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Applied Pathophysiology for the Advanced Practice Nurse 2nd Edition By Lucie Dlugasch; Lachel Story Applied Pathophysiology for the Advanced Practice Nurse2nd Edition Dlugasch Story Test Bank
Chapter 1 Cellular Function
1.
The nucleus cell.
, which is essential for function and survival of the
A)
is the site of protein synthesis
B)
contains the genetic code
C)
transforms cellular energy
D)
initiates aerobic metabolism
2.
Although energy is not made in mitochondria, they are known as the power plants of the cell because they:
A)
contain RNA for protein synthesis.
B)
utilize glycolysis for oxidative energy.
C)
extract energy from organic compounds.
D)
store calcium bonds for muscle contractions.
3.
Although the basic structure of the cell plasma membrane is formed by a lipid bilayer, most of the specific membrane functions are carried out by:
A)
bound and transmembrane proteins.
B)
complex, long carbohydrate chains.
C)
surface antigens and hormone receptors.
D)
a gating system of selective ion channels.
4. A)
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To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that: displace surface receptor proteins.
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B)
accumulate within cell gap junctions.
C)
bind to contractile microfilaments.
D)
release secretions into extracellular fluid.
5.
Aerobic metabolism, also known as oxidative metabolism, provides energy by:
A)
removing the phosphate bonds from ATP.
B)
combining hydrogen and oxygen to form water.
C)
activating pyruvate stored in the cytoplasm.
D)
breaking down glucose to form lactic acid.
6.
Exocytosis, the reverse of endocytosis, is important in extracellular fluid.
into the
A)
Engulfing and ingesting fluid and proteins for transport
B)
Killing, degrading, and dissolving harmful microorganisms
C)
Removing cellular debris and releasing synthesized substances
D)
Destruction of particles by lysosomal enzymes for secretion
7.
The process responsible for generating and conducting membrane potentials is:
A)
diffusion of current-carrying ions.
B)
millivoltage of electrical potential.
C)
polarization of charged particles.
D)
ion channel neurotransmission.
8.
Epithelial tissues are classified according to the shape of the cells and the number of layers. Which of the following is a correctly matched description and type of epithelial tissue?
A)
Simple epithelium: cells in contact with intercellular matrix; some do not extend to surface
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B)
Stratified epithelium: single layer of cells; all cells rest on basement membrane
C)
Glandular epithelium: arise from surface epithelia and underlying connective tissue
D)
Pseudostratified epithelium: multiple layers of cells; deepest layer rests on basement membrane
9.
Connective tissue contains fibroblasts that are responsible for:
A)
providing a fibrous framework for capillaries.
B)
synthesis of collagen, elastin, and reticular fibers.
C)
forming tendons and the fascia that covers muscles.
D)
filling spaces between tissues to keep organs in place.
10 .
Although all muscle tissue cells have some similarities, smooth muscle (also known as involuntary muscle) differs by:
A)
having dense bodies attached to actin filaments.
B)
containing sarcomeres between Z lines and M bands.
C)
having rapid contractions and abundant cross-striations.
D)
contracting in response to increased intracellular calcium.
11 .
Which of the following aspects of the function of the nucleus is performed by ribosomal RNA (rRNA)?
A)
Copying and carrying DNA instructions for protein synthesis
B)
Carrying amino acids to the site of protein synthesis
C)
Providing the site where protein synthesis occurs
D)
Regulating and controlling protein synthesis
12 . A)
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Breakdown and removal of foreign substances and worn-out cell parts are performed by which of the following organelles? Lysosomes
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B)
Golgi apparatus
C)
Ribosomes
D)
Endoplasmic reticulum (ER)
13 .
Impairment in the function of peroxisomes would result in:
A)
inadequate sites for protein synthesis.
B)
an inability to transport cellular products across the cell membrane.
C)
insufficient energy production within a cell.
D)
accumulation of free radicals in the cytoplasm.
14 .
