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Essentials of Pathophysiology 4th Edition Essentials of Pathophysiology 4th Edition Porth Test Bank Porth Test Bank Table of Contents Chapter 01 - Cell Structure and Function Chapter 02 - Cellular Responses to Stress, Injury, and Aging Chapter 03 - Inflammation, the Inflammatory Response, and Fever Chapter 04 - Cell Proliferation, Tissue Regeneration, and Repair Chapter 05 - Genetic Control of Cell Function and Inheritance Chapter 06 - Genetic and Congenital Disorders Chapter 07 - Neoplasia Chapter 08 - Disorders of Fluid, Electrolyte, and Acid-Base Balance Chapter 09 - Stress and Adaptation Chapter 10 - Disorders of Nutritional Status Chapter 11 - Disorders of White Blood Cells and Lymphoid Tissues Chapter 12 - Disorders of Hemostasis Chapter 13 - Disorders of Red Blood Cells Chapter 14 - Mechanisms of Infectious Disease Chapter 15 - Innate and Adaptive Immunity Chapter 16 - Disorders of the Immune Response Chapter 17 - Control of Cardiovascular Function Chapter 18 - Disorders of Blood Flow and Blood Pressure Chapter 19 - Disorders of Cardiac Function Chapter 20 - Heart Failure and Circulatory Shock Chapter 21 - Control of Respiratory Function Chapter 22 - Respiratory Tract Infections, Neoplasms, and Childhood Disorders Chapter 23 - Disorders of Ventilation and Gas Exchange Chapter 24 - Structure and Function of the Kidney Chapter 25 - Disorders of Renal Function Chapter 26 - Acute Kidney Injury and Chronic Kidney Disease Chapter 27 - Disorders of the Bladder and Lower Urinary Tract Chapter 28 - Structure and Function of the Gastrointestinal System Chapter 29 - Disorders of Gastrointestinal Function Chapter 30 - Disorders of Hepatobiliary and Exocrine Pancreatic Function Chapter 31 - Mechanisms of Endocrine Control Chapter 32 - Disorders of Endocrine Control of Growth and Metabolism Chapter 33 - Diabetes Mellitus and the Metabolic Syndrome Chapter 34 - Organization and Control of Neural Function Chapter 35 - Somatosensory Function, Pain, and Headache Chapter 36 - Disorders of Neuromuscular Function Chapter 37 - Disorders of Brain Function Chapter 38 - Disorders of Special Sensory Function Chapter 39 - Disorders of the Male Genitourinary System Chapter 40 - Disorders of the Female Genitourinary System Chapter 41 - Sexually Transmitted Infections Chapter 42 - Structure and Function of the Skeletal System Chapter 43 - Disorders of the Skeletal System Chapter 44 - Disorders of the Skeletal System Chapter 45 - Structure and Function of the Integumentum Chapter 46 - Disorders of Skin Integrity and Function 1
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https://studentmagic.indiemade.com/ Chapter 01 - Cell Structure and Function
1.
The nucleus
, which is essential for function and survival of the cell.
A)
is the site of protein synthesis
B)
contains the genetic code
C)
transforms cellular energy
D)
initiates aerobic metabolism
2.
Although energy is not made in mitochondria, they are known as the power plants of the cell because they:
A)
contain RNA for protein synthesis.
B)
utilize glycolysis for oxidative energy.
C)
extract energy from organic compounds.
D)
store calcium bonds for muscle contractions.
3.
Although the basic structure of the cell plasma membrane is formed by a lipid bilayer, most of the specific membrane functions are carried out by:
A)
bound and transmembrane proteins.
B)
complex, long carbohydrate chains.
C)
surface antigens and hormone receptors.
D)
a gating system of selective ion channels.
4.
To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that:
A)
displace surface receptor proteins.
B)
accumulate within cell gap junctions.
C)
bind to contractile microfilaments.
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release secretions into extracellular fluid. Aerobic metabolism, also known as oxidative metabolism, provides energy by:
A)
removing the phosphate bonds from ATP.
B)
combining hydrogen and oxygen to form water.
C)
activating pyruvate stored in the cytoplasm.
D)
breaking down glucose to form lactic acid.
6.
Exocytosis, the reverse of endocytosis, is important in
into the extracellular fluid.
A)
Engulfing and ingesting fluid and proteins for transport
B)
Killing, degrading, and dissolving harmful microorganisms
C)
Removing cellular debris and releasing synthesized substances
D)
Destruction of particles by lysosomal enzymes for secretion
7.
The process responsible for generating and conducting membrane potentials is:
A)
diffusion of current-carrying ions.
B)
millivoltage of electrical potential.
C)
polarization of charged particles.
D)
ion channel neurotransmission.
8.
Epithelial tissues are classified according to the shape of the cells and the number of layers. Which of the following is a correctly matched description and type of epithelial tissue?
A)
Simple epithelium: cells in contact with intercellular matrix; some do not extend to surface
B)
Stratified epithelium: single layer of cells; all cells rest on basement membrane
C)
Glandular epithelium: arise from surface epithelia and underlying connective tissue
D)
Pseudostratified epithelium: multiple layers of cells; deepest layer rests on basement membrane
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Connective tissue contains fibroblasts that are responsible for:
A)
providing a fibrous framework for capillaries.
B)
synthesis of collagen, elastin, and reticular fibers.
C)
forming tendons and the fascia that covers muscles.
D)
filling spaces between tissues to keep organs in place.
10.
Although all muscle tissue cells have some similarities, smooth muscle (also known as involuntary muscle) differs by:
A)
having dense bodies attached to actin filaments.
B)
containing sarcomeres between Z lines and M bands.
C)
having rapid contractions and abundant cross-striations.
D)
contracting in response to increased intracellular calcium.
11.
Which of the following aspects of the function of the nucleus is performed by ribosomal RNA (rRNA)?
A)
Copying and carrying DNA instructions for protein synthesis
B)
Carrying amino acids to the site of protein synthesis
C)
Providing the site where protein synthesis occurs
D)
Regulating and controlling protein synthesis
12.
Breakdown and removal of foreign substances and worn-out cell parts are performed by which of the following organelles?
A)
Lysosomes
B)
Golgi apparatus
C)
Ribosomes
D)
Endoplasmic reticulum (ER)
13.
Impairment in the function of peroxisomes would result in:
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inadequate sites for protein synthesis.
B)
an inability to transport cellular products across the cell membrane.
C)
insufficient energy production within a cell.
D)
accumulation of free radicals in the cytoplasm.
14.
After several months of trying to conceive, a couple is undergoing fertility testing. Semen analysis indicates that the man’s sperm have decreased motility, a finding that is thought to underlie the couple’s inability to become pregnant. Which of the following cellular components may be defective within the man’s sperm?
A)
Ribosomes
B)
Microtubules
C)
Mitochondria
D)
Microfilaments
15.
Which of the following statements is true of glycolysis?
A)
Glycolysis requires oxygen.
B)
Glycolysis occurs in cells without mitochondria.
C)
Glycolysis provides the majority of the body’s energy needs.
D)
Glycolysis produces energy, water, and carbon dioxide.
16.
Which of the following membrane transport mechanisms requires the greatest amount of energy?
A)
Facilitated diffusion
B)
Passive transport
C)
Vesicular transport
D)
Simple diffusion
17.
A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia because he lacks sufficient insulin to increase the availability of glucose transporters in his cell membranes. Consequently, his cells lack intracellular glucose and it accumulates in his blood. Which of the
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Facilitated diffusion
B)
Simple diffusion
C)
Secondary active transport
D)
Endocytosis
18.
Which of the following statements is true of skeletal muscle cells?
A)
Skeletal muscle cells each have an apical, lateral, and basal surface.
B)
They are closely apposed and are joined by cell-to-cell adhesion molecules.
C)
Their basal surface is attached to a basement membrane.
D)
Skeletal muscle is multinucleated, lacking true cell boundaries.
19.
Which of the following body tissues exhibits the highest rate of turnover and renewal?
A)
The squamous epithelial cells of the skin
B)
The connective tissue supporting blood vessels
C)
The skeletal muscle that facilitates movement
D)
The nervous tissue that constitutes the central nervous system
20.
A patient with a pathophysiologic condition that affects the desmosomes is most likely to exhibit:
A)
impaired contraction of skeletal and smooth muscle.
B)
weakness of the collagen and elastin fibers in the extracellular space.
C)
impaired communication between neurons and effector organs.
D)
separation at the junctions between epithelial cells.
Answer Key 1.
B
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2.
C
3.
A
4.
D
5.
B
6.
C
7.
A
8.
C
9.
B
10.
A
11.
C
12.
A
13.
D
14.
B
15.
B
16.
C
17.
A
18.
D
19.
A
20.
D
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https://studentmagic.indiemade.com/ Chapter 02 - Cellular Responses to Stress, Injury, and Aging
1.
Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of:
A)
release of stored calcium from the mitochondria.
B)
improved intracellular volume regulation.
C)
decreased influx across the cell membrane.
D)
attraction of calcium to fatty infiltrates.
2.
The patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to of the remaining liver cells.
A)
metaplasia
B)
organ atrophy
C)
compensatory hyperplasia
D)
physiologic hypertrophy
3.
A person eating peanuts starts choking and collapses. His airway obstruction is partially cleared, but he remains hypoxic until he reaches the hospital. The prolonged cell hypoxia caused a cerebral infarction and resulting in the brain.
A)
caspase activation
B)
coagulation necrosis
C)
rapid phagocytosis
D)
protein p53 deficiency
4.
Bacteria and viruses cause cell damage by caused by other injurious agents.
, which is unique from the intracellular damage
A)
disrupting the sodium/potassium ATPase pump
B)
interrupting oxidative metabolism processes
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replicating and producing continued injury
D)
decreasing protein synthesis and function
5.
The patient has a prolonged interruption in arterial blood flow to his left kidney, causing hypoxic cell injury and the release of free radicals. Free radicals damage cells by:
A)
destroying phospholipids in the cell membrane.
B)
altering the immune response of the cell.
C)
disrupting calcium storage in the cell.
D)
inactivation of enzymes and mitochondria.
6.
Injured cells have impaired flow of substances through the cell membrane as a result of:
A)
increased fat load.
B)
altered permeability.
C)
altered glucose utilization.
D)
increased surface receptors.
7.
Reversible adaptive intracellular responses are initiated by:
A)
stimulus overload.
B)
genetic mutations.
C)
chemical messengers.
D)
mitochondrial DNA.
8.
Injured cells become very swollen as a result of:
A)
increased cell protein synthesis.
B)
altered cell volume regulation.
C)
passive entry of potassium into the cell.
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bleb formation in the plasma membrane. A diabetic patient has impaired sensation, circulation, and oxygenation of his feet. He steps on a piece of glass, the wound does not heal, and the area tissue becomes necrotic. The necrotic cell death is characterized by:
A)
rapid apoptosis.
B)
cellular rupture.
C)
shrinkage and collapse.
D)
chronic inflammation.
10.
A 99-year-old woman has experienced the decline of cell function associated with age. A group of theories of cellular aging focus on programmed:
A)
changes with genetic influences.
B)
elimination of cell receptor sites.
C)
insufficient telomerase enzyme.
D)
DNA mutation or faulty repair.
11.
An 89-year-old female patient has experienced significant decreases in her mobility and stamina during a 3-week hospital stay for the treatment of a femoral head fracture. Which of the following phenomena most likely accounts for the patient’s decrease in muscle function that underlies her reduced mobility?
A)
Impaired muscle cell metabolism resulting from metaplasia
B)
Dysplasia as a consequence of inflammation during bone remodeling
C)
Disuse atrophy of muscle cells during a prolonged period of immobility
D)
Ischemic atrophy resulting from vascular changes while on bedrest
12.
A 20-year-old college student has presented to her campus medical clinic for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the smear will examine cell samples for evidence of:
A)
changes in cell shape, size, and organization.
B)
the presence of unexpected cell types.
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ischemic changes in cell samples.
D)
abnormally high numbers of cells in a specified field.
13.
Which of the following pathophysiologic processes is most likely to result in metastatic calcification?
A)
Benign prostatic hyperplasia
B)
Liver cirrhosis
C)
Impaired glycogen metabolism
D)
Hyperparathyroidism
14.
Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician is aware of the need to minimize her exposure to ionizing radiation. What is the primary rationale for the technician’s precautions?
A)
Radiation stimulates pathologic cell hypertrophy and hyperplasia.
B)
Radiation results in the accumulation of endogenous waste products in the cytoplasm.
C)
Radiation interferes with DNA synthesis and mitosis.
D)
Radiation decreases the action potential of rapidly dividing cells.
15.
The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?
A)
White blood cell levels with differential
B)
Red blood cell levels and morphology
C)
Urea and creatinine levels
D)
Liver function panel
16.
A)
A 70-year-old male patient has been admitted to a hospital for the treatment of a recent hemorrhagic stroke that has left him with numerous motor and sensory deficits. These deficits are most likely the result of which of the following mechanisms of cell injury? Free radical injury
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Hypoxia and ATP depletion
C)
Interference with DNA synthesis
D)
Impaired calcium homeostasis
17.
Which of the following processes associated with cellular injury is most likely to be reversible?
A)
Cell damage resulting from accumulation of fat in the cytoplasm
B)
Cellular changes as a result of ionizing radiation
C)
Cell damage from accumulation of free radicals
D)
Apoptosis
18.
The extrinsic pathway of apoptosis can be initiated by:
A)
damage to cellular DNA.
B)
decreased ATP levels.
C)
activation of the p53 protein.
D)
activation of death receptors on the cell surface.
19.
A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis?
A)
Inappropriate activation of apoptosis
B)
Bacterial invasion
C)
Impaired arterial blood supply
D)
Metaplastic cellular changes
20.
Which of the following facts underlies the concept of replicative senescence?
A)
Genes controlling longevity are present or absent in varying quantities among different individuals.
B)
Telomeres become progressively shorter in successive generations of a cell.
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The damaging influence of free radicals increases exponentially in later generations of a cell.
D)
Aging produces mutations in DNA and deficits in DNA repair.
Answer Key 1.
A
2.
C
3.
B
4.
C
5.
A
6.
B
7.
C
8.
B
9.
B
10.
A
11.
C
12.
A
13.
D
14.
C
15.
B
16.
B
17.
A
18.
D
19.
C
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20.
B
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https://studentmagic.indiemade.com/ Chapter 03 - Inflammation, the Inflammatory Response, and Fever
1.
The characteristic, localized cardinal signs of acute inflammation include:
A)
fever.
B)
fatigue.
C)
redness.
D)
granuloma.
2.
The vascular, hemodynamic stage of acute inflammation is initiated by momentary vasoconstriction followed by vasodilation that causes localized:
A)
bleeding.
B)
congestion.
C)
pale skin.
D)
coolness.
3.
The cellular stage of acute inflammation is marked by the movement of leukocytes into the area. Which of the following cells arrives early in great numbers?
A)
Basophils
B)
Lymphocytes
C)
Neutrophils
D)
Platelets
4.
The phagocytosis process involves three distinct steps. What is the initial step in the process?
A)
Engulfment
B)
Intracellular killing
C)
Antigen margination
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Recognition and adherence Which of the following mediators of inflammation causes increased capillary permeability and pain?
A)
Serotonin
B)
Histamine
C)
Bradykinin
D)
Nitric oxide
6.
Inflammatory exudates are a combination of several types. Which of the following exudates is composed of enmeshed necrotic cells?
A)
Serous
B)
Fibrinous
C)
Suppurative
D)
Membranous
7.
The acute-phase systemic response usually begins within hours of the onset of inflammation and includes:
A)
fever and lethargy.
B)
decreased C-reactive protein.
C)
positive nitrogen balance.
D)
low erythrocyte sedimentation rate.
8.
In contrast to acute inflammation, chronic inflammation is characterized by which of the following phenomena?
A)
Profuse fibrinous exudation
B)
A shift to the left of granulocytes
C)
Metabolic and respiratory alkalosis
D)
Lymphocytosis and activated macrophages
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9.
Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to the release of endogenous pyrogens that:
A)
stabilize thermal control in the brain.
B)
produce leukocytosis and anorexia.
C)
block viral replication in cells.
D)
inhibit prostaglandin release.
10.
An older adult patient has just sheared the skin on her elbow while attempted to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patient’s inflammation?
A)
Outpouring of exudate into interstitial spaces
B)
Chemotaxis
C)
Accumulation of leukocytes along the epithelium
D)
Phagocytosis of cellular debris
11.
Which of the following individuals most likely has the highest risk of experiencing chronic inflammation?
A)
A patient who has recently been diagnosed with type 2 diabetes
B)
A patient who is a carrier of an antibiotic-resistant organism
C)
A patient who is taking oral antibiotics for an upper respiratory infection
D)
A patient who is morbidly obese and who has a sedentary lifestyle
12.
Which of the following core body temperatures is within normal range?
A)
35.9°C (96.6°F)
B)
38.0°C (100.4°F)
C)
35.5°C (95.9°F)
D)
37.3°C (99.1°F)
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13.
A postsurgical patient who is recovering in the postanesthetic recovery unit states that she is freezing cold. Which of the following measures is likely to be initiated in the patient’s hypothalamus in an effort to reduce heat loss?
A)
Opening of arteriovenous (AV) shunts
B)
Reduced exhalation of warmed air
C)
Contraction of pilomotor muscles
D)
Decreased urine production
14.
An elderly patient is dressed only in a hospital gown and complains of a draft in her room. Consequently, she has requested a warm blanket while she sits in her wheelchair. Which of the following mechanisms of heat loss is most likely the primary cause of her request?
A)
Evaporation and conduction
B)
Radiation and convection
C)
Conduction and convection
D)
Convection and evaporation
15.
Which of the following pathophysiologic processes are capable of inducing the production of pyrogens? Select all that apply.
A)
Acute inflammation
B)
Obesity
C)
Myocardial infarction
D)
Malignancy
E)
Renal failure
16.
Which of the following patients is most likely to be susceptible to developing a neurogenic fever?
A)
A patient who has stage II Alzheimer disease
B)
A patient who has sustained a head injury in a bicycle crash
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A patient who has become delirious after the administration of a benzodiazepine
D)
A patient who has begun taking a selective serotonin-reuptake inhibitor (SSRI) for the treatment of depression
17.
Patients are commonly administered antipyretics when their oral temperature exceeds 37.5°C (99.5°F). Which of the following statements related to the rationale for this action is most accurate?
A)
Temperatures in excess of 37.5°C (99.5°F) can result in seizure activity.
B)
Lower temperatures inhibit the protein synthesis of bacteria.
C)
There is little empirical evidence for this treatment modality.
D)
Most common antipyretics have been shown to have little effect on core temperature.
18.
A patient has sought care because of recent malaise and high fever. Upon assessment, the patient states that his current fever began two days earlier, although he states that for the last 2 weeks he is in a cycle of high fever for a couple of days followed by a day or two of normal temperature. Which of the following fever patterns is this patient experiencing?
A)
Recurrent fever
B)
Remittent fever
C)
Sustained fever
D)
Intermittent fever
19.
