Term
What happens in the lungs when the diaphragm relaxes?
a. Air is forced out of the lungs.
b. Lung volume increases.
c. Intrapulmonic pressure decreases.
d. Intrapleural pressure decreases. |
|
Definition
|
|
Term
The respiratory mucosa is continuous through the:
1. upper and lower respiratory tracts
2. nasal cavities and the sinuses
3. nasopharynx and oropharynx
4. middle ear cavity and auditory tube
a. 1 only
b. 1, 2
c. 2, 3
d. 1, 3, 4
e. 1, 2, 3, 4 |
|
Definition
|
|
Term
Which of the following activities does NOT require muscle contractions and energy?
a. quiet inspiration
b. forced inspiration
c. quiet expiration
d. forced expiration |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
Which of the following causes bronchodilation?
a. epinephrine
b. histamine
c. parasympathetic nervous system
d. drugs that block beta-2 adrenergic receptors |
|
Definition
|
|
Term
The central chemoreceptors are normally most sensitive to:
a. low oxygen level
b. low concentration of hydrogen ions
c. elevated oxygen level
d. elevated carbon dioxide level |
|
Definition
|
|
Term
97. 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 |
|
Definition
|
|
Term
Which of the following distinguishes influenza from infectious rhinitis?
a. Influenza is a viral infection.
b. The virus causing influenza mutates frequently.
c. Influenza has a sudden onset with fever, marked muscle aching, and severe malaise.
d. Complications can occur with influenza. |
|
Definition
|
|
Term
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. prevent collapse of pharyngeal tissues
d. awaken the person and increase respirations |
|
Definition
|
|
Term
Hemoptysis is a significant sign of:
a. pleural effusion
b. pulmonary embolus
c. pulmonary edema
d. atelectasis |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
The mutated gene for cystic fibrosis is located on the:
a. seventh chromosome
b. tenth chromosome
c. fifteenth chromosome
d. X chromosome |
|
Definition
|
|
Term
Aspiration pneumonia is usually caused by aspiration of:
a. sharp pointed objects
b. solid round objects
c. water
d. liquids such as oils or milk |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
What would hypercapnia cause?
a. increased serum pH
b. decreased respirations
c. respiratory acidosis
d. decreased carbonic acid in the blood |
|
Definition
|
|
Term
Which of the following would result from hyperventilation?
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic alkalosis
d. metabolic acidosis |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
What would be the most effective compensation for respiratory acidosis?
a. the kidneys secreting more bicarbonate ions
b. the kidneys producing more bicarbonate ions
c. the kidneys reabsorbing more hydrogen ions
d. an increase in respiratory rate |
|
Definition
|
|
Term
What is the acid-base status of a patient with the following values for arterial blood gases?
serum bicarbonate 36.5 mmol/L (normal range: 22-28)
PCO2 75 mm Hg (normal range: 35-45)
serum pH 7.0
a. compensated metabolic acidosis
b. decompensated metabolic acidosis
c. compensated respiratory acidosis
d. decompensated respiratory acidosis |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
How is oxygen toxicity manifested?
a. a decreased response to increased CO2 levels in the blood
b. decreased pulmonary compliance with diffuse atelectasis
c. depression of bone marrow activity
d. damage to both peripheral and central chemoreceptors |
|
Definition
|
|
Term
How is respiratory failure defined?
a. cessation of respiratory function
b. inability to increase respiratory function during increased activity
c. the presence of slow, irregular respirations
d. PaO2 less than 50 mm Hg or PaCO2 greater than 50 mm Hg |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Orthopnea is:
a. very deep, rapid respirations
b. difficulty breathing in a recumbent position
c. waking up suddenly, coughing, and struggling for breath
d. noisy breathing with stridor or rhonchi |
|
Definition
|
|
Term
20. 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, 3-7 years |
|
Definition
|
|
Term
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 and tenderness in the face
d. fetid breath and sore throat |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
What is the most common cause of viral pneumonia?
a. Rhinovirus
b. influenza virus
c. Haemophilus influenza
d. Pneumococcus |
|
Definition
|
|
Term
26. 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 cause low-grade fever with cough and thick greenish sputum |
|
Definition
|
|
Term
How does severe hypoxia develop with pneumonia?
a. acidosis depresses 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 |
|
Definition
|
|
Term
Rust-colored sputum in a patient with pneumonia usually indicates:
a. secondary hemorrhage in the lungs
b. Streptococcus pneumoniae is the infecting agent
c. prolonged stasis of mucous secretions in the airways
d. persistent coughing has damaged the mucosa in the bronchi |
|
Definition
|
|
Term
What is the cause of Legionnaires’ disease?
a. Mycoplasma
b. a fungus
c. a gram-negative bacterium
d. Pneumococcus |
|
Definition
|
|
Term
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. The microbe is an acid-fast bacillus, resistant to many disinfectants.
d. The microbe is quickly destroyed by the immune response. |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
When does active (secondary) infection by M. tuberculosis with tissue destruction occur?
a. Host resistance is decreased for any reason.
b. A hypersensitivity reaction is initiated.
c. BCG vaccine is not administered immediately following exposure to the microbe.
d. Ghon complexes form in the lungs. |
|
Definition
|
|
Term
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 are destroyed by most antibacterial drugs. |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Which of the following is a major factor contributing to the current increase in cases of tuberculosis?
a. increased use of BCG vaccine
b. the increase in immunodeficient individuals
c. the lack of effective medication
d. increased use of unpasteurized milk |
|
Definition
|
|
Term
Histoplasmosis is caused by a:
a. fungus
b. virus
c. bacillus
d. protozoa |
|
Definition
|
|
Term
Cystic fibrosis is transmitted as a/an:
a. X-linked recessive gene
b. autosomal recessive gene
c. autosomal dominant gene
d. chromosomal defect |
|
Definition
|
|
Term
The basic pathophysiology of cystic fibrosis is considered to be:
a. an abnormality of the exocrine glands
b. impaired function of the endocrine glands
c. chronic inflammatory condition of the lungs
d. an abnormal immune response in the lungs and other organs |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Persistent thick mucus in the bronchioles of a child with cystic fibrosis may cause:
1. air trapping
2. atelectasis
3. repeated infections
4. irreversible damage to lung tissue
a. 1, 2
b. 2, 4
c. 1, 3, 4
d. 1, 2, 3, 4 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
What is an early sign of bronchogenic carcinoma?
a. air trapping and overinflation of the lung
b. pain when coughing
c. hemoptysis
d. chronic cough |
|
Definition
|
|
Term
Cigarette smoking predisposes to malignant neoplasms because smoking:
a. causes 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 |
|
Definition
|
|
Term
Why does hypercalcemia occur with bronchogenic carcinoma?
a. invasion of the parathyroid gland by the tumor
b. secretion of parathyroid or like hormone by the tumor
c. destruction of the ribs
d. failure of the kidney to excrete calcium ions |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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. depression of the cough and swallow reflexes by drugs
d. lack of food intake for the previous 24 hours |
|
Definition
|
|
Term
What is the pathophysiology of an acute attack of extrinsic asthma?
a. gradual degeneration and fibrosis
b. continuous severe attacks unresponsive to medication
c. type 1 hypersensitivity reaction
d. hyperresponsive mucosa |
|
Definition
|
|
Term
During an acute asthma attack, how does respiratory obstruction occur?
