2023 /2024 Nursing5315 Exam Questions With Tested and Verified Answers Already GRADED A+, Exams of Nursing

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2023 /2024 Nursing5315 Exam Questions With Tested

and Verified Answers Already GRADED A+

Ch 18 Questions

1. The person at highest risk for traumatic brain injury (TBI) is A. black and economically disadvantaged. Correct Those at highest risk for TBI are children 0–4 years of age, older adolescents aged 15–19 years, and adults aged 65 years and older. Males have the highest incidence in every age group. TBI is highest among black and in lower- and median-income families. B. male and disabled. C. female and over 20 years of age. D. an economically advantaged young adult. 2. 2.ID: 18662106476 Age and the admission of the Glasgow Coma Scale (GCS) are important diagnostic factors in TBI. Which GCS score describes a severe TBI? A. 13– B. 12– C. 9– D. 3–8 Correct The hallmark of a severe TBI is a loss of consciousness for more than 24 hours. A severe TBI is a GCS score of 8 or less associated with cognitive and/or physical disability or death. 3 ..............3.ID: 18662106484 An older adult who abuses alcohol has fallen and is diagnosed with a hematoma that is located on the top of the brain. Which type of hematoma fits this description? A. Subdural Correct Acute subdural hematomas rapidly develop (within hours) and are usually located at the top of the skull. Subacute subdural hematomas develop more slowly, often over 48 hours to 2 weeks. Falls, especially in older adults or in those with long-term alcohol abuse, are associated with chronic subdural hematomas. Chronic subdural hematomas develop over weeks to months. Extradural or epidural hemorrhages occur between the dura and the skull and are most likely caused by a temporal fracture. Intracerebral hematomas occur in 2% to 3% of head injuries and are not located on top of the brain. B. Epidural C. Extradural D. Intracerebral 4 ..............4.ID: 18662106492 A patient is hit in the temporal portion of his skull. Although initial loss of consciousness occurs, the patient soon awakens and is conversant. Three hours later vomiting, drowsiness, and confusion are noted. These symptoms are most likely related to which type of brain injury? A. Diffuse axonal

B. Intracerebral

C. Subdural D. Epidural Correct The classical presentation of an epidural hematoma is a person hit in the temporal area with damage to the middle meningeal artery. The patient will lose consciousness at the time of injury, but there may be a period where consciousness is regained. The patient will then become more confused and drowsy. This scenario is not typical with the other types of brain injury. A person experiences a vertebral fracture in which the C1 vertebra is fractured into several fragments. This type of fracture can be described as which of the following? E. Simple F. Compressed G. Comminuted Correct A comminuted fracture is also called a burst fracture , in which the vertebral body is shattered into several fragments. A simple fracture is a single break usually affecting the transverse or spinous process. A compressed fracture is also called a wedge fracture ; it occurs when a crush type of injury occurs and the vertebra is anteriorly compressed. H. Wedge Which statement is true regarding spinal shock? I. It is characterized by a complete loss of reflex function. Correct Spinal shock is characterized by a complete loss of reflex function, flaccid paralysis, sensory deficit, and loss of bladder and rectal control in all segments below the level of the lesion. Because an interruption occurs in the communication with the spinal nerves, often a transient drop in blood pressure transpires and disturbed thermal regulation with faulty control of sweating ensues. Uncontrolled heat radiation through capillary dilation also occurs. Spinal shock may persist for a few days up to 3 months. J. It is permanent. K. It causes increased muscle tone below the lesion. L. No disruption of thermal control results. Which statement is true regarding the epidemiologic effects of an acute cerebrovascular accident (CVA)? M. The incidence of a CVA is twice as high among whites than it is among blacks in the United States. N. CVAs are the fifth leading cause of death in the United States. Correct Strokes are the fifth leading cause of death in the United States. The incidence of stroke is approximately two times higher among blacks than it is among whites. Of the 795,000 new and recurrent strokes that occur annually in the United States, approximately 185,000 of these are recurrent. O. Fifty percent of all strokes are recurrent. P. Two million individuals are victims of stroke each year in the United States.

