PATHO 370 TEST 3 COMPLETE 2023

PATHO 370 TEST 3 COMPLETE 2023. Administration of which therapy is most appropriate for hypovolemic shock? Selected Answer: c. Crystalloids Correct Answer: c. Crystalloids Response Feedback: Crystalloids are solutions that contain electrolytes. Isotonic solutions, such as lactated Ringers, are commonly used crystalloid solutions. These solutions are preferred for volume resuscitation, because they remain in the extracellular space and are more effective in increasing blood volume. Vasoconstrictor agents are contraindicated in hypovolemic shock. Isotonic crystalloids are the most appropriate fluid for volume resuscitation. Isotonic fluids are preferred over glucose or hypotonic electrolyte solutions.  Question 2 0.125 out of 0.125 points Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. Selected Answer: b. mean arterial Correct Answer: b. mean arterial Response Feedback: The mean arterial pressure is used to make incremental adjustments to vasoactive drugs. The MAP is the calculated average pressure within the circulatory system throughout the cardiac cycle. The systolic pressure is a part of the calculation but is not the data element used in adjustment of vasoactive medications. The diastolic reading is involved in calculating the MAP, but is not the number used in titration of vasoactive medications. The pulse pressure is the difference between the systolic and diastolic pressure.  Question 3 0.125 out of 0.125 points Restriction of which electrolytes is recommended in the management of high blood pressure? Selected Answer: d. Sodium Correct Answer: d. Sodium Response Feedback: The balance of the intake of water and sodium with their excretion by the kidney remains the central feature of long-term blood pressure maintenance. Sodium is not rapidly eliminated by the kidney like water and adds to the body’s fluid volume. It is not necessary to restrict the intake of calcium when managing high blood pressure. Potassium does not need to be restricted in the management of high blood pressure. Magnesium does not play a role in the management of high blood pressure.  Question 4 0.125 out of 0.125 points A patient with significant aortic stenosis is likely to experience Selected Answer: b. syncope. Correct Answer: b. syncope. Response Feedback: In the patient with aortic stenosis, syncope and “greying out” episodes may occur when cerebral perfusion is inadequate. Low systolic blood pressure is a common sign of aortic stenosis. Faint pulses are a common sign of aortic stenosis. Peripheral edema is not associated with aortic stenosis.  Question 5 0.125 out of 0.125 points The majority of tachydysrhythmias are believed to occur because of Selected Answer: b. reentry mechanisms. Correct Answer: b. reentry mechanisms. Response Feedback: Reentry is thought to be the culprit in most tachydysrhythmias. Reentry is a complex process in which a cardiac impulse continues to depolarize in a part of the heart after the main impulse has finished its path. Triggered activity occurs when an impulse is generated during or just after repolarization. Alterations in automaticity create electrolyte imbalances. Defective gap junctions are not related to tachydysrhythmias.  Question 6 0.125 out of 0.125 points Which dysrhythmia is thought to be associated with reentrant mechanisms? Selected Answer: d. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome) Correct Answer: d. Preexcitation syndrome tachycardia (Wolf-Parkinson-White syndrome) Response Feedback: Reentry is a complex process in which a cardiac impulse continues to depolarize in a part of the heart after the main impulse has finished its path and the majority of the fibers have repolarized. Wolff– Parkinson–White syndrome is caused by accessory pathways that originate in the atria, bypass the AV node, and enter a site in the ventricular myocardium. This causes the ventricles to contract prematurely, resulting in a reentrant tachycardia. Second-degree block is a conduction failure between the sinus impulse and its ventricular response. Sinus bradycardia is a slowed impulse generation by the sinus node. A junctional escape rhythm originates in the AV node.  Question 7 0.125 out of 0.125 points Chronic elevation of myocardial wall tension results in atrophy. Selected Answer: a. False Correct Answer: a. False Response Feedback: Chronic elevation of myocardial wall tension results in hypertrophy.  