NR283 Pathophysiology / NR 283 Patho Test Bank QUESTIONS AND ANSWERS (Exam1,2,3 &Final A+, Exams of Nursing

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NR 283 / NR283 Pathophysiology / NR 283 Patho Test Bank QUESTIONS AND ANSWERS (Exam 1, Exam 2, Exam 3, Final Exam)(CHAMBERLAIN COLLEGE OF NURSING)

1. Which of the following areas lacks blood vessels and nerves? a. Epidermis b. Dermis c. Subcutaneous tissue d. Fatty tissue ANS: A REF: 142
2. What is a raised, thin-walled lesion containing clear fluid called? a. Papule b. Pustule c. Vesicle d. Macule ANS: C REF: 143
3. Which of the following is a common effect of a type I hypersensitivity response to ingested substances? a. Contact dermatitis b. Urticaria c. Discoid lupus erythematosus d. Psoriasis ANS: B REF: 145
4. What change occurs in the skin with psoriasis? a. Recurrent hypersensitivity reactions b. Autoimmune response c. Increased mitosis and shedding of epithelium d. Basal cell degeneration ANS: C REF: 147
5. Which of the following best describes the typical lesion of psoriasis? a. Purplish papules that can erode and become open ulcers b. Firm, raised pruritic nodules that can become cancerous c. Moist, red vesicles, which develop into bleeding ulcers d. Begins as a red papule and develops into silvery plaques ANS: D REF: 147

6. Why do secondary infections frequently develop in pruritic lesions? a. Loss of protective sebum b. Entry of resident flora while scratching the lesion c. Blockage of sebaceous glands d. Increased sweat production ANS: B REF: 148
7. Which disease is considered an autoimmune disorder? a. Pemphigus b. Erysipelas c. Contact dermatitis d. Scleroderma ANS: A REF: 147
8. Which of the following skin lesions are usually caused by Staphylococcus aureus? a. Furuncles b. Verrucae c. Scabies d. Tinea ANS: A REF: 148
9. Which of the following statements applies to impetigo? a. Lesions usually appear on the hands and arms. b. The cause is usually a virus. c. The infection is highly contagious. d. Scar tissue is common following infection. ANS: C REF: 148
10. What is the common signal that a recurrence of herpes simplex infection is developing? a. Severe pain around the mouth b. Malaise and fatigue c. Fever and severe headaches d. Mild tingling along the nerve or on the lips ANS: D REF: 150
11. Herpes virus is usually spread by all of the following EXCEPT: a. saliva during an exacerbation and for a short time thereafter. b. contact with the fluid in the lesion. c. contaminated blood. d. autoinoculation by fingers.

ANS: C REF: 150

12. How are antiviral drugs effective in treating a viral infection? a. They destroy the virus if administered for at least 2 weeks. b. They limit the acute stage and viral shedding. c. They prevent any systemic effects of viruses. d. They prevent any secondary bacterial infection. ANS: B REF: 150
13. Tinea capitis is an infection involving the: a. trunk. b. feet. c. scalp. d. nails. ANS: C REF: 150
14. Plantar warts are caused by: a. the fungus aspergillus. b. a parasitic arthropod. c. human papillomavirus. d. the bacterium Streptococcus pyogenes. ANS: C REF: 150
15. Which of the following statements regarding acute necrotizing fasciitis is TRUE? a. Infection is localized in a small area of the epidermis. b. It is usually caused by S. aureus. c. Spontaneous recovery usually occurs in 48 hours. d. Infection rapidly causes extensive tissue necrosis and toxic shock. ANS: D REF: 149
16. Which type of microbe causes Tinea infections? a. Fungus b. Virus c. Gram-negative bacterium d. Mite ANS: A REF: 150
17. What causes the pruritus associated with scabies? a. An allergic reaction to the causative microbe due to endotoxins b. Mites burrowing into the epidermis and reaction to their feces c. Bleeding and injected toxin from bites of the larvae

