MIDTERM
Blood flow throughout the periphery is regulated by
the autonomic nervous system.
Pulse pressure is defined as
systolic pressure – diastolic pressure
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who
has had diarrhea for over a week.
Uncompensated metabolic alkalosis would result in
increased pH, increased HCO 3 –.
A common characteristic of viral pneumonia is
increased carbonic acid.
A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.
False (resp alkalosis)
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?
Septic
Respiratory acidosis is associated with
increased carbonic acid.
Croup is characterized by
a barking cough
A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with
telangiectasia.
The inward-pulling force of particles in the vascular fluid is called _____ pressure.
capillary osmotic
Transfusion reactions involve RBC destruction caused by
recipient antibodies
The major cause of death from leukemic disease is
infection
The arterial oxygen content (CaO 2) for a patient with PaO 2 100 mm Hg, SaO 2 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL.
19.4
Mitral stenosis is associated with
a pressure gradient across the mitral valve.
An example of an acyanotic heart defect is
ventricular septal defect.
A loud pansystolic murmur that radiates to the axilla is most likely a result of
mitral regurgitation.
After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of
right-sided heart failure.
What age group has a larger volume of extracellular fluid than intracellular fluid?
Infants
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone–related peptide monitored for the resulting electrolyte imbalance?
Serum calcium, bowel function, level of consciousness
A deficiency of von Willebrand factor impairs
platelet adhesion to injured tissue
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV.
The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is
digitalis.
Rheumatic heart disease is most often a consequence of
β-hemolytic streptococcal infection.
How do clinical conditions that increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with
high cardiac output
After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of
tertiary prevention.
Which causes vasoconstriction?
Norepinephrine
Renal compensation for respiratory acidosis is evidenced by
elevated bicarbonate ion concentration.
Which change in a patient’s assessment has the greatest urgency?
Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing
Peripheral edema is a result of
venous thrombosis.
Necrotic death of brain tissue usually produces _____ necrosis.
liquefactive
While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?
Increased LDL levels are associated with increased risk of coronary artery disease
Hypotension associated with neurogenic and anaphylactic shock is because of
peripheral pooling of blood.
A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of
vitamin K deficiency.
Which disorder is associated with a type III hypersensitivity mechanism of injury?
Systemic lupus erythematosus
What is the correct definition of complete remission (CR) of leukemia?
CR is less than 5% blasts in marrow and normal CBC values.
In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing?
Class II, Compensated Stage
Certain autoimmune diseases are associated with the presence of specific proteins on a person’s cells. These proteins are called ________ proteins.
HLA or MHC
After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports “moderate” adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time?
Continue lifestyle modifications only
Selye’s three phases of the stress response include all the following except
allostasis.
All the following stress-induced hormones increase blood glucose except
aldosterone.
The hypersecretion of mucus resulting for chronic bronchitis is the result of
recurrent infection.
Administration of a vasodilator to a patient in shock would be expected to
decrease left ventricular afterload.
The person at highest risk for developing hypernatremia is a person who
receives tube feedings because he or she is comatose after a stroke.
The primary adaptive purpose of the substances produced in the alarm stage is
energy and repair.
Respiratory acidosis may be caused by
hypoventilation
Persistence of the alarm stage will ultimately result in
permanent damage and death
An increase in hemoglobin affinity for oxygen occurs with
shift to the left.
Hyperaldosteronism causes
ECV excess and hypokalemia.
A patient has a positive Chvostek sign. The nurse interprets this as a sign of
increased neuromuscular excitability.
Angiotensin-converting enzyme (ACE) inhibitors block the
conversion of angiotensin I to angiotensin II.
Hemophilia B is also known as Christmas disease.
True
The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of
tumor necrosis factor.
Which serum biomarker(s) are indicative of irreversible damage to myocardial cells?
Elevated CK-MB, troponin I, and troponin T
The cellular component that is most susceptible to radiation injury is the
DNA.
The hypersensitivity reaction that does not involve antibody production is type
IV.
Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?
Pain in long bones, infection, fever, bruising
Cancer grading is based on
cell differentiation.
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?
Inflammation, mucosal edema, and bronchoconstriction
Airway obstruction in chronic bronchitis is because of
thick mucus, fibrosis, and smooth muscle hypertrophy.
Early manifestations of a developing metabolic acidosis include
headache.
A patient with flail chest will demonstrate
outward chest movement on expiration
When systemic vascular resistance is decreased, blood flow
decreases.
Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of
nitric oxide.
The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.
sodium
Velocity of blood flow is measured in
centimeters per second.
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by
increased residual lung volumes.
An increase in the resting membrane potential (hyperpolarized) is associated with
hypokalemia.
The most appropriate treatment for secondary polycythemia is
measured to improve oxygenation.
The majority of cardiac cells that die after myocardial infarction do so because of
apoptosis.
Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
128/82
Second-degree heart block type I (Wenckebach) is characterized by
lengthening PR intervals and dropped P wave.
An abnormally wide (more than 0.10 second) QRS complex is characteristic of
premature ventricular complexes.
The primary source of erythropoietin is provided by the
kidney.
The assessment findings of a 5-year-old with a history of asthma include extreme shortness of breath, nasal flaring, coughing, pulsus paradoxus, and use of accessory respiratory muscles. There is no wheezing and the chest is silent in many areas. How should you interpret your assessment?
The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.
Metaplasia is
the replacement of one differentiated cell type with another.
A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?
Septic
Which characteristic is indicative of hemolytic anemia?
Jaundice
Retroviruses are associated with human cancers, including
Burkitt lymphoma.
The imbalance that occurs with oliguric renal failure is
hyperkalemia
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of
bacterial pneumonia.
High blood pressure increases the workload of the left ventricle, because it increases
afterload.
The characteristic x-ray findings in tuberculosis include
Ghon tubercles.
Cardiogenic shock is characterized by
reduced cardiac output.
First-degree heart block is characterized by
prolonged PR interval.
The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient
has chronic heart failure that is treated with diuretics
Clinical manifestations of severe symptomatic hypophosphatemia are caused by
deficiency of ATP.
Patent ductus arteriosus is accurately described as a(n)
communication between the aorta and the pulmonary artery.
When a parent asks how they will know if their 2-month-old baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse’s best response is
“If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated.”
Individuals who have chronic bronchitis most often have
a productive cough.
Red blood cells differ from other cell types in the body, because they
have no cytoplasmic organelles.
Metabolic alkalosis is often accompanied by
hypokalemia.
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia.
A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is
myeloma.
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
True
Clinical manifestations of chronic arterial obstruction include
intermittent claudication
A patient has a history of falls, syncope, dizziness, and blurred vision. The patient’s symptomology is most likely related to
hypotension
A 5-year-old patient’s parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child’s most likely diagnosis is
ALL (acute lymphoid leukemia)
Increased preload of the cardiac chambers may lead to which patient symptom?
Edema