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PATHO 2410 Perfusion/Oxygenation Test Bank Questions And Answers( Complete Solution Rated A)

PATHO 2410 Perfusion/Oxygenation (CP #3) Test Bank Chapter 12 1. Which of the following actions causes the atrioventricular (AV) valves to close? a.... [Show More] Increased intraventricular pressure b. Depola rization at the AV node c. Ventricular relaxation and backflow of blood d. Contraction of the atria 2. When stroke volume decreases, which of the following could maintain cardiac output? a. Decreased peripheral resistance b. Increased heart rate c. Decreased venous return d. General vasodilation 3. Which of the following describes the pericardial cavity? a. It contains sufficient fluid to provide a protective cushion for the heart. b. It is a potential space containing a very small amount of serous fluid. c. It is lined by the endocardium. d. It is located between the double-walled pericardium and the epicardium. 4. Which of the following factors greatly improves venous return to the heart during strenuous exercise? a. Rapid emptying of the right side of the heart b. Forceful action of the valves in the veins c. Contraction and relaxation of skeletal muscle d. Peristalsis in the large veins 5. The function of the baroreceptors is to: a. Stimulate the parasympathetic or sympathetic nervous system at the sinoatrial (SA) node as needed. b. Adjust blood pressure by changing peripheral resistance. c. Sense a change in blood oxygen and carbon dioxide levels. d. Signal the cardiovascular control center of changes in systemic blood pressure. 6. The normal delay in conduction through the AV node is essential for: a. Preventing an excessively rapid heart rate b. Limiting the time for a myocardial contraction c. Allowing the ventricles to contract before the atria d. Completing ventricular filling 7. Which of the following is a result of increased secretion of epinephrine? a. Increased heart rate and force of contraction b. Decreased stimulation of the SA node and ventricles c. Vasoconstriction in skeletal muscles and kidneys d. Vasodilation of cutaneous blood vessels 8. Which of the following causes increased heart rate? a. Stimulation of the vagus nerve b. Increased renin secretion c. Administration of beta-blocking drugs d. Stimulation of the sympathetic nervous system 9. The event that causes the QRS wave on an electrocardiogram (ECG) tracing is: a. Atrial depolarization b. Atrial repolarization c. Ventricular depolarization d. Ventricular repolarization 10. The cardiac reserve is: a. Afterload b. The difference between the apical and redial pulses c. The ability of the heart to increase cardiac output when needed d. The extra blood remaining in the heart after in contracts 11. The term preload refers to: a. Volume of venous return b. Peripheral resistance c. Stroke volume d. Cardiac output 12. The first arteries to branch off the aorta are the: a. Common carotid arteries b. Pulmonary arteries c. Coronary arteries d. Subclavian arteries 13. Cardiac output refers to: a. The amount of blood passing through either of the atria b. The volume of blood ejected by a ventricle in one minute c. The volume of blood ejected by each ventricle in a single contraction d. The total number of heartbeats in one minute 14. Vasodilation in the skin and viscera results directly from: a. Decreased blood pressure b. Increased parasympathetic stimulation c. Relaxation of smooth muscle in the arterioles d. Increased stimulation of alpha-adrenergic receptors 15. Which of the following drugs decrease sodium and fluid retention in the body? a. Warfarin (Coumadin) b. Digoxin (Lanoxin) c. Nitroglycerin (Isordil) d. Hydrochlorothiazide (HydroDIURIL) 16. Which of the following are predisposing factors to thrombus formation in the circulation? (Select all that apply) a. Decreased viscosity of the blood b. Damaged blood vessel walls c. Immobility d. Prosthetic valves 17. A drug taken in small doses on a continuing basis to reduce platelet adhesion is: a. Acetylsalicylic acid (ASA) b. Streptokinase c. Acetaminophen d. Heparin 18. A partial obstruction in a coronary artery will likely cause: a. Pulmonary embolus b. Hypertension c. Angina attacks d. Myocardial infarction 19. Cigarette smoking is a risk factor in coronary artery disease because smoking: a. Reduced vasoconstriction and peripheral resistance b. Decreases serum lipid levels c. Promotes platelet adhesion d. Increases serum HDL levels 20. The term arteriosclerosis specifically refers to: a. Development