Portage Learning Pathophysiology NURS 231/BIOD 331 Module 4 Exam All Versions Latest, Exams of Nursing

Download Portage Learning Pathophysiology NURS 231/BIOD 331 Module 4 Exam All Versions Latest and more Exams Nursing in PDF only on Docsity! All Versions Of Exam 4 Categorized By Question Types 2024-2025 NURS 231/BIOD 231 Pathophysiology Portage Learning. Question Type Breakdown ➢ Matching, multiple choice and short answer: ➢ Clinical questions: Only questions are provided for clinical questions as examinees are strongly encouraged to answer them in their own words. All the Best! Matching Multiple Choice And Short Answer: Which of the following is NOT a risk factor for hypertension? -Increased potassium intake -Increased salt intake -Increased alcohol intake -Increased caloric intake Increased potassium intake Which pharmacologic treatment of hypertension has a mechanism of action characterized by reducing vascular smooth muscle tone (vasodilation) and reducing cardiac contractility and heart rate? -Diuretics -Calcium channel blockers -Beta-blockers -Ace-inhibitors Calcium channel blockers The _____ is the organ most closely associated with platelet storage and destruction. Spleen Which arrhythmias are dangerous because of severely reduced diastolic time and cardiac output? Select all that apply. -Premature atrial contractions -Paroxysmal atrial tachycardia -Ventricular tachycardia -Ventricular fibrillation -Premature ventricular contractions -Atrial fibrillation Ventricular tachycardia Ventricular fibrillation Approximately 55% of blood volume consists of _____. Plasma Which cardiomyopathy is the most common cause of sudden cardiac death in young athletes due to ventricular arrhythmias? -Dilated -Restrictive -Inflammatory -Hypertrophic Hypertrophic The three stages of hemostasis include each of the following except: -Vascular constriction -Vascular dilation -Formation of platelet plug -Blood coagulation Vascular dilation A deficiency in which of the following would lead to a hypercoagulable state? Select all that apply. -Protein C -Protein S -Factor II -Factor VII -Dehydration -Cold exposure -Physical exertion Dehydration Cold exposure Physical exertion The spleen of a patient with sickle cell anemia would be expected to be: -Enlarged -Shrunken -Normal sized Shrunken Which of the following is NOT true of vitamin B12 deficiency anemia? -Vitamin B12 is bound to intrinsic factor -Peripheral neuropathy can be a result of deficiency -Dietary deficiencies are common -MCV is elevated Dietary deficiencies are common A decrease in this type of cell can lead to an increased risk of bacterial infections: -Red blood cell -Neutrophil -Platelets -Monocyte Neutrophil An increased incidence of atherosclerosis has been correlated with each of the following associations except: -Hypertension -Diabetes mellitus -Use of oral contraceptives -Increased serum HDL concentration Increased serum HDL concentration Which of the following is true of fatty streaks of atherosclerotic lesions? -Present in adults only -Can be symptomatic -Form scar tissue and calcifications -Consist of macrophages and smooth muscle cells Consist of macrophages and smooth muscle cells Matching: Match the cardiac procedures to their description and what they are best used for. 2 answers per question (1 from Set 1, and 1 from Set 2). 1. Cardiac catheterization 2. Exercise stress testing 3. Electrocardiography 4. Echocardiography Set 1: a. Records electrical potential differences during the cardiac cycle b. Observes cardiac function under stress c. Checks for structure and function of the heart d. Catheter is inserted into the great vessels and chambers of the heart Set 2: a. Best to assess ventricular function and heart failure b. Best to assess for arrhythmias and myocardial infarction c. Best to assess need for coronary artery bypass graft and stenting d. Best to assess suspected ischemic heart disease Cardiac Catheterization, 1:d, 2:c Exercise stress testing, 1:b, 2:d Electrocardiography, 1:a, 2:b Echocardiography, 1:c, 2:a Which arrhythmia requires the use of antiplatelet or anticoagulant therapy to prevent stroke risk? -ventricular fibrillation -Atrial flutter -Sinus tachycardia -Atrial fibrillation -Premature ventricular contractions Atrial fibrillation The coagulation cascade involves each of the following except: 1. Make thrombocytes 2. Activate the intrinsic and extrinsic pathways 3.Convert fibrinogen to fibrin 4. Convert prothrombin to thrombin 1. Make thrombocytes Which of the following is NOT a hypercoagulable state? Select all that apply. 