Nokea
Contraction of the ventricles of the heart leads to blood moving directly
- A. into arteries.
- B. into capillaries.
- C. into veins.
- D. through an atrioventricular valve.
Correct Answer: A
Rationale: During ventricular contraction (systole), blood is ejected out of the heart into arteries. The atrioventricular valves close to prevent backflow into the atria.
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Smooth muscle in blood vessels is located in the:
- A. tunica externa
- B. tunica intima
- C. tunica media
- D. All of the above
Correct Answer: C
Rationale: The tunica media contains smooth muscle, enabling vessel constriction and dilation.
A 45-year-old woman presents with a chief complaint of fatigue. Her BMI is 27, and her sleep experience includes frequent loud snoring and witnessed apneas. A polysomnography is performed and reveals an apnea hypopnea index of 11 (normal less than 5). Patient is started on continuous positive airway pressure (CPAP) therapy, as well as dietary modification and recommended an exercise program. At follow-up visit patient reports compliance with CPAP therapy and improved energy. She has also lost 6 kg because of lifestyle modifications. Her BMI is now 24. Which of the following management strategies would be most appropriate for this patient?
- A. Discontinue CPAP therapy and evaluate symptoms in 4 weeks
- B. Schedule a repeat polysomnography and CPAP titration
- C. Decrease CPAP settings by 20% and reevaluate response in 4 weeks
- D. Continue CPAP therapy at current settings
Correct Answer: B
Rationale: Weight loss and lifestyle changes may reduce OSA severity, but the current AHI and optimal CPAP settings need reassessment. A repeat polysomnography with CPAP titration is the most appropriate step to ensure therapy aligns with her current condition, per sleep medicine guidelines.
While assessing a 68-yr-old with ascites, the nurse also notes jugular venous distention (JVD) with the head of the patient's bed elevated 45 degrees. The nurse knows this finding indicates
- A. decreased fluid volume
- B. jugular vein atherosclerosis
- C. increased right atrial pressure
- D. incompetent jugular vein valves
Correct Answer: C
Rationale: The jugular veins empty into the superior vena cava and then into the right atrium, so JVD with the patient sitting at a 45-degree angle reflects increased right atrial pressure. JVD is an indicator of excessive fluid volume (increased preload), not decreased fluid volume. JVD is not caused by incompetent jugular vein valves or atherosclerosis.
Arteriolar constriction is caused by:
- A. Serotonin
- B. ANP
- C. NO
- D. Histamine
Correct Answer: A
Rationale: Serotonin causes arteriolar constriction by activating smooth muscle receptors.
The biology of tumor growth most commonly follows which of the following mechanisms?
- A. Logarithmic progression
- B. Logarithmic regression
- C. Gompertzian kinetics
- D. Michaelis-Mendelson kinematics
Correct Answer: C
Rationale: Tumor growth typically follows Gompertzian kinetics where growth rate slows as the tumor size increases.