A 23-year-old reports bilateral pain with a sensation of a tight band around the head. Which type of headache fits this description? Q. Migraine with aura R. Migraine without aura S. Tension headache Correct Tension headache is the most common type of headache, often feels like a band is constricting the head, and is bilateral. Migraines tend to throb and are often unilateral. A migraine is classified as with and without aura and is precipitated by a triggering event. Cluster headaches are more common in men and occur in episodes several times during a day for a period of days at different times of the year. The pain of a cluster headache is unilateral, intense, tearing, and burning. T. Cluster headache Which primary brain tumor occurs most commonly? U. Astrocytoma Correct Astrocytomas are the most common brain tumors and account for 50% of brain and spinal tumors. Ependymomas are gliomas that arise from ependymal cells and account for 6% of primary brain tumors in adults. Oligodendrogliomas are less commonly occurring gliomas and account for 2% of primary brain tumors. Meningiomas account for approximately 3% to 4% of all intracranial tumors. V. Ependymoma W. Oligodendroglioma X. Meningioma Which statement is true regarding migraine? ( Select all that apply .) Y. An electroencephalogram (EEG) can be used to confirm a diagnosis of migraine headache. Correct Z. Migraines occur most frequently before and during menses. Correct AA. Migraine is not linked with any other disorder. BB. Drug therapy always includes the administration of narcotics. The diagnosis of migraine is made from medical history and a physical examination. An EEG helps confirm diagnosis. When the headache is not attributable to any other condition and any two of the following occur— unilateral head pain, pulsating pain, pain worsening with activity, and moderate or severe pain intensity—and at least one of the following occur— nausea or vomiting or both, photophobia, and phonophobia—the diagnosis of migraine is made. Many individuals with migraines have comorbid depression. Drug therapy includes antiemetic agents, nonsteriodal antiinflammatory drugs (NSAIDs), ergotamine and dihydroergotamine, and serotonin receptor agonists (e.g., sumatriptan). Narcotics may be used, but they are not routine.

Ch 19 Questions

1. 1.ID: 18662108872

Which best describes schizophrenia? A. Positive personality B. Negative personality

C. Disruption of thoughts Correct Schizophrenia is a collection of illnesses characterized by thought disorders that reflect a break in reality or a splitting of the cognitive from the emotional side of a person’s personality. It is characterized by positive and negative symptoms. Hallucinations, delusions, and cognitive defects are components of schizophrenia. D. Constant hallucinations Awarded 0.0 points out of 1.0 possible points.

2. 2.ID: 18662108876 A woman with a history of schizophrenia asks the nurse, “Now that I’m pregnant, how will my mental illness affect my baby?” Which response from the nurse is true regarding the woman’s child? A. Schizophrenia may result from neurodevelopmental defects. Correct Alterations are suspected in the brain structure that may be the result of neurodevelopmental defects. Researchers believe that environmental factors may alter brain development; these factors include prenatal infection, prenatal nutritional deficiencies, perinatal complications, hypoxia, and upbringing in an urban environment. Researchers also hypothesize that an early brain defect may remain silent until that part of the brain is used. B. Research does not indicate any environmental involvement in schizophrenia. C. An early brain defect immediately reveals itself. D. No alterations are suspected in the brain structure. I Awarded 0.0 points out of 1.0 possible points.
3. 3.ID: 18662108878 When an individual reports that, “Voices are telling me to steal money from the church,” the nurse determines that the person is experiencing A. delusions. B. disorganized speech. C. disorganized behavior. D. hallucinations. Correct A hallucination is a perception experienced without external stimulation of the sense organs. Sensory hallucinations may involve auditory, tactile, visual, gustatory, and olfactory features. A delusion is a persistent belief contrary to the educational and cultural background of the individual. Disorganized speech and behavior (bizarre behavior) are also positive symptoms of schizophrenia. Incongruity of affect is another dimension of disorganized behavior. Awarded 1.0 points out of 1.0 possible points.
4. 4.ID: 18662108862 Which term describes the inability to experience emotions, especially pleasure? A. Alogia B. Avolition C. Anhedonia Correct

Anhedonia is the inability to experience emotions, and individuals often report a sense of detachment from the environment. Alogia is the absence of spontaneous speech production for the purpose of answering or expressing oneself. Avolition is a deficit in spontaneous or goal-directed behavior. Aphasia is the lack of speech. D. Aphasia Awarded 0.0 points out of 1.0 possible points.

5. 5.ID: 18662108874 Which statement is true regarding a mood disorder? A. Mood disorder is a sustained emotional state. Correct A mood disorder is a sustained emotional state. The condition is unipolar or a major depressive disorder, or it is bipolar (manic-depressive) illness. A disruption of thought is consistent with schizophrenia, not a mood disorder. Lifetime prevalence for depression is 16.2% for the general population. The prevalence of the bipolar disorder ranges from 3% to 5% in the general population. Approximately 80% of depressed persons will respond to antidepressant drugs such as monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), and selective serotonin reuptake inhibitors (SSRIs). B. It is a disruption of thought. C. Lifetime prevalence rate for depression is 1%. D. Of those with depression, 95% respond to medication. Awarded 1.0 points out of 1.0 possible points.
6. 6.ID: 18662108880 Which statement is true regarding mood disorders? A. The hypothalamic-pituitary-adrenal (HPA) system hormones are decreased in a large percentage of individuals with major depression. B. Depression occurs with deficits in brain norepinephrine. Correct The monoamine hypothesis of depression suggests that a deficit in brain norepinephrine, dopamine, and/or serotonin is the underlying cause of depression. HPA system activity is increased in a large percentage of individuals with major depression (30% to 70% of those with major depression have chronic activation of the HPA system and elevated glucocorticoid secretion). Environmental and genetic factors play large roles in the development of depression. C. Environmental factors play no role in depression. D. No genetic role exists in depression. Awarded 1.0 points out of 1. possible points.
7. 7.ID: 18662108870 Which statement is true of anxiety disorders? A. Anxiety disorders are the most prevalent psychiatric illness. Correct Anxiety disorders are the most prevalent psychiatric illness, occurring in approximately 10% to 30% of the general population. Many individuals with anxiety disorders develop major depression, and the high comorbidity of anxiety disorders and depression suggests a common

