Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/328

Click to flip

328 Cards in this Set

  • Front
  • Back
1. Which of the following is TRUE regarding the constituents of blood?
a. Plasma is composed of 90% dissolved substances and 10% water.
b. Blood volume in adults is about 6 L.
c. Plasma accounts for 10% of blood volume.
d. Plasma and serum are identical.
Blood volume in adults is about 6 L.
1. Which component of the blood system is responsible for the critical colloid oncotic pressure?
a. Immune globulins
b. Albumin
c. Gamma globulin
d. Clotting factors
Albumin
2. Which of the following is TRUE regarding erythrocytes?
a. They comprise 80% of blood volume.
b. Erythrocytes are responsible for tissue oxygenation.
c. They contain ribosomes and mitochondria.
d. They can synthesize proteins.
Erythrocytes are responsible for tissue oxygenation.
2. Which of the following is NOT a granulocyte?
a. Neutrophil
b. Basophil
c. Eosinophil
d. Monocyte
Monocyte
2. A person develops a severe urinary tract infection. Which of the following are the predominant cells of early inflammation?
a. Monocyte
b. Neutrophil
c. Basophil
d. Eosinophil
Neutrophil
2. Which of the following is NOT true about platelet?
a. Platelets initiate repair process including clot dissolution (fibrinolysis)
b. Induce vasoconstriction to regulate blood flow to damaged site
c. Activate the cooagulation (or clotting cascade)
d. Normally circulate freely in plasma in an unactivated state
e. Platelet counts above 100,000 is called thrombocytopenia
Platelet counts above 100,000 is called thrombocytopenia
2. Which of the lymphoid organs cluster around lymphatic veins and collect interstitial fluid from tissues?
a. Spleen
b. Bone Marrow
c. Lymph nodes
d. Thymus
Lymph Nodes
2. Which of the following is NOT one of the four processes of platelet activation?
a. Adhesion
b. Aggregation
c. Secretion
d. Inhibition
Inhibition
2. Which of the following is responsible for lysis or the breakdown of blood clots?
a. Nitric oxide
b. Tissue factor
c. Antithrombin III
d. Fibrinolytic system
Fibrinolytic system (plasmin)
1. True or False The neurologic symptoms in vitamin B12 deficiency anemia are not reversed even with appropriate treatment.
True
1. True or False Considering oral iron therapy, the ferric form is preferred to the ferrous form because ferric is more readily absorbed.
False
1. True or False In hemolytic anemia, the bone marrow is capable of increasing red cell production because of elevated levels of erythropoietin.
True
1. True or False Anemia of chronic disease (ACD) is initially a normochromic and normocytic anemia, but as the condition progresses, it becomes hypochromic and microcytic.
True
1. In some anemias the erythrocytes are present in various sizes, which is referred to as:
a. poikilocytosis.
b. isocytosis.
c. anisocytosis.
d. microcytosis.
Anisocytosis
1. The major physiologic manifestation of anemia is:
a. hypotension.
b. hyperesthesia.
c. hypoxia.
d. ischemia.
Hypoxia
1. True or False Paresthesia occurs in vitamin B12 deficiency anemia.
True
1. The body compensates for anemia by:
a. increasing rate and depth of breathing.
b. capillary vasoconstriction.
c. hemoglobin holds on to oxygen more firmly.
d. pituitary gland release more erythropoietin.
Increasing rate and depth of breathing
1. Deficiencies in folate and vitamin B12 alter the synthesis of:
a. RNA.
b. Cell membrane
c. DNA.
d. mitochondria.
DNA
1. The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12.
a. Microcytic
b. Pernicious
c. Hypochromic
d. Hemolytic
Pernicious
1. Atrophy of gastric mucosal cells results in pernicious anemia because of:
a. erythrocyte destruction.
b. folic acid malabsorption.
c. vitamin B12 malabsorption.
d. poor nutritional intake.
Vit B12 Malabsorption
1. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with _____ anemia.
a. folate deficiency
b. pernicious
c. iron deficiency
d. aplastic
Pernicious
1. The Schilling test is described as the:
a. administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency.
b. measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia.
c. measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia.
d. administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia.
administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency.
1. Pernicious anemia is treated with:
a. vitamin B12by oral intake.
b. cyanocobalamin by intramuscular injection.
c. ferrous fumarate by intramuscular injection, Z track.
d. folate by oral intake.
cyanocobalamin by intramuscular injection.
1. Untreated pernicious anemia is fatal, usually because of:
a. brain hypoxia.
b. liver hypoxia.
c. heart failure.
d. renal failure.
heart failure
2. How is the effectiveness of vitamin B12 therapy measured?
a. Reticulocyte count
b. Serum transferring
c. Hemoglobin
d. Serum vitamin B12
Reticulocyte Count
2. Which statement about folic acid is false?
a. Folic acid absorption is dependent on the enzyme folacin.
b. Folic acid is stored in the liver.
c. Folic acid is essential for RNA and DNA synthesis within erythrocytes.
d. Folic acid is absorbed in the upper small intestine.
Folic acid absorption is dependent on the enzyme folacin.
2. Which anemia produces small, pale erythrocytes (microcytic-hypochromic)?
a. Folic acid
b. Hemolytic
c. Iron deficiency
d. Pernicious
Iron Deficiency
1. A man has fatigue, weakness, and dyspnea. His conjunctiva and palms are pale. His nails appear brittle, thin, and concave, and he has sores at the corners of his mouth. Considering this information, the nurse practitioner suspects that this patient probably has _____ anemia.
a. Pernicious
b. iron deficiency
c. aplastic
d. hemolytic
Iron Deficiency
1. The most common cause of iron deficiency anemia is:
a. decreased dietary intake.
b. chronic blood loss.
c. vitamin deficiency.
d. autoimmune disease.
Chronic Blood Loss
1. Pernicious anemia generally requires continued therapy lasting:
a. 6 to 8 weeks.
b. 8 to 12 months.
c. until the iron level is normal.
d. the rest of ones life.
Rest of one's life
1. A man has cheilosis, stomatitis, and painful ulceration of the buccal mucosa and mouth. He complains of dysphagia and watery diarrhea. These clinical manifestations are indicative of:
a. PA. (pernicious anemia)
b. folate deficiency anemia.
c. anemia of chronic disease.
d. IDA. (iron deficiency anemia)
Folate Deficiency Anemia (No neuro symtptoms)
1. Clinical manifestations of mild to moderate splenomegaly and hepatomegaly, bronze-colored skin, and cardiac dysrhythmias are indicative of which anemia?
a. Iron deficiency
b. Pernicious
c. Sideroblastic
d. Aplastic
Sideroblastic
1. A person with sideroblastic anemia would be likely to have _____ plasma levels of iron.
a. High
b. Low
c. Normal
d. Absent
High
1. (Figure 26-7) In a plastic anemia, pancytopenia develops as a result of the:
a. suppression of erythropoietin to produce adequate amounts of erythrocytes.
b. suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes.
c. lack of DNA to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes.
d. lack of stem cells to form sufficient quantities of leukocytes.
suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes.
1. What is the pathophysiologic process of aplastic anemia?
a. Autoimmune disease against hematopoiesis by activated cytotoxic T cells
b. Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells
c. Inherited genetic disorder with recessive X-linked transmission
Autoimmune disease against hematopoiesis by activated cytotoxic T cells
1. An allogenic bone marrow transplantation remains the preferred and most successful method for treating which anemia?
a. Polycythemia vera
b. Aplastic anemia
c. Sideroblastic anemia
d. Anemia of chronic disease
Aplastic Anemia
1. In hemolytic anemia, jaundice occurs only when:
a. erythrocytes are destroyed in the spleen.
b. heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.
c. the patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT).
d. the erythrocytes are coated with an immunoglobulin.
heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.
