Pathophysiology Exam 3

A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause?

Hyperventilation

Hypoventilation

Apnea

Cyanosis

Hyperventilation

A 65-year-old female with emphysema presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse chart this condition? Patient has:

Cyanosis

Hemoptysis

Hematemesis

Jaundice

Cyanosis

A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions. When giving report, what term should be used to describe this condition?

Hematemesis

Cyanosis

Rhinitis

Hemoptysis

Hemoptysis

A technician is reviewing the results of an Arterial Blood Gas (ABG) and finds reduced oxygenation of arterial blood. What term should be used to describe this condition?

Ischemia

Hypoxia

Hypoxemia

Hypocapnia

Hypoxemia

Which of the following pathophysiologies is found in pneumothorax?

blood in the pleural space

air in the pleural space

microorganisms and pus in the pleural space

all of the above

air in the pleural space

A 42-year-old female presents with dyspnea; rapid, shallow breathing; inspiratory crackles; decreased lung compliance; and hypoxemia. Tests reveal a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury. Which of the following is the most likely diagnosis?

Acute respiratory distress syndrome (ARDS)

Sarcoidosis

Postoperative respiratory failure

Malignant respiratory failure

Acute respiratory distress syndrome (ARDS)

A student is preparing a PowerPoint about asthma. Which information should be included? Airway hyper-responsiveness in asthma is related to:

Increased sympathetic nervous system response

The release of stress hormones

Exposure to an allergen causing mast cell degranulation

Hereditary decrease in IgE responsiveness

Exposure to an allergen causing mast cell degranulation

A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. When a staff member asks why the patient's airways are obstructed, how should the doctor respond? The airways are obstructed because of:

Excessive mucus production

Loss of elastic recoil

Infection and inflammation

Airway edema

Loss of elastic recoil

A 60-year-old male undergoes surgery for a bone fracture. Which of the following nursing measures would be most effective for preventing pulmonary embolism (PE) in this patient?

Ensure that patient uses supplemental oxygen.

Prevent deep vein thrombosis formation.

Check hematocrit and hemoglobin levels frequently during the postoperative period.

Promote aggressive fluid intake.

Prevent deep vein thrombosis formation.

A patient comes into the emergency room because he is coughing up blood and has chest pain, he also complains about fatigue, night sweats and problems breathing. He spent 3 months traveling in India a year ago. A chest X-ray showed fibrotic scars. Which disease is he likely to have?

emphysema

whooping cough

tuberculosis

pneumothorax

tuberculosis

A premature newborn has respiratory distress syndrome. A nurse monitors the newborn for atelectasis because of:

A lack of surfactant

Pulmonary edema

Airway obstruction

Pulmonary fibrosis

A lack of surfactant

A geneticist is discussing cystic fibrosis (CF). Which information should be included? CF is an _____ disease.

Autosomal recessive

Autosomal dominant

X-linked recessive

X-linked dominant

Autosomal recessive

While reviewing lab results, to help confirm a diagnosis of cystic fibrosis in a 1-year-old child which substance will be present in the child's sweat?

Potassium

Chloride

Magnesium

Carbonic acid

Chloride

A 1-year-old female is diagnosed with croup. When the parent asks what caused this, what is the nurse's best response? The most likely cause of this disease is:

Bacteria

Acute hyperventilation

Allergy

Viral infection

Viral infection

A 5-month-old female is found dead in her crib. The coroner ruled sudden infant death syndrome (SIDS) as the cause of death. Which of the following risk factors is most likely associated with SIDS?

Congenital heart disease

Female gender

Caucasian race

Prone sleeping position

Prone sleeping position

A patient wants to know what causes atherosclerosis. How should the doctor respond? In general, atherosclerosis is caused by:

High serum cholesterol levels

Endothelial injury and inflammation

An increase in antithrombotic substances

Congenital heart disease

Endothelial injury and inflammation

A staff member asks a nurse what foam cells are. What is the nurse's best response? Foam cells in a fatty streak are:

Deposited adipose cells

Injured neutrophils

Macrophages that engulf low-density lipoprotein (LDL)

Lipid-laden mast cells

Macrophages that engulf low-density lipoprotein (LDL)

A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins?

Extreme exercise

Long periods of standing

Trauma to the deep veins

Ischemia

Long periods of standing

A 52-year-old female is diagnosed with coronary artery disease. The nurse assesses for myocardial:

Hypertrophy

Ischemia

Infection

Inflammation

Ischemia

A 28-year-old female presents to the ER reporting severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. Based upon the assessment findings, the doctor determines the patient is experiencing:

Acute pericarditis

Myocardial infarction (MI)

Stable angina

Mitral valve prolapse syndrome

Acute pericarditis

While planning care, the nurse remembers which principle? In valvular _____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.

Regurgitation

Insufficiency

Stenosis

Incompetence

Stenosis

A 60-year-old female was diagnosed with mitral stenosis. As a result, the nurse realizes the patient has incomplete emptying of the:

Right atrium

Right ventricle

Left atrium

Left ventricle

Left atrium

A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. A nurse recalls his untreated hypertension led to:

Ventricular dilation and wall thinning

Myocardial hypertrophy and ventricular remodeling

Inhibition of renin and aldosterone

Alterations in alpha and beta receptor function

Myocardial hypertrophy and ventricular remodeling

An 82-year-old female was admitted to the hospital with confusion and severe hypotension. Her body's compensatory mechanisms are increased heart rate, vasoconstriction, and movement of large volumes of interstitial fluid to the vascular compartment. What kind of shock does the nurse suspect the patient is experiencing?

