Nokea
The common iliac artery is in which blood circuit?
- A. pulmonary
- B. coronary
- C. systemic
- D. pelvic
Correct Answer: C
Rationale: The common iliac artery is part of the systemic circuit, delivering blood to the lower body.
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A 68-y old male with a longstanding history of cigarette smoking presents with a 3-month history of progressive shortness of breath and dyspnea on exertion. The symptoms have been ongoing and indolent. He reports chronic cough productive of his usual yellow sputum. Physical exam is notable for normal vital signs, prolonged expiratory phase and wheeze bilaterally, elevated jugular venous pressure, and moderate pedal edema. Hematocrit 49%. Which of the following is most likely to prolong his survival?
- A. Phosphodiesterase-4 inhibitor
- B. Oral glucocorticoid
- C. Inhaled anticholinergic
- D. Oxygen
Correct Answer: D
Rationale: This patient likely has COPD with cor pulmonale (elevated JVP, edema). Long-term oxygen therapy is proven to prolong survival in hypoxemic COPD patients by reducing pulmonary hypertension and improving tissue oxygenation, as shown in trials like the NOTT and MRC studies.
Which action should the nurse take when giving the first dose of oral labetalol to a patient with hypertension?
- A. Encourage the use of hard candy to prevent dry mouth.
- B. Teach the patient that headaches often occur with this drug.
- C. Instruct the patient to call for help if heart palpitations occur.
- D. Ask the patient to request assistance before getting out of bed.
Correct Answer: D
Rationale: Labetalol decreases sympathetic nervous system activity by blocking both α-and β-adrenergic receptors, leading to vasodilation and a decrease in heart rate, which can cause severe orthostatic hypotension. Heart palpitations, dry mouth, dehydration, and headaches are possible side effects of other antihypertensives.
The Frank-Starling mechanism:
- A. explains the increased heart rate during exercise.
- B. determines the method of computing cardiac output.
- C. shows the relationship between the stretch of heart muscle and strength of contraction.
- D. determines peripheral resistance by determining blood viscosity and vasoconstriction.
Correct Answer: C
Rationale: The Frank-Starling mechanism correlates the stretch of cardiac muscle fibers with the strength of contraction.
Which of the following statements is true concerning a newly diagnosed Type 2 diabetic's risk for progression to ESRD?
- A. Retinopathy is predictive for renal disease
- B. The degree of proteinuria
- C. The degree of creatinine elevation at the time of diagnosis
- D. All of the above
Correct Answer: D
Rationale: All factors (retinopathy, proteinuria, creatinine elevation) are predictive of progression to ESRD in Type 2 diabetes, reflecting systemic microvascular damage.
If the Purkinje fibers, situated distal to the AV junction, become the pacemaker of the heart, what is the expected heart rate?
- A. 30/min
- B. 50/min
- C. 60/min
- D. 70/min
Correct Answer: A
Rationale: Purkinje fibers as pacemakers produce a rate of 20-40 beats/min, with 30/min being typical.