neural pathophysiologic basis linking these two mental illnesses. When normal fear and anxiety mental states persist and become

uncontrollable, an individual may develop an anxiety disorder. PD, GAD, PTSD, and OCD are examples of uncontrollable fear and anxiety states that require medical attention. Panic disorders are generally treatable with cognitive behavioral therapy (CBT) and antidepressants such as TCAs and SSRIs. Benzodiazepines (BZs) are used as an adjunct or augmentation therapy for individuals who are nonresponsive to SSRIs or TCAs. B. Anxiety disorders and depression are not linked. C. Anxiety disorders are normal and will correct themselves. D. Benzodiazepines are first-line, single treatment for panic disorder. Awarded 1.0 points out of 1.0 possible points.

8. 8.ID: 18662108864 Which term describes recurrent, intrusive thoughts or impulses? A. Hallucinations B. Compulsions C. Obsessions Correct Obsessions are recurrent, intrusive thoughts or impulses that provoke an intense anxiety that leads the individual to perform compulsive repetitive behavioral acts to alleviate the anxiety activated by the obsessions. Hallucinations are perceptions experienced without external stimulation of the sense organs. Delusions are persistent beliefs contrary to the educational and cultural background of the individual. D. Delusions Awarded 0.0 points out of 1.0 possible points.
9. 9.ID: 18662108868 Which drugs may produce psychosis at high doses? ( Select all that apply. ) A. Levodopa Correct B. Fluphenazine C. Haloperidol D. Cocaine Correct Drugs that increase dopamine transmission such as levodopa or cocaine may produce psychosis at high doses. Traditional antipsychotic drugs, such as fluphenazine and haloperidol, have a high affinity for dopamine receptors and reduce psychotic states. Awarded -2.0 points out of 2.0 possible points.
10. 10.ID: 18662108866 Which statement is true regarding the epidemiologic effects of schizophrenia? ( Select all that apply .) A. If one twin has schizophrenia, then a 70% chance exists that the remaining twin will develop the disease. B. One percent of the general population has schizophrenia. Correct C. Schizophrenia is a simple genetic transmission. D. Concordance between siblings is 12%. Correct Monozygotic twins have a concordance rate of 30% to 50%. Siblings and dizygotic twins have a 12% concordance rate. Schizophrenia can occur in a child with parents who do

not have the disease. Schizophrenia occurs in approximately 1% of the population. The genetic penetrance is not simple. Awarded 0.0 points out of 2.0 possible points.

Ch 20 Questions

1. 1.ID: 18662105374

The origin of the peripheral nervous system is which of the following? A. Neural crest Correct The neural crest is a cellular band that is created when the neuroectodermal cells separate from the neural tube but remain between the tube and the surface ectoderm. This cellular band develops into the cranial and spinal ganglia, more commonly referred to as the peripheral nervous system. During the fourth week of gestation, the neural groove deepens and ultimately becomes the central nervous system (CNS). The neural plate is the thickening of the ectoderm. This plate appears around the middle of the third week of gestation and unfolds to form a neural groove and neural folds. B. Neural tube C. Neural groove D. Neural plate Awarded 0.0 points out of 1.0 possible points.

2. 2.ID: 18662105380 An infant is born with a wide membranous junction between skull bones. What is the appropriate name for this structure? A. Suture B. Fontanel Correct When an infant is born, the bones of the skull are separated at the suture lines, thus forming two fontanels or “soft spots”: one diamond-shaped anterior fontanel and one triangular-shaped posterior fontanel. The fontanels are wide, membranous junctions of the sutures between skull bones that allow for the expansion of the skull during normal growth and development. Schwann cells are specialized connective tissue cells in the peripheral nervous system. Myelin is the conductive coating on nerve cells. C. Schwann cell D. Myelin Awarded 1.0 points out of 1.0 possible points.
3. 3.ID: 18662105384 Premature closure of one or more of the cranial sutures during the first 18– months of an infant’s life is known as A. anencephaly. B. craniosynostosis. Correct Craniosynostosis (craniostenosis) is the premature closure of one or more of the cranial sutures during the first 18–20 months of an infant’s life. Anencephaly is an

anomaly in which the soft, bony component of the skull and part of the brain are missing. Encephalocele is a midline skull defect in which a large mass protrudes. Meningocele is a saclike cyst of meninges with spinal fluid that protrudes through the vertebral column. C. encephalocele. D. meningocele. Awarded 1.0 points out of 1.0 possible points.