of atheromas in large arteries b. Intermittent vasospasm in coronary arteries c. Degeneration with loss of elasticity and obstruction in small arteries d. Ischemia and necrosis in the brain, kidneys, and heart 21. A modifiable factor that increases the risk for atherosclerosis is: a. Leading a sedentary lifestyle b. Being female and older than 40 years of age c. Excluding saturated fats from the diet d. Familial hypercholesterolemia 22. An atheroma develops from: a. A torn arterial wall and blood clots b. Accumulated lipids, cells, and fibrin where endothelial injury has occurred c. Thrombus forming on damaged walls of veins d. Repeated vasospasms 23. Low-density lipoproteins (LDL): a. Promote atheroma development b. Contain only small amounts of cholesterol c. Transport cholesterol from cells to the liver for excretion d. Are associated with low intake of saturated fats 24. Factors that may precipitate an angina attack include all of the following EXCEPT: a. Eating a large meal b. Engaging in an angry argument c. Taking a nap d. Shoveling snow on a cold, windy day 25. When comparing angina with myocardial infarction (MI), which statement is true? a. Both angina and MI cause tissue necrosis b. Angina often occurs at rest; MI occurs during a stressful time c. Pain is more severe and lasts longer with angina than with MI d. Angina pain is relieved by rest and intake of nitroglycerin; the pain of MI is not 26. The basic pathophysiology of myocardial infarction is best described as: a. Cardiac output that is insufficient to meet the needs of the heart and body. b. Temporary vasospasm that occurs in a coronary artery. c. Total obstruction of a coronary artery, which causes myocardial necrosis. d. Irregular heart rate and force, reducing blood supply to coronary arteries. 27. Typical early signs or symptoms of myocardial infarction include: a. Brief, substernal pain radiating to the right arm, with labored breathing. b. Persistent chest pain radiating to the left arm, pallor, and rapid, weak pulse. c. Bradycardia, increased blood pressure, and severe dyspnea. d. Flushed face, rapid respirations, left-side weakness, and numbness. 28. The most common cause of a myocardial infarction is: a. An imbalance in calcium ions b. An infection of the heart muscle c. Atherosclerosis involving an attached thrombus d. A disruption of the heart conduction system 29. Calcium-channel blocking drugs are effective in: a. Reducing the risk of blood clotting b. Decreasing the attraction of cholesterol into lipid plaques c. Reducing cardiac and smooth muscle contractions d. Decreasing all types of cardiac arrhythmias 30. Which of the following confirms the presence of a myocardial infarction? a. A full description of the pain, including the sequence of development b. The presence of elevated serum cholesterol and triglycerides c. Serum isoenzymes released from necrotic cells and an ECG d. Leukocytosis and elevated C-reactive protein (CRP) 31. The size of the necrotic area resulting from myocardial infarction may be minimized by all of the following EXCEPT: a. Previously established collateral circulation b. Immediate administration of thrombolytic drugs c. Maintaining maximum oxygen supply to the myocardium d. Removing the predisposing factors to atheroma development 32. The most common cause of death immediately following a myocardial infarction is: a. Cardiac arrhythmias and fibrillation b. Ruptured ventricle or aorta c. Congestive heart failure d. Cerebrovascular accident 33. Why does ventricular fibrillation result in cardiac arrest? a. Delayed conduction through the AV node blocks ventricular stimulation. b. Insufficient blood is supplied to the myocardium. c. The ventricles contract before the atria. d. Parasympathetic stimulation depresses the SA node. 34. The term cardiac arrest refers to which of the following? a. Condition where cardiac output is less than the demand b. A decreased circulating blood volume c. Missing a ventricular contraction d. The cessation of all cardiac function 35. Which change results from total heart block? a. A prolonged PR interval b. Periodic omission of a ventricular contraction c. A wide QRS wave d. Spontaneous slow ventricular contractions, not coordinated with atrial contraction 36. The term premature ventricular contraction refers to the condition where: a. Atrial muscle cells are stimulating additional cardiac contractions b. The ventricles contract spontaneously following a period without a stimulus c. Additional contractions arise from ectopic foci