Path week 5 Midterm
The ________ is the study of causes or reasons for phenomena and identifies causal factors that, acting in concert, provoke a particular disease or injury
etiology
The _________ is the time during which the first signs
and/or
symptoms appear indicating the onset of the disease.
prodrome
The ___________ is the test's ability to give the same
results
in repeated measurements.
reliability
Which of the following statements is FALSE about homeostasis?
Homeostasis is primarily controlled by the circulatory system.
The Validity is the degree to which a measurement
reflects the
true value of what it intends to measure.
true
Which of the following is an example of a factor that
would
affect the epidemiology of a particular disease?
Southeast asian etiology
Risk Factors are not stressors, but conditions or
situations
that increase the likelihood of encountering a
stressor.
true
A patient presenting with fever, hypotension, and
lactic
acidosis is most likely to be experiencing what type of
shock?
septic shock
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
Massive release of histamine with consequent
vasodilation and
hypotension occurs with what type of shock?
Anaphylactic
The most reliable indicator that a person is experiencing an acute
myocardial infarction (MI)
is_
ST-Segement Elevation
Cardiogenic shock is characterized by
reduced cardiac output
Hypertrophy of the right ventricle is a compensatory response to
pulmonary stenosis
Carbon monoxide injures cells by
reducing oxygen level on hemoglobin
Bacteria cause injury to cells by (Select all that apply.
-Producing destructive enzymes
-Evoking an immune
reaction
-Producing endotoxins
-producing exotoxins
Side effects of chemotherapy include (Select all that apply.)
-Anemia
-nausea
-bleeding
-infections
Malignant neoplasms of epithelial origin are known as
carcinomas
Deficits in immune system function occur in cancer
due to
(Select all that apply.)
-Chemotherapy
-cancer cells
-cancer metastasis
-bone
marrow
-malnutrition
Familial retinoblastoma involves the transmission of what from parent to offspring?
mutant tumor suppressor gene
Retroviruses are associated with human cancers, including
Burkitt lymphoma
The effect of nitric oxide on systemic arterioles is
Vasodilation
Positive inotropic drugs work by increasing (Select all
that apply.)
-Contractility,
-cardiac output,
-tissue perfusion,
-vascular resistance
Lactated Ringer solution and normal saline are commonly used ________
solutions that contain
electrolytes.
Crystaloid
Septic shock is commonly associated with Gram-negative infections and Gram-positive organisms that enter the body through the (Select all that apply.)
-Skin
-Genitourinary tract
-Gastrointestinal tract
-respiratory tract
Progressive stage of shock is marked by
_________________.
hypotension and marked tissue hypoxia
Which is true about Obstructive Shock?
- results from mechanical obstructions that prevent effective cardiac filling and stroke volume - common causes include pulmonary embolism, cardiac tamponade, and tension pneumothorax- rapid management of underlying obstruction is required to prevent cardiovascular collapse
The Primary cause of death in ARDS ( Acute
Respiratory Distress
Syndrome ) is
sepsis syndrome
Which one is true about Disseminated Intravascular
Coagulation?
It is both a bleeding and clotting disorder
Which one is incorrect about Heart Failure?
most common cause of heart condition
Which of the following escape rhythms originates in
Purkinje
fibers (rate of 15 to 40 beats/min with abnormally wide QRS).?
Ventricular escape rhythm
The ___________ is a completely disorganized and irregular trail rhythm accompanied by an irregular ventricular rythm
Arrhythmia/atrial arrhymia
Aortic regurgitation is associated with
DIASTOLIC MURMUR
Which one is true about biventricular heart failure?
it can only be Measured through Ejection Fraction
Angina due to coronary artery spasm is called _____ angina.
Prinzmetal variant
Which serum biomarker(s) are indicative ofirreversible damage to myocardial cells?
