Identifying Characteristics of Various Skin Conditions and Hemorrhagic Disorders, Exams of Nursing

Download Identifying Characteristics of Various Skin Conditions and Hemorrhagic Disorders and more Exams Nursing in PDF only on Docsity! NR 283 Pathophysiology Test Question Bank 1. Which of the following areas lacks blood vessels and nerves? a. Epidermis b. Dermis c. Subcutaneous tissue d. Fatty tissue ANS: A REF: 142 2. What is a raised, thin-walled lesion containing clear fluid called? a. Papule b. Pustule c. Vesicle d. Macule ANS: C REF: 143 3. Which of the following is a common effect of a type I hypersensitivity response to ingested substances? a. Contact dermatitis b. Urticaria c. Discoid lupus erythematosus d. Psoriasis ANS: B REF: 145 4. What change occurs in the skin with psoriasis? a. Recurrent hypersensitivity reactions b. Autoimmune response c. Increased mitosis and shedding of epithelium d. Basal cell degeneration ANS: C REF: 147 5. Which of the following best describes the typical lesion of psoriasis? a. Purplish papules that can erode and become open ulcers b. Firm, raised pruritic nodules that can become cancerous c. Moist, red vesicles, which develop into bleeding ulcers d. Begins as a red papule and develops into silvery plaques ANS: D REF: 147 6. Why do secondary infections frequently develop in pruritic lesions? a. Loss of protective sebum b. Entry of resident flora while scratching the lesion c. Blockage of sebaceous glands d. Increased sweat production ANS: B REF: 148 7. Which disease is considered an autoimmune disorder? a. Pemphigus b. Erysipelas c. Contact dermatitis d. Scleroderma ANS: A REF: 147 8. Which of the following skin lesions are usually caused by Staphylococcus aureus? a. Furuncles b. Verrucae c. Scabies d. Tinea a. An allergic reaction to the causative microbe due to endotoxins b. Mites burrowing into the epidermis and reaction to their feces c. Bleeding and injected toxin from bites of the larvae d. Neurotoxins secreted by mites on the skin surface ANS: B REF: 152-153 18. How can pediculosis be diagnosed? a. Pruritus in hairy areas of the body b. Loss of blood due to lice bites c. Finding lice in clothing d. The presence of nits at the base of hair shafts ANS: D REF: 153 19. What is the major predisposing factor to squamous cell carcinoma? a. Viral infection b. Presence of nevi (moles) on the skin c. Exposure to ultraviolet light d. Frequent hypersensitivity reactions ANS: C REF: 154 20. All of the following statements apply to malignant melanoma EXCEPT: a. The malignant cell is a melanocyte. b. They present as non-pruritic purplish macules. c. The neoplasm grows rapidly and metastasizes early. d. The lesion is usually dark or multicolored with an irregular border. ANS: B REF: 155 21. Which of the following factors has contributed to the increased incidence of Kaposi’s sarcoma? a. Excessive sun exposure b. Increased number of nevi c. Increase in immunosuppressed individuals d. Presence of more seborrheic keratoses ANS: C REF: 155 22. Which of the following applies to actinic keratoses? a. They predispose to malignant melanoma. b. They arise on skin exposed to ultraviolet radiation. c. They occur primarily on dark-skinned persons. d. They are malignant and invasive. ANS: B REF: 154-155 23. Which lesion distinguishes Tinea corporis? a. Small, brown pruritic lines b. Painful and pruritic fissures c. Erythematous ring of vesicles with a clear center d. Firm, red, painful nodule or pustule ANS: C REF: 150 24. Systemic effects of acute necrotizing fasciitis include: a. low-grade fever and malaise. b. toxic shock and disorientation. c. mild nausea and vomiting. d. headache and difficulty breathing. ANS: B REF: 149 25. The cause of contact dermatitis can often be identified by: a. using a culture and sensitivity test on the exudate. b. checking the frequency of the exacerbations. c. noting the location and size of the lesion. d. the type of pain associated with the lesion. ANS: C REF: 145 26. The pathological change associated with scleroderma is: a. abnormal activation of T lymphocytes and an increase of cytokines. b . an autoimmune reaction damaging the epidermis. 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 REF: 147 27. Choose the best description of the typical lesion of impetigo. a. Large, red, painful nodule filled with purulent exudates b. Small vesicles that rupture to produce a crusty brown pruritic mass c. Red, swollen, painful areas often with projecting red streaks d. Firm, raised papules that may have a rough surface and may be painful ANS: B REF: 149 28. Choose the correct match of the skin condition and its usual location. a. Scabies—fingers, wrists, waist b. Impetigo—legs, feet c. Pediculosis humanus corporis—scalp d. Seborrheic keratosis—feet, hands ANS: A REF: 153 29. Leprosy (Hansen’s disease) is caused by: b. lower metabolic rate. c. loss of protein and electrolytes. d. smaller amount of recycled iron available. ANS: D REF: 193 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 REF: 198 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 REF: 201 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 REF: 195 11. Jaundice is one typical sign of: a. sickle cell anemia. b. aplastic anemia. c. iron deficiency