After several months of trying to conceive, a couple is undergoing fertility testing. Semen analysis indicates that the mans sperm have decreased motility, a finding that is thought to underlie the couples inability to become pregnant. Which of the following cellular components may be defective within the mans sperm?
A)
Ribosomes
B)
Microtubules
C)
Mitochondria
D)
Microfilaments
15 .
Which of the following statements is true of glycolysis?
A)
Glycolysis requires oxygen.
B)
Glycolysis occurs in cells without mitochondria.
C)
Glycolysis provides the majority of the bodys energy needs.
D)
Glycolysis produces energy, water, and carbon dioxide.
16 . A)
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Which of the following membrane transport mechanisms requires the greatest amount of energy? Facilitated diffusion
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B)
Passive transport
C)
Vesicular transport
D)
Simple diffusion
17 .
A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia because he lacks sufficient insulin to increase the availability of glucose transporters in his cell membranes. Consequently, his cells lack intracellular glucose and it accumulates in his blood. Which of the following processes would best allow glucose to cross his cell membranes?
A)
Facilitated diffusion
B)
Simple diffusion
C)
Secondary active transport
D)
Endocytosis
18 .
Which of the following statements is true of skeletal muscle cells?
A)
Skeletal muscle cells each have an apical, lateral, and basal surface.
B)
They are closely apposed and are joined by cell-to-cell adhesion molecules.
C)
Their basal surface is attached to a basement membrane.
D)
Skeletal muscle is multinucleated, lacking true cell boundaries.
19 .
Which of the following body tissues exhibits the highest rate of turnover and renewal?
A)
The squamous epithelial cells of the skin
B)
The connective tissue supporting blood vessels
C)
The skeletal muscle that facilitates movement
D)
The nervous tissue that constitutes the central nervous system
20 .
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A patient with a pathophysiologic condition that affects the desmosomes is most likely to exhibit:
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A)
impaired contraction of skeletal and smooth muscle.
B)
weakness of the collagen and elastin fibers in the extracellular space.
C)
impaired communication between neurons and effector organs.
D)
separation at the junctions between epithelial cells.
Answer Key
1.
B
2.
C
3.
A
4.
D
5.
B
6.
C
7.
A
8.
C
9.
B
10 .
A
11 .
C
12 .
A
13 .
D
14 .
B
15 .
B
16 .
C
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17 .
A
18 .
D
19 .
A
20 .
D
Chapter 2 Immunity
1.
Innate immunity, also called natural or native immunity, consists of mechanisms that respond specifically to:
A)
self-cells.
B)
microbes.
C)
antibodies.
D)
inflammation.
2.
Adaptive immune responses, also called acquired or specific immunity, are composed of and their products.
A)
granulocytes
B)
lymphocytes
C)
epithelial cells
D)
Toll-like receptors
3.
The effector cells of the immune system have the primary function of:
A)
activating phagocytic cells.
B)
eliminating the antigens.
C)
processing antigen into epitopes.
D)
controlling the immune response.
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4.
Activation of lymphocytes is dependent upon the of the antigens by macrophages.
A)
memory; clustering
B)
capture; destruction
C)
recognition; grouping
D)
processing; presentation
5.
Major histocompatibility complex (MHC) molecules, with human leukocyte antigens (HLAs), are markers on all nucleated cells and have an important role in:
A)
identifying blood types.
B)
cell membrane transport.
C)
suppressing viral replication.
D)
avoiding transplant rejections.
6.
Dendritic cells, found in skin tissues and lymphoid tissues, are important for:
A)
initiation of adaptive immunity.
B)
deep-tissue phagocytosis.
C)
disposal of dead cells.
D)
delaying inflammation.
7.
Once T helper cells are activated, they secrete that activate and regulate nearly all of the other cells of the immune system.
A)
complement proteins
B)
cytokines
C)
leukotrienes
D)
bradykinins
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and
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8.
The first circulating immunoglobulin to appear in response to a new antigen is:
A)
IgG.
