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NURS 545/BIOLOGY 4344: Patho Exam 2 Review: 100%
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        101.   The level of TSH in Graves’ disease is usually:

a.

high.

b.

low.

c.

normal.

 

 

____ 102.   Upon palpation of the neck of a patient with Graves’ disease, what would the nurse expect to find?

a.

Normal-sized thyroid

b.

Small discrete thyroid nodule

c.

Multiple discrete thyroid nodules

d.

Diffuse thyroid enlargement

 

 

____ 103.   What are clinical manifestations of hypothyroidism?

a.

Intolerance to heat, tachycardia, and weight loss

b.

Oligomenorrhea, fatigue, and warm skin

c.

Restlessness, increased appetite, and metrorrhagia

d.

Constipation, decreased heat rate, and lethargy

 

 

____ 104.   Diagnosing thyroid carcinoma is best done with:

a.

measurement of serum thyroid levels.

b.

radioisotope scanning.

c.

ultrasonography.

d.

fine-needle aspiration biopsy.

 

 

____ 105.   Renal failure is the most common cause of _____ hyperparathyroidism.

a.

primary

b.

secondary

c.

exogenous

d.

inflammatory

 

 

____ 106.   What is the most common cause of hypoparathyroidism?

a.

Pituitary hyposecretion

b.

Parathyroid adenoma

c.

Parathyroid gland damage

d.

Autoimmune parathyroid disease

 

 

____ 107.   An adult female had a thyroidectomy this morning. She develops muscle spasms, increased deep tendon reflexes, and laryngeal spasm. What is the most common cause of these findings?

a.

Calcium deficit due to reduced parathormone

b.

Overuse of radioactive iodine given pre-operatively

c.

A history of insufficient dietary intake of iodine

d.

An increase in serum phosphorous caused by reduced calcitonin

 

 

____ 108.   What is the most probable cause of low serum calcium following thyroidectomy?

a.

Hyperparathyroidism secondary to Graves’ disease

b.

Myxedema secondary to surgery

c.

Hypoparathyroidism caused by surgical injury

d.

Hypothyroidism caused by lack of thyroid replacement

 

 

____ 109.   A male patient with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; urine glucose and ketones positive; serum K+ 2 mEq/L; serum Na+ 130 mEq/L. He reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?

a.

Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.

b.

Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.

c.

Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.

d.

Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

 

 

____ 110.   What is a description of diabetes mellitus type 2?

a.

There is a resistance to insulin by insulin-sensitive tissues.

b.

The patient uses lispro instead of regular insulin.

c.

There is an increased glucagon secretion from -cells of the pancreas.

d.

There are insulin autoantibodies that destroy ß-cells in the pancreas.

 

 

____ 111.   A patient with diabetes mellitus type 1 experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. What is the most probable cause of these symptoms?

a.

Hyperglycemia caused by incorrect insulin administration

b.

Dawn phenomenon from eating a snack before bed time

c.

Hypoglycemia caused by increased exercise

d.

Somogyi effect from insulin sensitivity

 

 

____ 112.   Which clinical finding occurs first in metabolic acidosis of the patient with type 1 diabetes mellitus?

a.

Ketones in the urine

b.

Palpitations, anxiety, and confusion

c.

Hyperlipidemia

d.

Kussmaul respirations

 

 

____ 113.   Why does hyperkalemia develop in diabetic ketoacidosis?

a.

Because sodium is low, which stimulates aldosterone to retain sodium and potassium

b.

Because hydrogen shifts into the cell in exchange for potassium to compensate for metabolic acidosis

c.

Because phosphorus shifts into the cell in exchange for potassium due to the lack of insulin

d.

Because the blood is concentrated due to the loss of water from polyuria

 

 

____ 114.   What is a difference in clinical manifestations between diabetic ketoacidosis and hyperglycemic, hyperosmolar non-ketosis syndrome?

a.

Fluid loss

b.

Glycosuria

c.

Increased serum glucose

d.

Kussmaul respirations

 

 

____ 115.   Hypoglycemia followed by rebound hyperglycemia is seen in:

a.

the Somogyi effect.

b.

the dawn phenomenon.

c.

diabetic ketoacidosis (DKA).

d.

hyperosmolar hyperglycemic nonketosis syndrome (HHNKS).

 

 

____ 116.   What is the first lab test that indicates a patient with type 1 diabetes is developing nephropathy?

a.

Dipstick test for urine ketones

b.

