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178 terms

Final exam

test 2
When stroke volume decreases, which of the following could maintain cardiac output?
increased heart rate
Which of the following describes the pericardial cavity correctly?
It is a potential space containing a very small amount of serous fluid.
Which of the following factors greatly improves venous return to the heart during strenuous exercise?
contraction and relaxation of skeletal muscle
Which of the following causes increased heart rate?
Stimulation of the sympathetic nervous system
Which event causes the QRS wave on an ECG tracing?
ventricular depolarization
Which of the following are predisposing factors to thrombus formation in the circulation?
2. damaged blood vessel walls
3. immobility
4. prosthetic valves
What will a partial obstruction in a coronary artery likely cause?
angina attacks
Modifiable factor that increase the risk for atherosclerosis include:
sedentary life style
When comparing angina with myocardial infarction (MI), which statement is true?
Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is not.
Which of the following best describes the basic pathophysiology of myocardial infarction?
Total obstruction of a coronary artery causes myocardial necrosis
Which of the following are typical early signs or symptoms of myocardial infarction?
persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse
What is the most common cause of death immediately following a myocardial infarction?
cardiac arrhythmias
Which is the best definition of congestive heart failure?
inability of the heart to pump enough blood to meet the metabolic needs of the body
Which of the following are significant signs of right-sided congestive heart failure?
edematous feet and legs with hepatomegaly
Why does pericarditis cause a reduction in cardiac output?
Excess fluid in the pericardial cavity decreases ventricular filling.
Which of the following may cause pericarditis?
1. infection
2. abnormal immune responses
3. injury
4. malignant neoplasm
Which of the following could be the source of an embolus causing an obstruction in the brain?
carotid artery
When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals?
blood pressure remains consistently above 140/90
What does the term intermittent claudication refer to?
ischemic muscle pain in the legs, particularly with exercise
An echocardiogram is used to demonstrate any abnormal:
movement of the heart valves
A friction rub is associated with
How does a dissecting aortic aneurysm develop?
A tear in the intimal lining allows blood flow between layers of the aortic wall.
What is the outcome for many aortic aneurysms?
rupture and hemorrhage
Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because
thrombus forms in a vein and is asymptomatic
The classic early manifestation(s) of left-sided congestive heart failure are ____, whereas the early indicator(s) of right-sided failure are _______.
shortness of breath on exertion or lying down; swelling of the ankles
The cause of essential hypertension is considered to be:
Which of the following is considered to be the most dangerous arrhythmia?
ventricular fibrillation
Which of the following would confirm the diagnosis of a myocardial infarction?
specific changes in the ECG
. elevation of cardiac isoenzymes in serum
A very rapid heart rate reduces cardiac output because
ventricular filling is reduced
Which statement applies to paroxysmal nocturnal dyspnea?
It is caused by increased blood in the lungs when lying in a supine position.
Prophylactic antibacterial drugs such as amoxicillin are given to those with certain congenital heart defects or damaged heart valves immediately before invasive procedures to prevent:
infectious endocarditis
Varicose ulcers may develop and be slow to heal because:
edema reduces arterial blood supply to the area
Cigarette smoking is a risk factor in coronary artery disease because smoking:
promotes platelet adhesion
What does the term arteriosclerosis specifically refer to?
degeneration with loss of elasticity and obstruction in small arteries
An atheroma develops from
accumulated lipids, cells, and fibrin where endothelial injury has occurred
Factors that may precipitate an angina attack include all of the following EXCEPT:
walking down stairs
Which of the following is most likely to cause left-sided congestive heart failure?
uncontrolled essential hypertension
What is considered to be the basic pathophysiologic change in essential hypertension?
increased systemic vasoconstriction
What is atherosclerosis in the iliac or femoral arteries likely to cause?
strong rapid pulses in the legs
intermittent claudication
Which factor predisposes to varicose veins during pregnancy?
compressed pelvic veins
Which of the following statements regarding aneurysms is true?
Manifestations of aneurysms result from compression of adjacent structures.
What is the most common factor predisposing to the development of varicose veins?
increased venous pressure
What happens in the lungs when the diaphragm relaxes?
