1.The cardiovascular control mechanisms include A) The antidiuretic hormone secreted by the adrenal medulla B) The aldosterone secreted by the hypophysis C) The natriuretic peptide from the atrium D) the angiotensinogen secreted by the lungs ANSWER: C 2. Which of the following events is specifically seen on EKG A) Sinoatrial node depolarization B) Atrioventricular node depolarization C) Bundle of His depolarization D) Bachman's Bundle depolarization E. Atrial muscle depolarization ANSWER: E 3.Baroreceptors in the carotid artery walls aorta and medulla respond to which of the following conditions? A) Decreased blood pressure B) Increased blood pressure C) Decreased pulse D) Increased pulse ANSWER: A 4. Which of the following arteries feed the anterior wall of the heart A) Circumflex artery B) Internal mammary artery C) Left anterior descending coronary artery D) Right coronary artery ANSWER: C 5.When conducting a physical examination of a patient, the nurse should be aware that a pathologic S4 extra heart sound is the result of A) Physiologic splitting of the aortic and pulmonic valves with inspiration B) Increased resistance to ventricular filling following atrial contraction C) Opening of a stenotic valve D) Mitral valve prolapsed ANSWER: C 6.Which of the following types of angina is most closely associated with an impending myocardial infarction? A) Angina decubitus B) Chronic stable angina C) Nocturnal angina D) Unstable angina ANSWER: D 7.Which of the following conditions is the predominant cause of angina? A) Right sided heart failure B) Left-sided heart failure C) Coronary artery spasm D) Inadequate oxygen supply to the heart ANSWER: D 8.A patient with myocardial infarction develops pulmonary crackles and dyspneA) A chest X-ray shows evidence of pulmonary edemA) The specific type of MI, the patient had is most probably A) Anterior B) Posterior C) Lateral D) Inferior ANSWER: A 9.The patient was transferred to the ICU since he was showing signs of Complications. Which of these complications is often the cause of most deaths after MI? A) Pulmonary edema B) Arrhythmia C) Congestive heart failure D) Myocardial rupture ANSWER: B 10.An acute onset of heart failure caused by extensive myocardial infarction will result in which of the following? A) Insufficient available time to develop hypertrophy B) Indirect impairment of cardiac contractility C) Gradual decrease in cardiac output D) Its acuteness will not result in cardiogenic shock ANSWER: A 11.Which levels of electrolytes should be obtained in a patient with frequent episodes of ventricular tachycardia? A) Calcium and magnesium B) Potassium and calcium C) Magnesium and potassium D) Potassium and sodium ANSWER: C 12.Tachycardia with absent P and T waves and a ventricular rate of 100-200 beats per minute is seen in which of the following arrhythmias? A) Atrial sinus rhythm B) Atrial fibrillation C) Ventricular standstill D) Ventricular tachycardia ANSWER: D 13.A patient with a long history of myocardial infarction developed shortness of breath, anxiety and slight confusion. Assessment findings include a regular heart rate of 120 beats/min, audible third and fourth heart sounds, blood pressure of 84/60 mm Hg,bibasilar crackles on lung auscultation, and a urine output of 5 ml over the past hour. The nurse anticipates preparing the patient for possible transfer to the intensive care unit because A) The patient is experiencing heart failure B) The patient is going into cardiogenic shock C) The patient shows signs and symptoms of aneurysm rupture D) The patient is in the early stage of right –sided failure ANSWER: B 14.The patient with right ventricular heart failure may develop ascites because of: A) Loss of cellular components in blood B) Rapid osmosis from tissue spaces to cells C) Increased pressure within the circulatory system D) Rapid diffusion of solutes and solvents into the plasma ANSWER: C 15.In right ventricular heart failure, the extremities of the patient is expected to have pitting edema because of which of the following? A) Increased in tissue colloid osmotic pressure B) Decrease in the plasma colloid osmotic pressure C) increase in the tissue hydrostatic pressure at the arterial end of the capillary bed D) Elevation in the plasma hydrostatic pressure at the venous end of the capillary bed ANSWER: D 16.Which of the following assessment findings would suggest to the home