1. relaxation of bronchial smooth muscle
2. edema of the mucosa
3. increased secretion of thick, tenacious mucus
4. contraction of elastic fibers
a. 1, 2
b. 1, 3
c. 2, 3
d. 2, 4 |
|
Definition
|
|
Term
49. What cause the expanded 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 |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
Destruction of alveolar walls and septae is a typical change in:
a. chronic bronchitis
b. acute asthma
c. emphysema
d. asbestosis |
|
Definition
|
|
Term
When patients with chronic hypercapnia are administered oxygen:
a. only high concentrations of oxygen should be administered
b. carbon dioxide should be included with the oxygen administered
c. blood levels of oxygen should remain slightly below normal
d. serum pH must remain high |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
55. Which of the following are 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 |
|
Definition
|
|
Term
What are typical pathological changes with bronchiectasis?
a. bronchospasm and increased mucus 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 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
What are common signs of cor pulmonale?
a. rales and rhonchi
b. paroxysmal nocturnal dyspnea
c. secondary polycythemia and cyanosis
d. hepatomegaly and edema in the legs |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Pulmonary edema causes severe hypoxia because of:
a. decreased diffusion of carbon dioxide from the alveoli
b. increasing difficulty expanding the lungs
c. constant cough and hemoptysis
d. decreased recoil of lungs and ineffective expiration |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
How does total obstruction of a major bronchus 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. |
|
Definition
|
|
Term
How does a large pleural effusion cause 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. |
|
Definition
|
|
Term
When does flail chest 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. |
|
Definition
|
|
Term
With a flail chest injury, events during inspiration include:
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 |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Which of the following is an effect of a large open pneumothorax (sucking wound)?
a. mediastinal flutter
b. increased venous return
c. progressive atelectasis of both lungs
d. overexpansion of the unaffected lung |
|
Definition
|
|
Term
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 enters with inspiration
c. shift of the mediastinal contents toward the affected lung
d. continually increasing pressure on the unaffected lung |
|
Definition
|
|
Term
Which of the following statements describe the pathophysiology of adult respiratory distress syndrome?
1. damage leading to increased permeability of the alveolar walls
2. decreased surface tension in the alveoli
3. excessive fluid and protein interstitially and in the alveoli
4. multiple diffuse hemorrhages in the lungs
a. 1, 2
b. 1, 3
c. 2, 3
d. 3, 4 |
|
Definition
|
|
Term
Infant respiratory distress syndrome results from:
a. insufficient surfactant production
b. incomplete expiration shortly after birth
c. retention of fluid in the lungs after birth
d. immature neural control of respirations |
|
Definition
|
|
Term
Obstruction in the upper airway is indicated by:
a. stridor
b. rales
c. wheezing
d. orthopnea |
|
Definition
|
|
Term
77. 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. |
|
Definition
|
|
Term
Whenever PO2 levels decrease below normal, then PCO2 levels:
a. increase
b. decrease also
c. may or may not change |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Lobar pneumonia is usually caused by:
a. Mycoplasma pneumonia
b. Streptococcus pneumonia
c. Legionella pneumophila
d. Pneumocystis carinii |
|
Definition
|
|
Term
81. Severe acute respiratory syndrome (SARS) is caused by a/an:
a. Rhinovirus
b. Mycoplasma
c. Influenza virus
d. Coronavirus |
|
Definition
|
|
Term
82. 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 |
|
Definition
|
|
Term
In addition to effects on the lungs and pancreas, cystic fibrosis causes:
a. excess bile production
b. high sodium chloride content in saliva and sweat
c. gastric ulcers
d. frequent ear and sinus infections |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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. |
|
Definition
|
|
Term
86. Which of the following would confirm a diagnosis of primary tuberculosis?
a. a positive tuberculin skin test
b. occurrence of hemoptysis
c. sputum containing TB bacilli
d. small areas of calcification on a chest X-ray |
|
Definition
|
|
Term
87. 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 |
|
Definition
|
|
Term
Which of the following statements is FALSE?
a. TB bacilli are spread by oral droplet.
b. TB bacilli multiply rapidly under anaerobic conditions.
c. Active TB must be treated in hospital for many months.
d. Active TB can be prevented by good host resistance. |
|
Definition
|
|
Term
Choose the correct reason for severe hypoxia occurring with pulmonary edema:
a. Diffusion of oxygen into the pulmonary capillaries 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. |
|
Definition
|
|
Term
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 beta-2-adrenergic agent |
|
Definition
|
|
Term
Which of the following values for arterial blood gases would be expected in a patient with advanced emphysema?
a. decreased PCO2, decreased bicarbonate ion, serum pH 7.35
b. decreased PCO2, increased bicarbonate ion, serum pH 7.4
c. increased PCO2, increased bicarbonate ion, serum pH 7.35
d. increased PCO2, increased bicarbonate ion, serum pH 7.45 |
|
Definition
|
|
Term
Which factors contribute to postoperative atelectasis?
1. decreased secretions in the airways
2. drug-related respiratory depression
3. abdominal distention and pain
4. excessive deep-breathing and coughing
a. 1, 2
b. 2, 3
c. 3, 4
d. 1, 4 |
|
Definition
|
|
Term
93. Pleurisy associated with lobar pneumonia is manifested by:
a. rales and hemoptysis
b. severe dyspnea, fever and chills
c. cyclic chest pain and friction rub
d. productive cough with rusty sputum |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
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 |
|
Definition
|
|
Term
Which of the following structures is most likely to be located in the renal medulla?
a. proximal convoluted tubule
b. glomerulus
c. loop of Henle
d. afferent arteriole |
|
Definition
|
|
Term
Which of the following is NOT a function of the kidney?
a. regulation of body fluid concentrations
b. removal of nitrogenous and acidic wastes
c. activation of vitamin D
d. production of albumin |
|
Definition
|
|
Term
3. Which of the following describes the correct flow of blood in the kidney?
a. afferent arteriole to the peritubular capillaries to the venule
b. efferent arteriole to the glomerular capillaries to the peritubular capillaries
c. peritubular capillaries to the glomerular capillaries to the venule
d. afferent arteriole to the glomerular capillaries to the efferent arteriole |
|
Definition
|
|
Term
Which of the following describes the flow of filtrate in the kidney?
a. the collecting duct to the distal convoluted tubule to the renal pelvis
b. Bowman’s capsule to the proximal convoluted tubule to the loop of Henle
c. the loop of Henle to the collecting duct to Bowman’s capsule
d. the distal convoluted tubule to the loop of Henle to the collecting duct |
|
Definition
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|
Term
Which of the following describes the normal flow of urine?
a. collecting duct to the renal pelvis to the ureter to the bladder
b. renal pelvis to the urethra to the bladder to the ureter
c. ureter to the renal pelvis to the urethra to the bladder
d. collecting duct to the ureter to the urethra |
|
Definition
|
|
Term
Which statement about the bladder is TRUE?
a. The bladder wall lacks rugae.
b. Three openings from the urinary bladder form the trigone.
c. It contracts when stimulated by the sympathetic nervous system.