Air is forced out of the lungs
The central chemoreceptors are normally most sensitive to
elevated carbon dioxide level
What does the term hemoptysis refer to?
bright red streaks of blood in frothy sputum
Orthopnea is:
difficulty breathing in a recumbent position
Signs and symptoms of acute sinusitis usually include:
severe localized pain and tenderness in the face
The maximum volume of air a person can exhale after a maximum inspiration is termed the
vital capacity
Carbon dioxide is primarily transported in the blood
as bicarbonate ion
Which of the following would result from hyperventilation?
respiratory alkalosis
What are early signs and symptoms of infectious rhinitis?
serous nasal discharge, congestion, and sneezing
Which of the following describes lobar pneumonia?
sudden onset of fever and chills, with rales and rusty sputum
Rust-colored sputum in a patient with pneumonia usually indicates:
Streptococcus pneumoniae is the infecting agent
Select the statement related to tuberculosis:
The microbe is an acid-fast bacillus, resistant to many disinfectants.
How is primary tuberculosis identified?
caseation necrosis and formation of a tubercle in the lungs
Which of the following confirms the presence of active (reinfection) tuberculosis?
identification of acid-fast bacilli in a sputum sample
Histoplasmosis is caused by a:
Why does hypercalcemia occur with bronchogenic carcinoma?
secretion of parathyroid or like hormone by the tumor
What is the pathophysiology of an acute attack of extrinsic asthma?
type 1 hypersensitivity reaction
During an acute asthma attack, how does respiratory obstruction occur?
edema of the mucosa
increased secretion of thick, tenacious mucus
What cause the expanded A-P thoracic diameter (barrel chest) in patients with emphysema?
air trapping and hyperinflation
Destruction of alveolar walls and septae is a typical change in
What is the cause of chronic bronchitis?
chronic irritation, inflammation, and recurrent infection of the larger airways
Which of the following are typical of chronic bronchitis?
fibrosis of the bronchial wall
Why does cor pulmonale develop with chronic pulmonary disease?
Pulmonary fibrosis and vasoconstriction increase vascular resistance
What are common signs of cor pulmonale?
hepatomegaly and edema in the legs
What is caused by frequent inhalation of irritating particles such as silica?
fibrosis and loss of compliance
Pulmonary edema causes severe hypoxia because of:
increasing difficulty expanding the lungs
Which of the following is NOT a cause of pulmonary edema?
hyperproteinemia and increasing osmotic pressure of the blood
Which of the following is a common source of a pulmonary embolus?
thrombus forming in the femoral veins
What is a large-sized pulmonary embolus likely to cause?
hypotension and right-sided heart failure
Which manifestation(s) of atelectasis is/are associated with airway obstruction?
decreased breath sounds on the affected side
How does total obstruction of a major bronchus lead to atelectasis?
Air is absorbed from the alveoli distal to the obstruction.
How does a large pleural effusion cause atelectasis?
The cohesion between the pleural membranes is disrupted.
When does flail chest occur?
Several ribs are fractured at two sites.
With a flail chest injury, events during inspiration include
the mediastinum shifts toward the unaffected side
How is cardiac output reduced with a flail chest injury?
Venous return is impaired
Which of the following is a manifestation of a simple closed pneumothorax?
asymmetrical chest movements
Which of the following is an effect of a large open pneumothorax (sucking wound)?
mediastinal flutter
With a tension pneumothorax, which factors contribute to severe hypoxia?
continually increasing pressure on the unaffected lung
Which of the following statements describe the pathophysiology of adult respiratory distress syndrome?
damage leading to increased permeability of the alveolar walls
excessive fluid and protein interstitially and in the alveoli
Infant respiratory distress syndrome results from:
insufficient surfactant production
Obstruction in the upper airway is indicated by:
Which of the following does NOT apply to carbon dioxide?
It is replaced on hemoglobin by oxygen in the lungs
Whenever PO2 levels decrease below normal, then PCO2 levels:
may or may not change
Laryngotracheobronchitis is typically manifested by
hoarse voice and barking cough
Lobar pneumonia is usually caused by
Streptococcus pneumonia
Severe acute respiratory syndrome (SARS) is caused by a/an
SARS typically begins as a flulike syndrome followed after a few days by:
interstitial lung congestion, dyspnea, and dry cough
In addition to effects on the lungs and pancreas, cystic fibrosis causes
high sodium chloride content in saliva and sweat
Which of the following is a significant early sign of bronchogenic carcinoma in a smoker?
hemoptysis and weight loss
Which of the following is likely to cause pneumothorax or hemothorax in a patient with bronchogenic carcinoma?