Increase in serum creatinine and blood urea nitrogen (BUN)

c.

Protein in the urinalysis

d.

Cloudy urine on the urinalysis

 

 

____ 117.   Why do patients with diabetes mellitus develop hyperlipidemia?

a.

Because they have increases in low density lipoproteins (­LDL) and triglycerides (­TG)

b.

Because they have decreased low density lipoproteins (¯LDL) and increased triglycerides (­TG)

c.

Because they have decreased low density lipoproteins (¯LDL) and increased high density lipoproteins (­HDL)

d.

Because they have increased high density lipoproteins (­HDL) and decreased triglycerides (¯TG)

 

 

____ 118.   What causes the microvascular complications of clients with diabetes mellitus?

a.

The capillaries contain plaques of lipids that obstruct blood flow.

b.

There is increased pressure within capillaries as a result of the elevated glucose attracting water.

c.

The capillary basement membranes thicken and there is endothelial cell hyperplasia.

d.

Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.

 

 

____ 119.   What causes the macrovascular complications of clients with diabetes mellitus?

a.

The capillaries contain plaques of lipids that obstruct blood flow.

b.

There is increased pressure within capillaries caused by the elevated glucose attracting water.

c.

The capillary basement membranes thicken and there is endothelial cell hyperplasia.

d.

Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.

 

 

____ 120.   Which chronic complication of diabetes mellitus is caused by microvascular complications?

a.

Nephropathy

b.

Coronary artery disease

c.

Neuropathy

d.

Peripheral vascular disease

 

 

____ 121.   Why does retinopathy develop in patients with type 2 diabetes?

a.

Because there are plaques of lipids within the retinal vessels

b.

Because of an increased pressure within the retinal vessels from the increased osmotic pressure

c.

Because ketones cause microaneurysms within the retinal vessels

d.

Because of increased retinal capillary permeability and microaneurysm formation

 

 

____ 122.   A patient has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder?

a.

Hyperthyroidism

b.

Hypoaldosteronism

c.

Diabetes insipidus (DI)

d.

Cushing disease

 

 

____ 123.   Which statement about the pericardium is false?

a.

It is a double-walled membranous sac that encloses the heart.

b.

It is composed of connective tissue and a layer of squamous cells.

c.

It protects the heart against infection and inflammation from the lungs and pleural space.

d.

It contains pain and mechanoreceptors that can elicit reflex changes in blood pressure and heart rate.

 

 

____ 124.   During the cardiac cycle, what makes the mitral and tricuspid valves close after the ventricles are filled with blood?

a.

The chordae tendineae relax, which allows the valves to close.

b.

The increased pressure in the ventricles pushes the values to close.

c.

The trabeculae carneae contract, which pulls the valves closed.

d.

The reduced pressure in the atria creates a negative pressure that pulls the valves closed.

 

 

____ 125.   What is the significance of the “atrial kick”?

a.

It is the contraction of the right atria that is necessary to open the tricuspid valve.

b.

It is the contraction of the right atria that is necessary to increase the blood volume from the venae cavae.

c.

It is the contraction of the left atria that increases the blood volume into the ventricle.

d.

It is the contraction of the left atria that is necessary to open the mitral valve.

 

 

____ 126.   Occlusion of the left anterior descending artery during a myocardial infarction would interrupt blood supply to which part of the heart?

a.

To portions of the left and right ventricles and much of the interventricular septum

b.

To the left atrium and the lateral wall of the left ventricle

c.

To the upper right ventricle, right marginal branch, and right ventricle to the apex

d.

To the posterior interventricular sulcus and smaller branches of both ventricles

 

 

____ 127.   Occlusion of the circumflex artery during a myocardial infarction would interrupt blood supply to which part of the heart?

a.

To portions of the left and right ventricles and much of the interventricular septum

b.

To the posterior interventricular sulcus and smaller branches of both ventricles

c.

To the upper right ventricle, right marginal branch, and right ventricle to the apex

d.

To the left atrium and the lateral wall of the left ventricle

 

 

____ 128.   Where are the coronary ostia located?

a.

Left ventricle

b.

Medial to the aortic valve

c.

Coronary sinus

d.

Aorta

 

 

____ 129.   The coronary sinus empties into the:

a.

right atrium.

b.

left atrium.

c.

superior vena cava.

d.

aorta.

 

 

____ 130.   Which statement about development of collateral arteries in the heart is false?

a.

