreamlike state. How does the healthcare professional chart this episode?
a. Focal seizure
b. Complex focal seizure
c. Tonic-clonic seizure
d. Atonic seizure

A

b. Complex focal seizure

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13
Q

A patient is in status epilepticus. In addition to giving medication to stop the seizures, what would the healthcare professional place highest priority on?
a. Facilitating a CT scan of the head
b. Providing oxygen
c. Assessing for brain death
d. Assessing for drug overdose

A

b. Providing oxygen

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14
Q

What is the most critical aspect in correctly diagnosing a seizure disorder and establishing its cause?
a. Computed tomographic (CT) scan
b. Cerebrospinal fluid analysis
c. Skull x-ray studies
d. Health history

A

d. Health history

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15
Q

What area of the brain mediates the executive attention functions?
a. Limbic
b. Prefrontal
c. Parietal
d. Occipital

A

b. Prefrontal

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16
Q

A healthcare professional is caring for a patient diagnosed with aphasia. What action by the professional would be best in working with this patient?
a. Provide physical therapy.
b. Provide speech therapy.
c. Provide special thickened foods.
d. Provide balance activities.

A

b. Provide speech therapy.

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17
Q

A patient’s chart notes receptive aphasia. What does the healthcare professional understand about this patient’s abilities related to speech?
a. Speak in made up words.
b. Produce verbal speech, but not comprehend language.
c. Comprehend speech, but not verbally respond.
d. Neither respond verbally nor comprehend speech.

A

b. Produce verbal speech, but not comprehend language.

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18
Q

The healthcare professional notes that the patient’s intracranial pressure is 12 mmHg. What action should the professional take?
a. Do nothing; this is a normal finding.
b. Give medications to immediately lower the pressure.
c. Give medication to immediately raise the pressure.
d. Repeat the reading because the first one was inaccurate.

A

a. Do nothing; this is a normal finding.

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19
Q

Cerebral edema is an increase in the fluid content of what part of the brain?
a. Ventricles
b. Tissue
c. Neurons
d. Meninges

A

b. Tissue

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20
Q

What type of cerebral edema occurs when permeability of the capillary endothelium increases after injury to the vascular structure?
a. Cytotoxic
b. Interstitial
c. Vasogenic
d. Ischemic

A

c. Vasogenic

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21
Q

What is a communicating hydrocephalus caused by an impairment of?
a. Cerebrospinal fluid flow between the ventricles
b. Cerebrospinal fluid flow into the subarachnoid space
c. Blood flow to the arachnoid villi
d. Absorption of cerebrospinal fluid

A

d. Absorption of cerebrospinal fluid

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22
Q

Which dyskinesia involves involuntary movements of the face, trunk, and extremities?
a. Paroxysmal
b. Tardive
c. Hyperkinesia
d. Cardive

A

b. Tardive

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23
Q

Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of an increase of what?
a. Dopamine
b. Gamma-aminobutyric acid
c. Norepinephrine
d. Acetylcholine

A

a. Dopamine

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24
Q

The existence of regular, deep, and rapid respirations after a severe closed head injury is indicative of neurologic injury to what?
a. Lower midbrain
b. Pontine area
c. Supratentorial
d. Cerebral area

A

a. Lower midbrain

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25
Q

What type of posturing exists when a person with a severe closed head injury has all four extremities in rigid extension with the forearms in hyperpronation and the legs in plantar
extension?
a. Decorticate
b. Decerebrate
c. Spastic
d. Cerebellar

A

b. Decerebrate

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26
Q

After a cerebrovascular accident, a patient has been diagnosed with anosognosia. What action by the healthcare professional would be most helpful?
a. Provide a white board for the patient to write on.
b. Ensure the patient has a safe environment.
c. Provide physical therapy for strengthening exercises.
d. Practice naming colors using flash cards.

A

b. Ensure the patient has a safe environment.

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27
Q

After a cerebrovascular accident, a man is unable to either feel or identify a comb with his eyes closed. What is this an example of?
a. Agraphia
b. Tactile agnosia
c. Anosognosia
d. Prosopagnosia

A

b. Tactile agnosia

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28
Q

Most aphasias are associated with cerebrovascular accidents involving which artery?
a. Anterior communicating
b. Posterior communicating
c. Circle of Willis
d. Middle cerebral

A

d. Middle cerebral

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29
Q

A healthcare professional reads in a patient’s chart that the patient shows behaviors suggestive of neurofibrillary tangles. What information does the healthcare professional plan to provide the spouse?
a. The patient will probably develop seizures.
b. The patient will lose all motor function.
c. The patient will have a gradual decline in function.
d. The patient’s intracranial pressure will rise.

A

c. The patient will have a gradual decline in function.

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30
Q

The body compensates for a rise in intracranial pressure by first displacing what?
a. Cerebrospinal fluid
b. Arterial blood
c. Venous blood
d. Cerebral cells

A

a. Cerebrospinal fluid

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31
Q

A patient is in the intensive care unit and has intercranial pressure (ICP) monitoring. The patient’s ICP is 17 mmHg. The healthcare professional notes that the chart indicates the patient is now in stage 1 intracranial hypertension. What assessment finding does the professional associate with this condition?
a. Rapid spike in measured ICP
b. No significant change in ICP readings
c. Restlessness and subtle breathing and pupil changes
d. A widened pulse pressure and bradycardia

A

b. No significant change in ICP readings

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32
Q

Dilation of the ipsilateral pupil following uncal herniation is the result of pressure on which cranial nerve (CN)?
a. Optic (CN I)
b. Abducens (CN VI)
c. Oculomotor (CN III)
d. Trochlear (CN IV)

A

c. Oculomotor (CN III)

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33
Q

To quickly assess a patient’s nervous system for dysfunction, what assessment should the healthcare professional perform as the priority?
a. Size and reactivity of pupils
b. Pattern of breathing
c. Motor response
d. Level of consciousness

A

d. Level of consciousness

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34
Q

What does diagnostic criteria for a persistent vegetative state include?
a. Absence of eye opening
b. Lack of subcortical responses to pain stimuli
c. Roving eye movements with visual tracking
d. Return of autonomic functions

A

d. Return of autonomic functions

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35
Q

When does uncal herniation occur?
a. The hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa.
b. The diencephalon shifts from the middle fossa straight downward through the tentorial notch into the posterior fossa.
c. The cingulate gyrus shifts under the falx cerebri.
d. A cerebellar tonsil shifts through the foramen magnum.

