practice test Flashcards
What is the primary function of ATP in cellular metabolism?
A. Structural support
B. Energy transfer
C. Hormone regulation
D. Oxygen transport
B. Energy transfer
Which electrolyte imbalance is most commonly associated with Chvostek’s and Trousseau’s signs?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypomagnesemia
B. Hypocalcemia
Which process describes the movement of water across a semipermeable membrane from an area of low solute concentration to high solute concentration?
A. Diffusion
B. Osmosis
C. Filtration
D. Active transport
B. Osmosis
What is the primary compensatory mechanism in metabolic acidosis?
A. Kidneys retain bicarbonate
B. Lungs decrease respiratory rate
C. Kidneys excrete hydrogen ions
D. Lungs increase respiratory rate
D. Lungs increase respiratory rate
Which term describes an increase in cell size due to increased workload or demand?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Metaplasia
C. Hypertrophy
Which mechanism causes edema in heart failure?
A. Increased capillary hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction
A. Increased capillary hydrostatic pressure
Which acid-base imbalance is expected in a patient with prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
B. Metabolic alkalosis
Which of the following describes apoptosis?
A. Accidental cell injury
B. Unregulated cell death due to inflammation
C. Programmed cell death without inflammation
D. Cell death due to hypoxia
C. Programmed cell death without inflammation
Which pathophysiologic process is responsible for the systemic effects of sepsis?
A. Vasoconstriction and increased cardiac output
B. Widespread inflammation and increased capillary permeability
C. Decreased cytokine release and immune suppression
D. Localized infection with minimal systemic involvement
B. Widespread inflammation and increased capillary permeability
Which type of hypersensitivity reaction is responsible for anaphylaxis?
A. Type I (IgE-mediated)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Delayed hypersensitivity)
A. Type I (IgE-mediated)
Which cancer staging system is most commonly used to classify the extent of tumor spread?
A. TNM system
B. ABCD system
C. RICE system
D. GCS system
A. TNM system
What does the “T” in the TNM cancer staging system represent?
A. Tumor size and extent
B. Tumor location
C. Tumor grade
D. Tumor recurrence
A. Tumor size and extent
Which cancer grade indicates the most abnormal and undifferentiated cells?
A. Grade I
B. Grade II
C. Grade III
D. Grade IV
D. Grade IV
Which of the following best describes Stage IV cancer?
A. Cancer is localized to the primary site
B. Cancer has spread to nearby lymph nodes
C. Cancer has metastasized to distant organs
D. Cancer cells are well-differentiated
C. Cancer has metastasized to distant organs
Why is tumor grading important in cancer diagnosis?
A. It determines the exact size of the tumor
B. It helps predict the tumor’s growth and aggressiveness
C. It identifies the tumor’s primary location
D. It indicates whether the cancer has spread to lymph nodes
B. It helps predict the tumor’s growth and aggressiveness
What does the “N” in the TNM cancer staging system represent?
A. Number of tumors
B. Node involvement
C. Necrosis of the tumor
D. New tumor growth
B. Node involvement
Which tumor characteristic is assessed during grading?
A. Degree of cell differentiation
B. Tumor location
C. Presence of metastasis
D. Tumor size
A. Degree of cell differentiation
Which statement about low-grade (Grade I) tumors is true?
A. They are highly aggressive and fast-growing
B. They appear well-differentiated and resemble normal cells
C. They have a high potential for metastasis
D. They are always classified as Stage IV
B. They appear well-differentiated and resemble normal cells
Which diagnostic tool is most commonly used to determine cancer stage?
A. Complete blood count (CBC)
B. Biopsy
C. MRI/CT scan
D. Tumor marker blood test
C. MRI/CT scan
What does an “M1” designation in the TNM system indicate?
A. No distant metastasis
B. Tumor is in multiple lymph nodes
C. Distant metastasis is present
D. Tumor is localized to the primary site
C. Distant metastasis is present
Which type of necrosis is most commonly associated with ischemic injury, such as in myocardial infarction?
A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
c
Which type of necrosis is characterized by a cheese-like appearance and is commonly seen in tuberculosis infections?
A. Liquefactive necrosis
B. Caseous necrosis
C. Coagulative necrosis
D. Fat necrosis
b
Which type of necrosis is typically seen in brain tissue due to hypoxic injury?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
b
Which type of necrosis results from the enzymatic digestion of adipose tissue, often due to pancreatic enzyme release?
A. Coagulative necrosis
B. Fat necrosis
C. Liquefactive necrosis
D. Fibrinoid necrosis
b
Which necrotic process is associated with immune complex deposition and is seen in blood vessel walls?
A. Caseous necrosis
B. Fibrinoid necrosis
C. Liquefactive necrosis
D. Fat necrosis
b
Which type of necrosis is most commonly seen in bacterial infections, leading to pus formation?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Fat necrosis
D. Fibrinoid necrosis
b
Which type of necrosis is most commonly associated with gangrene, particularly in the limbs?
A. Caseous necrosis
B. Fibrinoid necrosis
C. Coagulative necrosis
D. Fat necrosis
c
Which type of necrosis is associated with wet gangrene due to bacterial infection and extensive tissue liquefaction?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
b
What is the primary distinguishing feature of coagulative necrosis compared to liquefactive necrosis?
A. Coagulative necrosis preserves tissue architecture
B. Coagulative necrosis results in complete tissue liquefaction
C. Coagulative necrosis occurs only in the brain
D. Coagulative necrosis is caused by bacterial infections
a
Which type of necrosis is characterized by the presence of amorphous, proteinaceous material in affected blood vessel walls?
A. Liquefactive necrosis
B. Caseous necrosis
C. Fibrinoid necrosis
D. Fat necrosis
c
Which enzyme is deficient in Phenylketonuria (PKU)?
A. Tyrosinase
B. Phenylalanine hydroxylase
C. Glucose-6-phosphatase
D. Galactose-1-phosphate uridyltransferase
b
What dietary restriction is essential for managing PKU?
A. Low-fat diet
B. High-protein diet
C. Low-phenylalanine diet
D. High-carbohydrate diet
c
Which of the following is a hallmark physical feature of Down syndrome?
A. Tall stature
B. Large ears
C. Epicanthal folds
D. Hyperpigmented café-au-lait spots
c
What chromosomal abnormality causes Down syndrome?
A. Trisomy 13
B. Trisomy 18
C. Trisomy 21
D. Monosomy X
c
Which of the following conditions is associated with Klinefelter syndrome?
A. Turner syndrome
B. XXY karyotype
C. XO karyotype
D. Trisomy 18
b
Which clinical feature is most commonly seen in Klinefelter syndrome?
A. Short stature
B. Gynecomastia
C. Increased muscle mass
D. Early-onset puberty
b
Which mode of inheritance is seen in neurofibromatosis type 1 (NF1)?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
a
Which of the following is a common skin manifestation of neurofibromatosis type 1 (NF1)?
A. Port-wine stains
B. Café-au-lait spots
C. Bullous lesions
D. Petechiae
b
Which serious complication is associated with neurofibromatosis type 1 (NF1)?
A. Increased risk of malignant tumors
B. Early-onset osteoporosis
C. Hyperthyroidism
D. Pulmonary fibrosis
a
Which of the following is a common cognitive finding in children with Down syndrome?