The incidence of aneurysm formation after a myocardial infarction is reduced in individuals who develop significant collateral circulation.

b.

The incidence of myocardial regeneration after a myocardial infarction increases in individuals who develop significant collateral circulation.

c.

The risk of dysrhythmias after a myocardial infarction is reduced in individuals with well-developed collateral circulation.

d.

Collateral circulation may extend the “window of time” to benefit reperfusion therapy after a myocardial infarction, resulting in greater improvement in cardiac function.

 

 

____ 131.   What is the ratio of coronary capillaries to cardiac muscle cells?

a.

1:1 (1 capillary per 1 muscle cell)

b.

1:2 (1 capillary per 2 muscle cells)

c.

1:4 (1 capillary per 4 muscle cells)

d.

1:10 (1 capillary per 10 muscle cells)

 

 

____ 132.   What is the function of P cells found in the sinoatrial node and Purkinje fibers?

a.

They are receptors for pain stimuli, such as the pain that occurs during infarction.

b.

They prolong the refractory period before the next contraction.

c.

They are assumed to be the site of impulse formation.

d.

They initiate repolarization of the myocardium.

 

 

____ 133.   Depolarization of a cardiac muscle cell occurs as the result of a:

a.

decrease in the permeability of the cell membrane to potassium.

b.

rapid movement of sodium into the cell.

c.

rapid movement of calcium into the cell.

d.

slow movement of sodium out of the cell.

e.

slow movement of calcium out of the cell.

 

 

____ 134.   What occurs during phase 1 of the normal myocardial cell depolarization and repolarization?

a.

Repolarization when potassium moves out of the cells

b.

Repolarization when sodium rapidly enters into cells

c.

Early repolarization when sodium slowly enters cells

d.

Early repolarization when calcium slowly enters cells

 

 

____ 135.   Phase 0 of the normal myocardial cell depolarization and repolarization correlates with which part of the electrocardiogram (EKG)?

a.

QRS complex

b.

P-R interval

c.

Q-T interval

d.

U wave

 

 

____ 136.   Which phase of the normal myocardial cell depolarization and repolarization correlates with diastole?

a.

Phase 0

b.

Phase 1

c.

Phase 2

d.

Phase 3

e.

Phase 4

 

 

____ 137.   _____ nerves can shorten the conduction time of action potential through the atrioventricular (AV) node.

a.

Parasympathetic

b.

Sympathetic

c.

Vagal

d.

Glossopharyngeal

 

 

____ 138.   If the sinoatrial (SA) node fails, at what rate can the atrioventricular (AV) node polarize?

a.

60 to 70 per minute

b.

40 to 60 per minute

c.

30 to 40 per minute

d.

10 to 20 per minute

 

 

____ 139.   What, if any, is the effect of epinephrine on b2-receptors of the heart?

a.

None, b1-receptors are the only b-receptors in the heart.

b.

Dilate coronary arterioles

c.

Increase the strength of myocardial contraction

d.

Increase the heart rate

 

 

____ 140.   Where are the receptors for neurotransmitters located in the heart?

a.

Semilunar and atrioventricular valves

b.

Endocardium and sinoatrial node

c.

Myocardium and coronary vessels

d.

Epicardium and atrioventricular node

 

 

____ 141.   Within a physiologic range, an increase in left ventricular end-diastolic volume (preload) leads to a(n):

a.

increased force of contraction.

b.

decrease in refractory time.

c.

increase in afterload.

d.

increase in repolarization.

 

 

____ 142.   Continuous increases in left ventricular filing pressures results in which disorder?

a.

Mitral regurgitation

b.

Mitral stenosis

c.

Pulmonary edema

d.

Jugular vein distention

 

 

____ 143.   The Bainbridge reflex is thought to be initiated by sensory neurons in the:

a.

atria.

b.

aorta.

c.

atrioventricular node.

d.

ventricles.

 

 

____ 144.   What is the correct sequence of events that occur after the baroreceptor reflex is stimulated?

a.

From the carotid artery to the vagus nerve to the medulla to increase parasympathetic activity and decrease sympathetic activity

b.

From the carotid artery to glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase sympathetic activity and decrease parasympathetic activity

c.

From the carotid artery to glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase parasympathetic activity and decrease sympathetic activity

d.

