Gould Pathophysiology for the Health Professions, 5th Edition by Karin C. VanMeter Test Bank

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Gould Pathophysiology for the Health Professions, 5th Edition by Karin C. VanMeter Test Bank


Goulds Pathophysiology for the Health Professions, 5th Edition by Karin C. VanMeter Test Bank

Chapter 02: Fluid, Electrolyte, and Acid-Base Imbalances

Test Bank




  1. Choose the correct proportion of water to body weight to be expected in a healthy male adults body:
a. 30%
b. 45%
c. 60%
d. 70%



ANS:  C                    REF:   15


  1. Choose the correct proportion of blood (to body weight) in an adult males body:
a. 30%
b. 20%
c. 10%
d. 4%



ANS:  D                    REF:   15


  1. Insensible fluid loss refers to water lost through:
a. perspiration only.
b. feces only.
c. perspiration and expiration.
d. urine and feces.



ANS:  C                    REF:   15


  1. When the osmotic pressure of the blood is elevated above normal, water would shift from the:
a. blood into the cells.
b. interstitial compartment into the cells.
c. interstitial compartment into the blood.
d. cells into the interstitial compartment.



ANS:  C                    REF:   16


  1. Which of the following would result from a deficit of plasma proteins?
a. Increased osmotic pressure
b. Decreased osmotic pressure
c. Increased hydrostatic pressure
d. Decreased hydrostatic pressure



ANS:  B                    REF:   16


  1. Which of the following would cause edema?
a. Decreased capillary hydrostatic pressure
b. Increased capillary osmotic pressure
c. Decreased capillary permeability
d. Increased capillary permeability



ANS:  D                    REF:   16-19


  1. Which of the following would likely be related to an elevated hematocrit reading?
a. Fluid excess
b. Fluid deficit
c. Increased sodium level
d. Decreased erythrocytes



ANS:  B                    REF:   23-24


  1. Which of the following is a typical sign of dehydration?
a. Rapid, strong pulse
b. Low hematocrit
c. Increased urine output
d. Rough oral mucosa



ANS:  D                    REF:   21


  1. Which of the following terms refers to a combination of decreased circulating blood volume combined with excess fluid in a body cavity?
a. Dehydration
b. Third-spacing
c. Hypovolemia
d. Water retention



ANS:  B                    REF:   21


  1. Which of the following is the primary cation in the extracellular fluid?
a. Sodium
b. Potassium
c. Calcium
d. Iron



ANS:  A                    REF:   21


  1. Which of the following is a common cause of hyponatremia?
a. Loss of the thirst mechanism
b. Excessive sweating
c. Excessive aldosterone secretion
d. Prolonged period of rapid, deep respirations



ANS:  B                    REF:   22-23


  1. Which of the following is a common effect of both hypokalemia and hyperkalemia?
a. Skeletal muscle twitch and cramps
b. Oliguria
c. Elevated serum pH
d. Cardiac arrhythmias



ANS:  D                    REF:   26


  1. Choose the correct effect of increased parathyroid hormone.
a. Increased movement of calcium ions into the bones
b. Increased activation of vitamin D
c. Increased absorption of calcium from the digestive tract
d. Decreased reabsorption of calcium in the kidneys



ANS:  C                    REF:   26


  1. Which of the following results from hypocalcemia?
  2. Low serum phosphate levels
  3. Nausea and constipation
  4. Skeletal muscle twitch and spasms
  5. Weak cardiac contractions
a. 1, 2
b. 1, 4
c. 2, 3
d. 3, 4



ANS:  D                    REF:   27


  1. Which of the following causes tetany?
a. Increased permeability of nerve membranes due to low serum calcium
b. Excess calcium ions in skeletal muscle due to excess parathyroid hormone (PTH)
c. Excess calcium ions inside somatic nerves as a result of neoplasms
d. Increased stimulation of the nerves in the cerebral cortex



ANS:  A                    REF:   27


  1. In which of the following processes is phosphate ion NOT a major component?
a. Bone metabolism
b. Metabolic processes involving adenosine triphosphate (ATP)
c. Blood clotting
d. Acid-base balance



ANS:  C                    REF:   28


  1. Which of the following would be considered normal serum pH?
a. 4.5-8
b. 7.0
c. 7.4
d. 8



ANS:  C                    REF:   28


  1. When many excess hydrogen ions accumulate in the blood, what happens to serum pH? The pH:
a. decreases.
b. increases.
c. remains constant.
d. varies based on metabolism.