in the ventricular muscle d. Increased heart rate causes palpitations 37. Which of the following is most likely to cause left-sided congestive heart failure? a. Incompetent tricuspid heart valve b. Chronic pulmonary disease c. Infarction in the right atrium d. Uncontrolled essential hypertension 38. The definition of congestive heart failure is: a. Cessation of all cardiac activity b. Inability of the heart to pump enough blood to meet the metabolic needs of the body c. Insufficient circulating blood in the body d. The demand for oxygen by the heart is greater than the supply 39. Significant signs of right-sided congestive heart failure include: a. Severe chest pain and tachycardia b. Edematous feet and legs with hepatomegaly c. Frequent cough with blood-streaked frothy sputum d. Orthopnea, fatigue, increased blood pressure 40. Paroxysmal nocturnal dyspnea is marked by: a. Hemoptysis and rales b. Distended neck veins and flushed face c. Bradycardia and weak pulse d. Cardiomegaly 41. Compensation mechanisms for decreased cardiac output in cases of congestive heart failure include: a. Slow cardiac contractions b. Increased renin and aldosterone secretions c. Decreased erythropoietin secretion d. Fatigue and cold intolerance 42. In which blood vessels will failure of the left ventricle cause increased hydrostatic pressure? a. Veins of the legs and feet b. Jugular veins c. Pulmonary capillaries d. Blood vessels of the liver and spleen 43. Which of the following drugs improves cardiac efficiency by slowing the heart rate and increasing the force of cardiac contractions? a. Furosemide b. Digoxin c. Epinephrine d. Nifedipine 44. In an infant, the initial indication of congestive heart failure is often: a. Distended neck veins b. Feeding problems c. Low-grade fever and lethargy d. Frequent vomiting 45. Effects that may be expected from a beta-adrenergic blocking drug include: a. Increasing systemic vasoconstriction b. Decreased sympathetic stimulation of the heart c. Blockage of an angiotensin receptor site d. Increased release of renin 46. A sign of aortic stenosis is: a. Increased cardiac output b. Congestion in the liver, spleen, and legs c. Flushed face and headache d. A heart murmur 47. An incompetent mitral valve would cause: a. Increased blood to remain in the right atrium b. Hypertrophy of the right ventricle c. Decreased output from the left ventricle d. Decreased pressure in the left atrium 48. Which of the following describes the blood flow occurring with a ventricular septal defect? a. From the left ventricle to the right ventricle b. From the right ventricle to the left ventricle c. Increased cardiac output from the left ventricle d. Mixed oxygenated and unoxygenated blood in the systemic circulation 49. Unoxygenated blood enters the systemic circulation in children with tetralogy of Fallot because: a. The aorta and pulmonary artery have exchanged positions. b. Pulmonary stenosis changes the ventricular pressures. c. The left ventricular wall has hypertrophied. d. The septal defect allows exchange of blood between the atria. 50. Cyanosis occurs in children with tetralogy of Fallot because: a. More carbon dioxide is present in the circulating blood. b. A large amount of hemoglobin in the general circulation is unoxygenated. c. The pulmonary circulation is overloaded and congested. d. The circulation is sluggish (slow) throughout the system. 51. The initial effect on the heart in cases of rheumatic fever is: a. Infection in the heart by hemolytic streptococci b. Highly virulent microbes causing vegetations on the heart valves c. Septic emboli obstructing coronary arteries d. Acute inflammation in all layers of the heart due to abnormal immune response 52. Common signs of rheumatic fever include all of the following EXCEPT: a. Arthritis, causing deformity of the small joints in the hands and feet. b. Erythematous skin rash and subcutaneous nodules. c. Epistaxis, tachycardia, and fever. d. Elevated ASO titer and leukocytosis. 53. Rheumatic heart disease usually manifests in later years as: a. Swollen heart valves and fever b. Cardiac arrhythmias and heart murmurs c. Thrombus formation and septic emboli d. Petechial hemorrhages of the skin ad mucosa 54. Septic emboli, a common complication of infective endocarditis, are a result of the fact that: a. Vegetations are loosely attached and fragile b. The valves are no longer competent c. Cardiac output is reduced d. Heart contractions are irregular 55. Which of the following applies to subacute infective endocarditis? a. A microbe of low virulence attacks abnormal or damaged heart valves. b. Virulent microbes invade normal heart valves. c. No permanent damage occurs to the valves. d. Prophylactic medication does not prevent infection. 