A febrile, 3-week-old infant has been brought to the emergency department by his parents and is currently undergoing a diagnostic workup to determine the cause of his fever. Which of the following statements best conveys the rationale for this careful examination?
A)
The immature hypothalamus is unable to perform normal thermoregulation.
B)
Infants are susceptible to serious infections because of their decreased immune function.
C)
Commonly used antipyretics often have no effect on the core temperature of infants.
D)
Fever in neonates is often evidence of a congenital disorder rather than an infection.
20.
An 84-year-old patient’s blood cultures have come back positive, despite the fact that his oral temperature has remained within normal range. Which of the following phenomena underlies the alterations in fever response that occur in the elderly?
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Disturbance in the functioning of the thermoregulatory center
B)
Increased heat loss by evaporation
C)
The presence of comorbidities that are associated with lowered core temperature
D)
Persistent closure of arteriovenous shunts
Answer Key 1.
C
2.
B
3.
C
4.
D
5.
C
6.
D
7.
A
8.
D
9.
B
10.
A
11.
D
12.
D
13.
C
14.
B
15.
A, C, D
16.
B
17.
C
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18.
D
19.
B
20.
A
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https://studentmagic.indiemade.com/ Chapter 04 - Cell Proliferation, Tissue Regeneration, and Repair
1.
Epithelialization, the first component of the proliferative phase of wound healing, is delayed in open wounds until after has formed.
A)
granulation tissue
B)
fibrinous meshwork
C)
capillary circulation
D)
collagenous layers
2.
A mutation has occurred during mitosis of an individual’s bone marrow cell. This event may be the result of the failure of which of the following?
A)
Progenitor cells
B)
Fibroblasts
C)
Stem cells
D)
Cyclins
3.
A patient has experienced a myocardial infarction with accompanying necrosis of cardiac muscle, a permanent tissue. What are the ramifications of the fact that cardiac muscle is a permanent tissue?
A)
The cardiac muscle cells will remain perpetually in the G1 stage of mitosis.
B)
Regeneration of the patient’s cardiac muscle will be exceptionally slow.
C)
The necrotic cells will be replaced with muscle cells that have limited metabolism.
D)
The cells will not proliferate and will be replaced with scar tissue.
4.
A couple have chosen to pay for the harvesting and storage of umbilical cord blood after the delivery of their child to secure a future source of embryonic stem cells. What is the most likely rationale for the couple’s decision?
A)
The stem cells may be able to produce a wide range of body cells.
B)
The embryonic stem cells allow stable and permanent tissues to enter mitosis.
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The stem cells can change the proliferative capacity of other cells.
D)
The embryonic stem cells remove cyclin-dependent kinase inhibitors from the body.
5.
The basement membrane surrounding a patient’s foot wound remains intact, a fact that bodes well for the wound-healing process. Which of the following components constitute this form of the extracellular matrix? Select all that apply.
A)
Prostaglandins
B)
Fibrous structural proteins
C)
Lymphocytes
D)
Water-hydrated gels
E)
Glycoproteins
6.
A nursing student is cleaning and changing the dressing on a patient’s sacral ulcer. The student has vigorously cleansed the wound bed to remove all traces of the beefy, red tissue that existed in the wound bed. The student has most likely removed:
A)
Necrotic tissue
B)
Granulation tissue
C)
Stem cells
D)
The extracellular matrix
7.
A 12-year-old boy’s severe wound that he received from a dog bite has begun to heal and currently shows no signs of infection. Which of the following processes occurred first during this process of repair by connective tissue deposition?
A)
Reorganization of fibrous tissue
B)
Angiogenesis
C)
Emigration of fibroblasts to the wound site
D)
Deposition of the extracellular matrix
8.
Which of the following wounds is most likely to heal by secondary intention?
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A finger laceration that a cook received while cutting up onions
B)
A boy’s road rash that he got by falling off his bicycle
C)
A needlestick injury that a nurse received when injecting a patient’s medication
D)
The incision from a teenager’s open appendectomy
9.
A patient underwent an open cholecystectomy 4 days ago and her incision is now in the proliferative phase of healing. What is the dominant cellular process that characterizes this phase of the patient’s healing?
A)
Hemostasis and vasoconstriction
B)
Keloid formation
C)
Collagen secretion by fibroblasts
D)
Phagocytosis by neutrophils
10.
Which of the following surgical patients is most likely to experience enhanced wound healing as a result of his or her diet?
A)
A patient who eats a high-calorie diet and large amounts of red meat
B)
A patient who is a vegetarian and who eats organic foods whenever possible
C)
A patient who practices carefully calorie control and who avoids animal fats
D)
A patient who is receiving total parenteral nutrition due to recurrent nausea
11.
Which of the following patients is most likely to experience impaired wound healing?
A)
A patient with a diagnosis of type 1 diabetes and a history of poor blood sugar control
B)
A child whose severe cleft lip and palate have required a series of surgeries over several months
C)
A patient who takes nebulized bronchodilators several times daily to treat chronic obstructive pulmonary disease
D)
A patient with persistent hypertension who takes a b-adrenergic blocker and a potassium-wasting diuretic daily
Answer Key
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A
2.
D
3.
D
4.
A
5.
B, D, E
6.
B
7.
B
8.
B
9.
C
10.
A
11.
A
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https://studentmagic.indiemade.com/ Chapter 05 - Genetic Control of Cell Function and Inheritance
1.
Triplet codes of three bases are the genetic codes used in transmitting genetic information necessary for:
A)
chromatin formation.
B)
protein synthesis.
C)
enzyme activation.
D)
nucleotide bonding.
2.
Unlike messenger RNA (mRNA) and transfer RNA (tRNA), ribosomal RNA (rRNA):
A)
is produced in the nucleolus.
B)
delivers activated amino acids.
C)
is formed by transcription.
D)
coordinates RNA translation.
3.
Splicing of mRNA during processing permits a cell to:
A)
form different proteins.
B)
increase DNA content.
C)
stop copying DNA onto RNA.
D)
add nucleic acid end pieces.
4.
When an infant is born with gene mutations in his/her cells, the errors may be a result of all of the following except of base pairs.
A)
deletion
B)
substitution
C)
differentiation
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rearrangement Identifying the genetic sex of a child is based on finding intracellular Barr bodies that consist of:
A)
inactive chromatin material.
B)
male-specific chromosomes.
C)
homologous chromosomes.
D)
excess autosomal material.
6.
Multifactorial inheritance is similar to polygenic inheritance because both involve:
A)
environmental effects on alleles.
B)
multiple alleles at different loci.
C)
predictable somatic allele effects.
D)
homozygous pairing of two alleles.
7.
Crossing over of chromatid segments during meiosis division 1 results in:
A)
spontaneous gene mutations.
B)
initial DNA synthesis.
C)
bivalent X and Y genes.
D)
new gene combinations.
8.
During the transcription process, RNA:
A)
polymerase attaches to DNA.
B)
exon sequences are reversed.
C)
delivers activated amino acids.
D)
reverses redundant base pairs.
9.
The process of gene expression is increased by:
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A)
mutation of normal suppressor genes.
B)
induction by an external influence.
C)
repression of internal penetrance.
D)
activation of growth control genes.
10.
Gene therapy, insertion of genes into the genome of multicellular organisms, is accomplished by:
A)
restriction enzymes.
B)
transferring genes.
C)
DNA fragment separation.
D)
cross-over gene exchange.
11.
Which of the following statements is true of genetic mutations?
A)
Errors in DNA duplication are normally irreparable.
B)
Mutations that occur in somatic cells are inheritable.
C)
Mutations may result from extrinsic factors or from spontaneous error.
D)
Errors in DNA replication are most often fatal.
12.
Individual differences in appearance, behavior, and disease susceptibility are a result of:
A)
karyotyping.
B)
mutations.
C)
DNA repair.
D)
a haplotype.
13. A)
Which of the following statements is true of messenger RNA (mRNA)? mRNA is produced in the nucleolus.
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mRNA provides the template for protein synthesis.
C)
Each mRNA molecule has two recognition sites.
D)
mRNA delivers the activated form of an amino acid to the protein being synthesized.
14.
Prenatal genetic testing that counts the number of Barr bodies in a chromosome is able to determine:
A)
the genetic sex of a child.
B)
susceptibility to hemophilia B.
C)
the presence of fragile X syndrome.
D)
fetal viability.
15.
The gene responsible for a particular congenital cardiac anomaly is said to have complete penetrance. What are the clinical implications of this fact?
A)
The anomaly is a result of polygenetic inheritance.
B)
The heart defect does not result from any other gene.
C)
Multiple alleles contribute to the defect.
D)
All the individuals who possess the gene will exhibit the anomaly.
16.
A dominant genetic trait:
A)
is expressed only in a heterozygous pairing.
B)
is expressed in either a homozygous or heterozygous pairing.
C)
is expressed only in a homozygous pairing.
D)
is expressed in some carriers.
17.
Which of the following methods of genetic mapping focuses on the measurement of enzyme activity?
A)
Hybridization studies
B)
Haplotype mapping
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Linkage studies
D)
Gene dosage studies
18.
Which of the following facts underlies the application of RNA interference in the treatment of disease?
A)
Restriction enzymes are able to cleave genetic molecules at predictable sites.
B)
It is possible to produce proteins that have therapeutic properties.
C)
Faulty gene activity that produces unwanted proteins can sometimes be stopped.
D)
Individual differences are attributable to a very small percentage of the genes in the human body.
19.
Although the majority of cellular DNA exists in the cell nucleus, part of the cell DNA is located in the:
A)
mitochondria.
B)
Golgi apparatus.
C)
smooth endoplasmic reticulum.
D)
microfilaments.
20.
Which of the following is an application of recombinant DNA technology?
A)
Production of human insulin
B)
DNA fingerprinting
C)
Gene dosage studies
D)
Somatic cell hybridization
Answer Key 1.
B
2.
A
3.
A
4.
C
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5.
A
6.
B
7.
D
8.
A
9.
B
10.
B
11.
C
12.
D
13.
B
14.
A
15.
D
16.
B
17.
D
18.
C
19.
A
20.
A
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https://studentmagic.indiemade.com/ Chapter 06 - Genetic and Congenital Disorders
1.
Genetic disorders that involve a single gene trait are characterized by:
A)
multifactorial gene mutations.
B)
chromosome rearrangements.
C)
Mendelian patterns of transmission.
D)
abnormal numbers of chromosomes.
2.
In addition to having a 50% chance of inheriting an autosomal dominant disorder from an affected parent, such a disorder is characterized by:
A)
aneuploidy of genes in all cells.
B)
deficiencies in enzyme synthesis.
C)
affected X transmission to daughters.
D)
varied gene penetration and expression.
3.
Autosomal recessive disorders are characterized by:
A)
age of onset later in life.
B)
abnormal protein structure.
C)
inborn errors of metabolism.
D)
one in two risk of a carrier child.
4.
When a male child inherits an X-linked disorder from his heterozygous carrier mother,
A)
his sons will be carriers.
B)
his father has the disorder.
C)
some of his sisters will be carriers.
D)
his daughters will have the disorder.
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5.
Multifactorial inheritance disorders, such as cleft palate, are often caused by development.
A)
multiple gene mutations
B)
dominant gene expression
C)
X-linked crossover problem
D)
polyploidy of chromosomes
6.
The newborn has the distinctive physical features of trisomy 21, Down syndrome, which includes:
A)
upward slanting of eyes.
B)
large, protruding ears.
C)
thin lips and small tongue.
D)
long fingers with extra creases.
7.
Aneuploidy of the X chromosome can result in a monosomy or polysomy disorder. The manifestations of monosomy X, Turner syndrome, differ from polysomy X disorders in numerous ways that include:
A)
short-stature female individual..
B)
mental retardation.
C)
enlarged breasts.
D)
early onset puberty.
8.
during fetal
A teratogenic environmental agent can cause birth defects when:
A)
inherited as a recessive trait.
B)
intense exposure occurs at birth.
C)
disjunction occurs during meiosis.
D)
retained during early pregnancy.
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Fetal alcohol syndrome (FAS) is unlike other teratogens in that the harmful effects on the fetus:
A)
directly result in liver damage.
B)
extend throughout the pregnancy.
C)
is most noticeable in adulthood.
D)
cause death in early childhood.
10.
Prenatal diagnosis methods include the use of ultrasonography for identifying
A)
cytogenic
B)
skeletal
C)
chromosomal
D)
a-fetoprotein
11.
A woman who is a carrier for which of the following diseases possesses the greatest likelihood of passing the disease to her future children when heterozygous pairing exists?
A)
Phenylketonuria (PKU)
B)
Tay-Sachs disease
C)
Neurofibromatosis
D)
Cystic fibrosis
12.
Which of the following statements is true of autosomal recessive disorders?
A)
Onset is typically late in childhood or early in adulthood.
B)
Symptomatology is less uniform than with autosomal dominant disorders.
C)
Mitochondrial DNA is normally the site of genetic alteration.
D)
Effects are typically the result of alterations in enzyme function.
13.
abnormalities.
The parents of a newborn infant are relieved that their baby was born healthy, with the exception of a cleft lip that will be surgically corrected in 10 or 12 weeks. Which of the nurse’s following statements to the parents best conveys the probable cause of the infant’s cleft lip?
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A)
Though you are both healthy, you likely both carry the gene for a cleft lip.
B)
Provided one of you had the gene for a cleft lip, your baby likely faced a 50/50 chance of having one.
C)
Your child’s cleft lip likely results from the interplay between environment and genes.
D)
A cleft lip can sometimes result from taking prescription drugs, even when they’re taken as ordered.
14.
Which of the following practitioners is most likely to be of assistance in the early care of an infant with a cleft lip?
A)
Lactation consultant
B)
Respiratory therapist
C)
Occupational therapist
D)
Social worker
15.
A 41-year-old woman has made the recent decision to start a family, and is eager to undergo testing to mitigate the possibility of having a child with Down syndrome. Which of the following tests is most likely to provide the data the woman seeks?
A)
Genetic testing of the woman
B)
Genetic testing of the woman and the father
C)
Prenatal blood tests
D)
Ultrasonography
16.
Genetic testing has revealed that a male infant has been born with an extra X chromosome. What are the most likely implications of this finding?
A)
The child is unlikely to survive infancy
B)
The child is likely to have no manifestations of this chromosomal abnormality
C)
The child will have significant neurological and cognitive defects
D)
The child will be unable to reproduce
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17.
Which of the following variables determine the extent of teratogenic drug effects? Select all that apply.
A)
Maternal health history
B)
Molecular weight of the drug
C)
Stage of pregnancy when the drug was taken
D)
Duration of drug exposure
E)
Fetal blood type
18.
A woman who has just learned that she is pregnant for the first time has sought advice from her healthcare provider about the safe use of alcohol during pregnancy. What advice should the clinician provide to the woman?
A)
It’s likely best to eliminate alcohol from your diet while you’re pregnant.
B)
Moderation in alcohol use is critical while you are pregnant.
C)
You should limit yourself to a maximum of one drink daily while you’re pregnant.
D)
You should drink no alcohol until you are in your second trimester.
19.
Which of the following health problems may be identified by a TORCH screening test?
A)
Rubella and herpes
B)
Tenovaginitis and human papillomavirus
C)
Rhinovirus and Ormond disease
D)
Chlamydia and rickets
20.
Ultrasonography is most likely to detect which of the following fetal abnormalities?
A)
Neural tube defects
B)
Skeletal abnormalities
C)
Chromosomal defects
D)
Single-gene disorders
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Answer Key 1.
C
2.
D
3.
C
4.
C
5.
A
6.
A
7.
A
8.
D
9.
B
10.
B
11.
C
12.
D
13.
C
14.
A
15.
C
16.
B
17.
B, C, D
18.
A
19.
A
20.
B
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https://studentmagic.indiemade.com/ Chapter 07 - Neoplasia
1.
Unlike the tissue growth that occurs with hypertrophy and hyperplasia, the growth of a malignancy is:
A)
adaptive.
B)
specialized.
C)
predictable.
D)
autonomous.
2.
In contrast to malignancies, benign tumors are characterized by:
A)
a fibrous capsule.
B)
distant infiltration.
C)
rapid replication.
D)
undifferentiated cells.
3.
Because of their rapid growth, malignant tumors affect area tissues by:
A)
increasing tissue blood flow.
B)
providing essential nutrients.
C)
liberating enzymes and toxins.
D)
forming fibrous membranes.
4.
The metastatic spread of tumor cells is facilitated by distant tissues.
A)
cell cohesiveness
B)
enzyme secretion
C)
contact inhibition
D)
cell-to-cell signaling
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5.
The angiogenesis process, which allows tumors to develop new blood vessels, is triggered and regulated by tumor-secreted:
A)
procoagulants.
B)
growth factors.
C)
attachment factors.
D)
proteolytic enzymes.
6.
Cancerous transformation of a cell requires the activation of:
A)
cell cycle apoptosis.
B)
multiple mutations.
C)
a single gene mutation.
D)
tumor suppressor genes.
7.
Although clinical manifestations vary with the type of cancer and organs involved, abnormal tumor growth causes general manifestations that include:
A)
copious lymph flow.
B)
sleep disturbances.
C)
involuntary weight gain.
D)
visceral organ expansion.
8.
Paraneoplastic syndromes are manifestations of cancer that often result from:
A)
radiation and chemotherapy.
B)
compression of area vessels.
C)
tumor-related tissue necrosis.
D)
inappropriate hormone release.
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https://studentmagic.indiemade.com/ 9.
Although both grading and staging are methods for classifying cancer and selecting a treatment plan, staging is used to determine the:
A)
number of mitoses.
B)
tissue characteristics.
C)
level of differentiation.
D)
extent of disease spread.
10.
Early diagnosis of childhood cancers is often difficult because the signs and symptoms are:
A)
already present at birth.
B)
absent until the late stage.
C)
similar to those of other childhood diseases.
D)
seen as developmental delays.
11.
A lung biopsy and magnetic resonance imaging have confirmed the presence of a benign lung tumor in a patient. Which of the following characteristics are associated with this patient’s neoplasm?
A)
The tumor will grow by expansion and is likely encapsulated.
B)
The cells that constitute the tumor are undifferentiated, with atypical structure.
C)
If left untreated, the patient’s tumor is likely to metastasize.
D)
The tumor is likely to infiltrate the lung tissue that presently surrounds it.
12.
Which of the following processes characterizes an epigenetic contribution to oncogenesis?
A)
A DNA repair mechanism is disrupted.
B)
A tumor suppressor gene is present, but it is not expressed.
C)
Cells lose their normal contact inhibition.
D)
Regulation of apoptosis in impaired, resulting in accumulation of cancer cells.
13.
A farmer’s long-term exposure to pesticides has made the cells in his alveoli and bronchial tree susceptible to malignancy. Which of the following processes has taken place in the farmer’s lungs?
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A)
Promotion
B)
Progression
C)
Initiation
D)
Differentiation
14.
Genetic screening may be indicated for individuals who have a family history of which of the following neoplasms?
A)
Liver cancer
B)
Multiple myeloma
C)
Leukemia
D)
Breast cancer
15.
