Herzing NU621 Unit 2 Exam 1 Latest 2020 March

NU621 Advanced Pathophysiology

Unit 2 Exam 1

1 What is the process that ensures mitral and tricuspid valve closure after the ventricles are filled with blood?

 Chordae tendineae relax, which allows the valves to close.

Increased pressure in the ventricles pushes the valves to close.

 Trabeculaecarneae contract, which pulls the valves closed.

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

2What is an expected change in the cardiovascular system that occurs with aging?

Arterial stiffening

 Decreased left ventricular wall tension

Decreased aortic wall thickness

Arteriosclerosis

3A patient in the Emergency department is suspected of having a myocardial infarction (MI). The initial cardiac troponin 1 level was negative. What action by the healthcare professional is best?

 Prepare the patient for thrombolytic therapy.

Dismiss the patient because the lab was negative.

Schedule repeat lab within a few hours.

 Give the patient oxygen and pain medication.

4A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsusparadoxus. A student asks for an explanation of how this occurs. What description by the professional is best?

Diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles

 Blood ejected from the right atrium and reduction of blood volume in the right ventricle

Blood ejected from the left atrium and reduction of blood volume in the left ventricle

Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers

5In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?

 Increases preload and decreases afterload

Increases preload and increases afterload

 Decreases preload and increases afterload

Decreases preload and decreases afterload

6Events in the development of atherosclerotic plaque include all the following except:

 accumulation of LDL (low-density lipoprotein) cholesterol.

smooth muscle proliferation.

 calcification.

decreased elasticity.

7The complications of uncontrolled hypertension include all of the following except:

 cerebrovascular accidents.

renal injury.

cardiac hypertrophy.

All of the above are complications.

8Identify the correct sequence of the portions of the pulmonary circulation.

 (1) pulmonary veins

(2) pulmonary arteries

(3) lungs

(4) right ventricle

(5) left atrium

 1, 5, 3, 2, 4

 

4, 2, 3, 1, 5

 4, 1, 3, 2, 5

5, 2, 3, 1, 4

9Primary hypertension:

is essentially idiopathic.

 can be caused by renal disease.

can be caused by hormone imbalance.

results from arterial coarctation.

10Which is a possible cause of varicose veins?

gravitational forces on blood

Selected Answer - Incorrect

long periods of standing

trauma to the saphenous veins

11A 76-year-old man came to the emergency room after experiencing chest pain while shoveling snow. Laboratory tests revealed essentially normal blood levels of SGOT, CPK, and LDH enzymes. The chest pain was relieved following rest and nitroglycerin therapy. The most probable diagnosis is:

 myocardial infarct.

emphysema.

angina pectoris.

 hepatic cirrhosis.

12Which factor might increase resistance to the flow of blood through the blood vessels?

an increased inner radius of diameter of blood vessels

decreased numbers of capillaries

 decreased blood viscosity

decreased numbers of red blood cells

13Blood pressure is measured as the:

 pressure exerted on the ventricular walls during systole.

pressure exerted by the blood on the wall of any blood vessel.

pressure exerted on arteries by the blood.

 product of the stroke volume times heart rate.

 

14Complications of an infarcted myocardium likely could include:

 emphysema.

heart failure.

 COPD

urinary retention.

15In pericardial effusion:

there is associated rheumatoid arthritis.

tamponade compresses the right heart before affecting other structures.

arterial blood pressure during expiration exceeds that during inspiration.

16Chamber volume increase is observed in what type of cardiomyopathy?

dilated

hypertrophic

restrictive

17Which statement is true regarding rheumatic heart disease?

 It is caused by staphylococcal infections.

It is caused by hypersensitivity/immunity to streptococci.

 It damages the tricuspid valve most often.

It usually damages the pulmonic valve.

18Transmural myocardial infarction:

 displays non-STEMI.

occurs when infarction is limited to part of the heart wall.

is categorized as STEMI.

 displays I-wave inversion.

19Bacterial infective endocarditis differs from rheumatic heart disease because of which of the following? (More than one answer may be correct.)

Bacterial endocarditis is an infection of the heart, endocardium, and valves.

 It always follows a myocardial infarction.

It may occur following colonoscopy procedures.

It commonly involves the vena cava valve.

20Individuals with only left heart failure would exhibit which of the following? (More than one answer may be correct.)

 hepatomegaly

dyspnea

 facial swelling

pulmonary fibrosis

21In congestive heart failure, the pump or myocardium itself fails because of which of the following?

loss of contractile force of the heart

 hypotension

cardiac perfusion

intermittent claudication from occlusive vascular disease

22Shock is a complex pathophysiologic process involving all of the following except:

 decreased blood perfusion to kidneys.

acidosis.

hypertension.

 anaerobic glycolysis.

23Which statement is incorrect concerning hypertension?

 Malignant hypertension is characterized by a diastolic pressure higher than140 mm Hg.

More than 90% of cases are of the essential or primary type.

Headache is the most reliable symptom.

 When it is left untreated, the major risks include CVAs and cardiac hypertrophy.

24A 53-year-old man was admitted to the emergency room after experiencing shortness of breath, weakness, cardiac dysrhythmias, and chest pain that did not subside after nitroglycerin therapy. Laboratory tests showed that the patient had an elevations of serum CPK, troponin, and SCOT or AST. ECG tracings revealed a prominent Q wave and an elevated ST segment. The most probable diagnosis is:

 a transient ischemic attack.

an acute myocardial infarct.

 an attack of unstable angina pectoris.

Prinzmetal angina.

25High altitudes may produce hypoxemia by:

 right-to-left shunts.

hypoventilation.

decreased oxygen inspiration.

 diffusion abnormalities.