health nurse that the patient is developing congestive heart failure? A) Othopnea B) Weight loss C) Fever D) Calf pain ANSWER: A 17.Which of the following conditions would a nurse expect when assessing a patient who has right sided failure? A) Shortness of breath B) Peripheral edema C) Decreased urinary output D) Paroxysmal nocturnal dyspnea ANSWER: B 18.Which of the following clinical manifestations would support a nursing diagnosis of decreased cardiac output? A) Cool, moist skin B) Bounding peripheral pulses C) Increased urinary output D) Diminished breath sounds ANSWER: A 19.A patient with left-sided failure complains of increasing shortness of breath and is agitated and coughing up of blood tinged foamy sputum. The nurse should recognize these as signs and symptoms of A) Right sided failure B) Acute pulmonary edema C) Pneumonia D) Cardiogenic shock ANSWER: B 20.An 84 year old male is returning from the operating room, after inguinal hernia repair, the nurse notes that he has fluid volume excess from operation and is at risk for left-sided failure. Which of the following signs and symptoms indicates left sided failure? A) Jugular vein distension B) Right upper quadrant pain C) Bibasilar fine crackles D) Peripheral edema ANSWER: C 21. In presenting a workshop on parameters of cardiac function, which conditions should the nurse list as the most likely to lead to a decrease preload? A) Hemorrhage, sepsis and anaphylaxis B) Myocardial infarction, fluid overload and diuresis C) Fluid overload, sepsis and vasodilation D) Third spacing, heart failure and diuresis ANSWER: A 22. In a patient with chronic bronchitis, which signs would lead a nurse to suspect right sided failure? A) Cyanosis of the lips B) Bilateral crackles C) Productive cough D) Leg edema ANSWER: D 23.For a patient with cadiomyopathy, the most important nursing diagnosis is A) Decrease cardiac output related to reduced myocardial contractility B) Fluid volume excess related to fluid retention alteration C) Ineffective individual coping related to fear of debilitating disease D) Anxiety related to actual threat to health status ANSWER: A 24.In left sided heart failure, which part of the heart is affected? A) Left atrium B) Left ventricle C) Pulmonary vein D) Pulmonary artery ANSWER: B 25. Which of the following percentages represent the amount of damage the myocardium must sustain before sign and symptoms of cardiogenic shock develop? A) 10 percent B) 25 percent C) 40 percent D) 90 percent 26.A nurse should expect a patient diagnosed with angina pectoris to report chest pain during which of the following activities? A) Taking a deep breath B) Moving the extremities C) Climbing the flight of stairs D) Sleeping in a supine position ANSWER: C 27.MI is also termed coronary artery disease. The pain associated with MI is due to: A) Contraction of heart muscle B) Decreased electrolytes in the blood C) Insufficient oxygen supply to the heart muscle D) Inflammation of the heart muscle ANSWER: C 28.A newborn is suspected of having patent ductus arteriosus. The nurse should recognize that the newborn is at risk for the development of which of the following cardiovascular complication? A) Mitral valve prolapse B) Inflammation of the pericardium C) Pulmonary edem D) Bacterial endocarditis ANSWER: C 29.A 12 year old who is suspected of having coarctation of the aorta is hospitalizeD) It is essential that a nurse perform which of the following assessments during the initial physical examination? A) Palpating the lower margin of the liver B) Monitoring the blood pressure in all four extremities C) Performing pulmonary function tests D) Do EKG ANSWER: B 30.Which of the following factors can cause blood pressure to drop to normal levels? A) Kidney's excretion of sodium only B) Kidney's retention of sodium and water C) Kidney's excretion of sodium and water D) Kidney's retention of sodium and excretion of water ANSWER: C 31.The Renin-Angiotensin system is triggered by baroreceptors in the carotid artery walls aorta and medulla because they respond to which of the following conditions? A) Decreased blood pressure B) Increased blood pressure C) Decreased pulse D) Increased pulse 32.Which of the following hormones is responsible for raising arterial pressure and promoting venous return? A) Angiotensin 1 B) Angiotensin 11 C) Epinephrine D) Renin ANSWER: C 33.Distribution of blood flow is