Question 8 0.125 out of 0.125 points Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of Selected Answer: a. cardiac tamponade. Correct Answer: a. cardiac tamponade. Response Feedback: The three classic symptoms of cardiac tamponade are hypotension, distended neck veins, and muffled heart sounds. There are many other manifestations as well. Myocardial infarction is not exhibited by the symptoms described. Classic symptoms of cardiac tamponade are hypotension, distended neck veins, and muffled heart sounds. Symptoms of CHF may include jugular venous distention. Cardiomyopathy is not exhibited by the symptoms described.  Question 9 0.125 out of 0.125 points The common denominator in all forms of heart failure is Selected Answer: a. reduced cardiac output. Correct Answer: a. reduced cardiac output. Response Feedback: The common manifestation of all forms of heart failure is the failure of the heart to pump blood adequately. The clinical presentation may differ depending on which ventricle fails (left or right, or both). Poor diastolic filling is not seen in all forms of heart failure. Pulmonary edema is seen in left-sided failure. Tissue ischemia is directly related to myocardial infarction, which may induce heart failure.  Question 10 0.125 out of 0.125 points High blood pressure increases the workload of the left ventricle, because it increases Selected Answer: d. afterload. Correct Answer: d. afterload. Response Feedback: Hypertension reflects an elevation in SVR; rising afterload increases myocardial oxygen demand and overall cardiac workload. The workload of the left ventricle does not increase the stroke volume, blood volume, or preload.  Question 11 0.125 out of 0.125 points In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with Selected Answer: a. high cardiac output. Correct Answer: a. high cardiac output. Response Feedback: In the hyperdynamic stage of septic shock, blood pressure falls because of the decreased systemic vascular resistance and decreased venous return. The heart rate and stroke volume increase and cardiac output is higher than normal. In the hyperdynamic phase of septic shock, afterload is not high. Cardiac output is high in the hyperdynamic stage of septic shock. The heart rate and stroke volume increase during the hyperdynamic stage of septic shock.  Question 12 0.125 out of 0.125 points The progressive stage of hypovolemic shock is characterized by Selected Answer: d. tachycardia. Correct Answer: d. tachycardia. Response Feedback: In the progressive stage of hypovolemic shock, the patient is anxious and confused, with decreased blood pressure and heart rate greater than 120 beats/minute. In this stage of shock, the blood pressure is decreased. Lactic acidosis does not occur in the progressive stage of hypovolemic shock. Cardiac failure is not likely to occur in the earlier stages of hemorrhagic shock.  Question 13 0.125 out of 0.125 points In which stage of shock is a patient who has lost 1200 mL of blood, who has normal blood pressure when supine, but who experiences orthostatic hypotension upon standing? Selected Answer: c. Class II, Compensated Stage Correct Answer: c. Class II, Compensated Stage Response Feedback: In compensated stage hemorrhage (Class II), the blood loss is between 750 and 1500 mL. Blood pressure remains normal when the patient is supine but decreases upon standing. In initial stage hemorrhage (Class I) blood loss is up to 750 mL, and the patient’s vital signs remain normal. Class III hemorrhage (progressive stage) is blood loss of 1500 and 2000 mL. Vital signs are changing. Severe Class IV hemorrhage (refractory stage) occurs when more than 2000 mL is lost. The patient is lethargic, with severe hypotension.  Question 14 0.125 out of 0.125 points A patient with pure left-sided heart failure is likely to exhibit Selected Answer: d. pulmonary congestion with dyspnea. Correct Answer: d. pulmonary congestion with dyspnea. Response Feedback: Left-sided heart failure is most often associated with left ventricular infarction and systemic hypertension. The ineffective pumping of the left ventricle results in an accumulation of blood within the pulmonary circulation. As a result, pulmonary congestion with dyspnea is an expected finding. Jugular vein distention is more often associated with right-sided failure. Peripheral edema is associated with right-sided failure. Hepatomegaly is not seen in pure left-sided edema.