d. Continuous peristalsis in the bladder wall promotes urine flow. |
|
Definition
|
|
Term
Which of the following increases glomerular filtration rate?
a. increased plasma osmotic pressure
b. dilation of the efferent arteriole
c. increased hydrostatic pressure in the glomerular capillaries
d. constriction of the afferent arteriole |
|
Definition
|
|
Term
8. Normally, which of the following is reabsorbed completely from the filtrate?
a. glucose
b. sodium
c. water
d. urea |
|
Definition
|
|
Term
9. Which substance directly controls the reabsorption of water from the collecting ducts?
a. renin
b. aldosterone
c. angiotensin
d. antidiuretic hormone |
|
Definition
|
|
Term
Under what circumstances do cells in the kidneys secrete renin?
a. The urine pH decreases.
b. Blood flow in the afferent arteriole decreases.
c. Serum potassium levels are high.
d. Serum osmotic pressure increases. |
|
Definition
|
|
Term
Which of the following should be present in the filtrate in the proximal convoluted tubule?
a. plasma proteins
b. erythrocytes
c. sodium and potassium ions
d. leukocytes |
|
Definition
|
|
Term
From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.
a. albumin
b. urea
c. sodium
d. creatinine |
|
Definition
|
|
Term
Which of the following functions would be impaired when tubular epithelial cells have been damaged?
a. adjusting the specific gravity of the urine
b. reabsorbing the plasma proteins
c. secreting renin
d. exchanging sodium ions for bicarbonate ions |
|
Definition
|
|
Term
When a respiratory infection with high fever is present in the body, how would the kidney tubules maintain normal pH of body fluids?
a. Increase the flow of filtrate.
b. Secrete more acids and reabsorb more bicarbonate ions.
c. Excrete a larger volume of more dilute urine.
d. Retain more potassium ions in exchange for sodium ions. |
|
Definition
|
|
Term
When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?
a. diffusion
b. osmosis
c. ultrafiltration
d. active transport |
|
Definition
|
|
Term
What is the cause of most cases of pyelonephritis?
a. an ascending infection by E. coli
b. abnormal immune response, causing inflammation
c. dialysis or other invasive procedure
d. virulent bacteria in the blood |
|
Definition
|
|
Term
Which disease is manifested by dysuria and pyuria?
a. nephrotic syndrome
b. cystitis
c. glomerulonephritis
d. urolithiasis |
|
Definition
|
|
Term
Why may acute pyelonephritis and cystitis follow untreated prostatitis?
a. Microbes spread through the circulation.
b. Antibodies have not yet formed.
c. There is no effective treatment.
d. There is a continuous mucosa along these structures. |
|
Definition
|
|
Term
Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of:
a. microbes, leukocytes, and pus in the urine
b. painful micturition
c. urgency and frequency
d. urinary casts and flank pain |
|
Definition
|
|
Term
In a case of acute pyelonephritis, what is the cause of flank pain?
a. inflammation, causing ischemia in the tubules
b. inflammation, stretching the renal capsule
c. increasing glomerular permeability, creating an increased volume of filtrate in the kidney
d. microbes irritating the tissues |
|
Definition
|
|
Term
Which pathophysiologic process applies to acute poststreptococcal glomerulonephritis?
a. streptococcal infection affects both the glomerular and tubule functions
b. ischemic damage occurs in the tubules, causing obstruction and decreased GFR
c. immune complexes deposit in glomerular tissue, causing inflammation
d. increased glomerular permeability for unknown reasons |
|
Definition
|
|
Term
What causes the dark urine associated with acute poststreptococcal glomerulonephritis?
a. increased glomerular permeability resulting in gross hematuria
b. proteinuria and microscopic hematuria from the inflammation
c. pyuria from inflammatory exudate
d. bleeding from ulcerations in the kidneys |
|
Definition
|
|
Term
Renal disease frequently causes hypertension because:
a. albuminuria increases vascular volume
b. congestion and ischemia stimulates release of renin
c. ADH secretion is decreased
d. damaged tubules absorb large amounts of filtrate |
|
Definition
|
|
Term
Urinary casts are present with acute poststreptococcal glomerulonephritis because of:
a. large numbers of microbes and leukocytes enter the filtrate
b. ruptured capillaries release debris into the tubules
c. normal reabsorption of cells and proteins cannot take place
d. inflamed tubules mold RBCs and protein into a typical mass |
|
Definition
|
|
Term
Which disease would cause an increased ASO titer and elevated serum ASK?
a. nephrotic syndrome
b. acute poststreptococcal glomerulonephritis
c. pyelonephritis
d. polycystic kidney |
|
Definition
|
|
Term
Why does metabolic acidosis develop with bilateral kidney disease?
a. Tubule exchanges are impaired.
b. GFR is increased.
c. Serum urea is increased.
d. More bicarbonate ion is produced. |
|
Definition
|
|
Term
What is the first indicator in the arterial blood gases of acidosis caused by kidney disease?
a. increased carbonic acid
b. increased bicarbonate ion
c. pH less than 7.35
d. decreased bicarbonate ion |
|
Definition
|
|
Term
What would be the long-term effects of chronic infection or inflammation of the kidneys?
a. dehydration and hypovolemia
b. gradual necrosis, fibrosis, and development of uremia
c. sudden anuria and azotemia
d. severe back or flank pain |
|
Definition
|
|
Term
What factors contribute to headache, anorexia, and lethargy with kidney disease?
1. increased blood pressure
2. elevated serum urea
3. anemia
4. acidosis
a. 1 only
b. 2, 4
c. 1, 3, 4
d. 1, 2, 3, 4 |
|
Definition
|
|
Term
What are the significant signs of nephrotic syndrome?
a. hyperlipidemia and lipiduria
b. pyuria and leucopenia
c. hypertension and heart failure
d. gross hematuria and pyuria |
|
Definition
|
|
Term
Why does blood pressure often remain near normal in patients with nephrotic syndrome?
a. Massive amounts of fluid are lost from the body with polyuria.
b. Renin and aldosterone are no longer secreted.
c. Tubules do not respond to ADH and aldosterone.
d. Hypoproteinemia results in significant fluid shift to the interstitial compartment. |
|
Definition
|
|
Term
Common causes of urolithiasis include all of the following EXCEPT:
a. hypercalcemia
b. hyperlipidemia
c. inadequate fluid intake
d. hyperuricemia |
|
Definition
|
|
Term
Which of the following results from obstruction of the left ureter by a renal calculus?
a. mild flank pain on the affected side
b. hydronephrosis in both kidneys
c. immediate cessation of urine production
d. an attack of renal colic |
|
Definition
|
|
Term
What does hydronephrosis lead to?
a. ischemia and fibrosis in the compressed area
b. multiple hemorrhages in the kidney
c. severe colicky pain radiating into the groin
d. increased GFR |
|
Definition
|
|
Term
Which of the following is a predisposing factor to bladder cancer?
a. prostatic cancer
b. hormonal abnormalities
c. exposure to chemicals and cigarette smoke
d. presence of embryonic tissue |
|
Definition
|
|
Term
What is the common initial sign of adenocarcinoma of the kidney?