regulated easily by A) capillaries B) arterioles C) venules D) arterovenous anastomosis E. post capillary venules ANSWER: C 34.The most common site of aneurysm formation is in which segment of the aorta? A) Abdominal aorta, just below the renal arteries B) Ascending aorta, around the aortic arch C) Descending aorta, beyond the subclavian arteries D) Aortic arch, around the ascending aorta ANSWER: A 35.A nurse is performing an admission assessment on a client admitted with a diagnosis of Raynaud's disease. The nurse assesses for the symptoms associated with Raynaud's disease by A) Observing for the softening of the nails and nail beds B) Palpating for diminished or absent peripheral pulse C) Checking for a rash on the digits D) Palpating for a rapid or irregular pulse ANSWER: B 36. Mr. Suarez, who has a history of hypertension six years ago , came to the clinic complaining of shortness of breath. Inspection shows the point of maximum impulse is shifted to the left and down, and auscultation revealed resonant, fine crackles in both lung fields. The best explanation for his shortness of breath is most likely related to? A) Pulmonary congestion from inadequate functioning of the left ventricle B) Insufficient blood return to the right side of the heart C) Asynergestic pumping of the left ventricle D) Obesity and sedentary life style ANSWER: a 37. In patients who are confined in bed due to illness ,the patient is advised to moved his leg in beD) This exercise is primarily done to help; A) Decrease the occurrences of decubitus ulcer B) Prevent thrombophlebitis and blood clot formation C) Prepare the patient for ambulation D) Prevent increase of weight ANSWER: B 38.The most important reason for the nurse to encourage a patient with peripheral vascular disease to initiate walking is because this form of exercise is A) Reduce stasis B) Aids in weight reduction C) Increase high density lipoprotein D) Promotes collateral circulation ANSWER: D 39.Manifestations of anemia are caused by which of the following? A) hypotension due to decreased iron in the blood B) tissue hypoxia weakness and fatigue C) tachycardia due to low blood pressure D) palpitation anxiety created by the condition ANSWER: B 40. Following surgery ,the nurse must observe for signs of pernicious anemiA) Why may pernicious anemia be a problem after gastrectomy?. A) The extrinsic factor is produced in the stomach B) The extrinsic factor is absorbed in the antral portion of the stomach C) The intrinsic factor is produced in the stomach D) Decreased hydrochloric acid production inhibits Vitamin B12 reabsorption ANSWER: C 41.A patient who consumes excessive alcohol has a prescription for folic acid supplements. A nurse should recognize that the desired effect of this medication is to A) Promote maturation of red blood cells B) Stimulate the production of the intrinsic factor C) Enhance the synthesis of clotting factors D) Increase the rate of glucose uptake ANSWER: A 42.Which of the following is true of Polycytemia vera? A) An absolute increase in red cell mass B) Decrease blood viscosity C) Risk of bleeding D) Decrease in hematocrit ANSWER: A 43. Which of the following couples will have the highest risk of having a child with sickle cell disease? A) Father is HbS and the mother is HbS B) Father is HbS and the mother is HbAS C) Father is HbAS and the mother is HbAS D) Father is HbAS and the mother is HbS 44.The nurse should inform individuals diagnosed as having sickle cell anemia that they should avoid which of the following activities? A) Flying in a small aircraft B) Playing basketball C) Water skiing D) Swimming in the ocean ANSWER: A 45.Primary preventive measures a child with sickle cell anemia is which of the following? A) The need for the child to avoid physical activity B) The need for the child to consume large quantities of liquids each day C) The need for the child to restrict his or her nutritional intake of fruits and vegetables D)The need for the child to avoid producing children in the future 46.The nurse is evaluating a patient's ventilation and perfusion. Which of the following statements is true? A) Normally ventilation and perfusion are equally balanced throughout the lung. B The normal perfusion ratio is 0:8:1 C) Perfusion scans are performed by having the patient inhale a radio-active Substance D) A low ventilation ratio-perfusion ratio occurs in pulmonary emboli 