1. Erythrocyte life span less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiology of
a. aplastic anemia.
b. sideroblastic anemia.
c. anemia of chronic disease.
d. IDA.
anemia of chronic diease
1. Symptoms of polycythemia vera are mainly the result of:
a. a decreased erythrocyte count.
b. destruction of erythrocytes.
c. increased blood viscosity.
d. neurologic involvement.
increased blood viscosity
1. Treatment for polycythemia vera involves:
a. therapeutic phlebotomy and radioactive phosphorus.
b. restoration of blood volume by plasma expanders.
c. the administration of cyanocobalamin.
d. blood transfusions.
therapeutic phlebotomy and radioactive phosphorus.
1. Match the phrases with the corresponding terms. Options will be used more than once.
Pernicious anemia
c. Macrocytic-normochromic anemia
1. Match the phrases with the corresponding terms. Options will be used more than once.
Sideroblastic anemia
b. Microcytic-hypochromic anemia
1. Match the phrases with the corresponding terms. Options will be used more than once.
Aplastic anemia
a. Normocytic-normochromic anemia
1. Match the phrases with the corresponding terms. Options will be used more than once.
Iron deficiency
b. Microcytic-hypochromic anemia
1. True or False A shift to the left describes the premature release of immature neutrophils when the demand for mature neutrophils exceeds the supply.
True
1. True or False Frequently the initial sign of Hodgkin disease is a painless mass, lump, or swelling, most commonly on the neck.
True
1. True or False Non-Hodgkin lymphoma may be associated with Epstein Barr virus or HIV.
True
1. True or False One of the most common causes of disseminated intravascular coagulation (DIC) is sepsis.
True
2. True or False DIC is a paradoxical condition in which clotting and hemorrhage occur within the vascular system simultaneously.
True
2. What change is seen in leukocytes during an allergic disorder (type I) often caused by asthma, hay fever, and drug reactions?
a. Neutrophilia
b. Basophilia
c. Eosinophilia
d. Monocytosis
Eosinophilia
2. In infectious mononucleosis (IM), what does the Monospot test detect?
a. IgE
b. IgM
c. IgG
d. IgA
IgM
1. A 20-year-old is diagnosed with infectious mononucleosis (IM). Which of the following is one of the classic clinical manifestations?
a. Lymph node enlargement
b. Hepatitis
c. Rash on the trunk and extremities
d. Edema in the area of the eyes
Lymph Node Enlargement
1. Which of the following is a description consistent with acute lymphocytic leukemia (ALL)?
a. It is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
b. The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
c. There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
d. The translocation of genetic material from genes 9 and 22 create an abnormal, fused gene identified as BCR-ABL.
It is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
1. Early detection of acute leukemia would include which of the following symptoms?
a. Dizziness, dehydration, palpitations, hypotension
b. Dyspnea, paresthesia, malaise
c. Bradycardia, abdominal pain, fever
d. Bruising, fatigue, bone pain, anorexia
Bruising, fatigue, bone pain, anorexia
1. Which of the following is a description consistent with chronic myelogenous leukemia (CML)?
a. There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
b. The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
c. There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
d. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.
The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.
1. Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)?
a. There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
b. The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
c. There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
d. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.
There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
1. Which electrolyte imbalance accompanies multiple myeloma (MM)?
a. Hyperkalemia
b. Hypercalcemia
c. Hyperphosphatemia
d. Hypernatremia
Hypercalcemia
1. Local signs and symptoms of Hodgkin disease related lymphadenopathy are a result of:
a. ischemia and pressure.
b. pressure and obstruction.
c. inflammation and ischemia.
d. obstruction and pressure.
Pressure and Obstruction
1. _____ is the virus associated with Burkitt lymphoma in African children.
a. Cytomegalovirus
b. Adenovirus
c. Human papillomavirus
d. Epstein-Barr virus
Epstein-Barr virus
1. A patient with a bleeding disorder has a red-purple discoloration caused by diffuse hemorrhage into skin tissues. The nurse practitioner documents this discoloration as:
a. petechiae.
b. hematoma.
c. ecchymosis.
d. purpura.
purpura
1. Heparin-induced thrombocytopenia (HIT) is described as a(n):
a. IgG immune-mediated adverse drug reaction that reduces circulating platelets.
b. hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body’s needs.
c. IgE-mediated allergic drug reaction that reduces circulating platelets.
d. cell-mediated drug reaction in which macrophages process the heparin and platelet complexes that are then destroyed by activated cytotoxic T cells.
IgG immune-mediated adverse drug reaction that reduces circulating platelets.
1. Immune thrombocytopenia (ITP) is a(n) _____ condition in adults and a(n) _____ condition in children.
a. acute; acute
b. chronic; chronic
c. acute; chronic
d. chronic; acute
Chronic; Acute
1. Vitamin _____ is required for normal clotting factor synthesis by the _____.
a. K; kidneys
b. D; kidneys
c. K; liver
d. D; liver
K; Liver
1. What is the most common cause of vitamin K deficiency?
a. Administration of warfarin (Coumadin)
b. Total parenteral nutrition (TPN) with antibiotic therapy
c. An IgG-mediated autoimmune disorder
d. Liver failure
TPN w/ Antibiotic Therapy
1. Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation and accelerated fibrinolysis?
a. DIC
b. ITP
c. Heparin-induced thrombocytopenia (HIT)
d. Essential thrombocythemia (ET)
DIC
1. In DIC, what are indications of microvascular thrombosis?
a. Reduced amplitude in peripheral pulses
b. Symmetric cyanosis of fingers and toes
c. Numbness and tingling in fingers and toes
d. Pallor and edema of fingers and toes bilaterally
Symmetric cyanosis of fingers and toes
1. The most reliable and specific test for diagnosing DIC is:
a. prothrombin time (PT).
b. activated partial thromboplastin time (aPTT).
c. fibrin degradation products (FDP).
d. D-dimer.
D-Dimer (fibrin degradation)
1. The most significant risk factors for the development of thrombus formation are referred to as the Virchow triad and include: (Select all that apply.)
a. endothelial injury to blood vessels.
b. turbulent arterial blood flow.
c. rapid coagulation of the blood.
d. stagnant venous blood flow.
e. history of obesity.
Everthything but history of obesity
1. Match the causes or diagnostic tests with the hematologic disorders.
a. Epstein-Barr virus
Infectious Mononucleosis
1. Match the causes or diagnostic tests with the hematologic disorders.
a. Bence Jones protein
Multiple myeloma
1. Match the causes or diagnostic tests with the hematologic disorders.
a. Diagnosed by the Reed-Sternberg (RS) cell
Hodgkin diease
1. Match the causes or diagnostic tests with the hematologic disorders.
a. Diagnosed by the Philadelphia chromosome
Chronic myelogenous leukemia
1. Match the descriptions with the platelet disorders.
a. Thrombi composed of platelets with minimal fibrin and erythrocytes that occlude arterioles and capillaries
Thrombotic thrombocytopenic purpura (TTP)
1. Match the descriptions with the platelet disorders.
a. Causes ischemic signs and symptoms in the central nervous system
Acute idiopathic thrombotic thrombocytopenic purpura
1. Match the descriptions with the platelet disorders.
a. Caused by an alteration of multipotent stem cells, resulting in an excess production of platelets
Essential (primary) thrombocythemia (ET)
1. Match the descriptions with the platelet disorders.
a. Antibody-coated platelets removed from circulation by mononuclear phagocytes in the spleen
Immune thrombocytopenic purpura (ITP)
1. True or False Between 4 years of age and the onset of puberty, dietary iron deficiency is common.
False
1. True or False HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal erythrocytes.
True
1. True or False Rh incompatibility rarely causes hemolytic disease of the newborn in the first incompatible fetus.
True
1. True or False Sickled erythrocytes (characteristic of sickle cell anemia) are stiff and cannot change shape as easily as normal erythrocytes and thus tend to plug the microcirculation.