4. 4.ID: 18662105392 A child is diagnosed with congenital hydrocephalus. Which clinical findings are not correlated with this diagnosis? A. Congential hydrocephalus presents in the second month of life Correct Congenital hydrocephalus is present at birth, whereas acquired hydrocephalus usually becomes apparent in the first weeks to months of life. Sunsetting is the visualization of the sclera above the cornea. The Dandy-Walker deformity is a congenital defect of midline cerebellar structures and the fourth ventricle, which block the ventricular flow of cerebrospinal fluid (CSF). Other causes of obstructions within the ventricular system that can result in hydrocephalus include brain tumors, cysts, trauma, arteriovenous malformations, blood clots, and infection. Because of the increased intracranial pressure, the fontanels typically enlarge and become full and bulging. B. Sunsetting eyes C. Obstructive causes such as Dandy-Walker deformity D. Full and bulging fontanels Awarded 1.0 points out of 1.0 possible points.
5. 5.ID: 18662105382 A child diagnosed with cerebral palsy has increased muscle tone, prolonged primitive reflexes, scoliosis, and contractures. Which form of cerebral palsy does this child have? A. Pyramidal or spastic Correct Spastic cerebral palsy demonstrates increased muscle tone, prolonged primitive reflexes, scoliosis, and contractures. Dyskinetic cerebral palsy is associated with extreme difficulty in fine motor coordination. Ataxic cerebral palsy is associated with gait disturbances and instability. The mixed variety of cerebral palsy has components of each of these forms. B. Dyskinetic C. Ataxic D. Mixed variety Awarded 0.0 points out of 1.0 possible points.
6. 6.ID: 18662105388 Which statement is true regarding brain tumors in children? A. Brain tumors represent the most common primary neoplasm in children. B. Twenty percent of the brain tumors are nonmalignant. C. Brain tumors account for 50% of all childhood cancers. D. Brain tumors spread by direct invasion of cells through CSF.

Correct

Brain tumors spread by direct invasion or dissemination of cells through CSF. Brain tumors are the leading cause of cancer death in children. Approximately 45% of primary brain tumors in children are nonmalignant. Overall, primary brain tumors account for nearly 26% of all childhood cancers. Awarded 0.0 points out of 1.0 possible points.

7. 7.ID: 18662105386 Simple febrile seizures occur in A. less than 1% of children. B. 2% to 5% of children. Correct Simple febrile seizures occur in 2% to 5% of children, most frequently between the ages of 3 months and 5 years. The seizures are brief and self- limited, and the cause is unknown. C. 7% to 10% of children. D. 12% to 15% of children. Awarded 0.0 points out of 1.0 possible points.
8. 8.ID: 18662105390 A patient has a hernial protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a deficit in the spinal column. This condition is described as a(n) A. encephalocele. B. meningocele. C. myelomeningocele. Correct This is a description of a myelomeningocele. Encephalocele is a midline skull defect in which a large mass protrudes. Meningocele is a saclike cyst of meninges with spinal fluid that protrudes through the vertebral column. An Arnold-Chiari malformation is a downward displacement of the cerebellum. D. Arnold-Chiari malformation. Awarded 0.0 points out of 1.0 possible points.
9. 9.ID: 18662105378 A child presents with congenital hydrocephalus. Upon tapping of his skull, a resonant sound is appreciated, which is referred to as A. Macewen sign. Correct Macewen sign, or cracked pot sign, occurs with separation of the cranial sutures and produces the characteristic sound. Sunsetting is the visualization of the sclera above the cornea. The Dandy-Walker deformity is a congenital defect of midline cerebellar structures. An Arnold-Chiari malformation is the downward displacement of the cerebellum. B. sunsetting. C. Dandy-Walker D. Arnold Chiari. Awarded 0.0 points out of 1.0 possible points.
10. 10.ID: 18662105376 Which statements are true regarding neurologic development? ( Select all that

apply. )

A. The head size is the fastest growing body part during infancy. Correct B. The infant’s skull contains fontanels. Correct C. An adult’s head will expand with an intracranial mass. D. E. The posterior fontanel may remain open until 2–3 months of age. Correct An infant’s skull contains open sutures and fontanels to allow for head expansion. The head is the fastest growing body part during infancy. The posterior fontanel may be open until 2–3 months of age; the anterior fontanel normally does not fully close until 18 months of age. An adult’s head size will not expand, regardless of intracranial events, such as tumor growth, bleeding, or the increased production of CSF. Awarded 0.0 points out of 3.0 possible points.

Ch 32 Questions

1. 1.ID: 18662094783

Which cardiac chamber has the thickest wall? A. Left atrium B. Right atrium C. Left ventricle Correct The atria are approximately 1–2 mm thick. The right ventricle is 4–5 mm thick, and the left ventricle, the most muscular chamber, is approximately 12–15 mm thick. D. Right ventricle Awarded 1.0 points out of 1.0 possible points.