anemia. d. acute leukemia. ANS: A REF: 198 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 REF: 193 13. What is the cause of oral ulcerations and delayed healing occurring with any severe anemia? a. Lack of folic acid for DNA synthesis b. Frequent microinfarcts in the tissues c. Deficit of oxygen for epithelial cell mitosis and metabolism d. Elevated bilirubin levels in blood and body fluids ANS: C REF: 193 14. Which of the following is present with pernicious anemia? a. Pancytopenia b. Hypochlorhydria c. Leukocytosis d. Multiple infarcts ANS: B REF: 195 15. Why is pernicious anemia treated with injections of vitamin B12? a. An immune reaction in the stomach would destroy the vitamin. b. Digestive enzymes would destroy the vitamin. c. The vitamin irritates the gastric mucosa. d. The ingested vitamin would not be absorbed into the blood. ANS: D REF: 195 16. Why do abnormally low hemoglobin values develop with pernicious anemia? a. Decreased production of erythrocytes b. Shorter life span of erythrocytes c. Abnormal structure of hemoglobin chains d. Deficit of folic acid ANS: B REF: 195 17. What are the common early signs of aplastic anemia? a. Painful joints and skeletal deformity b. Abdominal discomfort and splenomegaly c. Excessive bleeding and recurrent infections d. Palpitations and chest pain ANS: C REF: 197 18. Why do vascular occlusions and infarcts occur frequently with sickle cell anemia? a. The red blood cells are abnormally large. b. Increased hemolysis of erythrocytes occurs. c. Erythrocytes change to sickle shape when hypoxia occurs. d. HbS is unable to transport oxygen. ANS: C REF: 199 19. Which of the following applies to sickle cell trait? a. Most hemoglobin is in the form of HgS b. Sickling of erythrocytes occurs with severe hypoxia. c. Fibrinogen d. Vitamin K ANS: B REF: 190 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 REF: 206-208 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 REF: 206-207 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 REF: 206-207 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 REF: 207 32. Von Willebrand disease is caused by: a. defective erythrocytes that become deformed in shape, causing occlusions. b. excessive lymphocytes that do not mature. c. absence of a clotting factor that helps platelets clump and stick. d. a lack of hemoglobin due to iron deficiency. ANS: C REF: 203 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 REF: 204 34. Multiple myeloma is a malignant tumor involving: a. plasma cells. b. granulocytes. c. bone cells. d. lymph nodes. ANS: A REF: 209 35. What is the primary treatment for the leukemias? a. Radiation b. Chemotherapy c. Surgery d. Immunotherapy ANS: B REF: 207 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 REF: 188 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 REF: 200 38. Secondary polycythemia may be associated with: a. frequent angina attacks. b. certain types of anemia. c. severe chronic bronchitis. d. renal disease. c. It results in an inability of platelets to adhere. d. It is not life threatening. ANS: A REF: 203-204 47. In which blood dyscrasia does pancytopenia develop? a. Pernicious anemia b. Aplastic anemia c. Iron deficiency anemia d. Sickle cell anemia ANS: B REF: 205 48. Which of the following applies to the etiology of aplastic anemia? It is: a. idiopathic in many cases. b. a genetic disorder. c. predisposed by exposure to myelotoxins. d. Both A and C. ANS: D REF: 197 49. Microcytic and hypochromic erythrocytes are commonly found as a result of: a. iron deficiency anemia. b. polycythemia. c. disseminated intravascular coagulation. d. hemophilia A. ANS: A REF: 201 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 REF: 227 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 REF: 228 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 REF: 224 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 REF: 224 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 REF: 225 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. c. allowing the ventricles to contract before the atria. d. completing ventricular filling. ANS: D REF: 225 7. Which of the following is a result of increased secretion of epinephrine? a. Increased heart rate and force of contraction b. Decreased stimulation of the SA node and ventricles c. Vasoconstriction in skeletal muscles and kidneys d. Vasodilation of cutaneous blood vessels ANS: A REF: 225 8. Which of the following causes increased heart rate? a. Stimulation of the vagus nerve b. Increased renin secretion c. Administration of beta-blocking drugs d. Stimulation of the sympathetic nervous system ANS: D REF: 230 9. The event that causes the QRS wave on an electrocardiogram (ECG) tracing is: a. atrial depolarization. b. atrial repolarization. 