True
1. True or False Sickle cell crisis can be prevented by avoiding fever, infection, acidosis, dehydration, constricting clothing, and exposure to cold.
True
1. True or False In beta-thalassemia major, most erythroblasts are destroyed in the spleen.
False
1. True or False Hyperdiploidy (increased number of chromosome copies) is associated with a poor prognosis in leukemia.
False
1. Polycythemia occurs in a fetus because:
a. fetal hemoglobin has a greater affinity for oxygen due to DPG.
b. there is increased erythropoiesis in response to the hypoxic intrauterine environment.
c. the lungs of the fetus are undeveloped and unable to adequately diffuse oxygen to the pulmonary capillaries.
the lungs of the fetus are undeveloped and unable to adequately diffuse oxygen to the pulmonary capillaries.
1. In a full-term infant, the normal erythrocyte life span is _____ days, whereas the adult is _____ days.
a. 30 to 50; 80
b. 60 to 80; 120
c. 90 to 110; 140
d. 120 to 130; 150
60 to 80; 120
1. The most common cause of anemia from insufficient erythropoiesis in children is:
a. folic acid deficiency.
b. iron deficiency.
c. hemoglobin abnormality.
d. erythrocyte abnormality.
iron deficiency
1. An infant hemoglobin must fall below ___ g/dl before signs of pallor, tachycardia, and systolic murmurs occur.
a. 11
b. 9
c. 7
d. 5
5
1. Which vitamin improves the absorption of oral iron taken to treat iron deficiency anemia in children?
a. Vitamin A
b. Vitamin B
c. Vitamin C
d. Vitamin E
Vit C
1. Hemolytic disease of the newborn can occur if the mother is:
a. Rh-positive and the fetus is Rh-negative.
b. Rh-negative and the fetus is Rh-positive.
c. type A blood and the fetus has type O.
d. type AB blood and the fetus has type B.
Rh-negative and the fetus is Rh-positive.
1. During HDN, the newborn develops hyperbilirubinemia after birth, but not in utero because:
a. excretion of unconjugated bilirubin through the placenta into the mother’s circulation is no longer possible.
b. hemoglobin does not break down into bilirubin in the intrauterine environment.
c. the liver of the fetus is too immature to conjugate bilirubin from a lipid-soluble to water-soluble form.
d. the destruction of erythrocytes producing bilirubin is greater after birth.
excretion of unconjugated bilirubin through the placenta into the mother’s circulation is no longer possible.
1. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?
a. Kernicterus
b. Icterus neonatorum
c. Jaundice
d. Icterus gravis neonatorum
Kernicterus
1. What prevents kernicterus caused by hemolytic disease of the newborn?
a. Administration of intravenous fluids to dilute the blood and remove the bilirubin through the kidneys faster
b. Replacement transfusion of Rh-positive erythrocytes to prevent the deposit of bilirubin in the kidneys
c. Performance of a splenectomy to prevent the destruction of abnormal erythrocytes
d. Replacement transfusion of Rh-negative erythrocytes to prevent the deposit of bilirubin in the brain
Replacement transfusion of Rh-negative erythrocytes to prevent the deposit of bilirubin in the brain
1. The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait:
a. inherited normal hemoglobin A from one parent and Hb S from the other parent, whereas the child with sickle cell disease has Hb S from both parents.
b. has a mild form of sickle cell disease that causes sickling during fever and infection, but not during acidosis or hypoxia, whereas the child with sickle cells disease develops sickling during each of these conditions.
c. has a milder form of the disease that is characterized by vaso-occlusive crises and is believed to result from higher hemoglobin values and viscosity.
d. has the mildest form of the disease with normal hemoglobin and hemoglobin F, which prevents sickling.
inherited normal hemoglobin A from one parent and Hb S from the other parent, whereas the child with sickle cell disease has Hb S from both parents.
1. The manifestations of chronic sickle cell disease in children include:
a. atelectasis and pneumonia.
b. edema of the hands and feet.
c. stasis ulcers of the hands, ankles, and feet.
d. splenomegaly and hepatomegaly.
stasis ulcers of the hands, ankles, and feet.
1. The type of anemia that occurs as a result of thalassemia is:
a. microcytic, hypochromic.
b. microcytic, normochromic.
c. macrocytic, hyperchromic.
d. macrocytic, normochromic.
microcytic, hypochromic.
1. True or False Hemophilia B is caused by a clotting factor deficiency.
True
1. Idiopathic thrombocytopenic purpura (ITP) is an autoimmune process involving antibodies against:
a. neutrophils.
b. eosinophils.
c. platelets.
d. basophils.
Platelets
1. Which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura, bleeding, and fever?
a. ITP
b. Acute lymphocytic leukemia (ALL)
c. Non-Hodgkin lymphoma (NHL)
d. Iron deficiency anemia (IDA)
Acute lymphocytic leukemia (ALL)
1. Match the sickle cell crises with its description.
a. Vaso-occlusive crisis
Blood flow is impaired by tangled masses of rigid, sickled cells.
1. Match the sickle cell crises with its description.
a. Aplastic crisis
Compensatory erythropoiesis is compromised, thus limiting the number of erythrocytes that are replaced.
1. Match the sickle cell crises with its description.
a. Sequestration crisis
Large amounts of blood become acutely pooled in the liver and spleen.
1. Match the sickle cell crises with its description.
a. Hyperhemolytic crisis
Occurs in association with certain drugs or infection
1. True or False Blood contained within the atria and the ventricles is a recognized source of oxygen for the cells of the heart.
False
1. True or False Ventricular hypertrophy results in the capillaries of the heart becoming more extensive as well as numerous.
False
1. True or False To produce an action potential, the sinoatrial node must be stimulated by the autonomic nervous system.
False
1. True or False The arteries in the peripheral vasculature system are less able to stretch and recoil than the arteries of the great vessels.
True
1. True or False Veins are less compliant than arteries.
False
1. True or False Autoregulation ensures constant coronary blood flow despite normal shifts in perfusion pressure.
True
1. True or False Metabolic and hormonal agents produce changes in the heart and circulatory system faster than autonomic neural transmission.
False
1. True or False The aortic valve obstructs coronary blood flow by pushing against the openings of the coronary arteries during systole.
True
1. True or False Although both produce vasoconstriction, the effects of norepinephrine are quantitatively more vasoconstrictive than the effects of epinephrine.
True
1. Which of the following statements does not accurately describe the pericardium?
a. It is a double-walled membranous sac that encloses the heart
b. It is composed of connective tissue and a surface 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.
It is composed of connective tissue and a surface layer of squamous cells.
1. Which cardiac chamber has the thinnest wall and why?
a. The right and left atria because they are low-pressure chambers that serve as storage units and conduits for blood
b. The right and left atria because they are not involved directly in the preload, contractility, or afterload of the heart.
c. The left ventricle because the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure
d. the right ventricle because it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation
The right and left atria because they are low-pressure chambers that serve as storage units and conduits for blood
1. Which chamber of the heart endures the highest pressures?
a. Right atrium
b. Left atrium
c. Left ventricle
d. Right ventricle
Left Ventricle
1. The mitral and tricuspid valves close after the ventricles are filled with blood because the:
a. chordae tendineae relax, which allows the valves to close.
b. increased pressure in the ventricles pushes the valves to close.
c. trabeculae carneae contract, which pulls the valves closed.
d. reduced pressure in the atria creates a negative pressure that pulls the valves closed.
increased pressure in the ventricles pushes the valves to close.
