Patho Test Bank Questions and Answers, Exams of Nursing

Download Patho Test Bank Questions and Answers and more Exams Nursing in PDF only on Docsity! NR 283 Patho Test Bank QUESTIONS AND ANSWERS (Final Exam 1, 2, 3 1. Which of the following areas lacks blood vessels and nerves? a. Epidermis b. Dermis c. Subcutaneous tissue d. Fatty tissue ANS: A REF: 142 2. What is a raised, thin-walled lesion containing clear fluid called? a. Papule b. Pustule c. Vesicle d. Macule ANS: C REF: 143 3. Which of the following is a common effect of a type I hypersensitivity response to ingested substances? a. Contact dermatitis b. Urticaria c. Discoid lupus erythematosus d. Psoriasis ANS: B REF: 145 4. What change occurs in the skin with psoriasis? a. Recurrent hypersensitivity reactions b. Autoimmune response c. Increased mitosis and shedding of epithelium d. Basal cell degeneration ANS: C REF: 147 5. Which of the following best describes the typical lesion of psoriasis? a. Purplish papules that can erode and become open ulcers b. Firm, raised pruritic nodules that can become cancerous c. Moist, red vesicles, which develop into bleeding ulcers d. Begins as a red papule and develops into silvery plaques ANS: D REF: 147 6. Why do secondary infections frequently develop in pruritic lesions? a. Loss of protective sebum b. Entry of resident flora while scratching the lesion c. Blockage of sebaceous glands d. Increased sweat production ANS: B REF: 148 7. Which disease is considered an autoimmune disorder? a. Pemphigus b. Erysipelas c. Contact dermatitis d. Scleroderma ANS: A REF: 147 8. Which of the following skin lesions are usually caused by Staphylococcus aureus? a. Furuncles b. Verrucae c. Scabies d. Tinea ANS: A REF: 148 9. Which of the following statements applies to impetigo? a. Lesions usually appear on the hands and arms. b. The cause is usually a virus. c. The infection is highly contagious. d. Scar tissue is common following infection. ANS: C REF: 148 10. What is the common signal that a recurrence of herpes simplex infection is developing? a. Severe pain around the mouth b. Malaise and fatigue c. Fever and severe headaches d. Mild tingling along the nerve or on the lips ANS: D REF: 150 11. Herpes virus is usually spread by all of the following EXCEPT: a. saliva during an exacerbation and for a short time thereafter. b. contact with the fluid in the lesion. c. contaminated blood. d. autoinoculation by fingers. ANS: C REF: 150 24. Systemic effects of acute necrotizing fasciitis include: a. low-grade fever and malaise. b. toxic shock and disorientation. c. mild nausea and vomiting. d. headache and difficulty breathing. ANS: B REF: 149 25. The cause of contact dermatitis can often be identified by: a. using a culture and sensitivity test on the exudate. b. checking the frequency of the exacerbations. c. noting the location and size of the lesion. d. the type of pain associated with the lesion. ANS: C REF: 145 26. The pathological change associated with scleroderma is: a. abnormal activation of T lymphocytes and an increase of cytokines. b an autoimmune reaction damaging the epidermis. .collagen deposits in the small blood vessels of the skin and sometimes the c. viscera.d . Type I hypersensitivity and increased serum IgE levels. ANS: C REF: 147 27. Choose the best description of the typical lesion of impetigo. a. Large, red, painful nodule filled with purulent exudates b. Small vesicles that rupture to produce a crusty brown pruritic mass c. Red, swollen, painful areas often with projecting red streaks d. Firm, raised papules that may have a rough surface and may be painful ANS: B REF: 149 28. Choose the correct match of the skin condition and its usual location. a. Scabies—fingers, wrists, waist b. Impetigo—legs, feet c. Pediculosis humanus corporis—scalp d. Seborrheic keratosis—feet, hands ANS: A REF: 153 29. Leprosy (Hansen’s disease) is caused by: a. a fungus. b. a bacterium. c. a virus. d. a helminth. ANS: B REF: 149 30. One factor that is responsible for increasing the mortality rate among patients suffering with necrotizing fasciitis is: a. a delay in initial diagnosis. b. lack of proper antibiotics. c. the appearance of additional opportunistic infections. d. secondary fungal infections. ANS: A REF: 149 31. Which of the following would result from a reduced number of erythrocytes in the blood? a. Increased hemoglobin in the blood b. Decreased hematocrit c. Increased risk of hemostasis d. Decreased osmotic pressure of the blood ANS: B REF: 185 32. What term is used to describe a deficit of all types of blood cells? a. Leucopenia b. Neutropenia c. Pancytopenia d. Erythrocytosis ANS: C REF: 205 33. Capillary walls consist of: a. multiple endothelial layers. b. a thick layer of smooth muscle. c. two or three epithelial layers. d. a single endothelial layer. ANS: D REF: 183 34. Vitamin K is required by the liver to synthesize: a. heparin. b. prothrombin. c. amino acids. d. bilirubin. ANS: B REF: 190 | 202 35. Individuals with type O blood are considered to be universal donors because their blood: a. contains A and B antibodies. b. contains A and B antigens. c. lacks A and B antibodies. d. lacks A and B antigens. ANS: D REF: 192 36. What are the two circulations that comprise the overall circulatory system? a. Pulmonary and systemic circulations b. Peripheral and central circulations c. Cardiovascular and lymphatic circulations d. Cardiopulmonary and peripheral circulations ANS: A REF: 183 37. Chronic blood loss causes anemia because of the: a. shortened life span of the erythrocytes. b. lower metabolic rate c. loss of protein and electrolytes. d. smaller amount of recycled iron available. ANS: D REF: 193 38. What is the cause of sickle cell anemia? a. A defective gene inherited from both parents b. A chronic bacterial infection c. Bone marrow depression d. An autoimmune reaction ANS: A REF: 198 39. Which of the following best describes the characteristic erythrocyte associated with pernicious anemia? a. Hypochromic, microcytic b. Normochromic, normocytic c. Elongated, sickle-shaped d. Megaloblastic or macrocytic nucleated cells ANS: D REF: 201 40. What causes numbness and tingling in the fingers of individuals with untreated pernicious anemia? a. Persistent hyperbilirubinemia b. Increasing acidosis affecting metabolism c. Vitamin B12 deficit causing peripheral nerve demyelination d. Multiple small vascular occlusions affecting peripheral nerves c. Thalassemia major d. Pernicious anemia ANS: D REF: 195 52. In individuals with pernicious anemia, antibodies form to: a. vitamin B12. b. intrinsic factor or parietal cells c. mucus-producing glands. d. hydrochloric acid. ANS: B REF: 195 53. In cases of polycythemia vera, blood pressure is elevated as a result of: a. increased blood volume. b. frequent infarcts in the coronary circulation. c. congested spleen and bone marrow. d. increased renin and aldosterone secretions. ANS: A REF: 205 54. Petechiae and purpura are common signs of: a. excessive hemolysis. b. leucopenia. c. increased bleeding. d. hemoglobin deficit. ANS: C REF: 201 55. Which statement applies to the disorder hemophilia A? a. It is transmitted as an X-linked dominant trait. b. There is usually a total lack of factor VIII in the blood c. Males and females can be carriers. d. Hematomas and hemarthroses are common. ANS: D REF: 203 56. Which of the following occurs when disseminated intravascular coagulation develops? a. Increased thrombocytes and blood clotting b. Hemolysis with loss of blood cells c. Massive sepsis and hemorrhage d. Multiple thrombi and deficit of clotting factors ANS: D REF: 203-204 57. Which of the following substances acts as an anticoagulant? a. Prothrombin b. Heparin c. Fibrinogen d. Vitamin K ANS: B REF: 190 58. In individuals with acute leukemia, the increased number of malignant leukocytes leads to: 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 59. Multiple opportunistic infections develop with acute leukemia primarily because: a. the number of white blood cells is decreased. b. many circulating leukocytes are immature. c. severe anemia interferes with the immune response. d. decreased appetite and nutritional intake reduce natural defenses. ANS: B REF: 206-207 60. Why is excessive bleeding a common occurrence with acute leukemia? a. Deficit of calcium ions b. Impaired production of prothrombin and fibrinogen c. Decreased platelets d. Dysfunctional thrombocytes ANS: C REF: 206-207 61. Predisposing factors to leukemia commonly include: a. exposure to radiation. b. certain fungal and protozoal infections. c. familial tendency. d. cigarette smoking. ANS: A REF: 207 62. Von Willebrand disease is caused by: a. defective erythrocytes that become deformed in shape, causing occlusions. b. excessive lymphocytes that do not mature. c. absence of a clotting factor that helps platelets clump and stick. d. a lack of hemoglobin due to iron deficiency. ANS: C REF: 203 63. Thrombophilia can result in conditions such as: a. severe chronic kidney disease. b. peripheral vascular disease. c. deficient calcium levels in the long bones. d. excessive bleeding of hematomas. ANS: B REF: 204 64. Multiple myeloma is a malignant tumor involving: a. plasma cells. b. granulocytes. c. bone cells. d. lymph nodes. ANS: A REF: 209 65. What is the primary treatment for the leukemias? a. Radiation b. Chemotherapy c. Surgery d. Immunotherapy ANS: B REF: 207 66. Which of the following statements applies to hemochromatosis. It is: a. caused by excessive iron intake in the diet. b. results from excessive hemolysis of RBCs.a metabolic error that leads to excess amounts of hemosiderin, causing c. damage to