1. Pregnancy 2. Mutation of factor V Leiden 3. Antiphospholipid antibody syndrome 4. Thrombocytopenia 5. Cancer 4. Thrombocytopenia Which of the following terms refers to the end-diastolic pressure when the ventricle has been filled? 1. Cardiac contractility 2. Preload 3. Afterload 4. Frank-Starling mechanism 2. Preload 1. a. Diastolic pressure. 2. Heart rate 3. c. Myocardial infarction. 4. d. Decreased systemic vascular resistance With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called what? 1. Stable angina 2. Unstable angina 3. Myocardial infarction 2. Unstable angina Right ventricular failure is commonly characterized by each of the following changes except: 1. Distended neck veins 2. Hepatomegaly 3. Ankle edema 4. Sodium and water retention 5. Pulmonary edema 5. Pulmonary edema Left ventricular failure is commonly characterized by each of the following except: 1. Decreased cardiac output 2. Liver congestion 3. Orthopnea 4. Paroxysmal nocturnal dyspnea 5. Pulmonary edema 2. Liver congestion What are the natural and drug therapy anticoagulants? Antithrombin III, protein C, protein S, warfarin, heparin, Dabigatran, Rivaroxaban, Apixaban What is peripheral vascular resistance? The collective resistance of all the vessels in the peripheral circulation Hemodynamics or blood flow is affected by what factors? Pressure, resistance, flow, radius, blood viscosity, compliance, wall tension What are the most common causes of inherited disorders of hypercoagulability? Factor V gene and prothrombin gene What are acquired or secondary factors of hypercoagulability that lead to venous stasis? Prolonged bed rest and immobility, myocardial infarction, cancer, hyperestrogenic states, oral contraceptives, smoking, and obesity What is thrombocytopenia? The term to describe a reduction in platelet number, of less than 150,000/µL How can anemias be classified according to size and color? Anemias can be normochromic (normal color) or hypochromic (decreased color). Red cells can also vary in size: normocytic (normal size), microcytic (small cells), and macrocytic (large cells). What is neutropenia and what are people who have it at risk for? A decrease in the number of neutrophils to less than 1000/µL; infections What are the five types of lipoproteins? Which one is the good and bad cholesterol? Chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). HDL is good, LDL is bad cholesterol. Where does lipoprotein synthesis take place? Small intestine and liver What are xanthomas? Cholesterol deposits along the skin and tendons in extremely elevated hyperlipidaemia What is atherosclerosis and what is it a major risk factor of? Hardening of arteries What causes coronary artery disease (CAD)? atherosclerosis What can CAD cause? CAD leads to myocardial ischemia and angina, myocardial infarction (heart attack), cardiac arrhythmias, conduction defects, heart failure, and sudden death What are the major risk factors of CAD? Cigarette smoking, elevated blood pressure, elevated serum total and low-density lipoprotein (LDL) cholesterol, low serum high-density lipoprotein (HDL) cholesterol, diabetes, advancing age, abdominal obesity, and physical inactivity. What are the 2 different ways heart failure can be defined? Systolic vs diastolic failure and right vs left heart failure What are the current stages of hypertension? Currently, normal blood pressure is defined as less than 120/80. Elevated blood pressure is < 130/80; hypertension stage 1 is < 140/90; and hypertension stage 2 is > 140/90. What is cardiogenic shock? The heart fails to pump blood sufficiently to meet the body’s needs. What causes cardiogenic shock? Myocardial infarction, myocardial contusion, sustained arrhythmias, or cardiac surgery What is the function of blood? Transport materials to and from the body’s cells. What are the three stages of hemostasis? Vascular constriction, platelet plug formation, blood coagulation What is vitamin K needed to synthesize? Factors II, VII, IX, and X, prothrombin, and protein C Which of the following medications would decrease a person's risk for clotting? Select all that apply. { heparin, warfarin, lovenox Which of the following is a hypercoagulable state? Select all that apply. congestive heart failure, smoking, post-surgical state Which of the following is FALSE of disseminated intravascular