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WorksheetsMedical Multiple Choice Questions (81-84)
Total questions: 90
Worksheet time: 45mins
Which of the following are risk factors for osteoporosis?
Low BMI (body mass index)
Repetitive stress to joint
Being overweight
Smoking
Being Caucasian
What hormone, released in a stressful situation, will cause alteration in glucose metabolism?
Epinephrine
Renin
Erythropoietin
Cortisol
What is a true statement about the difference between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)?
DKA occurs with diabetics, HHS occurs in anyone
DKA is characterized by hyperglycemia, HHS is characterized by hypoglycemia
DKA patients have ketones in the urine and blood; HHS patients do not
DKA is very dangerous; HHS is less serious
Exophthalmos is caused by what mechanism?
Decreased cardiac output results in activation of RAAS system and increased blood pressure
Increased inflammation of eyes affecting muscles and fatty tissue around eye
Increased pressure in anterior chamber of eye causes hardening of eyeball and blurring of vision
Inflammation of cornea causes intense pressure and pain in eye
For what condition would a nurse teach a patient about “stress dosing” of steroids?
Cushing’s disease
Acromegaly
Addison’s disease
Hypothyroidism
What is seen in early infections (“shift to the left”)?
Increased B cells
Lymphocytosis
Thrombocytopenia
Bandemia
What does Frank-Starling law predict about heart function?
More afterload, less perfusion
More preload, increased contraction
Less afterload, more ischemia
More contraction, less output
What is the function of the glomerulus?
Filter blood
Activate vitamin D
Actively reabsorb glucose
Regulate sodium excretion
Neurotransmitter changes in the brain associated with mood depression include:
Increased dopamine levels
Decreased serotonin levels
Elevated acetylcholine levels
Increased norepinephrine levels
Which neurotransmitter level is low in depression?
High dopamine
Low serotonin
Increase acetylcholine (ACh)
Low norepinephrine
Which is true about HIV transmission? (select all that apply)
It can be transmitted by sharing needles
It is transmitted via breast milk
Saliva is a common route for transmission
It has been transmitted via aerosol route
It cannot be transmitted during pregnancy until delivery
Which is associated with initial HIV infection?
Flulike symptoms and rash
Decreased CD4 T cells
Seroconversion within 3–6 days
CD4 T cell count <200 per mcg/L
Which statement is true regarding HIV testing?
The first test is the electrophoresis
The new rapid finger stick tests give results in 20 min
All patients with a positive test must have the ELISA performed
The Western blot is the initial test
Which are required for erythropoiesis? (select all that apply)
Vitamin K
Vitamin B12
Folate
Vitamin E
Which of the following are required for erythropoiesis?
Folate
Niacin
Ascorbic acid (Vitamin C)
Niacin
Vitamin B12
What causes a shift of the oxyhemoglobin curve to the right?
Chronic disease
Increased pH
Decreased H+ ions
Decreased temperature
What is the term for an excess of RBCs?
Anemia
Polycythemia
Pancytopenia
Granulocytosis
What is false regarding aplastic anemia?
It runs in families
It causes overproduction of hematopoietic tissue
It is characterized by pancytopenia
It is caused by viral infections
Which is a macrocytic anemia?
Thalassemia
Anemia of chronic renal failure
Iron deficiency anemia
Pernicious anemia
Which is appropriate for sickle cell anemia?
Early spleen removal
Acetaminophen (Tylenol) for fever
Dehydration to prevent crises
Maintain cool room temperature
Anemia of chronic disease is caused by lack of:
Estrogen
Erythropoietin
Parathyroid hormone
Adrenaline
Signs & symptoms of anemia include: (select all that apply)
Pallor
Bradycardia
Shortness of breath
Reduced activity tolerance
Dry mucous membranes
How do platelets contribute to hemostasis?
Cause vasoconstriction
Stimulate fibrinolysis
Clumping
Intrinsic pathway
What is true of petechiae in vascular and platelet disorders?
Red, raised, and macular
Flat and purple with vesicles
Flat, pinpoint, and non-blanching
What is the typical appearance of petechiae?
Raised, red, and blanching
Flat, red, and blanching
Flat, pinpoint, and non-blanching
Raised, red, and blanching
What is true about disseminated intravascular coagulation (DIC)?
It is both a bleeding and a clotting disorder
The acute form has more thrombotic episodes
Fibrinogen level is increased
Fibrin split products are decreased
Allergic purpura lesions include all of the following except:
Fever, itching, arthralgias
Very palpable lesions
Bleeding from lesions
Lesions located mainly on the trunk and face
Which statement is true about the lymphatic system?
The arrangement is similar to the circulatory system
It reabsorbs fluid that leaks into the interstitium and returns it to the circulation
Lymphatic vessels are thick-walled with no valves
Lymphatic tissue is found deep within muscles
Expected findings with arterial thrombosis of the legs?