B)
IgM.
C)
IgA.
D)
IgD.
9.
The effector function of activated members of the complement system includes all of the following EXCEPT:
A)
chemotaxis.
B)
opsonization.
C)
pathogen lysis.
D)
phagocytosis.
10 .
During the latent period before antibodies are detected in the humoral immune response, B cells differentiate into cells.
A)
plasma
B)
cytotoxic
C)
stem
D)
helper
11 .
Which of the following would participate in the innate immune response to an infectious microorganism?
A)
T lymphocytes
B)
Antibodies
C)
B lymphocytes
D)
Neutrophils
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12 .
A patient has recently received a pneumococcal vaccine and the patients B cells are consequently producing antibodies. Which of the following cells may enhance this production of antibodies?
A)
Helper T cells
B)
Regulatory T cells
C)
Cytotoxic T cells
D)
Natural killer cells
13 .
A childs thymus gland is fully formed and proportionately larger than an adults. Which of the following processes that contribute to immunity takes place in the thymus gland?
A)
Differentiation of B cells
B)
Production of natural killer (NK) cells
C)
Proliferation of T cells
D)
Filtration of antigens from the blood
14 .
A patients exposure to an antibiotic-resistant microorganism while in the hospital has initiated an immune response, a process that is mediated and regulated by cytokines. Which of the following statements is true of cytokines?
A)
They are stored in the peripheral lymphoid tissues until required.
B)
They have a long half-life that contributes to an ongoing immune response.
C)
They are normally released at cell-to-cell interfaces, binding to specific receptors.
D)
They are capable of performing phagocytosis in the response to viral invasion.
15 .
The entrance of a microbe into an individuals vascular space has initiated opsonization. Which of the following processes is involved in opsonization?
A)
Stimulation of B cells by helper T cells
B)
Coating of a microbe to aid phagocyte recognition
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C)
Release of proteins that stimulate cell production by the bone marrow
D)
Lysis of intracellular microbes by cytotoxic T cells
16 .
Bacteria on a sliver in a boys finger have initiated an adaptive immune response. The boys lymphocytes and antibodies recognize immunologically active sites on the bacterial surfaces known as:
A)
Toll-like receptors.
B)
opsonins.
C)
chemokines.
D)
epitopes.
17 .
Histocompatability molecules are of primary importance to which of the following aspects of immunity?
A)
Induction of T-cell immunity
B)
T-cell maturation
C)
NK cell activation
D)
Phagocytosis by neutrophils
18 .
Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?
A)
Secondary humoral response
B)
Cell-mediated immune response
C)
Primary humoral response
D)
Innate immunity
19 .
A patients cell-mediated immune response has resulted in the release of regulator T cells. These cells will perform which of the following roles?
A)
Suppressing the immune response to limit proliferation of potentially harmful lymphocytes
B)
Presenting antigens to B cells to facilitate the production of antibodies
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C)
Differentiating into subpopulations of helper T cells
D)
Destroying target cells by releasing cytolytic enzymes and other toxins
20 .
A 1-day-old infant was exposed to an infectious microorganism prior to discharge home from the hospital, but was able to effect a sufficient immune response in the hours and days following exposure. This immune response may have been due to the presence of which of the following immunoglobulins from the infants mother?
A)
IgA
B)
IgG
C)
IgM
D)
IgD
Answer Key
1.
B
2.
B
3.
B
4.
D
5.
D
6.
A
7.
B
8.
B
9.
D
10 .
A
11 .
D
12 .
A
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13 .
B
14 .
C
15 .
B
16 .
D
17 .
A
18 .
A
19 .
A
20 .
B
Disorders and Immune Response
1.
The mediators involved in type I hypersensitivity allergic responses are released from:
A)
mast cells.
B)
plasma cells.
C)
monocytes.
D)
arachidonic acid.
2.
A genetically determined hypersensitivity to common environmental allergens causes reactions, such as:
A)
atopic; urticaria.
B)
autoimmune; diarrhea.