A

a. The hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa.

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36
Q

Which assessment finding marks the end of spinal shock?
a. Return of blood pressure and heart rate to normal
b. Gradual return of spinal reflexes
c. Return of bowel and bladder function
d. Evidence of diminished deep tendon reflexes and flaccid paralysis

A

b. Gradual return of spinal reflexes

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37
Q

A patient has finally been diagnosed with amyotrophic lateral sclerosis (ALS) after seeing several physicians. The patient expresses frustration that the diagnosis has taken so long. What
information can the healthcare professional give to the patient about this situation?
a. Many diseases cause weakness and fatigue.
b. Only upper motor neurons are involved.
c. Several nerves are connected to each muscle.
d. Lack of sensation makes it hard to describe.

A

c. Several nerves are connected to each muscle.

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38
Q

Parkinson disease is a degenerative disorder of which part of the brain?
a. Hypothalamus
b. Anterior pituitary
c. Frontal lobe
d. Basal ganglia

A

d. Basal ganglia

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39
Q

Clinical manifestations of Parkinson disease are caused by a deficit in which of the brain’s neurotransmitters?
a. Gamma-aminobutyric acid
b. Dopamine
c. Norepinephrine
d. Acetylcholine

A

b. Dopamine

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40
Q

What do diffuse axonal injuries (DAIs) of the brain often result in?
a. Reduced levels of consciousness
b. Mild but permanent dysfunction
c. Fine motor tremors
d. Visual disturbances

A

a. Reduced levels of consciousness

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41
Q

What event is most likely to occur when a person experiences a closed head injury?
a. Brief period of vital sign instability
b. Cerebral edema throughout the cerebral cortex
c. Cerebral edema throughout the diencephalon
d. Disruption of axons extending from the diencephalon and brainstem

A

a. Brief period of vital sign instability

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42
Q

A healthcare professional wants to volunteer for a community education project to help prevent spinal cord injury. What activity would the professional most likely volunteer for?
a. Teaching school aged children bicycle safety
b. Teaching stretching to high school athletes
c. Teaching adults good body mechanics for lifting
d. Teaching older adults how to prevent trip-and-fall events

A

d. Teaching older adults how to prevent trip-and-fall events

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43
Q

A patient has a spinal cord injury at C4. What should the healthcare professional assess as the priority in this patient?
a. Blood pressure
b. Respirations
c. Pulse
d. Temperature

A

b. Respirations

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44
Q

What indicates that spinal shock is terminating?
a. Voluntary movement below the level of injury
b. Reflex emptying of the bladder
c. Paresthesia below the level of injury
d. Decreased deep tendon reflexes and flaccid paralysis

A

b. Reflex emptying of the bladder

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45
Q

A healthcare professional is caring for a patient who has a spinal cord injury at T5. The patient exhibits severe hypertension, a heart rate of 32 beats/min, and sweating above the spinal cord lesion. How does the professional chart this event?
a. Craniosacral dysreflexia
b. Parasympathetic dysreflexia
c. Autonomic hyperreflexia
d. Retrograde hyperreflexia

A

c. Autonomic hyperreflexia

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46
Q

Why does a person who has a spinal cord injury experience faulty control of sweating?
a. The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.
b. The thalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.
c. The hypothalamus is unable to regulate body heat as a result of damage to the parasympathetic nervous system.
d. The thalamus is unable to regulate body heat as a result of damage to spinal nerve roots.

A

a. The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.

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47
Q

Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what?
a. Sympathetic nervous system to -adrenergic receptors to the sinoatrial node
b. Carotid sinus to the vagus nerve to the sinoatrial node
c. Parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
d. Bundle branches to the -adrenergic receptors to the sinoatrial node

A

b. Carotid sinus to the vagus nerve to the sinoatrial node

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48
Q

A herniation of which disk will likely result in motor and sensory changes of the lateral lower legs and soles of the feet?
a. L2 to L3
b. L3 to L5
c. L5 to S1
d. S2 to S3

A

c. L5 to S1

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49
Q

A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?
a. Insulin-resistant diabetes mellitus
b. Hypertension
c. Polycythemia
d. Smoking

A

b. Hypertension

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50
Q

A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. Which cerebral artery is most likely affected by the emboli?
a. Middle cerebral
b. Vertebral
c. Posterior cerebral
d. Anterior cerebral

A

d. Anterior cerebral

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51
Q

Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
a. Hemorrhagic
b. Thrombotic
c. Embolic
d. Lacunar

A

c. Embolic

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52
Q

Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?
a. Embolic
b. Hemorrhagic
c. Lacunar
d. Thrombotic

A

c. Lacunar

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53
Q

Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?
a. Cavernous angioma
b. Capillary telangiectasia
c. Arteriovenous angioma
d. Arteriovenous malformation

A

d. Arteriovenous malformation

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54
Q

Which clinical finding is considered a diagnostic indicator for an arteriovenous malformation (AVM)?
a. Systolic bruit over the carotid artery
b. Decreased level of consciousness
c. Hypertension with bradycardia
d. Diastolic bruit over the temporal artery

A

a. Systolic bruit over the carotid artery

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55
Q

Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
a. Intracranial
b. Subarachnoid
c. Epidural
d. Subdural

A

b. Subarachnoid

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56
Q

In adults, how are most intracranial tumors located?
a. Infratentorially
b. Supratentorially
c. Laterally
d. Posterolaterally

A

b. Supratentorially

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57
Q

In children, how are most intracranial tumors located?
a. Infratentorially
b. Supratentorially
c. Laterally
d. Posterolaterally

A

a. Infratentorially

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58
Q

What is the most common primary central nervous system (CNS) tumor?
a. Microglioma
b. Neuroblastoma
c. Astrocytoma
d. Neuroma

A

c. Astrocytoma

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59
Q

A person has been diagnosed with multiple sclerosis and asks the healthcare professional to explain the disease. What description by the professional is most accurate?
a. Myelination of nerve fibers in the peripheral nervous system (PNS)
b. Demyelination of nerve fibers in the CNS
c. Development of neurofibrillary tangles in the CNS
d. Inherited autosomal dominant trait with high penetrance