A public health nurse has cited a reduction in cancer risk among the many benefits of maintaining a healthy body-mass index. Which of the following facts underlies the relationship between obesity and cancer?
A)
Obesity can cause inflammation and hormonal changes that are associated with cancer.
B)
Adipose tissue is more susceptible to malignancy than other types of connective tissue.
C)
Increased cardiac workload and tissue hypoxia can interfere with normal cell differentiation.
D)
Increased numbers of body cells increase the statistical chances of neoplastic cell changes.
16.
Which of the following dietary guidelines should a nurse provide to a group of older adults to possibly decrease their risks of developing colon cancer?
A)
As much as possible, try to eat organic foods.
B)
Regular vitamin supplements and a low-carbohydrate diet are beneficial.
C)
Try to minimize fat and maximize fiber when you’re planning your meals.
D)
Eat enough fiber in your diet that you have bowel movement at least once daily.
17.
A male patient with a diagnosis of liver cancer has been recently admitted to a palliative care unit
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https://studentmagic.indiemade.com/ following his recent development of bone metastases. Despite his family’s encouragement, the patient has experienced precipitous weight loss in recent weeks. Which of the following factors may underlie the patient’s loss of fat and muscle mass? A)
The action of cytokines and consequent inflammation
B)
Loss of appetite due to fatigue and pain
C)
Changes in peptide hormone levels
D)
Production of onconeural antigens by cancerous cells
18.
A 51-year-old patient has been diagnosed with stage IV breast cancer with lung metastases. Which of the following treatment options is most likely to treat both her primary and distant cancer sites?
A)
Radiation therapy
B)
Chemotherapy
C)
Surgery
D)
Hormone therapy
19.
A patient’s oncologist has presented the possibility of implementing biotherapy in the treatment of the patient’s brain tumor. Which of the following mechanisms of action provide the therapeutic effects of biotherapy? Select all that apply.
A)
Stimulating the immune response to tumor cells
B)
Inhibiting tumor protein synthesis
C)
Reversing angiogenesis
D)
Altering the hormonal environment of tumor cells
E)
Causing breaks in the DNA of tumor cells
20.
A 5-year-old girl’s diagnosis of bone cancer required an aggressive treatment regimen. Which of the following considerations forms the most significant threat to her future health?
A)
Retention of chemotherapeutic drugs in the healthy bone matrix
B)
Unwanted effects of chemotherapy and radiation therapy
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Resistance to chemotherapy and radiation if required later in life
D)
Risk for recurrence of the primary neoplasm after puberty
Answer Key 1.
D
2.
A
3.
C
4.
B
5.
B
6.
B
7.
B
8.
D
9.
D
10.
C
11.
A
12.
B
13.
C
14.
D
15.
A
16.
C
17.
A
18.
B
19.
A, B
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20.
B
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https://studentmagic.indiemade.com/ Chapter 08 - Disorders of Fluid, Electrolyte, and Acid-Base Balance
1.
An injured patient develops interstitial edema as a result of decreased:
A)
vascular volume.
B)
hydrostatic pressure.
C)
capillary permeability.
D)
colloidal osmotic pressure.
2.
The most reliable method for measuring body water or fluid volume increase is by assessing:
A)
tissue turgor.
B)
intake and output.
C)
body weight change.
D)
serum sodium levels.
3.
The syndrome of inappropriate ADH is characterized by:
A)
increased osmolality.
B)
excessive water thirst.
C)
copious dilute urination.
D)
dilutional hyponatremia.
4.
In isotonic fluid volume deficit, changes in total body water are accompanied by:
A)
intravascular hypotonicity.
B)
increased intravascular water.
C)
increases in intracellular sodium.
D)
proportionate losses of sodium.
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5.
Hyponatremia can be caused by
A)
hypovolemia; dehydration
B)
third spacing; hypertonicity
C)
water retention; hypotonicity
D)
aldosterone excess; low ADH
6.
One of the major causes of hyperkalemia is
A)
renal dysfunction
B)
aldosterone excess
C)
metabolic alkalosis
D)
plasma albumin deficit
7.
and manifested by
increasing serum magnesium.
B)
increasing phosphate excretion.
C)
blocking bone release of calcium.
D)
blocking action of intestinal vitamin D. Magnesium is important for the overall function of the body because of its direct role in:
A)
cell membrane permeability.
B)
somatic cell growth control.
C)
sodium and tonicity regulation.
D)
DNA replication and transcription.
9.
, which alters potassium elimination.
Hypoparathyroidism causes hypocalcemia by:
A)
8.
.
A patient has acidosis that is suspected to be respiratory in etiology. Which of the following is the major cause of acute primary respiratory acidosis?
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Decreased CO2 retention
B)
Increased metabolic acids
C)
Renal bicarbonate retention
D)
Impaired alveolar ventilation
10.
As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased:
A)
intracellular albumin.
B)
hydrogen/potassium binding.
C)
sodium/phosphate anion absorption.
D)
bicarbonate/carbonic acid regulation.
11.
A patient with a diagnosis of liver cirrhosis secondary to alcohol use has a distended abdomen as a result of fluid accumulation in his peritoneal cavity (ascites). Which of the following pathophysiologic processes contributes to this third spacing?
A)
Abnormal increase in transcellular fluid volume
B)
Increased capillary colloidal osmotic pressure
C)
Polydipsia
D)
Impaired hormonal control of fluid volume
12.
A patient has been receiving intravenous normal saline at a rate of 125 mL per hour since her surgery 2 days earlier. As a result of her consequent increase in vascular volume, she has become edematous. Which of the following phenomena accounts for this patient’s edema?
A)
Obstruction of lymph flow
B)
Increased capillary permeability
C)
Decreased capillary colloidal osmotic pressure
D)
Increased capillary filtration pressure
13.
A patient with a diagnosis of schizophrenia has been admitted to the emergency department after
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https://studentmagic.indiemade.com/ ingesting more than 2 gallons of water. Which of the following pathophysiologic processes may result from the sudden water gain? A)
Hypernatremia
B)
Water movement from the extracellular to intracellular compartment
C)
Syndrome of inappropriate secretion of ADH (SIADH)
D)
Isotonic fluid excess in the extracellular fluid compartment
14.
Which of the following patients would likely be at highest risk of developing hyperkalemia?
A)
A patient who has been admitted for the treatment of acute renal failure following a drug overdose
B)
A patient who has experienced an ischemic stroke with multiple sensory and motor losses
C)
An elderly patient who is experiencing vomiting and diarrhea as a result of influenza
D)
A patient whose thyroidectomy resulted in the loss of his parathyroid gland
15.
A female patient with a history of chronic renal failure has developed hypocalcemia. Which of the following assessment findings would provide potential confirmation of this diagnosis?
A)
The patient experiences shortness of breath on exertion with decreased oxygen saturation levels.
B)
The patient is difficult to rouse and is disoriented to time and place.
C)
The patient’s heart rate is 120 beats per minute and she is diaphoretic (sweaty).
D)
The patient has muscle spasms and complains of numbness around her mouth.
16.
Which of the following assessments should be prioritized in the care of a patient who is being treated for hypokalemia?
A)
Detailed fluid balance monitoring
B)
Arterial blood gases
C)
Cardiac monitoring
D)
Monitoring of hemoglobin levels and oxygen saturation
17.
Magnesium is an important component of which of the following processes that are integral to the
48
https://studentmagic.indiemade.com/ maintenance of homeostasis? Select all that apply. A)
Intracellular and extracellular buffering
B)
Cellular energy metabolism
C)
Function of the sodium-potassium pump
D)
Nerve conduction
E)
Cell membrane function
18.
A 77-year-old woman has been brought to the emergency department by her daughter because of a sudden and unprecedented onset of confusion. The patient admits to ingesting large amounts of baking soda since the morning in an effort to treat indigestion. How will the woman’s body attempt to resolve this disruption in acid-base balance?
A)
Hyperventilation
B)
Increasing renal H+ excretion
C)
Increased renal HCO3 reabsorption
D)
Hypoventilation
19.
Arterial blood gases of a patient with a diagnosis of acute renal failure reveal a pH of 7.25 (low), HCO3-of 21 mEq/L (low), decreased PCO2 accompanied by a respiratory rate of 32 (high). What disorder of acid-base balance is the patient most likely experiencing?
A)
Metabolic acidosis
B)
Metabolic alkalosis
C)
Respiratory acidosis
D)
Respiratory alkalosis
20.
A nurse who is providing care for a patient with a diagnosis of diabetes insipidus should prioritize the close monitoring of serum levels of which of the following electrolytes?
A)
Potassium
B)
Sodium
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Magnesium
D)
Calcium
Answer Key 1.
D
2.
C
3.
D
4.
D
5.
C
6.
A
7.
C
8.
D
9.
D
10.
D
11.
A
12.
D
13.
B
14.
A
15.
D
16.
C
17.
B, C, D, E
18.
D
19.
A
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20.
B
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https://studentmagic.indiemade.com/ Chapter 09 - Stress and Adaptation
1.
According to Walter B. Cannon, homeostasis is a stable internal environment achieved through a system of:
A)
interdependent system-wide adaptive responses.
B)
variable internal and external conditioning factors.
C)
coordinated physiologic processes that oppose change.
D)
compatibility between cells and the internal environment.
2.
Allostasis is characterized by:
A)
organ-specific physiologic responses.
B)
interactive physiologic changes in numerous systems.
C)
systems that detect psychologic function.
D)
future expectations as a catalyst for change.
3.
According to Hans Selye, the first stage of the general adaptation syndrome (GAS) is:
A)
alarm.
B)
exhaustion.
C)
resistance.
D)
anticipation.
4.
Although stress exposure initiates integrated responses by multiple systems, the functional changes are first manifested by which system?
A)
Pulmonary
B)
Gastrointestinal
C)
Cardiovascular
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https://studentmagic.indiemade.com/ D) 5.
Neuroendocrine Which manifestation of stress reflects the nonspecific fight-or-flight response?
A)
Decreased pupillary light response
B)
Increased gastrointestinal motility
C)
Decreased short-term memory
D)
Increased cardiopulmonary rates
6.
Stress-induced cortisol hormone secretion is associated with:
A)
increased growth hormone level.
B)
regulation of the stress response.
C)
increased thyroid-stimulating hormone.
D)
depressed adrenal gland function.
7.
Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:
A)
a sense of purpose in life.
B)
circadian rhythm disruption.
C)
age-related renal dysfunction.
D)
excessive weight gain or loss.
8.
Acute stress is characterized by:
A)
a time-limited fight or flight response.
B)
recurrent exposure to a stressor.
C)
negative feedback overactivity.
D)
system impairment and fatigue.
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https://studentmagic.indiemade.com/ 9.
The patient recently returned from a year of military battle duty and has posttraumatic stress disorder (PTSD). This disorder includes an intrusion state that is experienced as:
A)
excessive anxiety and safety concerns.
B)
repeated relived memories as nightmares.
C)
loss of concentration and increased vigilance.
D)
emotional numbing and feelings of depression.
10.
A patient is extremely anxious about his impending surgery. Which of the following measures should the nurse implement to create an atmosphere for effective use of relaxation techniques?
A)
A quiet, dim environment
B)
A soothing, warm foot soak
C)
Gentle muscle stroking
D)
Repetitive questioning
11.
A patient is experiencing significant stress while awaiting the results of her recent lymph node biopsy. Among the hormonal contributors to this response is a release of aldosterone, resulting in which of the following physiologic effects?
A)
Decreased release of insulin
B)
Increased cardiac contractility
C)
Potentiation of epinephrine
D)
Increased sodium absorption
12.
A patient is experiencing stress as a nurse prepares to insert a peripheral intravenous catheter into his forearm. The patient’s locus ceruleus (LC) is consequently producing which of the following hormones?
A)
Norepinephrine (NE)
B)
Corticotropin-releasing factor (CRF)
C)
Antidiuretic hormone (ADH)
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https://studentmagic.indiemade.com/ D) 13.
Adrenocorticotropic hormone (ACTH) A college student has just learned that her latest Pap smear revealed atypical cells, a fact that has resulted in stress and an accompanying release of angiotensin II. How would the effects of this hormone be objectively demonstrated?
A)
Increased respiratory rate
B)
Increased blood pressure
C)
Decreased oxygen saturation
D)
Decreased blood sugar
14.
A nursing student’s current clinical placement has been a source of stress due to high patient acuity combined with interpersonal conflict with some of the unit staff. At the same time, the student has been fighting a cold for more than 2 weeks and has been unable to regain a normal feeling of health. How might these two phenomena be related?
A)
Epinephrine and norepinephrine inhibit the release and action of lymphocytes.
B)
Stress and illness lack a statistical correlation, though they are often thought to coexist.
C)
The effects of stress on the cerebellum initiate a decrease in immunity.
D)
Endocrine-immune interactions may suppress the student’s immune response.
15.
Which of the following factors are known to contribute to an individual’s ability to adapt to stress? Select all that apply.
A)
Ethnicity
B)
Age
C)
Socioeconomic status
D)
Gender
E)
Health status
16.
A student is participating in an extended fast as part of a charitable fundraising effort. Which of the following is an example of the physiologic reserve that will facilitate the student’s adaptation to the stress of this sudden change in diet?
A)
The student has experience in demonstrating perseverance from previous participation in
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The student’s adipose tissue contains large and accessible stores of energy.
C)
The student is young, male, and has no pre-existing medical conditions.
D)
The student is utilizing guided imagery to achieve a sense of mind over matter.
17.
A 70-year-old patient admitted to a hospital for a prostatectomy is surprised to learn that his physician has prescribed insulin on a sliding scale, despite the fact that the patient successfully manages his type 2 diabetes using diet and oral antihyperglycemics when at home. Which of the following facts may underlie the physician’s action?
A)
The stress of illness stimulates the hypothalamus to release corticotropin-releasing factor (CRF).
B)
Stress-induced release of vasopressin increases serum blood glucose.
C)
Stress and illness can increase glycogenolysis and insulin resistance.
D)
Increased levels of epinephrine and norepinephrine cause alterations in glucose metabolism.
18.
A female patient experienced a random assault several months earlier, and her recent vigilance around her own safety is described as obsessive by her friends and family. Which of the following aspects of posttraumatic stress disorder (PTSD) characterizes the patient’s behavior?
A)
Avoidance
B)
Intrusion
C)
Hyperarousal
D)
Flashbacks
19.
An occupational therapist is preparing to begin a relaxation program on the oncology unit of a hospital. Which of the following variables is most likely to determine the success or failure of the program?
A)
Rapport between the therapist and patients
B)
The therapist’s own ability to relax
C)
A quiet and therapeutic environment
D)
Appropriate use of pharmacologic techniques
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A patient’s primary care provider has recommended biofeedback in an effort to address her chronic stress and reduce the potential for complications. What will be the goal of this intervention?
A)
Using exercise to control the patient’s endocrine function
B)
Helping the patient to accommodate continued nervous stimulation
C)
Relieving tension by using tactile stimulation
D)
Teaching the patient to consciously control her own body functioning
Answer Key 1.
C
2.
B
3.
A
4.
D
5.
D
6.
B
7.
A
8.
A
9.
B
10.
A
11.
D
12.
A
13.
B
14.
D
15.
B, D, E
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B
17.
C
18.
C
19.
C
20.
D
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https://studentmagic.indiemade.com/ Chapter 10 - Disorders of Nutritional Status
1.
The adipocytes in adipose tissue not only serve as a storage sites, they also:
A)
produce linoleic fatty acid.
B)
synthesize triglycerides.
C)
increase glucagon release.
D)
degrade fat-soluble vitamins.
2.
Protein contains nitrogen. A negative nitrogen balance represents:
A)
more protein consumed than excreted.
B)
a reduced need for nitrogen as protein.
C)
more nitrogen excreted than consumed.
D)
less use of nitrogen for protein synthesis.
3.
Natural appetite suppression mechanisms, necessary for food intake control, include :
A)
ketoacid deficiency.
B)
cholecystokinin storage.
C)
decreased blood glucose.
D)
leptin receptor stimulation.
4.
Body weight should be used in combination with other measurements to establish if a person is underweight or overweight. Obesity is indicated by:
A)
female body fat of 20% and 30%.
B)
body mass index (BMI) of 30 to 40.
C)
relative body weight of 70% to 100%.
D)
abdominal fat/ hip ratio of 0.8 to 1.0.
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5.
A patient with upper body obesity also has central fat distribution. This body fat configuration places the patient at greater risk for than a patient with lower body obesity.
A)
osteoporosis
B)
renal disease
C)
cardiometabolic disorders
D)
chronic anemia
6.
As the problem of childhood and adolescent obesity increases, an increase in the incidence of is occurring in this obese population.
A)
type 2 diabetes mellitus
B)
attention deficit disorder
C)
juvenile rheumatoid arthritis
D)
antibiotic-resistant bacterial infections
7.
A diet deficient in calories and protein causes marasmus, which is characterized by:
A)
discolored hair.
B)
bradycardia.
C)
enlarged liver.
D)
pitting edema.
8.
Protein-calorie malnutrition with loss of lean tissues and muscle mass results in:
A)
respiratory muscle stimulation.
B)
excessive blood cell production.
C)
diarrhea.
D)
increased cardiac contractility.
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Similarities between girls or women with anorexia nervosa and bulimia nervosa include:
A)
periodontal disease.
B)
low estrogen level.
C)
electrolyte imbalances.
D)
enlarged parotid gland.
10.
Both binge-eating and bulimia nervosa patients consume excessive amounts of foods secretively. A major difference is that binge-eaters:
A)
remain overweight.
B)
eat when not hungry.
C)
are substance abusers.
D)
experience depression.
11.
A large, high-calorie meal has resulted in the intake of far more energy than a person requires. What will the individual’s body do with the excess carbohydrates provided by this meal?
A)
Convert them into glucose and store them in the liver and muscles
B)
Excrete most of the excess polysaccharides through the kidneys
C)
Convert the carbohydrates into amino acids in preparation for long-term storage
D)
Create structural proteins from some of the carbohydrates and store the remainder as triglycerides
12.
Which of the following patients is most likely to be in positive nitrogen balance?
A)
A patient who is receiving treatment for sepsis
B)
A patient whose diagnosis of pneumonia is causing a fever
C)
A woman who has been admitted to the hospital in early labor
D)
A patient who sustained extensive burns in a recent industrial accident
13.
In addition to facilitating bowel movements, a diet that is high in fiber confers which of the following benefits?
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A)
Lowering cholesterol and blood glucose
B)
Removing toxins and metabolic byproducts
C)
Lowering blood pressure and resting heart rate
D)
Increasing intestinal absorption of vitamins and minerals
14.
Which of the following statements best conveys the endocrine function of adipose tissue?
A)
Adipose tissue antagonizes the effects of insulin on cell membranes.
B)
Adipose tissue produces ghrelin, which stimulates both appetite and eating.
C)
Adipose tissue produces and secretes cholecystokinin (CCK), which stimulates the hypothalamic feeding center.
D)
Adipose tissue produces leptin, which mediates body weight.
15.
Chronic inflammation as a result of excess adipose tissue is implicated in the etiology of which of the following health problems?
