PATHO 2410 Perfusion/Oxygenation Test Bank Questions And Answers( Complete Solution Rated A)

PATHO 2410 Perfusion/Oxygenation (CP #3) Test Bank Chapter 12 1. Which of the following actions causes the atrioventricular (AV) valves to close? a. Increased intraventricular pressure b. Depolarization at the AV n ...

PATHO 2410 Perfusion/Oxygenation (CP #3) Test Bank Chapter 12 1. Which of the following actions causes the atrioventricular (AV) valves to close? a. Increased intraventricular pressure b. Depolarization at the AV node c. Ventricular relaxation and backflow of blood d. Contraction of the atria 2. When stroke volume decreases, which of the following could maintain cardiac output? a. Decreased peripheral resistance b. Increased heart rate c. Decreased venous return d. General vasodilation 3. Which of the following describes the pericardial cavity? a. It contains sufficient fluid to provide a protective cushion for the heart. b. It is a potential space containing a very small amount of serous fluid. c. It is lined by the endocardium. d. It is located between the double-walled pericardium and the epicardium. 4. Which of the following factors greatly improves venous return to the heart during strenuous exercise? a. Rapid emptying of the right side of the heart b. Forceful action of the valves in the veins c. Contraction and relaxation of skeletal muscle d. Peristalsis in the large veins 5. The function of the baroreceptors is to: a. Stimulate the parasympathetic or sympathetic nervous system at the sinoatrial (SA) node as needed. b. Adjust blood pressure by changing peripheral resistance. c. Sense a change in blood oxygen and carbon dioxide levels. d. Signal the cardiovascular control center of changes in systemic blood pressure. 6. The normal delay in conduction through the AV node is essential for: a. Preventing an excessively rapid heart rate b. Limiting the time for a myocardial contraction c. Allowing the ventricles to contract before the atria d. Completing ventricular filling 7. Which of the following is a result of increased secretion of epinephrine? a. Increased heart rate and force of contraction b. Decreased stimulation of the SA node and ventricles c. Vasoconstriction in skeletal muscles and kidneys d. Vasodilation of cutaneous blood vessels 8. Which of the following causes increased heart rate? a. Stimulation of the vagus nerve b. Increased renin secretion c. Administration of beta-blocking drugs d. Stimulation of the sympathetic nervous system 9. The event that causes the QRS wave on an electrocardiogram (ECG) tracing is: a. Atrial depolarization b. Atrial repolarization c. Ventricular depolarization d. Ventricular repolarization 10. The cardiac reserve is: a. Afterload b. The difference between the apical and redial pulses c. The ability of the heart to increase cardiac output when needed d. The extra blood remaining in the heart after in contracts 11. The term preload refers to: a. Volume of venous return b. Peripheral resistance c. Stroke volume d. Cardiac output 12. The first arteries to branch off the aorta are the: a. Common carotid arteries b. Pulmonary arteries c. Coronary arteries d. Subclavian arteries 13. Cardiac output refers to: a. The amount of blood passing through either of the atria b. The volume of blood ejected by a ventricle in one minute c. The volume of blood ejected by each ventricle in a single contraction d. The total number of heartbeats in one minute 14. Vasodilation in the skin and viscera results directly from: a. Decreased blood pressure b. Increased parasympathetic stimulation c. Relaxation of smooth muscle in the arterioles d. Increased stimulation of alpha-adrenergic receptors 15. Which of the following drugs decrease sodium and fluid retention in the body? a. Warfarin (Coumadin) b. Digoxin (Lanoxin) c. Nitroglycerin (Isordil) d. Hydrochlorothiazide (HydroDIURIL) 16. Which of the following are predisposing factors to thrombus formation in the circulation? (Select all that apply) a. Decreased viscosity of the blood b. Damaged blood vessel walls c. Immobility d. Prosthetic valves 17. A drug taken in small doses on a continuing basis to reduce platelet adhesion is: a. Acetylsalicylic acid (ASA) b. Streptokinase c. Acetaminophen d. Heparin 18. A partial obstruction in a coronary artery will likely cause: a. Pulmonary embolus b. Hypertension c. Angina attacks d. Myocardial infarction 19. Cigarette smoking is a risk factor in coronary artery disease because smoking: a. Reduced vasoconstriction and peripheral resistance b. Decreases serum lipid levels c. Promotes platelet adhesion d. Increases serum HDL levels 20. The term arteriosclerosis specifically refers to: a. Development of atheromas in large arteries b. Intermittent vasospasm in coronary arteries c. Degeneration with loss of elasticity and obstruction in small arteries d. Ischemia and necrosis in the brain, kidneys, and heart 21. A modifiable factor that increases the risk for atherosclerosis is: a. Leading a sedentary lifestyle b. Being female and older than 40 years of age c. Excluding saturated fats from the diet d. Familial hypercholesterolemia 22. An atheroma develops from: a. A torn arterial wall and blood clots b. Accumulated lipids, cells, and fibrin where endothelial injury has occurred c. Thrombus forming on damaged walls of veins d. Repeated vasospasms 23. Low-density lipoproteins (LDL): a. Promote atheroma development b. Contain only small amounts of cholesterol c. Transport cholesterol from cells to the liver for excretion d. Are associated with low intake of saturated fats 24. Factors that may precipitate an angina attack include all of the following EXCEPT: a. Eating a large meal b. Engaging in an angry argument c. Taking a nap d. Shoveling snow on a cold, windy day 25. When comparing angina with myocardial infarction (MI), which statement is true? a. Both angina and MI cause tissue necrosis b. Angina often occurs at rest; MI occurs during a stressful time c. Pain is more severe and lasts longer with angina than with MI d. Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is not 26. The basic pathophysiology of myocardial infarction is best described as: a. Cardiac output that is insufficient to meet the needs of the heart and body. b. Temporary vasospasm that occurs in a coronary artery. c. Total obstruction of a coronary artery, which causes myocardial necrosis. d. Irregular heart rate and force, reducing blood supply to coronary arteries. 27. Typical early signs or symptoms of myocardial infarction include: a. Brief, substernal pain radiating to the right arm, with labored breathing. b. Persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse. c. Bradycardia, increased blood pressure, and severe dyspnea. d. Flushed face, rapid respirations, left-side weakness, and numbness. 28. The most common cause of a myocardial infarction is: a. An imbalance in calcium ions b. An infection of the heart muscle c. Atherosclerosis involving an attached thrombus d. A disruption of the heart conduction system 29. Calcium-channel blocking drugs are effective in: a. Reducing the risk of blood clotting b. Decreasing the attraction of cholesterol into lipid plaques c. Reducing cardiac and smooth muscle contractions d. Decreasing all types of cardiac arrhythmias 30. Which of the following confirms the presence of a myocardial infarction? a. A full description of the pain, including the sequence of development b. The presence of elevated serum cholesterol and triglycerides c. Serum isoenzymes released from necrotic cells and an ECG d. Leukocytosis and elevated C-reactive protein (CRP) 31. The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following EXCEPT: a. Previously established collateral circulation b. Immediate administration of thrombolytic drugs c. Maintaining maximum oxygen supply to the myocardium d. Removing the predisposing factors to atheroma development 32. The most common cause of death immediately following a myocardial infarction is: a. Cardiac arrhythmias and fibrillation b. Ruptured ventricle or aorta c. Congestive heart failure d. Cerebrovascular accident 33. Why does ventricular fibrillation result in cardiac arrest? a. Delayed conduction through the AV node blocks ventricular stimulation. b. Insufficient blood is supplied to the myocardium. c. The ventricles contract before the atria. d. Parasympathetic stimulation depresses the SA node. 34. The term cardiac arrest refers to which of the following? a. Condition where cardiac output is less than the demand b. A decreased circulating blood volume c. Missing a ventricular contraction d. The cessation of all cardiac function 35. Which change results from total heart block? a. A prolonged PR interval b. Periodic omission of a ventricular contraction c. A wide QRS wave d. Spontaneous slow ventricular contractions, not coordinated with atrial contraction 36. The term premature ventricular contraction refers to the condition where: a. Atrial muscle cells are stimulating additional cardiac contractions b. The ventricles contract spontaneously following a period without a stimulus c. Additional contractions arise from ectopic foci in the ventricular muscle d. Increased heart rate causes palpitations 37. Which of the following is most likely to cause left-sided congestive heart failure? a. Incompetent tricuspid heart valve b. Chronic pulmonary disease c. Infarction in the right atrium d. Uncontrolled essential hypertension 38. The definition of congestive heart failure is: a. Cessation of all cardiac activity b. Inability of the heart to pump enough blood to meet the metabolic needs of the body c. Insufficient circulating blood in the body d. The demand for oxygen by the heart is greater than the supply 39. Significant signs of right-sided congestive heart failure include: a. Severe chest pain and tachycardia b. Edematous feet and legs with hepatomegaly c. Frequent cough with blood-streaked frothy sputum d. Orthopnea, fatigue, increased blood pressure 40. Paroxysmal nocturnal dyspnea is marked by: a. Hemoptysis and rales b. Distended neck veins and flushed face c. Bradycardia and weak pulse d. Cardiomegaly 41. Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include: a. Slow cardiac contractions b. Increased renin and aldosterone secretions c. Decreased erythropoietin secretion d. Fatigue and cold intolerance 42. In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure? a. Veins of the legs and feet b. Jugular veins c. Pulmonary capillaries d. Blood vessels of the liver and spleen 43. Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions? a. Furosemide b. Digoxin c. Epinephrine d. Nifedipine 44. In an infant, the initial indication of congestive heart failure is often: a. Distended neck veins b. Feeding problems c. Low-grade fever and lethargy d. Frequent vomiting 45. Effects that may be expected from a beta-adrenergic blocking drug include: a. Increasing systemic vasoconstriction b. Decreased sympathetic stimulation of the heart c. Blockage of an angiotensin receptor site d. Increased release of renin 46. A sign of aortic stenosis is: a. Increased cardiac output b. Congestion in the liver, spleen, and legs c. Flushed face and headache d. A heart murmur 47. An incompetent mitral valve would cause: a. Increased blood to remain in the right atrium b. Hypertrophy of the right ventricle c. Decreased output from the left ventricle d. Decreased pressure in the left atrium 48. Which of the following describes the blood flow occurring with a ventricular septal defect? a. From the left ventricle to the right ventricle b. From the right ventricle to the left ventricle c. Increased cardiac output from the left ventricle d. Mixed oxygenated and unoxygenated blood in the systemic circulation 49. Unoxygenated blood enters the systemic circulation in children with tetralogy of Fallot because: a. The aorta and pulmonary artery have exchanged positions. b. Pulmonary stenosis changes the ventricular pressures. c. The left ventricular wall has hypertrophied. d. The septal defect allows exchange of blood between the atria. 50. Cyanosis occurs in children with tetralogy of Fallot because: a. More carbon dioxide is present in the circulating blood. b. A large amount of hemoglobin in the general circulation is unoxygenated. c. The pulmonary circulation is overloaded and congested. d. The circulation is sluggish (slow) throughout the system. 51. The initial effect on the heart in cases of rheumatic fever is: a. Infection in the heart by hemolytic streptococci b. Highly virulent microbes causing vegetations on the heart valves c. Septic emboli obstructing coronary arteries d. Acute inflammation in all layers of the heart due to abnormal immune response 52. Common signs of rheumatic fever include all of the following EXCEPT: a. Arthritis, causing deformity of the small joints in the hands and feet. b. Erythematous skin rash and subcutaneous nodules. c. Epistaxis, tachycardia, and fever. d. Elevated ASO titer and leukocytosis. 53. Rheumatic heart disease usually manifests in later years as: a. Swollen heart valves and fever b. Cardiac arrhythmias and heart murmurs c. Thrombus formation and septic emboli d. Petechial hemorrhages of the skin ad mucosa 54. Septic emboli, a common complication of infective endocarditis, are a result of the fact that: a. Vegetations are loosely attached and fragile b. The valves are no longer competent c. Cardiac output is reduced d. Heart contractions are irregular 55. Which of the following applies to subacute infective endocarditis? a. A microbe of low virulence attacks abnormal or damaged heart valves. b. Virulent microbes invade normal heart valves. c. No permanent damage occurs to the valves. d. Prophylactic medication does not prevent infection. 56. Pericarditis causes a reduction in cardiac output as a result of which of the following? a. Delays in the conduction system, interfering with cardiac rhythm b. Weak myocardial contractions due to friction rub c. Excess fluid in the pericardial cavity, which decreases ventricular filling d. Incompetent valves, which allow regurgitation of blood 57. Pericarditis may be caused by: (Select all that apply) a. Infection b. Abnormal immune responses c. Injury d. Malignant neoplasm 58. A source of an embolus causing an obstruction in the brain could be the: a. Femoral vein b. Pulmonary vein c. Carotid artery d. Coronary artery 59. The basic pathophysiological change associated with essential hypertension is: a. Development of lipid plaques in large arteries b. Recurrent inflammation and fibrosis in peripheral arteries c. Degeneration and loss of elasticity in arteries d. Increased systemic vasoconstriction 60. Uncontrolled hypertension is most likely to cause ischemia and loss of function in the: a. Kidneys, brain, and retinas of the eye b. Peripheral arteries in the legs c. Aorta and coronary arteries d. Liver, spleen, and stomach 61. When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals? a. Blood pressure remains consistently above 140/90 b. Blood pressure fluctuates between 130/85 and 180/105 c. Blood pressure increases rapidly and is unresponsive to medication d. Chronic kidney disease leads to consistently elevated blood pressure 62. Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following? (Select all that apply) a. Gangrenous ulcers in the legs b. Strong rapid pulses in the legs c. Intermittent claudication d. Red, swollen legs 63. The term intermittent claudication refers to: a. Sensory deficit in the legs due to damage to nerves b. Chest pain related to ischemia c. Ischemic muscle pain in the legs, particularly with exercise d. Dry, cyanotic skin with superficial ulcers 64. What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease? a. It promotes more rapid healing of ulcerated areas. b. It improves circulation to other areas. c. It prevents spread of infection and reduces pain. d. It reduces swelling in the peripheral areas. 65. An echocardiogram is used to demonstrate any abnormal: a. Activity in the conduction system b. Movement of the heart valves c. Change in central venous pressure d. Blood flow in coronary arteries 66. A friction rub is associated with: a. Infectious endocarditis b. Arrhythmias c. Pericarditis d. An incompetent aortic valve 67. A dissecting aortic aneurysm develops as: a. A dilation or bulge that develops at one point on the aortic wall. b. A thrombus that accumulates at a point in the aortic wall. c. A section of the aorta that weakens and dilates in all directions. d. A tear in the intimal lining, which allows blood flow between layers of the aortic wall. 68. The outcome for many aortic aneurysms is: a. Early diagnosis and repair b. Thrombus formation and pulmonary embolus c. Rupture and hemorrhage d. Pressure and adjacent organs or structures 69. Which factor predisposes to varicose veins during pregnancy? a. Compressed pelvic veins b. Stenotic valves in leg veins c. Thrombus formation d. Insufficient muscle support for veins 70. Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because: a. Platelets attach to the inflamed wall b. Thrombus forms in a vein and is less firmly attached c. Leg cramps require massage d. Systemic signs of inflammation require treatment 71. Shock is defined as: a. Failure of the heart to supple sufficient blood to body cells b. General hypoxia, causing damage to various organs c. Decreased circulating blood and tissue perfusion d. Loss of blood, causing severe hypoxia 72. Shock follows a myocardial infarction when: a. The stress response causes general vasodilation b. Fluid is lost into ischemic tissues c. Heart valves are damaged d. A large portion of the myocardium is damaged 73. What are the early signs of circulatory shock? (Select all that apply) a. Pale moist skin b. Loss of consciousness c. Anxiety and restlessness d. Rapid strong pulse 74. A compensation for shock would include: a. Increased heart rate and oliguria b. Lethargy and decreased responsiveness c. Warm, dry, flushed skin d. Weak, thread pulse 75. Why does anaphylactic shock cause severe hypoxia very quickly? a. Generalized vasoconstriction reduces venous return. b. Bronchoconstriction and bronchial edema reduce airflow. c. Heart rate and contractility are reduced. d. Metabolic rate is greatly increased. 76. Neurogenic (vasogenic) shock results from systemic vasodilation due to: a. Increased peripheral resistance and less blood in the microcirculation. b. Increased permeability of all the blood vessels, leading to hypovolemia. c. Slower, less forceful cardiac contractions. d. Increased capacity of the vascular system and reduced venous return. 77. A prolonged period of shock is likely to cause: a. Damage to, and increased permeability of, pulmonary capillaries. b. Increased permeability of the glomerular capillaries of the kidneys. c. Increased pH of blood and body fluids. d. Increased systemic vasoconstriction. 78. What would indicate decompensated acidosis related to shock? a. Serum bicarbonate level below normal b. PCO2 above normal c. Serum pH below normal range d. Urine pH of 4.5 79. With shock, anaerobic cell metabolism and decreased renal blood flow cause: a. Metabolic alkalosis b. Metabolic acidosis c. Decreased serum potassium d. Increased serum bicarbonate 80. Shock develops in patients with severe burns as a result of: a. Extensive hemorrhage b. Pain and loss of plasma c. Direct damage to the heart d. Extensive hemolysis of erythrocytes 81. The classic early manifestation(s) of left-sided congestive heart failure is/are , whereas the early indicator(s) of right-sided failure is/are . a. Palpitations and periodic chest pain; Shortness of breath on exertion b. Swelling of the ankles and abdomen; Chest pain c. Shortness of breath on exertion or lying down; Swelling of the ankles d. Coughing up frothy sputum; Hepatomegaly and splenomegaly 82. A common adverse effect of many antihypertensive medications is: a. Orthostatic hypotension b. Bradycardia c. Altered blood coagulation d. Peripheral edema 83. The cause of essential hypertension is considered to be: a. Chronic renal disease b. Excessive intake of saturated fats and salt c. Sedentary lifestyle d. Idiopathic 84. A cardiac pacemaker would most likely be inserted in cases of: a. Angina pectoris b. Heart block c. Congestive heart failure d. Ventricular fibrillation 85. Which of the following is considered to be the most dangerous arrhythmia? a. Tachycardia b. Bradycardia c. Ventricular fibrillation d. Second-degree heart block 86. Which of the following is NOT true of the drug nitroglycerin? a. It decreases myocardial workload by causing systemic vasodilation. b. It may be administered sublingually, transdermally, or by oral spray. c. Dizziness or syncope may follow a sublingual dose. d. It strengthens the myocardial contraction. 