2. During the cardiac cycle, the aortic and pulmonic valves close after the ventricles contract because the:
a. papillary muscles relax, which allows the valves to close.
b. chordae tendineae contract, which pulls the valves closed.
c. reduced pressure in the ventricles creates a negative pressure, which pulls the valves closed.
d. blood fills the cusps of the valves and causes the edges to merge, closing the valves.
blood fills the cusps of the valves and causes the edges to merge, closing the valves.
1. Oxygenated blood flows through the:
a. superior vena cava.
b. pulmonary veins.
c. pulmonary artery.
d. coronary veins.
pulmonary veins.
1. Occlusion of the left anterior descending artery during a myocardial infarction would interrupt blood supply to the:
a. left and right ventricles and much of the interventricular septum.
b. left atrium and the lateral wall of the left ventricle.
c. upper right ventricle, right marginal branch, and right ventricle to the apex.
d. posterior interventricular sulcus and smaller branches of both ventricles.
left and right ventricles and much of the interventricular septum.
1. Occlusion of the circumflex artery during a myocardial infarction would interrupt blood supply to the:
a. left and right ventricles and much of the interventricular septum.
b. posterior interventricular sulcus and smaller branches of both ventricles.
c. upper right ventricle, right marginal branch, and right ventricle to the apex.
d. left atrium and the lateral wall of the left ventricle.
left atrium and the lateral wall of the left ventricle.
1. The function of P cells found in the sinoatrial node and Purkinje fibers is that they:
a. are receptors for pain stimuli, such as the pain that occurs during infarction.
b. prolong the refractory period before the next contraction.
c. are assumed to be the site of impulse formation.
d. initiate repolarization of the myocardium.
are assumed to be the site of impulse formation.
1. 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. decrease in the movement of sodium out of the cell.
d. rapid movement of calcium out of the cell.
rapid movement of sodium into the cell.
1. Which of the following events 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
Early repolarization when calcium slowly enters cells
1. 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 (Potassium is moved out of the cell)
e. Phase 4 (a return to resting membrane potential)
Phase 4 (a return to resting membrane potential)
1. In the normal electrocardiogram, the PR interval represents:
a. atrial depolarization.
b. ventricular depolarization.
c. atrial activation to onset of ventricular activity.
d. electrical systole of the ventricles.
atrial activation to onset of ventricular activity.
1. The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because:
a. of its superior location in the right atrium.
b. it is the only area of the heart capable of spontaneous depolarization.
c. it has rich sympathetic innervation via the vagus nerve.
d. it depolarizes more rapidly than other automatic cells of the heart.
it depolarizes more rapidly than other automatic cells of the heart.
1. The _____ period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated.
a. Refractory
b. Hyperpolarization
c. Threshold
d. SA
refractory
1. The _____ complex (wave) represents the sum of all ventricular muscle cell depolarizations.
a. PRS
b. QRS
c. QT interval
d. P
QRS
1. Which of the following can shorten the conduction time of action potential through the atrioventricular (AV) node?
a. Parasympathetic nervous system
b. Catecholamines
c. Vagal stimulation
d. Sinoatrial node (SA)
Catecholamines
1. 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
40-60 per minute
1. What, if any, is the effect of epinephrine on beta2-receptors of the heart?
a. There is no effect
b. Dilate coronary arterioles
c. Increase the strength of myocardial contraction
d. Decrease the heart rate
dilate coronary arterioles
1. 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
myocardium and coronary vessels
1. 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. decrease in repolarization.
increased force of contraction
1. As stated by the Frank-Starling law, there is a direct relationship between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.
a. pressure; force
b. volume; strength
c. viscosity; force
d. viscosity; strength
volume; strength
1. Pressure in the left ventricle must exceed pressure in the _____ before the left ventricle can eject blood.
a. superior vena cava
b. aorta
c. inferior vena cava
d. pulmonary veins
aorta
1. Continuous increases in left ventricular filing pressures result in which disorder?
a. Pulmonic valve regurgitation
b. Mitral stenosis
c. Pulmonary edema
d. Jugular vein distention
Pulmonary edema
1. The resting heart in a healthy person is primarily under the control of the _____ nervous system.
a. Sympathetic
b. Parasympathetic
c. Somatic
d. spinal
parasympathetic (vagal stimulation)
1. The correct sequence of events that occur after the baroreceptor reflex is stimulated is that the impulse is transmitted from the carotid artery to the:
a. vagus nerve to the medulla to increase parasympathetic activity and decrease sympathetic activity.
b. glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase sympathetic activity and decrease parasympathetic activity.
c. glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase parasympathetic activity and decrease sympathetic activity.
d. ossopharyngeal cranial nerve through the vagus nerve to the hypothalamus to increase parasympathetic activity and decrease sympathetic activity.
glossopharyngeal cranial nerve through the vagus nerve to the medulla to increase parasympathetic activity and decrease sympathetic activity.
1. Reflex control of total cardiac output and total peripheral resistance is controlled by:
a. parasympathetic stimulation of the heart, arterioles, and veins.
b. sympathetic stimulation of the heart, arterioles, and veins.
c. autonomic control of the heart only.
d. somatic control of the heart, arterioles, and veins.
sympathetic stimulation of the heart, arterioles, and veins.
1. 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
autoregulation
1. The right lymphatic duct drains into the:
a. right subclavian artery.
b. right atrium.
c. right subclavian vein.
d. superior vena cava.
right subclavian vein
1. Where is the major cardiovascular center in the central nervous system?
a. Frontal lobe
b. Thalamus
c. Brainstem
d. Hypothalamus
Brainstem
1. 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
Arterial Stiffening
1. The major determinant of the resistance that blood encounters as it flows through the systemic circulation is the:
a. volume of blood in systemic circulation.
b. muscle layer of the metarterioles.
c. muscle layer of arterioles.
d. force of ventricular contraction.
Muscle Layer of Arterioles
1. True or False Atrial natriuretic peptide inhibits antidiuretic hormone by increasing urine sodium loss.
True
1. 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)
BNP
1. Match the intracardiac pressures with their description.
a. a wave
Generated by the atrial contraction
1. Match the intracardiac pressures with their description.
a. v wave
An early diastole peak caused by filling of the atrium from peripheral veins
1. Match the intracardiac pressures with their description.
a. c wave
May represent bulging of the mitral valve into the left atrium during early systole
1. Match the intracardiac pressures with their description.
a. x descent
Produced because of descent of the tricuspid valve ring and by ejection of blood from both ventricles
1. Match the intracardiac pressures with their description.
a. y descent
Reflects rapid flow of blood from the great veins and right atrium into the right ventricle
1. Match the description with the corresponding terms.
a. Relationship among blood flow, pressure, and resistance
Poiseuille’s formula
1. Match the description with the corresponding terms.
a. Increased heart rate from increased volume
Bainbridge reflex
1. Match the description with the corresponding terms.
a. Relationship of wall tension intraventricular pressure, internal radius, and wall thickness
Laplace’s law
1. Match the description with the corresponding terms.
a. Cycles of attachment, movement, and dissociation of thin filaments during the attachments of actin to myosin
Cross-bridge theory
1. Match the description with the corresponding terms.
a. Length-tension relationship of cardiac muscle
Frank-Starling law
1. True or False Atherosclerosis is an inflammatory disease.
True
1. True or False Decreasing low-density lipoproteins (LDLs) can cause regression of atherosclerotic lesions and improve endothelial function.
True
1. True or False Even though air is lighter than blood, it can form an embolism and cause the occlusion of a blood vessel.