C)
IgM-mediated; infections.
D)
delayed; poison ivy rash:
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3.
Mismatched blood transfusion reaction with hemolysis of blood cells is an example of type II, mediated hypersensitivity reaction.
A)
T-cell
B)
antibody
C)
leukotriene
D)
complement
4.
Type III hypersensitivity immune responses can be harmful when immune complex deposits in tissue activate that can directly damage area tissues.
A)
inflammation
B)
autoantibodies
C)
cytotoxic cells
D)
immunoglobulins
5.
The mechanism by which humans recognize self-cells from non-self (antigens)-cells is .
A)
autoimmunity
B)
self-tolerance
C)
non-self anergy
D)
immunocompatibility
6.
Organ rejection is a complication of organ transplantation caused by recipient immune cells:
A)
destroying the host T cells.
B)
attack on the donor cells.
C)
combining with grafts HLA.
D)
being recognized as foreign.
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7.
The leading cause of death for people with HIV is opportunistic .
A)
leukemia
B)
tuberculosis
C)
pneumonia
D)
toxoplasmosis
8.
Wasting syndrome, an AIDS-defining illness, is characterized by involuntary weight loss of at least 10% of baseline body weight in the presence of:
A)
diarrhea.
B)
hypermetabolism.
C)
weakness and fever.
D)
glucose intolerance.
9.
The window period of HIV infection refers to the period of time between infection and:
A)
transmission.
B)
seroconversion.
C)
initial symptoms.
D)
antibody screening.
10 .
HIV-positive persons that display manifestations of laboratory category 3 or clinical category C are considered to have:
A)
zero viral load.
B)
seroconversion.
C)
complete remission.
D)
AIDS-defining illnesses.
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11 .
Contact with poison ivy has resulted in intense pruritus, erythema, and weeping on a patients forearm. Which of the following processes resulted in the patients signs and symptoms?
A)
IgE-mediated mast cell degranulation
B)
Formation of antigen-antibody complexes
C)
Cytokine release by sensitized T cells
D)
Formation of antibodies against cell surface antigens
12 .
A patient with a long history of hay fever has recently begun a series of immunotherapy (allergy shots). How will this treatment potentially achieve a therapeutic effect?
A)
By blocking cytokine release from sensitized mast cells
B)
By preventing mast cells from becoming sensitized
C)
By causing T cells to be sequestered in the thymus for longer periods
D)
By stimulating production of IgG to combine with antigens
13 .
A patient with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. Which of the following cells is central to the rejection of the patients transplanted organ?
A)
Natural killer cells
B)
Mast cells
C)
T cells
D)
Neutrophils
14 .
A patient with a diagnosis of aplastic anemia has undergone allogenic bone marrow transplantation. Which of the following signs and symptoms would most clearly suggest the existence of graft-versus-host disease (GVHD)?
A)
Shortness of breath, audible crackles, and decreasing PaO2
B)
Presence of a pruritic rash that has begun to slough off
C)
Development of metabolic acidosis
D)
Diaphoresis, fever, and anxiety
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15 .
A patient has developed pericarditis after developing acute glomerulonephritis, a development that may be attributable to the presence of similar epitopes on group A, b-hemolytic streptococci and the antigens in the patients heart tissue. Which of the following has most likely accounted for this patients autoimmune response?
A)
Breakdown of T-cell anergy
B)
Release of sequestered antigens
C)
Superantigens
D)
Molecular mimicry
16 .
A 70-year-old female patient has had her mobility and independence significantly reduced by rheumatoid arthritis. Which of the following processes likely contributed to the development of her health problem?
A)
Delayed-type hypersensitivity (DTH) reaction
B)
Proliferation of cytotoxic T cells
C)
Failure of normal self-tolerance
D)
Deletion of autoreactive B cells
17 .
Which of the following would constitute a normal assessment finding in a neonate?