A. Severe intellectual disability in all cases
B. Normal cognitive function
C. Mild to moderate intellectual disability
D. Increased risk of schizophrenia
c
A patient with long-standing hypertension is found to have left ventricular hypertrophy on an echocardiogram. Which cellular adaptation is responsible for this finding?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
b
A 65-year-old patient with a history of smoking undergoes a biopsy of bronchial tissue, which reveals replacement of normal columnar epithelium with stratified squamous epithelium. What type of cellular adaptation is occurring?
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Hypertrophy
b
A patient with prolonged bed rest due to a spinal cord injury experiences muscle wasting. Which type of cellular adaptation is responsible?
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Dysplasia
a
A woman develops an enlarged thyroid gland due to increased TSH stimulation from iodine deficiency. Which cellular adaptation is responsible?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Atrophy
a
A patient with benign prostatic hyperplasia (BPH) presents with difficulty urinating. Which type of cellular adaptation has occurred in the prostate?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Dysplasia
b
A 50-year-old woman undergoes a Pap smear, which shows disorganized and abnormal cervical cells with an increased nuclear-to-cytoplasmic ratio. This finding is consistent with which type of cellular adaptation?
A. Hypertrophy
B. Hyperplasia
C. Dysplasia
D. Metaplasia
c
A bodybuilder increases muscle mass after months of weight training. Which cellular adaptation is occurring in skeletal muscle cells?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Dysplasia
b
A chronic alcoholic develops cirrhosis with extensive liver scarring. Initially, before fibrosis occurred, the liver underwent which type of adaptation to alcohol toxicity?
A. Metaplasia
B. Hyperplasia
C. Hypertrophy
D. Dysplasia
d
A patient with long-standing gastroesophageal reflux disease (GERD) undergoes an esophageal biopsy, revealing replacement of normal squamous epithelium with columnar epithelium. Which type of cellular adaptation has occurred?
A. Hyperplasia
B. Dysplasia
C. Metaplasia
D. Atrophy
c
A patient with chronic ischemia in the kidneys due to renal artery stenosis is found to have decreased renal size on imaging. Which type of cellular adaptation has occurred?
A. Metaplasia
B. Hypertrophy
C. Atrophy
D. Hyperplasia
c
A genetic counselor is evaluating a couple with a family history of cystic fibrosis (CF), an autosomal recessive disorder. If both parents are carriers, what is the probability that their child will inherit the disease?
A. 0%
B. 25%
C. 50%
D. 75%
b
A nurse is reviewing a genetic report that states a patient has a mutation in the BRCA1 gene. How should the nurse interpret this finding?
A. The patient will definitely develop breast cancer.
B. The patient has an increased risk of developing breast cancer.
C. The patient is immune to breast cancer.
D. The mutation has no clinical significance.
b
A male patient has an X-linked recessive disorder. What is the likelihood that he will pass this disorder to his son?
A. 0%
B. 25%
C. 50%
D. 100%
a
A newborn is diagnosed with a chromosomal disorder caused by nondisjunction during meiosis. Which condition is most likely?
A. Huntington’s disease
B. Marfan syndrome
C. Down syndrome
D. Duchenne muscular dystrophy
c
A patient with sickle cell trait asks if their future children will inherit sickle cell disease. What factor must be considered in making this determination?
A. The patient’s blood type
B. Whether the other parent carries the sickle cell gene
C. The number of sickled cells present in the blood
D. The patient’s history of symptoms
b
A geneticist explains to a patient that they have a condition with incomplete penetrance. What does this mean?
A. The genetic mutation is present but does not always cause disease.
B. The genetic mutation is only passed from father to son.
C. The condition is only seen in females.
D. The patient has multiple copies of the gene.
a
A nurse is counseling a couple who are both heterozygous for an autosomal dominant disorder. What is the probability that their child will inherit the disorder?
A. 0%
B. 25%
C. 50%
D. 75%
d
A patient is diagnosed with a genetic disorder that results from multiple genes interacting with environmental factors. Which of the following best describes this type of inheritance?
A. Autosomal recessive
B. X-linked dominant
C. Multifactorial inheritance
D. Mitochondrial inheritance
c
A child with Prader-Willi syndrome is found to have a deletion on chromosome 15 inherited from their father. This is an example of which genetic phenomenon?
A. Incomplete dominance
B. Genomic imprinting
C. X-inactivation
D. Polygenic inheritance
b
A scientist is designing a study to analyze how a single nucleotide polymorphism (SNP) affects drug metabolism in different patients. Which field of study is this research most related to?
A. Epigenetics
B. Pharmacogenomics
C. Gene therapy
D. Cytogenetics
b
Which of the following is a key characteristic of benign tumors?
A. Rapid, uncontrolled growth
B. Ability to invade surrounding tissues
C. Encapsulation and slow growth
D. High potential for metastasis
c
Which feature is most characteristic of malignant tumors?
A. Well-defined borders
B. Inability to metastasize
C. Rapid cell division and invasion of surrounding tissues
D. Growth limited to a single organ
c
Which term describes the spread of cancer cells from the primary tumor to distant organs?
A. Dysplasia
B. Metaplasia
C. Metastasis
D. Hyperplasia
c
Which of the following is true about benign tumors?
A. They do not require treatment
B. They have a low risk of recurrence after removal
C. They always become malignant over time
D. They invade blood vessels and lymph nodes
b
Which of the following best differentiates malignant tumors from benign tumors?
A. Malignant tumors are always slow-growing
B. Malignant tumors are well-differentiated
C. Malignant tumors can invade and metastasize
D. Malignant tumors remain localized
c
Which characteristic is typical of malignant tumor cells when viewed under a microscope?
A. Uniform cell shape and size
B. Well-organized tissue structure
C. Anaplastic, poorly differentiated cells
D. Encapsulated tumor margins
c
A patient is diagnosed with a benign brain tumor. Which of the following is most likely true?
A. The tumor will invade surrounding brain tissue
B. The tumor is unlikely to metastasize
C. The tumor will shrink on its own
D. The tumor is always life-threatening
b
Which of the following is a common method of metastasis for malignant tumors?
A. Direct local invasion only
B. Spread through blood and lymphatic systems
C. Formation of a protective capsule around tumor cells
D. Lack of angiogenesis
b
Which of the following terms describes the process by which malignant tumors develop new blood vessels to support their growth?
A. Dysplasia
B. Angiogenesis
C. Hyperplasia
D. Metaplasia
b
Which of the following statements is true regarding benign and malignant tumors?
A. Benign tumors never cause health complications
B. Malignant tumors always grow at the same rate
C. Benign tumors tend to be well-differentiated, while malignant tumors are often poorly differentiated
D. Malignant tumors always remain in their original location
c
Which type of pain is associated with damage or dysfunction of the nervous system?
A. Nociceptive pain
B. Neuropathic pain
C. Somatic pain
D. Visceral pain
b
Which of the following is an example of somatic pain?
A. Pain from a heart attack
B. Pain from a broken bone
C. Pain from irritable bowel syndrome
D. Pain from diabetic neuropathy
b
Which type of pain originates from internal organs and is often described as deep, dull, or cramping?