organs. d. an inherited defect that results in abnormal hemoglobin. ANS: C REF: 188 67. Thalassemia is caused by: 78. Which of the following applies to the etiology of aplastic anemia? It is: a. idiopathic in many cases. b. a genetic disorder. c. predisposed by exposure to myelotoxins. d. Both A and C. ANS: D REF: 197 79. Microcytic and hypochromic erythrocytes are commonly found as a result of: a. iron deficiency anemia. b. polycythemia. c. disseminated intravascular coagulation d. hemophilia A. ANS: A REF: 201 80. Which of the following actions causes the atrioventricular (AV) valves to close? a. Increased intraventricular pressure b. Depolarization at the AV node c. Ventricular relaxation and backflow of blood d. Contraction of the atria ANS: A REF: 2 81. When stroke volume decreases, which of the following could maintain cardiac output? a. Decrased peripheral resistance b. Increased heart rate c. Decreased venous return d. General vasodilation ANS: B REF: 228 82. Which of the following describes the pericardial cavity? a. It contains sufficient fluid to provide a protective cushion for the heart. b. It is a potential space containing a very small amount of serous fluid. c. It is lined by the endocardium. d. It is located between the double-walled pericardium and the epicardium. ANS: B REF: 224 83. Which of the following factors greatly improves venous return to the heart during strenuous exercise? a. Rapid emptying of the right side of the heart b. Forceful action of the valves in the veins c. Contraction and relaxation of skeletal muscle d. Peristalsis in the large veins ANS: C REF: 224 84. The function of the baroreceptors is to: stimulate the parasympathetic or sympathetic nervous system at the a. sinoatrial (SA) node as needed. b. . adjust blood pressure by changing peripheral resistance. c. sense a change in blood oxygen and carbon dioxide levels. d signal the cardiovascular control center of changes in systemic blood. pressure. ANS: D REF: 225 85. The normal delay in conduction through the AV node is essential for: a. preventing an excessively rapid heart rate. b. limiting the time for a myocardial contraction. c. allowing the ventricles to contract before the atria. d. completing ventricular filling. ANS: D REF: 225 86. Which of the following is a result of increased secretion of epinephrine? a. Increased heart rate and force of contraction b. Decreased stimulation of the SA node and ventricles c. Vasoconstriction in skeletal muscles and kidneys d. Vasodilation of cutaneous blood vessels ANS: A REF: 225 87. Which of the following causes increased heart rate? a. Stimulation of the vagus nerve b. Increased renin secretion c. Administration of beta-blocking drugs d. Stimulation of the sympathetic nervous system ANS: D REF: 230 88. The event that causes the QRS wave on an electrocardiogram (ECG) tracing is: a. atrial depolarization. b. atrial repolarization. c. ventricular depolarization. d. ventricular repolarization. ANS: C REF: 225 89. The cardiac reserve is: a. afterload. b. the difference between the apical and radial pulses. c. the ability of the heart to increase cardiac output when needed. d. the extra blood remaining in the heart after it contracts. ANS: C REF: 228 90. The term preload refers to: a. volume of venous return. b. peripheral resistance. c. stroke volume. d. cardiac output. ANS: A REF: 228 91. The first arteries to branch off the aorta are the: a. common carotid arteries. b. pulmonary arteries. c. coronary arteries. d. subclavian arteries. ANS: C REF: 226 92. Cardiac output refers to: a. the amount of blood passing through either of the atria. b. the volume of blood ejected by a ventricle in one minute. c. the volume of blood ejected by each ventricle in a single contraction. d. the total number of heartbeats in one minute. ANS: B REF: 228 93. Vasodilation in the skin and viscera results directly from: a. decreased blood pressure. b. increased parasympathetic stimulation. c. relaxation of smooth muscle in the arterioles. 104. When comparing angina with myocardial infarction (MI), which statement is true? a. Both angina and MI cause tissue necrosis. b. Angina often occurs at rest; MI occurs during a stressful time. c. Pain is more severe and lasts longer with angina than with MI.d Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is. not. ANS: D REF: 234 105. The basic pathophysiology of myocardial infarction is best described as: a. cardiac output that is insufficient to meet the needs of the heart and body. b. temporary vasospasm that occurs in a coronary artery. c. total obstruction of a coronary artery, which causes myocardial necrosis. d. irregular heart rate and force, reducing blood supply to coronary arteries. ANS: C REF: 240 106. Typical early signs or symptoms of myocardial infarction include: a. brief, substernal