17. A drug taken in small doses on a continuing basis to reduce platelet adhesion is: a. acetylsalicylic acid (ASA). b. streptokinase. c. acetaminophen. d. heparin. ANS: A REF: 233 18. A partial obstruction in a coronary artery will likely cause: a. pulmonary embolus. b. hypertension. c. angina attacks. d. myocardial infarction. ANS: C REF: 237 19. Cigarette smoking is a risk factor in coronary artery disease because smoking: a. reduces vasoconstriction and peripheral resistance. b. decreases serum lipid levels. c. promotes platelet adhesion. d. increases serum HDL levels. ANS: C REF: 237-238 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 REF: 234 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 REF: 238 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 REF: 234 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 REF: 235 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 REF: 240 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. ANS: D REF: 234 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 REF: 240 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 REF: 241 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 REF: 240 29. Calcium-channel blocking drugs are effective in: a. Incompetent tricuspid heart valve b. Chronic pulmonary disease c. Infarction in the right atrium d. Uncontrolled essential hypertension ANS: D REF: 246 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. ANS: B REF: 246 39. Significant signs of right-sided congestive heart failure include: a. severe chest pain and tachycardia. b. edematous feet and legs with hepatomegaly. c. frequent cough with blood-streaked frothy sputum. d. orthopnea, fatigue, increased blood pressure. ANS: B REF: 247 40. Paroxysmal nocturnal dyspnea is marked by: a. hemoptysis and rales. b. distended neck veins and flushed face. c. bradycardia and weak pulse. d. cardiomegaly. ANS: A REF: 250 41. Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include: a. slow cardiac contractions. b. increased renin and aldosterone secretions. c. decreased erythropoietin secretion. d. fatigue and cold intolerance. ANS: B REF: 246 42. In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure? a. Veins of the legs and feet b. Jugular veins c. Pulmonary capillaries d. Blood vessels of the liver and spleen ANS: C REF: 247 43. Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions? a. Furosemide b. Digoxin c. Epinephrine d. Nifedipine ANS: B REF: 250 44. In an infant, the initial indication of congestive heart failure is often: a. distended neck veins. b. feeding problems. c. low-grade fever and lethargy. d. frequent vomiting. ANS: B REF: 250 45. Effects that may be expected from a beta-adrenergic blocking drug include: a. increasing systemic vasoconstriction. b. decreased sympathetic stimulation of the heart. c. blockage of an angiotensin receptor site. d. increased release of renin. ANS: B REF: 232 46. A sign of aortic stenosis is: a. increased cardiac output. b. congestion in the liver, spleen, and legs. c. flushed face and headache. d. a heart murmur. ANS: D REF: 250-251 47. An incompetent mitral valve would cause: a. increased blood to remain in the right atrium. b. hypertrophy of the right ventricle. c. decreased output from the left ventricle. d. decreased pressure in the left atrium. ANS: C REF: 253 48. Which of the following describes the blood flow occurring with a ventricular septal defect? a. From the left ventricle to the right ventricle b. From the right ventricle to the left ventricle c. Increased cardiac output from the left ventricle d. Mixed oxygenated and unoxygenated blood in the systemic circulation ANS: A REF: 252 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 REF: 258 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 REF: 242 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 REF: 259 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 REF: 260 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 REF: 259 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 REF: 261 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. ANS: C REF: 261 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 REF: 262 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 REF: 225 66. A friction rub is associated with: a. infectious endocarditis. b. arrhythmias. c. pericarditis. d. an incompetent aortic valve. ANS: C REF: 258 67. A dissecting aortic aneurysm develops as: a. a dilation or bulge that develops at one point on the aortic wall. b . a thrombus that accumulates at a point in the aortic wall. ANS: A REF: 267 75. Why does anaphylactic shock cause severe hypoxia very quickly? a. Generalized vasoconstriction reduces venous return. b. Bronchoconstriction and bronchial edema reduce airflow. c. Heart rate and contractility are reduced. d. Metabolic rate is greatly increased. ANS: B REF: 267 76. Neurogenic (vasogenic) shock results from systemic vasodilation due to: a. increased peripheral resistance and less blood in the microcirculation. b. increased permeability of all the blood vessels, leading to hypovolemia. c. slower, less forceful cardiac contractions. d. increased capacity of the vascular system and reduced venous return. ANS: D REF: 265 | 266 77. A prolonged period of shock is likely to cause: a. damage to, and increased permeability of, pulmonary capillaries. b. increased permeability of the glomerular capillaries of the kidneys. c. increased pH of blood and body fluids. d. increased systemic vasoconstriction. ANS: A REF: 265 78. What would indicate decompensated acidosis related to shock? a. Serum bicarbonate level below normal b. PCO2 above normal c. Serum pH below normal range d. Urine pH of 4.5 ANS: C REF: 267 79. With shock, anaerobic cell