WGU D115 Unit 5 Questions and Answers with Certified Solutions

WGU D115 Unit 5 Questions and Answers with Certified Solutions Which two processes are involved in platelet activation? Cyclooxygenase-1 (COX-1) inactivation Aggregation Adhesion ✔✔Platelet activation involves three ...

WGU D115 Unit 5 Questions and Answers with Certified Solutions Which two processes are involved in platelet activation? Cyclooxygenase-1 (COX-1) inactivation Aggregation Adhesion ✔✔Platelet activation involves three linked processes: (1) adhesion, (2) activation, and (3) aggregation. Platelet activation stimuli include epinephrine, thrombin, and collagen. Select four common causes of anemia from the list below. Increased red cell destruction Chronic blood loss Severe bleeding Impaired erythrocyte production Blood transfusion ✔✔Impaired production of erythrocytes, increased red cell destruction, severe bleeding, and chronic blood loss can cause anemia. explain why the nurse practitioner should ask the patient about her paresthesias and ataxia. ✔✔Without the presence of intrinsic factor, vitamin B12 will not be absorbed effectively from the gastrointestinal tract. Describe what causes pernicious anemia. ✔✔Pernicious anemia is caused by vitamin B12 deficiency, which is often associated with the end stage of type A chronic atrophic (autoimmune) gastritis. Autoimmune gastritis impairs the production of IF, which is required for vitamin B12 uptake from the gut. Select three possible causes of lymphadenopathy from the options below. Inflammatory condition Lipid storage disease Neoplastic disease Cardiac disease Peripheral vascular dysfunction ✔✔There are multiple causes of lymphadenopathy. It may be caused by neoplastic disease, so all lymphadenopathies must be closely followed and evaluated. Lymphadenopathy may also be caused by an immunologic or inflammatory condition and by lipid storage disease; this type of lymphadenopathy is usually widespread, including the liver and spleen. What is the most common cause of iron deficiency anemia (IDA) in children during the first few years of life? Dietary insufficiencies Absorption problems Blood loss Increased iron requirement ✔✔Insufficient dietary iron is the most common cause of IDA in children during the first few years of life. Which stressor triggers sickling? Increased plasma volume Increased oxygen tension of the blood Decreased plasma osmolality Low temperature ✔✔Low temperature causes vasoconstriction, slowing blood flow, leading to RBC deoxygenation, which triggers sickling. cause of ITP ✔✔In 70% of ITP cases, there is an antecedent viral disease that stimulates production of antiplatelet antibodies that bind to the plasma membranes of platelets, causing platelet sequestration and destruction by phagocytes in the spleen and other lymphoid tissues at a rate that exceeds the ability of the bone marrow to produce them. What is the likelihood that the patient will recover? with ITP ✔✔The prognosis is excellent; 75% of children recover completely within three months. By six months after onset, 80% of affected children have regained normal platelet counts. What is a function of the pericardial sac? It provides protection to heart valves and heart chambers. It provides a physical barrier that protects the heart against infection and inflammation. It forms a lining that is continuous with the arteries, veins, and capillaries of the body. It creates a continuous closed circulatory system. ✔✔The pericardial sac provides a physical barrier that protects the heart against infection and inflammation. It also protects the heart during gravitational acceleration and deceleration. Which factors determine cardiac output? Parasympathetic and sympathetic activity Heart rate and stroke volume Right and left atrial pressure Preload and afterload Previousquestion ✔✔Cardiac output is the product of heart rate multiplied by stroke volume. Which three enzymes are released when the myocardial muscle is damaged? Lactic acid dehydrogenase (LDH) Creatine phosphokinase-myocardial band (CPK-MB) Cardiac troponin I (cTnI) Low-density lipoprotein (LDL) Aspartate aminotransferase (AST) ✔✔Creatine phosphokinase-myocardial band (CPK-MB) and lactic acid dehydrogenase (LDH) are biomarkers released by damaged myocardial cells. Cardiac troponin I (cTnI) is the most specific indicator of myocardial infarction. HTN is a risk factor for coronary atherosclerosis. What does it do to afterload? ✔✔It also increases afterload and causes ventricular hypertrophy, both of which increase myocardial oxygen demand. why it is important to determine if the patient has fainted recently or has blurred vision. ✔✔Syncope and blurred vision are signs of severely decreased cardiac output or orthostatic hypotension. Describe systolic heart failure. ✔✔Systolic heart failure is reduced contractility of the myocardium so that the heart is unable to produce enough cardiac output to meet the oxygen demands of body cells. Previousquestion What does systolic HF do to ejection fraction? ✔✔ejection fraction would be decreased below 40% because her stroke volume is decreased (reduced contractility) and her LVEDV is increased. Which statement