a. gross hematuria
b. microscopic hematuria
c. sharp flank pain
d. oliguria |
|
Definition
|
|
Term
Which of the following does NOT usually result from nephrosclerosis?
a. secondary hypertension
b. chronic renal failure
c. acute renal failure
d. increased renin and aldosterone secretions |
|
Definition
|
|
Term
Which of the following relates to polycystic kidney disease?
a. It affects only one of the kidneys.
b. It results in gradual degeneration and chronic renal failure.
c. The kidneys are displaced and the ureters are twisted.
d. The prognosis is good because there is adequate reserve for normal life. |
|
Definition
|
|
Term
Which of the following is related to Wilms’ tumor?
a. direct exposure to carcinogens
b. hormonal imbalance
c. repeated infections
d. a genetic defect |
|
Definition
|
|
Term
With severe kidney disease, either hypokalemia or hyperkalemia may occur and cause:
a. cardiac arrhythmias
b. encephalopathy
c. hypervolemia
d. skeletal muscle twitch or spasm |
|
Definition
|
|
Term
Which of the following indicates the early stage of acute renal failure?
a. polyuria with urine a fixed, low specific gravity
b. hypotension and increased urine output
c. development of decompensated acidosis
d. very low GFR and increased serum urea |
|
Definition
|
|
Term
What is a cause of acute tubule necrosis and acute renal failure?
a. prolonged circulatory shock
b. sudden significant exposure to nephrotoxins
c. crush injuries or burns
d. all of the above |
|
Definition
|
|
Term
Which of the following would likely cause chronic renal failure?
a. cystitis with pyelonephritis in the right kidney
b. circulatory shock
c. persistent bilateral glomerulonephritis
d. obstruction of a ureter by a renal calculus |
|
Definition
|
|
Term
What causes polyuria during the stage of renal insufficiency?
a. loss of tubule function
b. increased blood pressure
c. decreased aldosterone secretion
d. increased GFR |
|
Definition
|
|
Term
What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?
a. decreased parathyroid hormone secretion
b. insufficient calcium in the diet
c. excessive excretion of calcium ions in the urine
d. a deficit of activated vitamin D and hyperphosphatemia |
|
Definition
|
|
Term
Cystitis is more common in females due to:
a. the mucosa in the urinary tract is continuous
b. the urethra is short, wide, and adjacent to areas with resident flora
c. the pH of urine is more acidic in females
d. females have a higher incidence of congenital anomalies |
|
Definition
|
|
Term
Which of the following indicate a decreased GFR?
a. increased serum urea and decreased serum bicarbonate
b. urine with low specific gravity and dark color
c. albuminuria and hematuria
d. hyponatremia and hypokalemia |
|
Definition
|
|
Term
Which of the following is NOT likely to lead to hydronephrosis?
a. renal calculi
b. pyelonephritis
c. nephrosclerosis
d. benign prostatic hypertrophy |
|
Definition
|
|
Term
Which of the following congenital defects is a common cause of cystitis in young children?
a. polycystic kidney
b. horseshoe kidney
c. hypoplasia of the kidney
d. vesicoureteral reflux |
|
Definition
|
|
Term
50. Which factor contributes to severe anemia in individuals with chronic renal failure?
a. increased erythropoietin secretion
b. limited protein intake
c. compensatory increase in bone marrow activity
d. inability to absorb Vitamin B12 and iron |
|
Definition
|
|
Term
When acidosis becomes decompensated in renal failure, a key indicator is:
a. increased PCO2
b. increased bicarbonate ion
c. serum pH dropping below 7.35
d. serum buffer ratio of 20 bicarbonate ion to 1 carbonic acid |
|
Definition
|
|
Term
What is the primary action of the diuretic furosemide?
a. decreased reabsorption of sodium and water
b. decreased reabsorption of H+ in the tubules
c. increased secretion of antidiuretic hormone
d. inhibition of renin |
|
Definition
|
|
Term
Which of the following causes acute renal failure?
a. polycystic kidney disease
b. pyelonephritis in the right kidney
c. nephrosclerosis
d. bilateral acute glomerulonephritis |
|
Definition
|
|
Term
Which of the following is a significant indicator of renal insufficiency?
a. urine with pH of 5
b. increased serum urea and creatinine
c. urine with high specific gravity
d. increased blood pressure |
|
Definition
|
|
Term
Uremic signs of renal failure include all of the following EXCEPT:
a. encephalopathy
b. congestive heart failure
c. osteodystrophy
d. azotemia and acidosis |
|
Definition
|
|
Term
Choose the basic cause of osteodystrophy associated with chronic renal failure.
a. development of hypercalcemia
b. deficit of parathyroid hormone
c. failure of the kidney to activate vitamin D
d. excessive loss of phosphate ion |
|
Definition
|
|
Term
Agenesis is often not diagnosed because:
a. the kidney is displaced from its normal position
b. it is a genetic defect and asymptomatic until mid-life
c. the two functioning kidneys are fused together
d. one kidney provides more than adequate function |
|
Definition
|
|
Term
The normal pH of urine is:
a. 7.35-7.45
b. 4.5- 8.0
c. 1.5-7.5
d. 1.0-7.0 |
|
Definition
|
|
Term
Wilms’ tumor is:
a. a malignant tumor in the bladder
b. an encapsulated mass in one kidney
c. not considered to have a genetic origin
d. manifested in adulthood |
|
Definition
|
|
Term
Reduced urine output resulting from inflammation and necrosis of the tubules is called:
a. oliguria
b. anuria
c. pyuria
d. polyuria |
|
Definition
|
|
Term
The micturition reflex is initiated by:
a. sympathetic nerves in the sacral spinal cord
b. relaxation of the internal sphincter of the bladder
c. increased pressure distending the bladder
d. contraction of the bladder |
|
Definition
|
|
Term
Which of the following results from decreased blood flow into the kidneys?
a. decreasing blood pressure
b. dilation of the afferent arterioles
c. decreased aldosterone secretion
d. increased angiotensin and systemic vasoconstriction |
|
Definition
|
|
Term
In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from:
a. the antecedent infection
b. type III hypersensitivity reaction
c. ascending infection from the bladder
d. spread of infection from the tubules |
|
Definition
|
|
Term
In acute post-streptococcal glomerulonephritis, the inflammation causes:
a. increased permeability of the glomerular capillaries
b. glomerular congestion and decreased GFR
c. decreased blood pressure and edema
d. a, b
e. a, c |
|
Definition
|
|
Term
Circulatory shock causes:
a. decreased GFR and increased renin secretion
b. increased ADH and decreased aldosterone secretion
c. immediate tubule necrosis and obstruction
d. SNS stimulation and vasodilation of afferent and efferent arterioles
e. increased angiotensin II and systemic vasodilation |
|
Definition
|
|
Term
Autoregulation in the kidneys refers to:
a. control of blood flow by the sympathetic nervous system
b. the secretion of renin and activation of angiotensin
c. local minor reflex adjustments in the arterioles to maintain normal blood flow
d. the control of systemic blood pressure by the kidneys |
|
Definition
|
|
Term
The reabsorption of water and electrolytes by the kidneys is directly controlled by:
1. atrial natriuretic hormone
2. antidiuretic hormone
3. angiotensin
4. the levels of bicarbonate ion
a. 2 only
b. 3 only
c. 1, 2
d. 2, 4
e. 1, 3, 4 |
|
Definition
|
|
Term
Uncontrolled essential hypertension may cause chronic renal failure because of:
a. predisposition to recurrent urinary tract infections
b. damage to afferent arterioles and renal ischemia
c. failure of tubules to respond to hormonal controls
d. glomerular congestion causes damaged capillaries |
|
Definition
|
|
Term
In which of the following disorders is stress NOT considered to be an exacerbating factor?
