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Ane Class Practice > Pathopharm Exam 4- S4 > Flashcards

Pathopharm Exam 4- S4 Flashcards

1
Q

Which clinical manifestation of septic shock confirms an elevation in immune system response?
a. Tachycardia
b. Increased white blood cell count
c. Low respiratory rate
d. Hypothermia

A

b. Increased white blood cell count

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1
Q

What is the final outcome of impaired cellular metabolism?
a. Cellular alterations in the heart and brain
b. Buildup of cellular waste products
c. Cellular alterations in the vasculature structures and kidneys
d. Impairment of urine excretion

A

b. Buildup of cellular waste products

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2
Q

The release of catecholamine by the adrenal glands provides which compensatory mechanism in hypovolemic shock?
a. Interstitial fluid moves out of the vascular compartment.
b. Systemic vascular resistance is decreased.
c. Heart rate is increased.
d. Water excretion is increased.

A

c. Heart rate is increased.

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3
Q

Hypovolemic shock begins to develop when intravascular volume has decreased by what percentage?
a. 5
b. 10
c. 15
d. 20

A

c. 15

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4
Q

A student asks the professor to explain the basics of vasogenic shock. What statement by the professor is best?
a. The outcome of widespread hypersensitivity to an allergen
b. Bacteremia combined with systemic inflammatory response
c. Inability to get adequate blood to tissues and end organs
d. Vasodilation from an imbalance between the two nervous systems

A

d. Vasodilation from an imbalance between the two nervous systems

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5
Q

What is the clinical hallmark of neurogenic shock as a result of the overstimulation of the parasympathetic nervous system?
a. Vasoconstriction
b. Vasodilation
c. Increased metabolism
d. Respiratory distress

A

b. Vasodilation

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6
Q

Four patients are in the intensive care unit with different types of shock. Which patient would the healthcare professional assess as the priority?
a. Septic
b. Hypovolemic
c. Anaphylactic
d. Neurogenic

A

c. Anaphylactic

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7
Q

A patient is diagnosed with septic shock. What action by the healthcare professional will address the main underlying pathophysiologic mechanism of this disorder?
a. Administer antibiotics as soon as possible.
b. Provide high volumes of isotonic fluid.
c. Place patient on an intra-aortic balloon pump.
d. Give the patient antihistamines and steroids.

A

a. Administer antibiotics as soon as possible.

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8
Q

For which type of shock would antihistamines and corticosteroids be prescribed?
a. Septic
b. Anaphylactic
c. Hypovolemic
d. Cardiogenic

A

b. Anaphylactic

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9
Q

Which condition is best defined as a clinical syndrome involving a systemic response to infection, which is manifested by two or more of the systemic inflammatory response syndrome
criteria?
a. Bacteremia
b. Sepsis
c. Septicemia
d. Septic shock

A

b. Sepsis

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10
Q

The student learns that which mechanism causes organ injury in primary multiple organ dysfunction syndrome (MODS)?
a. Impaired immune response
b. Impaired glucose use
c. Impaired perfusion
d. Impaired ventilation

A

c. Impaired perfusion

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11
Q

A student has studied secondary multiple organ dysfunction syndrome (MODS). What substance does the student learn is least likely to stimulate the normal endothelial cells to change to a proinflammatory state?
a. Interleukin (IL)-1
b. IL-4
c. IL 6
d. Tumor necrosis factor

A

b. IL-4

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12
Q

What stimulates the respiratory burst and production of highly toxic free radicals in the multiple organ dysfunction syndrome (MODS)?
a. Neutrophils adhering to the endothelium
b. Activation of the complement cascade
c. Release of prostaglandins, thromboxanes, and leukotrienes
d. Activation of the fibrinolytic system

A

a. Neutrophils adhering to the endothelium

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13
Q

A student is perplexed that in a patient with multiple organ dysfunction syndrome (MODS), no infectious source has been found. What statement by the healthcare professional best describes this phenomenon?
a. Death of organs
b. Translocation of bacteria
c. Maldistribution of blood flow
d. Massive inflammatory response

A

b. Translocation of bacteria

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14
Q

Blistering of the skin within minutes occurs in which type of burn injury?
a. First degree
b. Superficial partial thickness
c. Deep partial thickness
d. Full thickness

A

b. Superficial partial thickness

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15
Q

A patient has an acute burn injury. What type of treatment for shock will the healthcare professional anticipate for this patient?
a. Intravenous fluids
b. Antibiotics
c. Intra-aortic balloon pump
d. Antihistamines and steroids

A

a. Intravenous fluids

16
Q

What assessment finding would indicate to the healthcare professional that the patient is no longer in burn shock?
a. Blood pressure 100/58 mmHg
b. Pulse rate 98 beats/min
c. Respiratory rate 24 breaths/min
d. Urine output 35 mL/hour for 4 hours

A

d. Urine output 35 mL/hour for 4 hours

17
Q

Which condition does a burn injury create for an extended period?
a. Hypervolemia
b. Hypermetabolism
c. Hyponatremia
d. Hypotension

A

b. Hypermetabolism

18
Q

A student learns that a fatal burn injury has what effect on interleukins (ILs)?
a. Decreases levels of IL-2
b. Decreases levels of IL-4 lymphocytes
c. Increases levels of IL-6
d. Increases levels of IL-12

A

a. Decreases levels of IL-2

19
Q

Daily evaporative water loss after a burn injury is approximately how many times the normal?
a. 5
b. 10
c. 15
d. 20

A

d. 20

20
Q

What is the significance of a high level of interleukin 1 (IL-1) in a patient who has experienced severe burns?
a. Prognosis is poor.
b. Antibiotic therapy is required.
c. Urinary function is improved.
d. They are less at risk for death.