47. Pulmonary perfusion allows alveolar gas exchange. All of these interfere with gas transport to the alveoli except A) Cardiac output less than the average of 5/L minute B) Elevations in pulmonary and systemic resistance to reduce blood flow C) Abnormal or insufficient hemoglobin picks up less oxygen for exchange D) Air in the alveoli at 4 liters/minute ANSWER: B 48.A patient is advised to do deep breathing exercises post op because A) The pore of Kohn will open to allow oxygenation to a blocked alveoli B) The pore of kohn will open to allow mucus to be dislodged C) The pore of kohn will close to prevent mucus from entering the alveoli D) The pore of kohn will close to prevent atelectasis ANSWER: A 49.What is the volume of air,you inspires and expires with every breath? A) Total lung capacity B) Forced vital capacity C) Tidal volume D) Residual volume ANSWER: C 50.Since you have a normal respiratory function, which of the following is true? A) Her physiologic dead space is higher than her anatomic dead space B) Her physiologic dead space is lower than her anatomic dead space C) Her physiologic dead space is equal to her anatomic dead space D) Her alveolar dead space is equal to her physiologic dead space ANSWER: A 51. When she inspires,which of the following occurs? A) Lungs recoil B) Diaphragm descends C) Alveolar pressure is positive D) Inspiratory muscles relaxes 52. Effective gas exchange of the lungs depend on matching perfusion with which of the following? A) Oxygenation B) Ventilation C) Diffusion D) Gas transport ANSWER: B 53.Physiologic shunting of blood usually results from: A) Destructive lung disease that impairs ventilation B) Blood moving from the venous to the arterial side of the circulation without moving through the lungs C) Obstruction of some lung alveoli D) Blood flowing through the areteriovenous fistula ANSWER: B 54. The pulmonary circulation facilitate gas exchange through which of the following oxygenation processes?: A) Perfusion B) Ventilation C) Diffusion D) Expiration ANSWER: A 55.Which oxygenation process is the movement of gases in the alveoli and across the alveolar capillary membrane?: A) Perfusion B) Oxygenation C) Ventilation D) Diffusion ANSWER: D 56.During gas exchange , oxygen and carbon dioxide diffusion occurs in the : A) Venules B) Alveoli C) Red blood cells D) Plasma ANSWER: B 57. A patient is receiving supplemental oxygen therapy, which arterial blood gas value is most important? A) pH B) Bicarbonate C) Partial pressure of arterial oxygen D) Partial pressure of arterial CO2 ANSWER: 58. Which of the following would be an early sign of hypoxia in a person with inadequate ventilation? A) Pallor B) Restlessness C) Mottling of the extremities D) Disorientation ANSWER: B 59. Severe obesity can impair ventilation because it makes it difficult to expand the thoracic cavity during inspiration. When a person's ventilation is impaired, what gas is retained by the body? A) NaCO2 B) CO2 C) Nitrous oxide D) Oxygen ANSWER: B 60.The following disorders share a common pathway to the formation of cor pulmonale except A) Pulmonary restrictive disorders B) Pulmonary congestion secondary to systemic hypertension C) Pulmonary obstructive disorders D) Recurrent pulmonary emboli ANSWER: B 61. An 80 year old woman had been lying in the hospital bed for a month because of a casted fractured femur, suddenly develops dyspneA) She is assessed by the nurse to have ventilation without perfusion. This is exemplified by which of the following? A) A blood clot obstructing pulmonary flow B) Collapse of lungs C) Aspiration D) Lobar pneumonia ANSWER: A 62. A patient with pneumococcal pneumonia is admitted to a hospital. The patient in the next room is being treated for mycoplasma pneumoniA) Despite the different causes of the various pneumonia, all of them have the same which f0llowing pathologic process A) Inflamed lung tissue B) Sudden onset C) Responsiveness to penicillin D) Elevated white blood cell count ANSWER: A 63.Which of the following is a characteristic of chronic bronchitis? 