True
1. True or False Many people with type 2 diabetes mellitus, who were treated with drugs that increased insulin sensitivity, experienced a decline in their blood pressure without taking antihypertensive drugs.
True
1. True or False Most body cells are also capable of synthesizing cholesterol.
True
1. True or False Angina pectoris is chest pain caused by myocardial ischemia.
True
1. True or False When fluid collects gradually in a pericardial effusion, the pericardium stretches to accommodate the fluid without compressing the heart.
True
1. True or False Acute rheumatic fever can develop only as a sequel to pharyngeal infection by group A beta-streptococcus.
True
1. True or False An increase in left ventricular end-diastolic volume (LVEDV) in diastolic heart failure may lead to pulmonary edema.
True
1. True or False Many cases of mitral valve prolapse are completely asymptomatic.
True
1. The pathophysiology of atherosclerosic injury includes all of the following EXCEPT
a. injured endothelial cells can not produce normal amounts of antithrombotic cytokines and vasodilating cytokines
b. numerous inflammatory cytokines are released
c. macrophages adhere to injured endothelium
d. macrophages release enzymes and toxic oxygen radicals that create oxidative stress
e. Fatty streaks lead to foam cell formation
Fatty streaks lead to foam cell formation
1. Atherosclerosis causes an aneurysm by:
a. causing ischemia of the intima.
b. increasing nitric oxide.
c. eroding the vessel wall.
d. obstructing the vessel.
eroding the vessel wall.
1. What is the usual source of pulmonary emboli?
a. Deep venous thrombosis
b. Endocarditis
c. Valvular disease
d. Left heart failure
DVT
1. Which statement best describes thromboangiitis obliterans (Buerger disease)?
a. An inflammatory disorder of small and medium-size 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
An inflammatory disorder of small and medium-size arteries in the feet and sometimes in the hands
1. Which of the following statements best describes Raynaud disease?
a. An inflammatory disorder of small and medium-size 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
A vasospastic disorder of the small arteries and arterioles of the fingers, and less commonly, the toes
1. What changes in veins occur to create varicose veins?
a. An increase in osmotic pressure
b. Damage to the valves within veins
c. Damage to the venous endothelium
d. An increase in hydrostatic pressure
Damage tot he valaves within veins
1. 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
Occlussion
1. A local state in which cells are temporarily deprived of blood supply is defined as:
a. infarction.
b. ischemia.
c. necrosis.
d. inflammation.
Ischemia
1. The risk of developing coronary artery disease is increased up to threefold by:
a. diabetes mellitus.
b. hypertension.
c. obesity.
d. high alcohol consumption.
HTN
1. Which of the following risk factors is NOT associated with coronary artery disease (CAD)?
a. Diabetes mellitus
b. Hypertension
c. Obesity
d. High HDL
High HDL
1. Nicotine increases atherosclerosis by the release of:
a. histamine.
b. nitric oxide.
c. angiotensin II.
d. epinephrine.
Epinephrine
1. Which elevated value may be protective of the development of atherosclerosis?
a. Very-low-density lipoproteins (VLDLs)
b. Low-density lipoproteins (LDLs)
c. High-density lipoproteins (HDLs)
d. Triglycerides (TGs)
HDLs
1. Which lab test is an indirect measure of atherosclerotic plaque?
a. Homocysteine
b. Low-density lipoprotein (LDL)
c. Erythrocyte sedimentation rate (ESR)
d. C-reactive protein (CRP)
CRP
1. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?
a. 10
b. 15
c. 20
d. 25
20
1. The scar tissue that is formed after a myocardial infarction (MI) is most vulnerable to injury between days:
a. 5 to 9.
b. 10 to 14.
c. 15 to 20.
d. 20 to 30.
10 to 14
1. An individual who is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH) is exhibiting indicators associated with:
a. myocardial ischemia.
b. hypertension.
c. myocardial infarction (MI).
d. coronary artery disease.
MI
1. What is the expected electrocardiogram pattern for a person 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 QT interval
b. ST elevation (STEMI)
c. ST depression (STDMI)
d. Non-ST elevation (non-STEMI)
STEMI
1. Angiotensin II increases the workload of the heart after a myocardial infarction by:
a. increasing the peripheral vascular resistance.
b. causing dysrhythmias as a result of hyperkalemia.
c. reducing the contractility of the myocardium.
d. stimulating the sympathetic nervous system.
increasing the peripheral vascular resistance
1. The pulsus paradoxus that occurs as a result of pericardial effusion is significant because it reflects the impairment of the:
a. diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles.
b. blood ejected from the right atria and reduction of blood volume in the right ventricle.
c. blood ejected from the left atria and reduction of blood volume in the left ventricle.
d. diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers.
diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers
1. A patient complains of sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when lying down. These clinical manifestations describe:
a. myocardial infarction.
b. pericardial effusion.
c. restrictive pericarditis.
d. acute pericarditis.
Acute pericarditis
1. Which of the following is a clinical manifestation of aortic stenosis?
a. Jugular vein distention
b. Bounding pulses
c. Peripheral edema
d. Angina
Angina
1. Aortic and mitral regurgitation as well as mitral stenosis are caused by:
a. congenital malformation.
b. cardiac failure.
c. rheumatic fever.
d. coronary artery disease.
Rheumatic Fever
1. Which predominantly female valvular disorder is thought to have an autosomal dominant inheritance pattern, as well as being associated with connective tissue disease?
a. Mitral valve prolapse
b. Tricuspid stenosis
c. Tricuspid valve prolapse
d. Aortic insufficiency
Mitral Valve Prolapse
1. 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
Rhematic Fever
1. Infective endocarditis is most often caused by:
a. a virus.
b. a fungus.
c. a bacterium.
d. rickettsiae.
a bacterium
1. Genitourinary instrumentation, male gender, and intravenous drug use are risk factors for which of the following?
a. Rheumatic fever
b. Infective endocarditis
c. Mitral regurgitation
d. Aortic regurgitation
Infective endocarditis
1. 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
Right Heart Failue
1. Ventricular remodeling is a result of:
a. left ventricular hypertrophy.
b. right ventricular failure.
c. myocardial ischemia.
d. contractile dysfunction.
Myocardil ischemia
1. 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
Increases preload and increases afterload
2. Match the descriptions with the corresponding terms.
a. Restrictive cardiomyopathy
Usually caused by infiltrative disease, such as amyloidosis
2. Match the descriptions with the corresponding terms.
a. Hypertrophic cardiomyopathy
Results in muscular subaortic stenosis
2. Match the descriptions with the corresponding terms.
a. Dilated cardiomyopathy
Usually caused by ischemic or valvular heart disease
1. Match the descriptions with the corresponding terms.
a. Impairs flow from left atrium to left ventricle
Mitral stenosis
1. Match the descriptions with the corresponding terms.
a. Impairs flow from the left ventricle
Aortic stenosis
1. Match the descriptions with the corresponding terms.
a. Backflow into left atrium
Mitral regurgitation
1. Match the descriptions with the corresponding terms.
a. Backflow into right atrium
Tricuspid regurgitation
1. Match the descriptions with the corresponding terms.
a. Backflow into left ventricle
Aortic regurgitation
1. True or False Cardiogenesis begins at approximately 3 weeks’ gestation, whereas most cardiovascular development occurs between the fourth and seventh.
True
1. True or False Closure of the patent ductus arteriosus (PDA) in a full-term infant normally occurs immediately after birth.
False
1. True or False The purpose of the foramen ovale is to allow a right-to-left shunt necessary for fetal circulation.
True
1. True or False Lesions that increase the pulmonary blood flow are called right-to-left shunts.
False
1. True or False Complete transposition of the great vessels is a congenital heart defect in which the left ventricle pumps blood to the pulmonary circulation.