87. Confirmation of the diagnosis of a myocardial infarction would include: (Select all that apply) a. Specific changes in the ECG b. Marked leukocytosis and increased erythrocyte sedimentation rate (ESR) c. Elevation of cardiac isoenzymes in serum d. A pattern of pain 88. Which of the following statements regarding aneurysms is true? a. Aneurysms are always caused by congenital malformations. b. The greatest danger with aneurysms is thrombus formation. c. Manifestations of aneurysms result from compression of adjacent structures. d. Aneurysms involve a defect in the tunica media of veins. 89. The most common factor predisposing to the development of varicose veins is: a. Trauma b. Congenital valve defect in the abdominal veins c. Infection d. Increased venous pressure 90. In the period immediately following a myocardial infarction, the manifestations of pallor and diaphoresis, rapid pulse, and anxiety result from: a. Onset of circulatory shock b. The inflammatory response c. Release of enzymes from necrotic tissue d. Heart failure 91. Septic shock differs from hypovolemic shock in that it is frequently manifested by: a. Fever and flushed face b. Elevated blood pressure c. Increased urinary output d. Slow bounding pulse 92. Heart block, in which a conduction delay at the AV node results in intermittent missed ventricular contractions, is called: a. First-degree block b. Second-degree block c. Bundle-branch block d. Total heart block 93. More extensive permanent damage is likely when a myocardial infarction is caused by: a. A hemorrhage b. An embolus c. A thrombus d. An arrhythmia 94. A very rapid heart rate reduces cardiac output because: a. Venous return is increased b. Ventricular fibrillation develops immediately c. Conduction through the AV node is impaired d. Ventricular filling is reduced 95. The right side of the heart would fail first in the case of: (Select all that apply) a. Severe mitral valve stenosis b. Uncontrolled essential hypertension c. Large infarction in the right ventricle d. Advanced chronic obstructive pulmonary disease (COPD) 96. Which of the following compensations that develop in patients with congestive heart failure eventually increase the workload of the heart? a. Faster heart rate and cardiomegaly b. Peripheral vasoconstriction c. Increased secretion of renin d. A and C e. A, B, and C 97. Which statement applies to paroxysmal nocturnal dyspnea? a. It indicates decreased CO2 diffusion in the lungs. b. It indicates swelling in the bronchioles and bronchi. c. It is caused by increased blood in the lungs when lying in a supine position. d. It results from pleural effusion. 98. In patients with congestive heart failure, ACE inhibitor drugs are useful because they: a. Reduce renin and aldosterone secretion b. Slow the heart rate c. Strengthen myocardial contraction d. Block arrhythmias 99. In a child with ventricular septal defect, altered blood flow: a. Leads to increased stroke volume from the left ventricle b. Results in unoxygenated blood in the systemic circulation c. Is called a right-to-left shunt d. Is called a left-to-right shunt 100. In a child with acute rheumatic fever, arrhythmias may develop due to the presence of: a. Endocarditis b. Myocarditis c. Pericarditis d. Congestive heart failure 101. Prophylactic antibacterial drugs such as amoxicillin are given to patients with certain congenital heart defects or damaged heart valves immediately before invasive procedures to prevent: a. Formation of septic thrombi b. Infectious endocarditis c. Abscess formation d. Myocarditis 102. Varicose ulcers may develop and be slow to heal because: a. Leg muscles are painful, restricting movement. b. Edema reduces arterial blood supply to the area. c. Emboli form in damaged veins, leading to local ischemia. d. Valves in veins restrict blood flow. 103. Excessive fluid in the pericardial space causes: a. Increased cardiac output b. Myocardial infarction c. Reduced venous return d. Friction rub 104. Aortic stenosis means the aortic valve: a. Allows blood to leak back into the left ventricle during diastole. b. Cannot fully open during systole. c. Functions to increase stroke volume. d. Does not respond to the cardiac cycle. 105. Septic shock is frequently caused by infections involving: a. Gram-negative endotoxin-producing bacteria. b. Spore-forming saprophytic fungi. c. Free-swimming, motile parasitic protozoa. d. Parasitic nematodes. Chapter 14 1. Through what area does the cerebrospinal fluid circulate around the brain and spinal cord? a. Between the double layers of the dura mater b. In the subdural space c. In the subarachnoid space d. Through the arachnoid villi 2. Which of the following is the usual location of language centers? a. Left hemisphere b. Right hemisphere c. Brainstem d. Hypothalamus 3. What would be the effect of damage to the auditory association area in the left hemisphere? a. Loss of hearing in both ears b. Inability to understand what is hears c. Loss of hearing in the left ear d. Inability to determine the source of sound 4. Which of the following applies to the corticospinal tract? a. It is an ascending tract b. The nerve fibers conduct sensory impulses c. It is an extrapyramidal tract d. It is a pyramidal tract for efferent impulses 5. What is a major function of the limbic system? a. Overall control of fluid balance b. Required for logical thinking, reason, and decision making c. Determines emotional responses d. Responsible for artistic and musical talents 6. Where are 1-adrenergic receptors located? a. Bronchiolar walls b. Arteriolar walls c. Cardiac muscle d. Glands of the intestinal tract 7. What does a vegetative state refer to? a. Depression of the reticular activating system (RAS) and inability to initiate action b. Loss of awareness and intellectual function but continued brainstem function c. Continuing intellectual function but inability to communicate or move d. Disorientation and confusion with decreased responsiveness 8. Which of the following conditions is NOT part of the criteria for a declaration of “brain death”? a. No activity on EEG b. Absence of all reflexes c. No spontaneous respirations d. Presence of any head injury 9. What is the best definition of aphasia? a. The inability to comprehend or express language appropriately b. Difficulty swallowing c. Loss of the visual field contralateral to the area of damage d. The inability to articulate words clearly 10. What is an early indicator of increased intracranial pressure? a. Papilledema b. Bilateral fixed dilated pupils c. Decreased responsiveness d. Rapid heart rate 11. What is the rationale for vomiting in a patient who has increased intracranial pressure? a. Chemoreceptors responding to changes in the blood b. Pressure extending to spinal nerves c. Pressure on the emetic center in the medulla d. Stimuli to the hypothalamic center for hunger and thirst 12. What is the typical change in blood pressure in a patient who has increased intracranial pressure? a. Erratic diastolic pressure b. Decreasing systolic pressure c. Systolic and diastolic pressures decreasing proportionately d. Increasing pulse pressure 13. The largest category of primary malignant brain tumors that arise from cells in the central nervous system (CNS) are called: a. Gliomas b. Sarcomas c. Lymphomas d. Myelomas 14. Which of the following causes papilledema? a. Increased pressure of cerebrospinal fluid (CSF) at the optic disc b. Increased intraocular pressure c. Pressure on the oculomotor nerve d. Pressure on the optic chiasm 15. What is the effect of an enlarging brain abscess on cardiovascular activity? a. Increased heart rate and systemic vasodilation b. Low blood pressure and irregular heart and respiratory rates c. Systemic vasoconstriction and slower heart rate d. Immediate depression of the cardiac control centers 16. As intracranial pressure rises, the pupil of the eye, ipsilateral to the lesion, becomes dilated and unresponsive to light because of pressure on the: a. Optic nerve b. Peripheral nervous system (PSNS) fibers in cranial nerve III c. Sympathetic nervous system (SNS) nerve to the eye d. Occipital lobe 17. Which of the following characteristics indicates that the CSF is normal? a. Cloudy and pale yellow color b. Presence of erythrocytes c. Presence of numerous leukocytes d. Clear and colorless fluid 18. Which of the following statements is TRUE about malignant brain tumors? a. Most brain tumors arise from malignant neurons. b. Primary brain tumors rarely metastasize outside the CNS. c. The blood-brain barrier prevents secondary brain tumors. d. Brainstem tumors do not manifest signs until they are quite large. 19. Secondary brain tumors usually arise from: a. Severe head trauma b. Metastasized breast or lung tumors c. Exposure to carcinogenic agents d. Exposure to radiation 20. Why are focal or generalized seizures sometimes an early indication of a brain tumor? a. Surrounding inflammation stimulates neurons to discharge spontaneously. b. Malignant tumors cause alkalosis, exciting the CNS. c. Systemic effects of the brain tumor may cause seizures. d. Metabolic effects of cancer change blood chemistry to trigger seizures. 21. Which of the following is a TRUE statement about transient ischemic attacks (TIAs)? a. They usually cause necrosis and permanent brain damage. b. They may be caused by rupture of an aneurysm or a damaged artery. c. They usually indicate systemic hypertension. d. They can warn of potential cerebrovascular accidents. 22. What is the probable source of an embolus causing a cerebrovascular accident (CVA)? a. Right ventricle of the heart b. Femoral vein c. Common carotid artery d. Pulmonary artery 23. Collateral circulation is most likely to be present when a CVA results from: a. Rupture of a cerebral artery b. An embolus c. Atherosclerosis d. Vasospasm in the cerebral circulation 24. All of the following apply to CVA EXCEPT: a. The common cause is an atheroma with thrombus. b. Maximum necrosis and infarction develop within several hours of onset. c. Warning signs may appear with partial obstruction of the artery. d. Increasing neurological deficits usually develop during the first few days. 25. Signs and symptoms of a stroke depend upon: a. Location of obstruction, size of artery, and area affected b. Duration of the blockage, distance from the heart, and type of obstruction c. Health of the victim, area affected, and collateral circulation d. Size of the obstruction, condition of the heart, and duration of blockage 26. In the weeks following CVA, why might some neurological function return? (Select all that apply) a. Presence of collateral circulation b. Immediate therapy to dissolve thrombi and maintain perfusion c. Reduced inflammation in the area d. Development of alternative neuronal pathways 27. Which of the following statements about berry aneurysms in the brain is NOT true? a. They usually develop at points of bifurcation in the circle of Willis. b. They are usually asymptomatic for many years. c. CSF remains free of blood. d. Following rupture, blood appears in the subarachnoid space. 