56. Pericarditis causes a reduction in cardiac output as a result of which of the following? a. Delays in the conduction system, interfering with cardiac rhythm b. Weak myocardial contractions due to friction rub c. Excess fluid in the pericardial cavity, which decreases ventricular filling d. Incompetent valves, which allow regurgitation of blood 57. Pericarditis may be caused by: (Select all that apply) a. Infection b. Abnormal immune responses c. Injury d. Malignant neoplasm 58. A source of an embolus causing an obstruction in the brain could be the: a. Femoral vein b. Pulmonary vein c. Carotid artery d. Coronary artery 59. The basic pathophysiological change associated with essential hypertension is: a. Development of lipid plaques in large arteries b. Recurrent inflammation and fibrosis in peripheral arteries c. Degeneration and loss of elasticity in arteries d. Increased systemic vasoconstriction 60. Uncontrolled hypertension is most likely to cause ischemia and loss of function in the: a. Kidneys, brain, and retinas of the eye b. Peripheral arteries in the legs c. Aorta and coronary arteries d. Liver, spleen, and stomach 61. When is a diagnosis of essential hypertension likely to be considered in young or middle-aged individuals? a. Blood pressure remains consistently above 140/90 b. Blood pressure fluctuates between 130/85 and 180/105 c. Blood pressure increases rapidly and is unresponsive to medication d. Chronic kidney disease leads to consistently elevated blood pressure 62. Atherosclerosis in the iliac or femoral arteries is likely to cause which of the following? (Select all that apply) a. Gangrenous ulcers in the legs b. Strong rapid pulses in the legs c. Intermittent claudication d. Red, swollen legs 63. The term intermittent claudication refers to: a. Sensory deficit in the legs due to damage to nerves b. Chest pain related to ischemia c. Ischemic muscle pain in the legs, particularly with exercise d. Dry, cyanotic skin with superficial ulcers 64. What is the primary reason for amputation of gangrenous toes or feet in patients with peripheral vascular disease? a. It promotes more rapid healing of ulcerated areas. b. It improves circulation to other areas. c. It prevents spread of infection and reduces pain. d. It reduces swelling in the peripheral areas. 65. An echocardiogram is used to demonstrate any abnormal: a. Activity in the conduction system b. Movement of the heart valves c. Change in central venous pressure d. Blood flow in coronary arteries 66. A friction rub is associated with: a. Infectious endocarditis b. Arrhythmias c. Pericarditis d. An incompetent aortic valve 67. A dissecting aortic aneurysm develops as: a. A dilation or bulge that develops at one point on the aortic wall. b. A thrombus that accumulates at a point in the aortic wall. c. A section of the aorta that weakens and dilates in all directions. d. A tear in the intimal lining, which allows blood flow between layers of the aortic wall. 68. The outcome for many aortic aneurysms is: a. Early diagnosis and repair b. Thrombus formation and pulmonary embolus c. Rupture and hemorrhage d. Pressure and adjacent organs or structures 69. Which factor predisposes to varicose veins during pregnancy? a. Compressed pelvic veins b. Stenotic valves in leg veins c. Thrombus formation d. Insufficient muscle support for veins 70. Phlebothrombosis is more likely to cause pulmonary emboli than is thrombophlebitis because: a. Platelets attach to the inflamed wall b. Thrombus forms in a vein and is less firmly attached c. Leg cramps require massage d. Systemic signs of inflammation require treatment 71. Shock is defined as: a. Failure of the heart to supple sufficient blood to body cells b. General hypoxia, causing damage to various organs c. Decreased circulating blood and tissue perfusion d. Loss of blood, causing severe hypoxia 72. Shock follows a myocardial infarction when: a. The stress response causes general vasodilation b. Fluid is lost into ischemic tissues c. Heart valves are damaged d. A large portion of the myocardium is damaged 73. What are the early signs of circulatory shock? (Select all that apply) a. Pale moist skin b. Loss of consciousness c. Anxiety and restlessness d. Rapid strong pulse 74. A compensation for shock would include: a. Increased heart rate and oliguria b. Lethargy and decreased responsiveness c. Warm, dry, flushed skin d. Weak, thread pulse 75. Why does anaphylactic shock cause severe hypoxia very quickly? a. Generalized vasoconstriction reduces venous return. b. Bronchoconstriction and bronchial edema reduce airflow. c. Heart rate and contractility are reduced. d. Metabolic rate is greatly increased. 