pain radiating to the right arm, with labored breathing. b. persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse. c. bradycardia, increased blood pressure, and severe dyspnea. d. flushed face, rapid respirations, left-side weakness, and numbness. ANS: B REF: 241 107. The most common cause of a myocardial infarction is: a. an imbalance in calcium ions. b. an infection of the heart muscle. c. atherosclerosis involving an attached thrombus. d. a disruption of the heart conduction system. ANS: C REF: 240 108. Calcium-channel blocking drugs are effective in: a. reducing the risk of blood clotting. b. decreasing the attraction of cholesterol into lipid plaques. c. reducing cardiac and smooth muscle contractions. d. decreasing all types of cardiac arrhythmias. ANS: C REF: 261 109. Which of the following confirms the presence of a myocardial infarction? a. A full description of the pain, including the sequence of development b. The presence of elevated serum cholesterol and triglycerides c. Serum isoenzymes released from necrotic cells and an ECG d. Leukocytosis and elevated C-reactive protein ANS: C REF: 242 110. The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following EXCEPT: a. previously established collateral circulation. b. immediate administration of thrombolytic drugs. c. maintaining maximum oxygen supply to the myocardium. d. removing the predisposing factors to atheroma development. ANS: D REF: 243 111. The most common cause of death immediately following a myocardial infarction is: a. cardiac arrhythmias and fibrillation. b. ruptured ventricle or aorta. c. congestive heart failure. d. cerebrovascular accident. ANS: A REF: 241-242 112. Why does ventricular fibrillation result in cardiac arrest? a. Delayed conduction through the AV node blocks ventricular stimulation. b. Insufficient blood is supplied to the myocardium. c. The ventricles contract before the atria. d. Parasympathetic stimulation depresses the SA node. ANS: B REF: 245 113. The term cardiac arrest refers to which of the following? a. Condition where cardiac output is less than the demand b. A decreased circulating blood volume c. Missing a ventricular contraction d. The cessation of all cardiac function ANS: D REF: 246 114. Which change results from total heart block? a. A prolonged PR interval b. Periodic omission of a ventricular contraction c. A wide QRS waved Spontaneous slow ventricular contractions, not coordinated with atrial . contraction ANS: D REF: 244 115. The term premature ventricular contraction refers to the condition where: a. atrial muscle cells are stimulating additional cardiac contractions. b. the ventricles contract spontaneously following a period without a stimulus. c. additional contractions arise from ectopic foci in the ventricular muscle. d. increased heart rate causes palpitations. ANS: C REF: 245 116. Which of the following is most likely to cause left-sided congestive heart failure? a. Incompetent tricuspid heart valve b. Chronic pulmonary disease c. Infarction in the right atrium d. Uncontrolled essential hypertension ANS: D REF: 246 117. The definition of congestive heart failure is: a. cessation of all cardiac activity. b inability of the heart to pump enough blood to meet the metabolic needs of . the body. c. insufficient circulating blood in the body. d. the demand for oxygen by the heart is greater than the supply. ANS: B REF: 246 118. Significant signs of right-sided congestive heart failure include: a. severe chest pain and tachycardia. b. edematous feet and legs with hepatomegaly. c. frequent cough with blood-streaked frothy sputum. d. orthopnea, fatigue, increased blood pressure. ANS: B REF: 247 120. Paroxysmal nocturnal dyspnea is marked by: a. hemoptysis and rales. b. distended neck veins and flushed face. c. bradycardia and weak pulse. d. cardiomegaly. ANS: A REF: 250 121. Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include: a. slow cardiac contractions. 132. 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 REF: 255-256 133. 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 REF: 256 134. 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 REF: 257 135. 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 REF: 257 136. 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 REF: 258 137. 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: 258 138. 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: 242 139. 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: 259 140. 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: 260 141. 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: 259 142. 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: 261 143. 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: 261 144. 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: 262 145. 