a. cystic fibrosis
b. rheumatoid arthritis
c. herpes simplex
d. multiple sclerosis |
|
Definition
|
|
Term
Improved function of the heart and brain during a stress response results from:
1. glycogenesis
2. bronchodilation
3. vasoconstriction in the skin and viscera
4. decreased metabolic rate
a. 1, 2
b. 2, 3
c. 2, 4
d. 3, 4 |
|
Definition
|
|
Term
In which of the following situations would the stress response be used to prevent blood pressure from dropping too low?
a. increasing anger during an argument
b. writing a final examination
c. fear about a medical diagnosis
d. internal hemorrhage from injuries in a car accident |
|
Definition
|
|
Term
During the stress response, glucocorticoids assist in:
a. increasing blood glucose levels and stabilizing blood pressure
b. depressing and calming cerebral function
c. stimulating increased secretion of aldosterone and insulin
d. preventing excessive secretion of epinephrine |
|
Definition
|
|
Term
Severe, prolonged stress may cause acute renal failure or stress ulcers to develop due to:
a. a deficit of glucose and oxygen in the body
b. development of decompensated acidosis
c. prolonged vasoconstriction and ischemia
d. the supply of hormones has been exhausted |
|
Definition
|
|
Term
Selye defined 3 stages in the stress response. The third stage is designated as the:
a. alarm stage
b. resistance stage
c. stage of exhaustion
d. maladaptive stage |
|
Definition
|
|
Term
The stress response involves the integrated action of the:
1. hypothalamus
2. hypophysis
3. sympathetic nervous system
4. adrenal glands
a. 1, 3
b. 2, 3
c. 1, 2, 4
d. 1, 2, 3, 4 |
|
Definition
|
|
Term
Possible complications caused by prolonged, severe stress include all EXCEPT:
a. hypertension
b. tension headache
c. diabetes mellitus
d. infection
e. blindness |
|
Definition
|
|
Term
A serious consequence of a major disaster, first recognized in war veterans is:
a. stress ulcers
b. delayed tissue healing
c. posttraumatic stress disorder (PTSD)
d. cancer |
|
Definition
|
|
Term
The basic physiologic response to stress is the same in all individuals.
a. true
b. false |
|
Definition
|
|
Term
Which of the following may alter a person’s perception of a stressor?
a. the presence of several stressors at the same time
b. past experiences
c. lack of effective coping mechanisms
d. b, c
e. a, b, c |
|
Definition
|
|
Term
Choose the correct proportion of water to body weight to be expected in a healthy male adult’s body:
a. 30%
b. 45%
c. 60%
d. 70% |
|
Definition
|
|
Term
Choose the correct proportion of blood (to body weight) in an adult male’s body:
a. 30%
b. 20%
c. 10%
d. 4% |
|
Definition
|
|
Term
Insensible fluid loss refers to water lost through:
a. perspiration only
b. feces only
c. perspiration and expiration
d. urine and feces |
|
Definition
|
|
Term
When the osmotic pressure of the blood is elevated above normal, water would shift from the:
a. blood into the cells
b. interstitial compartment into the cells
c. interstitial compartment into the blood
d. cells into the interstitial compartment |
|
Definition
|
|
Term
Which of the following would result from a deficit of plasma proteins?
a. increased osmotic pressure
b. decreased osmotic pressure
c. increased hydrostatic pressure
d. decreased hydrostatic pressure |
|
Definition
|
|
Term
Which of the following would cause edema?
a. decreased capillary hydrostatic pressure
b. increased capillary osmotic pressure
c. decreased capillary permeability
d. increased capillary permeability |
|
Definition
|
|
Term
Which of the following would likely be related to an elevated hematocrit reading?
a. fluid excess
b. fluid deficit
c. increased sodium level
d. decreased erythrocytes |
|
Definition
|
|
Term
Which of the following is a typical sign of dehydration?
a. rapid, strong pulse
b. low hematocrit
c. increased urine output
d. rough oral mucosa |
|
Definition
|
|
Term
Which of the following terms refers to a combination of decreased circulating blood volume combined with excess fluid in a body cavity?
a. dehydration
b. third-spacing
c. hypovolemia
d. water retention |
|
Definition
|
|
Term
Which of the following is a characteristic of sodium ion?
a. It is a cation.
b. It is present primarily in the intracellular fluid.
c. It shifts out of the blood by active transport.
d. Blood levels are controlled by ADH (antidiuretic hormone). |
|
Definition
|
|
Term
Which of the following is a common cause of hyponatremia?
a. loss of the thirst mechanism
b. excessive sweating
c. excessive aldosterone secretion
d. prolonged period of rapid, deep respirations |
|
Definition
|
|
Term
Which of the following is a common effect of both hypokalemia and hyperkalemia?
a. skeletal muscle twitch and cramps
b. oliguria
c. elevated serum pH
d. cardiac arrhythmias |
|
Definition
|
|
Term
Choose the correct effect of increased parathyroid hormone:
a. increased movement of calcium ions into the bones
b. increased activation of vitamin D
c. increased absorption of calcium from the digestive tract
d. decreased reabsorption of calcium in the kidneys |
|
Definition
|
|
Term
Which of the following results from hypocalcemia?
1. low serum phosphate levels
2. nausea and constipation
3. skeletal muscle twitch and spasms
4. weak cardiac contractions
a. 1, 2
b. 1, 4
c. 2, 3
d. 3, 4 |
|
Definition
|
|
Term
Which of the following causes tetany?
a. increased permeability of nerve membranes
b. insufficient calcium in skeletal muscle
c. excess calcium ions inside somatic nerves
d. increased stimulation of the nerves in the cerebral cortex |
|
Definition
|
|
Term
In which of the following processes is phosphate ion NOT a major component?
a. bone metabolism
b. metabolic processes involving ATP
c. blood clotting
d. acid-base balance |
|
Definition
|
|
Term
Which of the following would be considered normal serum pH?
a. 4.5-8
b. 7.0
c. 7.4
d. 8 |
|
Definition
|
|
Term
When many excess hydrogen ions accumulate in the blood, what happens to serum pH? The pH:
a. decreases
b. increases
c. remains constant |
|
Definition
|
|
Term
What is the slowest, but most effective control for acid-base balance?
a. respiratory system
b. buffer systems in the blood
c. kidneys
d. brain |
|
Definition
|
|
Term
Which of the following is essential in order to maintain serum pH within normal range?
a. Carbonic acid and bicarbonate ion must be present in equal quantities.
b. All excess carbonic acid must be excreted by the kidneys.
c. The concentration of bicarbonate ion must remain constant.