A

b. Demyelination of nerve fibers in the CNS

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60
Q

A blunt-force injury to the forehead would result in a coup injury to which region of the brain?
a. Frontal
b. Temporal
c. Parietal
d. Occipital

A

a. Frontal

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61
Q

A blunt-force injury to the forehead would result in a contrecoup injury to which region of the brain?
a. Frontal
b. Temporal
c. Parietal
d. Occipital

A

d. Occipital

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62
Q

Spinal cord injuries occur most frequently in which region?
a. Cervical and thoracic
b. Thoracic and lumbar
c. Lumbar and sacral
d. Cervical and thoracic lumbar

A

d. Cervical and thoracic lumbar

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63
Q

A patient who sustained a cervical spinal cord injury 2 days ago suddenly develops severe headache and blurred vision. What should the healthcare professional do?
a. Give the patient a glass of cool water.
b. Give the patient some pain medication.
c. Take the patient’s blood pressure and pulse.
d. Facilitate the patient having a head CT scan.

A

c. Take the patient’s blood pressure and pulse.

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64
Q

What is the type of vascular malformation that most often results in hemorrhage?
a. Cavernous angioma
b. Venous angioma
c. Capillary telangiectasia
d. Arteriovenous malformation

A

d. Arteriovenous malformation

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65
Q

Where are atheromatous plaques most commonly found?
a. In larger veins
b. Near capillary sphincters
c. At branches of arteries
d. On the venous sinuses

A

c. At branches of arteries

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66
Q

A patient has AIDS and reports fever, clumsiness, difficulty with balance and walking, and trouble speaking. What treatment does the healthcare professional educate the patient about?
a. Radiation therapy
b. Chemotherapy
c. Oral pyrimethamine
d. Surgery

A

c. Oral pyrimethamine

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67
Q

A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the healthcare professional is best?
a. It is often preceded by a viral illness.
b. It is due to a genetic defect in acetylcholine.
c. It could be caused by a brain tumor.
d. It is often transmitted by family pets.

A

a. It is often preceded by a viral illness.

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68
Q

In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors?
a. Guillain-Barré syndrome
b. Multiple sclerosis
c. Myasthenia gravis
d. Parkinson disease

A

c. Myasthenia gravis

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69
Q

Multiple sclerosis and Guillain-Barré syndrome are similar in that they both do what?
a. Result from demyelination by an immune reaction.
b. Cause permanent destruction of peripheral nerves.
c. Result from inadequate production of neurotransmitters.
d. Block acetylcholine receptor sites at the myoneuronal junction.

A

a. Result from demyelination by an immune reaction.

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70
Q

Which would be considered a positive symptom of schizophrenia?
a. Blunted affect
b. Auditory hallucinations
c. Poverty of speech
d. Lack of social interaction

A

b. Auditory hallucinations

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71
Q

A healthcare professional is seeing a patient with suspected schizophrenia. For which prenatal occurrence should the professional assess?
a. Viral infection
b. Maternal depression
c. Maternal smoking
d. Exposure to toxic waste

A

a. Viral infection

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72
Q

Which neurotransmitter is reduced in people with schizophrenia?
a. Dopamine
b. Gamma-aminobutyric acid
c. Acetylcholine
d. Serotonin

A

b. Gamma-aminobutyric acid

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73
Q

A patient has positive signs of schizophrenia and is scheduled for a brain scan. What part of the brain does the healthcare professional expect the scan will focus on?
a. Parietal lobe
b. Limbic system
c. Temporal lobe
d. Hypothalamus

A

c. Temporal lobe

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74
Q

A patient has started on clozapine. The healthcare professional educates the patient that this drug blocks which neurotransmitter receptor?
a. Norepinephrine
b. Gamma-aminobutyric acid
c. Serotonin
d. Dopamine

A

d. Dopamine

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75
Q

Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with what?

A

b. Major depression

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76
Q

The common property among the three types of medications used to treat depression is that they do what?
a. Increase neurotransmitter levels within the synapse
b. Increase neurotransmitter levels in the presynapse
c. Decrease neurotransmitter levels in the postsynapse
d. Decrease neurotransmitter levels within the synapse

A

a. Increase neurotransmitter levels within the synapse

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77
Q

A decrease in receptor binding for which neurotransmitter is found in individuals with depression?
a. Norepinephrine
b. Serotonin
c. Dopamine
d. Acetylcholine

A

b. Serotonin

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78
Q

A severely depressed patient has been taking venlafaxine but is now pregnant and asks the healthcare professional what treatment options are available for her. What therapy does the
professional discuss as a first choice?
a. Electroconvulsive therapy (ECT)
b. Switch to haloperidol
c. Intensive psychotherapy until the baby is weaned
d. Limit zinc and magnesium in the diet

A

a. Electroconvulsive therapy (ECT)

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79
Q

A patient has been diagnosed with lithium toxicity. Which electrolyte imbalance does the healthcare professional correlate with this condition?
a. Hypernatremia
b. Hyponatremia
c. Hyperkalemia
d. Hypokalemia

A

b. Hyponatremia

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80
Q

A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months?
a. 3
b. 6
c. 9
d. 12

A

b. 6

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81
Q

A patient is taking phenelzine and presents to the clinic complaining of “feeling awful.” The patient reports eating aged cheese and avocados last night. What assessment by the healthcare professional is the priority?
a. Kidney function studies
b. Blood pressure
c. Chest x-ray
d. Weight

A

b. Blood pressure

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82
Q

What is a notable complication of panic disorder?
a. Avolition
b. Anhedonia
c. Alogia
d. Agoraphobia

A

d. Agoraphobia

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83
Q

A patient reports frequent nightmares. For which of these should the healthcare professional assess the patient?
a. A recent major loss
b. Family history of nightmares
c. History of traumatic event
d. Poor nutrition and weight loss

A

c. History of traumatic event

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84
Q

The neural groove closes dorsally during which week of gestational life?
a. Second
b. Fourth
c. Eighth
d. Twelfth

