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Medicine & Health Science
Q:
Organizations within the health care industry have increasingly consolidated into ____ over the past two decades with the stated objective of being more efficient, but may not operate as such.
a. community care centers c. systems
b. corporations d. foundations
Q:
Investor-owned facilities comprise about ____ percent of the hospital sector.
a. 15-20 c. 55-60
b. 30-35 d. 75-80
Q:
The Premier Hospital Quality Incentive Demonstration (PHQID) was launched to determine if economic incentives are effective at improving ____.
a. the cost of inpatient care c. the cost of outpatient care
b. the quality of inpatient care d. the quality of outpatient care
Q:
Health care concerns shared by the U.S., China and India include concerns over ____.
a. the consolidated financial mechanism
b. lack of spending at the local level
c. the low number of specialists
d. lifestyle issues and behaviors
Q:
What is one issue that health care organizations must address in order to create and deliver value?
a. To create appropriate barriers to health care for equity
b. To improve access to health care
c. To increase cost acceleration
d. To decrease the overall quality of care
Q:
Match each item with a statement below:a. human relations schoolb. complex adaptive system perspectivesc. classical administration schoold. The Health Systems Integration Studye. World Health Organization (WHO)f. decision-making schoolg. Federal Trade Commission (FTC) and Department of Justice (DOJ)h. Taylorismi. scientific management perspectivej. population ecology1) Focused on structuring the tasks of individual workers2) Focused heavily on the external environment3) Focused on top executives4) Focused on motivating workers5) Conducted a series of workshops to assess the competitive and efficiency benefits of horizontal and vertical forms of consolidation6) Highlights the importance of social networks7) Suggests that the economic integration of hospitals and physicians forms part of the bedrock for improving clinical integration8) Developed a generic framework for the overall structure of any country's health care system9) Suggests that hospitals more vigorously pursue efforts at clinical integration10) Emphasizes the importance of unobtrusive controls to reduce discretion and shape the premises of decisions made by managers
Q:
The different theoretical schools suggest different strategies for changing organizations and different ____________________ that managers need to develop.
Q:
What effect does FIO2 1.0 at 1 atm have on the half-life of COHb?a. reduces half-life to less than 1 hour b. reduces half -life to 2.5 hours c. reduces half-life to 7.5 hoursd. reduces hal-life to 10 hours
Q:
What is the half life of COHb on FIO2 0.21 at 1 atm?a. 5 hours b. 10 hours c. 15 hoursd. 20 hours
Q:
Which of the following are clinical indications for hyperbaric oxygenation?I. Acute traumatic ischemiaII. Thermal burnsIII. Clostridial infectionsIV. Carbon monoxide poisoninga. I, II, III, and IV b. IV only c. I, II, and IV onlyd. I, III, and IV only
Q:
What is the leading cause of death by poisoning in the USA?a. carbon monoxide poisoning b. botulism food poisoning c. salmonella food poisoningd. arsenic posioning
Q:
Which of the following are clinical goals of hyperbaric oxygen in the treatment of decompression sickness?I. Reduction in bubble sizeII. Acceleration of bubble resolutionIII. Maintaining tissue oxygenationa. I, II, and III b. I and III onlyc. III onlyd. II and III only
Q:
What is the term for an abnormal collection of air in the abdominal cavity?a. pneumoperitoneum b. pneumomediastinum c. pneumothoraxd. pneumopericardium
Q:
What is the most common diving-related disorder encountered by divers?a. middle ear barotrauma b. decompression sickness c. conjuctival hemorrhagesd. gastrointestinal barotrauma
Q:
What is another name for the coughing and chest pain that is associated with decompression sickness?a. the chokes (pulmonary decompression sickness)b. the bendsc. squeezesd. barotrauma
Q:
Which of the following can occur with decompression sickness?I. Joint painII. Chest Pain and CoughingIII. Paresthesia and ParalysisIV. Circulatory Failurea. I, II, III, and IV b. I only c. I, II, and IVd. I and IV only
Q:
What is another name for lung packing?a. glossopharyngeal insufflation b. glossotracheal insufflation c. glossolaryngeal insufflationd. glossoesophageal insufflation
Q:
What was the world record time established in 2008 for the longest breath hold?a. 17 minutes + b. 14 minutes + c. 10 minutes+d. 8 minutes+
Q:
Which clinical condition is most commonly associated with too rapid of an ascent from a deep dive?a. decompression sickness b. pneumothorax c. pleural effusiond. pulmonary edema
Q:
