PORTAGE LEARNING
NURS 231: Pathophysiology 2022
MODULE 4
Question 1
2.5 / 2.5 pts
Which of the following increases the chance of clotting? Select all
... [Show More] that apply.
Vitamin K deficiency
Von Willebrand factor deficiency Correct!
Protein C deficiency Thrombocytopenia
Question 2
2.5 / 2.5 pts
A deficiency in which of the following would lead to a hypercoagulable state? Select all that apply. Correct!
Protein C Correct!
Protein S Factor II Factor VII Factor IX
Factor X Correct!
Antithrombin III Question 3
2.5 / 2.5 pts
Which of the following is a hypercoagulable state? Select all that apply.
Hemophilia A Correct!
Congestive heart failure Correct!
Smoking
Thrombocytopenia Correct!
Postsurgical state Question 4
0 / 2.5 pts
Which of the following is FALSE of disseminated intravascular coagulation (DIC)? Select all that apply.
Microthrombi cause vessel occlusion and tissue ischemia You Answered
It can cause multiple organ failure
Severe hemorrhage results
Obstetric disorders are the main cause of DIC Correct!
Lab results show a decreased PT, PTT Question 5
2.5 / 2.5 pts
Well-known causes of disseminated intravascular coagulation (DIC) include each of the following conditions except:
Retained dead fetus Carcinoma
Gram-negative sepsis Correct!
Heparin administration Question 6
2.5 / 2.5 pts
Which of the following does NOT affect the heart’s ability to increase its output?
Preload Afterload
Cardiac contractility Correct!
Cardiac reserve
Heart rate Question 7
2.5 / 2.5 pts
Which of the following is NOT a regulator of blood pressure? Baroreceptors
Renin-angiotensin-aldosterone system
Vasopressin Correct!
Parasympathetic nervous system activation Question 8
2.5 / 2.5 pts
Antiphospholipid syndrome is NOT associated with which of the following? Select all that apply. Correct!
Bleeding risk Thrombus risk Recurrent fetal loss Thrombocytopenia
Can be seen with SLE Question 9
2.5 / 2.5 pts
Multiple Choice
What is the most specific test for diagnosing iron deficiency anemia? Correct!
Ferritin RBC
Total iron binding capacity Hematocrit
Question 10
2.5 / 2.5 pts
Multiple Choice
Hemolytic anemias are characterized by each of the following except:
Premature destruction of red cells Correct!
Decrease in erythropoiesis
Sickle cell disease and thalassemias are included Bone marrow is hyperactive
Question 11
2.5 / 2.5 pts
Which of the following are potential causes of a sickle crisis in sickle cell anemia? Select all that apply.
Alkalosis Correct!
Dehydration Correct!
Cold exposure Correct!
Physical exertion Question 12
0 / 2.5 pts
Multiple Choice:
A 23-year-old African-American man with a history of severe lifelong anemia requiring many transfusions has nonhealing leg ulcers and recurrent periods of abdominal and chest pain. These signs and symptoms are most likely to be associated with which one of the following laboratory abnormalities?
Correct Answer
Sickle cells on peripheral blood smear Loss of intrinsic factor
You Answered
Decreased erythropoietin
Decreased ferritin Question 13
2.5 / 2.5 pts
Multiple Choice:
Which of the following is NOT true of vitamin B12 deficiency anemia?
Dietary deficiencies are not common
Peripheral neuropathy can be a result of deficiency Vitamin B12 is bound to intrinsic factor
Correct!
MCV is decreased Question 14
2.5 / 2.5 pts
Multiple Choice:
Each of the following are risk factors for secondary hyperlipidemia except?
Obesity
Diabetes mellitus
High cholesterol diet Correct!
Autosomal dominant disorder of LDL receptor Question 15
2.5 / 2.5 pts
Multiple Choice:
Risk factors for coronary heart disease include each of the following except: Correct!
HDL > 60
Smoking Hypertension
Family history of heart disease Question 16
2.5 / 2.5 pts
Multiple Choice:
Risk factors for atherosclerosis include each of the following except: Increasing age
Correct!
Female gender (pre-menopause) Elevated CRP levels
Cigarette smoking Question 17
8 / 10 pts
Matching: Match the cardiac procedures to their description and what they are best used for. 2 answers per question (1 from Set 1, and 1 from Set 2).
1. Cardiac catheterization
2. Exercise stress testing
3. Electrocardiography
4. Echocardiography
Set 1:
a. Records electrical potential differences during the cardiac cycle
b. Observes cardiac function under stress
c. Checks for structure and function of the heart
d. Catheter is inserted into the great vessels and chambers of the heart
Set 2:
a. Best to assess ventricular function and heart failure
b. Best to assess for arrhythmias and myocardial infarction
c. Best to assess need for coronary artery bypass graft and stenting
d. Best to assess suspected ischemic heart disease Your Answer:
1. D, C
2. B, D
3. A, A
4. C, B
1. Set 1: d, Set 2: c
2. Set 1: b, Set 2: d
3. Set 1: a, Set 2: b 4 . Set 1: c, Set 2: a Question 18
10 / 10 pts
Explain the differences in the pathophysiology, symptoms, and whether nitroglycerin and/or rest will relieve symptoms in stable angina, unstable angina, and myocardial infarction.
Your Answer:
In stable angina, with exertion, the vessels cannot properly vasodilate. This can cause chest pain, tightness or shortness of breath. Heart is stable at rest, but cannot keep up with the exertion demand. It is relieved with rest and/or use of nitroglycerin.
