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.

When a client diagnosed with COPD type A asks, “Why is my chest so big and round?”, the nurse responds that

“Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round.”

Patients who experience anemic episodes when exposed to certain drugs most likely have

glucose-6-phosphate dehydrogenase deficiency.

Respiratory acidosis may be caused by

hypoventilation.

Clinical manifestations of moderate to severe hypokalemia include

muscle weakness and cardiac dysrhythmias.

Clinical manifestations of hyponatremia include

confusion, lethargy, coma, and perhaps seizures.

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?

It is a procedure for determining the extent of tumor spread.

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

kill rapidly dividing cells.

A patient diagnosed with chronic compensated heart failure reports that, “My feet swell if I eat salt but I don’t understand why” The nurse’s best response isCorrect!

“Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell.”

Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate (HR) of 100?

Sitting BP 88/60, HR 118

Bacterial pneumonia leads to hypoxemia caused by

accumulation of alveolar exudates.

Low cardiac output in association with high preload is characteristic of ________ shock.

cardiogenic

The ________ system compensates for metabolic acidosis and alkalosis.

respiratory

Diarrhea and other lower intestinal fluid losses will contribute to

metabolic acidosis.

The liver is responsible for the synthesis of coagulation factors, with the exception of part of VIII.

True

A patient with flail chest will demonstrate

outward chest movement on expiration.

Blood flow throughout the periphery is regulated by

the autonomic nervous system.

What age group has a larger volume of extracellular fluid than intracellular fluid?

Infants

Metabolic alkalosis is often accompanied by

hypokalemia.

Administration of a vasodilator to a patient in shock would be expected to

decrease left ventricular afterload.

Hypertrophy of the right ventricle is a compensatory response to

pulmonary stenosis.

Autologous stem cell transplantation is a procedure in which

stem cells are harvested from the patient and then returned to the same patient.

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

bacterial pneumonia.

Clinical manifestations of severe symptomatic hypophosphatemia are caused by

deficiency of ATP.

The progressive stage of hypovolemic shock is characterized by

tachycardia.

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

massive histamine release from mast cells leads to vasodilation.

A commonly ingested substance associated with prolongation of the bleeding time is

aspirin.

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.”

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

Which dysrhythmia is thought to be associated with reentrant mechanisms?

Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

The body compensates for metabolic alkalosis by

hypoventilation.

Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia.

False

An increase in the resting membrane potential (hyperpolarized) is associated with

hypokalemia.

Myasthenia gravis is a type II hypersensitivity disorder that involves

impaired muscle function.

Retroviruses are associated with human cancers, including

Burkitt lymphoma.

A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of this disease. This stage of illness is called the _____ stage.

latent

First-degree heart block is characterized by

prolonged PR interval.

C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.’s disease is

streptococcal infection.

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.

True

The goal of long term heparin for the management of a deep vein thrombosis is to

prevent further clot formation.

The major buffer in the extracellular fluid is

bicarbonate.

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor

True

Decreased neuromuscular excitability is often the result of

hypomagnesemia and hyperkalemia.

Which form of leukemia demonstrates the presence of the Philadelphia chromosome?

CML (chronic myeloid leukemia)

A patient with cold and edematous extremities, low cardiac output, and profound hypotension is likely to be experiencing a progressive stage of ________ shock.

septic

Allergic (extrinsic) asthma is associated with

IgE-mediated airway inflammation.

Metaplasia is

the replacement of one differentiated cell type with another.

COPD leads to a barrel chest, because it causes

air trapping.

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

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

Constrictive pericarditis is associated with

impaired cardiac filling.

Excessive red cell lysis can be detected by measuring the serum

bilirubin.

Apoptosis is a process that results in cellular

death.

Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York Heart Association heart failure class?

Class I

Which acid are the kidneys unable to excrete?

Carbonic

What results when systemic blood pressure is increased?

Vasoconstriction

A patient is exhibiting severe dyspnea and anxiety. The patient also has bubbly crackles in all lung fields with pink, frothy sputum. This patient is most likely experiencing

acute cardiogenic pulmonary edema.

The organism that causes pulmonary tuberculosis is

Mycobacterium tuberculosis.

Coagulative necrosis is caused by

interrupted blood supply.

Transfusion reactions involve RBC destruction caused by

recipient antibodies.

Your patient eats “lots of fat,” leads a “stressful” life, and has smoked “about two packs a day for the last 40 years.” Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is

cigarette smoking.

The primary adaptive purpose of the substances produced in the alarm stage is

energy and repair.