d. The ratio of carbonic acid to bicarbonate ion must be 1:20. |
|
Definition
|
|
Term
21. Which is the correct effect on the body of abnormally slow respirations?
a. increased carbonic acid
b. decreased carbonic acid
c. increased bicarbonate ion
d. decreased bicarbonate ion |
|
Definition
|
|
Term
Which condition is likely to cause metabolic acidosis?
a. slow, shallow respirations
b. prolonged diarrhea
c. mild vomiting
d. excessive fluid in the body |
|
Definition
|
|
Term
What would a serum pH of 7.33 in a patient with kidney disease indicate?
a. metabolic alkalosis
b. metabolic acidosis
c. respiratory alkalosis
d. respiratory acidosis |
|
Definition
|
|
Term
Which serum value indicates decompensated metabolic acidosis?
a. pH is below normal range
b. pH is above normal range
c. bicarbonate level decreases
d. bicarbonate level increases |
|
Definition
|
|
Term
When excessive lactic acid accumulates in the body, serum:
a. bicarbonate ion levels decrease
b. bicarbonate ion levels increase
c. carbonic acid levels increase
d. pH increases |
|
Definition
|
|
Term
26. What does acidosis cause?
a. CNS hyperexcitability and nervousness
b. hypokalemia
c. CNS depression and drowsiness
d. hypernatremia |
|
Definition
|
|
Term
Compensation mechanisms in the body for dehydration would include:
a. increased ADH
b. decreased aldosterone
c. slow, strong heart contraction
d. peripheral vasodilation |
|
Definition
|
|
Term
Which acid-base imbalance results from impaired expiration due to emphysema?
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis |
|
Definition
|
|
Term
In patients with impaired expiration associated with emphysema, effective compensation for the acid-base imbalance would be:
a. increased rate and depth of respiration
b. decreased rate and depth of respiration
c. increased urine pH and decreased serum bicarbonate
d. decreased urine pH and increased serum bicarbonate |
|
Definition
|
|
Term
An anxiety attack often causes hyperventilation leading to:
a. increased Pco2
b. decreased Pco2
c. respiratory acidosis
d. metabolic acidosis |
|
Definition
|
|
Term
Young infants are more vulnerable to serious dehydration because of their:
a. decreased body surface area and insensible fluid loss
b. limited renal compensation
c. decreased proportion of fluid to body weight
d. slower metabolic rate |
|
Definition
|
|
Term
Compensation for respiratory system depression due to anesthesia and sedation would be:
a. decreased reabsorption of bicarbonate ions in the kidneys
b. increased secretion of hydrogen ions into the filtrate
c. increased respiratory rate and depth
d. increased renin secretion |
|
Definition
|
|
Term
A prolonged state of metabolic acidosis often leads to:
a. hypokalemia
b. hyperkalemia
c. hyponatremia
d. hypercalcemia |
|
Definition
|
|
Term
Strenuous physical exercise on a hot day is likely to result in:
a. hypokalemia
b. hypernatremia
c. hyperchloremia
d. hypovolemia |
|
Definition
|
|
Term
35. Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic. Not all options are used in the answers.
1. serum pH decreases
2. serum bicarbonate decreases
3. PCO2 decreases
4. respiration decreases
5. respiration increases
6. serum pH increases
7. urine pH decreases
a. 1, 3, 7, 4, 2, 6
b. 5, 2, 7, 3, 4, 1
c. 2, 1, 5, 3, 7, 6
d. 3, 1, 2, 5, 7, 6 |
|
Definition
|
|
Term
Which of the following is a manifestation of respiratory alkalosis?
a. bradycardia
b. drowsiness
c. muscle twitches
d. decreased urine pH |
|
Definition
|
|
Term
Prolonged diarrhea results in:
a. loss of fluid and bicarbonate ions leading to metabolic acidosis
b. increased fluid and serum bicarbonate ions leading to metabolic acidosis
c. loss of chloride ions only, leading to metabolic alkalosis
d. surplus bicarbonate ions, leading to respiratory alkalosis |
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Definition
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Term
In the initial stage, vomiting results in:
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory alkalosis
d. None of the above are correct. |
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Definition
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Term
Which two ions are most important in acid-base balance in the body?
a. K+, Na+
b. Cl- and HCO3-
c. Ca++, Na+
d. Na+, Cl- |
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Definition
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Term
The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance of the carbonic acid and bicarbonate ion levels are controlled by the:
a. liver and pancreas
b. lungs and kidneys
c. lungs and plasma proteins
d. kidneys and bone marrow |
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Definition
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Term
Alkalosis increases irritability and spontaneous stimulation of nerves by:
a. blocking normal nerve conduction
b. increasing the permeability of nerve membranes
c. blocking movement of calcium ions
d. depressing inhibitory actions |
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Definition
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Term
Hypocalcemia causes weak cardiac contractions because:
a. permeability of nerve membranes increases
b. insufficient calcium ions are available for muscle contraction
c. low phosphate ion levels prevent muscle contraction
d. excessive amounts of calcium are stored in cardiac muscle |
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Definition
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Term
Serum potassium levels are affected by:
1. ADH
2. aldosterone
3. serum H+ levels
4. insulin levels
a. 2 only
b. 1, 2
c. 1, 3
d. 2, 3, 4
e. 1, 2, 3 |
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Definition
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Term
Which of the following is the primary control of serum Na+ levels?
a. ADH
b. aldosterone
c. serum H+ levels
d. serum K+ levels |
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Definition
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Term
The control centre for thirst is located in the:
a. kidneys
b. thalamus
c. medulla
d. hypothalamus |
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Definition
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Term
Which statements apply to atrial naturetic peptide?
1. It is secreted by heart muscle cells.
2. It is a hormone secreted by the kidneys.
3. It helps to control water and sodium balance.
4. It is released in response to low blood pressure.
a. 1, 3
b. 1, 4
c. 2, 3
d. 2, 4 |
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Definition
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Term
What kind of control mechanism is indicated when increased blood glucose levels stimulate increased secretion of insulin?
a. control by releasing hormones
b. control by tropic hormones
c. negative feedback control
d. hypothalamus/hypophysis coordination |
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Definition
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Term
What is the most common cause of endocrine abnormalities?
a. malignant neoplasm
b. infection
c. congenital defect
d. benign tumor |
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Definition
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Term
Choose the statement that applies to Type I diabetes mellitus.
a. Onset often occurs during childhood.
b. Relative insufficiency of insulin or insulin resistance develops.
c. It can be treated by diet, weight control and exercise, or oral hypoglycemics.
d. Complications rarely occur. |
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Definition
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Term
Why does polyuria develop with diabetes mellitus?
a. increased thirst
b. ketoacidosis
c. glucosuria develops
d. diabetic nephropathy |
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Definition
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Term
What is the cause of diabetic ketoacidosis?
a. excess insulin in the body
b. loss of glucose in the urine
c. failure of the kidney to excrete sufficient acids
d. increased catabolism of fats and proteins |
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Definition
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Term
What is a precipitating factor for diabetic ketoacidosis?
a. skipping a meal
b. strenuous exercise
c. serious infection
d. insulin overdose |
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Definition
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Term
Which of the following may cause insulin shock to develop?