1)Cough with copious production of sputum 2)Dyspnea 3)Lethargy 4.)Abnormal breath sounds A) 1 and 2 B) 1 2 4 C) All of the above D) 1 only ANSWER: B 64. A patient is experiencing an acute asthmatic attack. The patient's symptoms started initially with wheezing and breath sounds on both lung fields but which in a few seconds became not audible. The reason for this change is that A) The attack is over B) The airways are so swollen that no air can get through C) The swelling has decreased D) crackles have replaced wheezes ANSWER: B 65. Which of these is not true about bronchial asthma? A) Allergic in nature B) Non allergic C) Hereditary D) Aggravated by emotional problem ANSWER: B 66.A nurse would explain to a patient who has emphysema that a home oxygen should be maintained at a low flow rate for which of the following reasons? A) Low serum oxygen concentrations trigger breathing B) High oxygen flow rates promote combustion C) Oxygen is drying to the respiratory mucosa D) Oxygen tolerance can develop ANSWER: A 67. A client with late stage emphysema complains of an occipital headache, drowsiness, and difficulty concentrating. The nurse interprets that these symptoms are indicative of which complication of emphysema? A) Encephalopathy B) Carbon dioxide narcosis C) Carbon monoxide poisoning D) Cerebral embolism ANSWER: B 68. The tissue change most characteristic of emphysema is: A) Accumulation of mucus in the pleural space B) Constriction of capillaries by fibrous tissue C) Filling of air space by inflammatory coagulation D) Overdistention, inelasticity and rupture of the alveoli ANSWER: D 69.A patient's chest Xray revealed white hazy densities all over the lung fields, indicating adult respiratory distress syndrome. Which of the following causes the manifestations of ARDS A) Pulmonary edema B) Consolidation of the lung fields C) Increased capillary permeability D) Parenchymal lung disease ANSWER: C 70.Tuberculosis of the kidneys is spread by which of the following methods? A) Homogenous dissemination B) Hematogenous dissemination C) Infected needle D) Use of infected eaing utensils ANSWER: B 71.Paradoxical breathing is a characteristics of A) Flail Chest B) Pneumothorax C) Emphysema D) Chronic Bronchitis ANSWER: A 72.Which of the following signs can be attributed to an iron deficiency anemia? A) a pale color of the sclera B) hepatosplenomegaly C) glossodynia [pain in the tongue] D) menorrhagia E) neurologic abnormalities ANSWER: A 73.In polycythemia rubra vera: A) the reticulocyte count is typically elevated B) the leukocyte alkaline phosphatase activity is low C) 30percent of patients exhibit hyperuricosuria D) the vitamin B12 binding capacity in the serum is elevated E) the serum total iron level is typically elevated ANSWER: A 74.Night blindness is a condition brought about by: A) vitamin A deficiency B) vitamin D deficiency C) vitamin K deficiency D) vitamin C deficiency ANSWER: A 75.Both rickets and osteomalacia can be prevented by a diet including enough vitamin A) A B) B C) C D) D ANSWER: D 76.The obese individual has a higher risk of which complication? A) Hypertension B) Maturity-onset diabetes C) Gall bladder disease D) all of the above are true ANSWER: D 77.Joints of obese individuals are likely to develop A) Joints of obese individuals are likely to develop B) rheumatoid arthritis C) atherosclerosi D) varicosities ANSWER: A 78.The best approach for losing weight would be: A) medications B) medications and a quick exercise program C) behavior modification and reduced caloric intake D) strict exercise ANSWER: C 79. People living in the mountain province would have to cope with a decrease in oxygen density in high altitudes. Thus they develop secondary polycythemia verA) Which of the following is found in Polycythemia Vera? A) An absolute increase in red cell mass B) Decrease blood viscosity C) Risk of bleeding D) Decrease in hematocrit ANSWER: A 80.What compensatory mechanism causes polycythemia vera? A) Physiologic response of erythropoietin caused by chronic hypoxia B) Exposure to the sun C) Exposure to cold D) Abnormal types of hemoglobin ANSWER: A 81.This is a type of Polycythemia VerA) What type is it? A) Pathologic B) Pathophysiologic C) Physiologic D) Genetic ANSWER: B 82. Manifestations of anemia are caused by which of the following? A) hypotension due to decreased iron in the blood B) tissue hypoxia weakness and fatigue C) tachycardia due to low blood pressure D) palpitation anxiety created by the condition ANSWER: B 83. A patient had been having heavy menstrual bleeding for months. Her gynecologist diagnosis microcytoc hypochromic anemia and prescribes ferrous sulfate 300 mg p.o. daily. Which condition contraindicate the use of ferrous sulfate? A) Pregnancy