76. Neurogenic (vasogenic) shock results from systemic vasodilation due to: a. Increased peripheral resistance and less blood in the microcirculation. b. Increased permeability of all the blood vessels, leading to hypovolemia. c. Slower, less forceful cardiac contractions. d. Increased capacity of the vascular system and reduced venous return. 77. A prolonged period of shock is likely to cause: a. Damage to, and increased permeability of, pulmonary capillaries. b. Increased permeability of the glomerular capillaries of the kidneys. c. Increased pH of blood and body fluids. d. Increased systemic vasoconstriction. 78. What would indicate decompensated acidosis related to shock? a. Serum bicarbonate level below normal b. PCO2 above normal c. Serum pH below normal range d. Urine pH of 4.5 79. With shock, anaerobic cell metabolism and decreased renal blood flow cause: a. Metabolic alkalosis b. Metabolic acidosis c. Decreased serum potassium d. Increased serum bicarbonate 80. Shock develops in patients with severe burns as a result of: a. Extensive hemorrhage b. Pain and loss of plasma c. Direct damage to the heart d. Extensive hemolysis of erythrocytes 81. The classic early manifestation(s) of left-sided congestive heart failure is/are , whereas the early indicator(s) of right-sided failure is/are . a. Palpitations and periodic chest pain; Shortness of breath on exertion b. Swelling of the ankles and abdomen; Chest pain c. Shortness of breath on exertion or lying down; Swelling of the ankles d. Coughing up frothy sputum; Hepatomegaly and splenomegaly 82. A common adverse effect of many antihypertensive medications is: a. Orthostatic hypotension b. Bradycardia c. Altered blood coagulation d. Peripheral edema 83. The cause of essential hypertension is considered to be: a. Chronic renal disease b. Excessive intake of saturated fats and salt c. Sedentary lifestyle d. Idiopathic 84. A cardiac pacemaker would most likely be inserted in cases of: a. Angina pectoris b. Heart block c. Congestive heart failure d. Ventricular fibrillation 85. Which of the following is considered to be the most dangerous arrhythmia? a. Tachycardia b. Bradycardia c. Ventricular fibrillation d. Second-degree heart block 86. Which of the following is NOT true of the drug nitroglycerin? a. It decreases myocardial workload by causing systemic vasodilation. b. It may be administered sublingually, transdermally, or by oral spray. c. Dizziness or syncope may follow a sublingual dose. d. It strengthens the myocardial contraction. 87. Confirmation of the diagnosis of a myocardial infarction would include: (Select all that apply) a. Specific changes in the ECG b. Marked leukocytosis and increased erythrocyte sedimentation rate (ESR) c. Elevation of cardiac isoenzymes in serum d. A pattern of pain 88. Which of the following statements regarding aneurysms is true? a. Aneurysms are always caused by congenital malformations. b. The greatest danger with aneurysms is thrombus formation. c. Manifestations of aneurysms result from compression of adjacent structures. d. Aneurysms involve a defect in the tunica media of veins. 89. The most common factor predisposing to the development of varicose veins is: a. Trauma b. Congenital valve defect in the abdominal veins c. Infection d. Increased venous pressure 90. In the period immediately following a myocardial infarction, the manifestations of pallor and diaphoresis, rapid pulse, and anxiety result from: a. Onset of circulatory shock b. The inflammatory response c. Release of enzymes from necrotic tissue d. Heart failure 91. Septic shock differs from hypovolemic shock in that it is frequently manifested by: a. Fever and flushed face b. Elevated blood pressure c. Increased urinary output d. Slow bounding pulse 92. Heart block, in which a conduction delay at the AV node results in intermittent missed ventricular contractions, is called: a. First-degree block b. Second-degree block c. Bundle-branch block d. Total heart block 93. More extensive permanent damage is likely when a myocardial infarction is caused by: a. A hemorrhage b. An embolus c. A thrombus d. An arrhythmia 94. A very rapid heart rate reduces cardiac output