A. Neuropathic pain
B. Somatic pain
C. Visceral pain
D. Phantom pain
c
Which of the following is an example of neuropathic pain?
A. Postherpetic neuralgia
B. Appendicitis pain
C. Muscle strain pain
D. Bone fracture pain
a
What type of pain occurs when an amputee experiences sensations in a limb that is no longer present?
A. Somatic pain
B. Referred pain
C. Phantom pain
D. Visceral pain
c
Which statement best describes referred pain?
A. Pain that originates in one location but is felt in another
B. Pain that occurs only with nerve damage
C. Pain that is always chronic and unrelenting
D. Pain that does not respond to analgesics
a
Which type of pain is typically short-term and serves as a warning signal for potential or actual tissue damage?
A. Chronic pain
B. Neuropathic pain
C. Acute pain
D. Referred pain
c
A patient with chronic lower back pain describes a burning, shooting sensation radiating down the leg. The nurse suspects neuropathic pain. Which assessment finding would best support this diagnosis?
A. Pain that worsens with movement but improves with rest
B. Pain that responds well to nonsteroidal anti-inflammatory drugs (NSAIDs)
C. Pain accompanied by numbness, tingling, or hypersensitivity
D. Pain that is well-localized and described as aching
c
A patient experiencing a myocardial infarction reports pain in the left shoulder and jaw. Which conclusion should the nurse make regarding this pain pattern?
A. It is a normal musculoskeletal response to stress
B. It is an example of referred pain due to shared neural pathways
C. It indicates an additional injury unrelated to the heart
D. It suggests the patient is experiencing phantom limb pain
b
A nurse is developing a pain management plan for a patient with advanced cancer who reports deep, cramping abdominal pain. Which type of pain is the patient most likely experiencing, and what intervention is most appropriate?
A. Neuropathic pain; prescribe anticonvulsants
B. Visceral pain; administer opioid analgesics
C. Somatic pain; apply heat therapy
D. Referred pain; use guided imagery techniques
b
Which of the following is a characteristic of innate immunity?
A. Develops after exposure to a specific pathogen
B. Provides immediate, non-specific defense
C. Involves memory cells for long-term protection
D. Requires prior vaccination to be effective
b
Which component is part of the body’s innate immune system?
A. B cells
B. T cells
C. Natural killer (NK) cells
D. Memory cells
c
Which of the following best describes acquired (adaptive) immunity?
A. It is present at birth and provides rapid defense
B. It does not involve antigen-specific responses
C. It includes humoral and cell-mediated immunity
D. It is independent of prior infection or vaccination
c
Which type of immunity is developed after vaccination?
A. Innate immunity
B. Passive immunity
C. Active acquired immunity
D. Autoimmunity
c
Which immune response involves antibodies produced by B cells?
A. Innate immunity
B. Cell-mediated immunity
C. Humoral immunity
D. Complement system
c
A patient receives a flu vaccine. Two weeks later, they are exposed to the flu virus but do not develop the illness. Which immune mechanism is responsible for this protection?
A. Innate immunity
B. Passive immunity
C. Active acquired immunity
D. Complement activation
c
A newborn baby receives antibodies from breast milk that help protect against infections. Which type of immunity is this an example of?
A. Innate immunity
B. Passive acquired immunity
C. Active acquired immunity
D. Cell-mediated immunity
b
A patient with a puncture wound experiences redness, swelling, and warmth at the injury site within a few hours. Which part of the immune system is responsible for this response?
A. Humoral immunity
B. Cell-mediated immunity
C. Innate immunity
D. Adaptive immunity
c
A 7-year-old child who previously had chickenpox is exposed to the virus again but does not develop symptoms. What is the primary reason for this immunity?
A. Innate immunity from birth
B. Passive immunity from maternal antibodies
C. Adaptive immunity due to memory B and T cells
D. Inflammation preventing viral replication
c
A patient with HIV has a significantly reduced number of CD4+ T cells, leading to frequent infections. This primarily affects which type of immunity?
A. Innate immunity
B. Passive immunity
C. Acquired immunity
D. Complement system
c
A nurse is educating a group of new mothers about neonatal immunity. Which statement by a mother indicates the need for further teaching?
A. “My baby’s immune system is fully developed at birth.”
B. “Breastfeeding can provide my baby with passive immunity.”
C. “My baby received some immunity from me through the placenta.”
D. “My baby’s immune system will continue to develop over time.”
a
An older adult patient is concerned about increased susceptibility to infections. Which age-related immune system change should the nurse explain as a contributing factor?
A. Increased production of T cells
B. Enhanced inflammatory response
C. Decreased antibody production and immune memory
D. Hyperactive immune surveillance
c
A nurse is developing a vaccination schedule for a 65-year-old patient with diabetes. Which rationale best supports the need for vaccines in older adults?
A. They have stronger immune responses and need more frequent boosters.
B. Age-related decline in immunity makes them more susceptible to infections.
C. Their innate immunity is completely ineffective.
D. Vaccines are only recommended for individuals with autoimmune disorders.
b
A premature infant is at higher risk for infections compared to a full-term infant. What is the primary reason for this increased susceptibility?
A. Reduced exposure to maternal pathogens
B. Inability to produce white blood cells
C. Limited transfer of maternal antibodies before birth
D. Excessive activation of the immune system at birth
c
A nurse is counseling an elderly patient on ways to boost immune function. Which lifestyle modification would be most effective in enhancing immune response?
A. Reducing protein intake to prevent inflammation
B. Increasing physical activity and maintaining a balanced diet
C. Avoiding all social interactions to prevent infections
D. Taking antibiotics regularly as a preventive measure
b
Which type of hypersensitivity reaction is associated with an immediate allergic response, such as anaphylaxis?
A. Type I
B. Type II
C. Type III
D. Type IV
a
Which hypersensitivity reaction involves immune complex deposition, leading to conditions such as lupus and rheumatoid arthritis?
A. Type I
B. Type II
C. Type III
D. Type IV
c
Which of the following is an example of a Type IV hypersensitivity reaction?
A. Anaphylaxis
B. Blood transfusion reaction
C. Poison ivy rash
D. Myasthenia gravis
c
Which type of hypersensitivity reaction involves IgG or IgM antibodies attacking specific cells, such as in hemolytic anemia?
A. Type I
B. Type II
C. Type III
D. Type IV
b
Which hypersensitivity reaction is T-cell mediated and typically delayed, occurring 24–48 hours after exposure?
A. Type I
B. Type II
C. Type III
D. Type IV
d
A patient presents to the emergency department with swelling of the face, difficulty breathing, and hives after eating peanuts. Which type of hypersensitivity reaction is occurring, and what is the priority intervention?
A. Type II; administer corticosteroids
B. Type III; provide antihistamines
C. Type I; administer epinephrine
D. Type IV; apply topical steroids
c
A nurse is preparing to administer a blood transfusion to a patient with type A blood. To prevent a hypersensitivity reaction, which action is most important?
A. Administering antihistamines before the transfusion
B. Ensuring the donor blood type matches the patient’s blood type
C. Observing for signs of a delayed hypersensitivity reaction
D. Monitoring for symptoms of serum sickness
b
A patient with systemic lupus erythematosus (SLE) experiences joint pain, fever, and kidney dysfunction due to immune complex deposition. Which type of hypersensitivity reaction is responsible for these symptoms?