Which of the following influence the volume of dissolved gas that moves into a diver's tissues during a deep dive?I. Solubility of the gas in the tissuesII. The partial pressure of the gasIII. The hydrostatic pressure in the tissuea. I, II, and III b. I and II only c. II onlyd. III only
Q:
What is the first line of defense against hypoxia during deep dives?a. mammalian diving reflex b. pre-dive voluntary hyperventilation c. rapid ascentd. rapid descent
Q:
Which of the following occur during the mammalian diving reflex during a breath hold deep dive?I. TachycardiaII. Decreased cardiac outputIII. Lactic acid acuumulationIV. Peripheral vasoconstrictiona. II, II, and IV only b. I, II, III, and IV c. I, II and III onlyd. II and IV only
Q:
What is the term for the drop in PAO2 that occurs when a breath hold diver ascends from a deep dive?a. hypoxia of ascent b. the bends c. diving responsed. decompression sickness
Q:
At what point in a breath hold deep dive would the CO2-O2 paradox occur?a. CO2 paradox occurs on descent, O2 paradox occurs on ascent.b. O2 paradox occurs on descent, CO2 paradox occurs on ascentc. both occur during descentd. both occur during ascent
Q:
How might hyperventilation prior to a breath hold dive allow the diver to extend the duration of the dive?a. reduces CO2 stores and extends time before breaking point is reachedb. decreases the CO2 and O2 stores and extends time before breaking point is reachedc. decreases the pH and CO2 stores and extends time before the breaking point is reachedd. reduces CO2 and O2 stores and lowers the pH to extend time before the breaking point is reached
Q:
What manuever is normally performed to prolong the duration of a breath-hold dive?a. voluntary hyperventilationb. voluntary hypoventilationc. hyperventilation with heliumd. hyperventilation with carbon dioxide-oxygen mixture
Q:
If an individual at sea level has a blood volume of 5 L, how much oxygen would be transported physically dissolved if the PaO2 were 100 mm Hg?a. 15 mL b. 1.5 ml c. 150 mLd. 50 mL
Q:
With a PaO2 of 100 mm Hg at 1 atm of pressure, what amount of oxygen can physically dissolve in 1 dL of blood?a. 0.3 mL b. 3.0 mL c. 0.03 mLd. 0.003 mL
Q:
What is the general term for the administration of gases at increased ambient pressures via a compression chamber?a. hyperbaric medicine b. bariatric medicine c. positive pressure medicined. hypobaric medicine
Q:
If the TLC is 6.6 L at sea level, what would it equal at a depth of 33 feet under water?a. 3.3 L b. 2.2 L c. 1.1 Ld. 4.4 L
Q:
Which gas law can be used to calculate the changes in gas volumes and pressures applied to diving?a. Boyle's b. Henry's c. Charles'd. Dalton's
Q:
If the TLC equals 4.8 L at sea level, what would it equal at a depth of 66 feet?a. 1.8 L b. 2 L c. 3 Ld. 4.8 L
Q:
At 66 feet below the surface of the water, what would the pressure equal expressed in mm Hg?a. 760 x 3 = 2280 mm Hg b. 760 x 2 = 1520 mm Hg c. 66 x 2 = 132 mm Hgd. 66 x 3 = 198 mm Hg
Q:
How many feet below the water's surface must a diver reach to be subjected to a total pressure of 4 atmospheres?a. 99 feet b. 66 feet c. 33 feetd. 132 feet
Q:
What cardiac change is associated with Monge's disease?a. right ventricular hypertrophy b. left ventricular hypertrophy c. mitral valve stenosisd. aortic valve stenosis
Q:
What is another name for Monge's disease?a. chronic mountain sickness b. acute mountain sickness c. high altitude cerebral edemad. high altitude pulmonary edema
Q:
Which abnormality is characterized by photophobia, ataxia, hallucinations and clouding of consciousness?a. high altitude cerebral edema b. high altitude pulmonary edema c. acute mountain sicknessd. Monge's disease
Q:
What is the best treatment for high altitude pulmonary edema?a. rapid descent and oxygen therapy b. oxygen therapy and rest c. IV fluids and oxygen therapyd. rest and IV fluids
Q:
Following ascent by lowlanders to high altitudes, when do symptons of acute mountain sickness normally appear?a. 6-12 hours b. 12-24 hours c. 1-6 hoursd. 24-36 hours
Q:
In high altitude natives, where are high concentrations of myoglobin located?I. DiaphragmII. MyocardiumIII. Pectoral musclesIV. Adductor leg musclesa. I, II, III, and IV b. I only c. II onlyd. I and II only
Q:
Which of the following simulates a continuous low barometric pressure environment?a. hypoxicator b. low flow oxygen system c. negative pressure ventilatord. cuirass
Q:
To derive physiologic benefits from altitude training, for what duration must athletes be exposed to 2000-2500m?a. more than 4 weeks b. 14 days c. 1 weekd. 12-24 hours
Q:
Which breathing pattern is often initially seen in lowlanders who ascend to high altitudes?a. Cheyne-Stokes b. Kussmaul's c. Biot'sd. apneusis
Q:
What of the following primarily controls the phenomenon of hypoxic pulmonary vasoconstriction?a. PAO2 b. PaO2 c. central chemoreceptorsd. baroreceptors