because: a. Venous return is increased b. Ventricular fibrillation develops immediately c. Conduction through the AV node is impaired d. Ventricular filling is reduced 95. The right side of the heart would fail first in the case of: (Select all that apply) a. Severe mitral valve stenosis b. Uncontrolled essential hypertension c. Large infarction in the right ventricle d. Advanced chronic obstructive pulmonary disease (COPD) 96. Which of the following compensations that develop in patients with congestive heart failure eventually increase the workload of the heart? a. Faster heart rate and cardiomegaly b. Peripheral vasoconstriction c. Increased secretion of renin d. A and C e. A, B, and C 97. Which statement applies to paroxysmal nocturnal dyspnea? a. It indicates decreased CO2 diffusion in the lungs. b. It indicates swelling in the bronchioles and bronchi. c. It is caused by increased blood in the lungs when lying in a supine position. d. It results from pleural effusion. 98. In patients with congestive heart failure, ACE inhibitor drugs are useful because they: a. Reduce renin and aldosterone secretion b. Slow the heart rate c. Strengthen myocardial contraction d. Block arrhythmias 99. In a child with ventricular septal defect, altered blood flow: a. Leads to increased stroke volume from the left ventricle b. Results in unoxygenated blood in the systemic circulation c. Is called a right-to-left shunt d. Is called a left-to-right shunt 100. In a child with acute rheumatic fever, arrhythmias may develop due to the presence of: a. Endocarditis b. Myocarditis c. Pericarditis d. Congestive heart failure 101. Prophylactic antibacterial drugs such as amoxicillin are given to patients with certain congenital heart defects or damaged heart valves immediately before invasive procedures to prevent: a. Formation of septic thrombi b. Infectious endocarditis c. Abscess formation d. Myocarditis 102. Varicose ulcers may develop and be slow to heal because: a. Leg muscles are painful, restricting movement. b. Edema reduces arterial blood supply to the area. c. Emboli form in damaged veins, leading to local ischemia. d. Valves in veins restrict blood flow. 103. Excessive fluid in the pericardial space causes: a. Increased cardiac output b. Myocardial infarction c. Reduced venous return d. Friction rub 104. Aortic stenosis means the aortic valve: a. Allows blood to leak back into the left ventricle during diastole. b. Cannot fully open during systole. c. Functions to increase stroke volume. d. Does not respond to the cardiac cycle. 105. Septic shock is frequently caused by infections involving: a. Gram-negative endotoxin-producing bacteria. b. Spore-forming saprophytic fungi. c. Free-swimming, motile parasitic protozoa. d. Parasitic nematodes. Chapter 14 1. Through what area does the cerebrospinal fluid circulate around the brain and spinal cord? a. Between the double layers of the dura mater b. In the subdural space c. In the subarachnoid space d. Through the arachnoid villi 2. Which of the following is the usual location of language centers? a. Left hemisphere b. Right hemisphere c. Brainstem d. Hypothalamus 3. What would be the effect of damage to the auditory association area in the left hemisphere? a. Loss of hearing in both ears b. Inability to understand what is hears c. Loss of hearing in the left ear d. Inability to determine the source of sound 4. Which of the following applies to the corticospinal tract? a. It is an ascending tract b. The nerve fibers conduct sensory impulses c. It is an extrapyramidal tract d. It is a pyramidal tract for efferent impulses 5. What is a major function of the limbic system? a. Overall control of fluid balance b. Required for logical thinking, reason, and decision making c. Determines emotional responses d. Responsible for artistic and musical talents 6. Where are 1-adrenergic receptors located? a. Bronchiolar walls b. Arteriolar walls c. Cardiac muscle d. Glands of the intestinal tract 7. What does a vegetative state refer to? a. Depression of the reticular activating system (RAS) and inability to initiate action b. Loss of awareness and intellectual function but continued brainstem function c. Continuing intellectual function but inability to communicate or move d. Disorientation and confusion with decreased responsiveness 8. Which of the following conditions is NOT part of the criteria for a declaration of “brain death”? a. No activity on EEG b. Absence of all reflexes c. No spontaneous respirations d. Presence of any head injury 9. What is