The most commonly recognized outcome of hypertension is pulmonary disease.

False

Lack of α-antitrypsin in emphysema causes

destruction of alveolar tissue.

Restriction of which electrolytes is recommended in the management of high blood pressure?

Sodium

A patient who was involved in a fall from a tree becomes short of breath. The lung sounds are absent on one side. This patient is experiencing ________ shock.

obstructive

Uncompensated metabolic alkalosis would result in

increased pH, increased HCO₃ ^–.

Croup is characterized by

a barking cough.

Most carbon dioxide is transported in the bloodstream as

bicarbonate ion.

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is

elevated total iron-binding capacity.

A disease that is native to a particular region is called

endemic.

Pulse pressure is defined as

systolic pressure – diastolic pressure.

Red blood cells differ from other cell types in the body, because they

have no cytoplasmic organelles.

Which causes vasoconstriction?

Norepinephrine

Selye’s three phases of the stress response include all the following except

allostasis.

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative ofCorrect!

vitamin K deficiency.

Indicators that an individual is experiencing high stress include all the following except

pupil constriction.

Peripheral edema is a result of

venous thrombosis.

Chronic elevation of myocardial wall tension results in atrophy.

False

Carbon monoxide injures cells by

reducing oxygen level on hemoglobin.

Viral pneumonia is characterized by

a dry cough.

Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with

hypophosphatemia.

Which serum biomarker(s) are indicative of irreversible damage to myocardial cells?

Elevated CK-MB, troponin I, and troponin T

When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will

put a sputum cup and a box of tissues on the bedside table.

Thalassemia may be confused with iron-deficiency anemia, because they are both

microcytic.

The effects of excessive cortisol production include

immune suppression.

A serious complication of deep vein thrombosis is

pulmonary embolus.

Malignant neoplasms of epithelial origin are known as

carcinomas.

What is necessary for red blood cell production?

Iron

Somatic death refers to death

of the entire organism.

A person who has hyperparathyroidism is likely to develop

hypercalcemia.

Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.

renin

Renal compensation for respiratory acidosis is evidenced by

elevated bicarbonate ion concentration.

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.You Answered

False

Which pulmonary function test result is consistent with a diagnosis of asthma?

Reduced forced expiratory volume in 1 second (FEV₁)

A patient has a positive Chvostek sign. The nurse interprets this as a sign of

increased neuromuscular excitability.

Activation of the extrinsic pathway of coagulation is initiated by

tissue thromboplastin.

Legionnaires disease is characterized by

presence of systemic illness.

The majority of tachydysrhythmias are believed to occur because of

reentry mechanisms.

Individuals who have chronic bronchitis most often have

a productive cough.

Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.

False

Aortic regurgitation is associated with

diastolic murmur.

In general, with aging, organ size and function

decrease.

All these cellular responses are potentially reversible except

necrosis.

Manifestations from sodium imbalances occur primarily as a result of

cellular fluid shifts.

The therapy that most directly improves cardiac contractility in a patient with systolic heart failure is

digitalis.

Patients with immunodeficiency disorders are usually first identified because they

develop recurrent infections.

Velocity of blood flow is measured in

centimeters per second.

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient’s symptomology is most likely related to

hypotension.

After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of

tertiary prevention.

The fraction of total body water (TBW) volume contained in the intracellular space in adults is

two thirds.

A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has no significant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly, and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visit today, the patient’s blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time?

Begin antihypertensive drug therapy.

Which condition enhances lymphatic flow?

Increased interstitial fluid colloid osmotic pressure

Neuromuscular disorders impair lung function primarily because of

weak muscles of respiration.

Obstructive sleep apnea would most likely be found in a patient diagnosed with

Pickwickian syndrome.

Improvement in a patient with septic shock is indicated by an increase in

systemic vascular resistance.

Increased preload of the cardiac chambers may lead to which patient symptom?

Edema

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

Which alterations can lead to edema?

Decreased lymphatic flow

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinopathy, and symptoms of an ischemic stroke. This symptomology is likely the result of

hypertensive crisis.

The common denominator in all forms of heart failure is

reduced cardiac output.

The arterial oxygen content (CaO₂) for a patient with PaO₂ 100 mm Hg, SaO₂ 95%, and hemoglobin 15 g/dL is _____ mL oxygen/dL.

19.4

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

is malignant.

What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?

Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

Cor pulmonale refers to

right ventricular hypertrophy secondary to pulmonary hypertension.

A person who experiences a panic attack and develops hyperventilation symptoms may experience

numbness and tingling in the extremities.