A. Type I
B. Type II
C. Type III
D. Type IV
c
A patient develops a red, itchy rash 48 hours after exposure to poison ivy. Which type of hypersensitivity reaction is this, and what is the underlying immune mechanism?
A. Type I; IgE-mediated histamine release
B. Type II; antibody-mediated cytotoxicity
C. Type III; immune complex deposition
D. Type IV; T-cell-mediated response
d
A nurse is caring for a patient who received penicillin and developed hemolytic anemia due to antibody-mediated destruction of red blood cells. Which type of hypersensitivity reaction is this, and what is the best treatment approach?
A. Type I; administer epinephrine
B. Type II; discontinue penicillin and provide supportive care
C. Type III; prescribe immunosuppressants
D. Type IV; apply topical steroids
b
Which stage of the stress response is characterized by the activation of the “fight-or-flight” response and the release of catecholamines like epinephrine and norepinephrine?
A. Alarm stage
B. Resistance stage
C. Exhaustion stage
D. Recovery stage
a
During which stage of the stress response does the body attempt to adapt to ongoing stress while maintaining homeostasis?
A. Alarm stage
B. Resistance stage
C. Exhaustion stage
D. Acute stage
b
Which stage of the stress response occurs when the body’s resources are depleted, leading to increased vulnerability to illness and disease?
A. Alarm stage
B. Resistance stage
C. Exhaustion stage
D. Adaptation stage
c
Which hormone is primarily released during the alarm stage to help mobilize energy and enhance the body’s response to stress?
A. Insulin
B. Cortisol
C. Glucagon
D. Aldosterone
b
Which of the following best describes the resistance stage of the stress response?
A. The body is in a state of shock and unable to respond
B. The body continues to release stress hormones to maintain an adaptive response
C. The body has completely recovered from stress and returns to normal function
D. The body experiences severe fatigue and immune system suppression
b
Which of the following is a primary purpose of the inflammatory response?
A. To destroy healthy tissues
B. To prevent blood clotting
C. To eliminate the initial cause of cell injury and promote healing
D. To suppress the immune system
c
Which of the following is a classic sign of inflammation?
A. Pallor
B. Cool skin
C. Redness
D. Bradycardia
c
Which chemical mediator is primarily responsible for vasodilation and increased vascular permeability during inflammation?
A. Insulin
B. Histamine
C. Glucagon
D. Epinephrine
b
Which white blood cell is the first to arrive at the site of acute inflammation?
A. Lymphocyte
B. Monocyte
C. Neutrophil
D. Eosinophil
c
Which of the following best describes the role of prostaglandins in the inflammatory response?
A. They decrease pain and fever
B. They promote blood clotting
C. They enhance pain, fever, and vasodilation
D. They suppress immune function
c
Which immunoglobulin is the first antibody produced during an initial immune response?
A. IgA
B. IgE
C. IgG
D. IgM
d
Which immunoglobulin is primarily found in secretions such as saliva, tears, and breast milk, providing mucosal immunity?
A. IgA
B. IgD
C. IgE
D. IgG
a
Which immunoglobulin is the most abundant in the bloodstream and provides long-term immunity after infection or vaccination?
A. IgA
B. IgE
C. IgG
D. IgMc
c
Which immunoglobulin is involved in allergic reactions and binds to mast cells and basophils, triggering histamine release?
A. IgA
B. IgE
C. IgG
D. IgM
b
Which immunoglobulin plays a role in the activation of B cells but has an unclear function in the immune response?
A. IgA
B. IgD
C. IgE
D. IgM
b
Which type of transplant rejection occurs within minutes to hours due to pre-existing antibodies attacking the graft?
A. Acute rejection
B. Chronic rejection
C. Hyperacute rejection
D. Delayed rejection
c
Which of the following is a characteristic of acute transplant rejection?
A. Occurs immediately after transplantation
B. Involves T-cell-mediated immune response
C. Is always reversible with no treatment needed
D. Occurs years after the transplant
b
Which type of rejection develops over months to years and leads to gradual loss of graft function?
A. Acute rejection
B. Hyperacute rejection
C. Chronic rejection
D. Subacute rejection
c
Which immune response is primarily responsible for chronic transplant rejection?
A. Preformed antibodies against the graft
B. T-cell and antibody-mediated fibrosis
C. Direct destruction of the graft by neutrophils
D. IgE-mediated hypersensitivity
b
Which intervention is most effective in preventing hyperacute rejection?
A. Administering high-dose steroids after transplant
B. Matching donor and recipient blood types and HLA
C. Delaying immunosuppressive therapy
D. Using radiation therapy on the transplanted organ
b
A patient who received a kidney transplant 5 days ago develops fever, decreased urine output, and tenderness over the graft site. The nurse suspects acute rejection. What is the priority intervention?
A. Discontinue all immunosuppressive medications
B. Administer high-dose corticosteroids as prescribed
C. Prepare the patient for immediate graft removal
D. Increase fluid intake and monitor urine output
b
A patient with a newly transplanted heart develops severe graft dysfunction within hours of surgery. The healthcare team suspects hyperacute rejection. What is the most likely cause?
A. Pre-existing antibodies against the donor organ
B. Gradual fibrosis due to long-term immune response
C. Activation of memory T cells
D. Delayed recognition of foreign antigensa
a
A nurse is educating a patient on how to reduce the risk of chronic rejection after a liver transplant. Which patient statement indicates a need for further teaching?
A. “I will take my immunosuppressant medications exactly as prescribed.”
B. “I need to follow up regularly to monitor my liver function.”
C. “Once my body accepts the organ, I can stop taking my medications.”
D. “I will avoid people who are sick to prevent infections.”
c
A patient with a history of lung transplantation presents with progressive shortness of breath and worsening pulmonary function test results one year after surgery. Which type of rejection is most likely occurring?
A. Hyperacute rejection
B. Acute rejection
C. Chronic rejection
D. Graft-versus-host disease
c
A patient is scheduled for a kidney transplant. The healthcare provider orders a crossmatch test before the procedure. What is the primary reason for this test?
A. To assess kidney function before transplant
B. To check for pre-existing antibodies that may cause hyperacute rejection
C. To determine the patient’s blood type
D. To monitor for signs of chronic rejection
b
Which type of virus is HIV?
A. DNA virus
B. Retrovirus
C. Bacteriophage
D. Coronavirus
b
Which immune cells are primarily targeted and destroyed by HIV?
A. B cells
B. Neutrophils
C. CD4+ T cells
D. Natural killer cells
c
Which of the following is the most common mode of HIV transmission worldwide?
A. Airborne droplets
B. Contaminated food or water
C. Unprotected sexual contact
D. Handshaking and casual contact
c
Which stage of HIV infection is characterized by severe immune suppression and opportunistic infections?
A. Acute HIV infection
B. Clinical latency stage
C. AIDS
D. Post-exposure phase
c
Which test is commonly used for initial HIV screening?
A. Western blot
B. CD4 count
C. ELISA (enzyme-linked immunosorbent assay)
D. Polymerase chain reaction (PCR)
c
What is the primary method by which HIV replicates in the body?