is true regarding congenital heart disease? Deficiency of folic acid has been associated with congenital birth defects. The underlying cause of congenital heart disease is known in 30% of cases. Congenital heart disease is the second leading cause of death in infants during the first year of life. Maternal use of drugs during pregnancy has not been shown to increase congenital heart disease. ✔✔Congenital heart disease is the leading cause of death, excluding prematurity, in infants during the first year of life. what is kawasaki disease ✔✔which is an acute, usually self-limiting systemic vasculitis that may have serious complications if not recognized and managed. The actual etiology of this disorder is not clear, but there is likely a genetic component, and current hypotheses are focused on immunologic responses to an infectious, toxic, or antigenic substance as the etiology for Kawasaki disease. During the acute phase, small capillaries, arterioles, and venules in the heart become inflamed. During the subacute state, inflammation spreads to larger blood vessels like the coronary arteries, and aneurysms may develop. During the convalescent stage, the mediumsized arteries begin to heal; however, the granulation process may cause coronary artery thickening with increased risk for coronary thrombosis. After the convalescent stage, inflammation decreases, but there is potential for scarring of the affected vessels, calcification, and the development of vessel stenosis. treatment for kawasaki in children ✔✔treated with oral aspirin therapy until the inflammation is resolved. Intravenous administration of immunoglobulin is also used to manage the acute inflammatory response. Prognosis for kawasaki in kids ✔✔Treatment of Kawasaki disease with aspirin and intravenous immunoglobulin during the acute phase has decreased the morbidity and reduced the incidence of coronary abnormalities, and most children like this patient completely recover from Kawasaki disease. However, there is the possibility of coronary thrombosis. chief phagocytes of early inflammation ✔✔Neutrophil- 57-67% of total leukocytes primary cells of immune response- ✔✔Lymphocytes-mature into T and B cells. most common blood disorder in children ✔✔. Anemia What causes pernicious anemia ✔✔caused by B12 deficiency, often associated with end stage type A chronic atrophic gastritis. Autoimmune gastritis impairs the production of intrinsic factor (IF), which is required for Vitamin B12 uptake from the gut. most common nutritional deficiency in kids ✔✔Iron deficiency anemia. with highest incidence between 6 months and two years of age due to high need for iron for growth. treatment for iron deficiency anemia in kids ✔✔dietary modification and possible iron supplements Whats the most important variable in determining the occurrence of sickling. ✔✔Deoxygenation What triggers sickling ✔✔Triggered by hypoxemia, decreased pH, increased plasma osmolality, and decreased temperature. Acute Leukemias happen how ✔✔abrupt and rapid onset Most common chronic leukemia ✔✔CLL-involves malignant transformation and progressive accumulation of monoclonal B lymphocytes. Where does lymphoma start ✔✔Usually starts in lymph nodes or lymphoid tissues of stomach or intestines accounts for 30% of childhood lymphomas ✔✔Burkitt Lymphoma- a B- cell non-Hodgkin lymphomaWhat is associated with almost all cases of B- cell non-Hodgkin lymphoms ✔✔EBV What is - Lymphoblastic Lymphoma- ✔✔rare Non-Hodgkin Lymphoma, but accounts for 20% of NHL in childrenSymptoms of plasma cell malignancies ✔✔increased calcium levels, renal failure, anemia, bone lesions, proteinuria, Increased M protein Risk factors for cardiovascular disease ✔✔HYPERTENSION, age, smoking, obesity, increased cholesterol, Diabetes, family history Most common cardiovascular disease condition ✔✔Hypertension then coronary atherosclerosis (HTN is a risk factor) what does an echocardiogram assess ✔✔most effective and widely used for evaluation structures of the heart- assesses cardiac output, ejection fraction, and valvular function What does a SPECT evaluate for ✔✔for CAD and MI during stress test What is raynauds phenomenon ✔✔attacks of vasospasm in the small arteries and arterioles of fingers and sometimes toes Symptom of raynauds ✔✔pallor, numbness, and cold sensation in fingers. Leading cause of CAD and cerebrovasuclar disease ✔✔Atherosclerosis What is atherosclerosis ✔✔thickening and hardening of the vessel are caused by the accumulation of lipid laden macrophages within arterial wall, leading to the formation of plaque. Most common complication of acute MI ✔✔Dysrhythmias what is a pericardial effusision ✔✔accumulation of fluid in the pericardial cavity. Can occur in all forms of pericarditis. May develop into tamponade (dyspnea, tachycardia, JVD, cardiomegaly, and pulsus paradoxus), muffled heart sounds, poorly palpable apical pulse, dyspnea on exertion, dull chest pain. Echo most reliable for diagnosis. Most common valve disorder ✔✔mitral valve prolapse What is a mitral valve prolapse ✔✔the anterior and posterior cusps of the mitral valve prolapse into atrium during systole symptoms of mitral valve prolapse ✔✔Usually