From the carotid artery to glossopharyngeal cranial nerve through the vagus nerve to the hypothalamus to increase parasympathetic activity and decrease sympathetic activity

 

 

____ 145.   Reflex control of total cardiac output and total peripheral resistance is controlled by:

a.

parasympathetic stimulation of heart, arterioles, and veins.

b.

sympathetic stimulation of heart, arterioles, and veins.

c.

autonomic control of the heart only.

d.

somatic control of the heart, arterioles, and veins.

 

 

____ 146.   Myogenic regulation of blood vessel diameter and subsequent blood flow through a vessel is an example of _____ of blood vessels.

a.

autonomic regulation

b.

somatic regulation

c.

autoregulation

d.

metabolic regulation

 

 

____ 147.   In assessing for allergies before coronary angiography, the nurse will be particularly concerned if the patient he has an allergy to:

a.

technetium.

b.

iodine.

c.

penicillin.

d.

warfarin sodium (Coumadin).

 

 

____ 148.   What is an expected change in the cardiovascular system that occurs with aging?

a.

Arterial stiffening

b.

Decreased left ventricular wall tension

c.

Decreased aortic wall thickness

d.

Arteriosclerosis

 

 

____ 149.   Which statement is false about the way in which substances pass from capillaries and the interstitial fluid?

a.

Substances pass through junctions between endothelial cells.

b.

Substances pass through pores or oval windows.

c.

Substances pass through vesicles by active transport across the endothelial cell membrane.

d.

Substances pass through by osmosis across the endothelial cell membrane.

 

 

____ 150.   Which natriuretic peptide inhibits antidiuretic hormone by increasing urine sodium loss?

a.

Urodilatin

b.

Brain natriuretic peptide (BNP)

c.

Atrial natriuretic peptide (ANP)

d.

C-type natriuretic peptide (CNP)

 

 

____ 151.   Which natriuretic peptide complements nitric oxide to mediate vasodilation?

a.

Urodilatin

b.

Brain natriuretic peptide (BNP)

c.

Atrial natriuretic peptide (ANP)

d.

C-type natriuretic peptide (CNP)

 

 

____ 152.   Which natriuretic peptide is proposed to be a biochemical marker to screen for left ventricular dysfunction?

a.

Urodilatin

b.

Brain natriuretic peptide (BNP)

c.

Atrial natriuretic peptide (ANP)

d.

C-type natriuretic peptide (CNP)

 

 

____ 153.   What is the primary mechanism of atherogenesis?

a.

The release of the inflammatory cytokines tumor necrosis factor alpha (TNF-), interferon gamma (IFN-), and interleukin 1 (Il-1)

b.

The release of the growth factor granulocyte-macrophage colony-stimulating factor (GM-CSF)

c.

The release of toxic oxygen radicals that oxidize low-density lipoproteins (LDL)

d.

The release of the inflammatory cytokines interferon beta (IFN-ß), interleukin 6 (Il-6), and granulocyte colony-stimulating factor (G-CSF)

 

 

____ 154.   What is the effect of oxidized low-density lipoproteins (LDL) in atherosclerosis?

a.

It causes smooth muscle proliferation.

b.

It causes regression of atherosclerotic plaques.

c.

It increases levels of inflammatory cytokines.

d.

It directs macrophages to the site within the endothelium.

 

 

____ 155.   Which inflammatory cytokines are released when endothelial cells are injured?

a.

Granulocyte-macrophage colony-stimulating factor (GM-CSF)

b.

Beta-interferon (ß-IFN), interleukin 6 (Il-6), and granulocyte colony-stimulating factor (G-CSF).

c.

Tumor necrosis factor alpha (TNF-), gamma interferon (-IFN), and interleukin 1 (Il-1).

d.

Interferon alpha (IFN-), interleukin 12 (Il-12), and macrophage colony-stimulating factor (M-CSF)

 

 

____ 156.   What are the vasoconstricting factors regulated by endothelium?

a.

Thromboxane A and endothelin

b.

Norepinephrine and acetylcholine

c.

Bradykinin and leukotriene

d.

Serotonin and prostacyclin

 

 

____ 157.   What alteration occurs in injured endothelial cells that contributes to atherosclerosis?

a.

They release toxic oxygen radicals that oxidize low-density lipoproteins (LDL).

b.

They are unable to make the normal amount of vasodilating cytokines.

c.

They produce an increased amount of antithrombic cytokines.

d.

They develop a hypersensitivity to homocystine and lipids.

 

 

____ 158.   What factor is responsible for the hypertrophy of the myocardium associated with hypertension?

a.