28. In a case of bacterial meningitis, where does swelling and purulent exudate form? a. In the pia mater, arachnoid, and surface of the entire brain b. In the dura mater and epidural space c. At the site of the injury or entry point of the microbes d. Primarily around the spinal cord 29. What are significant signs of acute bacterial meningitis? a. Severe headache, nuchal rigidity, and photophobia b. Fatigue and lethargy, fever, and anorexia c. Focal signs, such as progressive paralysis in a limb d. Ascending paralysis beginning in the legs 30. In many types of encephalitis, such as St. Louis encephalitis, how are the viruses transmitted? a. Carriers b. Mosquito and tick bites c. Respiratory droplet d. Septic emboli in the circulation 31. All of the following apply to tetanus infection EXCEPT: a. It is caused by an anaerobic, spore-forming bacillus b. The exotoxin causes strong skeletal muscle spasms c. Death usually results from respiratory failure d. Signs of fever, vomiting, stiff neck, and paralysis 32. In cases of Guillain-Barré syndrome, what does the pathophysiology include? a. Damage and loss of function in the motor neurons of the spinal cord and medulla b. Encephalopathy, with disorientation, headache, and coma c. Infection and inflammation of the motor cortex d. Inflammation and demyelination of peripheral nerves, leading to ascending paralysis 33. How does a depressed skull fracture cause brain damage? a. A bone fragment penetrates and tears brain tissue. b. A section of the skull is missing, leaving the brain unprotected. c. A section of skull bone is displaced below the level of the skull, causing pressure on the brain. d. Many fracture lines are present, causing instability. e. The contrecoup injury is the cause of brain damage. 34. Following a head injury, what is the most likely cause of secondary damage to the brain? a. Hematoma or infection b. Laceration by foreign objects c. Hypoxia or acidosis d. Tearing of blood vessels as the brain rotates across the inside of the skull 35. An epidural hematoma is located between the: a. Dura mater and the arachnoid mater b. Dura mater and the skull c. Arachnoid mater and the pia mater d. Pia mater and the brain 36. What does the term otorrhea mean? a. Bleeding from the nose b. CSF leaking from the ear c. Torn meninges but no skull fracture d. Hemorrhage from the ear 37. Vertebral fractures are classified as: a. Simple, compression, wedge, dislocation b. Compound, open, closed, shattered c. Complex, torsion, open, multiple d. Pressure, complex, simple, variable 38. Following a spinal injury at C5, what is the expected effect during the period of spinal shock? a. Spastic paralysis below the level of injury b. Urinary incontinence c. Labile body temperature d. Increased sensation in the legs 39. Following an injury at L2 to L3, what would indicate recovery from spinal shock? a. Spastic paraplegia b. Urinary retention c. Labile body temperature d. Increased sensation in the legs 40. What are the signs of autonomic dysreflexia in a person with cervical spinal injury? a. Unexpected drop in blood pressure and apnea b. Sudden marked increase in blood pressure with bradycardia c. Hyperreflexia in the arms and legs d. Urinary and bowel incontinence 41. Expressive aphasia is most likely to result from damage to: a. The left frontal lobe b. The left temporal lobe c. The right motor cortex d. Wernicke’s area 42. What is the usual result of damage to the right occipital lobe? a. Left eye is blind b. Loss of left visual field c. Right eye is blind d. Visual loss in the medial half of each eye 43. How does the heart rate change as intracranial pressure increases? a. Rate decreases b. Rate increases c. No change in rate d. Irregular heart rate 44. Which statement best describes herniation resulting from increased intracranial pressure? a. Movement of brain tissue into ventricles b. Movement of brain stem upward c. Pushing of excess CSF and blood down around the spinal cord d. Displacement of brain tissue downward toward the spinal cord 45. Which type of cerebrovascular accident (CVA) has the poorest prognosis? a. CVA caused by thrombus b. Hemorrhagic CVA c. Embolic CVA d. No difference among types 46. Which of the following factors predispose(s) an individual to a CVA? (Select all that apply) a. Hypertension b. Smoking cigarettes c. History of coronary artery disease d. Diabetes mellitus 47. What are the significant early signs of a ruptured cerebral aneurysm? a. Impaired speech and muscle weakness b. Severe headache, nuchal rigidity, and photophobia c. Abnormal sensations and tremors d. Vomiting and visual abnormalities 48. The stroke scale used to rapidly diagnose a stroke includes: a. Capacity for speech, level of consciousness, motor skills, eye movements. b. Motor skills, spatial awareness, time awareness, facial recognition. c. Short-term memory, cognitive skills, speech, name recognition. d. Hand-eye coordination, problem solving, ability to stand or walk, consciousness. 49. With regard to meningitis, choose the correct combination of microbe and the age group commonly affected. a. E. coli: elderly b. H. influenzae: neonate c. N. meningitides: children and youth d. S. pneumoniae: young children 50. Which of the following statements applies to a lumbar puncture? a. It is usually performed at L3-L4. b. Fluid is withdrawn from the epidural space. c. It can be used to confirm any diagnosis. d. The tissue seals up immediately after puncture. 51. Which signs are indicative of post-polio syndrome? a. Progressive spastic paralysis b. Ascending flaccid paralysis c. Progressive fatigue and weakness d. Increasing numbness and paresthesias 52. Which of the following does NOT apply to Reye’s syndrome? a. There is no permanent damage in the body b. It is precipitated by a combination of viral infection and administration of acetylsalicylic acid (ASA). c. Cerebral edema develops. d. Liver damage is common. 53. Which type of fracture typically occurs at the base of the skull? a. Depressed b. Contrecoup c. Comminuted d. Basilar 54. The primary reason for seizures frequently occurring with head injuries is: a. Presence of blood irritates the neurons. b. Otorrhea or rhinorrhea changes intracranial pressure. c. Inflammatory response causes general hypoxia. d. CNS is depressed 55. Brain injury where the brain is injured when it bounces off of the skull due to sudden acceleration or deceleration is referred to as a/an: a. Linear fracture b. Contusion c. Basilar injury d. Contrecoup injury 56. The rabies virus is usually transmitted by: a. Respiratory droplets b. Insects such as mosquitos c. Bites from infected animals d. The fecal-oral route 57. Common manifestations of rabies infection include: a. Headache, foaming at the mouth, and difficulty swallowing. b. Difficulty walking and coordinating movements. c. Decreased sensitivity to sound and touch. d. Vomiting, liver and kidney damage. 58. Which statement is TRUE about tetanus infection? a. It is caused by a virus b. Infection usually develops in deep puncture wounds c. It causes flaccid skeletal muscles, impairing mobility d. It affects peripheral nerves initially in the legs and feet 59. Which of the following impairments results from infection by the polio virus? a. Pain and paresthesia in a cranial nerve or dermatome b. Loss of motor and sensory function in the peripheral nerves c. Inflammation and increased intracranial pressure d. Loss of function of motor neurons of the spinal cord and medulla 60. Herpes zoster can be identified by a typical: a. Unilateral rash and pain along a cranial nerve or dermatome b. Weakness and muscle atrophy in the legs c. Ascending paralysis commencing in the legs d. Skeletal muscle spasms in the face and neck 61. Which of the following conditions is marked by focal signs? a. Meningitis b. Brain abscess c. Encephalitis d. Intracerebral hemorrhage 62. Typical signs of a TIA include: a. Rapidly increasing intracranial pressure b. Loss of consciousness c. Transient muscle weakness in a hand or leg d. Headache, photophobia, and nuchal rigidity 63. In cases of noncommunicating hydrocephalus, why does excess cerebrospinal fluid (CSF) accumulate? a. Absorption of CSF through the arachnoid villi is impaired. b. Excessive amounts of CSF are produced in the ventricles. c. An obstruction is present in the aqueduct of Sylvius or other channel. d. Flow around the spinal cord is blocked. 64. All of the following are typical signs of hydrocephalus in the neonate EXCEPT: a. Enlarged head with bulging fontanels b. Vomiting, headache, and paralysis c. Irritability and feeding difficulties d. Eyes turned downward with sclerae showing above the pupils 65. The best description of a myelomeningocele is: a. Asymptomatic failure of the posterior spinous processes of the vertebrae to fuse. b. Herniation of the meninges through a vertebral defect. c. Herniation of the meninges, CSF, and spinal cord or nerves through a vertebral defect. d. Herniation of brain tissue through a defect in the cranium. 