Nokea
In fetal circulation, the ductus arteriosus and foramen ovale:
- A. take blood from the fetus to the placenta
- B. connect the pulmonary artery with the aorta
- C. bypass the lungs
- D. shunt blood from the left atrium into the right atrium
Correct Answer: C
Rationale: Both structures allow blood to bypass the nonfunctional fetal lungs.
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A 34-y old lifelong nonsmoking male presents for evaluation of dyspnea, fatigue, and nonproductive cough which is worse in the evening. His symptoms have been ongoing for the last 6 months. He is an auto mechanic working in an autobody shop for the last 4 years. He believes his symptoms are work related. Medical history is otherwise negative and he is on no medications. Physical exam and vital signs are normal. CXR and spirometry are normal. What is the most appropriate next step?
- A. CT chest
- B. Repeat spirometry after workplace exposure
- C. Allergy testing
- D. Inhaled glucocorticoid
Correct Answer: B
Rationale: Symptoms worsening in the evening suggest occupational asthma related to autobody shop exposures (e.g., isocyanates). Repeat spirometry post-exposure can confirm reversible airway obstruction, a key diagnostic step per occupational lung disease guidelines.
What enzyme, or combination of enzymes, protects cells against superoxide generated in oxidation reactions?
- A. G6PD
- B. Catalase
- C. Superoxide dismutase and catalase
- D. Glutathione peroxidase
Correct Answer: C
Rationale: Superoxide dismutase converts superoxide to H2O2, which catalase then breaks down to water.
A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the following is an expected finding with this condition?
- A. Echocardiogram shows an ejection fraction of 38%.
- B. Heart catheterization shows an ejection fraction of 65%.
- C. Patient has frequent episodes of nocturnal paroxysmal dyspnea.
- D. Options A and C are both expected findings with left-sided systolic dysfunction heart failure.
Correct Answer: D
Rationale: Left-sided systolic dysfunction is characterized by a reduced ejection fraction (typically <40%, as in A) and symptoms like nocturnal paroxysmal dyspnea (C) due to pulmonary congestion. An ejection fraction of 65% (B) is normal.
Blood from the stomach and intestines is transported to the liver by the:
- A. aorta
- B. hepatic artery
- C. hepatic portal vein
- D. renal artery
Correct Answer: C
Rationale: The hepatic portal vein carries nutrient-rich, deoxygenated blood from the GI tract to the liver.
What is the nurse's best response if a patient on furosemide reports dizziness when standing?
- A. You may need to increase your salt intake.
- B. This is normal; continue taking your medication as prescribed.
- C. Stand up slowly to prevent lightheadedness.
- D. You may need to stop the medication temporarily.
Correct Answer: C
Rationale: Orthostatic hypotension is a common side effect of diuretics; standing slowly minimizes symptoms.