Q:
How is cardiac output and oxygen uptake affected by prolonged exposure to high altitudes?a. Both are the same as at sea levelb. Both are increasedc. Both are slightly decreasedd. Cardiac output is increased but oxygen uptake is the same as at sea level
Q:
In a healthy individual, how is ventilation and perfusion affected by high altitude exposure?a. Both ventilation and pulmonary perfusion are increasedb. Only perfusion is increasedc. Only ventilation is increasedd. Ventilation is increased and pulmonary perfusion decreases slightly
Q:
What impact does initial high altitude exposure have on the alveolar-arterial oxygen difference?a. It is increasedb. It is decreasedc. It is normal but will increase during exercised. It is not affected by changes in altitude
Q:
Which of the following are true regarding high altitude natives compared to lowlanders?I. Natives have a lower P(A-a)O2II. Natives have an increased DLCOIII. Natives have a lower PaO2 at rest and exercisea. I and II only b. I only c. II onlyd. I, II, and III
Q:
What is the most prevalent acid-base abnormality among natives at high altitudes?a. mild respiratory alkalosis b. mild respiratory acidosis c. mild metabolic acidoisd. mild metabolic alkalosis
Q:
For what duration do adaptive changes occur in the blood after ascent to high altitudes?a. 6 weeks b. 1 week c. 48-72 hoursd. 12-24 hours
Q:
What is the blood's adaptive response to low oxygen levels resulting from residing at high altitudes?a. polycythemia b. megacythemia c. anemiad. leukocytosis
Q:
Which hormone is released from the kidneys in response to hypoxia?a. erythropoietin b. aldosterone c. RHFd. HVR
Q:
How do the VCs lowlanders who ascend to high altitudes compared to those born and raised at high altitudes?a. The VCs of native high altitude residents remain largerb. After 2-3 days, the VCs are the same sizec. After 2-3 weeks, the VCs are the same sized. After 2-3 months, the VCs are the same size
Q:
What changes will occur in the VC and PEFR within 24 hours of ascent to a high altitude?a. VC will decrease and PEFR will increaseb. PEFR will decrease and VC will increasec. both will decreased. both will increase
Q:
After what duration at a high altitude will the peripheral chemoreceptors acclimate to the lower PO2?a. They do not acclimate to a decreased PaO2b. 12-24 hoursc. 24-48 hoursd. 48-72 hours
Q:
What is the acronym for the signals sent from the peripheral chemoreceptors to the medulla to increase ventilation ?a. HVR b. PBR c. CBRd. MBR
Q:
Which receptors are stimulated by the drop in PaO2 that occurs when lowlanders travel to high altitudes?a. peripheral chemoreceptors b. central chemoreceptors c. proprioceptorsd. baroreceptors
Q:
What is the term for the body's compensatory responses to relocation to a high altitude from seal level?a. acclimatization b. adjustment c. adaptationd. accomodation
Q:
What would the PIO2 equal at the summit of Mount Everest where the PB is 253 mm Hg?a. 43 mm Hg b. 79 mm Hg c. 100 mm Hgd. 159 mm Hg
Q:
Which of the following are benefits of pulmonary rehabilitation in COPD?I. Increased exercise capacityII. Reduction in anxiety and depressionIII. Increased hospital length of stayIV. Improved upper arm strength and endurancea. I , II, and IV only b. I, II, III, and IV c. I and IV onlyd. I and II only
Q:
What is the primary treatment for heat stroke?a. Rapid reduction of body temperatureb. Rehydrate as rapidly as possiblec. Restore electrolytes as rapidly as possibled. Reduce PaCO2 as rapidly as possible
Q:
Which of the following are signs and symptoms of heat stroke?I. Absence of sweatingII. Muscle crampingIII. Circulatory collapseIV. Confusiona. I, II, III, and IV b. II, III, and IV only c. I, II and IV onlyd. I and Ii only
Q:
What increase in body heat production can occur during exercise?a. 20-fold b. 30-fold c. 10-foldd. 5-fold
Q:
What percent of maximum can the respiratory system reach during extreme exercise?a. 65% b. 90% c. 50%d. 75%
Q:
Which exhibits the highest percent of change in a marathon runner?I. Cardiac outputII. Stroke volumeIII. Heart ratea. I only b. II only c. III onlyd. I and II increase by the same amount
Q:
Which of the following are benefits of moderate exercise?I. Reduced stress, anxiety and depressionII. Reduced weightIII. Decreased bone densityIV. Improved sleep qualitya. I, III, and IV only b. I, II, III, and IV c. I and IV onlyd. III and IV only
Q:
What changes would be expected in the size of the heart chambers and heart mass of a marathon runner?a. Both would increaseb. Both would decreasec. No change would occurd. The size of the heart chambers would remain normal but the heart mass would increase
Q:
What changes would be expected in the oxygen consumption and cardiac output when muscle work decreases?