Increased norepinephrine

b.

Adducin

c.

Angiotensin II

d.

Insulin resistance

 

 

____ 159.   What pathologic change occurs in kidneys of people with hypertension that leads to dysfunction of the glomeruli?

a.

Compression of the renal tubules

b.

Ischemia of the tubule

c.

Increased pressure from within the tubule

d.

Obstruction of the renal tubule

 

 

____ 160.   Cerebral aneurysms frequently occur in the:

a.

vertebral arteries.

b.

basilar artery.

c.

circle of Willis.

d.

carotid arteries.

 

 

____ 161.   How does atherosclerosis cause aneurysms?

a.

A reduction in oxygen causes ischemia of the intima.

b.

An increase in endothelin increases nitric oxide.

c.

Plaque formation erodes the vessel wall.

d.

The vessel is obstructed by plaques and thrombus formation.

 

 

____ 162.   What are the differences in arterial walls versus vs. walls that promote clot formation?

a.

There is inflammation of the endothelium of the artery and roughing of the endothelium of the vein.

b.

There is vasoconstriction of the endothelium of the artery and hypertrophy of the endothelium of the vein.

c.

There is excessive clot formation of the endothelium of the artery and lipid accumulation of the endothelium of the vein.

d.

There is roughening of the endothelium of the artery and inflammation of the endothelium of the vein.

 

 

____ 163.   What is the usual source of pulmonary emboli?

a.

Deep vein thrombosis

b.

Endocarditis

c.

Valvular disease

d.

Left heart failure

 

 

____ 164.   Which source of emboli introduces antigens, cells, and protein aggregates that trigger an immune response within the bloodstream?

a.

Amniotic fluid

b.

Fat

c.

Bacteria

d.

Air

 

 

____ 165.   Which is a description of thromboangiitis obliterans (Buerger disease)?

a.

An inflammatory disorder of small- and medium-sized arteries in the feet and sometimes in the hands

b.

A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly the toes

c.

An autoimmune disorder of the large arteries and veins of the upper and lower extremities

d.

A neoplastic disorder of the lining of the arteries and veins of the upper extremities

 

 

____ 166.   Which is a description of Raynaud phenomenon and disease?

a.

An inflammatory disorder of small- and medium-sized arteries in the feet and sometimes in the hands.

b.

A neoplastic disorder of the lining of the arteries and veins of the upper extremities.

c.

A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly the toes.

d.

An autoimmune disorder of the large arteries and veins of the upper and lower extremities.

 

 

____ 167.   What changes in veins occur to create varicose veins?

a.

An increase in osmotic pressure

b.

Damage to the valves with veins

c.

Damage to the venous endothelium

d.

An increase in hydrostatic pressure

 

 

____ 168.   Superior vena cava syndrome is a progressive _____ of the superior vena cava that leads to venous distention of the upper extremities and head.

a.

inflammation

b.

occlusion

c.

distention

d.

sclerosis

 

 

____ 169.   Coronary artery disease can diminish the myocardial blood supply until deprivation impairs myocardial metabolism enough to cause _____, a local state in which the cells are temporarily deprived of blood supply.

a.

infarction

b.

ischemia

c.

necrosis

d.

inflammation

 

 

____ 170.   Of the following risk factors for coronary artery disease, which is responsible for a twofold to threefold increase in risk?

a.

Diabetes mellitus

b.

Hypertension

c.

Obesity

d.

High alcohol consumption

 

 

____ 171.   Which of the following risk factors is associated with a twofold increase in the risk for coronary artery disease death and up to a sixfold risk for stroke?

a.

Diabetes mellitus

b.

Hypertension

c.

Obesity

d.

High alcohol consumption

 

 

____ 172.   How does nicotine increase atherosclerosis?

a.

By the release of histamine

b.

By decreasing nitric oxide

c.

By the release of angiotensin II

d.

By the release of epinephrine and norepinephrine

 

 

____ 173.   _____ are manufactured by the liver and primarily contains cholesterol and protein.

a.

Very-low-density lipoproteins (VLDL)

b.

Low-density lipoproteins (LDL)

c.

High-density lipoproteins (HDL)

d.

Triglycerides (TG)

 

 

____ 174.   Which value may be protective for the development of atherosclerosis?

a.

High values of very-low-density lipoproteins (VLDL)

b.

High values of low-density lipoproteins (LDL)

c.

High values of high-density lipoproteins (HDL)

d.

