WCU Patho 370 CHYU 2023 100% correct questions and answers

A patient has a history of falls, syncope, dizziness, and blurred vision. The patient's symptomology is most likely related to º hypertension. º hypotension. º deep vein thrombosis. º angina Hypotension An example of an acyanotic heart defect is º tetralogy of Fallot. º transposition of the great arteries. º ventricular septal defect. º all right-to-left shunt defects. Ventricular septal defect º In this condition, blood from the left ventricle leaks into the right ventricle because of a defect in the ventricular wall. This leakage causes extra pressure in the right ventricle resulting in pulmonary hypertension. Cor pulmonale refers to º bi-ventricular failure. º left ventricular hypertrophy secondary to lung disease. º right ventricular hypertrophy secondary to pulmonary hypertension. º right ventricular failure secondary to right ventricular infarction. rRight ventricular hypertrophy secondary to pulmonary hypertension Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells. º aldosterone º norepinephrine º angiotensinogen º renin Renin Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria? º 118/78 º 128/82 º 140/88 º 138/94 128/82 In which dysrhythmias should treatment be instituted immediately? º Asymptomatic sinus bradycardia at a heart rate of 50 beats/minute º Fever-induced tachycardia at 122 beats/minute º Premature atrial complexes occurring every 20 seconds º Atrial fibrillation with a ventricular rate of 220 beats/minute Atrial fibrillation with a ventricular rate of 220 beats/minute ºIt allows blood to become stagnant in the atria and may lead to formation of thrombi. This condition requires resuscitation because of the reduction in cardiac output Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP) of 110/70 and a heart rate(HR) of 100? º Sitting BP 88/60, HR 118 º Sitting BP 108/68, HR 102 º Sitting BP 110/78, HR 98 º Sitting BP 120/80, HR 100 Sitting BP 88/60, HR 118 Restriction of which electrolytes is recommended in the management of high blood pressure? º Calcium º Potassium º Sodium º Magnesium Sodium Hypertension with a specific, identifiable cause is known as _____ hypertension. º primary º orthostatic º secondary º malignant Secondary Critically ill patients may have parenterally administered vasoactive drugs that are adjusted according to their _____ pressure. º systolic º mean arterial º diastolic º pulse Mean arterial ºThe mean arterial pressure is used to make incremental adjustments to vasoactive drugs The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with º perfumes. º incompatible blood products. º. animal proteins or dander. º antibiotics. Antibiotics An abnormally wide (more than 0.10 second) QRS complex is characteristic of º paroxysmal atrial tachycardia. º supraventricular tachycardia. º junctional escape rhythm. º premature ventricular complexes. Premature ventricular complexes ºThe QRS of the premature complex is prolonged (greater than 0.10 second) and bizarre in appearance. What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume? º Hypotension º Bradycardia º Aortic regurgitation º Tachycardia Tachycardia Hypertension is closely linked to º obstructive sleep apnea. º urinary tract infection. º de Quervain syndrome. º spinal stenosis. Obstructive sleep apnea True or False: New-organ damage is a function of both the stage of hypertension and its duration. False: END-organ damage is a function of both the stage of hypertension and its duration Left-sided heart failure is characterized by º pulmonary congestion. º decreased systemic vascular resistance. º jugular vein distention. º peripheral edema. Pulmonary congestion True or False: A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. False: A type of shock that includes brain trauma that results in depression of the vasomotor center is neurogenic shock. Administration of which therapy is most appropriate for hypovolemic shock? º Crystalloids º Vasoconstrictor agents º Inotropic agents º 5% dextrose in water Crystalloids ºCrystalloids 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. Atherosclerotic plaques with large lipid cores are prone to º dislodgement. º binding. º rupture. º attachment. Rupture ºRupture of atherosclerotic plaques with large lipid cores initiates platelet aggregation and thrombus formation. A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock? º Cardiogenic º Septic º Anaphylactic º Neurogenic Septic ºPatients presenting with septic shock may have fever and hypotension. In addition, lactic acidosis may be present because of tissue hypoxemia. Myocarditis should be suspected in a patient who presents with º chest pain and ST elevation. º acute onset of left ventricular dysfunction. º murmur and abnormal valves on echocardiogram. º family history of cardiomyopathy. Acute onset of left ventricular dysfuntion ºAcute myocarditis is commonly characterized by left ventricular dysfunction or general dilation of all four heart chambers. True or False: The ingestion of certain drugs, foods, or chemicals can lead to secondary hypertension True Patients with structural evidence of heart failure who exhibit no signs or symptoms are classified into which New York HeartAssociation heart failure class? º Class I º Class II º Class III º Class IV Class I ºPatients who have structural heart disease but no signs or symptoms of heart failure are placed in Class I of the NYHA Classes.Class II patients have current or previous symptoms of heart failure. Class III patients have current or previous symptoms of heart failure, such as dyspnea or fatigue. Class IV patients have advanced structural heart disease and marked symptoms at rest. A patient with pure left-sided heart failure is likely to exhibit a. jugular vein distention. b. pulmonary congestion with dyspnea. c. peripheral edema. d. hepatomegaly. Pulmonary congestion with dyspnea A middle-aged patient has a follow up visit for a recorded blood pressure of 162/96 mm Hg taken 3 weeks ago. The patient has nosignificant past medical history and takes no medications, but smokes 1 1/2 packs of cigarettes per day, drinks