A

b. Fourth

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85
Q

A healthcare professional advises a pregnant woman to add supplements of which nutrient to her diet to prevent birth defects?
a. Iron
b. Vitamin C
c. Zinc
d. Folate

A

d. Folate

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86
Q

Which defect of neural tube closure is most common?
a. Anterior
b. Posterior
c. Lateral
d. Midline

A

b. Posterior

87
Q

What is the anomaly in which the soft bony component of the skull and much of the brain is missing?
a. Anencephaly
b. Myelodysplasia
c. Cranial meningocele
d. Hydrocephaly

A

a. Anencephaly

88
Q

What is the most common cause of obstructive hydrocephalus in infants?
a. Obstructed arachnoid villi
b. Stenosis of the aqueduct of Sylvius
c. Excessive production of cerebrospinal fluid
d. Impaired cerebrospinal fluid circulation in the subarachnoid space

A

b. Stenosis of the aqueduct of Sylvius

89
Q

Which defect of neural tube closure is most common?
a. Anterior
b. Posterior
c. Lateral
d. Midline

A

b. Posterior

90
Q

What is the result of a Chiari type II malformation associated with a myelomeningocele?
a. Upward displacement of the cerebellum into the diencephalon
b. Motor and sensory lesions below the level of the myelomeningocele
c. Downward displacement of the cerebellum, brainstem, and fourth ventricle
d. Generalized cerebral edema and hydrocephalus

A

c. Downward displacement of the cerebellum, brainstem, and fourth ventricle

91
Q

A baby is born with a myelomeningocele and needs urgent surgery to repair the defect. The parents want to take the baby home instead. What does the healthcare professional tell the parents about the purpose of this surgery?
a. “Surgery is much easier on a tiny infant than on a larger, older baby.”
b. “If your baby has surgery this young, he/she cannot feel pain.”
c. “Additional nervous system damage will occur the longer we wait.”
d. “Prompt surgery is needed to prevent total paralysis later on.”

A

c. “Additional nervous system damage will occur the longer we wait.”

92
Q

Gait disturbances and instability are characteristic of which form of cerebral palsy?
a. Spastic
b. Dystonic
c. Ataxic
d. Biochemical

A

c. Ataxic

93
Q

A healthcare professional teaches a parenting class that benign febrile seizures are characterized by what?
a. A temperature higher than 38.5C (101.3F)
b. Concurrent respiratory or ear infections
c. Onset after the fifth year of life
d. Episodes lasting 30 min or longer

A

b. Concurrent respiratory or ear infections

94
Q

A pregnant woman is seen for the first time at 6 months’ gestation and has not taken prenatal vitamins. The healthcare professional educates the woman on the need for a blood test
specifically to assess what substance?
a. Total protein
b. Culture
c. alpha-Fetoprotein
d. C-reactive protein

A

c. alpha-Fetoprotein

95
Q

The clinical manifestations of dyskinetic cerebral palsy include what?
a. Increased muscle tone and prolonged primitive reflexes
b. Exaggerated deep tendon reflexes, clonus, and rigidity of extremities
c. Scoliosis, contractures, and stiffness of trunk muscles
d. Jerky uncontrolled and abrupt fine musculoskeletal movements

A

d. Jerky uncontrolled and abrupt fine musculoskeletal movements

96
Q

What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?
a. Nasal turbinates
b. Alveolar macrophages
c. Cilia
d. Irritant receptors on the nares

A

c. Cilia

97
Q

Which term is used to identify the movement of gas and air into and out of the lungs?
a. Perfusion
b. Ventilation
c. Respiration
d. Diffusion

A

b. Ventilation

98
Q

When an individual aspirates food particles, where would the healthcare professional expect to hear decreased or absent breath sounds?
a. Left lung
b. Right lung
c. Trachea
d. Carina

A

b. Right lung

99
Q

Air passage among alveoli is collateral and evenly distributed because of the function of which structures?
a. Type I alveolar cells
b. Pores of Kohn
c. Acinus pores
d. Alveolar pores

A

b. Pores of Kohn

100
Q

Where in the lung does gas exchange occur?
a. Trachea
b. Segmental bronchi
c. Alveolocapillary membrane
d. Main bronchus

A

c. Alveolocapillary membrane

101
Q

Surfactant produced by type II alveolar cells facilitates alveolar distention and ventilation by which mechanism?
a. Decreasing thoracic compliance
b. Attracting water to the alveolar surface
c. Decreasing surface tension in the alveoli
d. Increasing surface tension in the alveoli

A

c. Decreasing surface tension in the alveoli

102
Q

Which part of the brainstem provides basic automatic rhythm of respiration by sending efferent impulses to the diaphragm and intercostal muscles?
a. Dorsal respiratory group (DRG)
b. Ventral respiratory group (VRG)
c. Pneumotaxic center
d. Apneustic center

A

b. Ventral respiratory group (VRG)

103
Q

Which structures secrete surfactant?
a. Type I alveolar cells
b. Type II alveolar cells
c. Alveolar macrophages
d. Stretch receptors

A

b. Type II alveolar cells

104
Q

Which describes the pressure in the pleural space?
a. Atmospheric
b. Below atmospheric
c. Above atmospheric
d. Variable

A

b. Below atmospheric

105
Q

A healthcare professional wants to determine the adequacy of a person’s alveolar ventilation. What assessment finding is most important for the professional to consider?
a. Respiratory rate of 12 breaths/min
b. Ventilatory pattern is regular and rhythmic.
c. Respiratory effort is strained with muscle involvement.
d. Arterial blood gas shows a PaCO2 of 44 mmHg.

A

d. Arterial blood gas shows a PaCO2 of 44 mmHg.