The tumor causes inflammation and erosion of the pleural membranes
Which of the following would confirm a diagnosis of primary tuberculosis?
small areas of calcification on a chest X-ray
Which of the following drugs is usually prescribed for prophylaxis in persons in close contact with a patient with active tuberculosis?
Which of the following statements is FALSE?
Active TB must be treated in hospital for many months
Choose the correct reason for severe hypoxia occurring with pulmonary edema
Diffusion of oxygen into the pulmonary capillaries is impaired.
Which of the following drugs in an inhaler would likely be carried by individuals to provide immediate control of acute asthma attacks?
a beta-2-adrenergic agent
Which of the following values for arterial blood gases would be expected in a patient with advanced emphysema?
increased PCO2, increased bicarbonate ion, serum pH 7.35
Which factors contribute to postoperative atelectasis?
drug-related respiratory depression
abdominal distention and pain
Pleurisy associated with lobar pneumonia is manifested by:
cyclic chest pain and friction rub
All of the following are expected with infant respiratory distress syndrome EXCEPT:
respiratory alkalosis
Which factor usually causes metabolic acidosis to develop in association with hypoxia?
anaerobic metabolism
Mediastinal flutter associated with chest injury is likely to:
decrease venous return to the heart
Which of the following individuals is NOT considered to be at high risk for developing active tuberculosis?
persons who experience acute asthma attacks
Which of the following distinguishes influenza from infectious rhinitis?
Influenza has a sudden onset with fever, marked muscle aching, and severe malaise
The use of a continuous positive airway pump in the treatment of sleep apnea will:
prevent collapse of pharyngeal tissues
Hemoptysis is a significant sign of:
pulmonary edema
Which of the following applies to anthrax infection?
When inhaled it causes flulike symptoms followed by acute respiratory distress
The mutated gene for cystic fibrosis is located on the
seventh chromosome
Aspiration pneumonia is usually caused by aspiration of:
liquids such as oils or milk
What is the most common cause of viral pneumonia?
influenza virus
Which of the following is a major factor contributing to the current increase in cases of tuberculosis?
the increase in immunodeficient individuals
What is an early sign of bronchogenic carcinoma?
chronic cough
Which statement does NOT apply to emphysema?
The ventilation/perfusion ratio remains constant.
Lobar pneumonia is usually caused by:
Streptococcus pneumonia
Which of the following individuals is NOT considered to be at high risk for developing active tuberculosis?
persons who experience acute asthma attacks
Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?
parietal cells
Which of the following is the primary site for absorption of nutrients?
When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?
Which of the following stimulates increased peristalsis and secretions in the digestive tract?
vagus nerve
Oral candidiasis is considered to:
be an opportunistic fungal infection of the mouth
Why does herpes simplex infection tend to recur?
The virus persists in latent form in sensory nerve ganglia.
Which of the following statements applies to bile salts?
They emulsify lipids and lipid-soluble vitamins.
Which of the following applies to the act of swallowing?
requires coordination of cranial nerves V, IX, X, and XII
What does the term periodontitis refer to?
bacterial damage to the ligaments and bone surrounding teeth
What is/are common location(s) for oral cancer?
floor of the mouth or tongue borders
What is a common sign of acute gastritis?
vomiting with epigastric tenderness
What is a common cause of gastroenteritis due to Salmonella?
raw or undercooked poultry or eggs
Which of the following individuals is likely to develop acute gastritis?
an individual with an allergy to shellfish
A patient with acquired pyloric stenosis would likely:
vomit undigested food from previous meals
The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:
increased stimulation of mucus-producing glands
What is frequently the first manifestation of stress ulcers?
hematemesis and hypotension
Which of the following is/are (a) manifestation(s) of hemolytic jaundice?
increased unconjugated bilirubin in the blood
Why does mild hyperbilirubinemia occur in newborns?
the immature liver cannot process bilirubin quickly enough
Predisposing factors to cholelithiasis include excessive:
bilirubin or cholesterol concentration in the bile
What is the major effect when a gallstone obstructs the cystic duct?
severe colicky pain in upper right quadrant
Which of the following applies to hepatitis A infection?