A)
Osteoporosis
B)
Type 2 diabetes
C)
Rheumatoid arthritis
D)
Systemic lupus erythematosus (SLE)
16.
A public health nurse has noted a significant increase in the number of school-aged children who are obese. Which of the following factors is most significant predictor of childhood obesity?
A)
Low socioeconomic status
B)
Low self-esteem
C)
Having obese parents
D)
Living in a rural or inner-city neighborhood
17.
Which of the following measures should a school nurse prioritize in the treatment and prevention of childhood obesity?
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A)
Group cognitive therapy
B)
Use of selective serotonin-reuptake inhibitors (SSRIs)
C)
Education on exercise and nutrition
D)
High-protein, low-carbohydrate diet
18.
Which of the following characteristics distinguishes kwashiorkor from marasmus?
A)
Impairment of immune function
B)
Lack of dietary fat intake
C)
High intake of carbohydrates
D)
Impaired pigment synthesis
19.
A frail, 87-year-old female patient has been admitted to a hospital after a fall and has been diagnosed with failure to thrive. Which of the following laboratory values would suggest that the patient may be experiencing malnutrition?
A)
Low prealbumin
B)
High C-reactive protein
C)
High bilirubin
D)
Low fasting blood sugar
20.
Which of the following assessments should be prioritized in the care of a patient with anorexia nervosa?
A)
Serum electrolyte levels
B)
Chest auscultation
C)
White blood cell count with differential
D)
Blood pressure monitoring
Answer Key
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B
2.
C
3.
D
4.
B
5.
C
6.
A
7.
B
8.
C
9.
C
10.
A
11.
A
12.
C
13.
A
14.
D
15.
B
16.
C
17.
C
18.
C
19.
A
20.
D
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https://studentmagic.indiemade.com/ Chapter 11 - Disorders of White Blood Cells and Lymphoid Tissues
1.
Cytokines that affect hematopoiesis in bone marrow are called colony-stimulating factors (CSFs) based on their ability to:
A)
support lymphocytes.
B)
differentiate red cells.
C)
regulate blood cells.
D)
stimulate lymphocytes.
2.
Leukocytes consist of three categories of cells that have different roles in the inflammatory and immune responses. Which of the following leukocytes is correctly matched with its function?
A)
Lymphocyte; phagocytosis
B)
Eosinophils; allergic reactions
C)
Basophils; engulf antigens
D)
Monocytes; release heparin
3.
The patient has an abnormally low neutrophil count. Neutropenia is most commonly caused by:
A)
Epstein-Barr virus.
B)
Kostmann syndrome.
C)
drug reactions.
D)
skin infections.
4.
The 16-year-old boy has enlarged lymph nodes and a sore throat. His girlfriend was recently diagnosed with infectious mononucleosis, which is caused by and commonly transmitted in .
A)
heterophil antibodies; blood
B)
Epstein Barr virus; saliva
C)
T-cell infection; plasma
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D) 5.
bacterial infection; monocytes The patient is diagnosed with Hodgkin type of lymphoma based on the results of laboratory tests and study of the tumor cells. A distinct characteristic of Hodgkin lymphoma is the presence of:
A)
Reed-Sternberg cells.
B)
Bence Jones proteins.
C)
M-type protein antibodies.
D)
Philadelphia chromosome.
6.
Manifestations of Hodgkin lymphoma that distinguish it from non-Hodgkin lymphoma include:
A)
noncontiguous nodal spread.
B)
superficial lymphadenopathy.
C)
pruritus and night fevers.
D)
poor humoral antibody response.
7.
Leukemias are classified according to the predominant cell type. The myelogenous cell type of leukemia can:
A)
interfere with thrombocyte cell maturation.
B)
originate in marrow and infiltrate nodes.
C)
affect B and T stem cells in bone marrow.
D)
transform mature cells into immature ones.
8.
A child has Down syndrome and has recently experienced unexplained nose bleeds. His blood tests identify blast cells in the peripheral smear. In addition to nose bleeds, his acute leukemia will typically manifest all of the following EXCEPT:
A)
infections due to neutropenia.
B)
fatigue due to RBC deficiency.
C)
hypogammaglobulinemia.
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D) 9.
bleeding due to thrombocytopenia. In contrast to acute leukemias, chronic leukemias are malignancies involving abnormal blood cells in the marrow.
A)
production of undifferentiated
B)
proliferation of well-differentiated
C)
uncontrolled growth of immature
D)
replication of pluripotent precursor
10.
Multiple myeloma is a malignancy of:
A)
plasma cells.
B)
bone osteoblasts.
C)
T-cell lymphocytes.
D)
immunoglobulin A.
11.
Which of the following statements accurately describes a component of the hematopoietic system?
A)
Lymphocytes lack cytoplasmic granules.
B)
Neutrophils are agranulocytes.
C)
Colony-forming units (CFUs) promote the growth of hematopoietic cell colonies.
D)
Neutrophils are the most prevalent lymphocytes.
12.
Which of the following parts of the body are considered to be parts of the lymphatic system? Select all that apply.
A)
Thyroid gland
B)
Thymus
C)
Spleen
D)
Kupffer cells
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E) 13.
Myelin A patient with a long-standing diagnosis of human immunodeficiency virus (HIV) has recently developed neutropenia and been admitted to a hospital. Which of the following measures should be prioritized by the nurses who are providing his care?
A)
Administration of prophylactic antibiotics
B)
Supplementary oxygen and administration of bronchodilators
C)
Administration of antiretroviral medications
D)
Vigilant infection control and handwashing
14.
A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter’s recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis?
A)
Auscultating the patient’s lungs
B)
Palpating the patient’s lymph nodes
C)
Assessing the patient’s cranial nerve reflexes
D)
Assessing the patient for bone pain
15.
Which of the following factors differentiates chronic leukemias from acute leukemias?
A)
Leukemic cells are disseminated throughout the body by the circulatory system.
B)
The leukemic cells are more fully differentiated than in acute leukemias.
C)
The prevalence among individuals with Down syndrome is high.
D)
They are cancers of the hematopoietic progenitor cells.
16.
Following peripheral blood testing and a bone marrow biopsy, a patient has been diagnosed with chronic myelogenous leukemia. Which of the following is most likely to have preceded the patient’s diagnosis?
A)
The presence of a Philadelphia chromosome
B)
Down syndrome
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Radiation exposure
D)
Exposure to the Epstein-Barr virus
17.
A patient has been diagnosed with non-Hodgkin lymphoma (NHL), a form of malignancy that most likely originated in which of the following sites?
A)
Thymus
B)
Spleen
C)
Bone marrow
D)
Lymph nodes
18.
A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this patient?
A)
Antiviral medications
B)
Surgery and whole blood transfusion
C)
Radiation and chemotherapy
D)
Bone marrow or stem cell transplantation
19.
Which of the following patient complaints should prompt a clinician to order a diagnostic work-up for multiple myeloma?
A)
Lately my bones just seem to ache so bad, and nothing seems to help.
B)
Every morning my joints are so stiff that it takes me 10 or 15 minutes just to get going.
C)
I feel so weak and the last few days I’ve actually fallen asleep on my coffee break at work.
D)
I vomited yesterday evening and it looked like coffee grounds mixed with some fresh blood.
20.
Which of the following abnormal blood work results is most closely associated with a diagnosis of multiple myeloma?
A)
Decreased hemoglobin, hematocrit, and red blood cells
B)
Extremely high levels of abnormal lymphocytes
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Low glomerular filtration rate and high calcium levels
D)
Low potassium levels and increased blood urea nitrogen
Answer Key 1.
C
2.
B
3.
C
4.
B
5.
A
6.
C
7.
A
8.
C
9.
B
10.
A
11.
A
12.
B, C
13.
D
14.
B
15.
B
16.
A
17.
D
18.
C
19.
A
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20.
C
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https://studentmagic.indiemade.com/ Chapter 12 - Disorders of Hemostasis
1.
With the exception of the first two steps, what is required in all steps of the clotting process?
A)
Calcium
B)
Prothrombin
C)
Tissue factor
D)
Plasminogen
2.
The first step of hemostasis occurs as a:
A)
fibrin clot.
B)
platelet plug.
C)
clot retraction.
D)
vessel spasm.
3.
To form a platelet plug, platelets are attracted to the damaged vessel, and then platelet occurs.
A)
adhesion
B)
fibrinolysis
C)
thrombosis
D)
thromboxane A2
4.
Blood coagulation is initiated by either of two pathways. The intrinsic pathway requires circulating to begin the step-wise coagulation cascade.
A)
protein C
B)
thrombin
C)
factor XII
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tissue factor Increased platelet function, and consequent hypercoagulability, can be caused by:
A)
factor V mutation.
B)
platelet insensitivity.
C)
vascular wall damage.
D)
decreased platelet numbers.
6.
Immune thrombocytopenia purpura (ITP) is a/an
A)
allergic; fibrinogen
B)
alloimmune; factor VIII
C)
autoimmune; platelets
D)
immunoglobulin; B cells
7.
.
Thrombotic thrombocytopenic purpura (TTP) causes which of the following manifestations? Select all that apply.
A)
Purpura
B)
Jaundice
C)
Petechiae
D)
Erythema
E)
Confusion
8.
disorder that destroys
Hemophilia A is a hereditary blood disorder caused by inadequate activity or absent:
A)
factor VIII.
B)
prothrombin.
C)
vWF complex.
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intrinsic factor. Disseminated intravascular coagulation (DIC) is characterized by:
A)
headaches.
B)
platelet loss.
C)
hypertension.
D)
hemorrhage.
10.
In persons with a bleeding disorder caused by vascular defects, laboratory tests will most often reveal:
A)
normal values.
B)
hypocalcemia.
C)
polycythemia.
D)
thrombocytopenia.
11.
Removal of a patient’s peripheral intravenous catheter resulted in brief bleeding and the loss of a small amount of blood. Which of the following processes occurred during the formation of the platelet plug that helped to stop blood flow?
A)
Activation of factor X
B)
Conversion of prothrombin to thrombin
C)
Release of von Willebrand factor from the epithelium
D)
Conversion of fibrinogen to fibrin threads
12.
A 69-year-old patient who is obese and has a diagnosis of angina pectoris has been prescribed clopidogrel (Plavix) by his primary care provider. The patient’s medication achieves its therapeutic effect in which of the following ways?
A)
Prevention of platelet aggregation
B)
Activation of plasminogen
C)
Inhibition of the intrinsic clotting pathway
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Deactivation of factor X A public health nurse is conducting a health promotion campaign under the auspices of the local community center. Which of the following measures that the nurse is promoting are likely to influence the participants’ risk of hypercoagulability disorders? Select all that apply.
A)
Smoking cessation
B)
Blood glucose screening
C)
Weight management
D)
Cholesterol screening and management
E)
Blood pressure screening and management
14.
During a patient’s admission assessment prior to reduction mammoplasty surgery, the nurse notes a reference to a Leiden mutation in the patient’s history. The nurse would recognize the patient’s increased risk for
A)
Hemorrhage
B)
Myocardial infarction
C)
Hemophilia A or B
D)
Deep vein thrombosis
15.
The most recent blood work of a patient with a diagnosis of acute myelogenous leukemia (AML) reveals thrombocytopenia. Where is the patient most likely to experience abnormal bleeding as a result of low platelets?
A)
In the brain
B)
Skin and mucous membranes
C)
Sclerae of the eyes
D)
Nephrons and ureters
16.
A)
A patient was started on a protocol for the prevention of deep vein thrombosis shortly after admission, and has been receiving 5000 units of heparin twice daily for the last 5 days. An immune response to this treatment may increase the patient’s chance of developing which health problem? Antiphospholipid syndrome
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B)
Disseminated intravascular coagulation (DIC)
C)
Von Willebrand disease
D)
Thrombocytopenia
17.
In light of the presence of numerous risk factors for coronary artery disease, a patient’s primary care provider has recommended that he take low-dose aspirin once daily. Doing so will reduce the patient’s risk of myocardial infarction by altering which of the following stages of hemostasis?
A)
Vessel spasm
B)
Platelet plug formation
C)
Blood coagulation
D)
Clot lysis
18.
A 23-year-old female patient has been diagnosed with von Willebrand disease following a long history of heavy periods and occasional nosebleeds. Which of the patient’s following statements demonstrates a sound understanding of her new diagnosis?
A)
I’m really disappointed that I won’t be able to do sports anymore.
B)
I read on a website that I might have to get blood transfusions from time to time.
C)
I’ll make sure to take Tylenol instead of aspirin when I get aches and pains.
D)
I hope my insurance covers the injections that I’ll need to help my blood clot.
19.
Which of the following patients likely faces the highest risk of an acquired hypocoagulation disorder and vitamin K deficiency?
A)
A patient who has a diagnosis of liver failure secondary to alcohol abuse
B)
A patient who has chronic renal failure as a result of type 1 diabetes mellitus
C)
A patient who is immunocompromised as a result of radiation therapy for the treatment of lung cancer
D)
A patient with dehydration and hypokalemia that have resulted from Clostridium difficileassociated diarrhea
20.
A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago, but the mother
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https://studentmagic.indiemade.com/ has experienced postpartum hemorrhage. Which of the following disorders is most likely to underlie the patient’s excessive bleeding after delivery? A)
Disseminated intravascular coagulation
B)
Hemophilia A
C)
Von Willebrand disease
D)
Thrombotic thrombocytopenic purpura (TTP)
Answer Key 1.
A
2.
D
3.
A
4.
C
5.
C
6.
C
7.
A, C, E
8.
A
9.
D
10.
A
11.
C
12.
A
13.
A, B, C, D, E
14.
D
15.
B
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D
17.
B
18.
C
19.
A
20.
A
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https://studentmagic.indiemade.com/ Chapter 13 - Disorders of Red Blood Cells
1.
Sue is fatigued and some blood tests are done. Her results include Hct 40%; Hgb 8g/dL; WBC 8,000; platelets 175,000. The nurse should interpret Sue’s blood work as indicative of:
A)
high platelets/thrombocytosis.
B)
low WBC count/granulocytopenia.
C)
low hemoglobin/anemia.
D)
high hematocrit/polycythemia.
2.
Manifestations of anemia that are directly due to the diminished oxygen-carrying capacity of hemoglobin include:
A)
fatigue.
B)
bleeding.
C)
bone pain.
D)
pale skin.
3.
When an Rh-negative mother has been sensitized and is pregnant with an Rh-positive fetus, what happens to the fetus?
A)
Bilirubin deficiency
B)
Nothing, this is normal
C)
Plasma volume depletion
D)
Profound red cell hemolysis
4.
The patient is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which of the following CBC results is characteristic of her type of anemia?
A)
Hematocrit 44%
B)
Reticulocytes 1.5%
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Band cells 3,000/mL
D)
Hemoglobin 8 g/dL
5.
Megaloblastic anemias caused by folic acid or vitamin B12 deficiencies can seriously affect RBC production. This is because both are necessary for synthesis and .
A)
iron; hemoglobin adhesion
B)
DNA; red blood cell maturation
C)
thrombin; platelet aggregation
D)
protein; reticulocyte maturation
6.
Polycythemia develops in patients with lung disease as a result of:
A)
hyperventilation.
B)
chronic hypoxia.
C)
decreased blood viscosity.
D)
excessive respiratory fluid loss.
7.
Which of the following types and characteristics of anemia are correctly matched?
A)
Hemolytic; abnormal iron uptake
B)
Iron deficiency; early RBC death
C)
Folate; decreased erythropoiesis
D)
Blood loss; bone marrow expansion
8.
Conditions that predispose to sickling of hemoglobin in persons with sickle cell anemia include:
A)
impaired red blood cell maturation.
B)
increased iron content of blood.
C)
decreased oxygen saturation.
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increased intravascular volume. An elevated level of unconjugated bilirubin, due to hemolysis of RBCs, results in a high level of iron released and:
A)
diarrhea.
B)
cyanosis.
C)
numbness.
D)
jaundice.
10.
Hemolytic anemia is characterized by excessive red blood cell destruction and compensatory:
A)
hypoactive bone marrow.
B)
increased erythropoiesis.
C)
iron retention in the body.
D)
shrinkage of the spleen.
11.
A 48-year-old male patient, who normally enjoys good health, has been admitted to the hospital for the treatment of polycythemia vera. The nurse who is providing care for the patient should prioritize assessments aimed at the early identification of which of the following health problems?
A)
Orthostatic hypotension
B)
Hyperventilation and respiratory alkalosis
C)
Vasculitis
D)
Thromboembolism
12.
Which of the following patients is most susceptible to experiencing the effects of inadequate erythropoiesis?
A)
A patient who has developed renal failure as a result of longstanding hypertension
B)
A patient who recently experienced an ischemic stroke and who remains bedridden
C)
A patient whose heavy alcohol use has culminated in a diagnosis of pancreatitis
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A patient whose estimated blood loss during recent surgery was 700 mL. A 72-year-old woman with complaints of increasing fatigue has completed a series of fecal occult blood tests that indicate the presence of blood in her stool. Which of the following health problems is likely to accompany this patient’s gastrointestinal bleed?
A)
Hemolytic anemia
B)
Aplastic anemia
C)
Iron-deficiency anemia
D)
Megaloblastic anemia
14.
Hemoglobin solubility results and hemoglobin electrophoresis have resulted in a diagnosis of sickle cell anemia in an African American infant. The parents of the child should be aware that their child is at a significant risk for which of the following health problems? Select all that apply.
A)
Acute pain
B)
Stroke
C)
Respiratory disease
D)
Autoimmune diseases
E)
Fractures
15.
The pathologic effects of the thalassemias are primarily due to which of the following pathophysiologic processes?
A)
Impaired hemoglobin synthesis
B)
Impaired folic acid absorption
C)
Erythropoietin deficiency
D)
Loss of iron
16.
Which of the following individuals likely faces the highest risk of megaloblastic anemia?
A)
A 69-year-old woman who takes ASA four times daily to treat her arthritis
B)
A 44-year-old man who lost approximately 500 mL of blood in a workplace accident
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C)
A 21-year-old college student who lives a vegan lifestyle
D)
An infant who is exclusively fed commercial baby formula
17.
For which of the following health problems is stem cell transplantation likely to be of therapeutic benefit?
A)
Aplastic anemia
B)
b-Thalassemias
C)
Chronic disease anemias
D)
Secondary polycythemia
18.
A 68-year-old patient with an 80 pack/year history of smoking was diagnosed with emphysema 18 months ago. The patient’s most recent scheduled blood work showed red blood cell indices, a problem that suggests the need for which of the following interventions?
A)
Vitamin B12 supplements
B)
Increased supplementary oxygen therapy
C)
Hemodialysis or peritoneal dialysis
D)
Scheduled erythropoietin injections
19.
Which of the following trends in the hematologic status of a 6-week-old infant most clearly warrants medical intervention?
A)
Decreasing red blood cell counts
B)
Increasing HgA levels
C)
Decreasing hematocrit and mean corpuscular volume (MCV)
D)
Increasing white blood cell counts
20.