alcohol regularly,and exercises infrequently. The patient is about 40 lbs. overweight and admits to a high-fat, high-calorie diet. At the office visittoday, the patient's blood pressure is 150/92 mm Hg. What is the least appropriate intervention for this patient at this time? º Begin lifestyle modifications. º Begin antihypertensive drug therapy. º Recheck blood pressure in 4 to 6 weeks. º Encourage smoking cessation. Begin antihypertensive drug therapy ºAntihypertensive drug therapy is not the first intervention in a person with modifiable risk factors. Primary treatment for myocardial infarction (MI) is directed at º protecting the heart from further ischemia. º decreasing myocardial oxygen demands. º reducing heart rate and blood pressure. º activating the parasympathetic system. Decreasing myocardial oxygen demands ºReducing oxygen demand may be effective in preserving myocardial muscle. Once the cardiac muscle has been damaged, it is more important to preserve remaining muscle and prevent further loss of the myocardium A patient who reports dizziness and who has absent P waves, wide QRS complexes, and a heart rate of 38 beats/minute on an ECG is most likely in which rhythm? º Ventricular escape rhythm º Sinus bradycardia º Third-degree heart block º Junctional tachycardia Ventricular escape rhythm ºA ventricular escape rhythm originates in the Purkinje fibers, has a rate of 15 to 40 beats/minute, and is characterized by a wide QRS complex. The majority of tachydysrhythmias are believed to occur because of º triggered activity. º enhanced automaticity. º defective gap junctions. º reentry mechanisms. Reentry mechanisms ºReentry 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. The prevalence of high blood pressure is higher in º Non-Hispanic white adults. º Mexican-American adults. º Non-Hispanic black adults. º Asian children. Non- Hispanic black adults What results when systemic blood pressure is increased? º Hypovolemia º Decreased cardiac output º Vasoconstriction º Decreased vascular resistance Vasoconstriction º At the smooth muscle of the arterial system, neurotransmitters bind to receptors to initiate vasoconstriction and increase systemic vascular resistance. An increase in vascular resistance causes the heart to work harder and thus increases blood pressure. A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion andrelieved by rest. The likely cause of this pain is º stable angina. º myocardial infarction. º coronary vasospasm. º unstable angina. Stable angina º Stable angina is the most common form of chest pain and is characterized by pain that is caused under conditions of increased myocardial workload, such as physical exertion or emotional strain. Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock? º Cardiogenic º Hypovolemic º Anaphylactic º Septic Septic ºThe overproduction of nitric oxide is seen in septic shock as a result of the release of immune cytokines. Low cardiac output in association with high preload is characteristic of ________ shock. º hypovolemic º cardiogenic º anaphylactic º septic Cardiogenic shock º In cardiogenic shock, preload is high and cardiac output is low. After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence tothe recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is themost appropriate intervention for this patient at this time? º Continue lifestyle modifications only. º Continue lifestyle modifications plus diuretic therapy. º Continue lifestyle modifications plus ACE inhibitor therapy. º Continue lifestyle modifications plus β-blocker therapy. Continue lifestyle modifications only. º The patient should be encouraged to continue compliance with lifestyle changes since the patient has exhibited some positive response to his changes. 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? º Class I, Initial Stage º Class II, Compensated Stage º Class III, Progressive Stage º Class IV, Refractory Stage Class II Second-degree heart block type I (Wenckebach) is characterized by º absent P waves. º lengthening PR intervals and dropped P wave. º constant PR interval and dropped QRS complexes. º no correlation between P waves and QRS complexes. lengthening PR intervals and dropped P wave ºType I second-degree block is associated with progressively lengthening PR intervals until one P wave is not conducted and becomes a dropped beat. A loud pansystolic murmur that radiates to the axilla is most likely a result of º aortic regurgitation. º aortic stenosis. º mitral regurgitation. º mitral stenosis. Mitral regurgitation º The murmur of mitral regurgitation usually occurs throughout ventricular systole (pansystolic), radiates toward the left axilla, and has a high-pitched blowing character The majority of cardiac cells that die after myocardial infarction do so because of º cell rupture. º insufficient glucose. º thrombus. º apoptosis. Apoptosis A patient is diagnosed with heart failure with normal ejection fraction. This patient is most likely characterized by a(n) º elderly woman without a previous history of MI. º middle-aged man with a previous history of MI. º young female athlete with cardiomegaly. º young sedentary male with a high-stress job. An elderly woman without a previous history of MI. º Heart failure with normal ejection fraction is particularly likely to develop in the elderly, in women, and in those without a history of MI. Which dysrhythmia is thought to be associated with reentrant mechanisms? º Second-degree AV block º Sinus bradycardia º Junctional escape º Pre-excitation syndrome tachycardia (Wolf-Parkinson-White syndrome) Pre-excitation syndrome tachycardia (Wolf-Parkinson-White syndrome) º 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. What are the blood loss ranges for each stage? º Class I (initial stage hemorrhage): up to 750 mL, and the patient's vital signs remain normal. º Class II (compensated stage hemorrhage) 750-1500 mL º Class III hemorrhage (progressive stage) blood loss of 1500 and 2000 mL. Vital signs are changing. º Severe Class IV hemorrhage (refractory stage) more than 2000 mL is lost. The patient is lethargic, with severe hypotension.