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MIDTERM

front 1

Blood flow throughout the periphery is regulated by

back 1

the autonomic nervous system.

front 2

Pulse pressure is defined as

back 2

systolic pressure – diastolic pressure

front 3

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

back 3

has had diarrhea for over a week.

front 4

Uncompensated metabolic alkalosis would result in

back 4

increased pH, increased HCO 3 –.

front 5

A common characteristic of viral pneumonia is

back 5

increased carbonic acid.

front 6

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

back 6

False (resp alkalosis)

front 7

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

back 7

Septic

front 8

Respiratory acidosis is associated with

back 8

increased carbonic acid.

front 9

Croup is characterized by

back 9

a barking cough

front 10

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

back 10

telangiectasia.

front 11

The inward-pulling force of particles in the vascular fluid is called _____ pressure.

back 11

capillary osmotic

front 12

Transfusion reactions involve RBC destruction caused by

back 12

recipient antibodies

front 13

The major cause of death from leukemic disease is

back 13

infection

front 14

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.

back 14

19.4

front 15

Mitral stenosis is associated with

back 15

a pressure gradient across the mitral valve.

front 16

An example of an acyanotic heart defect is

back 16

ventricular septal defect.

front 17

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

back 17

mitral regurgitation.

front 18

After sitting in a chair for an hour, an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

back 18

right-sided heart failure.

front 19

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

back 19

Infants

front 20

How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone–related peptide monitored for the resulting electrolyte imbalance?

back 20

Serum calcium, bowel function, level of consciousness

front 21

A deficiency of von Willebrand factor impairs

back 21

platelet adhesion to injured tissue

front 22

Pneumocystitis is a term that refers to a

back 22

fungal pneumonia secondary to HIV.

front 23

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

back 23

digitalis.

front 24

Rheumatic heart disease is most often a consequence of

back 24

β-hemolytic streptococcal infection.

front 25

How do clinical conditions that increase vascular permeability cause edema?

back 25

By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

front 26

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with

back 26

high cardiac output

front 27

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

back 27

tertiary prevention.

front 28

Which causes vasoconstriction?

back 28

Norepinephrine

front 29

Renal compensation for respiratory acidosis is evidenced by

back 29

elevated bicarbonate ion concentration.

front 30

Which change in a patient’s assessment has the greatest urgency?

back 30

Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing

front 31

Peripheral edema is a result of

back 31

venous thrombosis.

front 32

Necrotic death of brain tissue usually produces _____ necrosis.

back 32

liquefactive

front 33

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?

back 33

Increased LDL levels are associated with increased risk of coronary artery disease

front 34

Hypotension associated with neurogenic and anaphylactic shock is because of

back 34

peripheral pooling of blood.

front 35

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

back 35

vitamin K deficiency.

front 36

Which disorder is associated with a type III hypersensitivity mechanism of injury?

back 36

Systemic lupus erythematosus

front 37

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

back 37

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

front 38

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?

back 38

Class II, Compensated Stage

front 39

Certain autoimmune diseases are associated with the presence of specific proteins on a person’s cells. These proteins are called ________ proteins.

back 39

HLA or MHC

front 40

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?

back 40

Continue lifestyle modifications only

front 41

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

back 41

allostasis.

front 42

All the following stress-induced hormones increase blood glucose except

back 42

aldosterone.

front 43

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

back 43

recurrent infection.

front 44

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

back 44

decrease left ventricular afterload.

front 45

The person at highest risk for developing hypernatremia is a person who

back 45

receives tube feedings because he or she is comatose after a stroke.

front 46

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

back 46

energy and repair.

front 47

Respiratory acidosis may be caused by

back 47

hypoventilation

front 48

Persistence of the alarm stage will ultimately result in

back 48

permanent damage and death

front 49

An increase in hemoglobin affinity for oxygen occurs with

back 49

shift to the left.

front 50

Hyperaldosteronism causes

back 50

ECV excess and hypokalemia.