Intermittent claudication, cool & cyanotic skin, toe ulcer
Pain with activity, hot and dry skin, very pink
Claudication and pink skin, bounding pulse
Pain with activity, leg cool to warm, (+) Homan’s sign
Which cannot produce signs/symptoms of stroke?
Varicose veins
Atherosclerosis
Cerebral aneurysm
Cerebral AV malformation
Upper acceptable level of cholesterol in blood?
Total 40, HDL 200, LDL 160
Total 40, HDL 160, LDL 200
Total 200, HDL 140, LDL 60
Total 200, HDL 40, LDL 100
Modifiable risk factor for atherosclerosis?
Smoking
Age
Gender
Genetics
Major determinant of diastolic blood pressure?
Heart rate
Systemic vascular resistance
Stroke volume
Preload
Which does NOT stimulate renin release?
Renal hypoperfusion
Parasympathetic activation
Fight-or-flight response
Another name for vasopressin?
ANP
Angiotensin
Antidiuretic hormone
Aldosterone
Which causes increased blood pressure?
Dehydration
Intracerebral hemorrhage
Blood loss
Prolonged bed rest
Which is NOT an endocrine disorder that causes elevated BP?
Coarctation of the aorta
Cushing syndrome
Acromegaly
Pheochromocytoma
Renin-angiotensin system alters BP in response to:
Decreased kidney perfusion
Decreased brain flow
Decreased arm perfusion
Decreased liver perfusion
Arrangement where myocardial cells function together is called:
Intercalated discs
Desmosomes
Gap junctions
Syncytium
Which of the following is the correct answer?
Autoregulation
Ischemia
Myocyte
Syncytium
Which electrolytes are necessary for muscle contraction?
Sodium
Calcium
Magnesium
Potassium
Selenium
Blood flow in the human body:
L side → lungs → R side → body
RV → RA → lungs → LA → LV → body
RA → RV → lungs → LA → LV → body → veins → RA
None of the above
During which part of cardiac cycle do coronary arteries get oxygen?
Systole
Ventricular contraction
Atrial repolarization
Diastole
Which describes myocardial infarction, not angina?
Pain worse with cough
Pain with exercise or stress
Radiating pain, ST changes, ↑ troponin
What factor causes a congenital heart disease to produce cyanosis?
Left-to-right shunting of blood
Right-to-left shunting of blood
Ventricular septal obstruction
Atherosclerotic plaques
A patient with heart failure complains of awakening intermittently during the night with shortness of breath. Which term describes this?
Dyspnea
Orthopnea
Paroxysmal dyspnea
Cyanosis
A patient is admitted to the hospital with L heart failure. Which symptom is NOT expected?
Pedal edema
Cough
Dyspnea
Crackles in lungs
A patient is in hypovolemic shock. What compensatory mechanism will help preserve adequate circulation?
Renin-angiotensin-aldosterone cascade
Increased parasympathetic nervous system activity
Which of the following is a compensatory mechanism for shock?
Renin-angiotensin-aldosterone cascade
Vasodilation
Decreased secretion of ADH
Which kind of shock is NOT characterized by vasodilation and peripheral pooling of blood?
Cardiogenic
Septic
Anaphylactic
Neurogenic
What is the underlying problem in ALL shock states?
Tachycardia
Cardiac failure
Faulty compensatory mechanisms
Inadequate cellular oxygenation
When cells get hypoxic, they switch to anaerobic metabolism. What is produced?
Excess energy
Lactic acid
Carbon monoxide
Bilirubin
Which of the following is NOT a type of dead space?
Anatomic
Cartilaginous
Alveolar
Physiologic
Compliance is a measure of:
How easily the lung can be inflated
How easily gas exchange occurs at the alveoli
How much dead space the lung has
Shunting
Which of the following increases lung compliance?
Pneumonia
Emphysema
ARDS
Pulmonary edema
What occurs with hypoventilation?
The amount of air entering the alveoli increases
The PaCO₂ exceeds 45 mmHg
It is a normal response to high altitude
Hypocapnia occurs
Which is NOT a major obstructive airway disease?
Bronchitis
Asthma
Pneumonia
Emphysema
Which is NOT a pathogenic change associated with bronchitis?
Inflamed airways
Swelling from exudation of fluid
Which of the following is a feature of chronic bronchitis?
Increased ciliary function
Increased mucous production
Decreased mucous production
Loss of ciliary function
Most common cause of chronic bronchitis?
Viral infection
Bacterial infection
Air pollution
Smoking
A 24-year-old male with emphysema who never smoked. Which hereditary disease may be responsible?
Intrinsic asthma
Alpha-1 antitrypsin deficiency
Duchenne muscular dystrophy
Pulmonary fibrosis
Which value is consistent with acute respiratory failure?