Anaphylactic

Hypovolemic

Neurogenic

Septic

Hypovolemic

A nurse is teaching a patient about anaphylactic shock. Which information should the nurse include? The onset of anaphylactic shock is usually:

Mild

Immediate and life threatening

Delayed by several hours

Delayed by 24 hours

Immediate and life threatening

A newborn child is diagnosed with tetralogy of Fallot. What symptoms would the nurse expect to observe in the child?

High-pitched cry and dyspnea

Cyanosis and hypoxia

Leg pain and twitching

Epistaxis and anemia

Cyanosis and hypoxia

When a staff member asks what coarctation of the aorta is, how should the nurse respond? Coarctation of the aorta is the local narrowing of the aorta near the:

Aortic valve

Ductus arteriosus

Diaphragm

Bifurcation into the common iliac arteries

Ductus arteriosus

When a staff member asks what the patent opening between the aorta and pulmonary artery in a fetus is called, how should the nurse reply? It is the:

Foramen ovale

Sinus venosus

Ductus arteriosus

Septal defect

Ductus arteriosus

Alkaline electrophoresis of hemoglobin gave the results in the graph below. Which of the patients has normal hemoglobin patient 3 , which one will have symptoms of sickle cell disease patient 2 .

patient 2

patient 3

A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the child have?

Iron deficiency anemia

Pernicious anemia

Sideroblastic anemia

Hemolytic anemia

Pernicious anemia

When a laboratory technician is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the laboratory technician calls these erythrocytes:

Hyperchromic

Hypochromic

Macrocytic

Microcytic

Hypochromic

A 57-year-old male presents to his primary care provider for red face, hands, feet, ears, and headache and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:

Polycythemia vera

Leukemia

Sideroblastic anemia

Hemochromatosis

Polycythemia vera

A staff member asks what leukocytosis means. How should the lab manager respond? Leukocytosis can be defined as:

A normal leukocyte count

A high leukocyte count

A low leukocyte count

Another term for leukopenia

A high leukocyte count

A 20-year-old female has an increase in eosinophils. When the patient wants to know the most likely cause of the eosinophilia. What is the nurse's best response?

Parasitic invasion and allergic reactions

Viral and bacterial infections

Stress and anxiety reactions

Fungal infections and delayed hypersensitivi

Parasitic invasion and allergic reactions

A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the technician expect to find with this disease?

stomatocytes

sideroblasts

Reed-Sternberg cells

Kupffer cells

Reed-Sternberg cells

In thrombocytopenia the platelet count is below _______ platelets/microliter

600,000

400,000

250,000

100,000

100,000

Which mother is at most risk for a maternal-fetal blood incompatibility?

Mother is Rh-positive and fetus is Rh-negative

Mother is Rh-negative and fetus is Rh-positive

Mother has type A blood and fetus has type O blood

Mother has type AB and fetus has type B blood

Mother is Rh-negative and fetus is Rh-positive

Sickle cell disease is characterized by the presence of Hb S. A student is trying to differentiate between Hb S and normal Hb. Which of the following amino acids is present in Hb S and not present in normal Hb?

Glutamic acid

Proline

Histidine

Valine

Valine

The mother of a 3-year-old child speaks to the pediatrician because the child took several hours to stop bleeding following a minor scrape. Testing reveals that the child has hemophilia A resulting from a deficiency in factor:

II

VIII

X

XII

VIII

Blood pressure is expressed as systolic pressure/diastolic pressure. Which of the following blood pressure readings is normal?

170/110

130/95

120/80

95/55

120/80

Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension.

Primary

Secondary

Congenital

Acquired

Primary

A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is:

Asthma

Lung cancer

Left heart failure

Right heart failure

Left heart failure

An 80-year-old female develops pneumonia in the hospital. She becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. Which of the following is the most likely diagnosis documented on the chart?

Empyema

Emphysema

Pneumothorax

Chyle

Empyema

A 15-year-old female is diagnosed with restrictive lung disease caused by fibrosis. The patient had a pulmonary functions test. Which of the following findings is expected?

Increased compliance

Increased functional capacity

Decreased tidal volume

Decreased respiratory rate

Decreased tidal volume

A 50-year-old male with a 30-year history of smoking was diagnosed with lung cancer. He was previously exposed to air pollution, asbestos, and radiation at his job. Which of the following should the nurse realize had the greatest impact on the development of his cancer?

Radiation

Cigarette smoke

Asbestos

Air pollution

Cigarette smoke

What type of cell is proliferating in ALL?

The lymphocyte (WBC) is proliferating in ALL.

An elderly patient complains of indigestion. She has elevated levels of troponin and the ECG shown below (elevated ST segment). What is the likely diagnosis?

Myocardial infarction (STEMI)

Describe the flow of blood through the heart in a child with a small atrial septal defect starting at the vena cava and finishing in the aorta.

Vena cava>right atrium>tricuspid valve>right ventricle>pulmonary valve> pulmonary artery>lungs> pulmonary veins>left atrium>oxygenated blood in the left atrium leaks into and mixes with deoxygenated blood in right atrium> rest of the blood from pulmonary veins goes through mitral valve>left ventricle>aortic valve>aorta.

What changes in blood gases would you expect early in an acute asthma attack?

Increased o2 levels decreased CO2 levels.

A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how he got this disease, how should the doctor respond? The most likely cause is:

Adenovirus

Epstein-Barr virus

Cytomegalovirus

Fungal infection

Epstein-Barr virus

A nurse remembers a low ventilation-perfusion ratio results in:

Increased dead space

Shunting

Alveolar collapse

Bronchoconstriction

Shunting

What term should the nurse document for a blood clot that dislodged from somewhere else and traveled to the lungs and has lodged in a pulmonary capillary?

Thrombus

Embolus

Thromboembolus

Infarction

Thromboembolus