- ANSWER
Compensatory hyperplasia is an adaptive mechanism that enables certain organs to regener-
ate. For example, the removal of part of the liver leads to hyperplasia of the remaining liver
cells (hepatocytes) to compensate for the loss.
Which of the following statements best describes Raynaud disease?
a. An inflammatory disorder of small and medium-size arteries in the feet and sometimes in
the hands
b. A neoplastic disorder of the lining of the arteries and veins of the upper extremities
c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less com-
monly, the toes
d. An autoimmune disorder of the large arteries and veins of the upper and lower extremi-
ties - ANSWER c. A vasospastic disorder of the small arteries and arterioles of the fin-
gers, and less commonly, the toes
A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance.
Which of the following heart failures may result from this condition?
a. Right heart failure
b. Left heart failure
c. Low-output failure
d. High-output failure - ANSWER a. Right heart failure
Exp: Right heart failure is defined as the inability of the right ventricle to provide adequate
blood flow into the pulmonary circulation at a normal central venous pressure. It most often
results from the left heart failure when the increase in left ventricular filling pressure that is
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,reflected back into the pulmonary circulation is severe enough. As pressure in the pulmo-
nary circulation rises, the resistance to right ventricular emptying increases.
What physical sign is the result of turbulent blood flow through a vessel?
a. Increased blood pressure during periods of stress
b. Bounding pulse felt on palpation
c. Cyanosis observed on excretion
d. Murmur heard on auscultation - ANSWER d. Murmur heard on auscultation
Exp: Where flow is obstructed the vessel turns or blood flows over rough surfaces. The flow
becomes turbulent with whorls or eddy currents that produce noise causing a murmur to be
heard on auscultation such as occurs during blood pressure measurement with a sphygoma-
nometer. This selection is the only option that accurately identifies the physical sign of tur-
bulent vascular blood flow. pg 1113
Which congenital heart defects occur in trisomy 13, trisomy 18 and down syndrome?
a. Coarctation of the aorta and pulmonary stenosis
b. Tetralogy of Fallot and persistent truncus arteriosus
c. Atrial septal defect and dextrocardia
d. Ventricular septal defect and patent ductus arteriosus - ANSWER d. Ventricular sep-
tal defect and patent ductus arteriosus
Exp: Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18 and
down syndrome include VSD and PDA see Table 33-2 The other defects are not associated
with dysfunction of trisomy 13 or 17 and down syndrome. pg 1200
An infant has a continuous machine/type murmur best heard at the left upper sternal border
throughout systole and diastole as well as a bounding pulse and a thrill on palpation. These
clinical findings are consistent with which congenital heart defect?
a. Atrial septal defect
b. Ventricular septal defect
c. Patent ductus arteriosus
d. Atrioventricular canal defect - ANSWER c. Patent ductus arteriosus
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,Exp: If pulmonary vascular resistance has fallen then infants with will characteristically have
a continuous machine/type murmur best heard at the left upper sternal border throughout
systole and diastole. If the PDA is significant then the infant also will have bounding pulses
an active precordium, a thrill on palpation and signs and symptoms of pulmonary over circu-
lation. The presentations of the other congenital heart defects are not consistent with the
described the symptoms pages 1203-1204
Which compensatory mechanism is spontaneously used by children diagnosed with tetral-
ogy of Fallot to relieve hypoxic spells?
a. Lying on their left side
b. Performing the valsalva maneuver
c. Squatting
d. hyperventilating - ANSWER c. Squatting
Exp: squatting is a spontaneous compensatory mechanism used by older children to alleviate
hypoxic spells. Squatting and its variants increase systemic resistance while decreasing ve-
nous return to the heart from the inferior vena cava. The other options would not result in
these changes. pg 1209
An infant diagnosed with a small patent ductus arteriosus would likely exhibit which symp-
tom?
a. Intermittent murmur
b. Lack of symptoms
c. Need for surgical repair
d. Triad of congenital defects - ANSWER b. Lack of symptoms
Exp: Infants with a small PDA usually remain asymptomatic. page 1203-1204
Fluid in the pleural space characterizes which condition?
a. Pleural effusion
b. Atelectasis
c. Bronchiectasis
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, d. Ischemia - ANSWER a. Pleural Effusion
Exp: Pleural effusion is the presence of fluid in the pleural space. page1254
Which medication classification is generally included in the treatment of silicosis?
a. Corticosteroids
b. Antiboitics
c. Bronchodilators
d. Expectorants - ANSWER a. Corticosteroids
Exp: No specific treatment exists for silicosis, although corticosteroids may produce some
improvement in the early, more acute stages. page 1259
The risk for respiratory distress syndrome (RDS) decreases for premature infants when they
are born between how many weeks of gestation?
a. 16 and 24
b. 20 and 24
c. 24 and 30
d. 30 and 36 - ANSWER d. 30 and 36
Exp: Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options
are not true regarding the timeframe when the risk for RDS decreases. page 1292
What is the chief predisposing factor for respiratory distress syndrome (RDS) of the new-
born?
a. Low birth weight
b. Alcohol consumption during pregnanc
c. Premature birth
d. Smoking during pregnancy - ANSWER a. Premature birth
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