A mother has brought her 2-week-old infant to the emergency department due to the baby’s persistent and increasing jaundice. Blood testing reveals that the infant’s unconjugated bilirubin level is 28 mg/dL and assessment does not reveal neurologic deficits. The infant’s weight is normal and the mother claims to have had no significant difficulty feeding the infant. The most likely treatment for this infant will be:
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phototherapy.
B)
packed red blood cell transfusion.
C)
phlebotomy.
D)
intravenous antibiotics.
Answer Key 1.
C
2.
A
3.
D
4.
D
5.
B
6.
B
7.
C
8.
C
9.
D
10.
B
11.
D
12.
A
13.
C
14.
A, B, C
15.
A
16.
C
17.
A
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18.
B
19.
D
20.
A
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https://studentmagic.indiemade.com/ Chapter 14 - Mechanisms of Infectious Disease
1.
Although growth rate is variable among types of bacteria, the growth of bacteria is dependent on:
A)
biofilm communication.
B)
availability of nutrients.
C)
an intact protein capsid.
D)
individual cell motility.
2.
Treponema pallidum, the cause of syphilis, is a spirochete bacterium that is spread from human to human by:
A)
tick or lice vector bites.
B)
direct physical contact.
C)
exposure to infected urine.
D)
inhaling airborne particles.
3.
Chlamydiaceae, a rather common sexually transmitted infectious organism, has characteristics of both viruses and bacteria. The infectious form of this organism’s life cycle is until it enters the host cell.
A)
an elementary body
B)
adhered to cholesterol
C)
propelled by filaments
D)
encapsulated hyphae
4.
Because dermatophytes are capable of growing surfaces of the body.
A)
a powdery colony
B)
in moist skin folds
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on cooler tissue
D)
branching filaments
5.
Although both eukaryotes and prokaryotes are capable of causing infectious diseases in humans, eukaryotes are unique because they have a distinct:
A)
organized nucleus.
B)
circular plasmid DNA.
C)
cytoplasmic membrane.
D)
variation of shape and size.
6.
Whatever the mechanism of entry, the human-to-human transmission of infectious agents is directly related to the:
A)
source of contact.
B)
site of infection.
C)
number of pathogens absorbed.
D)
virulence factors.
7.
The course of any infectious disease progresses through several distinct stages after the pathogen enters the host. Although the duration may vary, the hallmark of the prodromal stage is:
A)
tissue inflammation and damage.
B)
initial appearance of symptoms.
C)
progressive pathogen elimination.
D)
containment of infectious pathogens.
8.
Although bacterial toxins vary in their activity and effects on host cells, a small amount of gramnegative bacteria endotoxin:
A)
is released during cell growth.
B)
inactivates key cellular functions.
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uses protein to activate enzymes.
D)
in the cell wall activates inflammation.
9.
Serology testing includes the measurement of which of the following?
A)
Antibody titers
B)
Culture growth
C)
Direct antigens
D)
DNA sequencing
10.
Prions cause transmissible neurodegenerative diseases and are characterized by:
A)
a lack of reproductive capacity.
B)
hypermetabolism.
C)
enzyme production.
D)
chronic inflammation.
11.
Which of the following individuals is experiencing a health problem that is the result of a parasite?
A)
A college student who contracted Chlamydia trachomatis during an unprotected sexual encounter
B)
A man who acquired malaria while on a tropical vacation
C)
A hospital patient who has developed postoperative pneumonia
D)
A woman who developed hepatitis A from eating at an unhygienic restaurant
12.
Which of the following traits is characteristic of saprophytes?
A)
They derive energy from decaying organic matter.
B)
They are beneficial components of human microflora.
C)
They have RNA or DNA, but never both.
D)
They are capable of spore production.
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13.
A hospital patient was swabbed on admission for antibiotic-resistant organisms and has just been informed that methicillin-resistant Staphylococcus aureus (MRSA) is present in his groin. The patient has a normal core temperature and white blood cell count. This patient is experiencing which of the following?
A)
Infection
B)
Proliferation
C)
Colonization
D)
Inflammation
14.
A 33-year-old patient who is a long-term intravenous user of heroin has been recently diagnosed with hepatitis C. Which of the following portals of entry most likely led to the patient’s infection?
A)
Direct contact
B)
Vertical transmission
C)
Ingestion
D)
Penetration
15.
A 9-month-old infant has been diagnosed with botulism after he was fed honey. The child’s mother was prompted to seek care because of this child’s sudden onset of neuromuscular deficits, which were later attributed to the release of substances by Clostridium botulinum bacteria. Which virulence factor contributed to this child’s illness?
A)
Endotoxins
B)
Adhesion factors
C)
Exotoxins
D)
Evasive factors
16.
A patient with a long-standing diagnosis of Crohn disease has developed a perianal abscess. Which of the following treatments will this patient most likely require?
A)
Antiviral therapy
B)
Antibiotic therapy
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Surgical draining
D)
Pressure dressing
17.
A patient’s primary care provider has ordered direct antigen detection in the care of a patient with a serious symptomatology of unknown origin. Which of the following processes will be conducted?
A)
Detecting DNA sequences that are unique to the suspected pathogen
B)
Growth of biofilms on various media in the laboratory setting
C)
Quantification of IgG and IgM antibodies in the patient’s blood
D)
Introduction of monoclonal antibodies to a blood sample from the patient
18.
A patient has begun taking acyclovir, an antiviral medication, to control herpes simplex outbreaks. What is this drug’s mechanism of action?
A)
Inhibition of viral adhesion to cells
B)
Elimination of exotoxin production
C)
Antagonism of somatic cell binding sites
D)
Interference with viral replication processes
19.
International travel has contributed to increased prevalence and incidence of nonindigenous diseases by increasing which of the following?
A)
Portals of entry
B)
Sources of infection
C)
Virulence
D)
Disease course
20.
A public health nurse should recognize that sexually transmitted infections (STIs) are typically spread by which of the following mechanisms?
A)
Penetration
B)
Vertical transmission
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Direct contact
D)
Ingestion
Answer Key 1.
B
2.
B
3.
A
4.
C
5.
A
6.
C
7.
B
8.
D
9.
A
10.
A
11.
B
12.
A
13.
C
14.
D
15.
C
16.
C
17.
D
18.
D
19.
B
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20.
C
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https://studentmagic.indiemade.com/ Chapter 15 - Innate and Adaptive Immunity
1.
Innate immunity, also called natural or native immunity, consists of mechanisms that respond specifically to:
A)
self-cells.
B)
microbes.
C)
antibodies.
D)
inflammation.
2.
Adaptive immune responses, also called acquired or specific immunity, are composed of and their products.
A)
granulocytes
B)
lymphocytes
C)
epithelial cells
D)
Toll-like receptors
3.
The effector cells of the immune system have the primary function of:
A)
activating phagocytic cells.
B)
eliminating the antigens.
C)
processing antigen into epitopes.
D)
controlling the immune response.
4.
Activation of lymphocytes is dependent upon the macrophages.
A)
memory; clustering
B)
capture; destruction
C)
recognition; grouping
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of the antigens by
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D) 5.
processing; presentation Major histocompatibility complex (MHC) molecules, with human leukocyte antigens (HLAs), are markers on all nucleated cells and have an important role in:
A)
identifying blood types.
B)
cell membrane transport.
C)
suppressing viral replication.
D)
avoiding transplant rejections.
6.
Dendritic cells, found in skin tissues and lymphoid tissues, are important for:
A)
initiation of adaptive immunity.
B)
deep-tissue phagocytosis.
C)
disposal of dead cells.
D)
delaying inflammation.
7.
Once T helper cells are activated, they secrete other cells of the immune system.
A)
complement proteins
B)
cytokines
C)
leukotrienes
D)
bradykinins
8.
that activate and regulate nearly all of the
The first circulating immunoglobulin to appear in response to a new antigen is:
A)
IgG.
B)
IgM.
C)
IgA.
D)
IgD.
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9.
The effector function of activated members of the complement system includes all of the following EXCEPT:
A)
chemotaxis.
B)
opsonization.
C)
pathogen lysis.
D)
phagocytosis.
10.
During the latent period before antibodies are detected in the humoral immune response, B cells differentiate into cells.
A)
plasma
B)
cytotoxic
C)
stem
D)
helper
11.
Which of the following would participate in the innate immune response to an infectious microorganism?
A)
T lymphocytes
B)
Antibodies
C)
B lymphocytes
D)
Neutrophils
12.
A patient has recently received a pneumococcal vaccine and the patient’s B cells are consequently producing antibodies. Which of the following cells may enhance this production of antibodies?
A)
Helper T cells
B)
Regulatory T cells
C)
Cytotoxic T cells
D)
Natural killer cells
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13.
A child’s thymus gland is fully formed and proportionately larger than an adult’s. Which of the following processes that contribute to immunity takes place in the thymus gland?
A)
Differentiation of B cells
B)
Production of natural killer (NK) cells
C)
Proliferation of T cells
D)
Filtration of antigens from the blood
14.
A patient’s exposure to an antibiotic-resistant microorganism while in the hospital has initiated an immune response, a process that is mediated and regulated by cytokines. Which of the following statements is true of cytokines?
A)
They are stored in the peripheral lymphoid tissues until required.
B)
They have a long half-life that contributes to an ongoing immune response.
C)
They are normally released at cell-to-cell interfaces, binding to specific receptors.
D)
They are capable of performing phagocytosis in the response to viral invasion.
15.
The entrance of a microbe into an individual’s vascular space has initiated opsonization. Which of the following processes is involved in opsonization?
A)
Stimulation of B cells by helper T cells
B)
Coating of a microbe to aid phagocyte recognition
C)
Release of proteins that stimulate cell production by the bone marrow
D)
Lysis of intracellular microbes by cytotoxic T cells
16.
Bacteria on a sliver in a boy’s finger have initiated an adaptive immune response. The boy’s lymphocytes and antibodies recognize immunologically active sites on the bacterial surfaces known as:
A)
Toll-like receptors.
B)
opsonins.
C)
chemokines.
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epitopes. Histocompatability molecules are of primary importance to which of the following aspects of immunity?
A)
Induction of T-cell immunity
B)
T-cell maturation
C)
NK cell activation
D)
Phagocytosis by neutrophils
18.
Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?
A)
Secondary humoral response
B)
Cell-mediated immune response
C)
Primary humoral response
D)
Innate immunity
19.
A patient’s cell-mediated immune response has resulted in the release of regulator T cells. These cells will perform which of the following roles?
A)
Suppressing the immune response to limit proliferation of potentially harmful lymphocytes
B)
Presenting antigens to B cells to facilitate the production of antibodies
C)
Differentiating into subpopulations of helper T cells
D)
Destroying target cells by releasing cytolytic enzymes and other toxins
20.
A 1-day-old infant was exposed to an infectious microorganism prior to discharge home from the hospital, but was able to effect a sufficient immune response in the hours and days following exposure. This immune response may have been due to the presence of which of the following immunoglobulins from the infant’s mother?
A)
IgA
B)
IgG
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IgM
D)
IgD
Answer Key 1.
B
2.
B
3.
B
4.
D
5.
D
6.
A
7.
B
8.
B
9.
D
10.
A
11.
D
12.
A
13.
B
14.
C
15.
B
16.
D
17.
A
18.
A
19.
A
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20.
B
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https://studentmagic.indiemade.com/ Chapter 16 - Disorders of the Immune Response
1.
The mediators involved in type I hypersensitivity allergic responses are released from:
A)
mast cells.
B)
plasma cells.
C)
monocytes.
D)
arachidonic acid.
2.
A genetically determined hypersensitivity to common environmental allergens causes reactions, such as:
A)
atopic; urticaria.
B)
autoimmune; diarrhea.
C)
IgM-mediated; infections.
D)
delayed; poison ivy rash:
3.
Mismatched blood transfusion reaction with hemolysis of blood cells is an example of type II, mediated hypersensitivity reaction.
A)
T-cell
B)
antibody
C)
leukotriene
D)
complement
4.
Type III hypersensitivity immune responses can be harmful when immune complex deposits in tissue activate that can directly damage area tissues.
A)
inflammation
B)
autoantibodies
C)
cytotoxic cells
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D) 5.
immunoglobulins The mechanism by which humans recognize self-cells from non-self (antigens)-cells is
A)
autoimmunity
B)
self-tolerance
C)
non-self anergy
D)
immunocompatibility
6.
Organ rejection is a complication of organ transplantation caused by recipient immune cells:
A)
destroying the host T cells.
B)
attack on the donor cells.
C)
combining with grafts HLA.
D)
being recognized as foreign.
7.
The leading cause of death for people with HIV is opportunistic
A)
leukemia
B)
tuberculosis
C)
pneumonia
D)
toxoplasmosis
8.
.
.
Wasting syndrome, an AIDS-defining illness, is characterized by involuntary weight loss of at least 10% of baseline body weight in the presence of:
A)
diarrhea.
B)
hypermetabolism.
C)
weakness and fever.
D)
glucose intolerance.
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The window period of HIV infection refers to the period of time between infection and:
A)
transmission.
B)
seroconversion.
C)
initial symptoms.
D)
antibody screening.
10.
HIV-positive persons that display manifestations of laboratory category 3 or clinical category C are considered to have:
A)
zero viral load.
B)
seroconversion.
C)
complete remission.
D)
AIDS-defining illnesses.
11.
Contact with poison ivy has resulted in intense pruritus, erythema, and weeping on a patient’s forearm. Which of the following processes resulted in the patient’s signs and symptoms?
A)
IgE-mediated mast cell degranulation
B)
Formation of antigen-antibody complexes
C)
Cytokine release by sensitized T cells
D)
Formation of antibodies against cell surface antigens
12.
A patient with a long history of hay fever has recently begun a series of immunotherapy (allergy shots). How will this treatment potentially achieve a therapeutic effect?
A)
By blocking cytokine release from sensitized mast cells
B)
By preventing mast cells from becoming sensitized
C)
By causing T cells to be sequestered in the thymus for longer periods
D)
By stimulating production of IgG to combine with antigens
13.
A patient with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. Which of the
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Natural killer cells
B)
Mast cells
C)
T cells
D)
Neutrophils
14.
A patient with a diagnosis of aplastic anemia has undergone allogenic bone marrow transplantation. Which of the following signs and symptoms would most clearly suggest the existence of graft-versushost disease (GVHD)?
A)
Shortness of breath, audible crackles, and decreasing PaO2
B)
Presence of a pruritic rash that has begun to slough off
C)
Development of metabolic acidosis
D)
Diaphoresis, fever, and anxiety
15.
A patient has developed pericarditis after developing acute glomerulonephritis, a development that may be attributable to the presence of similar epitopes on group A, b-hemolytic streptococci and the antigens in the patient’s heart tissue. Which of the following has most likely accounted for this patient’s autoimmune response?
A)
Breakdown of T-cell anergy
B)
Release of sequestered antigens
C)
Superantigens
D)
Molecular mimicry
16.
A 70-year-old female patient has had her mobility and independence significantly reduced by rheumatoid arthritis. Which of the following processes likely contributed to the development of her health problem?
A)
Delayed-type hypersensitivity (DTH) reaction
B)
Proliferation of cytotoxic T cells
C)
Failure of normal self-tolerance
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Deletion of autoreactive B cells Which of the following would constitute a normal assessment finding in a neonate?
A)
Minimal or absent levels of IgA and IgM
B)
Absence of plasma cells in the lymph nodes and spleen
C)
Undetectable levels of all immunoglobulins
D)
Absence of mature B cells with normal T-cell levels and function
18.
A patient was diagnosed as HIV positive several years ago. Which of the following blood tests is most clinically useful for determining the stage and severity of her disease?
A)
Plasma levels
B)
CD4+ cell counts
C)
Viral load
D)
White blood cell count with differential
19.
A patient has been admitted to the hospital for the treatment of HIV infection, which has recently progressed to overt AIDS. Which of the following nursing actions should the nurse prioritize when providing care for this patient?
A)
Frequent neurologic vital signs and thorough skin care
B)
Hemodynamic monitoring and physical therapy
C)
Careful monitoring of fluid balance and neurologic status
D)
Astute infection control and respiratory assessments
20.
Shortly after being diagnosed with HIV, a patient has begun highly active antiretroviral therapy (HAART). What is the primary goal of the patient’s drug regimen?
A)
To limit the latent period of HIV
B)
To slow the progression of the disease
C)
To minimize opportunities for transmission
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To prevent seroconversion
Answer Key 1.
A
2.
A
3.
B
4.
A
5.
B
6.
B
7.
B
8.
A
9.
B
10.
D
11.
C
12.
D
13.
C
14.
B
15.
D
16.
C
17.
A
18.
B
19.
D
20.
B
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1.
In the arterial-venous circulatory system, pressure is inversely related to:
A)
velocity.
B)
volume.
C)
tension.
D)
viscosity.
2.
Turbulent blood flow can be caused by a number of factors, including:
A)
increased velocity.
B)
short vessel length.
C)
high blood viscosity.
D)
layering of blood cells.
3.
Heart muscle differs from skeletal muscle tissue by being able to generate:
A)
contractions.
B)
calcium influx.
C)
action potentials.
D)
sarcomere binding.
4.
During ventricular systole, closure of the atrioventricular (AV) valves coincides with:
A)
atrial chamber filling.
B)
aortic valve opening.
C)
isovolumetric contraction.
D)
semilunar valves opening.
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5.
The difference between the end-diastolic and end-systolic volumes is the:
A)
stroke volume.
B)
cardiac output.
C)
ejection fraction.
D)
cardiac reserve.
6.
Preload represents the volume work of the heart and is largely determined by:
A)
venous blood return.
B)
vascular resistance.
C)
force of contraction.
D)
ventricular emptying.
7.
A large increase in heart rate can cause:
A)
increased blood viscosity.
B)
loss of action potential.
C)
decreased stroke volume.
D)
reduced cardiac contractility.
8.
Long-term autoregulation of local blood flow in the microcirculation is mediated by:
A)
collateral circulation.
B)
arteriovenous shunting.
C)
autonomic nervous system.
D)
metabolic needs of the tissues.
9.
The tissue factor that contributes to humoral control of blood flow by causing vasoconstriction is:
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histamine.
B)
bradykinin.
C)
serotonin.
D)
nitric oxide.
10.
The parasympathetic nervous system causes a slowing of the heart rate by increasing:
A)
norepinephrine.
B)
vessel constriction.
C)
vagus nerve activity.
D)
smooth muscle tone.
11.
A patient has entered hypovolemic shock after massive blood loss in a car accident. Many of the patient’s peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon?
A)
Blood pressure is no longer able to overcome vessel wall tension.
B)
Decreasing vessel radii have caused a decrease in blood pressure.
C)
Wall thickness of small vessels has decreased due to hypotension.
D)
Decreases in wall tension and blood pressure have caused a sudden increase in vessel radii.
12.
In the days following a tooth cleaning and root canal, a patient has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this patient’s most likely diagnosis?
A)
Pericarditis
B)
Endocarditis
C)
Myocarditis
D)
Vasculitis
13.