True
1. True or False Common clinical manifestations of right ventricular failure in infants include unexplained weight gain and periorbital edema
False
1. True or False In general, the pathophysiologic mechanisms of congestive heart failure (CHF) are very different in infants and children than in adults.
False
1. True or False Kawasaki disease is a self-limiting systemic vasculitis.
True
1. True or False Iron deficiency anemia may result from polycythemia that develops from chronic hypoxia.
True
1. True or False Diagnosis of primary hypertension in children is difficult because the early stages are often asymptomatic.
True
1. True or False Acquired heart disease is the most common cardiovascular disease in children.
False
1. True or False Conditions in which a patent foramen ovale may continue past the first month of life include pulmonary hypertension, right ventricular (RV) failure, and tricuspid atresia.
True
1. The function of a patent opening between the left and right atria in a fetus is that it allows:
a. right-to-left blood shunting
b. left-to-right blood shunting
c. blood to flow from the umbilical cord
d. blood to flow to the lungs
right-to-left blood shunting
1. Congenital heart defects that cause acyanotic congestive heart failure usually involve:
a. right-to-left shunts
b. left-to-right shunts
c. obstructive lesions
d. mixed lesions
left-to-right shunts
1. Congenital heart effects that cause hypoxemia, and therefore cyanosis, usually involve;
a. Right-to-left shunts
b. Left-to-right shunts
c. Obstructive lesions
d. Mixed lesions
Right-to-left shunts
1. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?
a. Coarctation of the aorta and pulmonary stenosis
b. Tetralogy of Fallot and persistent truncus arteriosus
c. Atrial septal defect and dextrocardia
d. Ventricular septal defect and patent ductus arteriosus
Ventricular septal defect and patent ductus arteriosus
1. What is the most important clinical manifestation of aortic coarctation in the neonate?
a. Congestive heart failure (CHF)
b. Cor pulmonale
c. Pulmonary hypertension
d. Cerebral hypertension
CHF
1. Children with tetralogy of Fallot compensate to relieve hypoxic spells by:
a. Lying on their left side
b. Performing the Valsalva maneuver
c. Squatting
d. Hyperventilating
Squatting
1. The infant diagnosed with small patent ductus arteriosus (PDA) is likely to present:
a. An intermittent murmur
b. Asymptomatically
c. A need for surgical repair
d. With a triad of congenital defects
Asymptomattically
1. Which of the following is consistent with the cardiac defect of transposition of the great vessels?
a. The aorta arises from the right ventricle
b. The pulmonary trunk arises from the right ventricle
c. The right ventricle pumps blood to the lungs
d. All of the above
The aorta arises from the right ventricle
1. Which of the following describes total anomalous pulmonary venous return?
a. The foramen ovale closes after birth
b. Pulmonary venous return is to the right atrium
c. Pulmonary venous return is to the left atrium
d. The left atrium receives oxygenated blood
Pulmonary venous return is to the right atrium
1. True or False The oropharynx is considered part of a conduction airway
True
1. True or False The bronchial circulation is part of the systemic circulation and does not participate in gas exchange.
True
1. True or False The PaO2 must drop below 80 mmHg before the peripheral chemoreceptors have much influence on ventilation.
False
1. True or False The lungs contain only superficial lymphatic capillaries.
False
1. True or False The movement of gas and air into and out of the lungs is called: ventliation
True
1. The nurse practitioner who is auscultating the lungs of a child who has aspirated a piece of hot dog, would expect decreased or absent breath sound over the:
a. left lung.
b. right lung.
c. trachea.
d. carina.
Right Lung
1. Aspiration is most likely to occur in the:
a. right mainstem bronchus because it extends vertically from the trachea.
b. left mainstem bronchus because it is more narrow.
c. trachea because it comes into contact with the food and drink first.
d. carina because of its location at the site where the bronchi bifurcates.
right mainstem bronchus because it extends vertically from the trachea.
1. Where in the lung does gas exchange occur?
a. Trachea
b. Segmental bronchi
c. Alveolocapillary membrane
d. Main bronchus
Alveolocapillary membrane
1. Surfactant produced by type II pneumocytes facilitates alveolar distention and ventilation by:
a. decreasing thoracic compliance.
b. attracting water to the alveolar surface.
c. decreasing surface tension in alveoli.
d. increasing surface tension in alveoli.
decreasing surface tension in alveoli.
1. True or False The basic automatic rhythm of respiration is set by the dorsal respiratory group DRG, a cluster of inspiratory nerve cells located in the medulla that sends efferent impulses to the diaphragm and inspiratory intercostal muscles.
True
1. Pressure in the pleural space is:
a. atmospheric.
b. below atmospheric.
c. above atmospheric.
d. variable.
Below atmospheric pressure
1. The adequacy of a person’s alveolar ventilation is assessed best by monitoring:
a. ventilatory rate.
b. ventilatory pattern.
c. respiratory effort.
d. arterial blood gas.
arterial blood gas
1. Normal physiologic changes in the aging pulmonary system include:
a. decreased flow resistance.
b. fewer alveoli.
c. stiffening of the chest wall.
d. improved elastic recoil.
stiffening of the chest wall
1. How is most of the oxygen in the blood transported?
a. Dissolved in plasma
b. Bound to hemoglobin
c. In the form of carbon dioxide (CO2)
d. Bound to protein
bound to hemoglobin
1. Stretch receptors as well as peripheral chemoreceptors send afferent impulses regarding ventilation to the:
a. pneumotaxic center in the pons.
b. apneustic center in the pons.
c. dorsal respiratory group in the medulla oblongata.
d. ventral respiratory group in the medulla oblongata.
dorsal respiratory group in the medulla oblongata.
1. Which endogenous substances cause bronchoconstriction?
a. Epinephrine and acetylcholine
b. Histamine and prostaglandin
c. Bradykinin and thromboxane A
d. Leukotrienes and prostacyclin
Histamine and prostaglandin
1. If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to:
a. shift to the right, causing more O2 to be released to the cells.
b. shift to the left, allowing less O2 to be released to the cells.
c. show no change, allowing the O2 concentration to remain stable.
d. show dramatic fluctuation, allowing the O2concentration to increase.
shift to the right, causing more O2 to be released to the cells.
1. Most carbon dioxide in the blood is transported:
a. attached to oxygen.
b. in the form of bicarbonate.
c. combined with albumin.
d. dissolved in the plasma.
in the form of bicarbonate.
1. Changes in the alveoli that cause an increase in alveolar surface tension, alveolar collapse, and decreased lung expansion are a result of:
a. decreased alveolar macrophage production.
b. increased compliance.
c. decreased surfactant production.
d. increased stimulation by peripheral chemoreceptors.
decreased surfactant production.