d. Neurotoxins secreted by mites on the skin surface ANS: B REF: 152-

18. How can pediculosis be diagnosed? a. Pruritus in hairy areas of the body b. Loss of blood due to lice bites c. Finding lice in clothing d. The presence of nits at the base of hair shafts ANS: D REF: 153
19. What is the major predisposing factor to squamous cell carcinoma? a. Viral infection b. Presence of nevi (moles) on the skin c. Exposure to ultraviolet light d. Frequent hypersensitivity reactions ANS: C REF: 154
20. All of the following statements apply to malignant melanoma EXCEPT: a. The malignant cell is a melanocyte. b. They present as non-pruritic purplish macules. c. The neoplasm grows rapidly and metastasizes early. d. The lesion is usually dark or multicolored with an irregular border. ANS: B REF: 155
21. Which of the following factors has contributed to the increased incidence of Kaposi’s sarcoma? a. Excessive sun exposure b. Increased number of nevi c. Increase in immunosuppressed individuals d. Presence of more seborrheic keratoses ANS: C REF: 155
22. Which of the following applies to actinic keratoses? a. They predispose to malignant melanoma. b. They arise on skin exposed to ultraviolet radiation. c. They occur primarily on dark-skinned persons. d. They are malignant and invasive. ANS: B REF: 154-
23. Which lesion distinguishes Tinea corporis?

a. Small, brown pruritic lines b. Painful and pruritic fissures c. Erythematous ring of vesicles with a clear center d. Firm, red, painful nodule or pustule ANS: C REF: 150

24. Systemic effects of acute necrotizing fasciitis include: a. low-grade fever and malaise. b. toxic shock and disorientation. c. mild nausea and vomiting. d. headache and difficulty breathing. ANS: B REF: 149
25. The cause of contact dermatitis can often be identified by: a. using a culture and sensitivity test on the exudate. b. checking the frequency of the exacerbations. c. noting the location and size of the lesion. d. the type of pain associated with the lesion. ANS: C REF: 145
26. The pathological change associated with scleroderma is: a. abnormal activation of T lymphocytes and an increase of cytokines. b an autoimmune reaction damaging the epidermis. .collagen deposits in the small blood vessels of the skin and sometimes the c. viscera.d . Type I hypersensitivity and increased serum IgE levels. ANS: C REF: 147
27. Choose the best description of the typical lesion of impetigo. a. Large, red, painful nodule filled with purulent exudates b. Small vesicles that rupture to produce a crusty brown pruritic mass c. Red, swollen, painful areas often with projecting red streaks d. Firm, raised papules that may have a rough surface and may be painful ANS: B REF: 149
28. Choose the correct match of the skin condition and its usual location. a. Scabies—fingers, wrists, waist b. Impetigo—legs, feet c. Pediculosis humanus corporis—scalp d. Seborrheic keratosis—feet, hands ANS: A REF: 153

29. Leprosy (Hansen’s disease) is caused by: a. a fungus. b. a bacterium. c. a virus. d. a helminth. ANS: B REF: 149
30. One factor that is responsible for increasing the mortality rate among patients suffering with necrotizing fasciitis is: a. a delay in initial diagnosis. b. lack of proper antibiotics. c. the appearance of additional opportunistic infections. d. secondary fungal infections. ANS: A REF: 149
31. Which of the following would result from a reduced number of erythrocytes in the blood? a. Increased hemoglobin in the blood b. Decreased hematocrit c. Increased risk of hemostasis d. Decreased osmotic pressure of the blood ANS: B REF: 185
32. What term is used to describe a deficit of all types of blood cells? a. Leucopenia b. Neutropenia c. Pancytopenia d. Erythrocytosis ANS: C REF: 205
33. Capillary walls consist of: a. multiple endothelial layers. b. a thick layer of smooth muscle. c. two or three epithelial layers. d. a single endothelial layer. ANS: D REF: 183

34. Vitamin K is required by the liver to synthesize: a. heparin. b. prothrombin. c. amino acids. d. bilirubin. ANS: B REF: 190 | 202
35. Individuals with type O blood are considered to be universal donors because their blood: a. contains A and B antibodies. b. contains A and B antigens. c. lacks A and B antibodies. d. lacks A and B antigens. ANS: D REF: 192
36. What are the two circulations that comprise the overall circulatory system? a. Pulmonary and systemic circulations b. Peripheral and central circulations c. Cardiovascular and lymphatic circulations d. Cardiopulmonary and peripheral circulations ANS: A REF: 183
37. Chronic blood loss causes anemia because of the: a. shortened life span of the erythrocytes. b. lower metabolic rate c. loss of protein and electrolytes. d. smaller amount of recycled iron available. ANS: D REF: 193
38. What is the cause of sickle cell anemia? a. A defective gene inherited from both parents b. A chronic bacterial infection c. Bone marrow depression d. An autoimmune reaction ANS: A REF: 198