A)
Minimal or absent levels of IgA and IgM
B)
Absence of plasma cells in the lymph nodes and spleen
C)
Undetectable levels of all immunoglobulins
D)
Absence of mature B cells with normal T-cell levels and function
18 .
A patient was diagnosed as HIV positive several years ago. Which of the following blood tests is most clinically useful for determining the stage and severity of her disease?
A)
Plasma levels
B)
CD4+ cell counts
C)
Viral load
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D)
19 .
White blood cell count with differential
A patient has been admitted to the hospital for the treatment of HIV infection, which has recently progressed to overt AIDS. Which of the following nursing actions should the nurse prioritize when providing care for this patient?
A)
Frequent neurologic vital signs and thorough skin care
B)
Hemodynamic monitoring and physical therapy
C)
Careful monitoring of fluid balance and neurologic status
D)
Astute infection control and respiratory assessments
20 .
Shortly after being diagnosed with HIV, a patient has begun highly active antiretroviral therapy (HAART). What is the primary goal of the patients drug regimen?
A)
To limit the latent period of HIV
B)
To slow the progression of the disease
C)
To minimize opportunities for transmission
D)
To prevent seroconversion
Answer Key
1.
A
2.
A
3.
B
4.
A
5.
B
6.
B
7.
B
8.
A
9.
B
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10 .
D
11 .
C
12 .
D
13 .
C
14 .
B
15 .
D
16 .
C
17 .
A
18 .
B
19 .
D
20 .
B
Chapter 3 Hematopoietic Function
1.
With the exception of the first two steps, what is required in all steps of the clotting process?
A)
Calcium
B)
Prothrombin
C)
Tissue factor
D)
Plasminogen
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2.
The first step of hemostasis occurs as a:
A)
fibrin clot.
B)
platelet plug.
C)
clot retraction.
D)
vessel spasm.
3.
To form a platelet plug, platelets are attracted to the damaged vessel, and then platelet occurs.
A)
adhesion
B)
fibrinolysis
C)
thrombosis
D)
thromboxane A2
4.
Blood coagulation is initiated by either of two pathways. The intrinsic pathway requires circulating to begin the step-wise coagulation cascade.
A)
protein C
B)
thrombin
C)
factor XII
D)
tissue factor
5.
Increased platelet function, and consequent hypercoagulability, can be caused by:
A)
factor V mutation.
B)
platelet insensitivity.
C)
vascular wall damage.
D)
decreased platelet numbers.
6.
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Immune thrombocytopenia purpura (ITP) is a/an destroys .
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disorder that
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A)
allergic; fibrinogen
B)
alloimmune; factor VIII
C)
autoimmune; platelets
D)
immunoglobulin; B cells
7.
Thrombotic thrombocytopenic purpura (TTP) causes which of the following manifestations? Select all that apply.
A)
Purpura
B)
Jaundice
C)
Petechiae
D)
Erythema
E)
Confusion
8.
Hemophilia A is a hereditary blood disorder caused by inadequate activity or absent:
A)
factor VIII.
B)
prothrombin.
C)
vWF complex.
D)
intrinsic factor.
9.
Disseminated intravascular coagulation (DIC) is characterized by:
A)
headaches.
B)
platelet loss.
C)
hypertension.
D)
hemorrhage.
10 . A)
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In persons with a bleeding disorder caused by vascular defects, laboratory tests will most often reveal: normal values.
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B)
hypocalcemia.
C)
polycythemia.
D)
thrombocytopenia.
11 .
Removal of a patients peripheral intravenous catheter resulted in brief bleeding and the loss of a small amount of blood. Which of the following processes occurred during the formation of the platelet plug that helped to stop blood flow?
A)
Activation of factor X
B)
Conversion of prothrombin to thrombin
C)
Release of von Willebrand factor from the epithelium
D)
Conversion of fibrinogen to fibrin threads
12 .
A 69-year-old patient who is obese and has a diagnosis of angina pectoris has been prescribed clopidogrel (Plavix) by his primary care provider. The patients medication achieves its therapeutic effect in which of the following ways?