a. Both would decrease
b. Both would increase
c. Oxygen consumption would remain unchanged but CO would decrease
d. Both would remain unchanged
Q:
What is the maximum cardiac output expected to be in marathon runners?a. up to 40 L/min b. up to 30 L/min c. up to 20 L/mind. up to 10 L/min
Q:
What changes would be expected in blood vessels in the following areas during exercise?I. Capillaries of working muscles would fully dilateII. Visceral blood vessels would dilateIII. Blood vessels of non-working muscles would constricta. I and III only b. I, II, and III c. I onlyd. II and III only
Q:
Which of the following can produce vasodilation of working muscles?I. Adenosine triphosphateII. AldosteroneIII. AcetylcholineIV. Lactic acida. I, II, and III only b. I, II, III, and IV c. I onlyd. IV only
Q:
At rest, what portion of the muscle capillaries are dilated?a. 20-25% b. 2-5% c. 30-35%d. 5-10%
Q:
What change would be expected in mean pulmonary arterial pressure and pulmonary capillary wedge pressure during intense exercise?a. Both should increaseb. Both should remain within normal limitsc. The mean pulmonary artery pressure would increase and PCWP would remain within normal limitsd. PCWP would increase but mean pulmonary artery pressure would drop due to the increased recruitment of pulmonary capillaries
Q:
.During exercise, how much variation would be expected to occur in the systolic blood pressure?a. increase by 20-80 mm Hgb. increase by 40-100 mm Hgc. increase less than 10 mm Hgd. Systolic pressure would remain unchanged with exercise
Q:
What is the formula for calculating the maximum heart rate?a. maximum heart rate = 220 - (age in years)b. maximum heart rate = 250- (age in years x 2)c. maximum heart rate = 220 - (age in years x 1.5)d. maximum heart rate = 250 -(age in years +20)
Q:
How does the Frank-Starling curve affect stroke volume during exercise?a. The increased venous return causes cardiac chambers to increase in size and thus contract with more forceb. The increased sympathetic stimulation causes the heart to be faster with smaller stroke volumesc. The Frank-Starling curve is only activated when the heart rate reaches 90% of the maximum targeted rated. The Frank-Starling law only affects heart rate, not stroke volume
Q:
Why would stroke volume increase during exercise?I. Parasympathetic discharge increases cardiac contractilityII. Vasodilation of working muscles increases venous return to the heartIII. Vascoconstriction of peripheral venous blood reservoirs increases venous returna. II and III only b. I , II, and III c. I onlyd. I and III only
Q:
Which of the following circulatory changes are expected during exercise?I. Rate and strength of cardiac contractions increaseII. Blood vessels in working muscles constrictIII. Blood vessels of peripheral vascular system dilateIV. Blood vessel of heart and brain constricta. I only c. I, II, and III onlyb. I, II, III and IV d. II only
Q:
During heavy exercise, what change in perfusion to working muscles can occur?a. It can increase 25-fold b. It can increase 8-fold c. It can increase 12-foldd. It can increase 4-fold
Q:
During heavy exercise, what change in CO can occur?a. It can increase 8-fold b. It can increase 4-fold c. It can increase 25-foldd. It can increase 2-fold