39. Which of the following best describes the characteristic erythrocyte associated with pernicious anemia? a. Hypochromic, microcytic b. Normochromic, normocytic c. Elongated, sickle-shaped d. Megaloblastic or macrocytic nucleated cells ANS: D REF: 201
40. What causes numbness and tingling in the fingers of individuals with untreated pernicious anemia? a. Persistent hyperbilirubinemia b. Increasing acidosis affecting metabolism c. Vitamin B12 deficit causing peripheral nerve demyelination d. Multiple small vascular occlusions affecting peripheral nerves ANS: C REF: 195
41. Jaundice is one typical sign of: a. sickle cell anemia. b. aplastic anemia. c. iron deficiency anemia. d. acute leukemia. ANS: A REF: 198
42. What are the typical early general signs and symptoms of anemia? a. Chest pain, palpitations b. Jaundice, stomatitis c. Pallor, dyspnea, and fatigue d. Bradycardia, heat intolerance ANS: C REF: 193
43. What is the cause of oral ulcerations and delayed healing occurring with any severe anemia? a. Lack of folic acid for DNA synthesis b. Frequent microinfarcts in the tissues c. Deficit of oxygen for epithelial cell mitosis and metabolism d. Elevated bilirubin levels in blood and body fluids ANS: C REF: 193

44. Which of the following is present with pernicious anemia? a. Pancytopenia b. Hypochlorhydria c. Leukocytosis d. Multiple infarcts ANS: B REF: 195
45. Why is pernicious anemia treated with injections of vitamin B12? a. An immune reaction in the stomach would destroy the vitamin. b. Digestive enzymes would destroy the vitamin. c. The vitamin irritates the gastric mucosa. d. The ingested vitamin would not be absorbed into the blood. ANS: D REF: 195
46. Why do abnormally low hemoglobin values develop with pernicious anemia? a. Decreased production of erythrocytes b. Shorter life span of erythrocytes c. Abnormal structure of hemoglobin chains d. Deficit of folic acid ANS: B REF: 195
47. What are the common early signs of aplastic anemia? a. Painful joints and skeletal deformity b. Abdominal discomfort and splenomegaly c. Excessive bleeding and recurrent infections d. Palpitations and chest pain ANS: C REF: 197
48. Why do vascular occlusions and infarcts occur frequently with sickle cell anemia? a. The red blood cells are abnormally large. b. Increased hemolysis of erythrocytes occurs. c. Erythrocytes change to sickle shape when hypoxia occurs. d. HbS is unable to transport oxygen. ANS: C REF: 199
49. Which of the following applies to sickle cell trait?

a. Most hemoglobin is in the form of HgS b. Sickling of erythrocytes occurs with severe hypoxia. c. Painful sickling crises with multiple infarctions occur frequently. d. A child’s skeletal growth is delayed. ANS: B REF: 198

50. What is the basic abnormality in thalassemia? Several amino acids in the globin chains have been replaced by substitute a. amino acids. b. More than four globin chains are found in the erythrocytes. c. The iron molecule is displaced in hemoglobin. d There is failure to synthesize either the alpha or beta chains in the hemoglobin molecule. ANS: D REF: 200
51. Which of the following can result from a malabsorption problem? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Pernicious anemia ANS: D REF: 195
52. In individuals with pernicious anemia, antibodies form to: a. vitamin B12. b. intrinsic factor or parietal cells c. mucus-producing glands. d. hydrochloric acid. ANS: B REF: 195
53. In cases of polycythemia vera, blood pressure is elevated as a result of: a. increased blood volume. b. frequent infarcts in the coronary circulation. c. congested spleen and bone marrow. d. increased renin and aldosterone secretions. ANS: A REF: 205
54. Petechiae and purpura are common signs of: a. excessive hemolysis.

b. leucopenia. c. increased bleeding. d. hemoglobin deficit. ANS: C REF: 201

55. Which statement applies to the disorder hemophilia A? a. It is transmitted as an X-linked dominant trait. b. There is usually a total lack of factor VIII in the blood c. Males and females can be carriers. d. Hematomas and hemarthroses are common. ANS: D REF: 203
56. Which of the following occurs when disseminated intravascular coagulation develops? a. Increased thrombocytes and blood clotting b. Hemolysis with loss of blood cells c. Massive sepsis and hemorrhage d. Multiple thrombi and deficit of clotting factors ANS: D REF: 203-
57. Which of the following substances acts as an anticoagulant? a. Prothrombin b. Heparin c. Fibrinogen d. Vitamin K ANS: B REF: 190
58. In individuals with acute leukemia, the increased number of malignant leukocytes leads to:
59. decreased hemoglobin.
60. thrombocytopenia.
61. bone pain with increased activity.
62. splenomegaly. a. 1, 3 b. 1, 2, 4 c. 2, 3, 4 d. 1, 2, 3, 4 ANS: B REF: 206-