Elevated CK-MB,
troponin l,
troponin T
Constrictive pericarditis is associated
with
impaired cardiac filling
A reduction in _________ production after birth
contributes to
the heart's closure and constriction in
patent ductus arteriosus.
patent ductus arterioles
Cor pulmonale refers to
right ventricular hypertrophy secondary to pulmonary hypertension
Primary treatment for myocardial infarction (MI) is directed at
decreasing myocardial oxygen demands
Second-degree heart block type I (Wenckebach) is
characterized by
Lengthening PR intervals and dropped P wave
A patient who reports dizziness and who has absent P
waves, wide
QRS complexes, and a heart rate of 38
Ventricular Escape Rhythm
Secondary immune deficiency problems may be caused
by (Select
all that apply.)
Surgery
-High blood sugar
-corticosteroids
-low
protein level
Which of the following is not part of the category of
the
Myeloid neoplasm?
none of the above
The most common complication of leukemia and
chemotherapy is
infection
Which is false about Chronic Myeloid Leukemia?
none of the above
Which is false about Hodgkin's Disease?
it is more common than non-Hodgkin lymphoma
A patient is diagnosed with stage IIA Hodgkin disease.
This
patient's clinical stage was most likely determined
by (Select
all that apply.)
Patient history,
CT scan,
physical examination
This anemia is characterized by genetically determined defects of
hemoglobin synthesis resulting in hemoglobin
instability and insolubility.
sickle cell anemia
Which is false about Vascular Purpura?
Senile purpura is an intravascular blood discoloration.
Which is false about secondary Polycythemia?
none of the above
The patients with Hemophilia B (Christmas disease) are deficient in
factor IX
Which of the following coagulation factors is not dependent on Vitamin K?
Everyhting except II, VII, IX, X and protein C and S
Severe combined immunodeficiency (SCID) syndrome Factor IX is an example of a(n)
Deficient Immune Response
Myasthenia gravis is a type II hypersensitivity disorder
that involves
impaired muscle function
All the following stress-induced hormones increase
Deficient immune response
blood glucose except
aldosterone
Indicators that an individual is experiencing high
stress
include all the following except
pupil constriction
Persistence of the alarm stage will ultimately result
permanent damage and death
Pernicious anemia is caused by a lack of.......WHAT?
Lack of Intrinsic Factor
A newborn has melena, bleeding from the umbilicus, and hematuria. The newborn most likely experiencing.________?
Vitamin K deficiency bleeding
A cause of thrombocytopenia includes
chemotherapy
Emphysema results from destruction of alveolar walls and capillaries, which is due to
Release of proteolytic enzymes from immune cells
Respiratory acidosis is associated with
increased carbonic acid
Which electrolyte imbalances cause increased
neuromuscular excitability?
Hypocalcemia and hypomagnesimia
COPD leads to a barrel chest, because it causes
air trapping
Two primary acid-base disorders that are present
independently
are referred to as
mixed acid base imbalance
A person with acute hypoxemia may hyperventilate and develop
respiratory alkalosis
Causes of metabolic acidosis include
tissue anoxia
Vomiting of stomach contents or continuous
nasogastric
suctioning may predispose to development of
Metabolic acid deficit
Diarrhea causes......and is not just a lot of poop
-Dehydration
-electrolyte Imbalance
-Hypovolemia
A person who experiences a panic attack and develops hyperventilation symptoms may experience
Numbness and tingling in the extremities
The finding of ketones in the blood suggests that a person may have
Metabolic Acidosis
The major buffer in the extracellular fluid is
bicarbonate
The secondary hemostasis involves the formation of a
fibrin clot
through intrinsic and extrinsic pathways and
coagulation.
true
The Neurogenic Shock is the result of loss of
sympathetic
activation of arteriolar skeletal muscle.
false
What information about INR does the nurse
understand?
It standardizes extrinsic clotting pathway analysis
What is involved in the release of plasminogen
activators?
(Select all that apply.)
