Download NR507 Midterm Edapt Review (Weeks 1-3) Questions and Answers and more Exams Advanced Education in PDF only on Docsity!
NR507 Midterm Edapt Review (Weeks
Choose the interstitial lung diseases that are the most diagnosed: Lupus Radiation pneumonitis Pneumoconiosis Acute interstitial pneumonia Hypersensitivity Pneumonitis Desquamative interstitial pneumonia - answer Radiation pneumonitis Pneumoconiosis Hypersensitivity Pneumonitis Hives (urticaria) are an example of a: - answerType 1 hypersensitivity reaction. Anaphylaxis is a
hypersensitivity reaction. - answertype 1 Allergic contact dermatitis is an example of
hypersensitivity reaction. - answertype 4 Type 2 (Cytotoxic) hypersensitivity reactions are mediated by: - answerIgG or IgM. Which of the following are considered the "first responders" of the innate immune system? - answerNeutrophils. Type I (Mechanism, Example, Pathology) - answerIgE action on mast cells Hay fever Mast cell degranulation results in an inflammatory response Type II (Mechanism, Example, Pathology) - answerTissue-specific destruction or impairment because of: Antibody binding followed by lysis via complement Antibody binding followed by macrophage phagocytosis Antibody binding followed by neutrophil destruction Antibody-dependent cell (NK)-mediated cytotoxicity, or Antireceptor antibodies 1-ABO incompatibility 5-Graves' disease
1-Complement damages RBC membrane and cells lyse 5-Autoantibodies specific for thyroid tissue impair receptor for TSH Type III (Mechanism, Example, Pathology) - answerAntigen-Antibody complex deposited in tissues Raynaud's phenomenon Complex deposited in small peripheral vessels in cool temperatures leading to vasoconstriction and blocked circulation Type IV (Mechanism, Example, Pathology) - answerCytotoxic T cell-mediated Contact dermatitis (e.g., poison ivy) T cells attack tissue directly (no antibody) Damage occurs with ABO incompatibility because: - answerComplement damages RBC membrane causing cell lysis. Which of the following is the underlying pathology for hay fever? - answerMast cell degranulation. The diagnosis for an individual who presents to the office with sudden swollen lips and eyes, shortness of breath and throat tightness after a bee sting is: - answerAnaphylaxis. Which of the following assessment findings would be expected in a patient who presents with urticaria? - answerEosinophilia. An example of a secondary immunodeficiency is: - answerPneumocystis Carinii. __________ is a predominant cause of secondary immune deficiencies worldwide. - answerMalnutrition An example of a primary immunodeficiency is: - answerChronic Granulomatous Disease. Which of the following is an autoimmune disease? - answerSystemic Lupus Erythematosus (SLE). Examples: Primary Immunodeficiencies - answerChronic granulomatous Disease of Childhood, DiGeorge Syndrome, Familial Mediterranean fever, Job Syndrome, Common Variable Immunodeficiency Examples: Secondary Immunodeficiencies - answerHuman Immunodeficiency Virus, Pneumocystis Carinii, Pneumonia, Sinus infection, Lung cancer T/F primary immunodeficiency: Are less common and occur due to a defect on the development of the immune system.
Anemia can be caused from which of the following? (Select all that apply.) -Excessive blood loss. -Increased red blood cell destruction. -Impaired red blood cell production. - answerall the above Which of the following is characterized as a microcytic, hypochromic anemia? Hereditary spherocytosis Iron deficiency Folate deficiency B12 deficiency - answeriron deficiency Which of the following normocytic anemias is characterized by hyperchromic RBCs? Folate deficiency. Iron deficiency. Hereditary spherocytosis. B12 deficiency. - answerHereditary spherocytosis. The terms normocytic, microcytic, and macrocytic characterizes red blood cells by their:
- answersize Which of the following symptoms reflects decreased tissue oxygenation as an effect of anemia? fatigue dyspnea weakness pallor - answerall the above t/f Identification of the type of anemia involves an examination of size of the RBC only. - answerfalse Which of the following would normocytic-normochromic indicate? - answerThe cell is normal in size and normal in hemoglobin level The treatment of iron deficiency anemia includes: - answeriron supplementation Which of the following anemias can be categorized as microcytic-hypochromic? (Select all that apply.) Sideroblastic anemia. Thalassemia anemia. Iron deficiency anemia. - answerall the above The most common type of anemia is - answerIron deficiency anemia Which of the following conditions could result in iron deficiency anemia?