With increasing occlusion of the coronary vessel, the demands of the resting heart may become too great. Unstable agina is when patient has angina without exertion. Rest is insuffient, but can be releived with nitroglycerin.
If the plaque ruptures, complete occulsion can occur. This can lead to lack of oxygen to tissues in the heart and muscle can die. This is myocardial infarction. Chest pain unrelieved by rest, sharp pain down left arm, vomitting are signs of distress. Emergency/hospital interventions are needed.
With atherosclerotic disease, the coronary vessel lumens are narrowed and blood supply to the heart is diminished. With exertion, the vessels cannot adequately vasodilate. This can manifest as chest pain or tightness and/or shortness of breath.
Stable angina- The heart is stable at rest but cannot keep up with the demand of exertion. Stable angina typically has a >70% stenosis of the coronary arteries. It is relieved by rest or nitroglycerin (vasodilator). Unstable angina- With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called unstable angina. It can be relieved by nitroglycerin, but not rest. Unstable angina means one or more coronary vessels is nearly totally occluded.
Myocardial infarction- If a plaque ruptures, coronary thrombosis can cause complete occlusion. If collateral flow is inadequate, the tissue supplied becomes ischemic. Without oxygen, a portion of the muscle can die. MI can present as chest pain unrelieved by rest, sometimes radiating down the left ram or into the jaw or neck, dyspnea, nausea/vomiting, sweating, and/or other signs of distress. Other symptoms include a crushing pain or like “something is sitting on my chest.” Women may present with weakness, fatigue, shortness of breath, or GI complaints. Symptoms are not relieved by nitroglycerin.
Question 19
10 / 10 pts
1. Name 2 lifestyle changes to prevent further progression of atherosclerotic diseases:
2. Name 2 medications used to treat someone with coronary artery disease and their mechanisms of action:
Your Answer:
1. Stop smoking and frequent exercise
2. ACE inhibitors prevent conversion of angiotensin I to angiotensin II, which decreases vasocontriction, aldosterone production, sodium and water retiention by the kidneys. Diuretics promote the excretion of fluids, reducing preload.
1. Reduction in fat intake, quitting smoking, weight loss, exercise
2. Aspirin or other platelet inhibitors are used to prevent thrombosis formation. Beta-blockers and calcium channel blockers (CCB) – both decrease the heart rate and contractile force – can be initiated to decrease the heart’s demand of oxygen. CCB also increase coronary vasodilatation and decrease coronary vasospasm. Nitrates are used to quickly dilate the coronary vessels. Nitrates also dilate veins, decreasing the heart’s work by decreasing preload and afterload.
Question 20
2.5 / 2.5 pts
Multiple Choice:
With increasing occlusion of the coronary vessel(s), the demands of the resting heart may become too great. When the patient experiences angina without exertion, or when the level of exertion necessary to cause anginal symptoms decreases, this is called what?
Stable angina Correct!
Unstable angina
Myocardial infarction Question 21
2.5 / 2.5 pts
Multiple Choice:
Which of the following is NOT a risk factor for hypertension? Correct!
Increased potassium intake Increased salt intake Increased alcohol intake
Increased caloric intake Question 22
2.5 / 2.5 pts
Multiple Choice:
Each of the following lifestyle modifications will help to decrease blood pressure except:
Losing weight
Increase fruits and vegetables Correct!
3 drinks or more of alcohol
Limiting salt intake Question 23
2.5 / 2.5 pts
Multiple Choice:
With atherosclerotic disease, the coronary vessel lumens are narrowed and blood supply to the heart is diminished. With exertion, the vessels cannot adequately vasodilate. This can manifest as chest pain or tightness and/or shortness of breath. What is this referred to as?
Correct!
Stable angina Unstable angina
Myocardial infarction Question 24
2.5 / 2.5 pts
Multiple Choice:
Which arrhythmia is the most common chronic arrhythmia and incidence increases with age?
Sinus bradycardia
Sinus tachycardia Correct!
Atrial fibrillation
Atrial flutter Question 25
2.5 / 2.5 pts
Fill in the blank:
The laboratory test that measures the volume of red cells in 100 mL of blood is . Your Answer:
hematocrit
hematocrit
Question 26
2.5 / 2.5 pts
Fill in the blank:
are a group of inherited disorders of hemoglobin synthesis common among Mediterranean populations.
Your Answer: thalassemias Thalassemias
Question 27
2.5 / 2.5 pts
Fill in the blank:
The drug most commonly associated with inhibition of platelet aggregation is . Your Answer:
aspirin
aspirin
Question 28
10 / 10 pts
Patient is found to have the above:
What risk factors mostly led to this disease state? What is this person at risk for developing?
What lifestyle modifications would you suggest for them? Your Answer:
1. Smoking, poor diet, high cholesteral values, obesity, diabetes
2. Atherosclerosis
3. Stop smoking, exercise, dietary changes, reduce alcohol consumption
Answer: Picture is of an atherosclerotic plaque
Hyperlipidemia, cigarette smoking, obesity and visceral fat, hypertension, diabetes mellitus. Increasing age, family history of premature CHD, and male sex. May also include C-reactive protein (CRP) and serum lipoprotein(a).
Coronary artery disease, angina, myocardial infarction, aneurysm, stroke (ischemia, thrombosis, emboli).
Stop smoking, lose weight/exercise, healthy diet (low-fat, low-cholesterol), adhere to medication for blood pressure, hyperlipidemia, and/or diabetes. [Show Less]