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?

Tachycardia

Which vessel normally demonstrates the most rapid blood flow?

The vena cava

What is the correct definition of complete remission (CR) of leukemia?

CR is less than 5% blasts in marrow and normal CBC values.

When a parent of a toddler recently diagnosed with pneumococcal pneumonia asks why their child is so much sicker than a classmate was when they were diagnosed with pneumonia, the nurse replies

“It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia.”

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?

Iron deficiency

The primary effect of aging on all body systems is

decreased functional reserve.

The prothrombin time (PT) and INR (international normalized ratio) measure the integrity of

extrinsic pathway.

The primary cause of infant respiratory distress syndrome is

lack of surfactant.

An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of

secondary prevention.

The arterial blood gas pH = 7.52, PaCO₂ = 30 mm Hg, HCO₃ ^– = 24 mEq/L demonstrates

respiratory alkalosis.

The cellular change that is considered preneoplastic is

dysplasia.

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is

activity restriction.

The relationship of blood flow (Q), resistance (R), and pressure (P) in a vessel can be expressed by which equation?

Q = P/R

A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with

hemophilia.

A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n)

elderly woman without a previous history of MI.

Treatment for hemophilia A includes

factor VIII replacement.

Pernicious anemia is caused by a lack of

intrinsic factor.

Which is not considered to be a risk factor for thrombus formation?

Thrombocytopenia

The effect of nitric oxide on systemic arterioles is

vasodilation.

Accumulation of fluid in the pleural space is called

pleural effusion.

Myocarditis should be suspected in a patient who presents with

acute onset of left ventricular dysfunction.

A restrictive respiratory disorder is characterized by

decreased residual volume.

Familial retinoblastoma involves the transmission of what from parent to offspring?

Mutant tumor-suppressor gene

The imbalance that occurs with oliguric renal failure is

hyperkalemia.

Individuals who have chronic bronchitis most often have

a productive cough.

Red blood cells obtain nearly all their energy from metabolism of

glucose.

Renal insufficiency is a common complication of which disease?

Myeloma

Obstructive disorders are associated with

low expiratory flow rates.

An increase in organ size and function caused by increased workload is termed

hypertrophy.

When the cause is unknown, a condition is said to be idiopathic

True

A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop

hypophosphatemia.

Which disorder is caused by inhalation of organic substances?

Hypersensitivity pneumonitis

Which disorder is considered a primary immunodeficiency disease?

HIV/AIDS

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.

III

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.

False

Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of

metabolic acid deficit.

Widespread activation of the clotting cascade secondary to massive trauma is called

disseminated intravascular coagulation (DIC).

All the following stress-induced hormones increase blood glucose except

aldosterone

A deficiency of von Willebrand factor impairs

platelet adhesion to injured tissue.

Which is not normally secreted in response to stress?

Insulin

The cellular component that is most susceptible to radiation injury is the

DNA.

Which clinical finding is indicative of compartment syndrome?

Absent peripheral pulses

The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who

has had diarrhea for over a week.

The movement of blood through the vascular system is opposed by the force of

resistance.

In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event?

Inflammation, mucosal edema, and bronchoconstriction

When systemic vascular resistance is decreased, blood flow

tissue anoxia.

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.

When systemic vascular resistance is decreased, blood flow

decreases.

Effects of hypernatremia on the central nervous system typically include

confusion

The strength of the bond between oxygen and hemoglobin is known as the

oxygen-hemoglobin affinity.

The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of

tumor necrosis factor.

In which dysrhythmias should treatment be instituted immediately?

Atrial fibrillation with a ventricular rate of 220 beats/minute

The hypersecretion of mucus resulting for chronic bronchitis is the result of

recurrent infection.

A patient presents to the physician’s office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years.

4 and 7

The activated partial thromboplastin time (aPTT) is a measure of the integrity of

the intrinsic pathway.

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.

A loud pansystolic murmur that radiates to the axilla is most likely a result of

mitral regurgitation.

Venous obstruction leads to edema because it ________ pressure.

increases capillary hydrostatic

Clinical manifestations of extracellular fluid volume deficit include

weak pulse, low blood pressure, and increased heart rate.

Administration of which therapy is most appropriate for hypovolemic shock?

Crystalloids

Allostasis is best defined as

the overall process of adaptive change necessary to maintain survival and well-being.

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by

norepinephrine.

Which alterations can lead to edema?

Decreased lymphatic flow

Osmoreceptors located in the hypothalamus control the release of

vasopressin (antidiuretic hormone, ADH).