A)
Prevention of platelet aggregation
B)
Activation of plasminogen
C)
Inhibition of the intrinsic clotting pathway
D)
Deactivation of factor X
13 .
A public health nurse is conducting a health promotion campaign under the auspices of the local community center. Which of the following measures that the nurse is promoting are likely to influence the participants risk of hypercoagulability disorders? Select all that apply.
A)
Smoking cessation
B)
Blood glucose screening
C)
Weight management
D)
Cholesterol screening and management
E)
Blood pressure screening and management
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14 .
During a patients admission assessment prior to reduction mammoplasty surgery, the nurse notes a reference to a Leiden mutation in the patients history. The nurse would recognize the patients increased risk for
A)
Hemorrhage
B)
Myocardial infarction
C)
Hemophilia A or B
D)
Deep vein thrombosis
15 .
The most recent blood work of a patient with a diagnosis of acute myelogenous leukemia (AML) reveals thrombocytopenia. Where is the patient most likely to experience abnormal bleeding as a result of low platelets?
A)
In the brain
B)
Skin and mucous membranes
C)
Sclerae of the eyes
D)
Nephrons and ureters
16 .
A patient was started on a protocol for the prevention of deep vein thrombosis shortly after admission, and has been receiving 5000 units of heparin twice daily for the last 5 days. An immune response to this treatment may increase the patients chance of developing which health problem?
A)
Antiphospholipid syndrome
B)
Disseminated intravascular coagulation (DIC)
C)
Von Willebrand disease
D)
Thrombocytopenia
17 .
In light of the presence of numerous risk factors for coronary artery disease, a patients primary care provider has recommended that he take low-dose aspirin once daily. Doing so will reduce the patients risk of myocardial infarction by altering which of the following stages of hemostasis?
A)
Vessel spasm
B)
Platelet plug formation
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C)
Blood coagulation
D)
Clot lysis
18 .
A 23-year-old female patient has been diagnosed with von Willebrand disease following a long history of heavy periods and occasional nosebleeds. Which of the patients following statements demonstrates a sound understanding of her new diagnosis?
A)
Im really disappointed that I wont be able to do sports anymore.
B)
I read on a website that I might have to get blood transfusions from time to time.
C)
Ill make sure to take Tylenol instead of aspirin when I get aches and pains.
D)
I hope my insurance covers the injections that Ill need to help my blood clot.
19 .
Which of the following patients likely faces the highest risk of an acquired hypocoagulation disorder and vitamin K deficiency?
A)
A patient who has a diagnosis of liver failure secondary to alcohol abuse
B)
A patient who has chronic renal failure as a result of type 1 diabetes mellitus
C)
A patient who is immunocompromised as a result of radiation therapy for the treatment of lung cancer
D)
A patient with dehydration and hypokalemia that have resulted from Clostridium difficileassociated diarrhea
20 .
A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago, but the mother has experienced postpartum hemorrhage. Which of the following disorders is most likely to underlie the patients excessive bleeding after delivery?
A)
Disseminated intravascular coagulation
B)
Hemophilia A
C)
Von Willebrand disease
D)
Thrombotic thrombocytopenic purpura (TTP)
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Answer Key
1.
A
2.
D
3.
A
4.
C
5.
C
6.
C
7.
A, C, E
8.
A
9.
D
10 .
A
11 .
C
12 .
A
13 .
A, B, C, D, E
14 .
D
15 .
B
16 .
D
17 .
B
18 .
C
19 .
A
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20 .
A
Red Blood Cell Disorders
1.
Sue is fatigued and some blood tests are done. Her results include Hct 40%; Hgb 8g/dL; WBC 8,000; platelets 175,000. The nurse should interpret Sues blood work as indicative of:
A)
high platelets/thrombocytosis.
B)
low WBC count/granulocytopenia.
C)
low hemoglobin/anemia.
D)
high hematocrit/polycythemia.
2.