66. How is the presence of spina bifida diagnosed? a. Prenatally by ultrasound or detection of alpha-fetoprotein (AFP) in maternal blood or amniotic fluid b. Only after birth by direct observation of the sac c. After birth when the sac herniates as CSF builds up d. Only with a spinal X-ray 67. What characteristic is common to all individuals with cerebral palsy? a. Some loss of cognitive function b. One or more types of seizure c. Serious multiple communication difficulties d. Some degree of motor disability 68. Which of the following applies to cerebral palsy? a. Nonprogressive brain damage to the fetus or neonate b. A genetic defect affecting metabolism and causing degeneration in the neurons c. A developmental error during early growth of the peripheral nervous system d. A chromosomal defect resulting in abnormalities in many body structures 69. Which of the following is characteristic of generalized seizures? a. The localization of the seizure activity b. The uncontrolled discharge of neurons in both hemispheres c. Seizures that persist for several hours d. Loss of consciousness and all motor function 70. From the following, choose the two events (in correct sequence) that immediately follow the aura during a tonic-clonic event: a. Prodromal signs, then the clonic stage b. Clonic stage, then the tonic stage c. Loss of consciousness, then the tonic stage d. Loss of consciousness and cessation of respiration 71. What does the clonic stage of a seizure consist of? a. A sudden strong skeletal muscle contraction and rigidity of trunk and limbs b. A cry and contraction of abdominal and thoracic muscles c. Alternating contractions and relaxation of skeletal muscles d. Cessation of all skeletal muscle activity 72. How would a seizure consisting of bizarre or inappropriate activity be classified? a. Absence seizure b. Psychomotor seizure c. Focal seizure d. Jacksonian seizure 73. Which of the following is characteristic of multiple sclerosis? a. Remissions and exacerbations b. Predictable pattern of progression in all patients c. Onset in men and women more than 60 years of age d. Full recovery of function during remissions 74. Which statement does NOT apply to the pathophysiology of multiple sclerosis? a. Demyelination of axons b. It affects the brain, spinal cord, and cranial nerves c. It affects motor, sensory, and autonomic fibers d. Progressive random degeneration of peripheral nerves 75. Which of the following are common early signs of multiple sclerosis? a. Paralysis of the lower body, impaired cognitive function b. Areas of numbness, weakness in the legs, visual problems c. Sensory deficit in the legs and trunk, memory loss, urinary incontinence d. Tremors, speech impairment, hearing loss 76. Which of the following applies to Parkinson’s disease? a. Usually develops in men and women over 60 years of age. b. There is no apparent genetic component. c. The majority of cases are predisposed by intake of antipsychotic medications. d. It rarely develops in women 77. What is the pathophysiological change in Parkinson’s disease? a. Degeneration of motor fibers in the pyramidal tracts b. Excess secretion of stimulatory neurotransmitters in the CNS c. Degeneration of the basal nuclei with a deficit of dopamine d. Deficit of acetylcholine and degeneration of the motor cortex in the frontal lobe 78. Which of the following are common early manifestations of Parkinson’s disease? a. Tremors at rest in the hands and repetitive motion of the hands b. Extreme weakness in the legs and spastic movements in the arms c. Visual deficits and speech impairment d. Loss of facial expressions and altered posture and gait 79. In which type of neuron is progressive degeneration occurring with amyotrophic lateral sclerosis (ALS)? a. Upper motor neurons b. Upper and lower motor neurons c. Motor and sensory neurons d. Motor, sensory, and autonomic system neurons 80. Which of the following statements does NOT apply to myasthenia gravis? a. The cholinergic receptors at the neuromuscular junctions are damaged. b. It is an autoimmune disorder. c. Muscle weakness and fatigue occur in the face and neck. d. Dementia develops in the later stage. 81. Which statement applies to Huntington’s disease? a. It is inherited as an autosomal recessive trait. b. It is manifested in individuals by age 20 years. c. It presents with choreiform movements in the upper body and decreased ability to concentrate. d. It causes decreased levels of all neurotransmitters in the CNS. 82. What are the characteristic changes in the brain of a patient with Alzheimer’s disease? a. Cortical atrophy with plaques and neurofibrillary tangles, impairing conduction b. Increased acetylcholine (ACh) and decreased GABA and serotonin levels c. Obstruction of many small arteries and arterioles throughout the cerebral cortex d. Vacuoles forming in the neurons, rapidly destroying them 83. Which disease is associated with excessive dopamine secretion, decreased gray matter in the temporal lobes, and abnormal hippocampal cells in the brain? a. Creutzfeldt-Jakob disease b. Schizophrenia c. Panic disorder d. Depression 84. In which disorders do biochemical abnormalities involving the neurotransmitters in the brain occur? (Select all that apply) a. Bipolar disorder b. Schizophrenia c. Huntington’s disease d. AIDS dementia 85. Which of the following are typical characteristics associated with schizophrenia? a. Disorganized thought processes, short attention span, delusions b. Lack of energy and motivation, poor concentration, insomnia c. Hyperventilation, tachycardia, intense anxiety d. Memory loss, mood swings, hostile behavior 86. What is the typical initial effect of a herniated intervertebral disc at the L4 to L5 level? a. Back pain and weakness at waist level b. Muscle weakness in both legs c. Lower back pain radiating down the leg d. Urinary incontinence e. 87. What causes a herniated intervertebral disc? a. A tear in the nucleus pulposus b. A protrusion of the nucleus pulposus through the annulus fibrosis c. Displacement of the annulus fibrosis between the laminae d. Failure of the spinous processes to restrict movement of the intervertebral disc 88. Which of the following dietary supplements has reduced the incidence of spina bifida in recent years? a. Vitamin B6 b. Folic acid c. Vitamins A and D d. Zinc and magnesium 89. Which of the following is the most common cause of brain damage in children with cerebral palsy? a. Hyperbilirubinemia b. Hypoglycemia c. Hypoxia d. Trauma 90. The ataxic form of cerebral palsy results from damage to the: a. Cerebellum b. Motor cortex c. Basal nuclei d. Pyramidal tracts 91. Which of the following is used to confirm the diagnosis of, and classify, seizures? a. Characteristics of the aura b. Presence of precipitating factors c. Electroencephalogram d. Changes in the characteristics of cerebrospinal fluid 92. Which statement does NOT apply to status epilepticus? a. Seizures are recurrent or continuous without full recovery between episodes. b. Severe hypoxia and acidosis develop. c. Person does not lose consciousness during seizure. d. If the episode persists, there may be additional brain damage. 93. Which type of seizure commonly occurs in children? a. Absence b. Tonic-clonic c. Focal d. Complex partial 94. All of the following may precipitate a seizure EXCEPT: a. Hypoglycemia b. Hypoventilation c. Brain abscess d. High fever in young children 95. Which of the following is NOT a typical effect of advanced Parkinson’s disease? a. Difficulty chewing and swallowing b. Urinary retention c. Loss of vision d. Orthostatic hypotension 96. Which of the following is a typical early sign of amyotrophic lateral sclerosis (ALS)? a. Impaired ventilation b. Cognitive impairment c. Poor control of eye movement d. Weakness and muscle atrophy in upper limbs 97. Which of the following classes of drugs may provide temporary improvement in cases of myasthenia gravis? a. Skeletal muscle relaxants b. Dopamine replacement drugs c. Anticholinesterase agents d. GABA replacement drugs 98. Which of the following are typical early signs of Alzheimer’s disease? (Select all that apply) a. Behavioral changes b. Reduced ability to reason and problem solve c. Decreased verbal responses d. Urinary incontinence 99. Which of the following is NOT considered to be a common contributing factor to AIDS dementia? a. Invasion of the central nervous system by HIV b. Development of arteriosclerosis c. Secondary toxoplasmosis infection d. Development of cerebral lymphoma 100. Communicating hydrocephalus causes increased intracranial pressure because of: a. Atresia at the foramen magnum b. Failure of the subarachnoid to absorb CSF c. Obstruction in the lumbar area of the spinal cord d. Scar tissue from encephalitis blocking flow od CSF 101. Failure of the spinous processes to fuse, but without herniation of the meninges, is called: a. Spina bifida occulta b. Meningocele c. Myelomeningocele d. Encephalocele 102. Which statement is TRUE about amyotrophic lateral sclerosis (ALS)? a. Cognitive function remains normal b. ALS affects primarily young women c. Sensory neurons are damaged initially d. Cause of death is usually cardiac arrhythmia 103. Creutzfeldt-Jakob disease is caused by: a. Inheritance of an autosomal dominant trait. b. Infection in the brain by HIV. c. An autoimmune reaction that damages nerve receptors. d. Infection in the brain by a prion. 104. Huntington’s disease is diagnosed by: a. Urinalysis b. Motor skills test c. DNA analysis d. Antibody agglutination test 105. Which statement is TRUE about depression? a. It is classified as a mood disorder. b. Episodes of intense fear are recurrent. c. It is marked by increased appetite and libido. d. It is not a common condition. Chapter 10 1. Which of the following would result from a reduced number of erythrocytes in the blood? a. Increased hemoglobin in the blood b. Decreased hematocrit c. Increased risk of hemostasis d. Decreased osmotic pressure of the blood 2. What term is used to describe a deficit of all types of blood cells? a. Leucopenia b. Neutropenia c. Pancytopenia d. Erythrocytosis 3. Capillary walls consist of: a. Multiple endothelial layers b. A thick layer of smooth muscle c. Two or three epithelial layers d. A single endothelial layer 4. Vitamin K is required by the liver to synthesize: a. Heparin b. Prothrombin c. Amino acids d. Bilirubin 5. Individuals with type O blood are considered to be universal donors because their blood: a. Contains A and B antibodies b. Contains A and B antigens c. Lacks A and B antibodies d. Lacks A and B antigens 6. What are the two circulations that compromise the overall circulatory system? a. Pulmonary and systemic circulations b. Peripheral and central circulations c. Cardiovascular and lymphatic circulations d. Cardiopulmonary and peripheral circulations 7. Chronic blood loss causes anemia because of the a. Shortened life span of erythrocytes b. Lower metabolic rate c. Loss of protein and electrolytes d. Smaller amount of recycles iron available 8. What is the cause of sickle cell anemia? a. A defective gene inherited from both parents b. A chronic bacterial infection c. Bone marrow depression d. An autoimmune reaction 9. Which of the following best describes the characteristic erythrocyte associated with pernicious anemia? a. Hypochromic, microcytic b. Normochromic, normocytic c. Elongated, sickle-shaped d. Megaloblastic or macrocytic nucleated cells 10. What causes numbness and tingling in the fingers of individuals with untreated pernicious anemia? a. Persistent hyperbilirubinemia b. Increasing acidosis affecting metabolism c. Vitamin B12 deficit causing peripheral nerve demyelination d. Multiple small vascular occlusion affecting peripheral