Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter, Exams of Pathophysiology

Download Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter and more Exams Pathophysiology in PDF only on Docsity! Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 1 Chapter 01: Introduction to Pathophysiology VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. Which of the following would be the most likely cause of an iatrogenic disease? a. An inherited disorder b. A combination of specific etiological factors c. An unwanted effect of a prescribed drug d. Prolonged exposure to toxic chemicals in the environment ANS: C 2. The manifestations of a disease are best defined as the a. subjective feelings of discomfort during a chronic illness. b. signs and symptoms of a disease. c. factors that precipitate an acute episode of a chronic illness. d. early indicators of the prodromal stage of infection. ANS: B 3. The best definition of the term prognosis is the a. precipitating factors causing an acute episode. b. number of remissions to be expected during the course of a chronic illness. c. predicted outcome or likelihood of recovery from a specific disease. d. exacerbations occurring during chronic illness. ANS: C 4. Which of the following is considered a systemic sign of disease? a. Swelling of the knee b. Fever c. Pain in the neck d. Red rash on the face ANS: B 5. Etiology is defined as the study of the a. causes of a disease. b. course of a disease. c. expected complications of a disease. d. manifestations of a disease. ANS: A 6. A type of cellular adaptation in which there is a decrease in cell size is referred to as a. hypertrophy. b. metaplasia. c. anaplasia. d. atrophy. ANS: D 7. A change in a tissue marked by cells that vary in size and shape and show increased mitotic figures would be called Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 2 a. metaplasia. b. atrophy. c. dysplasia. d. hypertrophy. ANS: C 8. A deficit of oxygen in the cells usually due to respiratory or circulatory problems is called a. apoptosis. b. ischemia. c. hypertrophy. d. necrosis. ANS: B 9. When a group of cells in the body dies, the change is called a. ischemia. b. gangrene. c. hypoxia. d. necrosis. ANS: D 10. Rigorous weightlifting/body building regimens may result in the skeletal muscle cells undergoing a. hypertrophy. b. dysplasia. c. atrophy. d. regeneration. ANS: A 11. The term cancer refers to a. dysplasia. b. hyperplasia. c. metaplasia. d. malignant neoplasm. ANS: D 12. To which of the following does the term apoptosis refer? a. Increased rate of mitosis by certain cells b. Ischemic damage to cells c. Liquefaction of necrotic tissue d. Preprogrammed cell self-destruction ANS: D 13. Which of the following statements is TRUE? a. Alteration of DNA does not change cell function. b. Damaged cells may be able to repair themselves. c. All types of cells die at the same rate. d. Mild ischemia causes immediate cell death. ANS: B 14. Caseation necrosis refers to an area where a. cell proteins have been denatured. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 5 ANS: A 27. If the data collected from the research process confirm that the new treatment has increased effectiveness and is safe, this is called a. the placebo effect. b. evidence-based research. c. blind research studies. d. approval for immediate distribution. ANS: B 28. A short-term illness that develops very quickly with perhaps a high fever or severe pain is called a. acute. b. latent. c. chronic. d. manifestation. ANS: A 29. The term prognosis refers to the a. period of recovery and return to a normal state. b. expected outcome of the disease. c. mortality and morbidity rates for a given population. d. typical collection of signs and symptoms. ANS: B 30. When prolonged ischemia occurs to an area of the heart, the resulting damage is referred to as a. atrophy. b. liquefactive necrosis. c. apoptosis. d. infarction. ANS: D 31. During the evaluation process for a new therapy’s effectiveness and safety, a double blind study may be conducted during a. the first stage. b. the second stage. c. the third stage. d. any of these stages. ANS: C 32. Why are the predisposing factors for a specific disease important to health professionals? a. To predict the prognosis b. To determine treatments c. To develop preventive measures d. To develop morbidity statistics ANS: C 33. Cell damage may be caused by exogenous sources such as a. abnormal metabolic processes. b. certain food additives. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 6 c. genetic defects. d. localized hypoxia. ANS: B 34. Which of the following is usually included in a medical history? 1. Past illnesses or surgeries 2. Current illnesses, acute and chronic 3. Prescribed medication or other treatments 4. Nonprescription drugs and herbal remedies 5. Current allergies a. 1, 3 b. 2, 4, 5 c. 1, 3, 4 d. 1, 2, 3, 4, 5 ANS: D 35. A situation when there is a higher than expected number of cases of an infectious disease within a given area is called a/an a. epidemic. b. exacerbation. c. morbidity. d. pandemic. ANS: A 36. The term pathogenesis refers to a. the development of a disease or sequence of events related to tissue changes involved in the disease process. b. the determination of the cause(s) involved in the development of a malignant neoplasm. c. the specific signs and symptoms involved in the change from an acute disease to a chronic disease. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 7 d. the changes in cells of affected tissue that result in necrosis. ANS: A 37. A therapy that has been approved for use and may show additional potential to treat a different disease is termed “ ” use. a. over-the-counter b. off-label c. additional d. conditional ANS: B 38. A potential unwanted outcome of a primary condition, such as paralysis following the recovery from a stroke, is referred to as a. complication. b. convalescence. c. sequelae. d. postcondition. ANS: C 39. An infectious disease that spreads over wide regions of the globe is called a(an) a. pandemic. b. endemic. c. epidemic. d. periodic. ANS: A 40. The type of necrosis that occurs when cell proteins are altered or denatured is referred to as a. liquefaction necrosis. b. coagulative necrosis. c. degenerative necrosis. d. caseous necrosis. ANS: B Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 10 13. Which of the following is a common cause of hyponatremia? a. Loss of the thirst mechanism b. Excessive sweating c. Excessive aldosterone secretion d. Prolonged period of rapid, deep respirations ANS: B 14. Which of the following is a common effect of both hypokalemia and hyperkalemia? a. Skeletal muscle twitch and cramps b. Oliguria c. Elevated serum pH d. Cardiac arrhythmias ANS: D 15. Choose the correct effect of increased parathyroid hormone. a. Increased movement of calcium ions into the bones b. Increased activation of vitamin D c. Increased absorption of calcium from the digestive tract d. Decreased reabsorption of calcium in the kidneys ANS: C 16. Which of the following results from hypocalcemia? 1. Low serum phosphate levels 2. Nausea and constipation 3. Skeletal muscle twitch and spasms 4. Weak cardiac contractions a. 1, 2 b. 1, 4 c. 2, 3 d. 3, 4 ANS: D 17. Which of the following causes tetany? a. Increased permeability of nerve membranes due to low serum calcium b. Excess calcium ions in skeletal muscle due to excess parathyroid hormone (PTH) c. Excess calcium ions inside somatic nerves as a result of neoplasms d. Increased stimulation of the nerves in the cerebral cortex ANS: A 18. Parestesia is an effect of a. hyperkalemia. b. hypokalemia. c. hyponatremia. d. hypernatremia. ANS: B 19. In which of the following processes is the phosphate ion NOT a major component? Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 11 a. Bone metabolism b. Metabolic processes involving adenosine triphosphate (ATP) c. Blood clotting d. Acid-base balance ANS: C 20. Which of the following would be considered normal serum pH? a. 4.5-8 b. 7.0 c. 7.4 d. 8 ANS: C 21. When many excess hydrogen ions accumulate in the blood, what happens to serum pH? The pH a. decreases. b. increases. c. remains constant. d. varies based on metabolism. ANS: A 22. What is the slowest but most effective control for acid-base balance? a. Respiratory system b. Buffer systems in the blood c. Kidneys d. Brain ANS: C 23. Which of the following is essential in order to maintain serum pH within normal range? a. Carbonic acid and bicarbonate ion must be present in equal quantities. b. All excess carbonic acid must be excreted by the kidneys. c. The concentration of bicarbonate ion must remain constant. d. The ratio of carbonic acid to bicarbonate ion must be 1:20. ANS: D 24. Which is the correct effect on the body of abnormally slow respirations? a. Increased carbonic acid b. Decreased carbonic acid c. Increased bicarbonate ion d. Decreased bicarbonate ion ANS: A 25. Which condition is likely to cause metabolic acidosis? a. Slow, shallow respirations b. Prolonged diarrhea c. Mild vomiting d. Excessive fluid in the body Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 12 ANS: B 26. What would a serum pH of 7.33 in a patient with kidney disease indicate? a. Metabolic alkalosis b. Metabolic acidosis c. Respiratory alkalosis d. Respiratory acidosis ANS: B 27. Which serum value indicates decompensated metabolic acidosis? a. pH is below normal range. b. pH is above normal range. c. Bicarbonate level decreases. d. Bicarbonate level increases. ANS: A 28. What is the effect on blood serum when excessive lactic acid accumulates in the body? a. Bicarbonate ion levels decrease. b. Bicarbonate ion levels increase. c. Carbonic acid levels increase. d. pH increases. ANS: A 29. The direct effects of acidosis are manifested primarily in the functioning of the a. digestive system. b. urinary system. c. nervous system. d. respiratory system. ANS: C 30. Compensation mechanisms in the body for dehydration would include a. increased antidiuretic hormone (ADH). b. decreased aldosterone. c. slow, strong heart contraction. d. peripheral vasodilation. ANS: A 31. Which acid-base imbalance results from impaired expiration due to emphysema? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis ANS: C 32. In patients with impaired expiration associated with emphysema, effective compensation for the acid-base imbalance would be Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 15 b. increasing the permeability of nerve membranes. c. blocking movement of calcium ions. d. decreasing phosphate ion levels. ANS: B 45. Hypocalcemia causes weak cardiac contractions because a. permeability of nerve membranes increases. b. insufficient calcium ions are available for muscle contraction. c. low phosphate ion levels prevent muscle contraction. d. excessive amounts of calcium are stored in cardiac muscle. ANS: B 46. Serum potassium levels are affected by 1. ADH. 2. aldosterone. 3. serum H+ levels. 4. insulin levels. a. 2 only b. 1, 2 c. 1, 3 d. 2, 3, 4 e. 1, 2, 3 ANS: D 47. Which of the following is the primary control of serum Na+ levels? a. ADH b. Aldosterone c. Serum H+ levels d. Serum K+ levels ANS: B 48. The control center for thirst is located in the a. kidneys. b. thalamus. c. medulla. d. hypothalamus. ANS: D 49. Which statements apply to atrial natriuretic peptide? 1. It is secreted by heart muscle cells. 2. It is a hormone secreted by the kidneys. 3. It helps to control water and sodium balance. 4. It is released in response to low blood pressure. a. 1, 3 b. 1, 4 c. 2, 3 d. 2, 4 Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 16 ANS: A 50. What are the three mechanisms that control or compensate for serum pH? a. Hypothalamus, metabolic changes by digestive system, lymphatic system filtration b. Buffer pairs in blood, change in kidney excretion rate, change in respiration rate c. Neural feedback, increase in heart rate, decrease in calcium intake d. Modification of water intake, increased capillary permeability, decrease in blood volume ANS: B 51. Hypokalemia refers to a condition in which the serum has a very low level of which ion? a. Sodium b. Phosphate c. Calcium d. Potassium ANS: D 52. In the blood and extracellular fluids, hypernatremia refers to a. a deficient sodium level. b. an excess phosphate level. c. an excess sodium level. d. an excessively low phosphate level. ANS: C 53. Increased milk and/or antacid intake can contribute to development of “milk-alkali syndrome,” which can cause which of the following? a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypovolemia ANS: C 54. Ingested vitamin D must be activated in the a. liver. b. kidney. c. pancreas. d. lung. ANS: B 55. Neuromuscular hyperirritability may be a cause of a. hypomagnesemia. b. hypermagnesemia. c. hypophosphatemia. d. hyperphosphatemia. ANS: A Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 17 Chapter 03: Introduction to Basic Pharmacology and Other Common Therapies VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. Documenting drug-induced responses of physiologic and biochemical systems is part of a. pharmacokinetics. b. pharmacodynamics. c. pharmacotherapeutics. d. toxicology. ANS: B 2. The study of the body’s response to drugs, harmful effects, mechanisms of actions, symptoms, treatment, and identification is the role of a. pharmacokinetics. b. pharmacodynamics. c. pharmacotherapeutics. d. toxicology. ANS: C 3. Which of the following are considered to be the toxic effects of a drug? a. Additional, mild, unwanted effects b. Unusual, unexpected mild effects c. Serious, possibly life-threatening effects d. Reduction of the allergic response ANS: C 4. Dry mouth and drowsiness after the administration of an antihistamine is considered to be a(n) a. adverse effect. b. toxic effect. c. side effect. d. hypersensitivity effect. ANS: C 5. An unexpected or unusual response to a drug is called a(n) a. iatrogenic reaction. b. teratogenic effect. c. toxic effect. d. idiosyncratic reaction. ANS: D 6. A drug dose refers to a. the amount of a drug given at a single time. b. the total amount of a drug given over a period of time. c. the daily amount of a drug given. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 20 19. The form of therapy that involves assessment of physical function and works to restore any problems and prevent any further dysfunction using methods such as appropriate exercises and ultrasound is referred to as a. registered massage therapy. b. naturopathy. c. physiotherapy. d. reflexology. ANS: C 20. A medical history should include all 1. legally prescribed drugs. 2. vitamin or mineral supplements. 3. any medication not requiring a prescription (over-the-counter items). 4. herbal treatments. a. 1 only b. 1, 3 c. 1, 2, 4 d. 1, 2, 3, 4 ANS: D 21. Antagonistic drugs may be used to a. increase the effectiveness of selected drugs. b. prolong the action of a drug. c. act as an antidote when necessary. d. speed up the excretion of a drug. ANS: C 22. The full course of a prescribed antimicrobial drug should be completed so as to prevent a. undesirable side effects. b. development of resistant microbes. c. an allergic response. d. proper metabolism and excretion of drug. ANS: B 23. Transcutaneous electrical nerve stimulation (TENS) is a technology often used in a. chemotherapy. b. physiotherapy. c. occupational therapy. d. massage therapy. ANS: B 24. Which of the following therapies is considered an alternative therapy? a. Acupuncture b. Chiropractic therapy c. Osteopathy d. Speech therapy Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 21 ANS: A Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 22 Chapter 04: Pain VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. The impulses related to acute pain are usually transmitted by a. nociceptors. b. myelinated A delta fibers. c. unmyelinated C fibers. d. any sensory fiber with a low pain threshold. ANS: B 2. In which structure do pain impulses ascend the spinal cord? a. Reticular formation b. Corticospinal tract c. Spinothalamic tract d. Relevant dermatome ANS: C 3. According to the gate-control theory, passage of pain impulses may be naturally blocked a. at the synapse by entry of other sensory impulses. b. by the stress response. c. by administration of morphine directly into the spinal cord. d. by referring the pain to other parts of the body. ANS: A 4. What is the term used to describe the degree of pain that is endured before an individual takes action? a. Pain threshold b. Referred pain c. Phantom pain d. Pain tolerance ANS: D 5. What is the definition of endorphins? a. Neurotransmitters at the nociceptors b. Transmitters for sensory impulses c. Opiate-like blocking agents in the central nervous system d. Pain-causing chemical mediators ANS: C 6. Pain perceived in the left arm during the course of a heart attack is an example of a. referred pain. b. phantom pain. c. chronic pain. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 25 19. Which of the following is a characteristic of chronic pain? a. It usually initiates a physiological stress response. b. It always involves a strong emotional response such as high anxiety. c. It is more difficult to diagnose and treat than is acute pain. d. It involves tissue damage to a specific organ. ANS: C 20. A headache that results from pressure on the meninges surrounding the brain is referred to as a/an a. intracranial headache. b. intrameningeal headache. c. migraine headache. d. cerebral headache. ANS: A 21. Opioids released within the central nervous system are secreted by a. astrocytes. b. motoneurons. c. oligodendrocytes. d. interneurons. ANS: D 22. The release of neuropeptides due to a reduction in serotonin is often the cause of a. migraine. b. tension headache. c. phantom pain. d. visceral pain. ANS: A 23. Trigger point injections may be used to help relieve pain in a. acute pain. b. phantom pain. c. fibromyalgia. d. arthritis. ANS: C 24. A non-medication therapy that can be used in pain management and can be self-administered is a. trigger point injection. b. TENS. c. bioelectric therapy. d. trigger point injection and TENS. ANS: B 25. A therapy that induces the production of endorphins to help relieve pain and should only be used as a part of a total pain management program is Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 26 a. TENS. b. trigger point injections. c. bioelectric therapy. d. surgical implants. ANS: C Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 27 Chapter 05: Inflammation and Healing VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. Tears are considered to be part of the a. first line of defense. b. second line of defense. c. third line of defense. d. specific defense. ANS: A 2. A specific defense for the body is a. phagocytosis. b. sensitized T lymphocytes. c. the inflammatory response. d. intact skin and mucous membranes. ANS: B 3. The inflammatory response is a nonspecific response to a. phagocytosis of foreign material. b. local vasodilation. c. any tissue injury. d. formation of purulent exudates. ANS: C 4. Chemical mediators released during the inflammatory response include a. albumin and fibrinogen. b. growth factors and cell enzymes. c. macrophages and neutrophils. d. histamine and prostaglandins. ANS: D 5. The unnecessary spread or prolongation of inflammation is mediated by a. prostaglandins. b. histamines. c. resolvins. d. serotonin. ANS: C 6. Granulation tissue is best described as a. highly vascular, very fragile, and very susceptible to infection. b. an erosion through the wall of viscera, leading to complications. c. a type of adhesion with no vascularization. d. a form of stenosis, in a duct, that is extremely tough and resists attack by microbes. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 30 19. Patients taking glucocorticoids for long periods of time are likely to develop all of the following EXCEPT a. decreased bone density. b. wasting of skeletal muscle. c. opportunistic infections. d. increased leukocyte production. ANS: D 20. Which of the following drugs relieves fever and some types of pain but is NOT an anti-inflammatory agent? a. Acetaminophen b. Prednisone c. Aspirin d. Ibuprofen ANS: A 21. A burn area in which the epidermis and part of the dermis is destroyed is classified as a. full-thickness. b. deep partial-thickness. c. superficial partial-thickness. d. first-degree. ANS: B 22. A woman has burns on the anterior surfaces of her right arm, chest, and right leg. The percentage of body surface area burned is approximately a. 13.5%. b. 18%. c. 22.5%. d. 31.5%. ANS: C 23. The characteristic appearance of a full-thickness burn is a. painful with multiple blisters. b. heavy bleeding. c. red with some swelling. d. dry, firm, charred, or hard white surface. ANS: D 24. A typical source of infection in burn areas is a. the skin grafts. b. microbes surviving in the hair follicles in the burn area. c. circulating blood bringing microbes to the burn wound. d. opportunistic virus in digestive tract. ANS: B 25. A large burn area predisposes to decreased blood pressure because a. bleeding occurs under the burn surface. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 31 b. the heart is damaged by toxic materials from the burn. c. fluid and protein shift out of the blood. d. vasoconstriction occurs in the burn area. ANS: C 26. During an inflammatory response, hyperemia is caused by a. increased blood flow in the area. b. increased capillary permeability. c. irritation of sensory nerve endings by histamine. d. increased leukocytes in the area. ANS: A 27. The advantages of applying a biosynthetic skin substitute to a large area of full-thickness burns include 1. reduced risk of infection. 2. decreased loss of plasma protein and fluid. 3. developing stronger fibrous scar tissue. 4. more rapid healing. 5. regeneration of all glands, nerves, and hair follicles. a. 1, 3 b. 4, 5 c. 1, 2, 4 d. 2, 3, 5 ANS: C 28. Purulent exudates usually contain a. small amounts of plasma protein & histamine in water. b. red blood cells & all types of white blood cells. c. numerous leukocytes, bacteria, and cell debris. d. large amounts of water containing a few cells. ANS: C 29. Isoenzymes in the circulating blood a. are a type of plasma protein normally present in the circulating blood. b. often indicate the precise location of an inflammatory response. c. are normally released from leukocytes during the inflammatory response. d. are pyrogens, causing low-grade fever. ANS: B 30. A serous exudate is best described as a a. thin, watery, colorless exudate. b. thick, sticky, cloudy secretion. c. thick, greenish material containing microbes. d. brownish, clotted material. ANS: A 31. Systemic manifestations of an inflammatory response include Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 32 a. edema and erythema. b. area of necrosis and loss of function. c. pain and tenderness. d. fever and malaise. ANS: D 32. Some local effects of a general inflammatory response would include a. high, spiking fever and chills. b. redness, warmth, and swelling. c. leukopenia and reduced erythrocyte sedimentation rate (ESR). d. anorexia and headaches. ANS: B 33. Prolonged administration of glucocorticoids such as prednisone may cause 1. atrophy of lymphoid tissue. 2. increased resistance to infection. 3. thrombocytopenia. 4. decreased protein synthesis. a. 1, 2 b. 1, 3 c. 1, 4 d. 2, 4 ANS: C 34. Application of ice to an injured knee reduces edema by a. promoting return of lymph fluid. b. causing local vasoconstriction. c. increasing the rate of tissue repair. d. causing systemic vasodilation. ANS: B 35. Healing of large areas of skin loss (including dermis and epidermis) would be most successful through a. rapid mitosis and regeneration of skin layers. b. resolution of damaged cells in the area. c. covering the area with biosynthetic skin substitute. d. graft of fibrous tissue to the area. ANS: C 36. Prostaglandins are produced from and cause . a. activated plasma protein; increased capillary permeability b. mast cells; vasodilation and pain c. platelets; attraction of neutrophils, chemotaxis d. mast cell granules; activation of histamines and kinins ANS: B 37. The number of neutrophils in the blood is increased significantly Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 35 a. Resolution occurs where there is minimal tissue damage and the cells can recover. b. Granulation tissue forms a permanent replacement for damaged tissue. c. Regeneration occurs where the cells are capable of mitosis. d. Scar tissue forms where the surrounding cells are incapable of mitosis. ANS: B 50. Which of the following statements regarding inflammation is incorrect? a. Inflammation caused by an allergen or a burn will typically produce a serous exudate. b. Infection is one cause of inflammation. c. Inflammation is the body’s nonspecific response to tissue injury. d. Disorders are named using the ending -sarcoma to indicate inflammation. ANS: D 51. Which of the following helps to localize and “wall off” the foreign material during an inflammatory response? a. Lymphocytes b. Increased fluid c. Fibrinogen d. Antibodies ANS: C 52. Why is an application of cold recommended as part of the RICE first aid measures immediately following an inflammatory response due to injury? a. It improves circulation in the area removing chemical mediators. b. It causes local vasoconstriction to reduce local edema. c. It draws more phagocytic cells to the area to remove debris. d. It promotes immediate healing. ANS: B 53. One goal for current research in tissue engineering is to a. create a functional replacement tissue when regeneration is not possible. b. adapt cells from the injured organ to produce replacement tissue. c. design a nonliving synthetic replacement tissue. d. use stem cells as a temporary covering for damaged tissue. ANS: A 54. Identify the proper sequence in the healing process. a. A blood clot forms; granulation tissue grows into the gap; new blood vessels develop; phagocytosis of foreign material and cell debris occurs; and collagen fibers form a tight, strong scar. b. A blood clot forms; phagocytes remove foreign material and cell debris; granulation tissue grows into the gap; new blood vessels form; and collagen fibers promote formation of a tight, strong scar. c. Collagen fibers form in the damaged area; a blood clot forms; granulation tissue grows into the gap; angiogenesis takes place; and foreign material and cell debris are removed by phagocytes. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 36 d. Foreign material and cell debris are removed by phagocytes; a blood clot forms; granulation tissue grows into the gap; new blood vessels form; and collagen fibers grow and cross-link. ANS: B 55. All of the following are factors that promote healing EXCEPT a. good nutrition: protein, vitamins A and C. b. a clean, undisturbed wound. c. effective circulation. d. advanced age. ANS: D 56. Identify the correct statement about burns: a. The severity of the burn depends on the temperature, duration, and extent of the burn. b. Young children are less likely to suffer severe burns from immersion in excessively hot water. c. Burns to the palms of the hands are more damaging than burns on the face. d. With a major burn, excessive bleeding usually causes shock. ANS: A 57. Which statement applies to the recommended emergency care for burns? a. Drop and lie completely still on your back. b. Call a neighbor for help if the burn appears to be extensive. c. Apply lotion and cover burn tightly with a sheet or towel. d. Cover the burn area with clean, cool, or tepid water and remove nonsticking clothing. ANS: D 58. Inhalation of carbon monoxide is a threat for many burn patients because this gas a. causes swelling in the trachea. b. quickly reduces the available oxygen in the blood. c. prevents full expansion of the lungs. d. is toxic to the nervous system. ANS: B 59. Hypermetabolism is common with major burns because of a. increased heat loss from the burn wound. b. demand for tissue repair. c. recurrent stress response. d. all of these. ANS: D 60. How does scar tissue usually cause obstructions to develop in tube-like structures? a. Scar tissue continues to grow and spread, causing a blockage. b. Scar tissue does not stretch, but rather shrinks in time, causing narrowing. c. Scar tissue twists and forms knots as it develops. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 37 d. Scar tissue attaches to nearby normal tissue, causing obstruction. ANS: B 61. Which of the following is a serious potential complication found only with the anti-inflammatory COX-2 inhibitor drugs? a. Increased risk of infection at the site of inflammation b. Reye’s syndrome developing in children and young adults c. Increased incidence of heart attacks d. Greatly delayed blood clotting ANS: C 62. Which of the following spices does NOT show anti-inflammatory action? a. White pepper b. Turmeric c. Ginger root d. Basil ANS: A 63. Cytokines are chemical mediators released by a. platelets. b. macrophages. c. B lymphocytes. d. mast cells. ANS: B 64. Which of the following cell types is significantly increased in numbers during an allergic response? a. Neutrophils b. Eosinophils c. Basophils d. Macrophages ANS: B 65. A substance normally not found in the blood, but appears with acute inflammation and necrosis within 24 to 48 hours is a. fibrinogen. b. histamine. c. prothrombin. d. C-reactive protein. ANS: D Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 40 ANS: C 13. Which of the following is a characteristic of rickettsia? a. It is a very small gram-negative intracellular microbe. b. It exists in three forms. c. It causes sexually transmitted disease. d. It reproduces by budding. ANS: A 14. Entamoeba histolytica is transmitted by which of the following? a. Mosquitoes (bites) b. Inhaling contaminated particles c. Sexual intercourse d. Cysts in feces ANS: D 15. Which of the following is a characteristic of resident or normal flora (microflora)? a. It exists in all areas of the body. b. Different species inhabit various areas of the body. c. It is of no benefit to the human host. d. It consists only of bacteria. ANS: B 16. Which of the following is normally considered sterile? a. Urine b. Pharynx c. Distal urethra d. Vagina ANS: A 17. The term nosocomial infection means a. transmission involves an insect or animal host. b. acquired in a hospital or medical facility. c. transmitted by a fomite. d. spread by direct contact with secretions from an open lesion. ANS: B 18. Transmission of microbes by direct contact includes a. touching a contaminated countertop. b. sexual intercourse. c. drinking contaminated water. d. inhaling dust-borne microbes. ANS: B 19. What does the term carrier mean? a. A person with active infection who acts as a reservoir for microbes b. Animals, insects, objects, or surfaces contaminated by pathogens Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 41 c. An individual who is contagious through infected secretions on the hands d. An asymptomatic person whose body harbors pathogens and can transmit them to others ANS: D 20. Opportunistic infection may develop when a. pathogens enter the body but cannot colonize the site of entry. b. an imbalance occurs in the normal resident flora. c. host resistance increases, and the balance of resident flora is restored. d. contaminated food or water is unknowingly ingested. ANS: B 21. Host resistance is promoted by all of the following EXCEPT a. prescribed immunizations. b. chronic respiratory disease. c. vitamin and mineral supplements. d. appropriate inflammatory or immune response. ANS: B 22. Which of the following factors would NOT increase the virulence of a specific microbe? a. Secretion of endotoxin b. Presence of a bacterial capsule c. Production of interferons d. Secretion of invasive enzymes ANS: C 23. That time in the course of an infection when the infected person may experience a headache or fatigue and senses he or she is “coming down with something” is referred to as which of the following? a. Subclinical period b. Eclipse period c. Prodromal period d. Presymptomatic period ANS: C 24. The principle of Universal Precautions is based on a. using disinfectants at all times to eliminate cross-infections. b. not touching any open or bleeding lesions. c. sterilizing all instruments and equipment after each use. d. assuming that all body fluids from all individuals are possible sources of infection. ANS: D 25. The “incubation period” refers to the time period between a. entry of the pathogen into the body and the first signs of infectious disease. b. the onset of the prodromal period and the peak of the acute infection. c. the onset of clinical signs and signs of recovery from infection. d. the acute period and establishment of chronic infection. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 42 ANS: A 26. What does “bacteremia” refer to? a. Numerous pathogens circulating and reproducing in the blood b. Uncontrolled sepsis throughout the body c. Multiple infections, primary and secondary, established in the body d. Microbes present in the blood ANS: D 27. Which of the following is a local sign of infection? a. Fever and leukocytosis b. Headache and anorexia c. Pain, erythema, and swelling d. Nausea, weight loss, and fatigue ANS: C 28. What are culture and sensitivity tests used for? a. To determine the type of microbe present in an exudate b. To provide a specific medium that supports maximum microbial growth c. To identify the causative microbe and the effective antimicrobial agent for it d. To provide living host cells for microbes requiring such for replication ANS: C 29. A broad-spectrum bactericidal agent would be expected to a. destroy many gram-positive and gram-negative bacteria. b. destroy all pathogenic microbes in contact with the agent. c. reduce the replication of many bacteria. d. inhibit the growth of most spores and acid-fast bacteria. ANS: A 30. How does penicillin act as a bactericidal agent? a. It interferes with cell-wall synthesis. b. It blocks protein synthesis. c. It increases cell membrane permeability. d. It prevents DNA replication. ANS: A 31. Secondary infection may occur with administration of antibacterial drugs because the a. patient is allergic to the drug. b. balance of species in the resident flora is upset. c. mucosa of the stomach is irritated. d. infecting microbes spread to adjacent areas. ANS: B 32. All of the following are mechanisms of antiviral drug action EXCEPT a. interference with attachment to host cell. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 45 45. Inflamed tissue is likely to become infected because a. the immune system is not effective in inflamed tissue. b. the increased fluid and protein in the inflamed area supports microbial growth. c. phagocytes cannot penetrate the inflamed areas. d. capillaries are less permeable in the affected area. ANS: B 46. When an infectious disease is occurring globally at a higher rate than usual, it may be designated as a/an a. sporadic occurrence. b. epidemic. c. pandemic. d. emerging disease. ANS: C 47. Which of the following is the primary difference between an antiseptic and a disinfectant? a. Antiseptic is used on living tissue, whereas disinfectant is designed for nonliving surfaces. b. Antiseptic is much stronger than the potency of a disinfectant. c. Antiseptic often causes allergic skin reactions, whereas disinfectant is always hypoallergenic. d. Antiseptic is effective against endospores; disinfectants are not effective against endospores. ANS: A 48. Drugs that are designed to inhibit or slow down growth of microbes but not necessarily kill them are considered a. ineffective. b. bacteriostatic. c. narrow-spectrum. d. bactericidal. ANS: B 49. Creutzfeldt-Jacob disease is caused by a(n) a. virus. b. bacterium. c. fungus. d. prion. ANS: D 50. The pandemic that started in 2019 is a. MERS. b. Covid-19. c. Ebola. d. SARS. ANS: B Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 46 Chapter 07: Immunity VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. Neutrophils a. are phagocytic cells. b. produce histamine. c. produce antibodies. d. are elevated during an allergic response. ANS: A 2. Which cells are required to process and present antigens from foreign material as the initial step in the immune response? a. T-helper cells b. Macrophages c. Eosinophils d. Monocytes ANS: B 3. Humoral immunity is mediated by a. natural killer cells. b. T lymphocytes (T cells). c. B lymphocytes (B cells). d. neutrophils. ANS: C 4. A secondary immune response differs from the primary immune response in that a. it is more rapid than the primary response and results in higher antibody levels. b. it is slower than the primary response and doesn’t change the antibody levels. c. it occurs at the same time as the primary response but results in a decrease in antibodies. d. it only occurs in hyperallergic reactions and results in a decrease of antibodies. ANS: A 5. Which type of immunity is provided by a vaccination? a. Active natural b. Active artificial c. Passive natural d. Passive artificial ANS: B 6. When an allergen binds with IgE antibodies on mast cells, resulting in release of chemical mediators, this reaction is called a. cytotoxic hypersensitivity. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 47 b. immune complex hypersensitivity. c. type I hypersensitivity. d. type IV hypersensitivity. ANS: C 7. The role of memory cells is to a. change into an antibody-secreting cell following activation. b. immediately secrete antibodies following the first exposure to antigen. c. recognize the antigen and stimulate the immune response. d. bind complement to the antibody. ANS: C 8. Which statement applies to contact dermatitis? a. It occurs when IgE antibodies on the skin react with the causative substance. b. It may result from ingested foods. c. Urticaria (hives) gradually spread over the body. d. A type IV reaction occurs in affected areas. ANS: D 9. Which of the following causes anaphylaxis? a. A severe, systemic allergic reaction b. Type III hypersensitivity c. Cell-mediated hypersensitivity d. Immune complex deposits in many tissues ANS: A 10. Following a positive HIV antibodies blood test and ELISA test, what is the test commonly used for confirmation? a. Agglutination b. Double immunodiffusion test c. Western blot test d. Sedimentation rate test ANS: C 11. Incompatible blood transfusions result in a. hemolysis of erythrocytes. b. a type I immune response. c. deposits in multiple organs. d. immune deficiency. ANS: A 12. An autoimmune disease is a. excessive formation of antibodies following exposure to foreign material. b. an extreme response to normally harmless material in the environment. c. an abnormal response to ingested food and drugs. d. failure of the immune system to distinguish self from nonself. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 50 ANS: C 25. In cases of HIV infection, the “window period” refers to the time between a. entry of the virus into the blood and the initial manifestations. b. entry of the virus into the body and the appearance of antibodies in the blood. c. entry of the virus into the body and a significant drop in CD4 T-helper lymphocyte count. d. diagnosis of “HIV positive” and diagnosis of “AIDS.” ANS: B 26. Which of the following is an effect of cytokines? They a. activate and stimulate proliferation of B and T lymphocytes. b. destroy antigens quickly. c. increase the rate of mitosis in tumors. d. cause immediate pain. ANS: A 27. What does seroconversion mean in relation to HIV and AIDS? a. The virus has been identified in the blood and body fluids. b. Antibodies for HIV have been identified in the blood. c. HIV was found in lymphocytes. d. Active infection has developed in the patient. ANS: B 28. Which of the following statements is TRUE regarding a patient who is HIV positive? a. No medication is required until the CD4 cell count drops below normal range. b. Antibodies are present, destroying the virus and preventing transmission to others. c. Antibodies in the blood indicate presence of virus and possible transmission to others. d. Enzymes have not yet converted RNA to DNA for replication. ANS: C 29. The term tolerance refers to a. surveillance and destruction of new cancer cells by the immune system. b. the ability of the immune system to ignore “self” cells. c. the ability of T and B lymphocytes to work together. d. the role of lymphoid tissue in the body defenses. ANS: B 30. Which of the following statements applies to the complement system? a. It is activated by IgE. b. It blocks the inflammatory response. c. It consists of proteins in the blood that must be activated. d. It may destroy antibodies in the circulation. ANS: C Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 51 31. Which of the following statements regarding immunoglobulins is TRUE? a. They consist of a unique sequence of amino acids. b. They are produced in the red bone marrow. c. They are attached to mucosal membranes at entry points into the body. d. IgA binds to allergens. ANS: A 32. Which of the following is NOT a cause of immunodeficiency? a. Hypoplasia of the thymus b. Delayed hypersensitivity c. Immunosuppressive drugs d. Atrophy of the lymph nodes ANS: B 33. Which statement is TRUE regarding infants born to HIV-infected mothers? a. Infants usually test negative for HIV after birth. b. There is little risk of infected mothers passing the virus to their infants during delivery. c. Breast milk does not contain HIV or antibodies. d. Infants test positive for HIV because of the presence of maternal antibodies. ANS: D 34. The most common cause of death in patients who have AIDS is a. HIV encephalopathy. b. tuberculosis. c. Pneumocystis carinii pneumonia. d. Candida infection. ANS: C 35. Tissue transferred between two genetically identical twins is referred to as a/an a. allograft. b. syngraft. c. isograft. d. autograft. ANS: C 36. The most common clinical condition associated with a cytokine storm is a. acute respiratory stress syndrome. b. ischemic attack. c. arrythmia. d. blood clotting. ANS: A 37. Which population in the US shows the highest incidence of AIDS? a. Caucasian b. Hispanic c. Black American Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 52 d. American Indian ANS: C 38. Maturation of B lymphocytes takes place in the a. thymus. b. bone marrow. c. lymph nodes. d. spleen. ANS: B 39. The type of antibody found in mucous membranes is a. IgD. b. IgM. c. IgG. d. IgA. ANS: D 40. IgGs transferred from mother to fetus across the placenta is referred to as a. passive artificial immunity. b. passive natural immunity. c. active artificial immunity. d. active natural immunity. ANS: B Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 55 a. trunk. b. feet. c. scalp. d. nails. ANS: C 14. Plantar warts are caused by a. the fungus aspergillus. b. a parasitic arthropod. c. human papillomavirus. d. the bacterium Streptococcus pyogenes. ANS: C 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 16. Which type of microbe causes Tinea infections? a. Fungus b. Virus c. Gram-negative bacterium d. Mite ANS: A 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 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 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 Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 56 ANS: C 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 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 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 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 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 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 26. The pathological change associated with scleroderma is a. abnormal activation of T lymphocytes and an increase of cytokines. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 57 b. an autoimmune reaction damaging the epidermis. c. collagen deposits in the small blood vessels of the skin and sometimes the viscera. d. Type I hypersensitivity and increased serum IgE levels. ANS: C 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 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 29. Leprosy (Hansen’s disease) is caused by a. a fungus. b. a bacterium. c. a virus. d. a helminth. ANS: B 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 31. Dupuytren’s contracture is a deformity that involves a. knots of tissue in the palm of the hand resulting in bent fingers. b. tissue atrophy of the long leg muscles. c. involuntary contraction of the muscles of the spine. d. scar tissue that causes excessive joint pain. ANS: A Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 60 a. Autosomal recessive gene b. X-linked recessive gene c. Autosomal dominant gene d. Codominant gene ANS: B 14. Which of the following is true about Duchenne’s muscular dystrophy? a. There is difficulty climbing stairs or standing up at 2 to 3 years of age. b. It involves only the legs and pelvis. c. Skeletal muscle atrophy can be seen in the legs of a toddler. d. It cannot be detected in any carriers. ANS: A 15. The most common type of joint, which are freely movable, are called a. synarthroses. b. amphiarthroses. c. anarthroses. d. diarthroses. ANS: D 16. Which of the following is characteristic of osteoarthritis? a. Inflammation and fibrosis develop at the joints. b. Degeneration of articulating cartilage occurs in the large joints. c. It progresses bilaterally through the small joints. d. There are no changes in the bone at the affected joints. ANS: B 17. What is a typical characteristic of the pain caused by osteoarthritis? a. Decreases over time b. Quite severe in the early stages c. Aggravated by general muscle aching d. Increased with weight-bearing and activity ANS: D 18. What limits joint movement in osteoarthritis? a. The osteophytes and irregular cartilage surface b. The wider joint space c. Decreased amount of synovial fluid in the cavity d. Fibrosis involving the joint capsule and ligaments ANS: A 19. Joints affected by osteoarthritis can sometimes affect healthy joints by a. causing enzymes to be released that travel to other joints. b. bacteria traveling from the affected join to a healthy one through the bloodstream. c. inflammation and edema affecting the entire limb. d. the affected individual’s exerting stress on the normal joint to protect the damaged one. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 61 ANS: D 20. What is the typical joint involvement with rheumatoid arthritis? a. Random single joints, progressing to involve other joints b. Bilateral small joints, symmetrical progression to other joints c. Abused or damaged joints first, then joints damaged by compensatory movement d. Progressive degeneration in selected joints ANS: B 21. What is the basic pathology of rheumatoid arthritis? a. Degenerative disorder involving the small joints b. Chronic inflammatory disorder affecting all joints c. Systemic inflammatory disorder due to an autoimmune reaction d. Inflammatory disorder causing damage to many organs ANS: C 22. How is the articular cartilage damaged in rheumatoid arthritis? a. Enzymatic destruction by the pannus. b. Inflamed synovial membrane covers the cartilage. c. Fibrous tissue connects the ends of the bones. d. Blood supply to the cartilage is lost. ANS: A 23. How does the joint appear during an exacerbation of rheumatoid arthritis? a. Relatively normal b. Enlarged, firm, crepitus with movement c. Deformed, pale, and nodular d. Red, warm, swollen, and tender to touch ANS: D 24. Ankylosis and deformity develop in rheumatoid arthritis because a. skeletal muscle hypertrophies. b. fibrosis occurs in the joint. c. replacement cartilage changes alignment. d. ligaments and tendons shorten. ANS: A 25. Systemic effects of rheumatoid arthritis are manifested as a. nodules in various tissues, severe fatigue, and anorexia. b. headache, leukopenia, and high fever. c. swelling and dysfunction in many organs. d. progressive damage to a joint. ANS: A 26. What is a common effect of long-term use of glucocorticoids to treat rheumatoid arthritis? a. Leukocytosis Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 62 b. Osteoporosis c. Severe anemia d. Orthostatic hypotension ANS: B 27. Juvenile rheumatoid arthritis (JRA) differs from the adult form in that a. only small joints are affected. b. rheumatoid factor is not present in JRA, but systemic effects are more severe. c. onset is more insidious in JRA. d. deformity and loss of function occur in most children with JRA. ANS: B 28. Which of the following distinguishes septic arthritis? a. Multiple joints that are swollen, red, and painful at one time b. Presence of mild fever, fatigue, and leukocytosis c. Purulent synovial fluid present in a single, swollen joint d. Presence of many antibodies in the blood ANS: C 29. Which of the following may precipitate an attack of gout? a. A sudden increase in serum uric acid levels b. Severe hypercalcemia c. Mild trauma to the toes d. Development of a tophus ANS: A 30. Where does inflammation usually begin in an individual with ankylosing spondylitis? a. Costovertebral joints with progression down the spine b. Cervical and thoracic vertebrae, causing kyphosis c. Sacroiliac joints with progression up the spine d. Peripheral joints and then proceeds to the vertebrae ANS: C 31. What is a common outcome of fibrosis, calcification, and fusion of the spine in ankylosing spondylitis? a. Damage to the spinal nerves and loss of function b. Frequent fractures of long bones c. Impaired heart function d. Rigidity, postural changes, and osteoporosis ANS: D 32. Which statement applies to menisci? a. They are found in the hip joints. b. They are secretory membranes in joints. c. They prevent excessive movement of joints. d. They are found in the shoulder joint. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 65 b. greenstick fracture. c. simple fracture. d. comminuted fracture. ANS: D 46. Fluid-filled sacs composed of synovial membrane located between structures such as tendons and ligaments and act as additional cushions are called a. articular capsules. b. bursae. c. synovial sacs. d. hyaline chambers. ANS: B 47. An autoimmune form of arthritis is known as a. septic arthritis. b. psoriatic arthritis. c. chronic arthritis. d. multifocal arthritis. ANS: B Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 66 Chapter 10: Blood and Circulatory System Disorders VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. 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 2. What term is used to describe a deficit of all types of blood cells? a. Leucopenia b. Neutropenia c. Pancytopenia d. Erythrocytosis ANS: C 3. 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 4. Vitamin K is required by the liver to synthesize a. heparin. b. prothrombin. c. amino acids. d. bilirubin. ANS: B 5. 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 6. 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 Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 67 ANS: A 7. 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 8. 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 9. 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 10. 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 11. Jaundice is one typical sign of a. sickle cell anemia. b. aplastic anemia. c. iron deficiency anemia. d. acute leukemia. ANS: A 12. 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 Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 70 26. 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 27. Which of the following substances acts as an anticoagulant? a. Prothrombin b. Heparin c. Fibrinogen d. Vitamin K ANS: B 28. In individuals with acute leukemia, the increased number of malignant leukocytes leads to 1. decreased hemoglobin. 2. thrombocytopenia. 3. bone pain with increased activity. 4. splenomegaly. a. 1, 3 b. 1, 2, 4 c. 2, 3, 4 d. 1, 2, 3, 4 ANS: B 29. 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 30. 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 31. Predisposing factors to leukemia commonly include a. exposure to radiation. b. certain fungal and protozoal infections. c. familial tendency. d. cigarette smoking. ANS: A 32. Von Willebrand disease is caused by Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 71 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 33. 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 34. Multiple myeloma is a malignant tumor involving a. plasma cells. b. granulocytes. c. bone cells. d. lymph nodes. ANS: A 35. What is the primary treatment for the leukemias? a. Radiation b. Chemotherapy c. Surgery d. Immunotherapy ANS: B 36. 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. c. a metabolic error that leads to excess amounts of hemosiderin, causing damage to organs. d. an inherited defect that results in abnormal hemoglobin. ANS: C 37. 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 38. Secondary polycythemia may be associated with a. frequent angina attacks. b. certain types of anemia. c. severe chronic bronchitis. d. renal disease. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 72 ANS: C 39. 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: D 40. 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 41. 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 42. 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 43. 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 44. 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 Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 75 Chapter 11: Lymphatic System Disorders VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. The spleen has a number of important functions, which include a. lymph production, hematopoiesis, platelet production. b. hematopoiesis, destruction of old erythrocytes, blood reservoir. c. defense from infection, metabolism of vitamins, platelet production. d. lipid metabolism, production of hemoglobin, water absorption. ANS: B 2. The function of the hormones secreted by the thymus gland is to a. break down old erythrocytes and recycle the hemoglobin. b. concentrate the lymph and filter out toxins. c. stimulate lymph production. d. enable lymphocytes to develop into mature T cells. ANS: D 3. Malignant neoplasms involving lymphocyte proliferation in the lymph nodes are called a. lymphomas. b. myelomas. c. lymphocytomas. d. lymphedemas. ANS: A 4. The atypical cell that serves as a marker for diagnosing Hodgkin’s lymphoma is the a. monocyte. b. Ann Arbor cell. c. Hodgkin’s lymphocyte. d. Reed-Sternberg cell. ANS: D 5. The staging system typically used in determining the stage of the Hodgkin’s lymphoma is the a. Reed-Sternberg system. b. sequential staging system. c. Ann Arbor system. d. differential landmark system. ANS: C 6. One of the reasons non-Hodgkin’s lymphomas are harder to treat than Hodgkin’s lymphomas is that they a. tend to be much larger than Hodgkin’s lymphomas. b. involve multiple nodes and widespread metastases. c. are not affected by the newer drug treatments. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 76 d. are asymptomatic until they reach stage IV. ANS: B 7. Multiple myeloma is a neoplastic disease of unknown etiology occurring in older adults and involving a. plasma cells. b. T cells. c. NK cells. d. monocytes. ANS: A 8. Elephantiasis, caused by the obstruction of lymphatic vessels by parasitic worms, is an example of the condition known as a. plasma cell myeloma. b. diverticulitis. c. lymphedema. d. obstructive vessel disorder. ANS: C 9. A rare illness that involves the overgrowth of lymphoid tissue, although not itself considered a cancer is a. Castleman disease. b. hyperlymphatic disease. c. hypolymphatic disease. d. Ann Arbor disease. ANS: A 10. Non-Hodgkin’s lymphomas are increasing in incidence, partly due to the numbers associated with a. an increase in resistant microorganisms. b. an increase in adult obesity. c. an increase in high cholesterol levels. d. an increase in HIV infections. ANS: D 11. A general term for the inflammation or infection of the lymph nodes is called a. gout. b. Castleman disease. c. myeloma. d. lymphadenopathy. ANS: D Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 77 Chapter 12: Cardiovascular System Disorders VanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th Edition MULTIPLE CHOICE 1. 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 2. When stroke volume decreases, which of the following could maintain cardiac output? a. Decreased peripheral resistance b. Increased heart rate c. Decreased venous return d. General vasodilation ANS: B 3. 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 4. 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 5. The function of the baroreceptors is to a. stimulate the parasympathetic or sympathetic nervous system at the 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 6. 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. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 80 a. reduces vasoconstriction and peripheral resistance. b. decreases serum lipid levels. c. promotes platelet adhesion. d. increases serum HDL levels. ANS: C 20. 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 21. 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 22. 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 23. 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 24. 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 25. 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. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 81 ANS: D 26. 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 27. 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 28. 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 29. 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 30. 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 31. 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 32. The most common cause of death immediately following a myocardial infarction is a. cardiac arrhythmias and fibrillation. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 82 b. ruptured ventricle or aorta. c. congestive heart failure. d. cerebrovascular accident. ANS: A 33. 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 34. 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 35. Which change results from total heart block? a. A prolonged PR interval b. Periodic omission of a ventricular contraction c. A wide QRS wave d. Spontaneous slow ventricular contractions, not coordinated with atrial contraction ANS: D 36. 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 37. 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 38. 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. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 85 ANS: D 52. Common signs of rheumatic fever include all of the following EXCEPT a. arthritis, causing deformity of the small joints in the hands and feet. b. erythematous skin rash and subcutaneous nodules. c. epistaxis, tachycardia, and fever. d. elevated ASO titer and leukocytosis. ANS: A 53. Rheumatic heart disease usually manifests in later years as a. swollen heart valves and fever. b. cardiac arrhythmias and heart murmurs. c. thrombus formation and septic emboli. d. petechial hemorrhages of the skin and mucosa. ANS: B 54. Septic emboli, a common complication of infective endocarditis, are a result of the fact that a. vegetations are loosely attached and fragile. b. the valves are no longer competent. c. cardiac output is reduced. d. heart contractions are irregular. ANS: A 55. Which of the following applies to subacute infective endocarditis? a. A microbe of low virulence attacks abnormal or damaged heart valves. b. Virulent microbes invade normal heart valves. c. No permanent damage occurs to the valves. d. Prophylactic medication does not prevent infection. ANS: A 56. Pericarditis causes a reduction in cardiac output as a result of which of the following? a. Delays in the conduction system, interfering with cardiac rhythm b. Weak myocardial contractions due to friction rub c. Excess fluid in the pericardial cavity, which decreases ventricular filling d. Incompetent valves, which allow regurgitation of blood ANS: C 57. Pericarditis may be caused by 1. infection. 2. abnormal immune responses. 3. injury. 4. malignant neoplasm. a. 1, 2 b. 3, 4 c. 1, 3, 4 d. 1, 2, 3, 4 ANS: D Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 86 58. A source of an embolus causing an obstruction in the brain could be the a. femoral vein. b. pulmonary vein. c. carotid artery. d. coronary artery. ANS: C 59. The basic pathophysiological change associated with essential hypertension is a. development of lipid plaques in large arteries. b. recurrent inflammation and fibrosis in peripheral arteries. c. degeneration and loss of elasticity in arteries. d. increased systemic vasoconstriction. ANS: D 60. Uncontrolled hypertension is most likely to cause ischemia and loss of function in the a. kidneys, brain, and retinas of the eye. b. peripheral arteries in the legs. c. aorta and coronary arteries. d. liver, spleen, and stomach. ANS: A 61. When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals? a. Blood pressure remains consistently above 140/90. b. Blood pressure fluctuates between 130/85 and 180/105. c. Blood pressure increases rapidly and is unresponsive to medication. d. Chronic kidney disease leads to consistently elevated blood pressure. ANS: A 62. Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following? 1. Gangrenous ulcers in the legs 2. Strong rapid pulses in the legs 3. Intermittent claudication 4. Red, swollen legs a. 1, 2 b. 1, 3 c. 2, 3 d. 2, 4 ANS: B 63. The term intermittent claudication refers to a. sensory deficit in the legs due to damage to nerves. b. chest pain related to ischemia. c. ischemic muscle pain in the legs, particularly with exercise. d. dry, cyanotic skin with superficial ulcers. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 87 ANS: C 64. What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease? a. It promotes more rapid healing of ulcerated areas. b. It improves circulation to other areas. c. It prevents spread of infection and reduces pain. d. It reduces swelling in the peripheral areas. ANS: C 65. An echocardiogram is used to demonstrate any abnormal a. activity in the conduction system. b. movement of the heart valves. c. change in central venous pressure. d. blood flow in coronary arteries. ANS: B 66. A friction rub is associated with a. infectious endocarditis. b. arrhythmias. c. pericarditis. d. an incompetent aortic valve. ANS: C 67. Shock is defined as a. failure of the heart to supply sufficient blood to body cells. b. general hypoxia, causing damage to various organs. c. decreased circulating blood and tissue perfusion. d. loss of blood, causing severe hypoxia. ANS: C 68. Shock follows a myocardial infarction when a. the stress response causes general vasodilation. b. fluid is lost into ischemic tissues. c. heart valves are damaged. d. a large portion of the myocardium is damaged. ANS: D 69. What are the early signs of circulatory shock? 1. Pale moist skin 2. Loss of consciousness 3. Anxiety and restlessness 4. Rapid strong pulse a. 1, 2 b. 1, 3 c. 1, 4 d. 3, 4 Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 90 83. Confirmation of the diagnosis of a myocardial infarction would include 1. specific changes in the ECG. 2. marked leukocytosis and increased erythrocyte sedimentation rate (ESR). 