a. recurrent vomiting
b. missing an insulin dose
c. eating excessively large meals
d. sedentary lifestyle |
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Definition
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Term
Which of the following indicates hypoglycemia in a diabetic?
a. deep, rapid respirations
b. flushed dry skin and mucosa
c. thirst and oliguria
d. staggering gait, disorientation, and confusion |
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Definition
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Term
Which of the following are signs of diabetic ketoacidosis in an unconscious person?
a. pale moist skin
b. thirst and poor skin turgor
c. deep rapid respirations and fruity breath odor
d. tremors and strong rapid pulse |
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Definition
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Term
Which of the following indicates compensated acidosis in the diabetic?
a. increased serum bicarbonate
b. serum pH of 7.35
c. increased serum carbonic acid
d. urine pH 8.0 |
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Definition
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Term
What causes loss of consciousness in a person with diabetic ketoacidosis?
a. toxic effects of excessive insulin
b. excessive glucose in the blood
c. acidosis and hypovolemia
d. lack of glucose in brain cells |
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Definition
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Term
Which of the following does NOT usually develop as a complication of diabetes?
a. osteoporosis
b. nephropathy
c. impotence
d. peripheral neuropathy |
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Definition
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Term
How do many oral hypoglycemic drugs act?
a. to replace insulin in patients with IDDM
b. to transport glucose into body cells
c. to prevent gluconeogenesis
d. to stimulate the pancreas to produce more insulin |
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Definition
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Term
Visual impairment may develop in diabetics, primarily because of:
a. abnormal metabolism in the lens
b. macroangiopathy
c. neuropathy affecting cranial nerves
d. development of exophthalmos |
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Definition
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Term
Which of the following applies to diabetic macro-angiography?
1. It affects the small arteries and arterioles.
2. It is related to elevated serum lipids.
3. It leads to increased risk of myocardial infarction and peripheral vascular disease.
4. It frequently causes damage to the kidneys.
a. 1, 3
b. 1, 4
c. 2, 3
d. 2, 4 |
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Definition
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Term
Why is amputation frequently a necessity in diabetics?
a. necrosis and gangrene in the feet and legs
b. lack of glucose to the cells in the feet and legs
c. severe dehydration in the tissues
d. elevated blood glucose increasing blood viscosity |
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Definition
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Term
How do the different types of available insulin vary?
1. time until onset of action
2. time until peak effect
3. duration of effect
4. source of insulin
a. 1, 2
b. 3, 4
c. 1, 2, 4
d. 1, 2, 3, 4 |
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Definition
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Term
Which one of the following develops hypoglycemia more frequently?
a. Type I diabetics
b. Type II diabetics
c. patients with a poor stress response
d. those with a regular exercise and meal plan |
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Definition
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Term
Which of the following hormonal imbalances causes Addison’s disease?
a. increased glucocorticoids
b. decreased glucocorticoids
c. deficit of ADH
d. deficit of T3 and T4 |
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Definition
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Term
Which of the following hormonal imbalances causes myxedema?
a. increased glucocorticoids
b. decreased glucocorticoids
c. deficit of ADH
d. deficit of T3 and T4 |
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Definition
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Term
Which of the following hormonal imbalances causes diabetes insipidus?
a. increased insulin
b. decreased glucocorticoids
c. deficit of ADH
d. deficit of T3 and T4 |
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Definition
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Term
What is caused by hyperparathyroidism?
a. hypocalcemia
b. tetany
c. bone demineralization
d. deficit of vitamin D |
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Definition
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Term
What is caused by hypocalcemia due to hypoparathyroidism?
1. skeletal muscle twitching or spasm
2. weak cardiac contraction
3. increased secretion of PTH
4. decreased serum phosphate level
a. 1, 2
b. 1, 3
c. 2, 3
d. 3, 4 |
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Definition
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Term
Which of the following applies to acromegaly?
a. It occurs in infants and children.
b. It causes excessive longitudinal bone growth.
c. It results from excessive secretion of GH.
d. It does not change soft tissue growth. |
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Definition
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Term
Which of the following may cause goiter?
1. hyperthyroidism
2. hypothyroidism
3. lack of iodine in the diet
4. pheochromocytoma
a. 1, 4
b. 2, 3
c. 1, 2, 3
d. 1, 2, 3, 4 |
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Definition
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Term
Which signs are typical of Graves’ disease?
a. facial puffiness, bradycardia, and lethargy
b. exophthalmos, heat intolerance, and restlessness
c. delayed physical and intellectual development
d. goiter and decreased BMR |
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Definition
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Term
Characteristics of Cushing’s syndrome include all of the following EXCEPT:
a. heavy body and round face
b. atrophied skeletal muscle in the limbs
c. staring eyes with infrequent blinking
d. atrophy of the lymph nodes |
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Definition
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Term
Why does diabetes insipidus cause polyuria?
a. There is increased osmotic pressure of the filtrate.
b. Damaged tubules cannot reabsorb sufficient fluid.
c. Excessive ADH secretion is present.
d. There is a deficit of ADH.
e. Excessive aldosterone is secreted. |
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Definition
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Term
Which of the following is an effect of long-term glucocorticoid therapy?
a. decreased secretion from the adrenal cortex gland
b. an increased inflammatory response to irritants
c. hypotension and poor circulation
d. increased number of hypersensitivity reactions |
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Definition
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Term
Which of the following is an effect of Addison’s disease?
a. elevated blood glucose levels
b. high blood pressure
c. low serum potassium levels
d. poor stress response |
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Definition
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Term
What is the most common cause of type 1 diabetes mellitus?
a. increased glucose production in the liver
b. destruction of pancreatic cells by an autoimmune reaction
c. increased resistance of body cells to insulin action
d. chronic obesity |
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Definition
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Term
Why does glucosuria occur in diabetics?
a. Excess ketoacids displace glucose into the filtrate.
b. Excess water in the filtrate draws more glucose into the urine.
c. The amount of glucose in the filtrate exceeds the renal tubule transport limit.
d. Sufficient insulin is not available for glucose reabsorption. |
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Definition
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Term
Which of the following are common early signs of a pituitary adenoma?
1. persistent headaches
2. hemianopia
3. hypertension
4. papilledema
a. 1, 4
b. 2, 3
c. 1, 2
d. 1, 3, 4 |
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Definition
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Term
Which of the following does NOT apply to inappropriate ADH syndrome?
a. The cause is excess ADH secretion.
b. Severe hyponatremia results.
c. Excessive sodium is retained.
d. Fluid retention increases. |
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Definition
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Term
What is/are the effect(s) of thyrotoxic crisis?
a. hyperthermia and heart failure
b. hypotension and hypoglycemia
c. toxic goiter and hypometabolism
d. decreased stress response |
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Definition
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Term
What is the recommended treatment for insulin shock if the patient remains conscious?
a. administration of insulin
b. administration of intravenous glucose
c. administration of epinephrine
d. oral administration of concentrated glucose |
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Definition
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Term
Which of the following conditions may precipitate or exacerbate hyperglycemia?
a. hypothyroidism
b. Cushing’s disease
c. Addison’s disease
d. growth hormone deficit |
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Definition
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Term
Which of the following conditions may cause immunosuppression?
a. Graves’ disease
b. acromegaly
c. Cushing’s disease
d. diabetes insipidus |
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Definition
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Term
Which characteristic of hyperosmolar hyperglycemic nonketotic coma (HHNK) differentiates it from diabetic ketoacidosis?
a. Dehydration is less severe.
b. Ketonuria is not present.
c. It only develops in Type 1 diabetes mellitus.
d. CNS depression develops. |
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Definition
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Term
Which of the following is recommended for immediate treatment of hypoglycemic shock?