nerves 11. Jaundice is one typical sign of: a. Sickle cell anemia b. Aplastic anemia c. Iron deficiency anemia d. Acute leukemia 12. What are the typical early general signs an symptoms of anemia? a. Chest pain, palpitations b. Jaundice, stomatitis c. Pallor, dyspnea, and fatigue d. Bradycardia, heat intolerance 13. What is the cause of oral ulcerations and delayed healing occurring with any severe anemia? a. Lack of folic acid for DNA synthesis b. Frequent microinfarcts in the tissues c. Deficit of oxygen for epithelial cell mitosis and metabolism d. Elevated bilirubin levels in blood and body fluids 14. Which of the following is present with pernicious anemia? a. Pancytopenia b. Hypochlorhydria c. Leukocytosis d. Multiple infarcts 15. Why is pernicious anemia treated with injections of vitamin B12? a. An immune reaction in the stomach would destroy the vitamin b. Digestive enzymes would destroy the vitamin c. The vitamin irritates the gastric mucosa d. The ingested vitamin would not be absorbed into the blood 16. Why do abnormally low hemoglobin values develop with pernicious anemia? a. Decreased production of erythrocytes b. Shorter life span of erythrocytes c. Abnormal structure of hemoglobin chains d. Deficit of folic acid 17. What are the common early signs of aplastic anemia? a. Painful joints and skeletal deformity b. Abdominal discomfort and splenomegaly c. Excessive bleeding and recurrent infections d. Palpitations and chest pain 18. Why do vascular occlusions and infarcts occur frequently with sickle cell anemia? a. The red blood cells are abnormally large b. Increased hemolysis of erythrocytes occurs c. Erythrocytes change to sickle shape when hypoxia occurs d. HbS is unable to transport oxygen 19. Which of the following applies to sickle cell trait? a. Most hemoglobin is in the form of HgS b. Sickling of erythrocytes occurs with severe hypoxia c. Painful sickling crises with multiple infarctions occur frequnently d. A child’s skeletal growth is delayed 20. What is the basic abnormality in thalassemia? a. Several amino acids in the globin chains have been replaced by substitute amino acids b. More than four globin chains are found in the erythrocytes c. The iron molecule is displaced in hemoglobin d. These is failure to synthesize either the alpha or beta chains in the hemoglobin molecule 21. Which of the following can result from a malabsorption problem? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Pernicious anemia 22. In individuals with pernicious anemia, antibodies form to: a. Vitamin B12 b. Intrinsic factor or parietal cells c. Mucus-producing glands d. Hydrochloric acid 23. In cases of polycythemia vera, blood pressure is elevated as a result of: a. Increased blood volume b. Frequent infarcts in the coronary circulation c. Congested spleen and bone marrow d. Increased renin and aldosterone secretions 24. Petechiae and purpura are common signs of: a. Excessive hemolysis b. Leucopenia c. Increased bleeding d. Hemoglobin deficit 25. Which statement applies to the disorder hemophilia A? a. It is transmitted as an X-linked dominant trait. b. There is usually a total lack of factor VIII in the blood. c. Males and females can be carriers. d. Hematomas and hemarthroses are common. 26. Which of the following occurs when disseminated intravascular coagulation develops? a. Increased thrombocytes and blood clotting b. Hemolysis with loss of blood cells c. Massive sepsis and hemorrhage d. Multiple thrombi and deficit of clotting factors 27. Which of the following substances acts as an anticoagulant? a. Prothrombin b. Heparin c. Fibrinogen d. Vitamin K 28. In individuals with acute leukemia, the increased number of malignant leukocytes leads to: (Select all that apply) a. Decreased hemoglobin b. Thrombocytopenia c. Bone pain with increased activity d. Splenomegaly 29. Multiple opportunistic infections develop with acute leukemia primarily because: a. The number of white blood cells is decreased b. Many circulating leukocytes are immune c. Severe anemia interferes with immune response d. Decreased appetite and nutritional intake reduce natural defenses 30. Why is excessive bleeding a common occurrence with acute leukemia? a. Deficit of calcium ions b. Impaired production of prothrombin and fibrinogen c. Decreased platelets d. Dysfunctional thrombocytes 31. Predisposing factors to leukemia commonly include: a. Exposure to radiation b. Certain fungal and protozoal infections c. Familial tendency d. Cigarette smoking 32. Von Willebrand disease is caused by: a. Defective erythrocytes that become deformed in shape, causing occlusion b. Excessive lymphocytes that do not mature c. Absence of a clotting factor that helps platelets clump and stick d. A lack of hemoglobin due to iron deficiency 33. Thrombophilia can result in conditions such as: a. Severe chronic kidney disease b. Peripheral vascular disease c. Deficient calcium levels in the long bones d. Excessive bleeding of hematomas 34. Multiple myeloma is a malignant tumor involving: a. Plasma cells b. Granulocytes c. Bone cells d. Lymph nodes 35. What is the primary treatment for the leukemias? a. Radiations b. Chemotherapy c. Surgery d. Immunotherapy 36. Which of the following statements applies to hemochromatosis. It is: a. Caused by excessive iron intake in the dier b. Results from excessive hemolysis of RBCs c. A metabolic error that leads to excess amounts of hemosiderin, causing damage to organs d. An inherited defect that results in abnormal hemoglobin 37. Thalassemia is caused by: a. A defect in one or more genes for hemoglobin b. An abnormal form of heme c. Abnormal liver production of amino acids and iron d. Overproduction of hypochromic, microcytic RBCs 38. Secondary polycythemia may be associated with: a. Frequent angina attacks b. Certain types of anemia c. Severe chronic bronchitis d. Renal disease 39. All of the following apply to vitamin K EXCEPT: a. It is used as an antidote for warfarin (Coumadin) b. The liver requires it to produce prothrombin c. It is a fat-soluble vitamin d. The bone marrow requires it to synthesize hemoglobin 40. Leukemia is sometimes linked to chromosome abnormalities, as evidence by: a. The presence of Philadelphia chromosome translocation in cases of acute myelogenous leukemia (AML) b. Very low incidence in persons with Down syndrome c. Little evidence of familial incidence d. Transmission as a recessive gene 41. Iron deficiency anemia frequently results from any of the following EXCEPT: a. Certain vegetarian diets b. Excessive menstrual flow c. Malabsorption syndromes d. Diabetes mellitus 42. Which of the following applies to leukemias? a. Chronis leukemias are more common in older people b. AML is the most common childhood leukemia c. Exposure to chemicals is not considered a predisposing factor d. Lymphoid tissue produces abnormal leukocytes 43. A high percentage of blast cells in the leukocyte population indicates a poor prognosis for an individual with: a. Thalassemia b. Acute myelogenous leukemia (AML) c. Myelodysplastic syndrome d. Multiple myeloma 44. Which of the following applies to erythropoietin? a. It is produced by the liver b. It increased iron absorption for heme production c. It stimulates production of red blood cells d. Hypoxia stimulates the red bone marrow to produce erythropoietin 45. Which of the following diagnostic tests would be within the normal range for an individual with hemophilia A? a. Bleeding time b. Coagulation time c. PTT time d. Prothrombin time 46. Which of the following applies to the condition disseminated intravascular coagulation (DIC)? a. It is usually a secondary complication b. It is always initiated by excessive bleeding c. It results in an inability of platelets to adhere d. It is not life threatening 47. In which blood dyscrasia does pancytopenia develop? a. Pernicious anemia b. Aplastic anemia c. Iron deficiency anemia d. Sickle cell anemia 48. Which of the following applies to the etiology of aplastic anemia? It is: a. Idiopathic in many cases b. A genetic disorder c. Predisposed by exposure to myelotoxins d. Both A and C 49. Microcytic and hypochromic erythrocytes are commonly dound as a result of: a. Iron deficiency anemia b. Polycythemia c. Disseminated intravascular coagulation d. Hemophilia A Chapter 13 1. What happens in the lungs when the diaphragm and external intercostal muscles relax? a. Air is forced out of the lungs b. Lung volume increases c. Intrapulmonic pressure decreases d. Intrapleural pressure decreases 2. The respiratory mucosa is continuous through the: (Select all that apply) a. Upper and lower respiratory tracts b. Nasal cavities and the sinuses c. Nasopharynx and oropharynx d. Middle ear cavity and auditory tube 3. Which of the following activities does NOT require muscle contractions and energy? a. Quiet inspiration b. Forced inspiration c. Quiet expiration d. Forced expiration 4. The maximum volume of air a person can exhale after a maximum inspiration is termed the: a. Expiratory reserve volume b. Inspiratory reserve volume c. Total lung capacity d. Vital capacity 5. Which of the following applies to the blood in the pulmonary artery? a. PCO2 is low b. PO2 is low c. Hydrostatic pressure is very high d. It is flowing into the left atrium 6. Which of the following causes bronchodilation? a. Epinephrine b. Histamine c. Parasympathetic nervous system (PSNS) d. Drugs that block b2-adrenergic receptors 7. The central chemoreceptors in the medulla are normally most sensitive to: a. Low oxygen level b. Low concentration of hydrogen ions c. Elevated oxygen level d. Elevated carbon dioxide level 8. Oxygen diffuses from the alveoli to the blood because: a. PO2 is higher in the blood b. PO2 is lower in the blood c. CO2 is diffusing out of the blood d. More CO2 is diffusing out of cells into the blood 9. Carbon dioxide is primarily transported in the blood: a. As dissolved gas b. Attached to the iron molecule in hemoglobin c. As bicarbonate ion d. As carbonic acid 10. What would hypercapnia cause? a. Increased serum pH b. Decreased respirations c. Respiratory acidosis d. Decreased carbonic acid in the blood 11. Which of the following would result from hyperventilation? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. Metabolic acidosis 12. Which of the following values is always decreased with respiratory alkalosis (compensated or decompensated)? a. Serum bicarbonate b. PaCO2 c. Serum pH d. Urine pH 13. What would be the most effective compensation for respiratory acidosis? a. The kidneys eliminating more bicarbonate ions b. The kidneys producing more bicarbonate ions c. The kidneys reabsorbing more hydrogen ions d. An increase in respiratory rate 14. What is the acid-base status of a patient with the following values for arterial blood gases? pH 7.0 PCO2 75 HCO3 36.5 a. Compensated metabolic acidosis b. Decompensated metabolic acidosis c. Compensated respiratory acidosis d. Decompensated respiratory acidosis 15. What does carbaminohemoglobin refer to? a. Replacement of oxygen by carbon monoxide on hemoglobin molecules b. Full saturation of all heme molecules by oxygen c. Carbon dioxide attached to an amino group on the hemoglobin molecule d. Oxygen combined with iron in the hemoglobin molecule 16. Approximately what percentage of bound oxygen is released to the cells for metabolism during an erythrocyte’s journey through the circulatory system? a. 80% b. 25% c. 10% d. 50% 17. The production of yellowish-green, cloudy, thick sputum is often an indication of: a. Bacterial infection b. Cancer tumor c. Damage of lung tissue due to smoking d. Emphysema 18. What does the term hemoptysis refer to? a. Thick, dark red sputum associated with pneumococcal infection b. Reddish-brown granular blood found in vomitus c. Bright red streaks of blood in frothy sputum d. Bloody exudate in the pleural cavity 19. Orthopnea is: a. Very deep, rapid respirations b. Difficulty breathing when lying down c. Waking up suddenly, coughing, and struggling for breath d. Noisy breathing with stridor or rhonchi 20. Light bubbly or crackling breathing sounds associated with serous secretions are called a. Rhonchi b. Stridor c. Rales d. Wheezing 21. Choose the correct information applying to laryngotracheobronchitis: a. Viral infection in infant under 12 months b. Viral infection in child, 3 months to 3 years c. Bacterial infection in infant under 6 months d. Bacterial infection in child, 3 to 7 years 22. Signs and symptoms of acute sinusitis usually include: a. Serous nasal discharge and chronic cough b. Copious frothy sputum and dyspnea c. Severe localized pain in the facial bone and tenderness in the face d. Fetid breath and sore throat 23. What are early signs and symptoms of infectious rhinitis? a. Purulent nasal discharge and periorbital pain b. Serous nasal discharge, congestion, and sneezing c. Copious purulent sputum, particularly in the morning d. Harsh barking cough and wheezing 24. Why does the influenza virus cause recurrent infection in individuals? a. Elderly patients are predisposed to secondary infections b. The virus is transmitted by numerous routes c. The virus is very difficult to destroy d. Viral mutation reduces immunity from prior infections 25. What are typical signs and symptoms of epiglottitis? a. Hyperinflation of the chest and stridor b. Hoarse voice and barking cough c. Sudden fever, sore throat, and drooling saliva d. Sneezing, mild cough, and fever 26. What is the most common cause of viral pneumonia? a. Rhinovirus b. Influenza virus c. Haemophilus influenzae d. Pneumococcus 27. Which of the following describes lobar pneumonia? a. Sudden onset of fever and chills, with rales and rusty sputum b. Insidious onset, diffuse interstitial infection c. Viral infection causing nonproductive cough and pleuritic pain d. Opportunistic bacteria causing low-grade fever with cough and thick greenish sputum 28. How does severe hypoxia develop with pneumonia? a. Acidosis depressed respirations b. Oxygen diffusion is impaired by the congestion c. Inflammatory exudate absorbs oxygen from the alveolar air d. Infection reduces effective compensation by the heart 29. Rust-colored sputum in a patient with pneumonia usually indicates: a. Secondary hemorrhage in the lungs b. Streptococcus pneumonia is the infecting agent c. Prolonged stasis of mucous secretions in the airways d. Persistent coughing has damaged the mucosa in the bronchi 30. What is the cause of Legionnaires’ disease? a. Mycoplasma b. A fungus c. A gram-negative bacterium d. Pneumococcus 31. Select the statement related to tuberculosis: a. The microbe is present in the sputum of all patients with a positive TB skin test. b. The infection is transmitted primarily by blood from an infected person. c. TB is usually caused by an acid-fast bacillus, resistant to many disinfectants. d. The microbe is quickly destroyed by the immune response. 32. How is primary tuberculosis identified? a. Cavitation in the lungs and spread of the microbe to other organs b. Persistent productive cough, low-grade fever, and fatigue c. Caseation necrosis and formation of a tubercle in the lungs d. Multiple granulomas in the lungs and rapid spread of the microbe 33. When does active (secondary) infection by Mycobacterium tuberculosis with tissue destruction occur? a. When host resistance is decreased b. When a hypersensitivity reaction is initiated c. When the BCG vaccine is not administered immediately following exposure to the microbe d. When Ghon complexes form in the lungs 34. Which of the following statements does NOT apply to M. tuberculosis? a. Microbes can survive for a long time inside tubercles. b. The bacilli can survive some adverse conditions such as drying and heat. c. Infection is limited to the lungs. d. The bacilli can be destroyed by antibacterial drugs. 35. Which of the following confirms the presence of active (reinfection) tuberculosis? a. A positive skin test for TB b. A calcified tubercle shown on a chest X-ray c. Identification of acid-fast bacilli in a sputum sample d. A history of exposure to individuals being treated for TB 36. Areas in the United States that show higher rates than the national rate of TB are areas that have a high incidence of: a. HIV and homelessness. b. Obesity and tobacco use c. Elderly persons and radon d. Steroid use and alcoholism 37. Histoplasmosis is caused by a: a. Fungus b. Virus c. Bacillus d. Protozoa 38. Cystic fibrosis is transmitted as a/an: a. X-linked recessive gene. b. Autosomal recessive gene. c. Autosomal dominant gene d. Chromosomal defect 39. The basic pathophysiology of cystic fibrosis is centered on a/an: a. Defect of the exocrine glands. b. Impaired function of the endocrine glands. c. Chronic inflammatory condition of the lungs. d. Abnormal immune response in the lungs and other organs. 40. Growth and development of a child with cystic fibrosis may be delayed because of: a. Deficit of gastric enzymes for protein digestion b. Mucus plugs obstructing the flow of pancreatic enzymes c. Lack of available treatment for steatorrhea d. Abnormal salivary secretions 41. Persistent thick mucus in the bronchioles of a child with cystic fibrosis may cause: (Select all that apply) a. Air trapping b. Atelectasis c. Repeated infections d. Irreversible damage to lung tissue 42. What is a common indicator of cystic fibrosis in the newborn? a. Infant respiratory distress syndrome b. Failure to excrete meconium c. Taste of ammonia on the skin d. Lack of bile secretions 43. What is an early sign of bronchogenic carcinoma? a. Air trapping and overinflation of the lung b. Weight loss c. Bone pain d. Chronic cough 44. Cigarette smoking predisposed to malignant neoplasms because smoking: a. Can cause metaplasia and dysplasia in the epithelium. b. Promotes malignant changes in all types of benign tumors in the lungs. c. Causes paraneoplastic syndrome. d. Increases exposure to carbon monoxide in the lungs. 45. Why does hypercalcemia occur with bronchogenic carcinoma? a. Invasion of the parathyroid gland by the tumor b. Secretion of parathyroid or parathyroid like hormones by the tumor c. Destruction of the ribs d. Failure of the kidney to excrete calcium ions 46. What is a sign indicating total obstruction of the airway by aspirated material? a. Hoarse cough b. Rapid loss of consciousness c. Dyspnea d. Inflammation of the mucosa 47. Which of the following predisposes to postoperative aspiration? a. Reduced pressure of the abdominal organs on the diaphragm b. Depression of the vomiting center by anesthetics and analgesics c. Vomiting caused by drugs or anesthesia d. Lack of food intake for the previous 24 hours 48. What is the pathophysiology of an acute attack of extrinsic asthma? a. Gradual degeneration and fibrosis b. Continuous severe attacks unresponsive to medication c. A hypersensitivity reaction involving release of chemical mediators d. Hyperresponsive mucosa 49. During an acute asthma attack, how does respiratory obstruction occur? (Select all that apply) a. Relaxation of bronchial smooth muscle b. Edema of the mucosa c. Increased secretion of thick, tenacious mucus d. Contraction of elastic fibers 50. What cause the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema? a. Air trapping and hyperinflation b. Persistent coughing to remove mucus c. Recurrent damage to lung tissues d. Dilated bronchi and increased mucous secretions 51. Which of the following is typical of progressive emphysema? a. Vital capacity increases b. Residual lung volume increases c. Forced expiratory volume increases d. Tidal volume increases 52. Destruction of alveolar walls and septae is a typical change in: a. Chronic bronchitis b. Acute asthma c. Emphysema d. Asbestosis 53. A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called: a. Mesothelioma b. COPD c. CF d. MD 54. Which statement does NOT apply to emphysema? a. The surface area available for gas exchange is greatly reduced. b. A genetic defect may lead to breakdown of elastic fibers. c. The ventilation/perfusion ratio remains constant. d. Expiration is impaired. 55. What is the cause of chronic bronchitis? a. Chronic irritation, inflammation, and recurrent infection of the larger airways b. A genetic defect causing excessive production of mucus c. Hypersensitivity to parasympathetic stimulation in the bronchi d. Deficit of enzymes, preventing tissue degeneration 56. Which of the following is typical of chronic bronchitis? a. Decreased activity of the mucous glands b. Fibrosis of the bronchial wall c. Overinflation of bronchioles and alveoli d. Formation of blebs or bullae on the lung surface 57. What are typical pathological changes with bronchiectasis? a. Bronchospasm and increased mucous secretion b. Adhesions and fibrosis in the pleural membranes c. Airway obstructions and weak, dilated bronchial walls d. Fixation of the ribs in the inspiratory position 58. Which of the following are significant signs of bronchiectasis? a. Persistent nonproductive cough, dyspnea, and fatigue b. Persistent purulent nasal discharge, fever, and cough c. Chronic cough, producing large quantities of purulent sputum d. Wheezing and stridor 59. Why does cor pulmonale develop with chronic pulmonary disease? a. The right ventricle pumps more blood than the left ventricle. b. Pulmonary fibrosis and vasoconstriction increase vascular resistance. c. Demands on the left ventricle are excessive. d. Blood viscosity is increased, adding to cardiac workload. 