metabolism and decreased renal blood flow cause: a. metabolic alkalosis. b. metabolic acidosis. c. decreased serum potassium. d. increased serum bicarbonate. ANS: B REF: 267-268 80. Shock develops in patients with severe burns as a result of: a. extensive hemorrhage. b. pain and loss of plasma. c. direct damage to the heart. d. extensive hemolysis of erythrocytes. ANS: B REF: 265-266 81. The classic early manifestation(s) of left-sided congestive heart failure is/are ____, whereas the early indicator(s) of right-sided failure is/are _______. a. palpitations and periodic chest pain; shortness of breath on exertion b. swelling of the ankles and abdomen; chest pain c. shortness of breath on exertion or lying down; swelling of the ankles d. coughing up frothy sputum; hepatomegaly and splenomegaly ANS: C REF: 249-250 82. A common adverse effect of many antihypertensive medications is: a. orthostatic hypotension. b. bradycardia. c. altered blood coagulation. d. peripheral edema. ANS: A REF: 261 83. The cause of essential hypertension is considered to be: a. chronic renal disease. b. excessive intake of saturated fats and salt. c. sedentary lifestyle. d. idiopathic. ANS: D REF: 259 84. A cardiac pacemaker would most likely be inserted in cases of: a. angina pectoris. b. heart block. c. congestive heart failure. d. ventricular fibrillation. ANS: B REF: 245 85. Which of the following is considered to be the most dangerous arrhythmia? a. Tachycardia b. Bradycardia c. Ventricular fibrillation d. Second-degree heart block ANS: C REF: 245 86. Which of the following is NOT true of the drug nitroglycerin? a. It decreases myocardial workload by causing systemic vasodilation. b. It may be administered sublingually, transdermally, or by oral spray. c. Dizziness or syncope may follow a sublingual dose. d. It strengthens the myocardial contraction. ANS: D REF: 232 87. Confirmation of the diagnosis of a myocardial infarction would include: 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 REF: 243 95. 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 REF: 246 96. 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. A and C e. A, B, and C ANS: E REF: 246 97. 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 REF: 249-250 98. 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 REF: 250 99. 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. c. is called a right-to-left shunt. d. is called a left-to-right shunt. ANS: D REF: 252-253 100. 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 REF: 256 101. 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 REF: 257 102. 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 REF: 264 103. Excessive fluid in the pericardial space causes: a. increased cardiac output. b. myocardial infarction. c. reduced venous return. d. friction rub. ANS: C REF: 258 104. 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 REF: 251 105. Septic shock is frequently caused by infections involving: a. gram-negative endotoxin-producing bacteria. ANS: D REF: 277 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 REF: 278 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 REF: 280 10. What would hypercapnia cause? a. Increased serum pH b. Decreased respirations c. Respiratory acidosis d. Decreased carbonic acid in the blood ANS: C REF: 278 11. Which of the following would result from hyperventilation? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. Metabolic acidosis ANS: B REF: 278 12. Which of the following values is always decreased with respiratory alkalosis (compensated or decompensated)? a. Serum bicarbonate b. PaCO2 c. Serum pH d. Urine pH ANS: B REF: 282-283 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 REF: 279-280 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 REF: 320 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 REF: 280 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 REF: 279 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 REF: 281 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 ANS: C REF: 281 19. Orthopnea is: a. very deep, rapid respirations. b. difficulty breathing when lying down. d . Opportunistic bacteria causing low-grade fever with cough and thick greenish sputum ANS: A REF: 288 28. How does severe hypoxia develop with pneumonia? a. Acidosis depresses respirations. b. Oxygen diffusion is impaired by the congestion. c. Inflammatory exudate absorbs oxygen from the alveolar air. d. Infection reduces effective compensation by the heart. ANS: B REF: 288 29. Rust-colored sputum in a patient with pneumonia usually indicates: a. secondary hemorrhage in the lungs. b. Streptococcus pneumoniae is the infecting agent. c. prolonged stasis of mucous secretions in the airways. d. persistent coughing has damaged the mucosa in the bronchi. ANS: B REF: 289 30. What is the cause of Legionnaires’ disease? a. Mycoplasma b. A fungus c. A gram-negative bacterium d. Pneumococcus ANS: C REF: 290 31. Select the statement related to tuberculosis: a. The microbe is present in the sputum of all patients with a positive TB skin test. b . The infection is transmitted primarily by blood from an infected person. c. TB is usually caused by an acid-fast bacillus, resistant to many disinfectants. d . The microbe is quickly