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: 225 146. A friction rub is associated with: a. infectious endocarditis. b. arrhythmias. c. pericarditis. d. an incompetent aortic valve. ANS: C REF: 258 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: 265 158. 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: 267 159. 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: 267-268 160. 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: 265-266 161. 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: 249-250 162. A common adverse effect of many antihypertensive medications is: a. orthostatic hypotension. b. bradycardia.c. altered blood coagulation. d. peripheral edema. ANS: A REF: 261 163. 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: 259 164. 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: 245 165. Which of the following is considered to be the most dangerous arrhythmia? a. Tachycardiab. Bradycardia c. Ventricular fibrillation d. Second-degree heart block ANS: C REF: 245 166. 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: 232 167. 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 REF: 242 168. 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. Manifestations of aneurysms result from compression of adjacent c. structures. d. Aneurysms involve a defect in the tunica media of veins. ANS: C REF: 263 169. The most common factor predisposing to the development of varicose veins is: a. trauma. b. congenital valve defect in the abdominal veins. c. infection. d. increased venous pressure ANS: D REF: 263 170. 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 REF: 267-269 171. 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 REF: 267 172. 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 REF: 244 b. myocardial infarction. c. reduced venous return. d. friction rub. ANS: C REF: 258 184. 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: 251 185. 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 ANS: A REF: 265 186. What happens in the lungs when the diaphragm and external intercostal muscles relax? a. Air is forced out of the lungs. b. Lung volume increases. c. Intrapulmonic pressure decreases. d. Intrapleural pressure decreases. ANS: A REF: 275 187. The respiratory mucosa is continuous through the: 1. upper and lower respiratory tracts. 2. nasal cavities and the sinuses. 3. nasopharynx and oropharynx. 4. middle ear cavity and auditory tube. a. 1 only b. 1, 2 c. 2, 3 d. 1, 3, 4 e. 1, 2, 3, 4 ANS: E REF: 273- 274 188. Which of the following activities does NOT require muscle contractions and energy? a. Quiet inspiration b. Forced inspiration c. Quiet expiration d. Forced expiration ANS: C REF: 275 189. The maximum volume of air a person can exhale after a maximum inspiration is termed the: a. expiratory reserve volume. b. inspiratory reserve volume. c. total lung capacity. d. vital capacity. ANS: D REF: 276-277 190. Which of the following applies to the blood in the pulmonary artery? a. PCO2 is low. b. PO2 is low. c. Hydrostatic pressure is very high. d. It is flowing into the left atrium. ANS: B REF: 279 191. Which of the following causes bronchodilation? a. Epinephrine b. Histamine c. Parasympathetic nervous system d. Drugs that block β2-adrenergic receptors ANS: A REF: 302 192. 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 REF: 277 193. 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: 278 194. 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: 280 195. What would hypercapnia cause? a. Increased serum pH b. Decreased respirations c. Respiratory acidosis d. Decreased carbonic acid in the blood ANS: C REF: 278 196. Which of the following would result from hyperventilation? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic alkalosis d. Metabolic acidosis ANS: B REF: 278 197. 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- 283 198. 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 ion d. An increase in respiratory rate ANS: B REF: 279-280 d. Viral mutation reduces immunity from prior infections. ANS: D REF: 285 209. What are typical signs and symptoms of epiglottitis? a. Hyperinflation of the chest and stridor b. Hoarse voice and barking cough c. Sudden fever, sore throat, and drooling saliva d. Sneezing, mild cough, and fever ANS: C REF: 289 210. What is the most common cause of viral pneumonia? a. Rhinovirusb. b.Influenza virus c. Haemophilus influenzae d. Pneumococcus ANS: B REF: 288 211. Which of the following describes lobar pneumonia? a. Sudden onset of fever and chills, with rales and rusty sputum b. Insidious onset, diffuse interstitial infection c. Viral infection causing nonproductive cough and pleuritic pain d Opportunistic bacteria causing low-grade fever with cough and thick greenish sputum ANS: A REF: 288 212. 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: 288 213. 