Following several weeks of increasing fatigue and a subsequent diagnostic work-up, a patient has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following
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Backup of blood from the right atrium into the superior vena cava
B)
Backflow from the right ventricle to the right atrium during systole
C)
Inhibition of the SA node’s normal action potential
D)
Backflow from the left ventricle to left atrium
14.
Harmful effects on cardiac action potential are most likely to result from a deficit of which of the following electrolytes?
A)
Magnesium (Mg2+)
B)
Chloride (Cl–)
C)
Potassium (K+)
D)
Hydrogen carbonate (HCO3)
15.
A male patient with a history of angina has presented to the emergency department with uncharacteristic chest pain and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle?
A)
Atrial depolarization
B)
Ventricular depolarization
C)
Ventricular repolarization
D)
Depolarization of the AV node, bundle branches, and Purkinje system
16.
A patient with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveal the following findings: heart rate 80 beats per minute; end-diastolic volume 120 mL; end-systolic volume 60 mL. What is this patient’s ejection fraction?
A)
200 mL
B)
50%
C)
.80
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180 mL A patient with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are ultimately suggestive of decreased cardiac output. Which of the following factors that determine cardiac output is hypertension likely to affect most directly?
A)
Preload
B)
Afterload
C)
Contractility
D)
Heart rate
18.
A patient who lives with a diagnosis of angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experienced while mowing his lawn. This drug has resulted in a release of nitric oxide, which will have what effect?
A)
Smooth muscle relaxation of vessels
B)
Decreased heart rate and increased stroke volume
C)
Increased preload
D)
Reduction of cardiac refractory periods
19.
Release of which of the following humoral factors will result in vasodilation?
A)
Norepinephrine
B)
Angiotensin II
C)
Serotonin
D)
Histamine
20.
Which of the following factors is the primary governor of the local control of blood flow?
A)
Action potential
B)
The nutritional needs of the tissue involved
C)
Cardiac contractility and preload
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Feedback from arterial baroreceptors and chemoreceptors
Answer Key 1.
B
2.
A
3.
C
4.
C
5.
A
6.
A
7.
C
8.
A
9.
C
10.
C
11.
A
12.
B
13.
D
14.
C
15.
C
16.
B
17.
B
18.
A
19.
D
20.
B
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1.
Because cholesterol is insoluble in plasma, it is mainly carried by the lipoprotein:
A)
IDL.
B)
HDL.
C)
LDL.
D)
VLDL.
2.
A major cause of secondary hyperlipoproteinemia is and conversion to LDL.
A)
high-calorie diet
B)
diabetes mellitus
C)
bile-binding resin
D)
cholesterol ingestion
3.
The most important complication of atherosclerosis is heart vessels.
A)
ulceration
B)
thrombosis
C)
fatty streaks
D)
fibrous plaque
4.
, which increases the production of VLDL
A serum marker for systemic inflammation, atherosclerosis, and vascular disease.
A)
leukocytosis
B)
homocysteine
C)
serum lipoprotein
, which may cause occlusion of small
, is now considered a major risk factor marker for
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D) 5.
C-reactive protein Small-vessel vasculitides, a group of vascular disorders that cause vasculitis, are mainly mediated by:
A)
infectious agents.
B)
tissue necrosis.
C)
mononuclear cells.
D)
hypersensitivity reactions.
6.
Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is:
A)
edema.
B)
calf pain.
C)
varicosities.
D)
strong pulse.
7.
Although both are characterized by ischemia, Raynaud phenomenon is caused by thromboangiitis obliterans is caused by:
A)
occlusion; compression.
B)
thrombi; vasoconstriction.
C)
vasculitides; hypertension.
D)
vasospasm; inflammation.
8.
, and
Because of its location, the presence of an abdominal aortic aneurysm may first be noticed as:
A)
constipation.
B)
indigestion.
C)
a pulsating mass.
D)
mid-abdominal pain.
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9.
By definition, hypertension is systolic blood pressure of pressure of mm Hg or higher.
A)
129; 85
B)
138; 89
C)
140; 90
D)
155; 95
10.
The patient is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the mid-calf area. He has many of the manifestations of:
A)
stasis ulcerations.
B)
arterial insufficiency.
C)
primary varicose veins.
D)
deep vein thrombosis.
11.
mm Hg or higher or diastolic blood
A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the patient’s following statements indicates a need for further healthpromotion teaching?
A)
I’ve starting going to the gym before work three times a week.
B)
I’m trying to cut back on the amount of salt that I cook with and add to my food.
C)
I’m resolving to eat organic foods from now on and to drink a lot more water.
D)
I’m planning to lose 15 pounds before the end of this year.
12.
A patient with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the patient’s increased blood pressure?
A)
Increased levels of adrenocortical hormones
B)
Activation of the renin-angiotensin-aldosterone mechanism
C)
Increased sympathetic stimulation by the autonomic nervous system (ANS)
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D) 13.
Coarctation of the patient’s aorta Which of the following physiologic processes contributes most to the long-term regulation of blood pressure?
A)
Actions of the renin-angiotensin-aldosterone system
B)
Release of antidiuretic hormone (vasopressin) by the posterior pituitary
C)
Renal monitoring and adjustment of extracellular fluid volume
D)
Integration and modulation of autonomic nervous system (ANS)
14.
Which of the following is a nonmodifiable risk factor for the development of primary hypertension?
A)
African American race
B)
High salt intake
C)
Male gender
D)
Obesity
15.
A patient with persistent, primary hypertension remains apathetic about his high blood pressure, stating, I don’t feel sick, and it doesn’t seem to be causing me any problems that I can tell. How could a clinician best respond to this patient’s statement?
A)
Actually, high blood pressure makes you very susceptible to getting diabetes in the future.
B)
That’s true, but it’s an indicator that you’re not taking very good care of yourself.
C)
You may not sense any problems, but it really increases your risk of heart disease and stroke.
D)
You’re right, but it’s still worthwhile to monitor it in case you do develop problems.
16.
A patient’s primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this diuretic achieve its therapeutic effect?
A)
By decreasing vascular volume by increasing sodium and water excretion
B)
By blocking the release of antidiuretic hormone from the posterior pituitary
C)
By inhibiting the conversion of angiotensin I to angiotensin II.
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D)
By inhibiting the movement of calcium into arterial smooth muscle cells
17.
A 29-year-old woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia-eclampsia in her second trimester. What should her care provider teach her about this change in her health status?
A)
We don’t really understand why some women get high blood pressure when they’re pregnant.
B)
This is likely a result of your nervous system getting overstimulated by pregnancy.
C)
Hypertension is a common result of all the hormonal changes that happen during pregnancy.
D)
Even though you’re a healthy person, it could be that you have an underlying heart condition.
18.
Which of the following patients should most likely be assessed for orthostatic hypotension?
A)
A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-thecounter analgesics.
B)
A patient whose vision has become much less acute in recent months and who has noticed swelling in her ankles.
C)
An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom.
D)
A patient who has a history of poorly controlled type 1 diabetes.
19.
A patient is receiving homecare for the treatment of a wound on the inside of her lower leg which is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the patient’s legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this patient’s most likely diagnosis?
A)
Chronic venous insufficiency
B)
Deep vein thrombosis
C)
Varicose veins
D)
Peripheral arterial disease
20.
A postsurgical patient’s complaints of calf pain combined with the emergence of swelling and redness in the area have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this patient?
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Analgesics and use of a pneumatic compression device
B)
Massage followed by vascular surgery
C)
Frequent ambulation and the use of compression stockings
D)
Anticoagulation therapy and elevation of the leg
Answer Key 1.
C
2.
A
3.
B
4.
D
5.
D
6.
B
7.
D
8.
C
9.
C
10.
D
11.
C
12.
B
13.
C
14.
A
15.
C
16.
A
17.
A
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18.
C
19.
A
20.
D
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https://studentmagic.indiemade.com/ Chapter 19 - Disorders of Cardiac Function
1.
Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by:
A)
fixed coronary obstruction.
B)
increased collateral circulation.
C)
intermittent vessel vasospasms.
D)
excessive endothelial relaxing factors.
2.
Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a:
A)
red thrombus.
B)
large lipid core.
C)
calcified lesion.
D)
vessel wall injury.
3.
Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac and the heart.
A)
ruptures; releases
B)
thickens; stretches
C)
contracts; friction rubs
D)
fills rapidly; compresses
4.
In adults, sudden death from an acute myocardial infarction is usually caused by:
A)
acute myocarditis.
B)
high troponin levels.
C)
acute ventricular arrhythmia.
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D) 5.
hypertrophic cardiomyopathy. On the second or third day after an acute myocardial infarction, the area of necrosis is:
A)
soft and yellow.
B)
acutely inflamed.
C)
granulation tissue.
D)
fibrous scar tissue.
6.
In aortic regurgitation, failure of aortic valve closure during diastole causes an abnormal drop in diastolic pressure. This change in pressure causes decreased:
A)
stroke volume.
B)
left ventricular size.
C)
coronary perfusion.
D)
arterial pulse pressure.
7.
Patients with ischemic coronary vessel disease and acute coronary syndrome (ACS) are classified as low or high risk for acute myocardial infarction based on characteristics that include significant:
A)
heart murmurs.
B)
ECG changes.
C)
pulmonary disease.
D)
pericardial effusion.
8.
Dilated cardiomyopathy with left ventricular dysfunction is characterized by increased wall:
A)
rigidity.
B)
thinning.
C)
thickness.
D)
contractility.
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9.
Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by:
A)
chronic atrial fibrillation.
B)
myocardial inflammation.
C)
left ventricle hypertrophy.
D)
vegetative valve destruction.
10.
Congenital heart defects can cause a right heart to left heart shunting of blood that results in increased:
A)
pulmonary blood volume.
B)
right ventricle workload.
C)
unoxygenated blood flow.
D)
right atrial blood volume.
11.
Which of the following assessment findings of a cardiac patient would be suggestive of cardiac tamponade?
A)
Increasing PaCO2 and decreasing PaO2
B)
Audible crackles on chest auscultation and presence of frothy sputum
C)
20 mm Hg Drop in systolic blood pressure during respiration
D)
Normal ECG combined with complaints of chest pain and shortness of breath
12.
The plaques in a patient’s coronary arteries are plentiful and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which of the following diagnoses?
A)
Stable angina
B)
Non-ST-segment elevation MI
C)
ST-Segment elevation MI
D)
Unstable angina
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13.
Which of the following individuals is suffering the effects of acute coronary syndrome (ACS)?
A)
A patient whose most recent ECG indicates that silent myocardial ischemia has occurred
B)
A patient who occasionally experiences persistent and severe chest pain when at rest
C)
A patient who sometimes experiences chest pain when climbing stairs
D)
A patient who has recently been diagnosed with variant (vasospastic) angina
14.
Coronary artery bypass grafting (CABG) is a relevant treatment modality for which of the following disorders of cardiac function?
A)
Atherosclerosis with history of MI
B)
Pericardial effusion and cardiac tamponade
C)
Dilated cardiomyopathies
D)
Aortic valve regurgitation and aortic stenosis
15.
Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to an enlarged heart. Which of the following disorders was the player’s most likely cause of death?
A)
Takotsubo cardiomyopathy
B)
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D)
C)
Hypertrophic cardiomyopathy (HCM)
D)
Dilated cardiomyopathy (DCM)
16.
Implantation of a pacemaker is most likely to benefit a patient with which of the following cardiomyopathies?
A)
Myocarditis
B)
Takotsubo cardiomyopathy
C)
Dilated cardiomyopathy (DCM)
D)
Primary restrictive cardiomyopathy
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17.
A child’s history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child?
A)
Cardiac catheterization and corticosteroid therapy
B)
Implanted pacemaker and b-adrenergic blockers
C)
Antibiotics and anti-inflammatories
D)
Pain control and oxygen therapy
18.
An elderly female patient with complaints of increasing fatigue has been diagnosed with aortic stenosis, a disease which her primary care provider believes may have been long-standing. Which of the following compensatory mechanisms has most likely maintained the woman’s ejection fraction until recently?
A)
Left ventricular hypertrophy
B)
Increased blood pressure
C)
Increased heart rate and stroke volume
D)
Aortic dilation
19.
Persistent cyanosis has led an infant’s care team to suspect a congenital heart defect. Which of the following assessment findings would suggest coarctation of the infant’s aorta?
A)
The child has a split S2 heart sound on auscultation.
B)
ECG reveals atrial fibrillation.
C)
The child experiences apneic spells after feeding.
D)
Blood pressure in the child’s legs is lower than in the arms.
20.
Which of the following assessment findings of a cyanotic infant is incongruent with a diagnosis of tetralogy of Fallot?
A)
The child has ventricular septal defect.
B)
The infant’s pulmonary outflow channel is narrowed.
C)
The child has right ventricular hypertrophy.
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D)
Answer Key 1.
A
2.
B
3.
D
4.
C
5.
B
6.
C
7.
B
8.
B
9.
D
10.
C
11.
C
12.
A
13.
B
14.
A
15.
C
16.
C
17.
C
18.
A
19.
D
20.
D
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https://studentmagic.indiemade.com/ Chapter 20 - Heart Failure and Circulatory Shock
1.
The pathophysiology of heart failure involves an interaction between decreased pumping ability and the to maintain cardiac output.
A)
aortic hypertrophy
B)
compensatory mechanisms
C)
electrical conductivity
D)
parasympathetic system
2.
Cardiac output is the
A)
volume load
B)
blood pumped
C)
stroke volume
D)
force generated
3.
each minute.
One of the principal mechanisms by which the heart compensates for increased workload is:
A)
myocardial hypertrophy.
B)
sodium and water retention.
C)
endothelin vasoconstrictors.
D)
ventricular wall tension increase.
4.
In right-sided heart failure, peripheral edema is evidenced by:
A)
weight gain.
B)
copious urination.
C)
shortness of breath.
D)
decreased blood pressure.
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5.
The most common causes of left-sided heart failure include:
A)
acute myocardial infarction.
B)
chronic pulmonary disease.
C)
impaired renal blood flow.
D)
tricuspid valve regurgitation.
6.
Hypovolemic shock occurs as a result of:
A)
myocardial infarction.
B)
excessive vasoconstriction.
C)
chronic intracellular fluid shift.
D)
acute intravascular volume loss.
7.
In shock, one of the best indicators of blood flow to vital organs is:
A)
warm legs.
B)
urine output.
C)
blood pressure.
D)
consciousness.
8.
Anaphylactic shock is directly associated with:
A)
loss of blood volume.
B)
bacterial blood infection.
C)
failure of the heart as a pump.
D)
type I hypersensitivity response.
9.
Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by:
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A)
hyperventilation.
B)
excessive surfactant.
C)
hyperinflated alveolar sacs.
D)
ventilation-perfusion mismatch.
10.
A common symptom of the ischemia associated with gastrointestinal redistribution of blood flow is:
A)
gastric bleeding.
B)
nausea and vomiting.
C)
irritable bowel syndrome.
D)
copious high volume diarrhea.
11.
A patient has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the patient’s end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this?
A)
Inotropy
B)
Cardiac contractility
C)
Preload
D)
Afterload
12.
Which of the following health problems is associated with heart failure as a result of diastolic dysfunction?
A)
Uncontrolled hypertension
B)
Chronic bradycardia
C)
Ischemic heart disease
D)
Myocardial hypertrophy
13.
Assessment of an elderly female patient reveals the presence of bilateral pitting edema of the patient’s
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Right-sided heart failure
B)
Left-sided heart failure
C)
Cardiogenic shock
D)
Cor pulmonale
14.
The most recent blood work of a patient with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What are the most likely effects of these peptides on the patient’s physiology?
A)
Water retention
B)
Increased tubular sodium reabsorption
C)
Inhibition of the renin-angiotensin-aldosterone system
D)
Sympathetic nervous stimulation
15.
A nurse is performing patient health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis?
A)
I’ll be sure to take my beta blocker whenever I feel short of breath.
B)
I’m going to avoid as much physical activity as I can so that I preserve my strength.
C)
I know it’s healthy to drink a lot of water, and I’m going to make sure I do this from now on.
D)
I’m trying to think of ways that I can cut down the amount of salt that I usually eat.
16.
Electrical burns over a large surface area of a patient’s body have resulted in hypovolemic shock after the loss of large amounts of blood and plasma. Which of the following mechanisms is the patient’s body likely to implement to compensate for this loss of fluid?
A)
Increased heart rate
B)
Vasodilation
C)
Diuresis
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D) 17.
Inhibition of ADH A patient who developed a deep vein thrombosis during a prolonged period of bedrest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this patient at risk of experiencing?
A)
Cardiogenic shock
B)
Hypovolemic shock
C)
Obstructive shock
D)
Distributive shock
18.
For which of the following types of shock might intravenous antibiotic therapy be indicated?
A)
Obstructive shock
B)
Distributive shock
C)
Cardiogenic shock
D)
Hypovolemic shock
19.
An 86-year-old male patient is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure?
A)
Increased vascular stiffness
B)
Orthostatic hypotension
C)
Increased cardiac contractility
D)
Loss of action potential
20.
A patient with a diagnosis of heart failure has returned from a visit with his primary care provider with a prescription for a change in his daily medication regimen. Which of the following drugs is likely to improve the patient’s cardiac function by increasing the force and strength of ventricular contractions?
A)
A b-adrenergic blocker
B)
A diuretic
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A cardiac glycoside
D)
An ACE inhibitor
Answer Key 1.
B
2.
B
3.
A
4.
A
5.
A
6.
D
7.
B
8.
D
9.
D
10.
A
11.
C
12.
D
13.
A
14.
C
15.
D
16.
A
17.
C
18.
B
19.
A
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20.
C
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1.
The function of the mucociliary blanket that lines the conducting airways is to:
A)
dehumidify inhaled air.
B)
remove foreign materials.
C)
warm the moving gases.
D)
spread antibacterial enzymes.
2.
Above the glottis that opens and closes for speech, the epiglottis functions to swallowing.
A)
open
B)
cover
C)
collapse
D)
constrict
3.
In addition to being the site of gas exchange, the lungs also:
A)
activate vasoactive substances.
B)
contain cells that produce heparin.
C)
empty extra blood volume into the left heart.
D)
use water vapor pressure to inflate alveoli.
4.
the larynx during
Bronchial circulation differs from the pulmonary circulation by providing blood for the:
A)
conducting airways.
B)
alveolar gas exchange.
C)
mediastinum and pleural space.
D)
intrapulmonary pressure balance.
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5.
Lung compliance is a measure of the change in pressure.
A)
elastic recoil
B)
surface tension
C)
lung volume
D)
vital capacity
6.
Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes pulmonary:
A)
vasospasms.
B)
hypertension.
C)
emboli formation.
D)
vasoconstriction.
7.
Diffusion of gases in the lung is decreased, as in pulmonary edema or pneumonia, by causing an increase in alveolar:
A)
gas pressure difference.
B)
size and surface area.
C)
anatomic shunting of blood.
D)
capillary membrane thickness.
8.
that occurs with a change in intrapulmonary
Respiratory movement of air that does not participate in alveolar gas exchange is known as alveolar dead space. Dead space increases when alveoli:
A)
carbon dioxide level is high.
B)
air supply exceeds blood flow.