the best definition of aphasia? a. The inability to comprehend or express language appropriately b. Difficulty swallowing c. Loss of the visual field contralateral to the area of damage d. The inability to articulate words clearly 10. What is an early indicator of increased intracranial pressure? a. Papilledema b. Bilateral fixed dilated pupils c. Decreased responsiveness d. Rapid heart rate 11. What is the rationale for vomiting in a patient who has increased intracranial pressure? a. Chemoreceptors responding to changes in the blood b. Pressure extending to spinal nerves c. Pressure on the emetic center in the medulla d. Stimuli to the hypothalamic center for hunger and thirst 12. What is the typical change in blood pressure in a patient who has increased intracranial pressure? a. Erratic diastolic pressure b. Decreasing systolic pressure c. Systolic and diastolic pressures decreasing proportionately d. Increasing pulse pressure 13. The largest category of primary malignant brain tumors that arise from cells in the central nervous system (CNS) are called: a. Gliomas b. Sarcomas c. Lymphomas d. Myelomas 14. Which of the following causes papilledema? a. Increased pressure of cerebrospinal fluid (CSF) at the optic disc b. Increased intraocular pressure c. Pressure on the oculomotor nerve d. Pressure on the optic chiasm 15. What is the effect of an enlarging brain abscess on cardiovascular activity? a. Increased heart rate and systemic vasodilation b. Low blood pressure and irregular heart and respiratory rates c. Systemic vasoconstriction and slower heart rate d. Immediate depression of the cardiac control centers 16. As intracranial pressure rises, the pupil of the eye, ipsilateral to the lesion, becomes dilated and unresponsive to light because of pressure on the: a. Optic nerve b. Peripheral nervous system (PSNS) fibers in cranial nerve III c. Sympathetic nervous system (SNS) nerve to the eye d. Occipital lobe 17. Which of the following characteristics indicates that the CSF is normal? a. Cloudy and pale yellow color b. Presence of erythrocytes c. Presence of numerous leukocytes d. Clear and colorless fluid 18. Which of the following statements is TRUE about malignant brain tumors? a. Most brain tumors arise from malignant neurons. b. Primary brain tumors rarely metastasize outside the CNS. c. The blood-brain barrier prevents secondary brain tumors. d. Brainstem tumors do not manifest signs until they are quite large. 19. Secondary brain tumors usually arise from: a. Severe head trauma b. Metastasized breast or lung tumors c. Exposure to carcinogenic agents d. Exposure to radiation 20. Why are focal or generalized seizures sometimes an early indication of a brain tumor? a. Surrounding inflammation stimulates neurons to discharge spontaneously. b. Malignant tumors cause alkalosis, exciting the CNS. c. Systemic effects of the brain tumor may cause seizures. d. Metabolic effects of cancer change blood chemistry to trigger seizures. 21. Which of the following is a TRUE statement about transient ischemic attacks (TIAs)? a. They usually cause necrosis and permanent brain damage. b. They may be caused by rupture of an aneurysm or a damaged artery. c. They usually indicate systemic hypertension. d. They can warn of potential cerebrovascular accidents. 22. What is the probable source of an embolus causing a cerebrovascular accident (CVA)? a. Right ventricle of the heart b. Femoral vein c. Common carotid artery d. Pulmonary artery 23. Collateral circulation is most likely to be present when a CVA results from: a. Rupture of a cerebral artery b. An embolus c. Atherosclerosis d. Vasospasm in the cerebral circulation 24. All of the following apply to CVA EXCEPT: a. The common cause is an atheroma with thrombus. b. Maximum necrosis and infarction develop within several hours of onset. c. Warning signs may appear with partial obstruction of the artery. d. Increasing neurological deficits usually develop during the first few days. 25. Signs and symptoms of a stroke depend upon: a. Location of obstruction, size of artery, and area affected b. Duration of the blockage, distance from the heart, and type of obstruction c. Health of the victim, area affected, and collateral circulation d. Size of the obstruction, condition of the heart, and duration of blockage 26. In the weeks following CVA, why might some neurological function return? (Select all that apply) a. Presence of collateral circulation b. Immediate therapy to dissolve thrombi and maintain perfusion c. Reduced inflammation in the area d. Development of alternative neuronal pathways 27. Which of the following statements about berry aneurysms in the brain is NOT true? a. They usually develop at points of bifurcation in the circle of Willis. b. They are usually asymptomatic for many years. c. CSF remains free of blood. d. Following rupture, blood appears in the subarachnoid space. 