B) Asthma C) Ulcerative colitis D) Severely impaired liver function ANSWER: C 84. A patient with sickle cell crisis would be expected to meet which of the following problem? A) Malnutrition due to anorexia B) Insomnia due to external stimuli C) Scratch wounds due to pruritus D) Pain related to sickle cell crisis ANSWER: D 85.Which of the following couple will have the highest risk of having a child with sickle cell disease? A) Father is HbS and the mother is HbS B) Father is HbS and the mother is HbAS C) Father is HbAS and the mother is HbAS D) Father is HbAS and the mother is HbS ANSWER: A 86.Individuals diagnosed as having sickle cell anemia should be adviced that they should avoid which of the following activities? A) Flying in a small aircraft B) Playing basketball C) Water skiing D) Swimming in the ocean ANSWER: A 87.Primary preventive measures a child with sickle cell anemia is which of the following? A) The need for the child to avoid physical activity B) The need for the child to consume large quantities of liquids each day C) The need for the child to restrict his or her nutritional intake of fruits and vegetables D) The need for the child to avoid producing children in the future ANSWER: B 88.A parent of a child who has sickle cell anemia feels guilty for the child's disorder. How should should you initially respond to this statement? A) Reassuring the parent that no one is at fault B) Referring the parent for genetic counseling C) Having the parent clarify the meaning of the statement D) Acknowledging the validity of the parent's statement ANSWER: A 89.In patient with sickle cell crisis, what would be the most important problem that has to be addressed ? A) Malnutrition due to poor intake B) Insomnia due to external stimuli C) Pruritus D) Pain ANSWER: D 90.Hemolytic anemias are characterized by which of the following? A) almost all have normocytic , hypochromic red blood cell B) the bone marrow is normoactive C) decreased number of reticulocytes in circulating blood D) cause may be intrinsic or extrinsic ANSWER: D 91.Prolonged anemia produces a strain in client'ss heart. Which of the following is responsible for this? A) Pressure B) Temperature C) Cardiac output D) Surface tension ANSWER: C 92. Following surgery ,a client must observe for signs of pernicious anemiA) Why may pernicious anemia be a problem after gastrectomy?. A) The extrinsic factor is produced in the stomach B) The extrinsic factor is absorbed in the antral portion of the stomach C) The intrinsic factor is produced in the stomach D) Decreased hydrochloric acid production inhibits Vitamin B12 reabsorption ANSWER: C 93.Which assessment findings are characteristics of iron deficiency anemia? A) Night sweats weight loss and diarrhea B) Dyspnea tachycardia and pallor C) Nausea vomiting and anorexia D) Itching rash and jaundice ANSWER: B 94.A 32 year old patient admitted with pernicious anemiA)Which set of findings would be manifested by the patient? A) Pallor, bradycardia and reduced pulse pressure B) Pallor,tachycardia and sore tongue C) Sore tongue,dyspnea and weight gain D) Angina, double vision and anorexia ANSWER: B 95.A patient with pernicious anemia is receiving parentheral Vitamin B12 therapy. Which of the following is true of parenteral Vitamin B12 therapy? A) Parenteral Vit B 12 therapy will be given until the signs and symptoms disappear B) Parentheral Vitamin B12therapy until the patient's Vitamin B12 level returns to normal C) Parenteral Vitamin B12 therapy will be given for 6 months to one year D) Parenteral Vitamin B12 therapy for the rest of his life ANSWER: 96. Characteristics of acute leukemia 1. Abrupt onset of respiratory symptoms 2. Excessive perspiration 3. Lowered heat tolerance 4. Weight loss and tachycardia A) 1 and 2 B) all but 2 C) all but 4 D) all of the above ANSWER: B 97. A child is diagnosed of having Burkitt's LymphomA)What is the etiologic agent of this lymphoma/ A) Papilloma virus B) Herpes Simplex type 2 C) Epstein Barr virus D) HIV virus ANSWER: C 98.You make all of these observations of a patient who has acute nonlymphocytic leukemiA) Which one should be reported immediately? A) Ecchymosis B) Fatigue C) Hematuria D) Pallor ANSWER: C 99.A child who has acute lymphocytic leukemia is receiving chemotherapeutic drugs and has an order for allopurinol. The nurse should recognize that the purpose for allopurinol for the