A

d. They are less at risk for death.

21
Q

What is the most common type of shock in children?
a. Hypovolemic
b. Cardiogenic
c. Neurogenic
d. Septic

A

a. Hypovolemic

22
Q

Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.
a. 2
b. 5
c. 7
d. 10

A

d. 10

23
Q

A healthcare professional assesses that a child’s capillary refill time is 4 sec. What does the healthcare professional evaluate that finding to mean?
a. The child is in shock.
b. The child must have septic shock.
c. The child has compensated shock.
d. This finding is normal.

A

a. The child is in shock.

24
Q

A 2-year-old is in shock. The healthcare professional assesses the child’s heart rate as 52 beats/min. What action by the healthcare professional is most appropriate?
a. Get an ECG.
b. Increase the intravenous rate.
c. Sedate the child.
d. Begin CPR.

A

d. Begin CPR.

25
Q

A child has a burn injury. What does the healthcare provider assess for when determining the child’s chance of surviving?
a. Immunosuppression
b. Hypermetabolism
c. Inhalation injury
d. Hypertrophic scarring

A

c. Inhalation injury

26
Q

A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and periorbital edema. What explanation by the healthcare professional is best?
a. Mass vasodilation as a result of chemical mediators released from the myocardium
b. Low cardiac output and systemic venous congestion
c. Tissue damage to the myocardium, causing increased capillary permeability
d. Reduced renal perfusion, stimulating the RAAS system

A

b. Low cardiac output and systemic venous congestion

27
Q

Approximately 80% of all hospital-acquired infections in children are a result of which type of organism?
a. Bacteria
b. Viruses
c. Fungi
d. Rickettsia

A

a. Bacteria

28
Q

A student asks the healthcare professional to explain reperfusion injuries. What explanation by the professional is best?
a. Tissue damage that can occur with blood transfusions
b. Tissue destruction during rewarming in frostbite
c. Damage from restored blood flow and exposure to oxygen
d. Fluid overload from intravenous therapy that is too rapid

A

c. Damage from restored blood flow and exposure to oxygen

29
Q

The healthcare professional plans care for a child in shock. What are the primary goals for the treatment of shock?
a. Maximizing oxygen delivery and minimizing oxygen demand
b. Maintaining hydration and adequate urinary output
c. Supporting all facets of the cardiovascular system
d. Maintaining all vital signs within normal functioning ranges

A

a. Maximizing oxygen delivery and minimizing oxygen demand

30
Q

To determine a child’s response to fluid therapy for shock, the healthcare professional should monitor which measurements as the priority?
a. Hematocrit and hemoglobin levels
b. Urine output and specific gravity
c. Blood pressure and pulse
d. Arterial blood gases and heart rate

A

b. Urine output and specific gravity

31
Q

A 33-pound child is in shock. Which fluid bolus should the healthcare professional prepare to administer to this child?
a. Hypotonic fluid, 150 mL
b. Hypotonic fluid, 300 mL
c. Isotonic fluid, 150 mL
d. Isotonic fluid, 300 mL

A

d. Isotonic fluid, 300 mL

32
Q

What causes renal failure after electrical burns in children?
a. Cytokines are released after the damaged tissue.
b. Immature kidneys are unable to compensate for the electrical burn.
c. Cardiac output is reduced.
d. Myoglobin is released from damaged muscles.

A

d. Myoglobin is released from damaged muscles.

33
Q

A 4-year-old child with a burn injury has entered the catabolic flow phase. What assessment would the healthcare provider correlate with this situation?
a. Oxygen saturation normal on room air
b. 7 pound weight loss in 1 week
c. Capillary refill <2 sec
d. Blood pressure 89/56 mmHg

A

b. 7 pound weight loss in 1 week

34
Q

The healthcare professional explains to a student that the most serious outcome resulting from limited glycogen stores in children who have been seriously burned is which of these?
a. Poor wound healing
b. Increased morbidity
c. Decreased immunity
d. Loss of adipose tissue stores

A

b. Increased morbidity

35
Q

A healthcare professional gets an update on four children. Which one should the professional assess as the priority?
a. 6-month old, respiratory rate of 42 breaths/min
b. 2-year-old, respiratory rate of 39 breaths/min
c. Preschooler, respiratory rate of 26 breaths/min
d. School-aged child, respiratory rate of 38 breaths/min

A

d. School-aged child, respiratory rate of 38 breaths/min

Ane Class Practice (26 decks)

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