C)
contain pulmonary edema fluid.
D)
collapse onto the capillary bed.
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9.
The oxyhemoglobin buffer system changes with the metabolic needs of the tissues. When the change causes a shift to the right in the dissociation curve, it is often the result of:
A)
decreased CO2 levels.
B)
increase tissue metabolism.
C)
decreased body temperature.
D)
increase red blood cell volume.
10.
The carbon dioxide content in the blood affects the regulation of ventilation through its effect on the of the brain.
A)
cerebrospinal fluid pH
B)
peripheral chemoreceptors
C)
afferent impulse regulation
D)
motor and premotor cortex
11.
A patient who is in a room at one atmosphere (760 mm Hg) is receiving supplementary oxygen therapy that is being delivered at a concentration of 50%. What is the consequent PO2?
A)
38,000 mm Hg
B)
More data are needed
C)
380 mm Hg
D)
15.2 mm Hg
12.
A patient’s recent history of emphysema has resulted in the functional loss of many alveoli. Which of the following physiologic functions is the primary role of type II alveoli?
A)
Facilitation of bronchial circulation
B)
Production of surfactant
C)
Gas exchange
D)
Production of macrophages
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13.
Which of the following respiratory pressures is always negative in relation to alveolar pressure?
A)
Airway pressure
B)
Intrapleural pressure
C)
Intrathoracic pressure
D)
Intrapulmonary pressure
14.
A respiratory therapist has asked a patient to breathe in as deeply as possible during a pulmonary function test. Inspiration is normally the result of which of the following phenomena?
A)
Decreased intrapulmonary pressure
B)
Increased airway pressure
C)
Increased intrapleural pressure
D)
Decreased intrathoracic pressure
15.
According to Poiseuille law, airway resistance would be largest in which of the following?
A)
The trachea
B)
A bronchus
C)
A bronchiole
D)
An alveolus
16.
A patient with a history of chronic obstructive pulmonary disease (COPD) is undergoing pulmonary function testing. Which of the following instructions should the technician provide in order to determine the patient’s forced vital capacity (FVC)?
A)
I’ll ask you to breathe in as deep as you can, and then blow out as much of that air as possible.
B)
I’d like you to take a deep breath, and then blow out as much air as you can during one second.
C)
I want you to breathe as normally as possible and I’m going to measure how much air goes in and out with each breath.
D)
Breathe normally, and then exhale as much as you possibly can when I tell you.
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17.
Completion of a patient’s pulmonary function study has yielded the following data: tidal volume: 500 mL; inspiratory reserve: 3100 mL; expiratory reserve: 1200 mL; residual volume: 1200 mL; functional residual capacity: 2400 mL. What is this patient’s inspiratory capacity?
A)
5500 mL
B)
2600 mL
C)
More data are needed
D)
3600 mL
18.
A patient with a diagnosis of community-acquired pneumonia is producing copious secretions that are physically obstructing her airway. Which of the following pathophysiologic processes will result from this condition?
A)
Compensatory vasoconstriction
B)
Ventilation without perfusion
C)
Dead air space
D)
Perfusion without ventilation
19.
Which of the following forms accounts for the greatest percentage of carbon dioxide transport?
A)
Free CO2
B)
Bicarbonate
C)
Dissolved CO2
D)
Attached to hemoglobin
20.
A patient has experienced a bout of coughing after aspirating some of his secretions. The patient’s coughing was triggered by which of the following?
A)
Sudden ventilation-perfusion mismatch
B)
Sudden rise in PCO2
C)
Signals from receptors in the tracheobronchial wall
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Signals from central chemoreceptors
Answer Key 1.
B
2.
B
3.
B
4.
A
5.
C
6.
D
7.
D
8.
B
9.
B
10.
A
11.
C
12.
B
13.
B
14.
D
15.
C
16.
A
17.
D
18.
D
19.
B
20.
C
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https://studentmagic.indiemade.com/ Chapter 22 - Respiratory Tract Infections, Neoplasms, and Childhood Disorders
1.
A distinguishing feature of viral influenza is:
A)
direct contact transmission.
B)
abrupt-onset, profound malaise.
C)
constant pounding headache.
D)
profuse watery nasal discharge.
2.
A common cause of bacterial pneumonia in both community and hospital setting is:
A)
E. coli
B)
S. aureus.
C)
Enterobacter.
D)
S. pneumoniae.
3.
Legionnaire disease is a form of bronchopneumonia caused by an organism frequently found in:
A)
warm, standing water.
B)
public restrooms.
C)
fermenting yogurt.
D)
potted plant dirt.
4.
The pathogenic capacity of the tubercle bacillus is related to:
A)
formation of a Ghon’s focus lesion.
B)
its inherent destructive capabilities.
C)
rapid viral replication in host cells.
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the initiation of a cell-mediated immune response. People infected with HIV and tuberculosis lack a hypersensitivity response to the tuberculin test as a result of:
A)
inherent anergy.
B)
host cell depletion.
C)
poor lung perfusion.
D)
boosting phenomenon.
6.
Which of the four categories of bronchogenic carcinoma has the greatest association with tobacco smoking and tends to metastasize to the brain?
A)
Small cell
B)
Large cell
C)
Squamous cell
D)
Adenocarcinoma
7.
Increased upper airway resistance and decreased airflow into the lungs in neonates (0 to 4 weeks of age) can result from:
A)
frequent crying.
B)
sleeping supine.
C)
nasal congestion.
D)
productive coughing.
8.
Most respiratory disorders in infants produce a decrease in:
A)
lung compliance.
B)
airway resistance.
C)
oxygen demand.
D)
respiratory rate.
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9.
Which of the following acute respiratory infections in children poses the greatest threat of severe hypoxia caused by inflammatory edema?
A)
Croup
B)
Asthma
C)
Epiglottitis
D)
Bronchiolitis
10.
The cold viruses are rapidly spread from person to person. The greatest source of spread is:
A)
fingers.
B)
sneezing.
C)
plastic toys.
D)
eye mucosa.
11.
A college student is lamenting the fact that she has developed a cold on the weekend prior to exam week. Which of the following statements shows that the student has an accurate understanding of her upper respiratory infection?
A)
I’m just going to try to rest as much as I can until these bacteria clear up.
B)
I think I’ll go to the campus clinic and see if I can get a prescription for antibiotics.
C)
I suppose I should have been washing my hands more in the past few days.
D)
If I can just start some antihistamines as soon as possible I bet I’ll get over this faster.
12.
A patient has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems?
A)
Take a sputum sample for culture and sensitivity.
B)
Compare the patient’s oral, tympanic, and axillary temperatures and order a white blood cell count.
C)
Palpate the patient’s lymph nodes and inspect the ears with an otoscope.
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Perform transillumination and ask the patient if bending forward exacerbates the headache. Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination?
A)
An 81-year-old resident of a long-term care facility
B)
A 19-year-old man who was admitted to a hospital for an appendectomy
C)
A neonate who was born in a busy, inner-city hospital in late October
D)
An 86-year-old patient whose flu symptoms have required hospitalization
14.
A patient has been admitted to a medical unit of a hospital for the treatment of pneumonia that is attributable to S. pneumonia. Which of the following considerations is the priority in this patient’s treatment?
A)
Maintaining the patient’s activities of daily living
B)
Maintaining the patient’s airway
C)
Monitoring and treating the patient’s pain
D)
Preventing and treating the patient’s fever
15.
A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborneMycobacterium tuberculosis bacteria and has subsequently developed latent tuberculosis infection. Which of the following is true of this nurse?
A)
The nurse is likely asymptomatic.
B)
The nurse is now immune to more severe tuberculosis infection.
C)
The nurse can spread tuberculosis to others.
D)
The nurse has active tuberculosis infection.
16.
Which of the following types of lung cancer is associated with the best prognosis in the majority of patients?
A)
Small cell lung cancer
B)
Adenocarcinoma
C)
Squamous cell carcinoma
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D)
Large cell carcinoma
17.
Which of the following individuals is most clearly in need of diagnostic testing for lung cancer?
A)
A patient who has required hospitalization with a fever and the production of copious lung secretions
B)
A patient with a history of secondary tuberculosis who failed to complete his prescribed course of antibiotics
C)
A woman who complains of recurrent lower respiratory infections and who has sought care for increasing shortness of breath
D)
A man who demonstrates wasting of the pelvic and shoulder muscles combined with signs of hypercalcemia
18.
Which of the following characteristics of the lungs of infants and small children creates an increased risk of respiratory disorders?
A)
Type II alveoli in children may overproduce surfactant.
B)
Smaller airways create a susceptibility to changes in airway resistance and airflow.
C)
The pneumotaxic center in the pons in underdeveloped until 8 years of age.
D)
There are fewer chemoreceptors in the young medulla.
19.
Which of the following respiratory infections in children is associated with the poorest outcomes?
A)
Viral croup
B)
Rhinosinusitis
C)
Epiglottitis
D)
Spasmodic croup
20.
A 6-month-old infant has been hospitalized with acute bronchiolitis. Which of the following treatments should be prioritized in the infant’s care?
A)
Supplementary oxygen therapy
B)
Intravenous antibiotics
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Transfusion of fresh frozen plasma
D)
Tracheotomy
Answer Key 1.
B
2.
B
3.
A
4.
D
5.
A
6.
A
7.
C
8.
A
9.
C
10.
A
11.
C
12.
D
13.
A
14.
B
15.
A
16.
C
17.
D
18.
B
19.
C
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20.
A
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1.
Pleuritic chest pain associated with respiratory movements is usually described as:
A)
bilateral.
B)
localized.
C)
continuous.
D)
substernal.
2.
A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because:
A)
expired air exits the bleeding wound.
B)
trapped, inspired air collapses the lung.
C)
the opposite lung hyperinflates.
D)
blebs on the lung surface rupture.
3.
Atelectasis is most commonly caused by:
A)
airway obstruction.
B)
pulmonary embolism.
C)
inflammation of the pleura.
D)
chronic forceful coughing.
4.
Acute onset bronchial asthma causes wheezing and breathlessness as a result of:
A)
airway inflammation.
B)
alveolar collapse.
C)
compression atelectasis.
D)
pulmonary hypertension.
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5.
Emphysema is characterized by hyperinflation of the lungs that produces increased:
A)
total lung capacity.
B)
alveolar wall thickness.
C)
a1-antitrypsin enzyme.
D)
submucosal gland hypertrophy.
6.
As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to:
A)
breakdown of elastin.
B)
left-sided heart failure.
C)
pulmonary hypertension.
D)
expiratory airway collapse.
7.
With bronchiectasis, persistent airway obstruction and chronic infection results in bronchial:
A)
dilation.
B)
rupture.
C)
infarction.
D)
thickening.
8.
Cystic fibrosis (CF), the major cause of severe chronic respiratory disease in children, is characterized by:
A)
constipation.
B)
salt depletion.
C)
watery mucus.
D)
high cholesterol.
9.
The adverse effects of emboli on the pulmonary circulation and airways include:
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A)
excess surfactant.
B)
area bronchodilation.
C)
local vasoconstriction.
D)
lower lobe consolidation.
10.
The common results of respiratory failure are hypoxemia and:
A)
hypercapnia.
B)
bradycardia.
C)
vasoconstriction.
D)
pulmonary emboli.
11.
A patient with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which of the following physiologic phenomena will occur as a consequence of hypoxemia?
A)
Peripheral vasodilation
B)
Necrosis
C)
Hypoventilation
D)
Increased heart rate
12.
An elderly patient who has been restricted to bed by numerous comorbidities for several weeks has been diagnosed with a large pleural effusion. Which of the following treatment modalities is most likely to resolve the patient’s most recent health problem?
A)
Thoracentesis
B)
Supplementary oxygen therapy
C)
Administration of corticosteroids
D)
Administration of bronchodilators
13.
A motor vehicle accident has resulted in a tension pneumothorax for the driver of the car. Which of the
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Audible friction rub over the affected lung
B)
Mediastinal shift
C)
Metabolic alkalosis
D)
Atrial fibrillation
14.
A patient has just been admitted to the postsurgical unit following a below-the-knee amputation. Which of the following measures should her care team prioritize to prevent atelectasis during the patient’s immediate recovery?
A)
Bedrest and supplementary oxygen by nasal cannula
B)
Administration of bronchodilators by nebulizer
C)
Deep-breathing exercises and early mobilization
D)
Adequate hydration and a high-humidity environment
15.
Which of the following manifestations typically accompanies an asthmatic attack?
A)
Decreased residual volume
B)
Decreased pulmonary arterial pressure
C)
Prolonged inspiration
D)
Hyperinflation of the lungs
16.
A 51-year-old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which of the man’s following statements demonstrates a sound understanding of his new diagnosis?
A)
If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis.
B)
I’m pretty sure that I first caught bronchitis from the person who has the cubicle next to mine at work.
C)
I read on the Internet that I might have got bronchitis because I was born with an enzyme deficiency.
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I think that I probably could have prevented this if I had got in the habit of exercising more when I was younger.
17.
Which of the following individuals is experiencing a disorder of ventilation that has a restrictive rather than obstructive etiology?
A)
A 30-year-old African American man who has been diagnosed with sarcoidosis
B)
An infant whose routine screening is suggestive of cystic fibrosis
C)
An elderly, lifelong smoker who has been admitted to hospital with emphysema
D)
A 16-year-old girl who must limit her activity to prevent asthmatic attacks
18.
Prolonged immobility is implicated in the development of which of the following disorders?
A)
Bronchitis and bronchiectasis
B)
Sarcoidosis and idiopathic pulmonary fibrosis
C)
Atelectasis and pulmonary embolism
D)
Pulmonary hypertension and cor pulmonale
19.
Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?
A)
Pet dander
B)
Cold weather
C)
Stress
D)
Respiratory tract infections
20.
Pain is an expected assessment finding in patients who have which of the following lung diseases?
A)
Asthma
B)
Pleural effusion
C)
Pulmonary arterial hypertension (PAH)
D)
Pleuritis
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Answer Key 1.
B
2.
B
3.
A
4.
A
5.
A
6.
C
7.
A
8.
B
9.
C
10.
A
11.
D
12.
A
13.
B
14.
C
15.
D
16.
A
17.
A
18.
C
19.
A
20.
D
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1.
When the kidneys have decreased perfusion or increased sympathetic nervous system stimulation, renal blood flow goes mainly to the medulla in order to decrease while maintaining the of urine.
A)
pressure; adequate output
B)
electrolyte loss; acidic pH
C)
filtration rate; concentration
D)
buffer loss; glucose level
2.
Although an average of glomerular filtrate is formed each minute, only and the rest is reabsorbed in the tubules.
A)
250 mL; 15 mL
B)
125 mL; 1 mL
C)
200 mL; 5 mL
D)
175 mL; 10 mL
3.
Alterations in the structure and function of the glomerular are responsible for protein and blood cell leakage into the filtrate that occurs in many forms of glomerular disease.
A)
renal corpuscle
B)
Bowman’s capsule
C)
peritubular network
D)
basement membrane
4.
is excreted as urine
When the glomerular transport maximum for a substance such as blood glucose is exceeded and its renal threshold has been reached, the substance will:
A)
reabsorb quickly.
B)
spill into the urine.
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counter-transport sodium.
D)
attach to protein carriers.
5.
In contrast to the descending limb, the ascending limb of the loop of Henle is impermeable to and the tubular filtrate becomes more as a result.
A)
potassium; acidic
B)
water; hypoosmolar
C)
sodium; concentrated
D)
chloride; reabsorbed
6.
The major sites of aldosterone action on sodium and potassium, potassium regulation, and the final concentration of sodium in urine are the tubule and the tubule.
A)
late distal; cortical collecting
B)
thin ascending; thick ascending
C)
proximal; thin descending segment
D)
juxtamedullary; elbow diluting segment
7.
Only the kidneys can eliminate when urine buffers are present.
A)
hydrogen (H+)
B)
potassium (K+)
C)
ammonia (NH3)
D)
phosphate (HPO4)
8.
from the body as a means of regulating body acid-base balance,
The kidney assists in blood pressure regulation by releasing from the juxtaglomerular cells in response to decreased renal blood flow, resulting in efferent arteriole vasoconstriction.
A)
renin
B)
angiotensin II
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aldosterone
D)
angiotensin I
9.
In addition to regulating body fluids and electrolytes, the kidneys function in maintaining bone calcium levels by:
A)
activating vitamin D.
B)
excreting bicarbonate.
C)
stimulating bone marrow.
D)
synthesizing erythropoietin.
10.
Which one of the following blood tests reflects the glomerular filtration rate (GFR) and is used to estimate renal function?
A)
Blood protein
B)
Serum creatinine
C)
Serum ammonia
D)
Blood urea nitrogen
11.
As glomerular filtrate exits Bowman’s capsule, it will enter the and then the .
, followed by the
A)
Proximal tubule; loop of Henle; distal tubule
B)
Ascending limb of the loop of Henle; descending limb of the loop of Henle; distal tubule
C)
Glomerulus; proximal tubule; distal tubule
D)
Collecting tubule; distal tubule; loop of Henle
12.
Reabsorption of electrolytes such as Na+, K+, Cl, and bicarbonate (HCO3) from glomerular filtrate takes place primarily in which of the following locations?
A)
Descending limb of the loop of Henle
B)
Ascending limb of the loop of Henle
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Bowman’s capsule
D)
Proximal convoluted tubule
13.
An athlete has become dehydrated during a long race in hot weather. Which of the following physiologic processes will occur in an attempt to protect the athlete’s extracellular fluid volume?
A)
Dilation of the afferent and efferent arterioles
B)
Release of ADH from the posterior pituitary
C)
Increased water reabsorption in the ascending limb of the loop of Henle
D)
Increased water reabsorption in the distal convoluted tubule
14.
A patient’s most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (normal range 8 to 25 mg/dL). Which of the following factors may have contributed to this finding?
A)
Increased salt intake
B)
Action of ADH
C)
Dehydration
D)
Parasympathetic nervous stimulation
15.
Which of the following physiologic processes is performed by the kidneys and contributes to increased blood pressure?
A)
Catalysis of the conversion of angiotensin I to angiotensin II
B)
Production and release of renin
C)
Secretion of aldosterone
D)
Conversion of aldosterone to angiotensin
16.
A patient has a diagnosis of chronic renal failure secondary to diabetic nephropathy. Which of the following hematologic changes may result from this patient’s kidney disorder?
A)
Anemia
B)
Leukocytosis
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Thrombocytopenia
D)
Leukopenia
17.
A patient has provided a routine urine sample during a scheduled visit to his primary care provider. Which of the following results is an expected finding in a healthy individual?
A)
Low to moderate amount of glucose in the urine
B)
Urine specific gravity of 1.020
C)
Presence of moderate amounts of albumin with the absence of other proteins
D)
Presence of urinary casts
18.
Which of the following factors is likely to result in decreased renal blood flow?
A)
Action of dopamine
B)
Release of nitric oxide
C)
Action of prostaglandins
D)
Sympathetic nervous stimulation
19.
Which of the following aspects of kidney function is performed by the juxtaglomerular complex?