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: 289 214. What is the cause of Legionnaires’ disease? a. Mycoplasma b. A fungus c. A gram-negative bacterium d. Pneumococcus ANS: C REF: 290 215. Select the statement related to tuberculosis: The microbe is present in the sputum of all patients with a positive TB skin a. test. b. The infection is transmitted primarily by blood from an infected person. TB is usually caused by an acid-fast bacillus, resistant to many c. disinfectants. d. The microbe is quickly destroyed by the immune response. ANS: C REF: 290-291 216. 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: 291 217. 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: 290 218. 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: 291 219. 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: 290 220. 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: 293 221. Histoplasmosis is caused by a: a. fungus. b. virus. c. bacillus. d. protozoa. ANS: A REF: 294 222. 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: 294 223. The basic pathophysiology of cystic fibrosis is centered on a/an: a. defect of the exocrine glands. b. impaired function of the endocrine glands. c. chronic inflammatory condition of the lungs. d. abnormal immune response in the lungs and other organs. ANS: A REF: 294 224. Growth and development of a child with cystic fibrosis may be delayed because of: a. deficit of gastric enzymes for protein digestion. b. mucus plugs obstructing the flow of pancreatic enzymes. ANS: C REF: 303 | 322 234. 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: 303 235. 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: 303 236. Destruction of alveolar walls and septae is a typical change in: a. chronic bronchitis. b. acute asthma. c. emphysema. d. asbestosis. ANS: C REF: 302 237. 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: 303 238. 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: 307 239. 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: 307 240. 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: 307 241. 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 d. Fixation of the ribs in the inspiratory position ANS: C REF: 308 242. Which of the following are significant signs of bronchiectasis? a. Persistent nonproductive cough, dyspnea, and fatigue b. Persistent purulent nasal discharge, fever, and cough c. Chronic cough, producing large quantities of purulent sputum d. Wheezing and stridor ANS: C REF: 302 | 304 243. Why does cor pulmonale develop with chronic pulmonary disease? a. The right ventricle pumps more blood than the left ventricle. b. Pulmonary fibrosis and vasoconstriction increase vascular resistance. c. Demands on the left ventricle are excessive. d. Blood viscosity is increased, adding to cardiac workload. ANS: B REF: 308 244. Restrictive lung disorders may be divided into two groups based on: a. patient history of obesity and exposure to other COPD. b. smoking history and congenital defects. c. previous lung disease and cardiovascular disorders. d. anatomical abnormality and lung disease damage, impairing expansion. ANS: D REF: 303 245. What is caused by frequent inhalation of irritating particles such as silica? a. Fibrosis and loss of compliance b. Frequent bronchospasm c. Increased number of mucus-producing glands d. Distorted shape of the thorax ANS: A REF: 309 246. Pulmonary edema causes severe hypoxia because of: a. decreased diffusion of carbon dioxide from the alveoli. b. interference with expansion of the lungs. c. constant cough and hemoptysis. d. decreased recoil of lungs and ineffective expiration. ANS: B REF: 309 247. Which of the following is NOT a cause of pulmonary edema? a. Left-sided congestive heart failure b. Excessive blood volume (overload) c. Inhalation of toxic gases d. Hyperproteinemia and increasing osmotic pressure of the blood ANS: D REF: 309 248. Which of the following is a common source of a pulmonary embolus? a. Mural thrombus from the left ventricle b. Thrombus attached to atheromas in the aorta or iliac arteries c. Thrombus forming in the femoral veins d. A blood clot in the pulmonary vein ANS: C REF: 309-310 249. What is a large-sized pulmonary embolus likely to cause? a. Hypertension and left-sided heart failure b. Atelectasis and respiratory failure c. Hypotension and right-sided heart failure d. Pleural effusion and atelectasis ANS: C REF: 312 260. 