A. By directly attacking red blood cells
B. By inserting its RNA into host CD4+ T cells and using reverse transcriptase
C. By producing toxins that destroy immune cells
D. By multiplying outside the body in bodily fluids
b
Which opportunistic infection is commonly associated with the progression of HIV to AIDS?
A. Streptococcal pneumonia
B. Tuberculosis
C. Influenza
D. Chickenpox
b
Which laboratory test is used to monitor disease progression in an HIV-positive patient?
A. Hemoglobin level
B. White blood cell count
C. CD4+ T-cell count
D. Blood glucose level
c
Which of the following statements about HIV transmission is correct?
A. HIV can be spread through casual contact like hugging and shaking hands.
B. An HIV-positive mother can transmit the virus to her baby during childbirth or breastfeeding.
C. HIV is primarily transmitted through mosquito bites.
D. HIV can survive for weeks outside the human body.
b
What is the main goal of antiretroviral therapy (ART) in HIV treatment?
A. To completely eliminate HIV from the body
B. To cure HIV infection permanently
C. To suppress viral replication and maintain immune function
D. To prevent common colds and flu
c
Which type of anemia is caused by a deficiency of vitamin B12 due to the lack of intrinsic factor?
A. Iron-deficiency anemia
B. Pernicious anemia
C. Aplastic anemia
D. Sickle cell anemia
b
Which of the following is the most common cause of iron-deficiency anemia?
A. Chronic blood loss
B. Excessive vitamin B12 intake
C. Bone marrow suppression
D. Genetic mutation
a
Which type of anemia is characterized by the destruction of red blood cells due to an autoimmune or inherited disorder?
A. Hemolytic anemia
B. Aplastic anemia
C. Megaloblastic anemia
D. Anemia of chronic disease
a
Which laboratory test is commonly used to diagnose sickle cell anemia?
A. Schilling test
B. Hemoglobin electrophoresis
C. Bone marrow biopsy
D. Coombs test
b
Which type of anemia results from bone marrow failure and a decrease in all blood cell types (pancytopenia)?
A. Iron-deficiency anemia
B. Hemolytic anemia
C. Aplastic anemia
D. Pernicious anemia
c
A patient diagnosed with iron-deficiency anemia reports frequent fatigue and dizziness. Which dietary recommendation should the nurse provide to help improve the patient’s condition?
A. Increase intake of dairy products and citrus fruits
B. Consume more leafy green vegetables, red meat, and beans
C. Avoid foods high in protein and vitamin C
D. Limit iron supplements to prevent toxicity
b
A patient with pernicious anemia is prescribed vitamin B12 injections. The patient asks why the medication cannot be taken orally. What is the best response by the nurse?
A. “Vitamin B12 is better absorbed when injected directly into the bloodstream.”
B. “Your stomach lacks intrinsic factor, which is needed for B12 absorption.”
C. “Oral vitamin B12 is only used for mild anemia.”
D. “Injections are given to prevent nausea associated with oral B12.”
b
A nurse is reviewing lab results for a patient with sickle cell anemia who is experiencing severe joint pain. What is the priority nursing intervention?
A. Encourage the patient to ambulate frequently
B. Administer IV fluids and pain management as prescribed
C. Apply cold packs to affected joints
D. Restrict fluid intake to prevent further complications
b
A patient with a history of chronic kidney disease is diagnosed with anemia. The nurse expects the provider to prescribe which treatment to address the underlying cause?
A. Iron supplements
B. Blood transfusions
C. Erythropoietin-stimulating agents (ESAs)
D. Vitamin B12 injections
c
A patient with aplastic anemia is admitted with a fever and low white blood cell count. What is the nurse’s priority action?
A. Administer iron supplements
B. Place the patient in protective isolation
C. Encourage the patient to ambulate frequently
D. Perform frequent neurological assessments
b
A patient with iron-deficiency anemia has been taking oral iron supplements for three months but reports no improvement in symptoms. As the nurse, what is the best next step in evaluating the patient’s condition?
A. Assess the patient’s diet and adherence to medication regimen
B. Increase the iron supplement dosage
C. Recommend switching to a vitamin B12 supplement
D. Suggest stopping the iron supplement and reassess in a month
a
A patient with sickle cell anemia presents with severe pain, fever, and dehydration. The provider orders IV fluids and pain management, but the patient continues to experience symptoms. What additional intervention should the nurse anticipate?
A. Administering high-dose aspirin for pain relief
B. Preparing the patient for an exchange blood transfusion
C. Encouraging ambulation to improve circulation
D. Administering a diuretic to reduce fluid overload
b
A nurse is evaluating a patient with pernicious anemia who has been receiving vitamin B12 injections for six months. Which finding suggests that the treatment has been effective?
A. Increased bruising and petechiae
B. Improved hemoglobin levels and resolution of neurological symptoms
C. Persistent fatigue and shortness of breath
D. Increased white blood cell count with no improvement in symptoms
b
A healthcare provider is considering treatment options for a patient with anemia of chronic disease. The nurse is asked to evaluate potential causes before treatment. Which condition is most likely contributing to this type of anemia?
A. Recent history of gastrointestinal bleeding
B. Autoimmune disorders such as rheumatoid arthritis
C. Malabsorption of vitamin B12 due to gastric bypass surgery
D. Genetic mutation affecting hemoglobin production
b
A nurse is developing an educational plan for a patient with aplastic anemia. What is the most important lifestyle modification to include in the teaching plan?
A. Increasing iron intake through diet and supplements
B. Avoiding crowded places and practicing infection prevention
C. Engaging in high-impact exercise to stimulate red blood cell production
D. Stopping immunosuppressive therapy to improve immune function
b
A patient with iron-deficiency anemia is prescribed ferrous sulfate. Which instruction should the nurse provide to enhance iron absorption?
A. Take the supplement with milk to prevent stomach irritation
B. Take the supplement with vitamin C-rich foods like orange juice
C. Take the supplement on an empty stomach with water only
D. Avoid consuming green leafy vegetables while on iron therapy
b
A nurse is caring for a patient with sickle cell anemia who reports severe pain in the legs and back. Which intervention should the nurse implement first?
A. Apply cold compresses to the painful areas
B. Encourage the patient to increase physical activity
C. Administer prescribed IV fluids and pain medication
D. Advise the patient to take deep breaths to reduce pain perception
c
A patient with chronic kidney disease presents with symptoms of anemia, including fatigue and pallor. Which laboratory result would the nurse expect to find?
A. Low erythropoietin levels
B. Elevated iron levels
C. Increased reticulocyte count
D. High hemoglobin levels
a
A nurse is reviewing dietary recommendations with a patient diagnosed with pernicious anemia. Which meal choice by the patient indicates an understanding of foods that support red blood cell production?
A. Grilled chicken with rice and steamed broccoli
B. Whole wheat pasta with marinara sauce and a side salad
C. Scrambled eggs with fortified cereal and a glass of milk
D. Baked fish with mashed potatoes and green beans
c
A patient with aplastic anemia has a critically low white blood cell count. Which nursing intervention is the highest priority?