2. 2.ID: 18662094785 Which statement accurately describes blood flow through the heart? A. Blood flows from the left atrium through the tricuspid valve to the left ventricle. B. Blood flows from the right atrium through the aortic valve to the right ventricle. C. Blood flows from the right ventricle through the pulmonic semilunar valve. Correct Blood flows from the right atrium through the tricuspid valve to the right ventricle. Blood then travels from the right ventricle through the pulmonic semilunar valve to the pulmonary circulation. Once in the pulmonary circulation, it is oxygenated and travels to the left atrium through the bicuspid valve to the left ventricle. Blood leaves the left ventricle through the aortic valve and enters the systemic circulation. D. Blood flows from the left ventricle through the bicuspid valve. Awarded 1.0 points out of 1.0 possible points.
3. 3.ID: 18662094775 Which statement correctly describes the A wave? A. The A wave is generated by atrial contraction. Correct

The A wave is generated by atrial contraction. The V wave is the early diastolic peak caused by the filling of the atrium. The X descent follows the A wave and is produced because of the descent of the tricuspid valve ring. The Y descent follows the V wave and reflects the rapid flow of blood from the great veins and right atrium into the right ventricle. B. The filling of the atrium causes early diastolic peak of the A wave. C. The A wave is produced as a result of the descent of the tricuspid valve ring. D. The A wave reflects the rapid flow of blood from the great veins and right atrium into right ventricle. Awarded 0.0 points out of 1.0 possible points.

4. 4.ID: 18662094779 Which artery travels in the coronary sulcus between the left atrium and the left ventricle? A. Left anterior descending B. Circumflex Correct The circumflex artery travels in the coronary sulcus. The left anterior descending artery travels down the anterior surface of the interventricular septum. The right coronary artery originates from an ostium behind the right aortic cusp and travels behind the pulmonary artery. The left coronary artery passes between the left atrial appendage and the pulmonary artery and generally divides into two branches. C. Right coronary D. Left coronary Awarded 0.0 points out of 1.0 possible points.
5. 5.ID: 18662094781 Which part of the heart is responsible for electrical impulse stimulation? A. Atrioventricular node B. Sinus node Correct The sinus node, the pacemaker of the heart, is the site of impulse formation. The atrioventricular node is the junction of the electrical transmission between the atria and the ventricles. The impulse then travels to the bundle of His and, finally, to the right and left bundle branches. The terminal branches are the Purkinje fibers. C. Bundle of His D. Right bundle branch Awarded 1.0 points out of 1.0 possible points.
6. 6.ID: 18662094787 Which cardiac event represents the measure of time from the onset of atrial activation to the onset of ventricular activation? A. PR interval Correct The PR interval measures the time of onset of atrial activation to the onset of ventricular activation. The QRS complex represents the sum of all ventricular muscle cell depolarization. The ST interval is the time when the entire ventricular myocardium is depolarized. The QT interval is often called

electrical systole.

B. QRS complex C. ST interval D. QT interval Awarded 0.0 points out of 1.0 possible points.

7. 7.ID: 18662094791 Which two items are related in the Frank-Starling law of the heart? A. Resting sarcomere length to tension generation Correct The Frank-Starling law of the heart relates resting sarcomere length (expressed as the volume of blood in the heart at the end of diastole or end-diastolic volume) to tension generation (development of left ventricular pressure). In summary, this means the volume of blood in the heart at the end of diastole is directly related to the force of contraction of the next systole. B. Resting sarcomere length to end-diastolic volume C. Tension generation and left ventricular pressure D. Tension generation and diastolic filling pressures Awarded 0.0 points out of 1.0 possible points.
8. 8.ID: 18662094773 Which statement correctly defines preload? A. Resistance to the ejection of blood from the left ventricle B. Wall tension that is related to internal blood vessel radius C. Pressure generated by atrial contraction D. Pressure generated by the end-diastolic volume Correct Preload is the pressure generated in the left ventricle at the end of diastole (end- diastolic volume). Afterload is the resistance or impedance to the ejection of blood from the left ventricle. Wall tension is directly related to the product of the intraventricular pressure and internal radius, and inversely related to the wall thickness (Laplace’s law). A tension curve lower than normal is characteristic of congestive heart failure. Awarded 1.0 points out of 1.0 possible points.
9. 9.ID: 18662094769 Which process is responsible for slowing the heart rate? A. Sympathetic excitation B. Parasympathetic excitation Correct The parasympathetic excitation slows the heart rate and is often referred to as the cardioinhibitory center. The sympathetic stimulation is often called the cardioexcitation center because the heart rate increases. The Bainbridge reflex causes the heart rate to increase after intravenous infusions of blood or fluid. The baroreceptor reflex facilitates blood pressure changes and heart rate changes. C. Bainbridge reflex D. Baroreceptor reflex Awarded 0.0 points out of 1.0 possible points.
10. 10.ID: 18662094771 Which factors determine cardiac output?