Reduced intake of Vitamin C. Increased absorption of iron-containing foods. Excessive bleeding. Reduced absorption of Vitamin B-12. - answerexcessive bleeding Which of the following are iron-rich foods? Lima beans. Meat. Spinach. - answerall the above t/f Although less common, transferrin deficiencies and mitochondrial defects can lead to iron deficiency anemia. - answertrue A transferrin deficiency will most likely result in: - answerIron-deficiency anemia. t/f The basic pathophysiology of iron deficiency anemia is that there are insufficient iron levels or the inability of the cell's mitochondria to utilize iron effectively. - answertrue t/f One of the common precipitating factors of folate deficiency is alcohol abuse. - answertrue A non-megaloblastic anemia would be caused by iron deficiency vitamin b12 deficiency liver disease folate deficiency - answerliver disease A deficiency of intrinsic factor will result in - answerPernicious anemia Loss of vibratory sense in a patient with Vitamin B-12 deficiency is due to which of the following pathophysiological changes: - answerPosterior and lateral column spinal cord changes due to nerve demyelination. The ________________ (MCHC, Reticulocyte count, Serum B-12, MCV) lab values will be normal in a patient in the early stages of pernicious anemia. - answerMCHC Which of the following lab values is normal or elevated for the patient with folate deficiency? Reticulocyte count Folate Ferritin MCV - answerReticulocyte count
-Is characterized by acute and painful episodes. - answerMay have many possible genetic mutations. t/f Cells that contain abnormal types of hemoglobin are more susceptible to infection by the parasite that causes malaria - answerfalse (Rationale: Cells that contain abnormal types of hemoglobin are more resistant to infection by the parasite that causes malaria.) t/f There are four genes involved in encoding synthesis of the alpha protein chains for Hb and are located on chromosome number 16. - answertrue t/f The pathophysiology of sickle cell anemia involves a single amino-acid change on the beta-chain. - answertrue Sickle-cell anemia is an: Immunodeficiency disorder. Idiopathic in blood disorder. Autosomal dominant genetic disorder. Autosomal recessive genetic disorder. - answerAutosomal recessive genetic disorder. t/f The patient with thalassemia is at high risk for stroke. - answerfalse (Stroke risk is high in patients with sickle cell anemia rather than thalassemia.) t/f Cells that contain abnormal types of hemoglobin are more susceptible to infection by the parasite that causes malaria. - answerfalse Thalassemia is similar to sickle cell anemia in that the individual with thalassemia: -Inherits an abnormal Hb gene from the mother only -Inherits an abnormal Hb gene from the father only -Inherits an abnormal Hb gene from both parents -Inherits an abnormal Hb gene from one parent - answerInherits an abnormal Hb gene from both parents Sickle cell anemia and thalassemia are more prevalent in which of the following geographic areas? Australia. Africa. South America. North America. - answerAfrica Which of the following statements correctly describes the flow of blood between the heart and lungs:
-The pulmonary arteries carry ox-Oxygenated blood is transported from the lungs to the heart via the pulmonary veins.ygenated blood from the lungs to the heart. -Oxygenated blood is transported from the lungs to the right atrium of the heart. -Deoxygenated blood is transported from the left ventricle to the lungs via the pulmonary arteries. -Oxygenated blood is transported from the lungs to the heart via the pulmonary veins. - answer-Oxygenated blood is transported from the lungs to the heart via the pulmonary veins. Which of the following is a non-modifiable risk factor for Coronary Artery Disease? Family history. Hyperlipidemia. Hypertension. Obesity. - answerfamily history Coronary artery disease (CAD) is mainly the result of: - answerLongstanding atherosclerosis. Which of the following is a modifiable risk factor for Coronary Artery Disease (CAD)? Menopause. Age. Obesity. Family history. - answerobesity t/f In Coronary Artery Disease (CAD), pumping ability of the heart can be impaired due to the deprivation of oxygen. - answertrue modifiable risk factors for coronary artery disease (CAD) - answerDyslipidemia Diabetes Mellitus Obesity Smoking Hypertension Sedentary Lifestyle nonmodifiable risk factors for coronary artery disease (CAD) - answerage Male Family History Menopause Hypertension has its most immediate effect on: - answerafterload Which of the following conditions can decrease preload? Fever.