destroyed by the immune response. ANS: C REF: 290-291 32. How is primary tuberculosis identified? a. Cavitation in the lungs and spread of the microbe to other organs b. Persistent productive cough, low-grade fever, and fatigue c. Caseation necrosis and formation of a tubercle in the lungs d. Multiple granulomas in the lungs and rapid spread of the microbe ANS: C REF: 291 33. When does active (secondary) infection by Mycobacterium tuberculosis with tissue destruction occur? a. When host resistance is decreased b . When a hypersensitivity reaction is initiated c. When the BCG vaccine is not administered immediately following exposure to the microbe d . When Ghon complexes form in the lungs ANS: A REF: 290 34. Which of the following statements does NOT apply to M. tuberculosis? a. Microbes can survive for a long time inside tubercles. b. The bacilli can survive some adverse conditions such as drying and heat. c. Infection is limited to the lungs. d. The bacilli can be destroyed by antibacterial drugs. ANS: C REF: 291 35. Which of the following confirms the presence of active (reinfection) tuberculosis? a. A positive skin test for TB b. A calcified tubercle shown on a chest X-ray c. Identification of acid-fast bacilli in a sputum sample d. A history of exposure to individuals being treated for TB ANS: C REF: 290 36. Areas in the United States that show higher rates than the national rate of TB are areas that have a high incidence of: a. HIV and homelessness. b. obesity and tobacco use. c. elderly persons and radon. d. steroid use and alcoholism. ANS: A REF: 293 37. Histoplasmosis is caused by a: a. fungus. b. virus. c. bacillus. d. protozoa. ANS: A REF: 294 38. Cystic fibrosis is transmitted as a/an: a. X-linked recessive gene. b. autosomal recessive gene. c. autosomal dominant gene. d. chromosomal defect. ANS: B REF: 294 c. Dyspnea d. Inflammation of the mucosa ANS: B REF: 299 47. Which of the following predisposes to postoperative aspiration? a. Reduced pressure of the abdominal organs on the diaphragm b. Depression of the vomiting center by anesthetics and analgesics c. Vomiting caused by drugs or anesthesia d. Lack of food intake for the previous 24 hours ANS: C REF: 300 48. What is the pathophysiology of an acute attack of extrinsic asthma? a. Gradual degeneration and fibrosis b. Continuous severe attacks unresponsive to medication c. A hypersensitivity reaction involving release of chemical mediators d. Hyperresponsive mucosa ANS: C REF: 300 49. During an acute asthma attack, how does respiratory obstruction occur? 1. Relaxation of bronchial smooth muscle 2. Edema of the mucosa 3. Increased secretion of thick, tenacious mucus 4. Contraction of elastic fibers a. 1, 2 b. 1, 3 c. 2, 3 d. 2, 4 ANS: C REF: 303 | 322 50. What cause the expanded anteroposterior (A-P) thoracic diameter (barrel chest) in patients with emphysema? a. Air trapping and hyperinflation b. Persistent coughing to remove mucus c. Recurrent damage to lung tissues d. Dilated bronchi and increased mucous secretions ANS: A REF: 303 51. Which of the following is typical of progressive emphysema? a. Vital capacity increases. b. Residual lung volume increases. c. Forced expiratory volume increases. d. Tidal volume increases. ANS: B REF: 303 52. Destruction of alveolar walls and septae is a typical change in: a. chronic bronchitis. b. acute asthma. c. emphysema. d. asbestosis. ANS: C REF: 302 53. A group of common chronic respiratory disorders characterized by tissue degeneration and respiratory obstruction is called: a. mesothelioma. b. COPD. c. CF. d. MD. ANS: B REF: 303 54. Which statement does NOT apply to emphysema? a. The surface area available for gas exchange is greatly reduced. b. A genetic defect may lead to breakdown of elastic fibers. c. The ventilation/perfusion ratio remains constant. d. Expiration is impaired. ANS: C REF: 307 55. What is the cause of chronic bronchitis? a. Chronic irritation, inflammation, and recurrent infection of the larger airways b . A genetic defect causing excessive production of mucus c. Hypersensitivity to parasympathetic stimulation in the bronchi d . Deficit of enzymes, preventing tissue degeneration ANS: A REF: 307 56. Which of the following is typical of chronic bronchitis? a. Decreased activity of the mucous glands b. Fibrosis of the bronchial wall c. Overinflation of bronchioles and alveoli d. Formation of blebs or bullae on the lung surface ANS: B REF: 307 57. What are typical pathological changes with bronchiectasis? a. Bronchospasm and increased mucous secretion b. Adhesions and fibrosis in the pleural membranes c. Airway obstructions and weak, dilated bronchial walls 66. Which manifestation(s) of atelectasis is/are associated with airway obstruction? a. Bradycardia and dyspnea b. Tracheal deviation toward the unaffected side c. Decreased breath sounds on the affected side d. Rales and rhonchi ANS: C REF: 312 67. How does total obstruction of the airway lead to atelectasis? a. Decreased surfactant production impairs lung expansion. b. The involved lung is compressed. c. Air is absorbed from the alveoli distal to the obstruction. d. Air continues to be inspired but is trapped distal to the obstruction. ANS: C REF: 312 68. How does a large pleural effusion lead