A. Parasympathetic and sympathetic activity B. Preload and afterload C. Heart rate and stroke volume Correct Cardiac output is directly related to the heart rate and stroke volume. Changes in either variable affect the cardiac output. Preload is the pressure generated in the left ventricle at the end of diastole (end-diastolic volume). Afterload is the resistance or impedance to the ejection of blood from the left ventricle. Although the parasympathetic stimulation has a bradycardic effect and sympathetic nervous system increases the frequency of the cardiac pacemaker and may influence cardiac output, these factors are not used in the cardiac output formula; neither are atrial pressures. D. Right and left atrial pressure Awarded 0.0 points out of 1. possible points.

11. 11.ID: 18662094789 Which statement is true regarding the thoracic duct? A. The thoracic duct is the major source of venous return to the heart. B. The thoracic duct receives lymph from most of the body. Correct Lymph is primarily water and small amounts of protein. It is reabsorbed through the lymph nodes and delivered to either the right lymphatic duct (lymph from right arm, head, and thorax) or the thoracic duct (rest of the body). These structures, in turn, dump the lymph into the inferior vena cava and superior vena cava (major sources of venous return to the heart), which conduct blood to the right atrium. C. The thoracic duct receives lymph from the right arm, head, and thorax. D. Blood is dumped into the right atrium through the thoracic duct. Awarded 0.0 points out of 1.0 possible points.
12. 12.ID: 18662094777 Which are the functions of the pericardial sac? ( Select all that apply. ) A. Prevents displacement of the heart during gravitational acceleration or deceleration Correct B. Physical barrier that protects the heart against infection and inflammation Correct C. Forms a lining that is continuous with the arteries, veins, and capillaries of the body D. Contains pain receptors and mechanoreceptors that affect blood pressure Correct E. Creates a continuous closed circulatory system Functions of the pericardial sac are: (1) to prevent the displacement of the heart during gravitational acceleration or deceleration, (2) to provide a physical barrier that protects the heart against infection and inflammation from the lungs and pleural space, and (3) to provide pain receptors and mechanoreceptors that can elicit reflex changes in blood pressure and heart rate. The endocardium is the lining that is continuous with the

arteries, veins, and capillaries of the body and creates a continuous closed circulatory system. Awarded -1.0 points out of 3.0 possible points.

1. Ch 33 Questions

1. 1.ID: 18662100551

Which term describes an occlusion in a blood vessel caused by a bolus of circulating matter in the bloodstream? A. Thrombus B. Embolus Correct An embolus is a bolus of matter that is circulating in the blood. A thrombus is a blood clot that remains attached to the vessel wall. Thrombophlebitis is the inflammation caused by a thrombus. Foam cells are lipid-laden cells that contribute to fatty streaks. C. Thrombophlebitis D. Foam cell Awarded 1.0 points out of 1.0 possible points.

2. 2.ID: 18662100537 Cyanosis, followed by rubor and paraesthesias in the digits, are associated with which condition? A. Raynaud phenomenon or disease Correct Attacks of vasospasm in the small arteries and arterioles of the fingers and, less commonly, of the toes, characterize Raynaud phenomenon and Raynaud disease. Symptoms include cold and numb digits. Thromboangiitis obliterans, an inflammatory disease of the peripheral arteries, tends to occur in young men who are heavy smokers. Arteries occlude in the feet and hands. The chief symptoms of thromboangiitis obliterans are pain and tenderness of the affected part. Atherosclerosis is an inflammatory disease and is the major cause of coronary artery disease and stroke. A varicose vein is a superficial vein in which blood has pooled. B. Thromboangiitis obliterans C. Atherosclerosis D. Varicose veins Awarded 0.0 points out of 1.0 possible points.
3. 3.ID: 18662100553 Which term is used to identify elevated systolic pressure accompanied by normal diastolic pressure (less than 90 mmHg)? A. Primary hypertension B. Secondary hypertension C. Stage 2 hypertension D. Isolated systolic hypertension Correct Isolated systolic hypertension is an elevated systolic pressure with a normal diastolic pressure. Primary hypertension is the result of extremely complicated interactions of

genetics and the environment, mediated by a host of neurohumoral effects. Altered hemodynamics, associated with a primary disease, cause secondary hypertension. Stage 2 hypertension is systolic pressure equal to or greater than 160 mmHg and diastolic pressure equal to or greater than 100 mmHg. Awarded 0.0 points out of 1.0 possible points.