front 51

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

back 51

increased neuromuscular excitability.

front 52

Angiotensin-converting enzyme (ACE) inhibitors block the

back 52

conversion of angiotensin I to angiotensin II.

front 53

Hemophilia B is also known as Christmas disease.

back 53

True

front 54

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

back 54

tumor necrosis factor.

front 55

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

back 55

Elevated CK-MB, troponin I, and troponin T

front 56

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

back 56

DNA.

front 57

The hypersensitivity reaction that does not involve antibody production is type

back 57

IV.

front 58

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?

back 58

Pain in long bones, infection, fever, bruising

front 59

Cancer grading is based on

back 59

cell differentiation.

front 60

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

back 60

Inflammation, mucosal edema, and bronchoconstriction

front 61

Airway obstruction in chronic bronchitis is because of

back 61

thick mucus, fibrosis, and smooth muscle hypertrophy.

front 62

Early manifestations of a developing metabolic acidosis include

back 62

headache.

front 63

A patient with flail chest will demonstrate

back 63

outward chest movement on expiration

front 64

When systemic vascular resistance is decreased, blood flow

back 64

decreases.

front 65

Tumor necrosis factor α and interleukin-1 contribute to shock states because they induce production of

back 65

nitric oxide.

front 66

The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions.

back 66

sodium

front 67

Velocity of blood flow is measured in

back 67

centimeters per second.

front 68

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

back 68

increased residual lung volumes.

front 69

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

back 69

hypokalemia.

front 70

The most appropriate treatment for secondary polycythemia is

back 70

measured to improve oxygenation.

front 71

The majority of cardiac cells that die after myocardial infarction do so because of

back 71

apoptosis.

front 72

Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?

back 72

128/82

front 73

Second-degree heart block type I (Wenckebach) is characterized by

back 73

lengthening PR intervals and dropped P wave.

front 74

An abnormally wide (more than 0.10 second) QRS complex is characteristic of

back 74

premature ventricular complexes.

front 75

The primary source of erythropoietin is provided by the

back 75

kidney.

front 76

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?

back 76

The child may be having such a severe asthma episode that the airways are closed, so start oxygen and get the doctor immediately.

front 77

Metaplasia is

back 77

the replacement of one differentiated cell type with another.

front 78

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

back 78

Septic

front 79

Which characteristic is indicative of hemolytic anemia?

back 79

Jaundice

front 80

Retroviruses are associated with human cancers, including

back 80

Burkitt lymphoma.

front 81

The imbalance that occurs with oliguric renal failure is

back 81

hyperkalemia

front 82

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

back 82

bacterial pneumonia.

front 83

High blood pressure increases the workload of the left ventricle, because it increases

back 83

afterload.

front 84

The characteristic x-ray findings in tuberculosis include

back 84

Ghon tubercles.

front 85

Cardiogenic shock is characterized by

back 85

reduced cardiac output.

front 86

First-degree heart block is characterized by

back 86

prolonged PR interval.

front 87

The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient

back 87

has chronic heart failure that is treated with diuretics

front 88

Clinical manifestations of severe symptomatic hypophosphatemia are caused by

back 88

deficiency of ATP.

front 89

Patent ductus arteriosus is accurately described as a(n)

back 89

communication between the aorta and the pulmonary artery.

front 90

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

back 90

“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.”

front 91

Individuals who have chronic bronchitis most often have

back 91

a productive cough.

front 92

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

back 92

have no cytoplasmic organelles.

front 93

Metabolic alkalosis is often accompanied by

back 93

hypokalemia.

front 94

Decreased neuromuscular excitability is often the result of

back 94

hypercalcemia and hypermagnesemia.

front 95

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

back 95

myeloma.

front 96

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

back 96

True

front 97

Clinical manifestations of chronic arterial obstruction include

back 97

intermittent claudication

front 98

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

back 98

hypotension

front 99

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

back 99

ALL (acute lymphoid leukemia)

front 100

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

back 100

Edema