to atelectasis? a. The cohesion between the pleural membranes is disrupted. b. There is decreased intrapleural pressure. c. The mediastinal contents compress the affected side. d. Pleuritic pain causes very shallow breathing. ANS: A REF: 316 69. When does flail chest usually occur? a. An open puncture wound involves the pleural membranes. b. The visceral pleura is torn by a fractured rib. c. Several ribs are fractured at two sites. d. Increasing fluid in the pleural cavity causes atelectasis. ANS: C REF: 316 70. With a flail chest injury, events during inspiration include which of the following? a. Air is sucked into the lung through the chest wall. b. The mediastinum shifts toward the unaffected side. c. The floating segment is pushed outward. d. The trachea deviates toward the affected side. ANS: B REF: 316 71. How is cardiac output reduced with a flail chest injury? a. Atelectasis compresses the heart. b. Venous return is impaired. c. Intrapleural pressure is decreased. d. Air pressure continues to increase in the pleural space. ANS: B REF: 314 72. Which of the following is a manifestation of a simple closed pneumothorax? a. Decreased respiratory rate b. Tracheal deviation toward the unaffected lung c. Asymmetrical chest movements d. Increased breath sounds on the affected side ANS: C REF: 314 73. Which of the following is an effect of a large open pneumothorax (sucking wound)? a. Mediastinal flutter, impairing venous return b. Increased venous return c. Progressive atelectasis of both lungs d. Overexpansion of the unaffected lung ANS: A REF: 316 74. With a tension pneumothorax, which factors contribute to severe hypoxia? a. Decreasing compression of the inferior vena cava b . More air leaving the pleural cavity on expiration than entering with inspiration c. Shift of the mediastinal contents toward the affected lung d . Continually increasing pressure on the unaffected lung ANS: D REF: 319 75. Which of the following statements describe the pathophysiology of adult respiratory distress syndrome? 1. Damage leading to increased permeability of the alveolar capillary membranes 2. Decreased surface tension in the alveoli 3. Excessive fluid and protein interstitially and in the alveoli 4. Multiple diffuse hemorrhages in the lungs a. 1, 2 b. 1, 3 c. 2, 3 d. 3, 4 ANS: B REF: 317 76. Infant respiratory distress syndrome results from: a. insufficient surfactant production. b. incomplete expiration shortly after birth. c. retention of fluid in the lungs after birth. d. immature neural control of respirations. ANS: A REF: 282 77. Obstruction in the upper airway is usually indicated by: a. stridor. b. rales. ANS: D REF: 297 86. Which of the following is likely to cause pneumothorax or hemothorax in a patient with bronchogenic carcinoma? a. The tumor obstructs a major bronchus. b. Compression of lung tissue by the tumor causes atelectasis. c. The tumor causes inflammation and erosion of the pleural membranes. d. Inflammation around the tumor causes exudate in the small bronchi. ANS: C REF: 292 87. Which of the following would confirm a diagnosis of primary tuberculosis? a. A positive tuberculin skin test b. Occurrence of hemoptysis c. Unproductive cough with absence of sputum d. Small areas of calcification on a chest X-ray ANS: D REF: 293 88. Which of the following drugs is usually prescribed for prophylaxis in persons in close contact with a patient with active tuberculosis? a. Streptomycin b. Isoniazid c. Rifampin d. Streptomycin ANS: B REF: 293 89. Which of the following statements is FALSE? a. TB bacilli are spread by oral droplet. b. TB bacilli are slow-growing bacteria. c. Active TB must be treated in hospital for many months. d. Active TB can be prevented by good host resistance. ANS: C REF: 309 90. Choose the correct reason for severe hypoxia occurring with pulmonary edema: a. Diffusion of oxygen into the alveoli is impaired. b. Fluid in the pleural cavity prevents normal lung expansion. c. Increased concentration of CO2 impairs diffusion of oxygen. d. Increased blood flow through the lungs prevents diffusion of gases. ANS: A REF: 302 91. Which of the following drugs in an inhaler would likely be carried by individuals to provide immediate control of acute asthma attacks? a. A glucocorticoid b. Epinephrine c. Cromolyn d. A β2-adrenergic agent ANS: D REF: 304 92. Development of emphysema in a nonsmoker may be the result of: a. a genetic factor. b. obesity. c. vitamin deficiencies. d. a developmental defect. ANS: A REF: 312 93. Which factors contribute to postoperative atelectasis? 