106
Q

Which normal physiologic change occurs in the aging pulmonary system?
a. Decreased flow resistance
b. Fewer alveoli
c. Stiffening of the chest wall
d. Improved elastic recoil

A

c. Stiffening of the chest wall

107
Q

How is most of the oxygen in the blood transported?
a. Dissolved in plasma
b. Bound to hemoglobin
c. In the form of carbon dioxide (CO2)
d. Bound to protein

A

b. Bound to hemoglobin

108
Q

Stretch receptors and peripheral chemoreceptors send afferent impulses regarding ventilation to which location in the brain?
a. Pneumotaxic center in the pons
b. Apneustic center in the pons
c. Dorsal respiratory group (DRG) in the medulla oblongata
d. Ventral respiratory group (VRG) in the medulla oblongata

A

c. Dorsal respiratory group (DRG) in the medulla oblongata

109
Q

If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to react in which manner?
a. Shift to the right, causing more oxygen (O2) to be released to the cells
b. Shift to the left, allowing less O2 to be released to the cells
c. Show no change, allowing the O2 concentration to remain stable
d. Show dramatic fluctuation, allowing the O2 concentration to increase

A

a. Shift to the right, causing more oxygen (O2) to be released to the cells

110
Q

The sternocleidomastoid and scalene muscles are referred to as which group?
a. Diaphragmatic muscles
b. Muscles of expiration
c. Intercostal muscles
d. Accessory muscles of inspiration

A

d. Accessory muscles of inspiration

111
Q

The lung is innervated by the parasympathetic nervous system via which nerve?
a. Vagus
b. Phrenic
c. Brachial
d. Pectoral

A

a. Vagus

112
Q

What event is characteristic of the function in Zone 1 of the lung?
a. Blood flow through the pulmonary capillary bed increases in regular increments.
b. Alveolar pressure is lesser than venous and arterial pressures.
c. The capillary bed collapses, and normal blood flow ceases.
d. Blood flows through Zone 1, but it is impeded by alveolar pressure.

A

c. The capillary bed collapses, and normal blood flow ceases.

113
Q

Hypoventilation that results in the retention of carbon dioxide will stimulate which receptors in an attempt to maintain a normal homeostatic state?
a. Irritant receptors
b. Central chemoreceptors
c. Peripheral chemoreceptors
d. Stretch receptors

A

b. Central chemoreceptors

114
Q

What is the most important cause of pulmonary artery constriction?
a. Low alveolar partial pressure of arterial oxygen (PaO2)
b. Hyperventilation
c. Respiratory alkalosis
d. Epinephrine

A

a. Low alveolar partial pressure of arterial oxygen (PaO2)

115
Q

A healthcare professional tells the student that a properly placed endotracheal tube for mechanical ventilation is 5 to 7 cm above the tracheal bifurcation. Where does this bifurcation occur?
a. Larynx
b. Bronchi
c. Carina
d. Nasopharynx

A

c. Carina

116
Q

How low must the partial pressure of arterial oxygen (PaO2) drop before the peripheral chemoreceptors influence ventilation?
a. Below 100 mmHg
b. Below 80 mmHg
c. Below 70 mmHg
d. Below 60 mmHg

A

d. Below 60 mmHg

117
Q

Which receptors are located in the smooth muscles of airways?
a. Central chemoreceptors
b. Stretch receptors
c. Peripheral chemoreceptors
d. J-receptors

A

b. Stretch receptors

118
Q

Which receptors are located near the respiratory center?
a. Peripheral chemoreceptors
b. Stretch receptors
c. Central chemoreceptors
d. J-receptors

A

c. Central chemoreceptors

119
Q

Which receptors are located in the aortic bodies, aortic arch, and carotid bodies?
a. Central chemoreceptors
b. Stretch receptors
c. J-receptors
d. Peripheral chemoreceptors

A

d. Peripheral chemoreceptors

120
Q

Besides dyspnea, what is the most common characteristic associated with pulmonary disease?
a. Chest pain
b. Digit clubbing
c. Cough
d. Hemoptysis

A

c. Cough

121
Q

A patient reports needing to sit up at night in order to breathe. What term does the healthcare professional document about this condition?
a. Hyperpnea
b. Orthopnea
c. Apnea
d. Atelectasis

A

b. Orthopnea

122
Q

Kussmaul respirations as a respiratory pattern may be associated with which characteristic(s)?
a. Alternating periods of deep and shallow breathing
b. Increased work of breathing
c. Inadequate alveolar ventilation in relation to metabolic demands
d. Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

A

d. Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause

123
Q

Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
a. Decreased blood flow to the medulla oblongata
b. Increased partial pressure of arterial carbon dioxide (PaCO2)
c. Stimulation of stretch or J-receptors
d. Fatigue of the intercostal muscles and diaphragm

A

a. Decreased blood flow to the medulla oblongata

124
Q

A hospitalized patient is complaining of shortness of breath, but the student does not notice cyanosis. The patient’s hemoglobin is 9 g/dL, so the student asks the healthcare professional to
explain. The professional tells the student that what amount of hemoglobin must be desaturated before cyanosis occurs?
a. 3
b. 5
c. 7
d. 9

A

b. 5

125
Q

What does the student learn about ventilation?
a. Hypoventilation causes hypocapnia.
b. Hypoventilation causes alkalosis.
c. Hyperventilation causes hypocapnia.
d. Hyperventilation causes acidosis.

A

c. Hyperventilation causes hypocapnia.

126
Q

A patient has long-standing pulmonary disease and chronic hypoxia. The student assesses the patient’s fingertips and notices bulbous enlargement of the distal segment of the digits. How does the student document this finding?
a. Edema
b. Clubbing
c. Angling
d. Osteoarthropathy

A

b. Clubbing

127
Q

The student asks the healthcare professional to explain how pulmonary edema and pulmonary fibrosis cause hypoxemia. What description by the professional is best?
a. Creates alveolar dead space
b. Decreases the oxygen in inspired gas
c. Creates a right-to-left shunt
d. Impairs alveolocapillary membrane diffusion

A

d. Impairs alveolocapillary membrane diffusion

128
Q

High altitudes may produce hypoxemia through which mechanism?
a. Shunting
b. Hypoventilation
c. Decreased inspired oxygen
d. Diffusion abnormalities

A

c. Decreased inspired oxygen

129
Q

Which condition is capable of producing alveolar dead space?
a. Pulmonary edema
b. Pulmonary emboli
c. Atelectasis
d. Pneumonia

A

b. Pulmonary emboli

130
Q

A patient has pulmonary edema. For what condition should the healthcare professional assess the patient as the priority?
a. Right-sided heart failure
b. Left-sided heart failure
c. Mitral valve prolapse
d. Aortic stenosis

A

b. Left-sided heart failure

131
Q

A patient has a lung problem caused by dysfunction in the pores of Kohn. What action by the healthcare professional is best?
a. Have the patient drink plenty of water.
b. Give the patient supplemental oxygen.
c. Have the patient do breathing exercises.
d. Withhold pain medicine so the patient stays awake.