28. In a case of bacterial meningitis, where does swelling and purulent exudate form? a. In the pia mater, arachnoid, and surface of the entire brain b. In the dura mater and epidural space c. At the site of the injury or entry point of the microbes d. Primarily around the spinal cord 29. What are significant signs of acute bacterial meningitis? a. Severe headache, nuchal rigidity, and photophobia b. Fatigue and lethargy, fever, and anorexia c. Focal signs, such as progressive paralysis in a limb d. Ascending paralysis beginning in the legs 30. In many types of encephalitis, such as St. Louis encephalitis, how are the viruses transmitted? a. Carriers b. Mosquito and tick bites c. Respiratory droplet d. Septic emboli in the circulation 31. All of the following apply to tetanus infection EXCEPT: a. It is caused by an anaerobic, spore-forming bacillus b. The exotoxin causes strong skeletal muscle spasms c. Death usually results from respiratory failure d. Signs of fever, vomiting, stiff neck, and paralysis 32. In cases of Guillain-Barré syndrome, what does the pathophysiology include? a. Damage and loss of function in the motor neurons of the spinal cord and medulla b. Encephalopathy, with disorientation, headache, and coma c. Infection and inflammation of the motor cortex d. Inflammation and demyelination of peripheral nerves, leading to ascending paralysis 33. How does a depressed skull fracture cause brain damage? a. A bone fragment penetrates and tears brain tissue. b. A section of the skull is missing, leaving the brain unprotected. c. A section of skull bone is displaced below the level of the skull, causing pressure on the brain. d. Many fracture lines are present, causing instability. e. The contrecoup injury is the cause of brain damage. 34. Following a head injury, what is the most likely cause of secondary damage to the brain? a. Hematoma or infection b. Laceration by foreign objects c. Hypoxia or acidosis d. Tearing of blood vessels as the brain rotates across the inside of the skull 35. An epidural hematoma is located between the: a. Dura mater and the arachnoid mater b. Dura mater and the skull c. Arachnoid mater and the pia mater d. Pia mater and the brain 36. What does the term otorrhea mean? a. Bleeding from the nose b. CSF leaking from the ear c. Torn meninges but no skull fracture d. Hemorrhage from the ear 37. Vertebral fractures are classified as: a. Simple, compression, wedge, dislocation b. Compound, open, closed, shattered c. Complex, torsion, open, multiple d. Pressure, complex, simple, variable 38. Following a spinal injury at C5, what is the expected effect during the period of spinal shock? a. Spastic paralysis below the level of injury b. Urinary incontinence c. Labile body temperature d. Increased sensation in the legs 39. Following an injury at L2 to L3, what would indicate recovery from spinal shock? a. Spastic paraplegia b. Urinary retention c. Labile body temperature d. Increased sensation in the legs 40. What are the signs of autonomic dysreflexia in a person with cervical spinal injury? a. Unexpected drop in blood pressure and apnea b. Sudden marked increase in blood pressure with bradycardia c. Hyperreflexia in the arms and legs d. Urinary and bowel incontinence 41. Expressive aphasia is most likely to result from damage to: a. The left frontal lobe b. The left temporal lobe c. The right motor cortex d. Wernicke’s area 42. What is the usual result of damage to the right occipital lobe? a. Left eye is blind b. Loss of left visual field c. Right eye is blind d. Visual loss in the medial half of each eye 43. How does the heart rate change as intracranial pressure increases? a. Rate decreases b. Rate increases c. No change in rate d. Irregular heart rate 44. Which statement best describes herniation resulting from increased intracranial pressure? a. Movement of brain tissue into ventricles b. Movement of brain stem upward c. Pushing of excess CSF and blood down around the spinal cord d. Displacement of brain tissue downward toward the spinal cord 45. Which type of cerebrovascular accident (CVA) has the poorest prognosis? [Show Less]

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