The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is

infection.

Which complication of asthma is life threatening?

Status asthmaticus

A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for

pneumothorax.

The primary source of erythropoietin is provided by the

kidney.

Angiotensin-converting enzyme (ACE) inhibitors block the

conversion of angiotensin I to angiotensin II.

The most effective therapy for anemia associated with kidney failure is

erythropoietin administration.

When a client diagnosed with COPD type A asks, “Why is my chest so big and round?”, the nurse responds that

“Loss of elastic tissue in your lungs allows your airways to close and trap air, which makes your chest round.”

The megakaryocyte is a precursor to

platelets.

Severe combined immunodeficiency (SCID) syndrome is an example of a(n)

deficient immune response.

The ________ system compensates for metabolic acidosis and alkalosis.

respiratory

Pneumocystitis is a term that refers to a

fungal pneumonia secondary to HIV.

Which characteristic is indicative of hemolytic anemia?

Jaundice

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

Anaphylactic

A major cause of treatment failure in tuberculosis is

noncompliance.

Which type of leukemia primarily affects children?

ALL (acute lymphoid leukemia)

Left-sided heart failure is characterized by

pulmonary congestion.

The effect of stress on the immune system

may involve enhancement or impairment the immune system.

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

secondary prevention.

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct?

"Lung cancer has about a 15% survival rate.”

The finding of ketones in the blood suggests that a person may have

metabolic acidosis.

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI) is

ST-segment elevation.

Manifestations from sodium imbalances occur primarily as a result of

cellular fluid shifts.

Clinical manifestations of chronic arterial obstruction include

intermittent claudication.

What laboratory finding is usually found in aplastic anemia?

Pancytopenia

The hallmark manifestation of acute respiratory distress syndrome is

hypoxemia.

A laboratory test finding helpful in confirming the diagnosis of iron-deficiency anemia is

elevated total iron-binding capacity.

Extreme cold injures cells by all the following except

decreased blood viscosity.

Mitral stenosis is associated with

a pressure gradient across the mitral valve.

The cause of the most common form of anemia is

iron deficiency.

Restriction of which electrolytes is recommended in the management of high blood pressure?

Sodium

Which is not a manifestation of acute arterial obstruction?

Purpura

The characteristic x-ray findings in tuberculosis include

Ghon tubercles.

Renal compensation for respiratory acidosis is evidenced by

elevated bicarbonate ion concentration.

A normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of

vitamin K deficiency.

Which dysrhythmia is thought to be associated with reentrant mechanisms?

Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome)

Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure.

mean arterial

Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called

tension pneumothorax.

A patient with pure left-sided heart failure is likely to exhibit

pulmonary congestion with dyspnea.

A patient with significant aortic stenosis is likely to experience

syncope.

The effects of histamine release include

increased vascular permeability.

Which acid are the kidneys unable to excrete?

Carbonic

The process responsible for distribution of fluid between the interstitial and intracellular compartments is

osmosis.

In general, a cancer cell that is more tissue-specific differentiated is more likely to be aggressive.

False

The final step in clot formation is

clot retraction.

Persistence of the alarm stage will ultimately result in

permanent damage and death.

The principle Ig mediator of type I hypersensitivity reactions is

IgE.

The most appropriate treatment for secondary polycythemia is

measured to improve oxygenation.

A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously. This patient presents with

telangiectasia.

The most common primary immune deficiency that affects only B cells is

selective IgA.

Which disorder is caused by inhalation of organic substances?

Hypersensitivity pneumonitis

A known cause of hypokalemia is

insulin overdose.

Early manifestations of a developing metabolic acidosis include

headache.

The increased anterior-posterior chest diameter associated with obstructive lung disease is caused byYou Answered

increased residual lung volumes.

Blood flow throughout the periphery is regulated by

the autonomic nervous system.

Emphysema results from destruction of alveolar walls and capillaries, which is because of

air trapping with resultant excessive alveolar pressure.

The hallmark manifestation of acute respiratory distress syndrome isYou Answered

hypoxemia

Hypernatremia may be caused by

decreased antidiuretic hormone secretion.

Which is indicative of a left tension pneumothorax?

Absent breath sounds on the left

Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called

tension pneumothorax.

What is likely to lead to hyponatremia?

Frequent nasogastric tube irrigation with water

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

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

A patient diagnosed with chronic compensated heart failure reports that, “My feet swell if I eat salt but I don’t understand why” The nurse’s best response is

“Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell.” gt56

What is likely to lead to hyponatremia?

Administration of intravenous normal saline