classification of heart failure: there is marked limitation of physical activity. The patient is comfortable at rest, but less than ordinary activity causes symptoms of HF. - answerClass III staging of heart failure: Patients at risk for heart failure who have not yet developed structural heart changes (i.e. those with diabetes, those with coronary disease without prior infarct). - answerstage A staging of heart failure: Patients with structural heart disease (i.e. reduced ejection fraction, left ventricular hypertrophy, chamber enlargement) who have not yet developed symptoms of heart failure. - answerStage B staging of heart failure: Patients who have developed clinical heart failure. - answerStage C Staging of Heart Failure: Patients with refractory heart failure that require advanced intervention (for example, the need for a biventricular pacemaker, left ventricular assist device, or heart transplant). - answerStage D t/f The patient with aortic regurgitation would most likely present with an early, high- pitched diastolic murmur heard at the left lower sternal border. - answertrue A patient with mitral stenosis would most likely present with: -Bradycardia. -Holosystolic murmur. -High-pitched murmur. -Rumbling, decrescendo diastolic murmur heard at apex of the heart. - answerRumbling, decrescendo diastolic murmur heard at apex of the heart. A patient with mitral regurgitation would most likely present with: -a blowing, holosystolic murmur -high-pitched murmur -clear lungs -bradycardia - answera blowing, holosystolic murmur The patient with aortic stenosis would most likely present with: -Right ventricular hypertrophy. -S3 gallop. -High-pitched murmur. -Mid-systolic crescendo-decrescendo murmur. - answerMid-systolic crescendo- decrescendo murmur. Rheumatic fever is a common cause for ______ valve disorder.
mitral stenosis mitral valve prolapse aortic stenosis aortic regurgitation - answermitral stenosis Case Study question: A 64-year old female reports to the primary care office with a complaint of "fainting". She reported the episode occurred while she was engaged in low impact aerobics class. She noticed during exercise that her heart "hurt". symptom analysis of the chest pain and determined that the patient describes it chest pressure. no dyspnea with exercise and denies orthopnea or paroxysmal nocturnal dyspnea. NP notes that VS are normal, lungs are clear There is a laterally displaced, sustained apical impulse &a grade 4/6 mid-systolic crescendo-decrescendo murmur, heard loudest at the base & radiating to the neck. There is also an S4 gallop. no peripheral edema noted. There is a laterally displaced, sustained apical impulse & a grade 4/6 mid-systolic crescendo-decrescendo murmur, heard loudest at the base and radiating to the neck. There is S4 gallop. ECG in the office discovers left ventricular hypertrophy - answerAortic Stenosis A 60-year old male reports to the primary care office with "shortness of breath" that started a few days after being released from the hospital following angioplasty and stent placement. Upon exam, the NP observes that the patient does have dyspnea and jugular vein distention. Crackles are also noted in lung bases bilaterally. A blowing holosystolic murmur is also heard at the heart's apex with radiation into the axilla. - answerMitral Regurgitation A woman brings her 67-year old father to see the NP at the primary care clinic. The patient reports that he has experienced shortness of breath for the last two months that has continued to get progressively worse. He expresses great concern that this development has kept him from participating in his Silver Sneaker's program that he enjoys with his friends. He can barely walk a city block or walk up the stairs in his home without becoming short of breath. Upon exam, the NP notes a blood pressure of 180/ mmHg and peripheral pulses are palpable at 4+. The cardiac exam reveals several murmurs: an early diastolic murmur that is high-pitched located loudest at the left lower sternal border; a diastolic rumbling sound heard at the heart's apex and a systolic crescendo-decrescendo murmur heard at the left upper sternal border. A chest x-ray is performed at the office & shows pulmonary edema and cardiomegaly. - answerAortic Regurgitation A 40-year old male reports to the primary care office with a chief complaint of dyspnea, especially with activity, over the last 5 days. He also notices that several times during the last two days that he could feel his heart "pounding and racing". On collecting the medical history, the patient indicates that he had rheumatic heart disease as a young child but remembers little about it. On exam, the NP determines that he is tachycardic with a heart rate of 120 beats/minute that is irregularly irregular. A low-pitched murmur
The NP notes that a patient's FEV1/FVC ratio is normal. Which of the following conditions is most likely the patient's pulmonary issue? Pneumonia. Emphysema. Chronic asthma. Pulmonary fibrosis. - answerPulmonary fibrosis. (Rationale: A normal FEV1/FVC points to a restrictive disorder. Pulmonary fibrosis is due to a restrictive cause.) T/F Simple spirometry includes a measure of residual capacity. - answerfalse (Residual capacity is not part of a simple spirometry test because it cannot be measure since it is not expelled.) Which of the following spirometry results indicate restrictive lung disease? -FEV1 reduced, FVC normal, total lung capacity reduced; FEV1/FVC ratio normal. -FEV1, FVC, and total lung capacity reduced; FEV1/FVC ratio normal. -FEV1, FEV, and total lung capacity normal: FEV1/FVC ratio normal. -FEV1, FEV, and total lung capacity reduced; FEV1/FVC ratio reduced. - answerFEV1, FVC, and total lung capacity reduced; FEV1/FVC ratio normal. Chronic bronchitis will decrease which of the following parameters? Decreased total lung capacity. Decreased forced expiratory flow (FEV1). Increased lung compliance. Decreased diffusing capacity. - answerDecreased forced expiratory flow (FEV1). A patient with chronic bronchitis is most likely to experience: Respiratory acidosis due to inability to exhale CO2. Respiratory alkalosis due to decreased intake of CO2. Respiratory alkalosis due to inability to exhale CO2. Respiratory acidosis due to decreased intake of CO2. - answerRespiratory acidosis due to inability to exhale CO2. Which of the following pulmonary function test results are expected in a patient with chronic bronchitis? Decreased FEV1/FVC ratio.