ANS:  A                    REF:   28


  1. What is the slowest but most effective control for acid-base balance?
a. Respiratory system
b. Buffer systems in the blood
c. Kidneys
d. Brain



ANS:  C                    REF:   29


  1. Which of the following is essential in order to maintain serum pH within normal range?
a. Carbonic acid and bicarbonate ion must be present in equal quantities.
b. All excess carbonic acid must be excreted by the kidneys.
c. The concentration of bicarbonate ion must remain constant.
d. The ratio of carbonic acid to bicarbonate ion must be 1:20.



ANS:  D                    REF:   30


  1. Which is the correct effect on the body of abnormally slow respirations?
a. Increased carbonic acid
b. Decreased carbonic acid
c. Increased bicarbonate ion
d. Decreased bicarbonate ion



ANS:  A                    REF:   31


  1. Which condition is likely to cause metabolic acidosis?
a. Slow, shallow respirations
b. Prolonged diarrhea
c. Mild vomiting
d. Excessive fluid in the body



ANS:  B                    REF:   32


  1. What would a serum pH of 7.33 in a patient with kidney disease indicate?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Respiratory acidosis



ANS:  B                    REF:   32


  1. Which serum value indicates decompensated metabolic acidosis?
a. pH is below normal range
b. pH is above normal range
c. Bicarbonate level decreases
d. Bicarbonate level increases



ANS:  A                    REF:   32


  1. What is the effect on blood serum when excessive lactic acid accumulates in the body?
a. Bicarbonate ion levels decrease
b. Bicarbonate ion levels increase
c. Carbonic acid levels increase
d. pH increases



ANS:  A                    REF:   32


  1. The direct effects of acidosis are manifested primarily in the functioning of the:
a. Digestive system
b. Urinary system
c. Nervous system
d. Respiratory system



ANS:  C                    REF:   32


  1. Compensation mechanisms in the body for dehydration would include:
a. increased antidiuretic hormone (ADH).
b. decreased aldosterone.
c. slow, strong heart contraction.
d. peripheral vasodilation.



ANS:  A                    REF:   21


  1. Which acid-base imbalance results from impaired expiration due to emphysema?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis



ANS:  C                    REF:   32


  1. In patients with impaired expiration associated with emphysema, effective compensation for the acid-base imbalance would be:
a. increased rate and depth of respiration.
b. decreased rate and depth of respiration.
c. increased urine pH and decreased serum bicarbonate.
d. decreased urine pH and increased serum bicarbonate.



ANS:  D                    REF:   32


  1. An anxiety attack often causes hyperventilation leading to:
a. increased PCO2.
b. decreased PCO2.
c. respiratory acidosis.
d. metabolic acidosis.



ANS:  B                    REF:   32


  1. One of the factors involved in the increased need for water in infants is:
a. proportionally smaller body surface area.
b. higher metabolic rate.
c. smaller respiratory capacity.
d. greater surface area of exposed mucous membranes.



ANS:  B                    REF:   20


  1. Compensation for respiratory system depression due to anesthesia and sedation would be:
a. decreased reabsorption of bicarbonate ions in the kidneys.
b. increased secretion of hydrogen ions into the filtrate.
c. increased respiratory rate and depth.
d. increased renin secretion.



ANS:  B                    REF:   32


  1. A prolonged state of metabolic acidosis often leads to:
a. hypokalemia.
b. hyperkalemia.
c. hyponatremia.
d. hypercalcemia.



ANS:  B                    REF:   25


  1. Strenuous physical exercise on a hot day is likely to result in:
a. hypokalemia.
b. hypernatremia.
c. hyperchloremia.
d. hypovolemia.