60. Restrictive lung disorders may be divided into two groups based on: a. Patient history of obesity and exposure to other COPD. b. Smoking history and congenital defects. c. Previous lung disease and cardiovascular disorders. d. Anatomical abnormality and lung disease damage, impairing expansion. 61. What is caused by frequent inhalation of irritating particles such as silica? a. Fibrosis and loss of compliance b. Frequent bronchospasm c. Increased number of mucus-producing glands d. Distorted shape of the thorax 62. Pulmonary edema causes severe hypoxia because of: a. Decreased diffusion of carbon dioxide from the alveoli. b. Interference with expansion of the lungs. c. Constant cough and hemoptysis. d. Decreased recoil of lungs and ineffective expiration. 63. Which of the following is NOT a cause of pulmonary edema? a. Left-sided congestive heart failure b. Excessive blood volume (overload) c. Inhalation of toxic gases d. Hyperproteinemia and increasing osmotic pressure of the blood 64. Which of the following is a common source of a pulmonary embolus? a. Mural thrombus from the left ventricle b. Thrombus attached to atheromas in the aorta or iliac arteries c. Thrombus forming in the femoral veins d. A blood clot in the pulmonary vein 65. What is a large-sized pulmonary embolus likely to cause? a. Hypertension and left-sided heart failure b. Atelectasis and respiratory failure c. Hypotension and right-sided heart failure d. Pleural effusion and atelectasis 66. Which manifestation(s) of atelectasis is/are associated with airway obstruction? a. Bradycardia and dyspnea b. Tracheal deviation toward the unaffected side c. Decreased breath sounds on the affected side d. Rales and rhonchi 67. How does total obstruction of the airway lead to atelectasis? a. Decreased surfactant production impairs lung expansion. b. The involved lung is compressed. c. Air is absorbed from the alveoli distal to the obstruction. d. Air continues to be inspired but is trapped distal to the obstruction. 68. How does a large pleural effusion lead to atelectasis? a. The cohesion between the pleural membranes is disrupted. b. There is decreased intrapleural pressure. c. The mediastinal contents compress the affected side. d. Pleuritic pain causes very shallow breathing. 69. When does flail chest usually occur? a. An open puncture wound involves the pleural membranes. b. The visceral pleura is torn by a fractured rib. c. Several ribs are fractured at two sites. d. Increasing fluid in the pleural cavity causes atelectasis. 70. With a flail chest injury, events during inspiration include which of the following? a. Air is sucked into the lung through the chest wall. b. The mediastinum shifts toward the unaffected side. c. The floating segment is pushed outward. d. The trachea deviates toward the affected side. 71. How is cardiac output reduced with a flail chest injury? a. Atelectasis compresses the heart. b. Venous return is impaired. c. Intrapleural pressure is decreased. d. Air pressure continues to increase in the pleural space. 72. Which of the following is a manifestation of a simple closed pneumothorax? a. Decreased respiratory rate b. Tracheal deviation toward the unaffected lung c. Asymmetrical chest movements d. Increased breath sounds on the affected side 73. Which of the following is an effect of a large open pneumothorax (sucking wound)? a. Mediastinal flutter, impairing venous return b. Increased venous return c. Progressive atelectasis of both lungs d. Overexpansion of the unaffected lung 74. With a tension pneumothorax, which factors contribute to severe hypoxia? a. Decreasing compression of the inferior vena cava b. More air leaving the pleural cavity on expiration than entering with inspiration c. Shift of the mediastinal contents toward the affected lung d. Continually increasing pressure on the unaffected lung 75. Which of the following statements describe the pathophysiology of adult respiratory distress syndrome? (Select all that apply) a. Damage leading to increased permeability of the alveolar capillary membranes b. Decreased surface tension in the alveoli c. Excessive fluid and protein interstitially and in the alveoli d. Multiple diffuse hemorrhages in the lungs 76. Infant respiratory distress syndrome results from: a. Insufficient surfactant production b. Incomplete expiration shortly after birth c. Retention of fluid in the lings after birth d. Immature neural control of respirations 77. Obstruction in the upper airway is usually indicated by: a. Stridor b. Rales c. Wheezing d. Orthopnea 78. Which of the following does NOT apply to carbon dioxide? a. It diffuses across membranes much more easily than does oxygen. b. It is carried in blood as carbaminohemoglobin. c. It can be converted into bicarbonate ion. d. It is replaced on hemoglobin by oxygen in the lungs. 79. Whenever PO2 levels decrease below normal, PCO2 levels: a. Increase b. Decrease also c. May or may not change d. Increase slightly 80. Laryngotracheobronchitis is typically manifested by: a. Drooling and difficulty swallowing. b. Hoarse voice and barking cough. c. Sore and scratchy throat with fever. d. Wheezing and dyspnea. 81. Lobar pneumonia is usually caused by: a. Mycoplasma pneumoniae. b. Streptococcus pneumoniae. c. Legionella pneumophila. d. Pneumocystis carinii. 82. Severe acute respiratory syndrome (SARS) is caused by a/an: a. Rhinovirus b. Mycoplasma c. Influenza virus d. Coronavirus 83. SARS typically begins as a flulike syndrome followed, after a few days, by: a. Increased exudates in the bronchial tree and pleural cavity. b. Productive cough and lobar consolidation. c. Interstitial lung congestion, dyspnea, and dry cough. d. Hemoptysis and necrosis of mucous membrane. 84. In addition to effects on the lungs and pancreas, cystic fibrosis results in: a. Excess bile production. b. High sodium chloride content in saliva and sweat. c. Gastric ulcers. d. Frequent ear and sinus infections. 85. Which of the following is a significant early sign of bronchogenic carcinoma in a smoker? a. Frequent nonproductive cough b. Fever, dyspnea, generalized aching c. Production of large volumes of purulent sputum d. Hemoptysis and weight loss 86. Which of the following is likely to cause pneumothorax or hemothorax in a patient with bronchogenic carcinoma? a. The tumor obstructs a major bronchus. b. Compression of lung tissue by the tumor causes atelectasis. c. The tumor causes inflammation and erosion of the pleural membranes. d. Inflammation around the tumor causes exudate in the small bronchi. 87. Which of the following would confirm a diagnosis of primary tuberculosis? a. A positive tuberculin skin test b. Occurrence of hemoptysis c. Unproductive cough with absence of sputum d. Small areas of calcification on a chest X-ray 88. Which of the following drugs is usually prescribed for prophylaxis in persons in close contact with a patient with active tuberculosis? a. Streptomycin b. Isoniazid c. Rifampin d. Streptomycin 89. Which of the following statements is FALSE? a. TB bacilli are spread by oral droplet. b. TB bacilli are slow-growing bacteria. c. Active TB must be treated in hospital for many months. d. Active TB can be prevented by good host resistance. 90. Choose the correct reason for severe hypoxia occurring with pulmonary edema: a. Diffusion of oxygen into the alveoli is impaired. b. Fluid in the pleural cavity prevents normal lung expansion. c. Increased concentration of CO2 impairs diffusion of oxygen. d. Increased blood flow through the lungs prevents diffusion of gases. 91. Which of the following drugs in an inhaler would likely be carried by individuals to provide immediate control of acute asthma attacks? a. A glucocorticoid b. Epinephrine c. Cromolyn d. A b2-adrenergic agent 92. Development of emphysema in a nonsmoker may be the result of: a. A genetic factor b. Obesity c. Vitamin deficiencies d. A developmental defect 93. Which factors contribute to postoperative atelectasis? (Select all that apply) a. Decreased secretions in the airways b. Drug-related respiratory depression c. Abdominal distention and pain d. Excessive deep-breathing and coughing 94. Primary atypical pneumonia (PAP) is caused by: a. Klebsiella oxytoca. b. Candida albicans. c. Mycoplasma pneumoniae. d. Streptococcus pneumoniae. 95. All of the following are expected with infant respiratory distress syndrome EXCEPT: a. Severe hypoxia b. Respiratory alkalosis c. Pulmonary vasoconstriction d. Fluid and protein in the alveoli 96. Which factor usually causes metabolic acidosis to develop in association with hypoxia? a. Anaerobic metabolism b. Failure to excrete CO2 c. Liver dysfunction d. Increased blood volume 97. Mediastinal flutter associated with chest injury is likely to: a. Cause pulmonary edema b. Cause hypocapnia c. Increase lung expansion d. Decrease venous return to the heart 98. Which of the following individuals is NOT considered to be at high risk for developing active tuberculosis? a. Homeless individuals b. Individuals with AIDS c. Persons who experience acute asthma attacks d. Those living in institutions 99. Which of the following distinguishes influenza from infectious rhinitis? a. Influenza is a viral infection b. Treatment is symptomatic c. Influenza has a sudden onset with fever, marked muscle aching, and severe malaise. d. Complications can occur with influenza. 100. The use of a continuous positive airway pump in the treatment of sleep apnea will: a. Reduce bronchospasm b. Force expansion of pleural membranes c. Maintain an open airway d. Awaken the person and increase respirations 101. Hemoptysis is a significant sign of: a. Pleural effusion b. Pulmonary embolus c. Pulmonary edema d. Atelectasis 102. Which of the following applies to anthrax infection? a. It is caused by a virus that mutates frequently. b. When inhaled, it causes flulike symptoms followed by acute respiratory distress. c. There is a long incubation period, often months, following exposure. d. It is a common infection in North America. 103. The mutated gene for cystic fibrosis is located on the: a. Seventh chromosome b. Tenth chromosome c. Fifteenth chromosome d. X chromosome