It is transmitted by the fecal-oral route
What can be concluded if the hepatitis B antigen level remains high in the serum?
Chronic infection has developed.
What is the most common type of hepatitis transmitted by blood transfusion?
What causes elevated serum levels of AST and ALT during the preicteric stage of hepatitis?
necrosis of liver cells
What is the likely effect of long-term exposure to a hepatotoxin?
gradual irreversible damage to the liver and cirrhosis
What indicates the presence of third-stage alcohol hepatitis?
accumulation of fat in the hepatocytes and hepatomegaly
A primary factor causing encephalopathy with cirrhosis is the elevated:
serum ammonia
What is the primary cause of esophageal varices?
portal hypertension
What is the primary cause of increased bleeding tendencies associated with cirrhosis?
deficit of vitamin K and prothrombin
In patients with cirrhosis, serum ammonia may increase when:
bleeding occurs in the digestive tract
Which factors contribute to ascites in patients with cirrhosis?
increased aldosterone and deficit of albumin
Malnutrition may develop in children with celiac disease because of:
damage to the intestinal villi
Which of the following is a major cause of primary hepatocellular cancer?
long-term exposure to certain chemicals
What causes massive inflammation and necrosis in acute pancreatitis?
activation and spread of proteolytic enzymes
Which of the following best describes steatorrhea?
bulky, fatty, foul-smelling stools
Stools that are more liquid and contain mucus, frank blood, and pus are typical of:
ulcerative colitis
What usually initiates acute appendicitis?
obstruction of the lumen of the appendix
With acute appendicitis, localized pain and tenderness in the lower right quadrant results from:
local inflammation of the parietal peritoneum
What is a typical early sign of cancer in the ascending colon?
occult blood in the stool
Which of the following statements about jaundice is/are true?
Jaundice usually develops with hepatocellular carcinoma
Which type(s) of hepatitis increase(s) the risk of hepatocellular carcinoma?
Deficiencies of vitamins A, D, and K occur in patients with cirrhosis primarily because of decreased?
production of bile for absorption
Pancreatic cancer may be diagnosed early if obstruction of bile or pancreatic secretions develops when the tumor is located:
at the head of the pancreas
"A gluten-free diet as required" for the client with celiac disease means avoiding:
certain grains
How does chemical peritonitis and shock frequently result from acute pancreatitis?
Inflammation and increased vascular permeability of the peritoneum affect fluid balance
Malnutrition may develop in children with celiac disease because of:
damage to the intestinal villi
What is the dietary requirement for a child with celiac disease?
What are the typical changes occurring with Crohn's disease?
inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas
What is the cause of inflammatory bowel disease?
What pain is typical of diverticulitis?
lower left quadrant
How does localized peritonitis develop from acute appendicitis before rupture?
Intestinal bacteria escape through the necrotic appendiceal wall.
To which site does colon cancer usually first metastasize?
What causes the characteristic rigid abdomen found in the patient with peritonitis?
inflamed peritoneum resulting in reflex abdominal muscle spasm
How does pelvic inflammatory disease frequently lead to bacterial peritonitis?
Infection spreads through the fallopian tubes directly into the peritoneal cavity.
Choose the significant change in arterial blood gases expected with prolonged severe vomiting:
decreased bicarbonate ion, decreased PCO2, serum pH 7.35
An individual with peptic ulcer disease exhibits hematemesis. What does this probably indicate?
erosion of a large blood vessel
What does the term melena mean?
blood in a dark-colored stool
Which of the following statements about jaundice is/are true
It is often the first manifestation of hepatitis.
Which of the following are related to post-hepatic jaundice?
pruritic skin and light-colored stools
Identify a major reason making it difficult to prevent the spread of hepatitis B
Infection is often asymptomatic
What is the initial pathological change in alcoholic liver disease?
accumulation of fat in hepatocytes with hepatomegaly
In which condition is a deficit of protein and vitamins most likely to occur?
regional ileitis