asymptomatic- may have murmur - symptomatic may cause palpations, tachycardia, fatigue, chest tightness, dyspnea, anxiety, depression, vague symptoms. seocond degree block Mobitz 1- Wenckebach ✔✔Rapid and irregular heart rhythm Ineffective blood pumping raises the likelihood of coagulation and thrombosis. Pt has increased risk for stroke. What is the term for a reduction in red blood cells, white blood cells, and platelets? Aplastic anemia Hereditary hemochromatosis Myelodysplastic syndrome Sideroblastic anemia ✔✔Aplastic anemia results in a reduction in red blood cells, white blood cells, and platelets. Which illness is the most common cause of aplastic anemia? Type A influenza virus Chronic myeloid leukemia Varicella zoster Human parvovirus B19 ✔✔Human parvovirus B19 infection may lead to the cessation of red blood cell production, resulting in aplastic anemia. What are three possible causes of eosinophilia? Hay fever Cushing syndrome Drug reactions Prolonged infection Asthma ✔✔Eosinophilia is an absolute increase (more than 450/µL) in the total number of circulating eosinophils. Asthma (or the initiators of asthma), hay fever, and drug reactions may cause eosinophilia. What are two true statements regarding Hodgkin lymphoma? Incidence is greater in black individuals. Incidence peaks in the early 20s through 30s and then later in life. The number of Reed-Sternberg cells is increased. Japan and Australia have the highest incidence rate. ✔✔The peak incidence of Hodgkin lymphoma occurs during the early 20s through 30s and again in the sixth and seventh decades of life. An increase in Reed-Sternberg cells occurs with Hodgkin lymphoma. What are two true statements regarding Burkitt lymphoma? Burkitt lymphoma is associated with the Epstein-Barr virus. Burkitt lymphoma is a fast-growing tumor of the jaw and facial bones. Burkitt lymphoma is common in the United States. Burkitt lymphoma is a type of Hodgkin lymphoma. ✔✔Burkitt lymphoma is fast-growing and primarily involves the jaw and facial bone and may cause distortion of the facial bones. It is also commonly associated with the Epstein-Barr virus and is one form of Epstein-Barr virusassociated lymphoproliferative disease. Which condition is cyanosis followed by rubor and paraesthesias in the digits associated with? Atherosclerosis Varicose veins Raynaud phenomenon or disease Thromboangiitis obliterans ✔✔Raynaud phenomenon affects the small vessels supplying blood to the fingers and toes; this vasoconstriction produces rubor and paresthesias in the digits. Which three assessment findings are a sign of atherosclerosis? Arcus senilis Cardiac murmurs Xanthelasmas Carotid arterial bruits Extra-rapid heart sounds ✔✔Xanthelasmas, arcus senilis, and carotid arterial bruits are associated with atherosclerosis. Xanthelasmas are small fat deposits around the eyes that suggests dyslipidemia, which is associated with atherosclerosis. Arcus senilis is a yellow lipid ring around the cornea that suggests dyslipidemia, which is associated with atherosclerosis. Carotid arterial bruits result from a narrowing of the carotid arteries and suggest probable atherosclerotic disease. Which three statements are true regarding atherosclerosis? Atherosclerosis is the thickening and hardening of the vessel wall. Atherosclerosis can affect all vascular systems in the body. Atherosclerosis is an acute process of heart muscle degeneration. Endothelial cell injury begins the process of atherosclerosis. ✔✔Atherosclerosis is a form of arteriosclerosis in which thickening and hardening of the vessels (not heart muscle) occurs. Collagen deposits over a fatty streak cause plaque. Additionally, atherosclerosis begins with injury to the endothelial cells that line artery walls. Furthermore, atherosclerosis is not a single disease; rather, it is a pathologic process that can affect vascular systems throughout the body. Which four cardiac anomalies are associated with tetralogy of Fallot? Right ventricular hypertrophy Atrial septal defect Tricuspid atresia Overriding aorta Ventricular septal defect Pulmonary stenosis ✔✔A ventricular septal defect (VSD) that is high in the septum and usually large is associated with tetralogy of Fallot. Pulmonary stenosis and right ventricular hypertrophy are also associated with tetralogy of Fallot. The overriding aorta straddles the VSD and is associated with tetralogy of Fallot. Select four characteristics of tricuspid atresia. No pathway between the right heart chambers Cyanosis in the newborn experiencing this disorder Children at risk for endocarditis Mixing of deoxygenated and oxygenated bloods Decrease in pulmonary blood flow ✔✔Tricuspid atresia is failure of the tricuspid valve to develop; consequently, there is no communication from the right atrium to the right ventricle. Additionally, blood flows through an atrial septal defect or a patent foramen ovale to the left atrium and through a VSD into the right ventricle, resulting in the complete mixing of deoxygenated and oxygenated blood. Moreover, in the newborn period, a murmur is noted, and cyanosis is usually seen. Lastly, children are at risk for bacterial endocarditis, brain abscess, and stroke.