1. Decreased lung compliance means that the lungs are
a. difficult to deflate.
b. easily inflated.
c. stiff.
d. unable to diffuse oxygen.
stiff
1. The lung is innervated by the parasympathetic nervous system via the _____ nerve.
a. Vagus
b. Phrenic
c. Brachial
d. Pectoral
vagus
1. Hypoventilation that results in the retention carbon dioxide will stimulate which of the following receptors in an attempt to maintain a normal homeostatic state?
a. Irritant receptors
b. Central chemoreceptors
c. Peripheral chemoreceptors
d. Stretch receptors
Central chemoreceptors
1. Which of the following is the most important cause of pulmonary artery constriction?
a. Low alveolar PO2
b. Hyperventilation
c. Respiratory alkalosis
d. Epinephrine
Low alveolar PO2
1. Match the receptor with its action and then with its location.
a. Irritant receptors
Initiates cough reflex
1. Match the receptor with its action and then with its location.
a. Stretch receptors
Hering-Breuer expiratory reflex
1. Match the receptor with its action and then with its location.
a. J-receptors
Initiates rapid, shallow breathing
1. Match the receptor with its action and then with its location.
a. Peripheral chemoreceptors
Monitors pH, PaCO2 and PaO2 in blood
1. Match the receptor with its action and then with its location.
a. Central chemoreceptors
Senses pH of cerebrospinal fluid
1. True or False An abnormal ventilation-perfusion ratio is a common cause of hypoxemia.
True
1. True or False Hypoxia is the reduced oxygenation of tissue cells, whereas hypoxemia is the reduced oxygenation of arterial blood (reduced PaO2)
True
1. True or False Tuberculosis (TB) is transmitted from person to person through airborne droplets.
True
1. True or False Chronic pulmonary hypertension can lead to cor pulmonale.
True
1. True or False The greatest single risk factor for reactivation of tuberculosis is infection with HIV.
True
1. Dyspnea is NOT a result of:
a. decreased pH, increased PaCO2 and decreased PaO2
b. decreased blood flow to the medulla oblongata.
c. stimulation of stretch or J-receptors.
d. fatigue of the intercostal muscles and diaphragm.
decreased blood flow to the medulla oblongata.
1. Paroxysmal nocturnal dyspnea (PND) is a result of:
a. obstructed bronchi.
b. collapsed alveoli.
c. fluid in the lungs.
d. inflamed bronchioles.
fluid in the lungs
1. _____ is generally relieved by sitting up in a forward-leaning position.
a. Hyperpnea
b. Orthopnea
c. Apnea
d. Dyspnea on exertion
orthopnea
1. Kussmaul respirations may be characterized as a respiratory pattern:
a. with alternating periods of deep and shallow breathing.
b. commonly observed in pulmonary fibrosis.
c. commonly observed in chronic obstructive pulmonary disease.
d. with a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause.
with a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause.
1. Respirations that are characterized by alternating periods of deep and shallow breathing are a result of:
a. decreased blood flow to the medulla oblongata.
b. increased PaCO2 decreased pH, and decreased PaO2
c. stimulation of stretch or J-receptors.
d. fatigue of the intercostal muscles and diaphragm.
decreased blood flow to the medulla oblongata
1. Which of the following is a true statement?
a. Hypoventilation causes hypocapnia.
b. Hyperventilation causes hypercapnia.
c. Hyperventilation causes hypocapnia.
d. Hyperventilation results in an increased PaCO2.
Hyperventilation causes hypocapnia.
12. ____________ is the selective bulbous enlargement of the distal segment of a digit and is commonly associated with diseases that interfere with oxygenation of the blood.
a. Edema
b. Clubbing
c. Angling
d. Osteoarthropathy
clubbing
12. Pulmonary edema and pulmonary fibrosis cause hypoxemia by:
a. creating alveolar dead space.
b. decreasing the oxygen in inspired gas.
c. creating a right-to-left shunt.
d. impairing alveolocapillary membrane diffusion.
impairing alveolocapillary membrane
12. High altitudes may produce hypoxemia through:
a. shunting
b. hypoventilation.
c. decreased inspired oxygen.
d. diffusion abnormalities.
decreased inspired oxygen.
12. Alveolar dead space is a result of:
a. pulmonary edema.
b. pulmonary emboli.
c. atelectasis.
d. pneumonia.
pulmonary emboli.
12. The most common cause of pulmonary edema is:
a. right-sided heart failure.
b. left-sided heart failure.
c. mitral valve prolapsed.
d. aortic stenosis.
left-sided heart failure.
12. Which pleural abnormality involves a site of pleural rupture that act as a one-way valve, permitting air to enter on inspiration but preventing its escape by closing during expiration?
a. Spontaneous pneumothorax
b. Tension pneumothorax
c. Open pneumothroax
d. Secondary pneumothorax
Tension pneumothorax
12. In ________ pleural effusion, the fluid is watery and diffuses out of the capillaries as a result of increased blood pressure or decreased capillary oncotic pressure.
a. exudative
b. purulent
c. transudative
d. large
transudative
12. _________ involves an abnormally enlarged gas-exchanged system and the destruction of alveolar walls.
a. Transudative effusion
b. Emphysema
c. Exudative effusion
d. Abscess
emphysema
12. A(n) _________ is a circumscribed area of suppuration and destruction of lung parenchyma.
a. consolidation
b. cavitation
c. empyema
d. abscess
abcess
12. Which of the following is not a cause of chest wall restriction?
a. Pneumothorax
b. Severe kyphoscoliosis
c. Gross obesity
d. Neuromuscular disease
pneumothorax
12. Which statement about silicosis and asbestosis is false? Neither silicosis nor asbestosis is:
a. caused by inhalation of inorganic dust particles.
b. a type of pneumoconiosis.
c. a cause of lung cancer.
d. a cause of cellular apoptosis.
a cause of lung cancer
12. _________ is a fulminant form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.
a. Acute respiratory distress syndrome (ARDS)
b. Pneumonia
c. Pulmonary emboli
d. Acute pulmonary edema
ARDS
12. Which type of pulmonary disease requires more force to expire a volume of air?
a. Restrictive
b. Obstructive
c. Acute
d. Communicable
Obstructive
12. Which immunoglobulin may contribute to the pathophysiology of asthma?
a. IgA
b. IgE
c. IgG
d. IgM
IgE
12. Which inflammatory mediators are produced in asthma?
a. Neutrophil proteases, bradykinin, and histamine
b. Bradykinin, serotonin, and neutrophil proteases
c. Histamine, prostaglandins, and leukotrienes
d. Lymphokines, serotonin, and prostaglandins
Histamine, prostaglandins, and leukotrienes
12. The effect of inflammatory cytokines, tumor necrosis factor-alpha (TNF-a), and IL-1 on asthma is that they increase the levels of:
a. norepinephrine, which causes bronchial smooth muscle contraction and mucus secretion.
b. acetylcholine, which causes bronchial smooth muscle contraction and mucus secretion.
c. epinephrine, which causes bronchial smooth muscle contraction and increases capillary permeability.
d. immunoglobulin G, which initiates the complement cascade and causes smooth muscle contraction and increased capillary permeability.
acetylcholine, which causes bronchial smooth muscle contraction and mucus secretion.
12. Clinical manifestations of inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea are indicative of:
a. chronic bronchitis.
b. emphysema.
c. pneumonia.
d. asthma.
asthma
12. The most successful treatment for chronic asthma begins with:
a. elimination of the causative agent.
b. broad-spectrum antibiotics.
c. drugs that reduce bronchospasm.
d. drugs that decrease airway inflammation.
elimination of the causative agent.
12. Which bacteria become embedded in the airway secretions in chronic bronchitis?
a. Legionella pneumophila and Chlamydia pneumonia
b. Klebsiella pneumonia and Pneumocystis jiroveci
c. Haemophilus influenza and Streptococcus pneumonia
d. Mycoplasma pneumonia and Staphylococcus aureus
Haemophilus influenza and Streptococcus pneumonia
12. Clinical manifestations of decreased exercise tolerance, wheezing, shortness of breath, and productive cough are indicative of:
a. chronic bronchitis.
b. emphysema.
c. pneumonia.
d. asthma.
chronic bronchitis
12. Clinical manifestations that include unexplained weight loss, dyspnea on exertion, use of accessory muscles, and tachypnea with prolonged expiration are indicative of:
a. chronic bronchitis.
b. emphysema.
c. pneumonia.
d. asthama.
emphysema
12. The most common route of lower respiratory tract infection is:
a. aspiration of oropharyngeal secretions.
b. inhalation of microorganisms.
c. microorganisms spread to lung via blood.
d. poor mucus membrane protection.
aspiration of oropharyngeal secretions.