59. Multiple opportunistic infections develop with acute leukemia primarily because: a. the number of white blood cells is decreased. b. many circulating leukocytes are immature. c. severe anemia interferes with the immune response. d. decreased appetite and nutritional intake reduce natural defenses. ANS: B REF: 206-
60. Why is excessive bleeding a common occurrence with acute leukemia? a. Deficit of calcium ions b. Impaired production of prothrombin and fibrinogen c. Decreased platelets d. Dysfunctional thrombocytes ANS: C REF: 206-
61. Predisposing factors to leukemia commonly include: a. exposure to radiation. b. certain fungal and protozoal infections. c. familial tendency. d. cigarette smoking. ANS: A REF: 207
62. Von Willebrand disease is caused by: a. defective erythrocytes that become deformed in shape, causing occlusions. b. excessive lymphocytes that do not mature. c. absence of a clotting factor that helps platelets clump and stick. d. a lack of hemoglobin due to iron deficiency. ANS: C REF: 203
63. Thrombophilia can result in conditions such as: a. severe chronic kidney disease. b. peripheral vascular disease. c. deficient calcium levels in the long bones. d. excessive bleeding of hematomas. ANS: B REF: 204
64. Multiple myeloma is a malignant tumor involving:

a. plasma cells. b. granulocytes. c. bone cells. d. lymph nodes. ANS: A REF: 209

65. What is the primary treatment for the leukemias? a. Radiation b. Chemotherapy c. Surgery d. Immunotherapy ANS: B REF: 207
66. Which of the following statements applies to hemochromatosis. It is: a. caused by excessive iron intake in the diet. b. results from excessive hemolysis of RBCs.a metabolic error that leads to excess amounts of hemosiderin, causing c. damage to organs. d. an inherited defect that results in abnormal hemoglobin. ANS: C REF: 188
67. Thalassemia is caused by: a. a defect in one or more genes for hemoglobin. b. an abnormal form of heme. c. abnormal liver production of amino acids and iron. d. overproduction of hypochromic, microcytic RBCs. ANS: A REF: 200
68. Secondary polycythemia may be associated with: a. frequent angina attacks. b. certain types of anemia. c. severe chronic bronchitis. d. renal disease. ANS: C REF: 205
69. All of the following apply to vitamin K EXCEPT:

a. it is used as an antidote for warfarin (Coumadin). b. the liver requires it to produce prothrombin. c. it is a fat-soluble vitamin. d. the bone marrow requires it to synthesize hemoglobin. ANS REF:189 | 190 | 202

70. Leukemia is sometimes linked to chromosome abnormalities, as evidenced by: a. the presence of Philadelphia chromosome translocation in cases of acute myelogenous leukemia (AML). b. very low incidence in persons with Down syndrome. c. little evidence of familial incidence. d. transmission as a recessive gene. ANS: A REF: 206-
71. Iron deficiency anemia frequently results from any of the following EXCEPT: a. certain vegetarian diets. b. excessive menstrual flow. c. malabsorption syndromes. d. diabetes mellitus. ANS: D REF: 193
72. Which of the following applies to the leukemias? a. Chronic leukemias are more common in older people. b. AML is the most common childhood leukemia. c. Exposure to chemicals is not considered a predisposing factor. d. Lymphoid tissue produces abnormal leukocytes. ANS: A REF: 207
73. A high percentage of blast cells in the leukocyte population indicates a poor prognosis for an individual with: a. thalassemia. b. acute myelogenous leukemia (AML). c. myelodysplastic syndrome. d. multiple myeloma. ANS: B REF: 208
74. Which of the following applies to erythropoietin? a. It is produced by the liver.

b. It increases iron absorption for heme production. c. It stimulates production of red blood cells. d. Hypoxia stimulates the red bone marrow to produce erythropoietin. ANS: C REF: 187 | 192