A

c. Have the patient do breathing exercises.

132
Q

A patient has a pulmonary capillary wedge pressure of 30mmHg. What assessment finding by the healthcare professional would be most consistent with this reading?
a. Normal lung sounds
b. Pink, frothy sputum
c. Eupnea
d. Rhonchi

A

b. Pink, frothy sputum

133
Q

In what form of bronchiectasis do both constrictions and dilations deform the bronchi?
a. Varicose
b. Symmetric
c. Cylindric
d. Saccular

A

a. Varicose

134
Q

A patient is brought to the Emergency Department with a gunshot wound to the chest. The healthcare professional assesses an abnormality involving a pleural rupture that acts as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration. What action by the healthcare professional is the priority?
a. Draw arterial blood gasses.
b. Assist with a chest tube insertion.
c. Give the patient low-flow oxygen.
d. Assess for clubbing of fingernails.

A

b. Assist with a chest tube insertion.

135
Q

A patient has a transudative pleural effusion but has minimal symptoms. What action by the healthcare professional is best?
a. Prepare for an immediate chest tube insertion.
b. Encourage the patient to use the incentive spirometer.
c. Facilitate a blood draw to check protein stores.
d. Arrange for an oncology consultation.

A

c. Facilitate a blood draw to check protein stores.

136
Q

Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung’s alveolar walls?
a. Transudative effusion
b. Emphysema
c. Exudative effusion
d. Abscess

A

b. Emphysema

136
Q

A patient has been diagnosed with pneumoconiosis and asks the healthcare professional to explain this disease. What description by the professional is best?
a. Pneumococci bacteria
b. Inhalation of inorganic dust particles
c. Exposure to asbestos
d. Inhalation of cigarette smoke

A

b. Inhalation of inorganic dust particles

137
Q

A patient has been diagnosed with acute respiratory distress syndrome (ARDS). For what other health condition should the healthcare professional assess this patient for as the priority?
a. Heart failure
b. Pneumonia
c. Pulmonary emboli
d. Acute pulmonary edema

A

b. Pneumonia

138
Q

Which structure(s) in acute respiratory distress syndrome (ARDS) release inflammatory mediators such as proteolytic enzymes, oxygen-free radicals, prostaglandins, leukotrienes, and platelet-activating factor?
a. Complement cascade
b. Mast cells
c. Macrophages
d. Neutrophils

A

d. Neutrophils

139
Q

Pulmonary edema in acute respiratory distress syndrome (ARDS) is the result of an increase in what?
a. Levels of serum sodium and water
b. Capillary permeability
c. Capillary hydrostatic pressure
d. Oncotic pressure

A

b. Capillary permeability

140
Q

In acute respiratory distress syndrome (ARDS), alveoli and respiratory bronchioles fill with fluid as a result of which mechanism?
a. Compression on the pores of Kohn, thus preventing collateral ventilation
b. Increased capillary permeability, which causes alveoli to fill with fluid
c. Inactivation of surfactant and the impairment of type II alveolar cells
d. Increased capillary hydrostatic pressure that forces fluid into the alveoli

A

c. Inactivation of surfactant and the impairment of type II alveolar cells

141
Q

Which type of pulmonary disease requires more force to expire a volume of air?
a. Restrictive
b. Obstructive
c. Acute
d. Communicable

A

b. Obstructive

142
Q

Which immunoglobulin (Ig) may contribute to the pathophysiologic characteristics of asthma?
a. IgA
b. IgE
c. IgG
d. IgM

A

b. IgE

143
Q

A patient comes to the Emergency Department with inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea. What treatment does the healthcare professional anticipate for this patient as the priority?
a. Sputum culture
b. History of illness exposure
c. Antibiotics
d. Inhaled bronchodilator

A

d. Inhaled bronchodilator

144
Q

A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action?
a. Avoidance of the causative agent
b. Administration of broad-spectrum antibiotics
c. Administration of drugs that reduce bronchospasm
d. Administration of drugs that decrease airway inflammation

A

a. Avoidance of the causative agent

145
Q

Which factor contributes to the production of mucus associated with chronic bronchitis?
a. Airway injury
b. Pulmonary infection
c. Increased Goblet cell size
d. Bronchospasms

A

c. Increased Goblet cell size

146
Q

A patient with emphysema comes to the clinic and reports increased, productive cough. What diagnostic test should the healthcare professional facilitate as the priority?
a. Chest x-ray
b. Peak expiratory flow
c. Pulmonary function tests
d. Sputum culture

A

a. Chest x-ray

147
Q

A patient has been diagnosed with primary emphysema but claims there is no history of smoking. What action by the healthcare professional is most appropriate?
a. Facilitate genetic testing on the patient.
b. Ask the family if the patient smokes.
c. Schedule pulmonary function studies.
d. Get baseline arterial blood gasses.

A

a. Facilitate genetic testing on the patient.

148
Q

Which of these is the most common route of lower respiratory tract infection?
a. Aspiration of oropharyngeal secretions
b. Inhalation of microorganisms
c. Microorganisms spread to the lung via blood
d. Poor mucous membrane protection

A

a. Aspiration of oropharyngeal secretions

149
Q

A patient has recently been diagnosed with emphysema. What initial step in management of this disease does the healthcare professional discuss with the patient?
a. Inhaled anticholinergic agents
b. Beta agonists
c. Cessation of smoking
d. Surgical reduction of lung volume

A

c. Cessation of smoking

150
Q

The student asks a professor to explain how tuberculosis (TB) can remain dormant in some people. What explanation by the professor is best?
a. It does not remain dormant but some host defenses can kill the bacteria.
b. The bacilli can become isolated within tubercles in the lungs.
c. Macrophages attack and phagocytize new areas of infection.
d. Virulence factors in the bacilli weaken over time leading to apoptosis.

A

b. The bacilli can become isolated within tubercles in the lungs.