Factor XII
HMWK,
kallikrein,
thrombin
Which involves bleeding associated with vascular or platelet defects? (Select all that apply.)
Bleeding that occurs immediately after trauma,
bleeding that
involves skin or mucous membranes, bleeding that is brief in duration
Which diseases may be associated with a bleeding
problem?
(Select all that apply.)
-Renal failure,
-cirrhosis,
-systemic lupus erythematous,
-ovarian cancer
- Hematuria
-Melena
-Hematemesis
-Hemoptysis
Events which occur during the alarm stage of the stress
response
include secretion of (Select all that apply.)
-catecholamines.
- ACTH.
-glucocorticoids.
-immune cytokines.
The ___________ is inadequate adaptation
mechanisms or excessive
allostatic load; resulting in an
inability to maintain homeostasis.
allostatic overload
The effects of the stress response are influenced by all
the
following, except; (select all that apply)
none of the above
All these cellular responses are potentially reversible
except
necrosis
The cellular change that is considered preneoplastic is
dysplasia
What roles does inflammation play in cancer
development? (Select
all that apply.)
-Initiates carcinogenesis
-Causes direct DNA
damage
-Contributes to angiogenesis
-Limits apoptosis
Which disorder is associated with a type III hypersensitivity mechanism of injury?
Systemic lupus erythematosus
Transfusion reactions involve RBC destruction caused
by__________.
recipient antibodies
Autoimmune diseases result from which of the
following? (Select
all that apply.)
-. overactive immune function
-failure of the immune system to
differentiate self and nonself molecules
- environmental toxin exposure
Which diseases are due to type IV hypersensitivity?
(Select all
that apply.)
contact dermatitis and drug hypersensitivity
Which is true about epiglottitis? (Select all that apply.)
-Is usually caused by H. influenza type B
-Can be caused by
bacterial infection
-Usually occurs in children
-Is
characterized by pain with swallowing
Which acid are the kidneys unable to excrete?
carbonic acid
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg,
HCO3- = 24
mEq/L demonstrates
Respiratory Alkalosis
Rheumatic heart disease is most often a consequence of
β-hemolytic streptococcal infection.
Myocarditis should be suspected in a patient who
presents with
acute onset of left ventricular dysfunction
Atherosclerotic plaques with large lipid cores are prone
to
rupture
Acute coronary syndrome in the presence of
thrombosis may
present with which manifestations?
(Select all that apply.)
-unstable angina.
- MI.
-sudden cardiac arrest
Patients who experience anemic episodes when exposed to certain drugs most likely have
glucose-6-phosphate dehydrogenase deficiency
Hapten mechanisms are found in which medications?
(Select all
that apply.)
Penicillin
d. Cephalosporins
e. Tetracycline
Tissues are able to autoregulate their rate of blood flow
by controlling______________.
Vascular resistance
Which clinical finding is indicative of compartment
syndrome?
Absent peripheral pulses
Which changes in the circulatory system occur in the
older
adult? (Select all that apply.)
- Increased systemic vascular resistance (SVR)
-Decreased elasticity of vessel walls
Blood flow is measured as a given number of which
measurements?
(Select all that apply.)
centimeters per second
A patient's ECG lacks recognizable waveforms and is
deemed to
represent sinus arrest. What conditions could
have caused this
condition? (Select all that apply.)
MI.
-electrical shock.
-electrolyte disturbance.
-acidosis.
The Renin-Angiotensin-Aldosterone System (RAAS)
has which
effects on the heart? (Select all that apply.)
causing constriction of arterioles and veins
After evaluation, a child's asthma is characterized
as
"extrinsic." This means that the asthma is
associated with specific allergic triggers
Cystic fibrosis is associated with____________
Defective epithelial chloride ion transport
Croup is characterized by__________
a barking cough
108. COPD leads to a barrel chest, because it causes
air trapping
When exposed to inhaled allergens, a patient with
asthma
produces large quantities of
ige
Lack of α antitrypsin in emphysema causes
destruction of alveolar tissue
To best prevent emphysema, a patient is instructed to
stop
smoking since cigarette smoke
impairs alpha1-antitrypsin, allowing elastase to predominate.