75. Which of the following diagnostic tests would be within the normal range for an individual with hemophilia A? a. Bleeding time b. Coagulation time c. PTT time d. Prothrombin time ANS: A REF: 192
76. Which of the following applies to the condition disseminated intravascular coagulation (DIC)? a. It is usually a secondary complication. b. It is always initiated by excessive bleeding. c. It results in an inability of platelets to adhere. d. It is not life threatening. ANS: A REF: 203- 204
77. In which blood dyscrasia does pancytopenia develop? a. Pernicious anemia b. Aplastic anemia c. Iron deficiency anemia d. Sickle cell anemia ANS: B REF: 205
78. Which of the following applies to the etiology of aplastic anemia? It is: a. idiopathic in many cases. b. a genetic disorder. c. predisposed by exposure to myelotoxins. d. Both A and C. ANS: D REF: 197
79. Microcytic and hypochromic erythrocytes are commonly found as a result of: a. iron deficiency anemia.

b. polycythemia. c. disseminated intravascular coagulation d. hemophilia A. ANS: A REF: 201

80. Which of the following actions causes the atrioventricular (AV) valves to close? a. Increased intraventricular pressure b. Depolarization at the AV node c. Ventricular relaxation and backflow of blood d. Contraction of the atria ANS: A REF: 2
81. When stroke volume decreases, which of the following could maintain cardiac output? a. Decrased peripheral resistance b. Increased heart rate c. Decreased venous return d. General vasodilation ANS: B REF: 228
82. Which of the following describes the pericardial cavity? a. It contains sufficient fluid to provide a protective cushion for the heart. b. It is a potential space containing a very small amount of serous fluid. c. It is lined by the endocardium. d. It is located between the double-walled pericardium and the epicardium. ANS: B REF: 224
83. Which of the following factors greatly improves venous return to the heart during strenuous exercise? a. Rapid emptying of the right side of the heart b. Forceful action of the valves in the veins c. Contraction and relaxation of skeletal muscle d. Peristalsis in the large veins ANS: C REF: 224
84. The function of the baroreceptors is to:

stimulate the parasympathetic or sympathetic nervous system at the a. sinoatrial (SA) node as needed. b.. adjust blood pressure by changing peripheral resistance. c. sense a change in blood oxygen and carbon dioxide levels. d signal the cardiovascular control center of changes in systemic blood. pressure. ANS: D REF: 225

85. The normal delay in conduction through the AV node is essential for: a. preventing an excessively rapid heart rate. b. limiting the time for a myocardial contraction. c. allowing the ventricles to contract before the atria. d. completing ventricular filling. ANS: D REF: 225
86. Which of the following is a result of increased secretion of epinephrine? a. Increased heart rate and force of contraction b. Decreased stimulation of the SA node and ventricles c. Vasoconstriction in skeletal muscles and kidneys d. Vasodilation of cutaneous blood vessels ANS: A REF: 225
87. Which of the following causes increased heart rate? a. Stimulation of the vagus nerve b. Increased renin secretion c. Administration of beta-blocking drugs d. Stimulation of the sympathetic nervous system ANS: D REF: 230
88. The event that causes the QRS wave on an electrocardiogram (ECG) tracing is: a. atrial depolarization. b. atrial repolarization. c. ventricular depolarization. d. ventricular repolarization. ANS: C REF: 225

89. The cardiac reserve is: a. afterload. b. the difference between the apical and radial pulses. c. the ability of the heart to increase cardiac output when needed. d. the extra blood remaining in the heart after it contracts. ANS: C REF: 228
90. The term preload refers to: a. volume of venous return. b. peripheral resistance. c. stroke volume. d. cardiac output. ANS: A REF: 228
91. The first arteries to branch off the aorta are the: a. common carotid arteries. b. pulmonary arteries. c. coronary arteries. d. subclavian arteries. ANS: C REF: 226
92. Cardiac output refers to: a. the amount of blood passing through either of the atria. b. the volume of blood ejected by a ventricle in one minute. c. the volume of blood ejected by each ventricle in a single contraction. d. the total number of heartbeats in one minute. ANS: B REF: 228
93. Vasodilation in the skin and viscera results directly from: a. decreased blood pressure. b. increased parasympathetic stimulation. c. relaxation of smooth muscle in the arterioles. d. increased stimulation of alpha-adrenergic receptors. ANS: C REF: 229-
94. Which of the following drugs decrease sodium and fluid retention in the body? a. warfarin (Coumadin)

b. digoxin (Lanoxin) c. nitroglycerin (Isordil) d. hydrochlorothiazide (HydroDIURIL) ANS: D REF: 233