A. Encouraging increased protein intake to promote cell regeneration
B. Implementing strict infection control measures
C. Administering blood transfusions as prescribed
D. Encouraging frequent ambulation to prevent blood stasis
b
Which type of anemia is caused by a deficiency of intrinsic factor leading to impaired vitamin B12 absorption?
A. Iron-deficiency anemia
B. Pernicious anemia
C. Aplastic anemia
D. Hemolytic anemia
b
Which anemia is characterized by the destruction of red blood cells faster than they can be produced?
A. Hemolytic anemia
B. Iron-deficiency anemia
C. Aplastic anemia
D. Megaloblastic anemia
a
Which type of anemia is most commonly associated with chronic kidney disease due to reduced erythropoietin production?
A. Iron-deficiency anemia
B. Hemolytic anemia
C. Anemia of chronic disease
D. Sickle cell anemia
c
Which laboratory test is commonly used to diagnose iron-deficiency anemia?
A. Hemoglobin electrophoresis
B. Serum ferritin and total iron-binding capacity (TIBC)
C. Bone marrow biopsy
D. Coombs test
b
Which genetic disorder leads to abnormally shaped red blood cells, resulting in episodes of pain and increased risk of organ damage?
A. Aplastic anemia
B. Sickle cell anemia
C. Pernicious anemia
D. Hemolytic anemia
b
Which condition is characterized by widespread clot formation followed by excessive bleeding due to depletion of clotting factors?
A. Immune thrombocytopenic purpura (ITP)
B. Thrombotic thrombocytopenic purpura (TTP)
C. Disseminated intravascular coagulation (DIC)
D. Hemophilia
c
Which disorder is an autoimmune condition that leads to platelet destruction in the spleen, resulting in thrombocytopenia?
A. TTP
B. DIC
C. ITP
D. Von Willebrand disease
c
Which of the following conditions is primarily associated with a deficiency of the ADAMTS13 enzyme, leading to abnormal platelet aggregation?
A. ITP
B. TTP
C. DIC
D. Hemophilia A
b
Which laboratory finding is most consistent with disseminated intravascular coagulation (DIC)?
A. Increased platelet count and prolonged PT/PTT
B. Decreased fibrinogen and increased D-dimer
C. Increased hemoglobin and hematocrit
D. Normal coagulation studies with isolated thrombocytopenia
b
Which clinical feature is most commonly associated with thrombotic thrombocytopenic purpura (TTP)?
A. Isolated thrombocytopenia without systemic symptoms
B. Widespread petechiae and mucosal bleeding
C. Microangiopathic hemolytic anemia, neurologic symptoms, and fever
D. Deep vein thrombosis and pulmonary embolism
c
A patient with a recent viral infection presents with petechiae and a platelet count of 20,000/mm³. The nurse suspects immune thrombocytopenic purpura (ITP). What is the most appropriate initial intervention?
A. Administer IV heparin
B. Prepare the patient for plasmapheresis
C. Monitor for signs of bleeding and administer corticosteroids as prescribed
D. Perform an immediate platelet transfusion
c
A nurse is caring for a patient diagnosed with thrombotic thrombocytopenic purpura (TTP). Which finding requires immediate intervention?
A. Fatigue and pallor
B. Temperature of 100.5°F (38°C)
C. Sudden confusion and weakness in one limb
D. Petechiae on the lower extremities
c
A postpartum patient develops bleeding from multiple IV sites, hypotension, and prolonged PT and aPTT. The nurse suspects disseminated intravascular coagulation (DIC). Which order should the nurse anticipate?
A. Administer platelets only
B. Begin heparin therapy to prevent clotting
C. Transfuse fresh frozen plasma and administer supportive care
D. Restrict IV fluids to avoid worsening the condition
c
A patient with suspected DIC has a lab report showing decreased fibrinogen and an elevated D-dimer. What is the best nursing action?
A. Administer iron supplements to correct anemia
B. Encourage ambulation to prevent further clot formation
C. Monitor for signs of organ dysfunction and bleeding
D. Withhold anticoagulation therapy and notify the provider
c
A patient with a history of lupus presents with thrombocytopenia and mucosal bleeding. The provider diagnoses ITP. Which medication should the nurse anticipate being prescribed first?
A. Aspirin
B. Prednisone
C. Warfarin
D. Tissue plasminogen activator (tPA)
b
A patient with Hodgkin’s lymphoma presents with painless cervical lymphadenopathy and night sweats. A biopsy reveals Reed-Sternberg cells. What is the priority nursing intervention?
A. Educate the patient on radiation and chemotherapy options
B. Encourage increased fluid intake to prevent dehydration
C. Recommend iron supplementation to improve red blood cell production
D. Prepare the patient for a bone marrow transplant
a
A nurse is caring for a child with hemophilia A who has a knee injury with swelling and limited movement. What is the best immediate nursing action?
A. Apply heat to promote circulation
B. Administer factor VIII replacement therapy
C. Encourage active range-of-motion exercises
D. Elevate the leg and perform deep tissue massageb
b
A patient undergoing chemotherapy for leukemia develops a fever of 101°F (38.3°C) and a neutrophil count of 400/mm³. What is the priority nursing intervention?
A. Administer antipyretics and encourage oral hydration
B. Obtain blood cultures and initiate broad-spectrum antibiotics
C. Delay chemotherapy until fever subsides
D. Perform frequent neurological checks to assess for changes in mental status
b
A patient with multiple myeloma complains of bone pain and weakness. The nurse reviews the lab results and notes hypercalcemia. What intervention should the nurse implement first?
A. Administer IV fluids to promote calcium excretion
B. Encourage bed rest to prevent fractures
C. Provide calcium supplements to prevent osteoporosis
D. Restrict oral fluid intake to prevent renal damage
a
A patient with newly diagnosed Hodgkin’s lymphoma is started on chemotherapy. The patient asks about potential side effects. What should the nurse include in the education?
A. “You may experience frequent joint pain and headaches.”
B. “Hair loss, nausea, and increased infection risk are common side effects.”
C. “You should avoid chemotherapy and opt for radiation therapy only.”
D. “Weight gain and increased appetite are expected with chemotherapy.”
b
A young male with hemophilia B is admitted for excessive bleeding after a minor dental procedure. What treatment should the nurse anticipate?
A. Administration of fresh frozen plasma
B. Infusion of factor IX concentrate
C. Platelet transfusion
D. Heparin therapy to prevent clot formation
b
A patient with leukemia is undergoing a bone marrow biopsy. What post-procedure nursing intervention is most important?
A. Apply pressure to the biopsy site to prevent bleeding
B. Encourage ambulation immediately to reduce complications
C. Monitor for signs of increased intracranial pressure
D. Administer aspirin for pain management
a
A patient with multiple myeloma is at risk for pathologic fractures. What is the best nursing intervention to minimize this risk?
A. Encourage weight-bearing exercises to strengthen bones
B. Provide a walker and educate on fall prevention strategies
C. Restrict mobility to prevent fractures
D. Administer iron supplements to improve bone density
b
Which of the following is the most common cause of infective endocarditis?
A. Viral infection
B. Fungal infection
C. Bacterial infection
D. Autoimmune disorder
c
Which classic symptom is most commonly associated with pericarditis?