High values of triglycerides (TG)

 

 

____ 175.   Which lab test is an indirect measure of atherosclerotic plaque?

a.

Homocysteine

b.

Low-density lipoproteins (LDL)

c.

Erythrocyte sedimentation rate (ESR)

d.

C reactive protein (CPR)

 

 

____ 176.   Cardiac cells can withstand ischemic conditions and still return to a viable state for _____ minutes.

a.

10

b.

15

c.

20

d.

25

 

 

____ 177.   _____ angina occurs because of vasospasms of one or more coronary arteries and often during sleep.

a.

Unstable

b.

Stable

c.

Silent

d.

Prinzmetal

 

 

____ 178.   When scar tissue replaces the myocardium after a myocardial infarction (MI), the forming scar tissue is very mushy and vulnerable to injury at about day _____ after MI.

a.

5 to 9

b.

10 to 14

c.

15 to 20

d.

20 to 30

 

 

____ 179.   An individual is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH). These elevated levels indicate:

a.

myocardial ischemia.

b.

hypertension.

c.

myocardial infarction.

d.

coronary artery disease.

 

 

____ 180.   What is the expected electrocardiogram pattern for a patient when a thrombus in a coronary artery lodges permanently in the vessel and the infarction extends through the myocardium from the endocardium to the epicardium?

a.

Prolonged Q-T interval

b.

ST elevation (STEMI)

c.

ST depression (STDMI)

d.

Non-ST elevation (non-STEMI)

 

 

____ 181.   How does angiotensin II increase the workload of the heart after a myocardial infarction?

a.

By increasing the peripheral vascular resistance

b.

By causing dysrhythmias as a result of hyperkalemia

c.

By reducing the contractility of the myocardium

d.

By stimulating the sympathetic nervous system

 

 

____ 182.   What is the significance of pulsus paradoxus that occurs in a pericardial effusion?

a.

It reflects impairment of the diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles.

b.

It reflects impairment of the blood ejected from the right atria and reduction of blood volume in the right ventricle.

c.

It reflects impairment of the blood ejected from the left atria and reduction of blood volume in the left ventricle.

d.

It reflects impairment of the diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers.

 

 

____ 183.   A patient complains of sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when lying down. What is causing these clinical manifestations?

a.

Myocardial infarction

b.

Pericardial effusion

c.

Restrictive pericarditis

d.

Acute pericarditis

 

 

____ 184.   Biventricular dilation is the result of _____ cardiomyopathy.

a.

hypertrophic

b.

restrictive

c.

congestive

d.

inflammatory

 

 

____ 185.   _____ cardiomyopathy is characterized by ventricular dilation and grossly impaired systolic function, leading to dilated heart failure.

a.

Dilated

b.

Hypertrophic

c.

Septal

d.

Dystrophic

 

 

____ 186.   The hallmark of _____ cardiomyopathy is a disproportionate thickening of the interventricular septum.

a.

dystrophic

b.

hypertrophic

c.

septal

d.

dilated

 

 

____ 187.   _____ cardiomyopathy is usually caused by an infiltrative disease of the myocardium, such as amyloidosis, hemochromatosis, or glycogen storage disease.

a.

Infiltrative

b.

Restrictive

c.

Septal

d.

Hypertrophic

 

 

____ 188.   What are clinical manifestations of aortic stenosis?

a.

Jugular vein distension

b.

Bounding pulses

c.

Peripheral edema

d.

Dyspnea on exertion

 

 

____ 189.   Aortic and mitral regurgitation and mitral stenosis are all caused by which of the following?

a.

Congenital malformation

b.

Cardiac failure

c.

Rheumatic fever

d.

Coronary artery disease

 

 

____ 190.   Which valvular disorder is thought to have an autosomal dominant inheritance pattern, to be associated with connective tissue disease that tends to be most prevalent in young women?

a.

Mitral valve prolapse

b.

Tricuspid stenosis

c.

Tricuspid valve prolapse

d.

Aortic insufficiency

 

 

____ 191.   Which disorder causes a transitory truncal rash that is nonpruritic and pink with erythematous macules that may fade in the center, making them appear as a ringworm?

a.

Fat emboli

b.

Rheumatic fever

c.

Bacterial endocarditis

d.

Myocarditis of acquired immunodeficiency syndrome

 

 

____ 192.   Infective endocarditis is most often caused by:

a.

a virus.

b.

a fungus.

c.

a bacteria.

d.

rickettsiae.