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."
Airway obstruction in chronic bronchitis is because of
thick mucus, fibrosis, and smooth muscle hypertrophy.
An acute asthma attack is associated with which signs
and
symptoms? (Select all that apply.)
- bronchoconstriction
- bronchial mucosal edema
-
hypersecretion of mucus
- hypoxemia
Which is false about Tricuspid Atresia?
none of the above
Which is false regarding the Truncus Arteriosus?
surgery is not necessary for individuals with this condition.
Widespread atelectasis, non-cardiogenic pulmonary
edema, and
diffuse, fluffy alveolar infiltrates on chest
radiograph are
characteristic of
acute respiratory distress syndrome.
Which is indicative of a left tension pneumothorax?
Absent breath sounds on the left
A patient exhibiting respiratory distress as well as a
tracheal
shift should be evaluated for
pneumothorax
The organism that causes pulmonary tuberculosis is
Mycobacterium tuberculosis.
Which disorder is caused by inhalation of organic substances?
Hypersensitivity pneumonitis
The hallmark manifestation of acute respiratory distress syndrome is
hypoxemia
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV.
Neuromuscular disorders impair lung function
primarily because of
weak muscles of respiration.
Legionnaires disease is characterized by
presence of systemic illness.
A restrictive respiratory disorder is characterized by
decreased residual volume
The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.
sodium
Osmoreceptors located in the hypothalamus control
the release of
vasopressin (antidiuretic hormone, ADH) ( increased blood osmolality)
The fraction of total body water (TBW) volume contained in the intracellular space in adults is
two thirds
An increase in the resting membrane potential
(hyperpolarized)
is associated with____
Hypokalemia
Clinical manifestations of hyponatremia include
Confusion, lethargy, coma, and perhaps seizures
A person who has hyperparathyroidism is likely to develop
Hypercalcemia
Clinical manifestations of severe symptomatic
hypophosphatemia
are caused by
deficiency of ATP
A known cause of hypokalemia is
pancreatitis
Hyperaldosteronism causes
ECV excess and hypokalemia
A patient has a positive Chvostek sign. The nurse interprets this as a sign of:
increased neuromuscular excitability.
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 conciousness
Which is false about Tetralogy of Fallot?
none of the above
Which is false about the Coarctation of the Aorta?
-Most aortic coarctations are at or below the diaphragm
Which is false about the Ventricular Septal Defect?
The signs and symptoms of a ventricular septal defect are most commonly detected in a baby following birth.
All of the following about high output failure of the lymphatic system are true, EXCEPT:
Lymphedema is usually caused by high output failure.
Which is true about Chronic Venous Insufficiency?
Chronic Venous Insufficiency (CVI) refers to an advanced stage of venous disease where the veins and muscle pump activity become incompetent.
Which of the following is not a sign or symptom of
Acute
Arterial Occlusion?
purulence
This kind of true aneurysm is recognized because it
possesses a
balloon that has a stem and neck.
Saccular ("BERRY") aneurysm
Which is false about Raynaud Syndrome?
Cold packs alleviate (reduce) the symptoms
Which one is false about Thrombosis?
Thrombosis is solidification of stagnant blood.
The __________ proposes that the net filtration is
equal to the
combined forces fostering filtration minus
the combined forces
opposing filtration
Starling's hypothesis
Which is false about Von Willebrand Disease?
Functional vWF molecules usually occur as a monomers or dimers.
In hepatic disease, the coagulopathies result from all
of the
following, except;
hepatic disease leads to enhanced activity of clotting factors or increased platelet count
Concerning the organization of the circulatory and
Lymphatic
Systems in Geriatrics, which one is correct?
select all that apply
all of the above