26In bronchial asthma:

 bronchial muscles contract.

 bronchial muscles relax.

mucous secretions decrease.

imbalances within the CNS develop.

27Surfactant produced by type II alveolar cells facilitates alveolar distention and ventilation by which mechanism?

 Decreasing thoracic compliance

Attracting water to the alveolar surface

Decreasing surface tension in the alveoli

 Increasing surface tension in the alveoli

28A healthcare professional wants to determine the adequacy of a person’s alveolar ventilation. What assessment finding is most important for the professional to consider?

 Respiratory rate of 12 breaths/min

Ventilatory pattern is regular and rhythmic.

Respiratory effort is strained with muscle involvement.

Arterial blood gas shows a PaCO2 of 44 mmHg.

29Which normal physiologic change occurs in the aging pulmonary system?

 Decreased flow resistance

Fewer alveoli

Stiffening of the chest wall

 Improved elastic recoil

30If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to react in which manner?

Shift to the right, causing more oxygen (O2) to be released to the cells

 Shift to the left, allowing less O2 to be released to the cells

Show no change, allowing the O2 concentration to remain stable

Show dramatic fluctuation, allowing the O2 concentration to increase

31A newborn has alveolar collapse, decreased lung expansion, increased work of breathing, and severe gas-exchange abnormalities and the student asks the healthcare professional for an explanation of what is happening. What response by the professional is best?

 A decrease in lung compliance from the trauma of a long childbirth process

A traumatic pneumothorax from a prolonged and difficult labor

Damage done to the alveoli from exposure to supplemental oxygen at birth

Lack of surfactant leading to increased alveolar surface tension and fluid collection

32The student asks the professor to explain what characteristic is demonstrated by lungs with decreased compliance?

 Difficult deflation

Easy inflation

Stiffness

 Inability to diffuse oxygen

33Which is inconsistent with pneumonia?

 chest pain, cough, and rales

involves only interstitial lung tissue

 may be caused by mycoplasmas

can be lobar pneumonia or bronchopneumonia

34Hypoventilation that results in the retention of carbon dioxide will stimulate which receptors in an attempt to maintain a normal homeostatic state?

 Irritant receptors

Central chemoreceptors

 Peripheral chemoreceptors

Stretch receptors

35Pulmonary emboli usually:

 obstructs blood supply to the heart.

originates from small aneurysms in the legs.

 occludes pulmonary vein branches.

dilates pulmonary artery branches.

36Pulmonary hypertension:

 occurs when left arterial pressure is decreased.

involves deep vein insufficiency.

shows right ventricular hypertrophy on an electrocardiogram.

37How low must the partial pressure of arterial oxygen (PaO2) drop before the peripheral chemoreceptors influence ventilation?

 Below 100 mmHg

Below 80 mmHg

Below 70 mmHg

Below 60 mmHg

38During expiration, which relationship is true?

 As the lung volume decreases, the number of gas molecules increases.

As the lung pressure increases, the number of gas molecules increases.

As the lung volume decreases, the pressure increases.

 As the partial pressure increases, less gas will dissolve in a liquid.

39Which ordinarily brings about the greatest increase in the rate of respiration?

excess carbon dioxide

 increased O2

increased arterial pH

a sudden rise in blood pressure

Results for item 40.

40The cilia of the bronchial wall:

 ingest bacteria.

trigger the sneeze reflex.

trap and remove bacteria.

propel mucus and trapped bacteria toward the oropharynx.

41Which type of pulmonary disease requires more force to expire a volume of air?

 Restrictive

Obstructive

 Acute

Communicable

42Which immunoglobulin (Ig) may contribute to the pathophysiologic characteristics of asthma?

 IgA

IgE

 IgG

IgM

43A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process?

 Norepinephrine causes bronchial smooth muscle contraction and mucus secretion but it also causes high blood pressure.

Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring.

 The release of epinephrine leads to development of cardiac dysrhythmias.

Immunoglobulin G causes smooth muscle contraction which will eventually weaken the respiratory muscles.

44A patient comes to the Emergency Department with inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea. What treatment does the healthcare professional anticipate for this patient as the priority?

 Sputum culture

History of illness exposure

 Antibiotics

Inhaled bronchodilator

45A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action?

Avoidance of the causative agent

 Administration of broad-spectrum antibiotics

Administration of drugs that reduce bronchospasm

Administration of drugs that decrease airway inflammation

46A patient with emphysema comes to the clinic and reports increased, productive cough. What diagnostic test should the healthcare professional facilitate as the priority?

 Chest x-ray

Peak expiratory flow

Pulmonary function tests

Sputum culture

47The student asks a professor to explain how tuberculosis (TB) can remain dormant in some people. What explanation by the professor is best?

 It does not remain dormant but some host defenses can kill the bacteria.

The bacilli can become isolated within tubercles in the lungs.

 Macrophages attack and phagocytize new areas of infection.

Virulence factors in the bacilli weaken over time leading to apoptosis.

48Oxygen diffusion from the alveolus to the alveolar capillary occurs because:

the PAO2 is less in the capillary than in the alveolus.

 the PAO2 is greater in the atmosphere than in the arterial blood.

oxygen diffuses faster than CO2.

 the PAO2 is higher in the capillary than in the alveoli

49A patient has long-standing pulmonary disease and chronic hypoxia. The student assesses the patient’s fingertips and notices bulbous enlargement of the distal segment of the digits. How does the student document this finding?

 Edema

Clubbing

Angling

Osteoarthropathy

50 Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung’s alveolar walls?

 Transudative effusion

Emphysema

 Exudative effusion

Abscess