A. Crushing substernal chest pain that radiates to the jaw
B. Sharp, pleuritic chest pain that is relieved by sitting up and leaning forward
C. Right upper quadrant pain with jaundice
D. Sudden onset of severe headache and vision changes
b
Which of the following is a major risk factor for the development of an aortic aneurysm?
A. Hypotension
B. Atherosclerosis
C. Low cholesterol levels
D. Hypoglycemia
b
Which cardiac enzyme is most specific for diagnosing a myocardial infarction (MI)?
A. Creatine kinase (CK)
B. Myoglobin
C. Troponin
D. Lactate dehydrogenase (LDH)
c
Which of the following is a common complication of peripheral vascular disease (PVD)?
A. Deep vein thrombosis (DVT)
B. Increased cardiac output
C. Excessive hair growth on the lower extremities
D. Hyperactive deep tendon reflexes
a
A patient with infective endocarditis presents with fever, new-onset heart murmur, and petechiae. Blood cultures reveal Streptococcus viridans. The provider prescribes IV antibiotics. What additional intervention should the nurse anticipate to prevent complications?
A. Encouraging bed rest for six weeks
B. Monitoring for signs of embolic events, such as stroke or limb ischemia
C. Discontinuing anticoagulant therapy to reduce bleeding risk
D. Administering high-dose corticosteroids to reduce inflammation
b
A patient with pericarditis reports worsening chest pain that improves when sitting forward. The nurse auscultates a pericardial friction rub. Which assessment finding would indicate the development of a life-threatening complication?
A. Muffled heart sounds and jugular vein distention
B. Increased urine output and hypertension
C. Bradycardia with an irregular pulse
D. Hyperactive bowel sounds and diarrhea
a
A nurse is reviewing the chart of a patient with a newly diagnosed abdominal aortic aneurysm (AAA). Which finding would require immediate intervention?
A. Blood pressure of 145/90 mmHg
B. Report of sudden, severe back pain and hypotension
C. Presence of an abdominal bruit on auscultation
D. Complaint of mild, intermittent abdominal discomfort
b
A patient presents to the emergency department with crushing chest pain, diaphoresis, and nausea. The ECG shows ST-segment elevations in leads II, III, and aVF. What is the priority intervention?
A. Administer nitroglycerin and obtain cardiac enzymes
B. Perform a stat echocardiogram to assess for structural abnormalities
C. Immediately prepare the patient for percutaneous coronary intervention (PCI)
D. Obtain a chest X-ray to rule out other causes of chest pain
c
A patient with peripheral vascular disease (PVD) reports pain in the legs while walking that improves with rest. The nurse notes weak pedal pulses and cool skin. Which nursing action would best address the underlying pathophysiology?
A. Encourage the patient to elevate their legs frequently to reduce swelling
B. Advise the patient to sit with legs crossed to improve circulation
C. Educate the patient on smoking cessation and prescribed statin therapy
D. Apply cold compresses to the legs to relieve discomfort
c
A patient reports chest pain that occurs predictably with exertion and is relieved by rest or nitroglycerin. The nurse recognizes this as which type of angina?
A. Unstable angina
B. Variant (Prinzmetal’s) angina
C. Stable angina
D. Silent ischemia
c
A patient with a history of coronary artery disease presents with chest pain at rest that has increased in frequency and duration over the past few days. What is the priority nursing intervention?
A. Administer sublingual nitroglycerin and re-evaluate in 5 minutes
B. Encourage the patient to rest and schedule a stress test
C. Prepare the patient for percutaneous coronary intervention (PCI)
D. Advise the patient that symptoms will resolve with lifestyle modifications
c
A patient experiencing chest pain at night is diagnosed with Prinzmetal’s angina. Which factor should the nurse identify as a primary cause of this condition?
A. Coronary artery spasm
B. Atherosclerotic plaque rupture
C. Increased myocardial oxygen demand
D. Aortic valve stenosis
a
A patient experiencing chest pain is prescribed a calcium channel blocker. The nurse understands this medication is most effective in treating which type of angina?
A. Stable angina
B. Unstable angina
C. Variant (Prinzmetal’s) angina
D. Silent ischemia
c
A patient with diabetes and hypertension is diagnosed with silent ischemia. What assessment finding would be most concerning for myocardial ischemia?
A. Severe, crushing chest pain
B. Sudden onset of confusion or dizziness
C. Increased pain with movement and deep inspiration
D. Burning sensation in the epigastric region after eating
b
Which of the following is the primary cause of left-sided heart failure?
A. Chronic lung disease
B. Pulmonary embolism
C. Hypertension and coronary artery disease
D. Deep vein thrombosis
c
Which symptom is most commonly associated with right-sided heart failure?
A. Pulmonary congestion and crackles
B. Pink, frothy sputum
C. Peripheral edema and jugular vein distention
D. Orthopnea and dyspnea
c
A patient with left-sided heart failure is most likely to experience which of the following?
A. Hepatomegaly and ascites
B. Dependent edema and weight gain
C. Dyspnea, orthopnea, and crackles in the lungs
D. Jugular vein distention and abdominal distension
c
Which of the following statements about right-sided heart failure is true?
A. It leads to congestion in the pulmonary circulation
B. It commonly results from untreated left-sided heart failure
C. It primarily affects the oxygenation of the lungs
D. It causes increased blood flow to the kidneys
b
Which of the following findings is most commonly seen in left-sided heart failure?
A. Dependent edema
B. Jugular vein distention
C. Pulmonary congestion and dyspnea
D. Hepatomegaly
c
Which type of hypertension has no identifiable cause and is the most common form?
A. Secondary hypertension
B. Primary (essential) hypertension
C. Malignant hypertension
D. Pulmonary hypertension
b
Which of the following is a common cause of secondary hypertension?
A. High sodium intake
B. Chronic kidney disease
C. Sedentary lifestyle
D. Family history of hypertension
b
Which type of hypertension is a medical emergency due to a sudden, severe increase in blood pressure that can lead to organ damage?
A. Primary hypertension
B. Malignant (hypertensive crisis) hypertension
C. White coat hypertension
D. Pulmonary hypertension
b
What is a potential complication of severe hypotension?
A. Increased cardiac output
B. Increased perfusion to the brain and kidneys
C. Shock and organ failure
D. Hypertensive crisis
c
Which of the following symptoms is most commonly associated with hypotension?
A. Headache and blurred vision
B. Dizziness, fainting, and confusion
C. Nosebleeds and facial flushing
D. Chest pain and palpitations
b
A patient is diagnosed with secondary hypertension. Which condition in the patient’s history most likely contributed to this diagnosis?
A. Chronic kidney disease
B. High sodium diet
C. Family history of hypertension
D. Sedentary lifestyle
a
A patient with a blood pressure of 200/120 mmHg presents with blurred vision, severe headache, and confusion. The nurse recognizes this as which type of hypertension?
A. Primary hypertension
B. Secondary hypertension
C. Malignant (hypertensive crisis) hypertension
D. Pulmonary hypertension
c
A nurse is caring for a patient who suddenly stands up and becomes dizzy, nearly fainting. What is the most likely cause of this reaction?
A. Primary hypertension
B. Orthostatic hypotension
C. Malignant hypertension
D. Secondary hypertension
b
A patient with a history of hypotension reports dizziness and weakness. The nurse notes a blood pressure of 85/50 mmHg. Which intervention should the nurse implement first?