ANS:  D                    REF:   19 | 23


  1. Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic patient. Not all options are used in the answers.
  2. Serum pH decreases
  3. Serum bicarbonate decreases
  4. PCO2 decreases
  5. Respiration decreases
  6. Respiration increases
  7. Serum pH increases
  8. Urine pH decreases
a. 1, 3, 7, 4, 2, 6
b. 5, 2, 7, 3, 4, 1
c. 2, 1, 5, 3, 7, 6
d. 3, 1, 2, 5, 7, 6



ANS:  C                    REF:   34-37


  1. Which of the following is a manifestation of respiratory alkalosis?
a. Bradycardia and deep rapid breathing
b. Drowsiness and general lethargy
c. Increased nervous system irritability
d. Decreased urine pH



ANS:  C                    REF:   33


  1. Prolonged diarrhea results in:
a. loss of fluid and bicarbonate ions, leading to metabolic acidosis.
b. increased fluid and serum bicarbonate ions, leading to metabolic acidosis.
c. loss of chloride ions only, leading to metabolic alkalosis.
d. surplus bicarbonate ions, leading to respiratory alkalosis.



ANS:  A                    REF:   32


  1. In the initial stage, vomiting results in:
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory alkalosis.
d. None of the above



ANS:  B                    REF:   32


  1. Which two ions are most important for acid-base balance in the body?
a. K+, Na+
b. Cl and HCO3
c. Ca++, Na+
d. Na+, Cl



ANS:  B                    REF:   28


  1. The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance of the carbonic acid and bicarbonate ion levels are controlled by the:
a. liver and pancreas.
b. lungs and kidneys.
c. lungs and plasma proteins.
d. kidneys and bone marrow.



ANS:  B                    REF:   30


  1. Alkalosis increases irritability and spontaneous stimulation of nerves by:
a. blocking normal nerve conduction.
b. increasing the permeability of nerve membranes.
c. blocking movement of calcium ions.
d. decreasing phosphate ion levels.



ANS:  B                    REF:   26 | 33


  1. Hypocalcemia causes weak cardiac contractions because:
a. permeability of nerve membranes increases.
b. insufficient calcium ions are available for muscle contraction.
c. low phosphate ion levels prevent muscle contraction.
d. excessive amounts of calcium are stored in cardiac muscle.



ANS:  B                    REF:   27


  1. Serum potassium levels are affected by:
  2. ADH.
  3. aldosterone.
  4. serum H+ levels.
  5. insulin levels.
a. 2 only
b. 1, 2
c. 1, 3
d. 2, 3, 4
e. 1, 2, 3



ANS:  D                    REF:   24 | 25


  1. Which of the following is the primary control of serum Na+ levels?
a. ADH
b. Aldosterone
c. Serum H+ levels
d. serum K+ levels



ANS:  B                    REF:   21


  1. The control center for thirst is located in the:
a. kidneys.
b. thalamus.
c. medulla.
d. hypothalamus.



ANS:  D                    REF:   15


  1. Which statements apply to atrial natriuretic peptide?
  2. It is secreted by heart muscle cells.
  3. It is a hormone secreted by the kidneys.
  4. It helps to control water and sodium balance.
  5. It is released in response to low blood pressure.
a. 1, 3
b. 1, 4
c. 2, 3
d. 2, 4



ANS:  A                    REF:   15


  1. What are the three mechanisms that control or compensate for serum pH?
a. Hypothalamus, metabolic changes by digestive system, lymphatic system filtration
b. Buffer pairs in blood, change in kidney excretion rate, change in respiration rate
c. Neural feedback, increase in heart rate, decrease in calcium intake
d. Modification of water intake, increased capillary permeability, decrease in blood volume



ANS:  B                    REF:   29-31


  1. Hypokalemia refers to a condition in which the serum has a very low level of which ion?
a. Sodium
b. Phosphate
c. Calcium
d. Potassium



ANS:  D                    REF:   24


  1. In the blood and extracellular fluids, hypernatremia refers to:
a. a deficient sodium level.
b. an excess phosphate level.
c. an excess sodium level.
d. an excessively low phosphate level.