 

 

____ 193.   For which disorder are the risk factors genitourinary instrumentation, dental procedure, hemodialysis, and intravenous drug use?

a.

Rheumatic fever

b.

Infective endocarditis

c.

Mitral regurgitation

d.

Aortic regurgitation

 

 

____ 194.   What is the most common cardiac disorder associated with acquired immunodeficiency syndrome (AIDS) resulting from myocarditis and infective endocarditis?

a.

Inflammatory cardiomyopathy

b.

Hypertrophic cardiomyopathy

c.

Dilated cardiomyopathy

d.

Restrictive cardiomyopathy

 

 

____ 195.   A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures may result from this condition?

a.

Right heart failure

b.

Left heart failure

c.

Low-output failure

d.

High-output failure

 

 

____ 196.   Ventricular remodeling is a result of:

a.

left ventricular hypertrophy.

b.

right ventricular failure.

c.

myocardial ischemia.

d.

contractile dysfunction.

 

 

____ 197.   In systolic heart failure, what effect does angiotensin II have on stroke volume?

a.

Increases preload and decreases afterload

b.

Increases preload and increases afterload

c.

Decreases preload and increases afterload

d.

Decreases preload and decreases afterload

 

 

Matching

 

Match the description with its corresponding term.

a.

Loss of differentiation:

b.

Cancer cells secrete growth factor for their own growth

c.

Cells that vary in size and shape

d.

Unaltered normal allele

e.

Responsible for maintenance of genomic integrity

 

 

____ 198.   Proto-oncogene

 

____ 199.   Pleomorphic

 

____ 200.   Anaplasia

 

____ 201.   Caretaker gene

 

____ 202.   Autocrine stimulation

 

Match the intracardiac pressures with their description.

a.

a wave

b.

v wave

c.

c wave

d.

x descent

e.

y descent

 

 

____ 203.   An early diastole peak caused by filling of the atrium from peripheral veins

 

____ 204.   Reflects rapid flow of blood from the great veins and right atrium into the right ventricle

 

____ 205.   Generated by the atrial contraction

 

____ 206.   Produced because of descent of the tricuspid valve ring and by ejection of blood from both ventricles

 

____ 207.   May represent bulging of the mitral valve into the left atrium during early systole

 