Manifestations of anemia that are directly due to the diminished oxygencarrying capacity of hemoglobin include:
A)
fatigue.
B)
bleeding.
C)
bone pain.
D)
pale skin.
3.
When an Rh-negative mother has been sensitized and is pregnant with an Rh-positive fetus, what happens to the fetus?
A)
Bilirubin deficiency
B)
Nothing, this is normal
C)
Plasma volume depletion
D)
Profound red cell hemolysis
4.
A)
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The patient is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which of the following CBC results is characteristic of her type of anemia? Hematocrit 44%
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B)
Reticulocytes 1.5%
C)
Band cells 3,000/mL
D)
Hemoglobin 8 g/dL
5.
Megaloblastic anemias caused by folic acid or vitamin B12 deficiencies can seriously affect RBC production. This is because both are necessary for synthesis and .
A)
iron; hemoglobin adhesion
B)
DNA; red blood cell maturation
C)
thrombin; platelet aggregation
D)
protein; reticulocyte maturation
6.
Polycythemia develops in patients with lung disease as a result of:
A)
hyperventilation.
B)
chronic hypoxia.
C)
decreased blood viscosity.
D)
excessive respiratory fluid loss.
7.
Which of the following types and characteristics of anemia are correctly matched?
A)
Hemolytic; abnormal iron uptake
B)
Iron deficiency; early RBC death
C)
Folate; decreased erythropoiesis
D)
Blood loss; bone marrow expansion
8.
Conditions that predispose to sickling of hemoglobin in persons with sickle cell anemia include:
A)
impaired red blood cell maturation.
B)
increased iron content of blood.
C)
decreased oxygen saturation.
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D)
9.
increased intravascular volume.
An elevated level of unconjugated bilirubin, due to hemolysis of RBCs, results in a high level of iron released and:
A)
diarrhea.
B)
cyanosis.
C)
numbness.
D)
jaundice.
10 .
Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory:
A)
hypoactive bone marrow.
B)
increased erythropoiesis.
C)
iron retention in the body.
D)
shrinkage of the spleen.
11 .
A 48-year-old male patient, who normally enjoys good health, has been admitted to the hospital for the treatment of polycythemia vera. The nurse who is providing care for the patient should prioritize assessments aimed at the early identification of which of the following health problems?
A)
Orthostatic hypotension
B)
Hyperventilation and respiratory alkalosis
C)
Vasculitis
D)
Thromboembolism
12 .
Which of the following patients is most susceptible to experiencing the effects of inadequate erythropoiesis?
A)
A patient who has developed renal failure as a result of longstanding hypertension
B)
A patient who recently experienced an ischemic stroke and who remains bedridden
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C)
A patient whose heavy alcohol use has culminated in a diagnosis of pancreatitis
D)
A patient whose estimated blood loss during recent surgery was 700 mL.
13 .
A 72-year-old woman with complaints of increasing fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this patients gastrointestinal bleed?
A)
Hemolytic anemia
B)
Aplastic anemia
C)
Iron-deficiency anemia
D)
Megaloblastic anemia
14 .
Hemoglobin solubility results and hemoglobin electrophoresis have resulted in a diagnosis of sickle cell anemia in an African American infant. The parents of the child should be aware that their child is at a significant risk for which of the following health problems? Select all that apply.
A)
Acute pain
B)
Stroke
C)
Respiratory disease
D)
Autoimmune diseases
E)
Fractures
15 .
The pathologic effects of the thalassemias are primarily due to which of the following pathophysiologic processes?
A)
Impaired hemoglobin synthesis
B)
Impaired folic acid absorption
C)
Erythropoietin deficiency
D)
Loss of iron
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16 .
Which of the following individuals likely faces the highest risk of megaloblastic anemia?
A)
A 69-year-old woman who takes ASA four times daily to treat her arthritis
B)
A 44-year-old man who lost approximately 500 mL of blood in a workplace accident
C)
A 21-year-old college student who lives a vegan lifestyle
D)
An infant who is exclusively fed commercial baby formula
17 .
