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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

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