1. Decreased secretions in the airways 2. Drug-related respiratory depression 3. Abdominal distention and pain 4. Excessive deep-breathing and coughing a. 1, 2 b. 2, 3 c. 3, 4 d. 1, 4 ANS: B REF: 289 94. Primary atypical pneumonia (PAP) is caused by: a. Klebsiella oxytoca. b. Candida albicans. c. Mycoplasma pneumoniae. d. Streptococcus pneumoniae. ANS: C REF: 317 95. All of the following are expected with infant respiratory distress syndrome EXCEPT: a. severe hypoxia. b. respiratory alkalosis. c. pulmonary vasoconstriction. d. fluid and protein in the alveoli. ANS: B REF: 282 96. Which factor usually causes metabolic acidosis to develop in association with hypoxia? a. Anaerobic metabolism b. Failure to excrete CO2 c. Liver dysfunction d. Increased blood volume ANS: A REF: 316 97. Mediastinal flutter associated with chest injury is likely to: a. cause pulmonary edema. b. Osteoblasts c. Osteoclasts d. Stem cells from the bone marrow ANS: B REF: 159 2. What is the chemical transmitter released at the neuromuscular junction? a. Norepinephrine b. GABA c. Serotonin d. Acetylcholine ANS: D REF: 161 3. What are the two types of bone tissue? a. Vascular and nonvascular b. Spongy and calcified c. Compact and cancellous d. Dense and pliable ANS: C REF: 159 4. Which of the following would identify an open or compound fracture? a. The skin and soft tissue are exposed at the fracture site. b. A bone is crushed into many small pieces. c. The bone appears bent with a partial fracture line. d. One end of a bone is forced into an adjacent bone. ANS: A REF: 164 5. Which of the following describes a Colles’ fracture? a. The distal radius is broken. b. The distal fibula is broken. c. A vertebra appears crushed. d. A spontaneous fracture occurs in weakened bone. ANS: A REF: 165 6. During the fracture healing process, the hematoma: a. is broken down and absorbed immediately. b. provides the base for bone cells to produce new bone. c. is the structure into which granulation tissue grows. d. produces fibroblasts to lay down new cartilage. ANS: C REF: 166 7. When a fracture is healing, the procallus or fibrocartilaginous callus: a. can bear weight. b. serves as a splint across the fracture site. c. is the tissue that lays down new cartilage. d. is made up of new bone. ANS: B REF: 166 8. The inflammation surrounding a fracture site during the first few days may complicate healing by causing: a. excessive bone movement. b. severe ischemia and tissue necrosis. c. malunion or nonunion. d. fat emboli to form. ANS: B REF: 166-167 9. What is a sign of a dislocation? a. Crepitus b. Pain and tenderness c. Increased range of motion at a joint d. Deformity at a joint ANS: D REF: 168 10. All of the following predispose to osteoporosis EXCEPT: a. weight-bearing activity. b. a sedentary lifestyle. c. long-term intake of glucocorticoids. d. calcium deficit. ANS: A REF: 169 11. Which of the following statements does NOT apply to osteoporosis? a. Bone resorption is greater than bone formation. b. It causes compression fractures of the vertebrae. c. Osteoporosis is always a primary disorder. d. It often leads to kyphosis and loss of height. ANS: C REF: 169 12. Which of the following best describes the typical bone pain caused by osteogenic sarcoma? a. Intermittent, increasing with activity b. Sharp, increased with joint movement c. Mild, aching when weight-bearing d. Steady, severe, and persisting with rest ANS: D REF: 171 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 REF: 175-177 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 REF: 175 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 REF: 177 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 REF: 176 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 REF: 176 26. What is a common effect of long-term use of glucocorticoids to treat rheumatoid arthritis? a. Leukocytosis b. Osteoporosis c. Severe anemia d. Orthostatic hypotension ANS: B REF: 177 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 REF: 177 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 REF: 178 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 REF: 178 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 REF: 178 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 REF: 178-179 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. a. excessive bone resorption by osteoclasts. b. a deficit of vitamin D and phosphates. c. replacement of bone by fibrous tissue. d. hyperparathyroidism. ANS: B REF: 170 41. Paget’s disease often leads to which of the following? a. A reduction in bone fractures b. Decreased intracranial pressure c. Cardiovascular disease d. Disintegration of joint cartilage ANS: C REF: 170 42. Bones classified as “irregular” would include: a. skull bones. b. the mandible. c. wrist bones. d. the femur. ANS: B REF: 159 43. A dislocation is: a. the tearing of a tendon in the joint. b. the separation of bones in the joint with a loss of contact. c. the twisting of a joint, causing excessive inflammation of the surrounding tissue. d. the overstressing of ligaments, causing loss of elasticity. ANS: B REF: 167 44. A diagnostic test that measures the electrical charge of muscle contraction and can help differentiate muscle disorders from neurological disease is a/an: a. electromyogram. b. arthroscopy. c. radiograph. d. electroencephalograph. ANS: A REF: 164 45. The type of compound fracture in which there are multiple fracture lines and bone fragments is referred to as a/an: a. compression fracture. b. greenstick fracture. c. simple fracture. d. comminuted fracture. ANS: D REF: 164 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 REF: 179 Chapter 16 Endocrine-System Disorders 1. What kind of control mechanism is indicated when increased blood glucose levels stimulate increased secretion of insulin? a. Control by releasing hormones b. Control by tropic hormones c. Negative feedback control d. Hypothalamus/hypophysis coordination ANS: C REF: 403-404 