95. Which of the following are predisposing factors to thrombus formation in the circulation?
96. Decreased viscosity of the blood
97. Damaged blood vessel walls
98. Immobility
99. Prosthetic valves a. 1, 3 b. 2, 4 c. 1, 3, 4 d. ANS: D REF: 263 2, 3, 4
100. A drug taken in small doses on a continuing basis to reduce platelet adhesion is: a. acetylsalicylic acid (ASA). b. streptokinase. c. acetaminophen. d. heparin. ANS: A REF: 233
101. A partial obstruction in a coronary artery will likely cause: a. pulmonary embolus. b. hypertension. c. angina attacks. d. myocardial infarction. ANS: C REF: 237
102. Cigarette smoking is a risk factor in coronary artery disease because smoking: a. reduces vasoconstriction and peripheral resistance. b. decreases serum lipid levels. c. promotes platelet adhesion. d. increases serum HDL levels. ANS: C REF: 237-

99. The term arteriosclerosis specifically refers to: a. development of atheromas in large arteries. b. intermittent vasospasm in coronary arteries. c. degeneration with loss of elasticity and obstruction in small arteries. d. ischemia and necrosis in the brain, kidneys, and heart. ANS: C REF: 234
100. A modifiable factor that increases the risk for atherosclerosis is: a. leading a sedentary lifestyle. b. being female and older than 40 years of age. c. excluding saturated fats from the diet. d. familial hypercholesterolemia. ANS: A REF: 238
101. An atheroma develops from: a. a torn arterial wall and blood clots. b. accumulated lipids, cells, and fibrin where endothelial injury has occurred. c. thrombus forming on damaged walls of veins. d. repeated vasospasms. ANS: B REF: 234
102. Low-density lipoproteins (LDL): a. promote atheroma development. b. contain only small amounts of cholesterol. c. transport cholesterol from cells to the liver for excretion. d. are associated with low intake of saturated fats. ANS: A REF: 235
103. Factors that may precipitate an angina attack include all of the following EXCEPT: a. eating a large meal. b. engaging in an angry argument. c. taking a nap. d. shoveling snow on a cold, windy day. ANS: C REF: 240
104. When comparing angina with myocardial infarction (MI), which statement is true? a. Both angina and MI cause tissue necrosis.

b. Angina often occurs at rest; MI occurs during a stressful time. c. Pain is more severe and lasts longer with angina than with MI.d Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is. not. ANS: D REF: 234

105. The basic pathophysiology of myocardial infarction is best described as: a. cardiac output that is insufficient to meet the needs of the heart and body. b. temporary vasospasm that occurs in a coronary artery. c. total obstruction of a coronary artery, which causes myocardial necrosis. d. irregular heart rate and force, reducing blood supply to coronary arteries. ANS: C REF: 240
106. Typical early signs or symptoms of myocardial infarction include: a. brief, substernal pain radiating to the right arm, with labored breathing. b. persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse. c. bradycardia, increased blood pressure, and severe dyspnea. d. flushed face, rapid respirations, left-side weakness, and numbness. ANS: B REF: 241
107. The most common cause of a myocardial infarction is: a. an imbalance in calcium ions. b. an infection of the heart muscle. c. atherosclerosis involving an attached thrombus. d. a disruption of the heart conduction system. ANS: C REF: 240
108. Calcium-channel blocking drugs are effective in: a. reducing the risk of blood clotting. b. decreasing the attraction of cholesterol into lipid plaques. c. reducing cardiac and smooth muscle contractions. d. decreasing all types of cardiac arrhythmias. ANS: C REF: 261
109. Which of the following confirms the presence of a myocardial infarction? a. A full description of the pain, including the sequence of development b. The presence of elevated serum cholesterol and triglycerides c. Serum isoenzymes released from necrotic cells and an ECG