151
Q

Squamous cell carcinoma of the lung is best described as a tumor that causes which alterations?
a. Abscesses and ectopic hormone production
b. Pneumonia and atelectasis
c. Pleural effusion and shortness of breath
d. Chest wall pain and early metastasis

A

b. Pneumonia and atelectasis

152
Q

A patient has been diagnosed with an empyema. What does the healthcare professional tell the patient about this condition?
a. We will have to drain the pus out of your pleural space.
b. You will be given a long course of antiviral medication.
c. These blebs in your lungs can rupture with exercise.
d. We will watch you for respiratory muscle fatigue.

A

a. We will have to drain the pus out of your pleural space.

153
Q

A patient has silicosis. Which medication classification does the healthcare professional educate
the patient about?
a. Corticosteroids
b. Antibiotics
c. Bronchodilators
d. Expectorants

A

a. Corticosteroids

154
Q

What medical term is used for a condition that results from pulmonary hypertension, creating chronic pressure overload in the right ventricle?
a. Hypoxemia
b. Hypoxia
c. Bronchiectasis
d. Cor pulmonale

A

d. Cor pulmonale

155
Q

Why is nasal congestion a serious threat to young infants?
a. Infants are obligatory nose breathers.
b. Their nares are small in diameter.
c. Infants become dehydrated when mouth breathing.
d. Their epiglottis is proportionally greater than the epiglottis of an adult’s.

A

a. Infants are obligatory nose breathers.

156
Q

The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?
a. 16 and 20
b. 20 and 24
c. 24 and 30
d. 30 and 36

A

d. 30 and 36

157
Q

A healthcare professional is educating a community parent group and informs them that which type of croup is most common?
a. Bacterial
b. Viral
c. Fungal
d. Autoimmune

A

b. Viral

158
Q

What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
a. Immature immune system
b. Small alveoli
c. Surfactant deficiency
d. Anemia

A

c. Surfactant deficiency

159
Q

What is the primary problem resulting from respiratory distress syndrome (RDS) of the newborn?
a. Consolidation
b. Pulmonary edema
c. Atelectasis
d. Bronchiolar plugging

A

c. Atelectasis

160
Q

Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?
a. Respiratory syncytial virus (RSV)
b. Influenza virus
c. Adenoviruses
d. Rhinovirus

A

a. Respiratory syncytial virus (RSV)

161
Q

Which immunoglobulin (Ig) is present in childhood asthma?
a. IgM
b. IgG
c. IgE
d. IgA

A

c. IgE

162
Q

Which T-lymphocyte phenotype is the key determinant of childhood allergic asthma?
a. Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes
b. CD4 T-helper Th2 lymphocytes
c. CD8 cytotoxic T lymphocytes
d. Memory T lymphocytes

A

b. CD4 T-helper Th2 lymphocytes

163
Q

Which statement by the healthcare professional accurately describes childhood asthma?

a. An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
b. A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
c. A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens
d. An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

A

a. An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation

164
Q

A 7 year-old-child presents to the clinic where parents report signs and symptoms consistent with asthma. What does the healthcare professional do in order to confirm this diagnosis?
a. Assess for a parental history of asthma
b. Draw serum levels of immunoglobulin E (IgE) and eosinophil levels
c. Measure expiratory flow rate with spirometry testing
d. Give a trial of asthma medication and check for improvement

A

c. Measure expiratory flow rate with spirometry testing

165
Q

When assessing for the signs and symptoms of acute respiratory distress syndrome (ARDS), the absence of which condition is considered characteristic?
a. Progressive respiratory distress
b. Bilateral infiltrates
c. Decreased pulmonary compliance
d. Heart failure

A

d. Heart failure

166
Q

Which statement best describes cystic fibrosis?

a. Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
b. Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
c. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
d. Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

A

c. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens

167
Q

Parents of a child with cystic fibrosis want to know the chance of their next baby having this disease. What response by the healthcare professional is most accurate?
a. Each child will have a 25% chance of having the disease.
b. None of your male children will inherit this disease.
c. All of your children will probably be carriers.
d. There is no way to know because it is a random mutation.

A

a. Each child will have a 25% chance of having the disease.

168
Q

What abnormalities lead to the mucus plugging seen in children with cystic fibrosis (CF)?
a. Excess mucus plugs the gut and keeps it from absorbing water effectively.
b. A weak inflammatory response allows bacterial to colonize the mucus.
c. Defective chloride secretion and excess sodium absorption thicken the mucus.
d. Pulmonary vascular remodeling occurs that leads to chronic hypoxia.

A

c. Defective chloride secretion and excess sodium absorption thicken the mucus.

169
Q

Between which months of age does sudden infant death syndrome (SIDS) most often occur?
a. 0 and 1
b. 2 and 4
c. 5 and 6
d. 6 and 7

A

b. 2 and 4

170
Q

What is the most common predisposing factor to obstructive sleep apnea in children?
a. Chronic respiratory infections
b. Adenotonsillar hypertrophy
c. Obligatory mouth breathing
d. Paradoxical breathing

A

b. Adenotonsillar hypertrophy

171
Q

Which antidepressant class should not be used in patients with uncontrolled narrow angle glaucoma due to anticholinergic side effects?

A

SNRI
-Duloxetine (Cymbalta)
- Milnacipran (Savella)
- Levomilnacipran (Fetzima)

172
Q

What is a significant issue of enhanced bleeding of both SSRI and SNRI when taken with ___, ____, _____ medications?

A

Aspirin
NSAIDS
Coumadin

173
Q

Which antidepressant class cannot be given with clomipramine (SSRI) or narcotics (meperidine) due to risk for serotonin syndrome?

A

MAOI

174
Q

Which antidepressant can cause seizures at high doses and should be avoided in patients with high risk of siezures?

A

Bupropion (Wellbutrin)
it is an MAOI

175
Q

Which antidepressant can cause dose dependent increase in diastolic blood pressure at high doses?

A

Venlafaxine (Effexor)

176
Q

Which two Antidepressant drug classes can never be given together due to risk for HTN crisis, tachycardia, and seizures?

A

MAOI and TCA

177
Q

Which antidepressant class has a severe interaction with tyramine containing foods leading to HTN crisis?