Match th

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NURS 545/BIOLOGY 4344: Patho Exam 2 Review: 100%
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        101.   The level of TSH in Graves’ disease is usually: a. high. b. low. c. normal. ____ 102.   Upon palpation of the neck of a patient with Graves’ disease, what would the nurse expect to find? a. Normal-sized thyroid b. Small discrete thyroid nodule c. Multiple discrete thyroid nodules d. Diffuse thyroid enlargement ____ 103.   What are clinical manifestations of hypothyroidism? a. Intolerance to heat, tachycardia, and weight loss b. Oligomenorrhea, fatigue, and warm skin c. Restlessness, increased appetite, and metrorrhagia d. Constipation, decreased heat rate, and lethargy ____ 104.   Diagnosing thyroid carcinoma is best done with: a. measurement of serum thyroid levels. b. radioisotope scanning. c. ultrasonography. d. fine-needle aspiration biopsy. ____ 105.   Renal failure is the most common cause of _____ hyperparathyroidism. a. primary b. secondary c. exogenous d. inflammatory ____ 106.   What is the most common cause of hypoparathyroidism? a. Pituitary hyposecretion b. Parathyroid adenoma c. Parathyroid gland damage d. Autoimmune parathyroid disease ____ 107.   An adult female had a thyroidectomy this morning. She develops muscle spasms, increased deep tendon reflexes, and laryngeal spasm. What is the most common cause of these findings? a. Calcium deficit due to reduced parathormone b. Overuse of radioactive iodine given pre-operatively c. A history of insufficient dietary intake of iodine d. An increase in serum phosphorous caused by reduced calcitonin ____ 108.   What is the most probable cause of low serum calcium following thyroidectomy? a. Hyperparathyroidism secondary to Graves’ disease b. Myxedema secondary to surgery c. Hypoparathyroidism caused by surgical injury d. Hypothyroidism caused by lack of thyroid replacement ____ 109.   A male patient with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; urine glucose and ketones positive; serum K+ 2 mEq/L; serum Na+ 130 mEq/L. He reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency? a. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space. b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis. c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis. d. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss. ____ 110.   What is a description of diabetes mellitus type 2? a. There is a resistance to insulin by insulin-sensitive tissues. b. The patient uses lispro instead of regular insulin. c. There is an increased glucagon secretion from -cells of the pancreas. d. There are insulin autoantibodies that destroy ß-cells in the pancreas. ____ 111.   A patient with diabetes mellitus type 1 experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. What is the most probable cause of these symptoms? a. Hyperglycemia caused by incorrect insulin administration b. Dawn phenomenon from eating a snack before bed time c. Hypoglycemia caused by increased exercise d. Somogyi effect from insulin sensitivity ____ 112.   Which clinical finding occurs first in metabolic acidosis of the patient with type 1 diabetes mellitus? a. Ketones in the urine b. Palpitations, anxiety, and confusion c. Hyperlipidemia d. Kussmaul respirations ____ 113.   Why does hyperkalemia develop in diabetic ketoacidosis? a. Because sodium is low, which stimulates aldosterone to retain sodium and potassium b. Because hydrogen shifts into the cell in exchange for potassium to compensate for metabolic acidosis c. Because phosphorus shifts into the cell in exchange for potassium due to the lack of insulin d. Because the blood is concentrated due to the loss of water from polyuria ____ 114.   What is a difference in clinical manifestations between diabetic ketoacidosis and hyperglycemic, hyperosmolar non-ketosis syndrome? a. Fluid loss b. Glycosuria c. Increased serum glucose d. Kussmaul respirations ____ 115.   Hypoglycemia followed by rebound hyperglycemia is seen in: a. the Somogyi effect. b. the dawn phenomenon. c. diabetic ketoacidosis (DKA). d. hyperosmolar hyperglycemic nonketosis syndrome (HHNKS). ____ 116.   What is the first lab test that indicates a patient with type 1 diabetes is developing nephropathy? a. Dipstick test for urine ketones b. Increase in serum creatinine and blood urea nitrogen (BUN) c. Protein in the urinalysis d. Cloudy urine on the urinalysis ____ 117.   Why do patients with diabetes mellitus develop hyperlipidemia? a. Because they have increases in low density lipoproteins (­LDL) and triglycerides (­TG) b. Because they have decreased low density lipoproteins (¯LDL) and increased triglycerides (­TG) c. Because they have decreased low density lipoproteins (¯LDL) and increased high density lipoproteins (­HDL) d. Because they have increased high density lipoproteins (­HDL) and decreased triglycerides (¯TG) ____ 118.   What causes the microvascular complications of clients with diabetes mellitus? a. The capillaries contain plaques of lipids that obstruct blood flow. b. There is increased pressure within capillaries as a result of the elevated glucose attracting water. c. The capillary basement membranes thicken and there is endothelial cell hyperplasia. d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries. ____ 119.   What causes the macrovascular complications of clients with diabetes mellitus? a. The capillaries contain plaques of lipids that obstruct blood flow. b. There is increased pressure within capillaries caused by the elevated glucose attracting water. c. The capillary basement membranes thicken and there is endothelial cell hyperplasia. d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries. ____ 120.   Which chronic complication of diabetes mellitus is caused by microvascular complications? a. Nephropathy b. Coronary artery disease c. Neuropathy d. Peripheral vascular disease ____ 121.   Why does retinopathy develop in patients with type 2 diabetes? a. Because there are plaques of lipids within the retinal vessels b. Because of an increased pressure within the retinal vessels from the increased osmotic pressure c. Because ketones cause microaneurysms within the retinal vessels d. Because of increased retinal capillary permeability and microaneurysm formation ____ 122.   A patient has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder? a. Hyperthyroidism b. Hypoaldosteronism c. Diabetes insipidus (DI) d. Cushing disease ____ 123.   Which statement about the pericardium is false? a. It is a double-walled membranous sac that encloses the heart. b. It is composed of connective tissue and a layer of squamous cells. c. It protects the heart against infection and inflammation from the lungs and pleural space. d. It contains pain and mechanoreceptors that can elicit reflex changes in blood pressure and heart rate. ____ 124.   During the cardiac cycle, what makes the mitral and tricuspid valves close after the ventricles are filled with blood? a. The chordae tendineae relax, which allows the valves to close. b. The increased pressure in the ventricles pushes the values to close. c. The trabeculae carneae contract, which pulls the valves closed. d. The reduced pressure in the atria creates a negative pressure that pulls the valves closed...
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