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: 282 261. Obstruction in the upper airway is usually indicated by: a. stridor. b. rales. c. wheezing. d. orthopnea. ANS: A REF: 280 262. Which of the following does NOT apply to carbon dioxide? a. It diffuses across membranes much more easily than does oxygen. b. It is carried in blood as carbaminohemoglobin. c. It can be converted into bicarbonate ion. d. It is replaced on hemoglobin by oxygen in the lungs. ANS: D REF: 278 263. Whenever PO2 levels decrease below normal, PCO2 levels: a. increase. b. decrease also. c. may or may not change. d. increase slightly. ANS: C REF: 283 264. Laryngotracheobronchitis is typically manifested by: a. drooling and difficulty swallowing. b. hoarse voice and barking cough. c. sore and scratchy throat with fever. d. wheezing and dyspnea. ANS: B REF: 286 265. Lobar pneumonia is usually caused by: a. Mycoplasma pneumoniae. b. Streptococcus pneumoniae. c. Legionella pneumophila. d. Pneumocystis carinii. ANS: B REF: 290 266. Severe acute respiratory syndrome (SARS) is caused by a/an: a. rhinovirus. b. mycoplasma. c. influenza virus. d. coronavirus. ANS: D REF: 290 267. SARS typically begins as a flulike syndrome followed, after a few days, by: a. increased exudates in the bronchial tree and pleural cavity. b. productive cough and lobar consolidation. c. interstitial lung congestion, dyspnea, and dry cough. d. hemoptysis and necrosis of mucous membrane. ANS: C REF: 294 267. In addition to effects on the lungs and pancreas, cystic fibrosis results in: a. excess bile production. b. high sodium chloride content in saliva and sweat. c. gastric ulcers. d. frequent ear and sinus infections. ANS: B REF: 297 268. Which of the following is a significant early sign of bronchogenic carcinoma in a smoker? a. Frequent nonproductive cough b. Fever, dyspnea, generalized aching c. Production of large volumes of purulent sputum d. Hemoptysis and weight loss ANS: D REF: 297 269. 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: 292 270. 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: 293 271. 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: 293 272. 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: 309 273. 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: 302 274. 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: 304 285. Which of the following applies to anthrax infection? a. It is caused by a virus that mutates frequently. b When inhaled, it causes flulike symptoms followed by acute respirator distress. c. There is a long incubation period, often months, following exposure. d. It is a common infection in North America. ANS: B REF: 294 286. The mutated gene for cystic fibrosis is located on the: a. seventh chromosome. b. tenth chromosome. c. fifteenth chromosome. d. X chromosome. ANS: A REF: 298 287. Which of the following cells produce new bone? a. Osteocytes 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: 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 13. How is Duchenne’s muscular dystrophy inherited? a. Autosomal recessive gene b. X-linked recessive gene c. Autosomal dominant gene d. Codominant gene ANS: B REF: 172 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 REF: 172 15. The most common type of joint, which are freely movable, are called: a. Synarthroses b. Amphiarthroses c. Anarthroses d. Diarthroses ANS: D REF: 163 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 REF: 173-174 17. What is a typical characteristic of the pain caused by osteoarthritis? a. Decreases over time b. Quite severe in the early stages 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. 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. ANS: C REF: 163 33. Which factors delay healing of bone fractures? 1. Lack of movement of the bone 2. Prolonged inflammation and ischemia 3. Presence of osteomyelitis 4. Close approximation of bone ends a. 1, 2 b. 1, 3 c. 2, 3 d. 3, 4 ANS: C REF: 166-167 34. What is the likely immediate result of fat emboli from a broken femur? a. Additional ischemia in the broken bone b. Nonunion or malunion of the fracture c. Pulmonary inflammation and obstruction d. Abscess and infection at a distant site ANS: C REF: 167 35. A sprain is a tear in a: a. ligament. b. tendon. c. skeletal muscle. d. meniscus. ANS: A REF: 168 36. Therapeutic measures for osteoporosis include: a. non–weight-bearing exercises. b. dietary supplements of calcium and vitamin D. c. transplants of osteoblasts. d. avoidance of all hormones. ANS: B REF: 170 37. What is the distinguishing feature of primary fibromyalgia syndrome? a. Joint pain and stiffness throughout the body b. Degeneration and atrophy of skeletal muscles in back and lower limbs c. Localized areas of constant pain 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 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 a. Skipping a meal b. Anorexia c. Serious infection d. Insulin overdose ANS: C REF: 410 7. Which of the following may cause insulin shock to develop? a. Strenuous exercise b. Missing an insulin dose c. Eating excessively large meals d. Sedentary lifestyle ANS: A REF: 409 8. Which of the following indicates hypoglycemia in a diabetic? a. Deep, rapid