4. 4.ID: 18662100555 Which condition is a complication of hypertension? A. Cardiovascular muscle atrophy B. Hypoglycemia C. Congestive heart failure Correct Cardiovascular complications include left ventricular hypertrophy, angina pectoris, congestive heart failure (left heart failure), coronary artery disease, myocardial infarction (MI), and sudden death. D. Neuropathy Awarded 1.0 points out of 1.0 possible points.
5. 5.ID: 18662100541 A woman with chest pain that occurs at rest is diagnosed as having abnormal vasospasm of her coronary arteries. These symptoms support which medical diagnosis? A. Stable angina B. Prinzmetal angina Correct Prinzmetal angina is an abnormal vasospasm of the coronary vessels that causes transient ischemia, unpredictably and usually at rest, and is more common in women. Stable angina occurs with activity, is often limited, and resolves with rest. Silent ischemia is poor myocardial perfusion that does not cause angina and may be associated only with nonspecific symptoms such as fatigue, dyspnea, or a feeling of unease. Angina pectoris is typically experienced as transient substernal chest discomfort, ranging from a sensation of heaviness or pressure to moderately severe pain. C. Silent ischemia D. Angina pectoris Awarded 0.0 points out of 1.0 possible points.
6. 6.ID: 18662100531 What is the most common complication of acute myocardium infarction (AMI)? A. Dressler postinfarction syndrome B. Dysrhythmia Correct Dysrhythmias (arrhythmias), which are disturbances of the cardiac rhythm, are the most common complication of AMI. Although all of these choices are true complications of AMI, dysrhythmias are the most common. Dressler postinfarction syndrome, which is a delayed form of acute pericarditis, can occur from 1 week to several months after AMI. Congestive heart failure can occur with a weakened cardiac muscle. C. Pericarditis D. Congestive heart failure

Awarded 0.0 points out of 1.0 possible points.

7. 7.ID: 18662100549 Which statement is true regarding cellular injury of the myocardium? A. Cardiac cells can withstand ischemic conditions for approximately 60 minutes. B. Electrocardiographic (ECG) changes are visible after approximately 120 seconds. C. Myocardial cells remain viable if blood flow returns within 20 minutes. Correct Cardiac cells can withstand ischemic conditions for approximately 20 minutes. ECG changes are visible after 30–60 seconds of hypoxia. After 8– 10 seconds of decreased blood flow, the myocardial cells are already cyanotic and cooler. Even if cardiac cells are metabolically altered and are nonfunctional, they can remain viable if blood flow returns within 20 minutes. D. After 20 seconds of decreased blood flow, myocardial cells become cooler. Awarded 1.0 points out of 1.0 possible points.
8. 8.ID: 18662100543 Which factors promote deep venous thrombosis? ( Select all that apply. ) A. Venous stasis Correct B. Venous endothelial damage Correct C. Polycythemia D. Hypercoagulable states Correct E. Female gender Three factors (triad of Virchow) promote venous thrombosis: (1) venous stasis, caused by immobility, obesity, prolonged leg dependency (e.g., air travel), age, heart failure (HF), (2) venous endothelial damage, caused by trauma or medications, and (3) hypercoagulable states, as a result of inherited disorders, malignancy, pregnancy, oral contraceptives, hormone replacement, hyperhomocysteinemia, or antiphospholipid syndrome. Neither polycythemia nor gender is known to be a factor that promotes venous thrombosis. Awarded -1.0 points out of 3.0 possible points.
9. 9.ID: 18662100535 Which statements are true regarding hypertension? ( Select all that apply. ) A. Approximately two thirds of Americans older than 60 years of age have hypertension. Correct B. More than two thirds of those with hypertension have it controlled. C. Hypertension is defined as a diastolic pressure higher than 90 mmHg. Correct D. Hypertension is a systolic pressure of 140 mmHg or higher. Correct E. Approximately 15% of US adults are in the prehypertension category and are at risk for developing hypertension.

Approximately two thirds of Americans older than 60 years of age have hypertension, and approximately 48% of those have adequately controlled hypertension. Hypertension is defined as a diastolic pressure of 90 mmHg or higher or a systolic pressure of 140 mmHg or higher. Between 25% and 37% of adults in the United States are prehypertensive. Awarded 1.0 points out of 3.0 possible points.

10. 10.ID: 18662100539 Which of the following are risk factors for hypertension? ( Select all that apply. ) A. Positive family history for hypertension Correct B. Asian race C. High dietary sodium intake Correct D. Glucose intolerance Correct E. Female gender The risk factors for hypertension include a positive family history for hypertension, male gender, advanced age, black race, obesity, and high sodium intake. Factors also include low potassium, calcium, and magnesium intake, diabetes mellitus, labile blood pressure, cigarette smoking, and heavy alcohol consumption. Awarded 1.0 points out of 3.0 possible points.
11. 11.ID: 18662100533 Which statements are true regarding atherosclerosis? ( Select all that apply. ) A. Atherosclerosis is an acute process of heart muscle degeneration. B. Atherosclerosis is the thickening and hardening of the vessel wall. Correct C. Atherosclerosis is a plaque caused by neutrophils. D. Endothelial cell injury begins the process of atherosclerosis. Correct E. Atherosclerosis can affect all vascular systems in the body. Correct Atherosclerosis is a form of arteriosclerosis in which thickening and hardening of the vessels (not heart muscle) occurs. Collagen deposits over a fatty streak causes plaque. Atherosclerosis begins with injury to the endothelial cells that line artery walls and is not a single disease; rather, it is a pathologic process that can affect vascular systems throughout the body. Awarded 1.0 points out of 3.0 possible points.
12. 12.ID: 18662100547 Which assessment findings are a sign of atherosclerosis? ( Select all that apply. ) A. Xanthelasmas Correct B. Arcus senilis Correct C. Cardiac murmurs D. Extra-rapid heart sounds E. Carotid arterial bruits Correct Xanthelasmas are small fat deposits around the eyes. Arcus senilis is a yellow lipid ring around the cornea. Both of these findings suggest dyslipidemia, which is associated with atherosclerosis. Carotid arterial bruit also suggests probable atherosclerotic disease. Cardiac murmurs may indicate acute valvular insufficiency. Extra-rapid heart