3. elevation of cardiac isoenzymes in serum. 4. a pattern of pain. a. 1, 2 b. 1, 3 c. 2, 4 d. 3, 4 ANS: B 84. Which of the following statements regarding aneurysms is true? a. Aneurysms are always caused by congenital malformations. b. The greatest danger with aneurysms is thrombus formation. c. Manifestations of aneurysms result from compression of adjacent structures. d. Aneurysms involve a defect in the tunica media of veins. ANS: C 85. In the period immediately following a myocardial infarction, the manifestations of pallor and diaphoresis, rapid pulse, and anxiety result from a. onset of circulatory shock. b. the inflammatory response. c. release of enzymes from necrotic tissue. d. heart failure. ANS: A 86. Septic shock differs from hypovolemic shock in that it is frequently manifested by a. fever and flushed face. b. elevated blood pressure. c. increased urinary output. d. slow bounding pulse. ANS: A 87. Heart block, in which a conduction delay at the AV node results in intermittent missed ventricular contractions, is called a. first-degree block. b. second-degree block. c. bundle-branch block. d. total heart block. ANS: B 88. More extensive permanent damage is likely when a myocardial infarction is caused by a. a hemorrhage. b. an embolus. c. a thrombus. d. an arrhythmia. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 91 ANS: B 89. A very rapid heart rate reduces cardiac output because a. venous return is increased. b. ventricular fibrillation develops immediately. c. conduction through the AV node is impaired. d. ventricular filling is reduced. ANS: D 90. The right side of the heart would fail first in the case of 1. severe mitral valve stenosis. 2. uncontrolled essential hypertension. 3. large infarction in the right ventricle. 4. advanced chronic obstructive pulmonary disease (COPD). a. 1, 2 b. 2, 3 c. 1, 4 d. 3, 4 ANS: D 91. Which of the following compensations that develop in patients with congestive heart failure eventually increase the workload of the heart? a. Faster heart rate and cardiomegaly b. Peripheral vasoconstriction c. Increased secretion of renin d. Faster heart rate and cardiomegaly, peripheral vasoconstriction e. Faster heart rate and cardiomegaly, peripheral vasoconstriction, increased secretion of renin ANS: E 92. Which statement applies to paroxysmal nocturnal dyspnea? a. It indicates decreased CO2 diffusion in the lungs. b. It indicates swelling in the bronchioles and bronchi. c. It is caused by increased blood in the lungs when lying in a supine position. d. It results from pleural effusion. ANS: C 93. In patients with congestive heart failure, ACE inhibitor drugs are useful because they a. reduce renin and aldosterone secretion. b. slow the heart rate. c. strengthen myocardial contraction. d. block arrhythmias. ANS: A 94. In a child with ventricular septal defect, altered blood flow a. leads to increased stroke volume from the left ventricle. b. results in unoxygenated blood in the systemic circulation. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 92 c. is called a right-to-left shunt. d. is called a left-to-right shunt. ANS: D 95. In a child with acute rheumatic fever, arrhythmias may develop due to the presence of a. endocarditis. b. myocarditis. c. pericarditis. d. congestive heart failure. ANS: B 96. Prophylactic antibacterial drugs such as amoxicillin are given to patients with certain congenital heart defects or damaged heart valves immediately before invasive procedures to prevent a. formation of septic thrombi. b. infectious endocarditis. c. abscess formation. d. myocarditis. ANS: B 97. Varicose ulcers may develop and be slow to heal because a. leg muscles are painful, restricting movement. b. edema reduces arterial blood supply to the area. c. emboli form in damaged veins, leading to local ischemia. d. valves in veins restrict blood flow. ANS: B 98. Excessive fluid in the pericardial space causes a. increased cardiac output. b. myocardial infarction. c. reduced venous return. d. friction rub. ANS: C 99. Aortic stenosis means the aortic valve a. allows blood to leak back into the left ventricle during diastole. b. cannot fully open during systole. c. functions to increase stroke volume. d. does not respond to the cardiac cycle. ANS: B 100. Septic shock is frequently caused by infections involving a. gram-negative endotoxin-producing bacteria. b. spore-forming saprophytic fungi. c. free-swimming, motile parasitic protozoa. d. parasitic nematodes. Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 95 6. Which of the following causes bronchodilation? a. Epinephrine b. Histamine c. Parasympathetic nervous system d. Drugs that block b2-adrenergic receptors ANS: A 7. The central chemoreceptors in the medulla are normally most sensitive to a. low oxygen level. b. low concentration of hydrogen ions. c. elevated oxygen level. d. elevated carbon dioxide level. ANS: D 8. Oxygen diffuses from the alveoli to the blood because a. PO2 is higher in the blood. b. PO2 is lower in the blood. c. CO2 is diffusing out of the blood. d. more CO2 is diffusing out of cells into the blood. ANS: B 9. Carbon dioxide is primarily transported in the blood a. as dissolved gas. b. attached to the iron molecule in hemoglobin. c. as bicarbonate ion. d. as carbonic acid. ANS: C 10. What would hypercapnia cause? a. Increased serum pH b. Decreased respirations c. Respiratory acidosis d. Decreased carbonic acid in the blood ANS: C 11. Which of the following would result from hyperventilation? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. Metabolic acidosis ANS: B 12. Which of the following values is always decreased with respiratory alkalosis (compensated or decompensated)? a. Serum bicarbonate b. PaCO2 c. Serum pH Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 96 d. Urine pH ANS: B 13. What would be the most effective compensation for respiratory acidosis? a. The kidneys eliminating more bicarbonate ions b. The kidneys producing more bicarbonate ions c. The kidneys reabsorbing more hydrogen ions d. An increase in respiratory rate ANS: B 14. What is the acid-base status of a patient with the following values for arterial blood gases? Serum bicarbonate 36.5 mmol/L (normal range: 22-28) PCO2 75 mm Hg (normal range: 35-45) Serum pH 7.0 a. Compensated metabolic acidosis b. Decompensated metabolic acidosis c. Compensated respiratory acidosis d. Decompensated respiratory acidosis ANS: D 15. What does carbaminohemoglobin refer to? a. Replacement of oxygen by carbon monoxide on hemoglobin molecules b. Full saturation of all heme molecules by oxygen c. Carbon dioxide attached to an amino group on the hemoglobin molecule d. Oxygen combined with iron in the hemoglobin molecule ANS: C 16. Approximately what percentage of bound oxygen is released to the cells for metabolism during an erythrocyte’s journey through the circulatory system? a. 80% b. 25% c. 10% d. 50% ANS: B 17. The production of yellowish-green, cloudy, thick sputum is often an indication of a. bacterial infection. b. cancer tumor. c. damage of lung tissue due to smoking. d. emphysema. ANS: A 18. What does the term hemoptysis refer to? a. Thick, dark red sputum associated with pneumococcal infection b. Reddish-brown granular blood found in vomitus c. Bright red streaks of blood in frothy sputum d. Bloody exudate in the pleural cavity Test Bank For Gould's Pathophysiology for the Health Professions 7th Edition VanMeter 97 ANS: C 19. Orthopnea is a. very deep, rapid respirations. b. difficulty breathing when lying down. c. waking up suddenly, coughing, and struggling for breath. d. noisy breathing with stridor or rhonchi. ANS: B 20. Light bubbly or crackling breathing sounds associated with serous secretions are called a. rhonchi. b. stridor. c. rales. d. wheezing. ANS: C 21. Choose the correct information applying to laryngotracheobronchitis: a. Viral infection in infant under 12 months b. Viral infection in child, 3 months to 3 years c. Bacterial infection in infant under 6 months d. Bacterial infection in child, 3 to 7 years ANS: B 22. Signs and symptoms of acute sinusitis usually include a. serous nasal discharge and chronic cough. b. copious frothy sputum and dyspnea. c. severe localized pain in the facial bone and tenderness in the face. d. fetid breath and sore throat. ANS: C 23. What are early signs and symptoms of infectious rhinitis? a. Purulent nasal discharge and periorbital pain b. Serous nasal discharge, congestion, and sneezing c. Copious purulent sputum, particularly in the morning d. Harsh barking cough and wheezing ANS: B 24. Why does the influenza virus cause recurrent infection in individuals? a. Elderly patients are predisposed to secondary infections. b. The virus is transmitted by numerous routes. c. The virus is very difficult to destroy. d. Viral mutation reduces immunity from prior infections. ANS: D 25. What are typical signs and symptoms of epiglottitis? a. Hyperinflation of the chest and stridor