Decreased residual volume. Increased forced expiratory volume in one second. (FEV1) Increased vital capacity. - answerDecreased FEV1/FVC ratio. The number one cause of chronic bronchitis is -cigarette smoking -alpha-antitrypsin deficiency -exposure dust -exposure to allergens - answerciggarette smoking The effects of an Alpha-antitrypsin 1 deficiency is: -Reduction in elastase production. -Inhibits the immune cell response. -Inability to block the effects of proteolysis. -Deactivates neutrophils. - answerInability to block the effects of proteolysis. Which of the following is considered a late effect of emphysema? Hypoxemia. Hypercapnia. Hypocapnia. Hypoxemia and Hypercapnia. - answerHypoxemia and Hypercapnia. A patient with chronic bronchitis is at risk for developing pneumonia due to: Mucus plugs. Overactive cilia in the lungs. Inability to cough. Hypoxemia. - answermucus plugs Hyperresonance found on lung percussion with a patient with COPD is primarily due to: -ruptured alveoli -air trapping -consolidation of secretions -mucus plugs - answerair trapping The NP is examining a patient with a longstanding history of chronic bronchitis. Cor pulmonale is expected in the patient that presents with: Hypocapnia. Hypoxia. Venous stasis ulcers. Splenomegaly. - answerSplenomegaly. A lung volume measurement that indicates air trapping in a COPD patient is:
Symptoms common to both intrinsic and extrinsic asthma include: Wheezing. Dizziness. Slowed breathing. Elevated heart rate. - answerwheezing Asthma results in: Scant mucus production. Increased alveolar oxygenation. Increased alveolar ventilation. Decreased alveolar ventilation. - answerDecreased alveolar ventilation. Extrinsic asthma is: Triggered by an allergic reaction. Triggered by non-allergic factors. Typically seen in adults less than 40 years of age. Characterized by no elevation in IgE. - answerTriggered by an allergic reaction Asthma is a chronic disease characterized by: Bronchial scarring. Intermittent, reversible airflow obstruction. Airway infection. Air trapping. - answerIntermittent, reversible airflow obstruction. Which of the following pulmonary function test results are consistent with asthma? -decreased residual volume -increased forced vital capacity (FVC) -increased forced expiratory volume (FEV1) and FEV1/FVC -decreased peak expiratory flow rate - answerdecreased peak expiratory flow rate Choose the types of interstitial lung diseases (ILD) that are commonly associated with smoking: -Respiratory bronchiolitis-interstitial lung disease -Pneumoconioses -Sarcoidosis -Desquamative interstitial pneumonia -Pulmonary Langerhans cell histiocytosis -Hypersensitivity pneumonitis - answer-Respiratory bronchiolitis-interstitial lung disease -Desquamative interstitial pneumonia -Pulmonary Langerhans cell histiocytosis Choose the drugs that are commonly associated with development of a medication- induced interstitial lung disease (ILD):
Omeprazole Nitrofurantoin Methotrexate Amiodarone Lisinopril Warfarin - answerNitrofurantoin Methotrexate Amiodarone T/F Interstitial lung disease refers to any disease affecting the pulmonary interstitium and typically excludes infectious and neoplastic diseases - answertrue T/F Interstitial lung disease (ILD) includes infectious and neoplastic lung diseases. - answerfalse T/F A subjective finding in interstitial lung disease is rhonchi in the upper posterior airways. - answerfalse (Fine crackles are noted instead of rhonchi.) T/F The symptoms that are common to all types of interstitial lung disease are shortness of breath and non-productive cough. - answertrue An objective finding in a patient with ILD include productive cough. - answerfalse T/F The characteristic finding of on a chest x-ray of an individual with ILD is a honey- comb pattern - answertrue t/f The four key diagnostic tests for interstitial lung disease are pulmonary function tests, high resolution CT scan, bronchoalveolar lavage and lung biopsy. - answertrue The NP is seeing a patient with chronic bronchitis that needs spirometry on today's visit. What pulmonary function test (PFT) findings are anticipated based on the diagnosis of chronic bronchitis? - answerDecreased forced expiratory flow (FEV1).