sounds,

such as a left ventricular gallop, indicate impaired left ventricular function during an ischemic attack. Awarded 1.0 points out of 3.0 possible points.

13. 13.ID: 18662100545 Damaged myocardial muscle will release which enzymes? ( Select all that apply. ) A. Creatine phosphokinase–myocardial band (CPK–MB) Correct B. Lactic acid dehydrogenase (LDH) Correct C. Aspartate aminotransferase (AST) D. Cardiac troponin I (cTnI) Correct E. Low-density lipoprotein (LDL) cTnI is the most specific indicator of MI. Other biomarkers released by myocardial cells include CPK-MB and LDH. AST is a liver enzyme that indicates damage to the liver cells. An increased level of LDL is a risk factor for atherosclerosis. Awarded 1.0 points out of 3.0 possible points.

Ch 34 Questions

1. 1.ID: 18662094795

Which structure allows right-to-left shunting, which is necessary for fetal circulation? A. Ostium primum B. Ostium secundum C. Foramen ovale Correct The foramen ovale is the flapped orifice that allows right-to-left shunting, which is necessary for fetal circulation. Altered development can lead to atrial septal defect. Failure of the septum primum to fuse with the endocardial cushions results in an ostium primum defect. Fenestrations (or openings), which develop in the superior portion of the septum primum, create the ostium secundum. The bulbus cordis is the conal portion of the ventricular septum that separates the aorta from the pulmonary artery. D. Bulbus cordis Awarded 1.0 points out of 1.0 possible points.

2. 2.ID: 18662095201 What is the appropriate name for the connection between the aorta and the pulmonary artery? A. Ductus arteriosus Correct The ductus arteriosus is the communication link between the aorta and the pulmonary artery. Once the ductus venosus closes, its remnants form the ligamentum venosum. The foramen ovale is the flapped orifice that allows right-to- left shunting, which is necessary for fetal circulation. The bulbus cordis is the conal portion of the ventricular septum that separates the aorta artery from the pulmonary artery. B. Ligamentum venosum

C. Foramen ovale D. Bulbus cordis Awarded 1.0 points out of 1.0 possible points.

3. 3.ID: 18662095205 A child who is about to begin school is found to have a crescendo- decrescendo systolic ejection murmur. This finding supports the presence of which cardiac anomaly? A. Mitral valve prolapse B. Atrial septal defect Correct An atrial septal defect may exhibit a crescendo-decrescendo systolic ejection murmur. Mitral valve prolapse is not usually diagnosed in childhood and is identified by an opening click. A ventricular septal defect has a harsh, loud, holosystolic murmur and systolic thrill. A child with congestive heart failure may show changes in feeding, respirations, or lung sounds. C. Ventricular septal defect D. Congestive heart failure Awarded 0.0 points out of 1.0 possible points.
4. 4.ID: 18662094797 What is the correct definition of Eisenmenger syndrome? A. Left-to-right shunt B. Oxygenated blood flows into pulmonary circulation C. Deoxygenated blood flows into systemic circulation Correct Eisenmenger syndrome occurs when pulmonary vascular resistance rises and becomes greater than systemic vascular resistance, causing blood flow to reverse direction. In this syndrome, deoxygenated blood now flows into the systemic circulation and cyanosis occurs. D. Correction of the ventricular septal defect Awarded 1.0 points out of 1.0 possible points.
5. 5.ID: 18662095209 A child has been noted to have hypertension with decreased pulses in the lower extremities. What is the most likely congenital cause for this finding? A. Tricuspid atresia B. Atrial septal defect C. Pulmonary stenosis D. Coarctation of the aorta Correct Coarctation of the aorta is a narrowing of the lumen of the aorta that impedes blood flow. Children may have cool, mottled skin and occasionally leg cramps during exercise. A systolic ejection murmur, heard best at the left interscapular area, is caused by rapid blood flow through the narrowed area, which is often found with hypertension. Children with pulmonary stenosis may have a systolic ejection murmur and possibly exertional dyspnea and fatigability. Atrial septal defects have a murmur. Cyanosis, growth failure, and dyspnea may occur with tricuspid atresia. Awarded 1.0 points out of 1.0 possible points.
6. 6.ID: 18662095207