d. Leukocytosis and elevated C-reactive protein ANS: C REF: 242

110. The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following EXCEPT: a. previously established collateral circulation. b. immediate administration of thrombolytic drugs. c. maintaining maximum oxygen supply to the myocardium. d. removing the predisposing factors to atheroma development. ANS: D REF: 243
111. The most common cause of death immediately following a myocardial infarction is: a. cardiac arrhythmias and fibrillation. b. ruptured ventricle or aorta. c. congestive heart failure. d. cerebrovascular accident. ANS: A REF: 241-242
112. Why does ventricular fibrillation result in cardiac arrest? a. Delayed conduction through the AV node blocks ventricular stimulation. b. Insufficient blood is supplied to the myocardium. c. The ventricles contract before the atria. d. Parasympathetic stimulation depresses the SA node. ANS: B REF: 245
113. The term cardiac arrest refers to which of the following? a. Condition where cardiac output is less than the demand b. A decreased circulating blood volume c. Missing a ventricular contraction d. The cessation of all cardiac function ANS: D REF: 246
114. Which change results from total heart block? a. A prolonged PR interval b. Periodic omission of a ventricular contraction c. A wide QRS waved Spontaneous slow ventricular contractions, not coordinated with atrial

. contraction ANS: D REF: 244

115. The term premature ventricular contraction refers to the condition where: a. atrial muscle cells are stimulating additional cardiac contractions. b. the ventricles contract spontaneously following a period without a stimulus. c. additional contractions arise from ectopic foci in the ventricular muscle. d. increased heart rate causes palpitations. ANS: C REF: 245
116. Which of the following is most likely to cause left-sided congestive heart failure? a. Incompetent tricuspid heart valve b. Chronic pulmonary disease c. Infarction in the right atrium d. Uncontrolled essential hypertension ANS: D REF: 246
117. The definition of congestive heart failure is: a. cessation of all cardiac activity. b inability of the heart to pump enough blood to meet the metabolic needs of . the body. c. insufficient circulating blood in the body. d. the demand for oxygen by the heart is greater than the supply. ANS: B REF: 246
118. Significant signs of right-sided congestive heart failure include: a. severe chest pain and tachycardia. b. edematous feet and legs with hepatomegaly. c. frequent cough with blood-streaked frothy sputum. d. orthopnea, fatigue, increased blood pressure. ANS: B REF: 247
119. Paroxysmal nocturnal dyspnea is marked by: a. hemoptysis and rales. b. distended neck veins and flushed face. c. bradycardia and weak pulse. d. cardiomegaly. ANS: A REF: 250

121. Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include: a. slow cardiac contractions. b. increased renin and aldosterone secretions. c. decreased erythropoietin secretion. d. fatigue and cold intolerance. ANS: B REF: 246
122. In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure? a. Veins of the legs and feet b. Jugular veins c. Pulmonary capillaries d. Blood vessels of the liver and spleen ANS: C REF: 247
123. Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions? a. Furosemide b. Digoxin c. Epinephrine d. Nifedipine ANS: B REF: 250
124. In an infant, the initial indication of congestive heart failure is often: a. distended neck veins. b. feeding problems. c. low-grade fever and lethargy. d. frequent vomiting. ANS: B REF: 250
125. Effects that may be expected from a beta-adrenergic blocking drug include: a. increasing systemic vasoconstriction. b. decreased sympathetic stimulation of the heart. c. blockage of an angiotensin receptor site. d. increased release of renin. ANS: B REF: 232

126. A sign of aortic stenosis is: a. increased cardiac output. b. congestion in the liver, spleen, and legs. c. flushed face and headache. d. a heart murmur. ANS: D REF: 250-251
127. An incompetent mitral valve would cause: a. increased blood to remain in the right atrium. b. hypertrophy of the right ventricle. c. decreased output from the left ventricle. d. decreased pressure in the left atrium. ANS: C REF: 253
128. Which of the following describes the blood flow occurring with a ventricular septal defect? a. From the left ventricle to the right ventricle b. From the right ventricle to the left ventricle c. Increased cardiac output from the left ventricle d. Mixed oxygenated and unoxygenated blood in the systemic circulation ANS: A REF: 252
129. Unoxygenated blood enters the systemic circulation in children with tetralogy of Fallot because: a. the aorta and pulmonary artery have exchanged positions. b. pulmonary stenosis changes the ventricular pressures. c. the left ventricular wall has hypertrophied. d. the septal defect allows exchange of blood between the atria. ANS: B REF: 254-255
130. Cyanosis occurs in children with tetralogy of Fallot because: a. more carbon dioxide is present in the circulating blood. b. a large amount of hemoglobin in the general circulation is unoxygenated. c. the pulmonary circulation is overloaded and congested. d. the circulation is sluggish (slow) throughout the system. ANS: B REF: 255