1. if conscious, immediately give sweet fruit juice, honey, candy, or sugar
2. if unconscious, give nothing by mouth (require intravenous glucose 50%)
3. treat immediately with insulin
4. give large quantity of clear fluids for shock
a. 1, 2
b. 1, 3
c. 2, 3
d. 1, 3, 4 |
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Definition
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Term
All these tissues use glucose without the aid of insulin EXCEPT:
a. liver
b. digestive system
c. exercising skeletal muscle
d. brain |
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Definition
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Term
Differences between Type I and Type II diabetes include:
a. Type 1 diabetes weight gain is common, and Type II weight loss often occurs
b. Type 1 diabetes leads to fewer complications than Type II diabetes
c. Type 1 diabetes may be controlled by adjusting dietary intake and exercise, but Type II diabetes requires insulin replacement
d. Type 1 diabetes occurs more frequently in children and adolescents, and Type II diabetes occurs more often in adults
e. None of the above are correct. |
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Definition
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Term
Complications of diabetes mellitus include:
a. peripheral neuropathy
b. frequent infections
c. cataracts
d. a, c
e. a, b, c |
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Definition
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|
Term
Which of the following often causes hyperparathyroidism?
a. a malignant tumor in the parathyroid glands
b. end-stage renal failure
c. osteoporosis
d. radiation involving the thyroid gland and neck area |
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Definition
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Term
Dwarfism is caused by:
a. excessive levels of somatotropin (GH)
b. a deficit of somatotropin (GH)
c. excessive levels of insulin
d. excessive levels of parathyroid hormone |
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Definition
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Term
Which of the following results from a deficit of antidiuretic hormone (ADH)?
a. inappropriate ADH syndrome
b. gigantism
c. diabetes insipidus
d. myxedema |
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Definition
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|
Term
Goiters occur more frequently in persons living in the:
a. Great Lakes or mountainous regions
b. southwest USA
c. temperate regions
d. areas bordering the oceans |
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Definition
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Term
Which of the following is caused by Graves’ disease?
a. increased metabolic rate
b. decreased size of thyroid gland
c. bradycardia and hypothermia
d. decreased blood levels of T3, T4, and TSH
e. increased epinephrine and norepinephrine |
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Definition
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Term
Which diagnostic test is useful in determining if a pituitary dysfunction is causing a thyroid disorder?
a. serum levels of thyroxine and triiodothyronine
b. serum TSH levels
c. uptake of radioactive iodine (T3 uptake test)
d. presence of antibodies to T3 and T4 |
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Definition
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Term
Severe impairment of all aspects of growth and development, including difficulty feeding, mental retardation, and stunted skeletal growth are associated with:
a. myxedema
b. Cushing’s syndrome
c. diabetes insipidus
d. cretinism
e. Graves’ disease |
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Definition
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Term
A benign tumor of the adrenal medulla that secretes epinephrine and norepinephrine is called:
a. pheochromocytoma
b. Cushing’s syndrome
c. Graves’ disease
d. Addison’s disease |
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Definition
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Term
The anterior pituitary gland secretes all of the following hormones EXCEPT:
a. prolactin (PRL)
b. glucagon
c. adrenocorticotropic hormone (ACTH)
d. growth hormone (GH)
e. antidiuretic hormone |
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Definition
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Term
Which of the following applies to oxytocin?
1. It stimulates contraction of the uterus after delivery.
2. It stimulates ejection of breast milk during lactation.
3. It stimulates mammary gland production of milk.
4. It is released from the adenohypophysis.
a. 1, 2
b. 1, 4
c. 1, 3, 4
d. 1, 2, 3, 4 |
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Definition
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Term
Which of the following is a major function of the hormone norepinephrine?
a. inhibition of an excessive stress response
b. visceral and cutaneous vasoconstriction
c. increased force of heart contraction
d. vasodilation in skeletal muscle |
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Definition
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Term
Early signs of hyperglycemia include polyphagia, which means:
a. thirst
b. increased urine output
c. hunger
d. glucose in the urine |
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Definition
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|
Term
Which of the following hormones is involved in both the stress response and the anti-inflammatory response?
a. aldosterone
b. norepinephrine
c. thyroxine
d. cortisol |
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Definition
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|
Term
Polydipsia occurs with diabetes mellitus when:
a. lack of insulin causes hunger
b. ketone levels rise in the blood
c. polyuria causes dehydration
d. glucosuria causes ketoacidosis |
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Definition
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Term
Trophic hormones include:
a. insulin
b. glucagon
c. triiodothyronine
d. adrenocorticotropic hormone |
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Definition
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|
Term
Metabolic syndrome is marked by:
a. abnormal lipid and glucose metabolism
b. periodic hypotension
c. deficit of glucagon
d. early onset on Type I diabetes mellitus |
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Definition
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Term
Compensation mechanisms occurring in the early stage of diabetic ketoacidosis include:
a. Kussmaul’s respirations
b. polydipsia
c. ketonuria
d. seizures |
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Definition
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|
Term
Which of the following may occur with a pituitary adenoma?
a. low blood pressure and bradycardia
b. headache and seizures
c. vomiting and diarrhea
d. loss of vision in one eye |
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Definition
|
|
Term
Which of the following may cause hypertension?
a. hypoparathyroidism
b. hypoglycemia
c. pheochromocytoma
d. Addison’s disease |
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Definition
|
|
Term
Catabolic effects of Cushing’s syndrome include:
a. osteoporosis
b. hypertension
c. increased erythrocyte production
d. moon face and buffalo hump |
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Definition
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|
Term
Blood glucose levels are increased by:
1. glucocorticoids
2. glucagon
3. epinephrine
4. norepinephrine
5. parathormone
a. 1, 2
b. 1, 2, 3
c. 2, 4, 5
d. 1, 3, 4, 5
e. all of the above |
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Definition
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Term
Which of the following are likely present in a patient immobilized for a long period of time?
a. hypocalcemia and low serum PTH levels
b. hypocalcemia and high serum PTH levels
c. hypercalcemia and low serum PTH levels
d. hypercalcemia and high serum PTH levels |
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Definition
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Term
Which of the following may cause high serum levels of parathyroid hormone?
a. hypoparathyroidism
b. chronic renal failure
c. hypercalcemia
d. adenoma in the thyroid gland |
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Definition
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Term
Diabetic retinopathy results from:
a. degeneration of large blood vessels supplying the eye
b. abnormal metabolism in the lens of the eye
c. neuropathy affecting the optic nerve
d. obstruction or rupture of retinal blood vessels |
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Definition
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Term
Why does hypocalcemia cause tetany?
a. Skeletal muscle contractions are weaker.
b. Nerves to skeletal muscle are more excitable.
c. Calcium is not stored in skeletal muscle cells.
d. Serum phosphate levels are low. |
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Definition
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