child is to; A) Stimulate erythropoietic activity. B) Promote the deposit of calcium in long bones C) Interfere with the production of leukemic cells D) Inhibit uric acid production ANSWER: D 100.While a patient who has Hodgkin's disease is receiving chemotherapy, it is important to assess the patient for symptoms of A) Thrombus formation B) Ascites C) Infection D) Spleenomegaly ANSWER: C 101. A patient with suspected lymphoma is scheduled for lymphoangiography. This procedure may cause which harmless temporary change? A) Purplish stools B) Bluish urine C) Redness of upper part of feet D) Coldness of the soles ANSWER: B 102.A 15 year old child is suspected of having Hodgkin's disease. It is most important that nurse perform which of the following assessments should be performed during the initial physical examination? A) Inspection of the mucous membranes B) Percussion of the kidneys C) Palpation of the lymph nodes D) Auscultation of the bowel sounds ANSWER: C 103. An eight year old boy who has hemophilia A was brought to the minor operating room for tooth extraction. What would be the priority intervention post-op? A) Applying warm compresses B) Dispensing ibuprofen C) Administering factor V111 D) Immobilizing the joint ANSWER: C 104.Which of the following actions would be the highest priority in the treatment of disseminated intravascular coagulation (DIC) A) Maintaining central blood volume B) Correcting the triggering cause C) Correcting the coagulaion defects D) Maintaining strict intake and output ANSWER: C 105.While monitoring a patient for development of disseminated intravascular coagulation, you should take note of what assessment parameters? A) Platelet count, prothrombin time and partial thromboplastin time B) Platelet count, blood glucose levels and WBC count C) Thrombin time, Calcium levels and potassium levels D) Fibrinogen levels, WBC and platelet count ANSWER:A 106. In Idiopathic thrombocytopenic purpura, which intervention is appropriate? A) Teaching coughing and deep breathing techniques to help prevent infection B) Administering platelet, as needed to maintain adequate platelet count C) Giving aspirin as treatment to control body temperature D) Administering stool softeners, to prevent straining during defecation ANSWER: B 107.In chronic lymphocytic leukemia: A) an absolute lymphocytosis is observed B) thrombocytosis is observed C) splenomegaly is always present D) the development of an acute blastic crisis is possible E) Coombs positivity is possible ANSWER:E 108.All of of the following findings would suggest a thrombocyte defect rather than a coagulation abnormality? A) hemarthrosis B) bleeding from superficial abrasions C) immediate and strong bleeding from tooth extraction D) bleeding of the mucous membranes ANSWER: A 109.Regarding the regulation of body temperature A) In a temperate climate under normal conditions, the greatest loss of body heat occurs through radiation B) During water immersion, heat is mainly lost via radiation C) The thalamus is the centre for integrating thermal information D) As the skin possesses thermoreceptors, its temperature is regulated more closely than the core temperature ANSWER: B 110.Regarding sweating and heat loss A) Heat loss through sweating is controlled by the parasympathetic nervous system B) The efficacy of sweating as a mechanism of heat loss is increased in a tropical rain forest C) Profuse sweating can lead to heat exhaustion D) Sweat is secreted by the apocrine glands ANSWER: C 111.Which of the following statements about thermoregulation ia not correct? A) In a temperate climate under normal conditions, the greatest loss of body heat occurs through convection B) Heat is lost more readily from the body surface during water immersion than in air C) Heat is lost more readily from the body surface during water immersion than in air D) Vasodilatation of cutaneous vessels promotes heat loss from the body ANSWER: A 112.Which of the following do not apply to a man who moves from a temperate to a tropical area to live? A) During the first few weeks in the tropical area his sweat rate will rise B) The salt content of his sweat will fall C) His rate of urine production will fall D) The rate at which aldosterone is secreted from his adrenal cortex will fall ANSWER: D 113.During aging, the needs for vitamins and minerals A) continually fluctuate B) greatly decrease C) somewhat