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Which of the following statements best describes Raynaud disease?
c. A vasospastic disorder of the small arteries and arterioles of the fingers, and less
commonly, the toes
A patient is diagnosed with pulmonary disease and elevated pulmonary vascular
resistance. Which of the following heart failures may result from this condition?
a. Right heart failure
Exp: Right heart failure is defined as the inability of the right ventricle to provide
adequate blood flow into the pulmonary circulation at a normal central venous
pressure. It most often results from the left heart failure when the increase in left
ventricular filling pressure that is reflected back into the pulmonary circulation is
severe enough. As pressure in the pulmonary circulation rises, the resistance to right
ventricular emptying increases.
What physical sign is the result of turbulent blood flow through a vessel?
d. Murmur heard on auscultation
Exp: Where flow is obstructed the vessel turns or blood flows over rough surfaces.
The flow becomes turbulent with whorls or eddy currents that produce noise causing
a murmur to be heard on auscultation such as occurs during blood pressure
measurement with a sphygmomanometer. This selection is the only option that
accurately identifies the physical sign of turbulent vascular blood flow. pg 1113
Which congenital heart defects occur in trisomy 13, trisomy 18 and down syndrome?
d. Ventricular septal defect and patent ductus arteriosus
Exp: Congenital heart defects that are related to dysfunction of trisomy 13, trisomy
18 and down syndrome include VSD and PDA see Table 33-2 The other defects are
not associated with dysfunction of trisomy 13 or 17 and down syndrome. pg 1200
,An infant has a continuous machine/type murmur best heard at the left upper
sternal border throughout systole and diastole as well as a bounding pulse and a
thrill on palpation. These clinical findings are consistent with which congenital heart
defect?
c. Patent ductus arteriosus
Exp: If pulmonary vascular resistance has fallen then infants with will
characteristically have a continuous machine/type murmur best heard at the left
upper sternal border throughout systole and diastole. If the PDA is significant then
the infant also will have bounding pulses an active precordium, a thrill on palpation
and signs and symptoms of pulmonary over circulation. The presentations of the
other congenital heart defects are not consistent with the described the symptoms
pages 1203-1204
Which compensatory mechanism is spontaneously used by children diagnosed with
tetralogy of Fallot to relieve hypoxic spells?
c. Squatting
Exp: squatting is a spontaneous compensatory mechanism used by older children to
alleviate hypoxic spells. Squatting and its variants increase systemic resistance while
decreasing venous return to the heart from the inferior vena cava. The other options
would not result in these changes. pg 1209
An infant diagnosed with a small patent ductus arteriosus would likely exhibit which
symptom?
b. Lack of symptoms
Exp: Infants with a small PDA usually remain asymptomatic. page 1203-1204
Fluid in the pleural space characterizes which condition?
a. Pleural Effusion
Exp: Pleural effusion is the presence of fluid in the pleural space. page1254
Which medication classification is generally included in the treatment of silicosis?
a. Corticosteroids
,Exp: No specific treatment exists for silicosis, although corticosteroids may produce
some improvement in the early, more acute stages. page 1259
The risk for respiratory distress syndrome (RDS) decreases for premature infants
when they are born between how many weeks of gestation?
30 and 36
Exp: Surfactant is secreted into fetal airways between 30 and 36 weeks. The other
options are not true regarding the timeframe when the risk for RDS decreases. page
1292
What is the primary problem resulting from respiratory distress syndrome (RDS) of
the newborn?
Atelectasis
Exp: The primary problem is atelectasis, which causes significant hypoxemia and is
difficult for the neonate to overcome because a significant negative inspiratory
pressure is required to open the alveoli with each breath. None of the other options
are considered a primary problem associated with RDS. page 1301
What is the chief predisposing factor for respiratory distress syndrome (RDS) of the
newborn?
a. Premature birth
Exp: RDS of the newborn, also known as hyaline membrane disease (HMD), is a major
cause of morbidity and mortality in premature newborns. page 1301
What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
c. Surfactant deficiency
Exp: RDS is primarily caused by surfactant deficiency and secondarily by a deficiency
in alveolar surface area for gas exchange. page 1301
Which statement best describes cystic fibrosis?
, c. Pulmonary disorder involving an abnormal expression of a protein-producing
viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
Exp: Cystic fibrosis is best described as a pulmonary disorder involving an abnormal
expression of a protein-producing viscous mucus that obstructs the airways,
pancreas, sweat ducts, and vas deferens. This selection is the only option that
accurately describes cystic fibrosis. pages 1310-1311
Cystic fibrosis is caused by which process?
a. Autosomal recessive inheritance
Exp: Cystic fibrosis is an autosomal recessive inherited disorder that is associated
with defective epithelial ion transport. None of the other options cause cystic
fibrosis. page 1310
What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?
c. Deficit of IL-10 and an excess of IL-1, IL-8 and TNF α
Exp: Abnormal cytokine profiles have been documented in CF airway fluids, including
deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to
promoting inflammation. pages 1311-12
Which hormone is required for water to be reabsorbed in the distal tubule and
collecting duct?
a. Antidiuretic hormone
Exp: Antidiuretic hormone is required for water to be reabsorbed in the distal tubule
and collecting duct. The later, straight segment of the distal tubule and the collecting
duct are permeable to water as controlled by antidiuretic hormone. The other
options are not involved in this process. page 1331
The concentration of the final urine is determined by antidiuretic hormone (ADH),
which is secreted by which gland?
a. Posterior pituitary