A. Encourage the patient to increase sodium intake
B. Place the patient in a supine position with legs elevated
C. Administer an antihypertensive medication
D. Encourage the patient to drink caffeine-containing beverages
b
A nurse is educating a patient about lifestyle changes to manage primary hypertension. Which statement by the patient indicates a need for further teaching?
A. “I will reduce my salt intake and eat more fruits and vegetables.”
B. “I should avoid smoking and limit alcohol consumption.”
C. “I can stop taking my blood pressure medication once my readings improve.”
D. “I will incorporate regular exercise into my daily routine.”
c
A patient with dilated cardiomyopathy presents with symptoms of heart failure, including dyspnea, fatigue, and lower extremity edema. Which diagnostic finding is most consistent with this condition?
A. Left ventricular hypertrophy with preserved ejection fraction
B. Severe atrial dilation with normal ventricular function
C. Enlarged ventricular chambers with reduced ejection fraction
D. Thickened ventricular septum with normal chamber size
c
A nurse is caring for a patient with hypertrophic cardiomyopathy (HCM). Which intervention should be avoided to prevent worsening of the condition?
A. Administering beta-blockers to reduce heart rate
B. Encouraging hydration to maintain blood volume
C. Administering nitrates to reduce preload
D. Monitoring for arrhythmias with continuous ECG
c
A patient with restrictive cardiomyopathy asks the nurse how this condition affects the heart. Which response by the nurse is most accurate?
A. “The walls of the heart become stiff, making it difficult for the ventricles to fill properly.”
B. “The heart muscle weakens and the chambers enlarge, leading to poor pumping ability.”
C. “The walls of the left ventricle thicken, obstructing blood flow out of the heart.”
D. “The heart muscle becomes inflamed due to a viral infection, leading to scarring.”
a
A patient with a new diagnosis of hypertrophic cardiomyopathy is at risk for which serious complication?
A. Pulmonary embolism
B. Sudden cardiac death
C. Aortic aneurysm rupture
D. Mitral valve regurgitation
b
A nurse is reviewing the treatment plan for a patient with dilated cardiomyopathy. Which intervention would be most beneficial to improve cardiac output?
A. Encourage bed rest to reduce myocardial oxygen demand
B. Administer diuretics and ACE inhibitors as prescribed
C. Increase fluid intake to maintain blood pressure
D. Recommend high-intensity exercise to strengthen the heart muscle
b
A patient with aortic stenosis reports increasing shortness of breath and chest pain with exertion. Which pathophysiological change best explains these symptoms?
A. Regurgitation of blood into the left atrium
B. Narrowing of the aortic valve, reducing cardiac output
C. Blood pooling in the right ventricle due to tricuspid valve dysfunction
D. Backflow of blood from the aorta into the left ventricle
b
A nurse is caring for a patient with mitral valve regurgitation. Which assessment finding would be expected?
A. Bounding pulses and widened pulse pressure
B. Crackles in the lungs and dyspnea on exertion
C. Peripheral edema and jugular vein distention
D. Cyanosis and clubbing of the fingers
b
A patient with a history of rheumatic fever is diagnosed with mitral stenosis. The nurse understands that this condition can lead to which complication?
A. Right ventricular hypertrophy and pulmonary congestion
B. Left ventricular hypertrophy and increased stroke volume
C. Decreased preload and increased cardiac output
D. Decreased right atrial pressure and improved circulation
a
A patient with severe aortic regurgitation is being evaluated for surgical intervention. Which symptom would indicate worsening of the condition?
A. Increased systolic blood pressure with a low diastolic pressure
B. Decreased respiratory rate and increased urinary output
C. Bradycardia and narrowed pulse pressure
D. Weight loss and improved exercise tolerance
a
A nurse is providing discharge teaching for a patient with mitral valve prolapse. Which statement by the patient indicates a need for further teaching?
A. “I should notify my healthcare provider if I develop palpitations or dizziness.”
B. “I need to take antibiotics before dental procedures to prevent infections.”
C. “I will avoid caffeine and alcohol to reduce symptoms.”
D. “I can stop my beta-blockers once my symptoms improve.”
d
Which part of the EKG represents atrial depolarization?
A. P wave
B. QRS complex
C. T wave
D. ST segment
a
The QRS complex on an EKG represents which electrical activity of the heart?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
b
Which segment of the EKG represents the time it takes for the electrical impulse to travel from the atria to the ventricles?
A. P wave
B. PR interval
C. ST segment
D. T wave
b
Which part of the EKG represents ventricular repolarization?
A. P wave
B. QRS complex
C. T wave
D. PR interval
c
What does the ST segment represent on an EKG?
A. Atrial contraction
B. The period between ventricular depolarization and repolarization
C. The time for electrical conduction from the SA node to the AV node
D. The resting phase of the atria
b
What is the best definition of preload?
A. The resistance the heart must pump against to eject blood
B. The volume of blood in the ventricles at the end of diastole
C. The amount of pressure in the arteries during contraction
D. The rate at which the heart beats per minute
b
Which factor primarily influences afterload?
A. Venous return to the heart
B. Systemic vascular resistance
C. The volume of blood in the right atrium
D. Heart rate
b
Which of the following conditions would most likely increase preload?
A. Severe dehydration
B. Administration of IV fluids
C. Peripheral vasoconstriction
D. Increased systemic vascular resistance
b
Afterload is primarily affected by which of the following?
A. Blood volume in the ventricles
B. Myocardial contractility
C. Arterial blood pressure and vascular resistance
D. Oxygen saturation levels
c
Which of the following statements about preload and afterload is correct?
A. Preload refers to the pressure the heart must pump against, while afterload is the volume of blood in the ventricles before contraction.
B. Preload is influenced by venous return, while afterload is influenced by arterial resistance.
C. Preload and afterload have no effect on cardiac output.
D. Increasing preload always leads to a decrease in stroke volume.
b
Which of the following best describes an arterial thrombus?
A. A clot that forms in veins due to slow blood flow
B. A clot that forms in arteries due to platelet aggregation and atherosclerosis
C. A clot that forms in the lungs from a deep vein thrombosis
D. A clot that dissolves on its own without causing complications
b
Which factor is most likely to contribute to the formation of a venous thrombus?
A. High blood pressure
B. Atherosclerotic plaque rupture
C. Blood stasis and hypercoagulability
D. Coronary artery spasm
c
What is the most common complication of an arterial thrombus?
A. Pulmonary embolism
B. Deep vein thrombosis
C. Tissue ischemia and infarction
D. Chronic venous insufficiency
c
Which of the following is a hallmark characteristic of a venous thrombus compared to an arterial thrombus?
A. Venous thrombi are primarily composed of platelets.
B. Venous thrombi develop rapidly due to high-pressure flow.
C. Venous thrombi are mainly composed of fibrin and red blood cells.
D. Venous thrombi cause immediate oxygen deprivation to tissues.
c
Which symptom is most commonly associated with a deep vein thrombosis (DVT), a type of venous thrombus?
A. Cold, pale extremity with weak pulses
B. Sudden chest pain and shortness of breath
C. Swelling, warmth, and pain in the affected limb
D. Numbness and paralysis in the affected area
c