PaO2 100 mmHg
PaCO2 40 mmHg
pH < 7.3
Hypocapnia
Which abnormality is characteristic of emphysema?
Extensive inflammation of lower airways
Trapping of air in distal air sacs
Widespread bronchial plugs
Collapse of proximal airways
Which triad suggests epiglottitis?
Sore throat, difficulty swallowing, drooling
Hoarseness, sore throat, productive cough
Persistent productive cough, vomiting, fever
Fever, sore throat, increased thirst
Tachycardia, absent breath sounds on affected side, hyperresonance, and sudden chest pain suggest:
Myocardial infarction
Pneumothorax
Sarcoidosis
ARDS
Tubercular bacilli are transmitted by:
Blood and body fluids
Contaminated food
Contaminated blood
Airborne droplet nuclei
When would ADH release be stimulated?
Hypervolemia and hypertension
Hypo-osmolality and lethargy
Fever and restlessness
Hypovolemia or hyper-osmolality
Clinical signs of hypocalcemia vs hypercalcemia?
Hypercalcemia → decreased neuromuscular irritability, lethargy, short ST
Hypocalcemia → headache, renal calculi, fatigue
Hypocalcemia → ↑ neuromuscular irritability, (+) Trousseau, (+) Chvostek, twitching
What happens if too much carbonic acid accumulates in blood?
Respirations ↑, depth ↓
Respirations ↓, depth ↑
Respirations ↓, depth ↓
Respirations ↑, depth ↑
Which is true about the kidneys?
Responsible for fluid and electrolyte homeostasis
Filter more than 70 mL/hr
Activate vitamin C
Contain 100,000 nephrons
What happens to calcium in chronic renal failure?
Increased absorption
High serum calcium
Low serum levels
Normal parathyroid activity
Which is normal for urine?
pH is acidic
Protein
Specific gravity 1.03–1.3
Basic pH
Predisposing factors for pyelonephritis include:
Pregnancy, neurogenic bladder, catheterization, urinary obstruction
Viral infection, sexual trauma, sepsis
Diabetes, polycystic kidney disease, cystoscopy
Irradiation, diabetes, trauma
Effect of urinary obstruction on filtration, urinary stasis, infection?
↓ hydrostatic pressure, ↓ filtration, anuria
↓ filtration, urinary stasis, infection risk
↑ filtration, diuresis, infection
No effect, ↑ stasis, infection
Glomerulonephritis results from:
Trauma
Infection caused by staphylococci
Obstructive pathology
Antigen-antibody complexes
Clinical findings suggesting nephritic syndrome?
Hypoproteinemia, hypoalbuminemia, edema, hyperlipidemia, hypercoagulability
Proteinuria, hypolipidemia, hypotension, WBCs present
Hyperproteinemia, proteinuria, hematuria, ↓ coagulability
Hyperalbuminemia, lipiduria, RBCs & casts
Which is NOT a risk factor for acute renal failure?
Atherosclerosis
Hypertension
Diabetes mellitus
Which of the following is associated with youth?
Old age
Middle age
Childhood
Youth
Which is a classic finding in renal failure?
Crystals in urine
Increased phosphorus
Increased calcium
Protein in urine
JVD, bounding pulses, rales, and peripheral edema in chronic renal failure caused by:
Azotemia
Hypocalcemia
Inability to excrete fluid
Hypertension
Which nutrient is NOT restricted in renal failure?
Protein
Carbohydrates
Sodium
Fluid
Incontinence with constant or intermittent dribbling is called:
Urge incontinence
Overflow incontinence
Mixed incontinence
Stress incontinence
What predisposes an elderly person to cystitis?
Obesity, diabetes, sexual relations
Lack of exercise, arthritis, ↓ estrogen
BPH, diabetes, bowel incontinence
Incontinence, neurologic illness, thirst
Normal cells commit suicide. What is this called?
Apoptosis
Anaplasia
Proto-oncogene
Suppressor genes
Ondansetron is an antiemetic. What imbalance may it prevent?
Hypoxia
Hypokalemia
Mixed acidosis
Metabolic alkalosis
What is expected when a client experiences chronic stress?
Increased energy
Reduced urine output
Reduced productivity
Heightened awareness
Which of the following could produce conductive hearing loss?
Bug in ear
Removal of dry cerumen
Disease of cochlear system
Listening to iPod at “10”
(a)
Which may result in sensorineural hearing loss?
Congenital absence of outer ear
Cochlear damage
Impacted cerumen
Bean in external canal
Patient with diabetic ketonuria develops hypokalemia during treatment. Why?
Decrease in serum pH
Activation of active transport mechanism in kidneys
K+ follows glucose into cells
Increase in cardiac output