A

MAOI

no smoked or aged meats, cheeses, bananas, avocados, chocolate

178
Q

What is the main drug treatment for Mania?

A

Lithium

179
Q

This drug is taken up through Na channels and increases the reuptake of Norepi and inhibits the release of norepi and serotonin
-Inhibits adenylate cyclase
- Increases GABA
- Increases duration of skeletal muscle relaxants

A

Lithium

180
Q

What is the effective therapeutic level of lithium?

A

1.0 Meq/l

181
Q

What is the toxic level of lithium?

At what level does pt become hypotensive, arrhythmias and seizure?

A

1.5 Meq/l toxic

2.0 Meq/l BAD

182
Q

What are positive symptoms of Schizophrenia?

A

Delusions
Hallucinations (Auditory)

183
Q

Winter births are a risk factor for which disease?

A

Schizophrenia

184
Q

The use of Droperidol (Haldol)- butyrophenones and Fentanyl (opioid) is used for this type of anesthesia?

A

Neuroleptic anesthesia

185
Q

A partial seizure in which the patient maintains consciousness during that seizure is called what?

A

Simple seizure

186
Q

A partial seizure in which the patient losses consciousness or awareness is called what?

A

Complex seizure

187
Q

Carbamazepine, Phenytoin, Lamotrigine, and Valrpate are ____ medications that work by altering ____?

A

Antiepileptic meds

Inactivate Na channels

188
Q

Valproate, Ethosuximide are ____ medications that work by altering ____?

A

Antiepileptic meds

Inactivate Ca channels

189
Q

Which antiepileptic is used to treat trigeminal and glossopharyngeal neuralgias.
- manage pain with MS
- Major side effect of Aplastic Anemia and Agranulocytosis

A

Carbamazepine (Tegretol)

190
Q

Which antiepileptic is a barbituate
- treats tonic clonic seizure and partial seizures
- increases synaptic inhibition of GABAa receptors
-Ca channel inhibition which decreases excitatory transmitter release

A

Phenobarbital (Luminal)

191
Q

Which antiepileptic is converted to an active metabolite that is equipotent to carbamazepine.
- used to treat epilepsy and anxiety
- synergistic with NMBA
-teratogenic

A

Oxcarbazepine (Trileptal)

192
Q

Which antiepileptic is a central agent in treating absence seizures?
- Major side effect is Steven Johnson syndrome, bone marrow depression and aplastic anemia.

A

Ethosuximide (Zarontin)

193
Q

Which 3 antiepileptics have a side effect of Steven Johnson syndrome?

A

Lamotrigine (Lamictal)
Ethosuximide (Zarontin)
Carbamazopine (Tegretol)

194
Q

Which antiepileptic is used to treat partial seizures and neuropathic pain?
- no major interactions
- no liver metabolism

A

Levetiracetam (Keppra)

195
Q

Best drug treatment for status epilepticus?
- Major side effect is respiratory depression and lethargy

A

Benzodiazepines
- Diazepam (Valium)

196
Q

Which antiepileptic is useful in treating myoclonic seizures in children and absence seizures?
- GABA increases Cl conductance.

A

Clonazepam (Klonopin)

197
Q

Which antiepileptic drug is effective in treating all types of seizures, EXCEPT absence seizures?
- Toxic effect include cardiac arrhythmias

A

Phenytoin (Dilantin)

198
Q

Whis antiepileptic drug is phenytoin produg and metabolized to formic acid?

A

Fosphenytoin (Cerebyx)

199
Q

Which antiepileptic drug is effective in treating partial and generalized seizures?
- Treats absence seizures
- metabolized by glucoronidation conjugation
- Major side effect is decreased clotting time and spontaneous bleeding when given with Aspirin, or warfarin.

A

Valproic Acid (Depakote)

200
Q

The use of which antiepileptic may Trigger seizures in non-epileptics?

A

Tiagabine (Gabitril)

201
Q

Which antiepileptic drug is effective in treating wide variety of seizures along with bulimia?
- Monosaccharide
- Major side effect is developing kidney stones

A

Topiramate (Topamax)

202
Q

Megaloblastic anemia, Osteomalacia, and Hypoprothrombinemia are major side effects of which 2 antiepileptics?

A

Primidone (mysoline) and
Phenobarbital (Luminal)

203
Q

With emphysema, large air spaces within the lung parenchyma are called what?
Bullae or Blebs

A

Bullae

204
Q

With emphysema, large air spaces adjacent to the pleurae are called what?
Bullae or Blebs

A

Blebs

205
Q

Are these Beta-2 agonists short or long acting?
-Albuterol
-Levalbuterol
-Metaproterenol

A

Short acting

206
Q

Are these Beta-2 agonists short or long acting?
-Formoterol
-Arformoterol
- Salmeterol

A

Long acting

207
Q

Are these Inhaled steroids or Systemic Steroids?
-Ciclesonide
-Mometasone
-Budesonide
-Fluticasone
-Beclomethasone

A

Inhaled Steroids

208
Q

Are these Inhaled steroids or Systemic Steroids?
-Methyprednisolone
-Prednisolone
-Prednisone
-Hydrocortisone

A

Systemic Steroids

209
Q

Which drug is a Methylxanthine that is structurally similar to caffeine and theobromine?
- Found in cocoa beans and tea
- Bronchodilor by inhibiting phosphodiesterase and increasing intracellular cAMP.

A

Theophylline

210
Q

Which drug is a PDE4 inhibitor that acts on airway smooth muscle?
- Less SE than Theophylline

A

Roflumilast (Daliresp)

211
Q

This drug inhibits the production of leukotrienes from arachadonic acid?
- May inhibit Warfarin metabolism and increase PTT
- SE is liver disease

A

5-Lipoxygenase Inhibitor

212
Q

This drug is a Mast cell stabilizer that blocks histamine, leukotriene and prostglandin release
- Blocks IgE trigger molecules on mast cells

A

Sodium Cromolyn

213
Q

This drug is a monoclonal antibody that binds to human IgE in blood and on surface of B lympcytes but NOT to IgE on mast cells.
- Treats severe asthma and chronic urticaria
- Cancer is possible side effect

A

Omalizumab (Xolair)

Ane Class Practice (24 decks)

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