respirations b. Flushed dry skin and mucosa c. Thirst and oliguria d. Staggering gait, disorientation, and confusion ANS: D REF: 409 9. Which of the following are signs of diabetic ketoacidosis in an unconscious person? a. Pale moist skin b. Thirst and poor skin turgor c. Deep rapid respirations and fruity breath odor d. Tremors and strong rapid pulse ANS: C REF: 410 10. Immediate treatment for insulin shock may include: a. administration of bicarbonates. b. consumption of fruit juice or candy. c. induced vomiting. d. consumption of large amounts of water. ANS: B REF: 409 11. What causes loss of consciousness in a person with diabetic ketoacidosis? a. Toxic effects of excessive insulin b. Excessive glucose in the blood c. Metabolic acidosis d. Lack of glucose in brain cells ANS: C REF: 411 12. Which of the following does NOT usually develop as a complication of diabetes? a. Osteoporosis 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. Elevated blood glucose levels b. High blood pressure c. Low serum potassium levels d. Poor stress response 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, 3c. 1, 2 d. ANS: C REF: 422 1, 3, 4 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. ANS: A REF: 410 1, 3, 4 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? a. Type 1 diabetes weight gain is common, and type 2 weight loss often occurs. b. Type 1 diabetes leads to fewer complications than does type 2 diabetes. Type 1 diabetes may be controlled by adjusting dietary intake and exercise, but type 2 diabetes requires insulin c. replacement. d Type 1 diabetes occurs more frequently in children and adolescents, and type 2 diabetes occurs more often in . adults. ANS: D REF: 406-407 41. Complications of diabetes mellitus include: a. peripheral neuropathy b. frequent infections. c. cataracts d. A, B, and C. ANS: D REF: 412-413 42. Which of the following often causes hyperparathyroidism? a. A malignant tumor in the parathyroid glands b. End-stage renal failur c. Osteoporosis d. Radiation involving the thyroid gland and neck area ANS: D REF: 416 4. It is released from the adenohypophysis. a. 1, 2 b. 1, 4 c. 1, 3, 4 d.ANS: A REF: 404 1, 2, 3, 4 52. Which of the following is a major function of the hormone norepinephrine? a. Inhibition of an excessive stress response b. Visceral and cutaneous vasoconstriction c. Increased force of heart contraction d. Vasodilation in skeletal muscle ANS: B REF: 404 53. Early signs of hyperglycemia include polyphagia, which means: a. thirst b. increased urine output c. hunger. d. glucose in the urine. ANS: C REF: 411 54. Which of the following hormones is involved in both the stress response and the anti- inflammatory response? a. Aldosterone b. Norepinephrine c. Thyroxine d. Cortisol ANS: D REF: 404 55. Polydipsia occurs with diabetes mellitus when: a. lack of insulin causes hunger. b. ketone levels rise in the blood. c. polyuria causes dehydration. d. glucosuria causes ketoacidosis ANS: C REF: 407 56. Metabolic syndrome is marked by: a. abnormal lipid and glucose metabolism b. periodic hypotension. c. deficit of glucagon. d. early onset of type 1 diabetes mellitus. ANS: A REF: 407 57. Compensation mechanisms occurring in the early stage of diabetic ketoacidosis include: a. Kussmaul’s respirations. b. polydipsia. c. ketonuria. d. seizures. ANS: A REF: 410 58. Which of the following may occur with a pituitary adenoma? a. Low blood pressure and bradycardia b. Headache and seizures c. Vomiting and diarrhea d. Loss of vision in one eye ANS: B REF: 416 59. Which of the following may cause hypertension? a. Hypoparathyroidism b. Hypoglycemia c. Pheochromocytoma d. Addison’s disease ANS: C REF: 422 60. Catabolic effects of Cushing’s syndrome include: a. osteoporosis b. hypertension c. increased erythrocyte production. d. moon face and buffalo hump. ANS: A REF: 423 61. Blood glucose levels are increased by: 1. glucocorticoids. 2. glucagon. 3. epinephrine. 4. norepinephrine. 5. parathyroid hormone (PTH) a.1, 2 b. 1, 2, 3 c. 2, 4, 5 d.ANS: B REF: 403 1, 3, 4, 5 62. Which of the following are likely present in a patient immobilized for a long period of time? a. Hypocalcemia and low serum parathyroid hormone (PTH) levels b. Hypocalcemia and high serum PTH levels c. Hypercalcemia and low serum PTH levels d. Hypercalcemia and high serum PTH levels ANS: C REF: 416 63. Which of the following may cause high serum levels of parathyroid hormone? a. Hypoparathyroidism b. Chronic renal failure c. Hypercalcemia d. Adenoma in the thyroid gland ANS: B REF: 416 64. Diabetic retinopathy results from: a. degeneration of large blood vessels supplying the eye. b. abnormal metabolism in the lens of the eye. c. neuropathy affecting the optic nerve. d. obstruction or rupture of retinal blood vessels. ANS: D REF: 412 65. Why does hypocalcemia cause tetany?