12. The progression of chronic bronchitis is best halted by:
a. regular use of bronchodilators.
b. smoking cessation.
c. postural chest drainage techniques.
d. identification of early signs of infection.
smoking cessation
12. Clinical manifestation of inspiratory crackles, increased tactile fremitus, egophony, and whispered pectoriloquy are indicative of:
a. chronic bronchitis.
b. emphysema.
c. pneumonia.
d. asthma.
pneumonia
12. Clinical manifestations of pulmonary hypertension include:
a. systemic blood pressure greater than 130/90.
b. productive cough and rhonchi bilaterally.
c. dyspnea on exertion and paroxysmal nocturnal dyspnea.
d. peripheral edema and jugular venous distention.
peripheral edema and jugular venous distention.
12. Pulmonary hypertension result from which of the following alteration?
a. Narrowed pulmonary capillaries
b. Narrowed bronchi and bronchioles
c. Destruction of alveoli
d. Ischemia of the myocardium
Narrowed pulmonary capillaries
12. Squamous cell carcinoma of the lung is best described as a tumor that:
a. causes airway obstruction and ectopic hormone production.
b. produces a productive cough and airway obstruction in addition to pneumonia and atelectasis.
c. causes pleural effusion and shortness of breath.
d. produces chest wall pain, pleural effusion, productive cough, and hemoptysis.
produces a productive cough and airway obstruction in addition to pneumonia and atelectasis.
12. Match the descriptions with the corresponding terms.
a. The passage of fluid and solid particles into the lung
Aspiration
12. Match the descriptions with the corresponding terms.
a. Inflammatory obstruction of small airways
Bronchiolitis
12. Match the descriptions with the corresponding terms.
a. Excessive amount of connective tissue in the lung
Pulmonary fibrosis
12. Match the descriptions with the corresponding terms.
a. Lung tissue collapse
Atelectasis
12. Match the descriptions with the corresponding terms.
a. Abnormal dilation of the bronchi
Bronchiectasis
13. Match the descriptions with the corresponding terms.
a. Accumulation of air in pleural space
Pneumothorax
13. Match the descriptions with the corresponding terms.
a. Pus in the pleural space
Empyema
13. Match the descriptions with the corresponding terms.
a. Accumulation of fluid in the pleural space
Pleural effusion
13. Match the descriptions with the corresponding terms.
a. Inflammation of the pleura
Exudative effusion
13. Match the descriptions with the corresponding terms.
a. Result of rib or sterna fractures
Flail chest
1. True or False - About 75% of aspirated foreign objects in children lodge in a bronchus.
True
1. True or False – The most common predisposing factor to obstructive sleep apnea of childhood is adenotonsillar hypertrophy.
True
1. True or False – Paradoxical breathing is an ominous sign in premature infants.
False
1. True or False – All alveoli are present and functioning at birth.
False
2. True or False – Surfactant is produced by the fourth week of gestation.
False
1. True or False – Respiratory syncytial virus (RSV) infects nearly 100% of children in the United States by 2 or 3 years of age.
True
1. True or False – Signs of acute respiratory failure remain the same regardless of etiology.
True
1. True or False - Asthma is one of the leading chronic illnesses in children and has become more prevalent in the past two decades.
True
1. True or False – Children with chronic asthma have clubbing of fingers and toes.
False
1. Chest wall compliance in infants is _________ in adults.
a. lower than
b. higher than
c. the same as
d. unlike that
higher than
1. Why is nasal congestion a serious threat to young infants?
a. They are obligatory nose breathers
b. Their noses are small in diameter
c. They become dehydrated when mouth breathing
d. Their epiglottis is proportionally greater than an adults
They are obligatory nose breathers
1. Which of the following types of croup is most common?
a. Bacterial
b. Viral
c. Fungal
d. Autoimmune
viral
1. Rhinorrhea, sore throat, a low-grade fever and a seal-like barking cough are clinical manifestations indicative of:
a. epiglottitis.
b. retropharyngeal abscess.
c. bacterial tracheitis.
d. croup.
croup
1. What is the primary cause of RDS of the newborn?
a. An immature immune system
b. Small alveoli
c. A surfactant deficiency
d. Anemia
A surfactant deficiency
1. The primary problem in RDS of the newborn is:
a. consolidation.
b. pulmonary edema.
c. atelectasis.
d. bronchiolar plugging.
atelectasis.
1. Which of the following statements about the advances in the treatment of RDS of the newborn is incorrect?
a. Administering glucocorticoids to women in preterm labor accelerates the maturation of the fetus’s lungs.
b. Administering oxygen to mothers during preterm labor increases their arterial oxygen before birth of the fetus.
c. Treatment includes the instillation of exogenous surfactant down an endotracheal tube of infants weighing less than 1000g.
d. Supporting the infant’s respiratory function by using continuous positive airway pressure (CPAP).
Administering oxygen to mothers during preterm labor increases their arterial oxygen before birth of the fetus.
1. Bronchiolitis tends to occur during the first years of life and is most often caused by _______ infection.
a. respiratory syncytial virus
b. influenzavirus
c. adenoviruses
d. Epstein-Barr virus
RSV
1. What are the clinical manifestations of bacterial pneumonia in children?
a. Mild to high fever, cough, rhinorrhea, crackles, and wheezes
b. High fever, productive cough, and pleuritic chest pain
c. Decreased breath sounds in areas of consolidation and dyspnea
d. Increased respiratory rate and respiratory alkalosis
Mild to high fever, cough, rhinorrhea, crackles, and wheezes
1. An accurate description of childhood asthma is that it is a(n):
a. obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
b. pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
c. pulmonary disorder involving and abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens.
d. obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.
obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
1. Which arterial blood gas values would be expected in the acute phase of childhood asthma?
a. pH 7.6, PaCO2 35 mmHg, HCO3 32 mEq/L
b. pH 7.4, PaCO2 40 mmHg, HCO3 24 mEq/L
c. pH 7.5, PaCO2 30 mmHg, HCO3 26 mEq/L
d. pH 7.2, PaCO2 20 mmHg, HCO3 30 mEq/L
pH 7.5, PaCO2 30 mmHg, HCO3 26 mEq/L
1. Acute respiratory distress syndrome (ARDS) is described as a(n):
a. obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
b. pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
c. respiratory disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens.
d. pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.
pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
1. Cystic fibrosis is best described as a(n):
a. obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation.
b. pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray.
c. pulmonary disorder involving an abnormal expression of aprotein producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens.
d. pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.
pulmonary disorder involving an abnormal expression of aprotein producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens.
1. Cystic fibrosis (CF) is caused by a(n):
a. autosomal recessive inheritance.
b. autosomal dominant inheritance.
c. infection.
d. malignancy.
autosomal recessive inheritance.
1. Sudden infant death syndrome (SIDS) occurs most often between ______ and ______ months of age.
a. 1; 2
b. 3; 4
c. 5; 6
d. 6; 7
3; 4
1. Match the sound with the location of the problem.
a. Sonorous snoring
Nasal problems, foreign body, polyps, or choanal atresia
1. Match the sound with the location of the problem.
a. Muffled voice
Pharyngeal problems.
1. Match the sound with the location of the problem.
a. High –pitched inspiratory sound, voice change, hoarse
Laryngeal problems
1. Match the sound with the location of the problem.
a. Expiratory stridor or central wheeze
Tracheal problems
1. Match the sound with the location of the problem.
a. Expiratory wheezes
Bronchial problems