ANS:  C                    REF:   23


  1. Increased milk and/or antacid intake can contribute to development of milk-alkali syndrome, which can cause which of the following?
a. Hyponatremia
b. Hyperkalemia
c. Hypercalcemia
d. Hypovolemia



ANS:  C                    REF:   27


Chapter 14: Neurological Disorders

Test Bank




  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



ANS:  C                    REF:   327


  1. Which of the following is the usual location of language centers?
a. Left hemisphere
b. Right hemisphere
c. Brainstem
d. Hypothalamus



ANS:  A                    REF:   329


  1. 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 heard
c. Loss of hearing in the left ear
d. Inability to determine the source of the sound



ANS:  B                    REF:   329


  1. 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.






REF:   332


  1. 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



ANS:  C                    REF:   330


  1. Where are b1-adrenergic receptors located?
a. Bronchiolar walls
b. Arteriolar walls
c. Cardiac muscle
d. Glands of the intestinal tract



ANS:  C                    REF:   337


  1. 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



ANS:  B                    REF:   338-339


  1. 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



ANS:  D                    REF:   339


  1. 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



ANS:  A                    REF:   340


  1. What is an early indicator of increased intracranial pressure?
a. Papilledema
b. Bilateral fixed dilated pupils
c. Decreasing responsiveness
d. Rapid heart rate



ANS:  C                    REF:   342


  1. 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



ANS:  C                    REF:   342


  1. 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



ANS:  D                    REF:   342


  1. 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.



ANS:  A                    REF:   345


  1. 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



ANS:  A                    REF:   342


  1. 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



ANS:  C                    REF:   342


  1. 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 (PNS) fibers in cranial nerve III.
c. sympathetic nervous system (SNS) nerve to the eye.
d. occipital lobe.



ANS:  B                    REF:   342


  1. 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



ANS:  D                    REF:   327


  1. 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.



ANS:  B                    REF:   345


  1. 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.



ANS:  B                    REF:   345


  1. 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.



ANS:  A                    REF:   345


  1. 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.



ANS:  D                    REF:   346


  1. 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



ANS:  C                    REF:   347


  1. 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.



ANS:  C                    REF:   347


  1. 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.



ANS:  B                    REF:   346-347


  1. 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.



ANS:  A                    REF:   348


  1. In the weeks following CVA, why might some neurological function return?
  2. Presence of collateral circulation
  3. Immediate therapy to dissolve thrombi and maintain perfusion
  4. Reduced inflammation in the area
  5. Development of alternative neuronal pathways
a. 1 only
b. 2 only
c. 1, 3
d. 2, 3, 4
e. 1, 2, 3, 4



ANS:  E                    REF:   347


  1. 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.



ANS:  C                    REF:   349-350


  1. 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



ANS:  A                    REF:   350


  1. 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



ANS:  A                    REF:   351


  1. 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



ANS:  B                    REF:   352


  1. 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.



ANS:  D                    REF:   353


  1. In cases of Guillain-Barr 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



ANS:  D                    REF:   354


  1. 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.



ANS:  C                    REF:   355


  1. 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



ANS:  A                    REF:   357


  1. 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.



ANS:  B                    REF:   358


  1. 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.



ANS:  B                    REF:   358


  1. 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.



ANS:  A                    REF:   359


  1. Following a spinal injury at C5, what is the expected effect during the period of spinal shock?
a. Spastic paralysis below the level of the injury
b. Urinary incontinence
c. Possible periods of apnea
d. Normal blood pressure



ANS:  C                    REF:   360


  1. 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



ANS:  A                    REF:   361


  1. 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



ANS:  B                    REF:   362


  1. 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. Wernickes area.



ANS:  A                    REF:   340


  1. 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



ANS:  B                    REF:   341


  1. 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



ANS:  A                    REF:   342


  1. 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



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