increase in some cases D) greatly increase ANSWER: D 114.Because of the high incidence of hypertension , many people are encouraged to lower their intake of: A) meats B) sugars and sweets C) dairy products D) salt ANSWER: D 115.Nutrients that deserve special emphasis in a diet plan for the elderly include all of the following except: A) vitamin B6 B) calcium C) zinc D) vitamin A ANSWER: D 116.Since the immune system becomes less efficient with age, it is especially important to consume adequate ______________ and ______________, nutrients that contribute to immune function. A) vitamin A vitamin B6 B) protein zinc C) zinc iodide D) vitamin A vitamin K ANSWER: B 117.Common nutrition-related chronic diseases of adults include: A) asthma, type 2 diabetes, and hypertension B) hypertension, cancer, and arthritis C) atherosclerosis, hypertension, and obesity D) atherosclerosis, hypertension, and kidney disease ANSWER: C 118.Decreased synthesis of intrinsic factor increases the risk of ______________ deficiency in older adults. A) vitamin B-6 B) vitamin B-12 C) folate D) vitamin D ANSWER: B 119.To combat the high incidence of overweight and obesity , many people are reducing their intake of: A) whole-grain cereals. B) calories C) cholesterol D) salt ANSWER: B 120.Recommendations for preventing osteoporosis include: A) consuming adequate amounts of calcium from infancy throughout adulthood B) consuming more potassium and selenium C) increasing the intake of iron, magnesium, and zinc during adulthood D) A and B ANSWER: A 121.The reason the incidence of obesity increases with age is that: A) the basal metabolic rate decreases with age B) physical activity often decreases with age C) energy intake exceeds energy expenditure D) all of the above ANSWER: D 123. Why do some malnourished patients bleed excessively when injured? A) Vitamin K deficiency B) Platelet sequestration by fatty liver C) Serum bilirubin raises neutralizing thrombin D) Low serum-protein levels cause factor XIII problems ANSWER: A 124.A patient who consumes excessive alcohol has a prescription for folic acid supplements. You should recognize that the desired effect of this medication is to A) Promote maturation of red blood cells B) Stimulate the production of the intrinsic factor C) Enhance the synthesis of clotting factors D) Increase the rate of glucose uptake ANSWER: A 125. What condition leads to a deficiency in factor IX that can be corrected by an intravenous injection of vitamin K? A) Classic hemophilia B) Hepatitis B C) Bile duct obstruction D) Genetic deficiency in antithrombin III ANSWER: A 126.Findings in iron deficiency: A) Increased apoferritin synthesis B) Decreased transferrin saturation C) Transferrin synthesis is reduced D) Increased amounts of ferritin E) Haemosiderin is produced ANSWER: B 127.Which of the following nutrients is increased significantly during the first trimester of pregnancy? A) Magnesium B) Iron C) Vitamin A D) Carbohydrates E) Protein ANSWER: B 128.A client with acute anxiety has the following arterial blood gas (ABG). pH 7.55,paO2 90mmHg,paCO2 27 mmHg,HCO3 24 mEq/L A) Metabolic acidosis B) Metabolic alkalosis C) Respiratory acidosis D) respiratory alkalosis ANSWER: A 130.A client with respiratory acidosis is admitted to the ER for observation.The nurse should stay alert for which complication associated With respiratory acidosis? A) Shock B) CVA C) Seizures D) Hyperglycemia ANSWER: C 130.A client with acute anxiety has the following arterial blood gas (ABG). pH 7.55,paO2 90mmHg,paCO2 27 mmHg,HCO3 24 mEq/L A) Metabolic acidosis B) Metabolic alkalosis C) Respiratory acidosis D) respiratory alkalosis ANSWER: A 131.During a therapeutic phlebotomy of a client with hemochromatosis, the nurse explains the rationale for the procedure by telling the client A) You may need several phlebotomies during your lifetime to keep the iron form damaging your pancreas and heart. B) The blood is being removed so your blood is available for future transfusions. C) If you hadn't been a vegetarian you wouldn't have gotten this disease. D) You have too much blood and some of it has to be removed to make you less prone to infections. ANSWER:A 132.A client with respiratory acidosis is admitted to the ER for observation.The nurse should stay alert for which complication associated With respiratory acidosis? A) Shock B) CVA C) Seizures D) Hyperglycemia ANSWER: C