coagulation (DIC)? Select all that apply. lab results show a decreased PT, PTT In which of the following ways is blood flow NOT negatively affected? low hematocrit Which of the following increases the strength of the muscular contraction? inotropic influence Which of the following is NOT a regulator of blood pressure? parasympathetic nervous system activation Which of the following does NOT lead to an increased risk for DVT? Select all that apply. non-smoker Which of the following symptoms is NOT associated with iron deficiency anemia? neurologic changes What are the two major causes of microcytic anemias? iron deficiency anemia, thalassemias Treatment of or prevention of sickling crisis in sickle cell disease include each of the following except: iron supplementation 1. Hypertension is often called "the silent killer." By the time symptoms of hypertension occur, the complications can affect the kidneys, heart, eyes, and blood vessels. What is this term called? 1. Target-organ damage 2. Left ventricular hypertrophy is a major risk factor for what other diseases? Name at least 2. 2. coronary heart disease, cardiac dysrhythmias, congestive heart failure, and sudden death. A 45-year-old man has a blood pressure at a screening program of 142/90. His father has a history of hypertension and heart attack. His grandfather died of a stroke. He is 20 lbs overweight, likes eating salty foods, and enjoys drinking beer. He states he is too tired and busy to exercise. According to JNC 8 guidelines, what category does this patient's blood pressure fall into? What is hypertension a risk factor for? What lifestyle modifications would you suggest for them? Name one medication therapy for hypertension and its mechanism of action. Hypertension stage 2 Atherosclerosis, CAD (MI), heart failure, stroke, peripheral artery disease Lose weight, exercise, decrease salt intake, decrease alcohol intake Diuretics, like thiazides, lower blood pressure by decreasing vascular volume; ACE inhibitors inhibit the conversion of angiotensin I to angiotensin II, thereby reducing vasoconstriction, aldosterone levels; Calcium channel receptor blockers inhibit the movement of calcium into cardiac and vascular smooth muscle. They reduce vascular smooth muscle tone (vasodilation); reduce cardiac contractility and heart rate, and decrease cardiac output Discuss the intrinsic and extrinsic pathways: The intrinsic and extrinsic pathways both form prothrombin activator. The intrinsic pathway begins with activation of factor XII and can cause clotting in 1 to 6 minutes, considered the slower process. The extrinsic pathway can cause clotting in 15 seconds and begins with the release of tissue thromboplastin from the subendothelial cells. Both pathways converge to activate factor X, the conversion of prothrombin to thrombin. Thrombin then converts fibrinogen to fibrin, the material needed to stabilize a clot. Both methods are needed for successful hemostasis. Explain the differences in the pathophysiology, symptoms, and whether nitroglycerin and/or rest will relieve symptoms in stable angina, unstable angina, and myocardial infarction. Stable angina- The heart is stable at rest but cannot keep up with the demand of exertion. Stable angina typically has a >70% stenosis of the coronary arteries. It is relieved by rest or nitroglycerin (vasodilator). Unstable angina- With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called unstable angina. It can be relieved by nitroglycerin, but not rest. Unstable angina means one or more coronary vessels is nearly totally occluded. Myocardial infarction- If a plaque ruptures, coronary thrombosis can cause complete occlusion. If collateral flow is inadequate, the tissue supplied becomes ischemic. Without oxygen, a portion of the muscle can die. MI can present as chest pain unrelieved by rest, sometimes radiating down the left ram or into the jaw or neck, dyspnea, nausea/vomiting, sweating, and/or other signs of distress. Other symptoms include a crushing pain or like "something is sitting on my chest." Women may present with weakness, fatigue, shortness of breath, or GI complaints. Symptoms are not relieved by nitroglycerin. 1. Name 2 lifestyle changes to prevent further progression of atherosclerotic diseases: 1. Reduction in fat intake, quitting smoking, weight loss, exercise 2. Name 2 medications used to treat someone with coronary artery disease and their mechanisms of action: 2. Beta-blockers & CCB