MN551 Advanced Pathophysiology Across the Lifespan

 

Unit 3 quiz

Question 3.                

A nurse practitioner is teaching a student NP about the physiologic basis for damage to the circulatory and neurological systems that can accompany hypotension. Which of the following responses by the student would warrant correction by the nurse practitioner?

“As vessel wall thickness increases, tension decreases.”

“Smaller blood vessels require more pressure to overcome wall tension.”

“The smaller the vessel radius, the greater the pressure needed to keep it open.”

    “Tension and vessel thickness increase proportionately.”

 

Question 4.                

A patient has suffered damage to his pericardium following a motor vehicle accident. Which of the following consequences should the nurse practitioner be most likely to rule out?

                                       Impaired physical restraint of the left ventricule

                                       Increased friction during the contraction/relaxation cycle

                                        Reduced protection from infectious organisms

                                        Impaired regulation of myocardial contraction

 

 

Question 5.                

An 81-year-old female patient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition?

Increased cardiac demand causes engorgement of systemic blood vessels, of which the jugular vein is one of the largest.

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart.

    Peripheral dilation is associated with decreased stroke volume and ejection fraction.

    Heart valves are not capable of preventing backflow in cases of atrial congestion.

 

Question 8.                

During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refers the woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of aneurysms would underlie the explanation the nurse provides?

Aneurysms are commonly a result of poorly controlled diabetes mellitus.

Hypertension is a frequent modifiable contributor to aneurysms.

  Individuals with an aneurysm are normally asymptomatic until the aneurysm ruptures.

Aneurysms can normally be resolved with lifestyle and diet modifications.

 

 

Question 10.              

A 54-year-old man with a long-standing diagnosis of essential hypertension is meeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring?

The patient’s juxtaglomerular cells are releasing aldosterone as a result of sympathetic stimulation.

Epinephrine from his adrenal gland is initiating the renin-angiotensin-aldosterone system.

  Vasopressin is exerting an effect on his chemoreceptors and baroreceptors, resulting in vasoconstriction.

The conversion of angiotensin I to angiotensin II in his lungs causes increases in blood pressure and sodium reabsorption.

 

 

 

  Question 16.             

Which of the following situations related to the transition from fetal to perinatal circulation would be most likely to necessitate medical intervention?

Pressure in the pulmonary circulation and the right side of the infant’s heart fall markedly.

    Alveolar oxygen tension increases, causing reversal of pulmonary vasoconstriction of the fetal arteries.

Systemic vascular resistance and left ventricular pressure are both increasing.

Pulmonary vascular resistance, related to muscle regression in the pulmonary arteries, rises over the course of the infant’s first week.

 

Question 18.              

A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol. Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session?

“Remember, the ‘H’ in HDL and the ‘L’ in LDL correspond to high danger and low danger to your health.”

“Having high cholesterol increases your risk of developing diabetes and irregular heart rate.”

“Smoking and being overweight increases your risk of primary hypercholesterolemia.”

“Your family history of hypercholesterolemia is important, but there are things you can do to compensate for a high inherited risk.”

 

Question 26.              

A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia and she is suspected of having sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion?

                                       Signal-averaged ECG

                                        Exercise stress testing

                                       Electrophysiologic study

                                        Holter monitoring

 

 

 

  Question 30.             

An 81-year-old male resident of a long-term care facility has a long-standing diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure?

An increase in preload via the Frank-Starling mechanism

  Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine

    Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP)

    AV node pacemaking activity and vagal nerve suppression