For which of the following health problems is stem cell transplantation likely to be of therapeutic benefit?
A)
Aplastic anemia
B)
b-Thalassemias
C)
Chronic disease anemias
D)
Secondary polycythemia
18 .
A 68-year-old patient with an 80 pack/year history of smoking was diagnosed with emphysema 18 months ago. The patients most recent scheduled blood work showed red blood cell indices, a problem that suggests the need for which of the following interventions?
A)
Vitamin B12 supplements
B)
Increased supplementary oxygen therapy
C)
Hemodialysis or peritoneal dialysis
D)
Scheduled erythropoietin injections
19 .
Which of the following trends in the hematologic status of a 6-week-old infant most clearly warrants medical intervention?
A)
Decreasing red blood cell counts
B)
Increasing HgA levels
C)
Decreasing hematocrit and mean corpuscular volume (MCV)
D)
Increasing white blood cell counts
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20 .
A mother has brought her 2-week-old infant to the emergency department due to the babys persistent and increasing jaundice. Blood testing reveals that the infants unconjugated bilirubin level is 28 mg/dL and assessment does not reveal neurologic deficits. The infants weight is normal and the mother claims to have had no significant difficulty feeding the infant. The most likely treatment for this infant will be:
A)
phototherapy.
B)
packed red blood cell transfusion.
C)
phlebotomy.
D)
intravenous antibiotics.
Answer Key
1.
C
2.
A
3.
D
4.
D
5.
B
6.
B
7.
C
8.
C
9.
D
10 .
B
11 .
D
12 .
A
13 .
C
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14 .
A, B, C
15 .
A
16 .
C
17 .
A
18 .
B
19 .
D
20 .
A
Chapter 4 Cardiovascular Function
1.
In the arterial-venous circulatory system, pressure is inversely related to:
A)
velocity.
B)
volume.
C)
tension.
D)
viscosity.
2.
Turbulent blood flow can be caused by a number of factors, including:
A)
increased velocity.
B)
short vessel length.
C)
high blood viscosity.
D)
layering of blood cells.
3.
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Heart muscle differs from skeletal muscle tissue by being able to generate:
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A)
contractions.
B)
calcium influx.
C)
action potentials.
D)
sarcomere binding.
4.
During ventricular systole, closure of the atrioventricular (AV) valves coincides with:
A)
atrial chamber filling.
B)
aortic valve opening.
C)
isovolumetric contraction.
D)
semilunar valves opening.
5.
The difference between the end-diastolic and end-systolic volumes is the:
A)
stroke volume.
B)
cardiac output.
C)
ejection fraction.
D)
cardiac reserve.
6.
Preload represents the volume work of the heart and is largely determined by:
A)
venous blood return.
B)
vascular resistance.
C)
force of contraction.
D)
ventricular emptying.
7.
A large increase in heart rate can cause:
A)
increased blood viscosity.
B)
loss of action potential.
C)
decreased stroke volume.
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D)
8.
reduced cardiac contractility.
Long-term autoregulation of local blood flow in the microcirculation is mediated by:
A)
collateral circulation.
B)
arteriovenous shunting.
C)
autonomic nervous system.
D)
metabolic needs of the tissues.
9.
The tissue factor that contributes to humoral control of blood flow by causing vasoconstriction is:
A)
histamine.
B)
bradykinin.
C)
serotonin.
D)
nitric oxide.
10 .
The parasympathetic nervous system causes a slowing of the heart rate by increasing:
A)
norepinephrine.
B)
vessel constriction.
C)
vagus nerve activity.
D)
smooth muscle tone.
11 .
A patient has entered hypovolemic shock after massive blood loss in a car accident. Many of the patients peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon?
A)
Blood pressure is no longer able to overcome vessel wall tension.
B)
Decreasing vessel radii have caused a decrease in blood pressure.
C)
Wall thickness of small vessels has decreased due to hypotension.
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