2. What is the most common cause of endocrine disorders? a. Malignant neoplasm b. Infection c. Congenital defect d. Benign tumor ANS: D REF: 406 3. Choose the statement that applies to type 1 diabetes mellitus. a. Onset often occurs during childhood. b. Relative insufficiency of insulin or insulin resistance develops. c. It can be treated by diet, weight control and exercise, or oral hypoglycemics. d. Complications rarely occur. ANS: C REF: 411 12. Which of the following does NOT usually develop as a complication of diabetes? a. Osteoporosis b. Nephropathy c. Impotence d. Peripheral neuropathy ANS: A REF: 412-413 13. How do many oral hypoglycemic drugs act? a. To replace insulin in patients with insulin-dependent diabetes mellitus (IDDM) b. To transport glucose into body cells c. To prevent gluconeogenesis d. To stimulate the pancreas to produce more insulin ANS: D REF: 409 14. Diabetes may cause visual impairment through damage to the lens; this is referred to as: a. cataracts. b. macular degeneration. c. myopia. d. strabismus. ANS: A REF: 415 15. Which of the following applies to diabetic macro-angiography? 1. It affects the small arteries and arterioles. 2. It is related to elevated serum lipids. 3. It leads to increased risk of myocardial infarction and peripheral vascular disease. 4. It frequently causes damage to the kidneys. a. 1, 3 b. 1, 4 c. 2, 3 d. 2, 4 ANS: C REF: 412 16. Why is amputation frequently a necessity in diabetics? a. Necrosis and gangrene in the feet and legs b. Lack of glucose to the cells in the feet and legs c. Severe dehydration in the tissues d. Elevated blood glucose increasing blood viscosity ANS: A REF: 412 17. A type of diabetes that may develop during pregnancy and disappear after delivery is called: a. temporary maternal diabetes. b. fetal diabetes. c. acute developmental diabetes. d. gestational diabetes. ANS: D REF: 407 18. Which one of the following develops hypoglycemia more frequently? a. Type 1 diabetic patients b. Type 2 diabetic patients c. Patients with a poor stress response d. Patients with a regular exercise and meal plan ANS: A REF: 406 19. Which of the following hormonal imbalances causes Addison’s disease? a. Increased glucocorticoids b. Decreased glucocorticoids c. Deficit of antidiuretic hormone (ADH) d. Deficit of T3 and T4 ANS: B REF: 423 20. Which of the following hormonal imbalances causes myxedema? a. Increased glucocorticoids b. Decreased glucocorticoids c. Deficit of ADH d. Deficit of T3 and T4 ANS: D REF: 422 21. Which of the following hormonal imbalances causes diabetes insipidus? a. Increased insulin b. Decreased glucocorticoids c. Deficit of ADH d. Deficit of T3 and T4 ANS: C REF: 407 22. What is caused by hyperparathyroidism? a. Hypocalcemia b. Tetany c. Bone demineralization d. Deficit of vitamin D ANS: C REF: 416 23. What is caused by hypocalcemia due to hypoparathyroidism? ANS: D REF: 423 30. What is the most common cause of type 1 diabetes mellitus? a. Increased glucose production in the liver b. Destruction of pancreatic cells by an autoimmune reaction c. Increased resistance of body cells to insulin action d. Chronic obesity ANS: B REF: 406 31. Why does glucosuria occur in diabetics? a. Excess ketoacids displace glucose into the filtrate. b. Excess water in the filtrate draws more glucose into the urine. c. The amount of glucose in the filtrate exceeds the renal tubule transport limit. d. Sufficient insulin is not available for glucose reabsorption. ANS: C REF: 407 32. Which of the following are common early signs of a pituitary adenoma? 1. Persistent headaches 2. Hemianopia 3. Hypertension 4. Papilledema a. 1, 4 b. 2, 3 c. 1, 2 d. 1, 3, 4 ANS: C REF: 422 33. Which of the following does NOT apply to inappropriate ADH syndrome? a. The cause is excess ADH secretion. b. Severe hyponatremia results. c. Excessive sodium is retained. d. Fluid retention increases. ANS: C REF: 418 34. What is/are the effect(s) of thyrotoxic crisis? a. Hyperthermia and heart failure b. Hypotension and hypoglycemia c. Toxic goiter and hypometabolism d. Decreased stress response ANS: A REF: 420 35. Which of the following conditions may precipitate or exacerbate hyperglycemia? a. Hypothyroidism b. Cushing’s disease c. Addison’s disease d. Growth hormone deficit ANS: B REF: 423 36. Which of the following conditions may cause immunosuppression? a. Graves’ disease b. Acromegaly c. Cushing’s disease d. Diabetes insipidus ANS: C REF: 423 37. Hyperosmolar hyperglycemic nonketotic coma (HHNC) more frequently develops in patients with: a. type 1 diabetes. b. type 2 diabetes. c. Grave’s disease. d. hyperparathyroidism. ANS: B REF: 411 38. Which of the following is recommended for immediate treatment of hypoglycemic shock? 1. If conscious, immediately give sweet fruit juice, honey, candy, or sugar. 2. If unconscious, give nothing by mouth (require intravenous glucose 50%). 3. Treat immediately with insulin. 4. Give large quantity of clear fluids for shock. a. 1, 2 b. 1, 3 c. 2, 3 d. 1, 3, 4 ANS: A REF: 410 39. All these tissues use glucose without the aid of insulin EXCEPT: a. liver. b. digestive system. c. exercising skeletal muscle. d. brain. ANS: A REF: 406 40. Differences between type 1 and type 2 diabetes include which of the following?