A)
Regulating urine concentration
B)
Facilitating active transport to reabsorb electrolytes
C)
Regulating sodium and potassium elimination
D)
Matching changes in GFR with renal blood flow
20.
Which of the following components of glomerular filtrate can cross the tubular epithelial cell membrane passively?
A)
Sodium
B)
Potassium
C)
Urea
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Glucose
Answer Key 1.
C
2.
B
3.
D
4.
B
5.
B
6.
A
7.
A
8.
A
9.
A
10.
B
11.
A
12.
D
13.
B
14.
C
15.
B
16.
A
17.
B
18.
D
19.
D
20.
C
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1.
A characteristic manifestation of polycystic kidney disease is:
A)
massive proteinuria.
B)
renal colic.
C)
alkaline urine.
D)
hypertension.
2.
Of the four types of kidney stones, the formation of magnesium ammonium phosphate (struvite) stones is directly associated with:
A)
hyperuricemia.
B)
hydronephrosis.
C)
high urine calcium.
D)
urinary tract infections.
3.
The most damaging effects of urinary obstruction are the result of urine outflow.
A)
urinary stasis
B)
concentrated urine
C)
kidney hyperplasia
D)
renal hypertension
4.
Glomerulonephritis is usually caused by:
A)
vesicoureteral reflux.
B)
catheter-induced infection.
C)
antigen-antibody complexes.
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glomerular membrane viruses. The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects:
A)
obstruction and reflux.
B)
salt and water retention.
C)
inability to concentrate urine.
D)
decreased glomerular permeability.
6.
The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to:
A)
red blood cells.
B)
plasma proteins.
C)
inflammatory cells.
D)
antibody complexes.
7.
Chronic pyelonephritis, a significant cause of renal failure, is most commonly caused by:
A)
viral organisms.
B)
intrarenal reflux.
C)
renal hyperplasia.
D)
abscess formation.
8.
High-risk factors for development of adult renal cell cancer include:
A)
heavy smoking.
B)
inherited renal disease.
C)
adrenal medulla tumors.
D)
anorexia/bulimia disorder.
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Which of the following assessment findings is most suggestive of nephrotic syndrome?
A)
Hematuria and anemia
B)
Proteinuria and generalized edema
C)
Renal colic and increased serum sodium
D)
Increased creatinine with normal blood urea nitrogen
10.
The most recent assessment of a patient with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk?
A)
Microalbuminuria
B)
Hematuria
C)
Orthostatic hypotension
D)
Diabetic retinopathy
11.
An elderly female patient has been hospitalized for the treatment of acute pyelonephritis. Which of the following characteristics of the patient is most likely implicated in the etiology of her current health problem?
A)
The patient was diagnosed with type 2 diabetes several years earlier.
B)
The patient takes a diuretic and an ACE inhibitor each day for the treatment of hypertension.
C)
The patient recently had a urinary tract infection.
D)
The patient has peripheral vascular disease.
12.
Which of the following disorders of renal function primarily affects the proximal and distal tubules?
A)
Chronic pyelonephritis
B)
Polycystic kidney disease
C)
Acute nephritic disease
D)
Renal calculi
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An adult patient has been diagnosed with polycystic kidney disease. Which of the patient’s following statements demonstrates an accurate understanding of this diagnosis?
A)
I suppose I really should have paid more attention to my blood pressure.
B)
I’ve always been prone to getting UTIs, and now I know why.
C)
I suppose I should be tested to see if my children might inherit this.
D)
I had a feeling that I was taking too many medications, and now I know the damage they can do.
14.
An infant has been diagnosed with autosomal recessive polycystic kidney disease (ARPKD). Which of the following treatments is the priority in the care of this child?
A)
Rehydration therapy
B)
Total parenteral nutrition
C)
Prophylactic antibiotics
D)
Respiratory support
15.
An obese, male patient with a history of gout and a sedentary lifestyle has been advised by his primary care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the patient’s susceptibility to which of the following types of kidney stones?
A)
Calcium stones
B)
Magnesium ammonium phosphate stones
C)
Uric acid stones
D)
Cystine stones
16.
A patient has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the patient integrate into his lifestyle to reduce the risk of recurrence?
A)
Increased fluid intake and dietary changes
B)
Weight loss and blood pressure control
C)
Regular random blood glucose testing
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Increased physical activity and use of over-the-counter diuretics A young child has been diagnosed with Wilms tumor after his mother discovered an unusual mass, prompting a diagnostic workup. Which of the following characteristics is typical of Wilms tumor?
A)
The tumor is usually asymptomatic.
B)
The tumor is usually self-limiting.
C)
The tumor is usually a secondary neoplasm.
D)
The tumor is usually encapsulated.
18.
Which of the following patient complaints most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?
A)
Urinary urgency
B)
Hematuria
C)
Oliguria
D)
Cloudy urine
Answer Key 1.
D
2.
D
3.
A
4.
C
5.
B
6.
B
7.
B
8.
A
9.
B
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A
11.
C
12.
A
13.
C
14.
D
15.
C
16.
A
17.
D
18.
B
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1.
The most common indicator of acute renal failure is:
A)
anemia.
B)
uremia.
C)
edema.
D)
azotemia.
2.
A patient had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:
A)
prerenal inflammation.
B)
bladder outlet obstruction.
C)
ischemic tubular necrosis.
D)
intrarenal nephrotoxicity.
3.
A patient is beginning to recover from acute tubular necrosis. The recovery phase of ATN is characterized by:
A)
edema.
B)
diuresis.
C)
proteinuria.
D)
hypokalemia.
4.
Regardless of the cause, chronic kidney disease results in progressive permanent loss of nephrons, glomerular filtration and renal:
A)
tubule dysplasia.
B)
vascular pressure.
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endocrine functions.
D)
hypophosphatemia.
5.
As chronic kidney disease progresses, the second stage (renal insufficiency) is identified by:
A)
isotonic polyuria.
B)
metabolic acidosis.
C)
hyperparathyroidism.
D)
diminished renal reserve.
6.
Both high-turnover and low-turnover renal osteodystrophy, the skeletal complications of chronic kidney disease, are manifested by abnormal and defective bone .
A)
shape; joint motion
B)
absorption; remodeling
C)
matrix density; marrow
D)
parathyroid hormone; surface
7.
Impaired skin integrity and skin manifestations are common in persons with chronic kidney disease. Pale skin and subcutaneous bruising are often present as a result of:
A)
thrombocytopenia.
B)
anticoagulant therapy.
C)
decreased vascular volume.
D)
impaired platelet function.
8.
When acute tubular necrosis (ATN) has occurred instead of prerenal azotemia, laboratory test findings will show the presence of excessive urine:
A)
protein.
B)
glucose.
C)
calcium.
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D) 9.
sodium. Manifestations of childhood renal disease are varied and may differ from adult onset renal failure. Features of childhood chronic kidney disease include:
A)
mental retardation.
B)
developmental delays.
C)
bladder incontinence.
D)
early sexual maturity.
10.
Reduced glomerular filtration rate (GFR), with a serum creatinine level that remains in the normal range, is associated with aging because is reduced in elderly persons.
A)
calcium intake
B)
muscle mass
C)
drug tolerance
D)
renal perfusion
11.
An 86-year-old female patient has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to prevent urinary incontinence. The patient’s most recent laboratory results are suggestive of acute renal failure. How would this patient’s renal failure be categorized?
A)
Prerenal
B)
Postrenal
C)
Intrinsic
D)
Intrarenal
12.
A patient with significant burns on his lower body has developed sepsis on the third day following his accident. Which of the following developments is most clearly suggestive of ischemic acute tubular necrosis rather than prerenal failure?
A)
The patient exhibits pulmonary and peripheral edema.
B)
The patient’s GFR does not increase after restoration of renal blood flow.
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C)
Emergency hemodialysis does not result in decreased BUN and creatinine.
D)
The patient exhibits oliguria and frank hematuria.
13.
Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease?
A)
A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage
B)
A patient whose diagnosis of thyroid cancer necessitated a thyroidectomy
C)
A patient who experienced a hemorrhagic stroke and now has sensory and motor deficits
D)
A patient with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet
14.
The primary care provider for a newly admitted hospital patient has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The patient’s GFR will be extrapolated from serum levels of:
A)
urea.
B)
protein.
C)
creatinine.
D)
myoglobin.
15.
The nurse is providing care for a patient who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this patient’s diagnosis?
A)
Metabolic alkalosis
B)
Hypophosphatemia
C)
Hypocalcemia
D)
Hypokalemia
16.
A patient with a recent diagnosis of renal failure that will require hemodialysis is being educated in the dietary management of the disease. Which of the patient’s following statements shows an accurate understanding of this component of treatment?
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I’ve made a list of high-phosphate foods so that I can try to avoid them.
B)
I’m making a point of trying to eat lots of bananas and other food rich in potassium.
C)
I’m going to try a high-protein, low-carbohydrate diet.
D)
I don’t think I’ve been drinking enough, so I want to include 8 to 10 glasses of water each day.
17.
A patient with a diagnosis of chronic kidney disease (CKD) may require the administration of which of the following drugs to treat the consequences of CKD?
A)
Antihypertensive medications
B)
Antiarrhythmic medications
C)
Opioid analgesics
D)
Nonsteroidal anti-inflammatory drugs (NSAIDs)
18.
A patient with a longstanding diagnosis of chronic kidney disease has been experiencing increasing fatigue, lethargy, and activity intolerance in recent weeks. His care team has established that his GFR remains at a low, but stable, level. Which of the following assessments is most likely to inform a differential diagnosis?
A)
Blood work for white cells and differential
B)
Cystoscopy and ureteroscopy
C)
Assessment of pancreatic exocrine and endocrine function
D)
Blood work for hemoglobin, red blood cells, and hematocrit
19.
Which of the following descriptions is true of peritoneal dialysis?
A)
Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt.
B)
Treatments typically occur three times each week for three to four hours.
C)
The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes.
D)
Treatment involves the introduction of a sterile dialyzing solution, which is drained after a specified time.
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Which of the following integumentary problems most often accompanies chronic kidney disease?
A)
Dry skin and pruritus
B)
Petechiae and purpura
C)
Hirsutism and psoriasis
D)
Alopecia
Answer Key 1.
D
2.
C
3.
B
4.
C
5.
A
6.
B
7.
D
8.
A
9.
B
10.
B
11.
A
12.
B
13.
D
14.
C
15.
C
16.
A
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17.
A
18.
D
19.
D
20.
A
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1.
Although urinary obstruction and urinary incontinence have almost opposite effects on urination, they can both result from:
A)
bladder structure changes.
B)
bladder wall atrophy.
C)
micturition reflex spasms.
D)
bladder distensibility loss.
2.
The body compensates for obstructed urine outflow. Compensatory changes to chronic obstruction include:
A)
bladder spasms.
B)
urinary frequency.
C)
high residual volume.
D)
overflow incontinence.
3.
A patient fell off a ladder and sustained a spinal cord injury that has resulted in bladder dysfunction. During the period immediately after the spinal injury, spinal shock develops and the bladder has function.
A)
atonic
B)
spasmodic
C)
uninhibited
D)
hyperactive
4.
In men, the condition of nonrelaxing external sphincter with urine retention is commonly caused by:
A)
psychosocial disorders.
B)
prostate enlargement.
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chronic stress response.
D)
pelvic inflammatory disease.
5.
In women, pelvic floor weakness may cause which type of incontinence?
A)
Urge
B)
Stress
C)
Overflow
D)
Overactive
6.
Many factors contribute to the incontinence that is common among the elderly. A major factor is increased:
A)
detrusor muscle function.
B)
intake of liquids and water.
C)
urethral closing pressure.
D)
use of multiple medications.
7.
Dysfunction of the
A)
trigone
B)
sphincter
C)
detrusor
D)
trabeculae
8.
muscle contraction can disrupt the ability to expel urine from the bladder.
Neurologic control of bladder function consists of three main levels or centers. The lower motor neuron spinal cord centers control micturition:
A)
reflexes.
B)
backflow.
C)
inhibition.
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coordination. Prolonged urethral outlet obstruction causes chronic high bladder pressure and overdistension, resulting in the formation of:
A)
detrusor dyssynergia.
B)
cellules.
C)
interstitial cystitis.
D)
sphincter dystonia.
10.
The most common sign of epithelial cell bladder cancer is:
A)
severe oliguria.
B)
hyperproteinuria.
C)
hyperphosphaturia.
D)
painless hematuria.
11.
Most common uncomplicated urinary tract infections are caused by
A)
Pseudomonas
B)
Escherichia coli
C)
Staphylococcus aureus
D)
Group B Streptococcus
12.
that enter through the urethra.
Although the distal portion of the urethra often contains pathogens, the urine formed in the kidney and found in the bladder is sterile because of the:
A)
alkaline urine.
B)
glomerular filtering.
C)
warm temperature.
D)
washout phenomenon.
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An elderly patient who experiences chronic pain takes opioid analgesics on a regular basis, a practice that has resulted in frequent constipation and occasional bowel obstructions. Which of the following problems may directly result from these gastrointestinal disorders?
A)
Urinary tract infections
B)
Overflow urinary incontinence
C)
Bladder cancer
D)
Neurogenic bladder
14.
After reviewing the 24-hour intake and output of a hospital patient, the nurse suspects that the patient may be experiencing flaccid bladder dysfunction. Which of the following diagnostic methods is most likely to confirm or rule out whether the patient is retaining urine?
A)
Blood test for creatinine, blood urea nitrogen, and glomerular filtration rate
B)
Urine test for culture and sensitivity
C)
Routine urinalysis
D)
Measurement of postvoid residual (PVR) by ultrasound
15.
A pregnant woman who is beginning her third trimester has been diagnosed with a urinary tract infection (UTI). Which of the following factors most likely predisposed this patient to the development of a UTI?
A)
Increased urine alkalinity during pregnancy
B)
Hypertrophy of the bladder wall
C)
Dilation of the upper urinary structures
D)
Spastic peristalsis of the ureters
16.
Which of the following signs and symptoms in a 2-year-old child should prompt assessment for a urinary tract infection?
A)
Unexplained fever and anorexia
B)
Decreased urine output and irritability
C)
Production of concentrated urine and recurrent nausea
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Frank hematuria Which of the following patients is likely at the greatest risk of developing a urinary tract infection?
A)
A pregnant woman who has been experiencing urinary frequency
B)
A patient with a diagnosis of chronic kidney disease who requires regular hemodialysis
C)
A 79-year-old patient with an indwelling catheter
D)
A confused, 81-year-old patient who is incontinent of urine
18.
A woman has sought care because of recurrent urinary tract infections, which have been increasing in both frequency and severity. Which of the following factors is likely to contribute to recurrent UTIs?
A)
Reflux flow of urine
B)
Fluctuations in urine pH
C)
Urethral trauma
D)
Inadequate fluid intake
19.
A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants’ following statements demonstrates an accurate understanding of the risk factors for bladder cancer?
A)
I suppose I should listen to my doctor and drink more cranberry juice.
B)
More than ever, I guess it would worthwhile for me to quit smoking.
C)
I can see that preventing bladder cancer is one more benefit of a healthy diet.
D)
I think I should be okay because there’s no history or bladder cancer in my family that I’m aware of.
20.
Which of the following events would suggest that an individual’s physiologic response to an obstruction has progressed beyond the compensatory stage and is now in the decompensatory stage?
A)
The bladder muscle hypertrophies.
B)
The detrusor loses its power of contraction.
C)
The ability to suppress urination is diminished.
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D)
The individual experiences urgency.
Answer Key 1.
A
2.
B
3.
A
4.
B
5.
B
6.
D
7.
C
8.
A
9.
B
10.
D
11.
B
12.
D
13.
B
14.
D
15.
C
16.
A
17.
C
18.
A
19.
B
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B
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1.
Bile and pancreatic juices enter the
A)
ileum
B)
antrum
C)
jejunum
D)
duodenum
2.
The digestive tract is a four-layered tube. Which layer consists of connective tissue and contains nerves, blood vessels, and structures for secreting the digestive juices?
A)
Mucosal
B)
Peritoneum
C)
Submucosal
D)
Circular muscle
3.
What body part is the largest serous membrane in the body, constitutes the outer wall of the intestine, and contains a serous fluid between its two layers?
A)
Mesentery
B)
Omentum
C)
Haustration
D)
Peritoneum
4.
through the common bile duct and the pancreatic duct.
Motility along the length of the gut, control of function, and communication of each segment are innervated by the neurons of the enteric nervous system.
A)
intramural
B)
vasovagal
C)
sympathetic
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D) 5.
preganglionic The patient chews an apple and starts the three phases of swallowing. As food enters the patient’s esophagus, stretching and nerve impulses initiate that are controlled by the swallowing center.
A)
phrenic; gag reflexes
B)
vagus; peristaltic waves
C)
hypoglossal; contractions
D)
trigeminal; tactile receptors
6.
In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum:
A)
during bile secretion.
B)
between contractions.
C)
with a mucosal surface.
D)
under gaseous pressure.
7.
Because intestinal secretions are mainly and are derived from the extracellular fluid, excessive secretion or impaired absorption can lead to extracellular .
A)
nitrogen; acidosis
B)
water; dehydration
C)
anaerobic; hypotonicity
D)
electrolytes; hypervolemia
8.
The stomach is the source of two hormones produced by the gastrointestinal tract: gastrin and ghrelin. Ghrelin is a peptide hormone produced in the mucosal layer that has an important role in regulation of secretion.
A)
gastric acid fluid
B)
growth hormone
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C)
biliary bicarbonate
D)
pancreatic enzyme
9.
In addition to mucus, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous type fluid are secreted to act as a:
A)
vehicle for absorption.
B)
enzyme that splits sugars.
C)
protection from acid content.
D)
parasympathetic stimulation.
10.
The intestinal absorption of glucose and amino acids is facilitated by a
A)
bile-salt micelles
B)
fat emulsification
C)
sodium-dependent
D)
brush border enzyme
11.
Parasympathetic stimulation results in which of the following gastrointestinal effects?
A)
Increase in smooth muscle tone
B)
Enhancement of sphincter function
C)
Decrease in gastrointestinal motility
D)
Increase in enteric nervous system activity
12.
transport system.
Which of the following functions is performed by saliva?
A)
Antimicrobial protection
B)
Promotion of intestinal flora
C)
Buffering of gastric secretions
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D) 13.
Catalysis of brush border enzymes Gastrin production, a task that is performed by the stomach, results in which of the following effects?
A)
Simulation of pancreatic enzyme secretions
B)
Stimulation of HCl secretions by parietal cells
C)
Conversion of polysaccharides to monosaccharides
D)
Release of insulin in response to glucose load
14.
A patient who is quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the following actions performed by the patient’s caregiver is likely to promote defecation?
A)
Digital stimulation of the patient’s rectum
B)
Massage of the patient’s abdomen
C)
Seating the patient in an upright position
D)
Administration of large amounts of free water
15.
Which of the following patients likely faces the greatest risk of a gastrointestinal bleed?
A)
A man whose hypertension requires him to take a diuretic, an ACE inhibitor, and a b-adrenergic blocker
B)
A patient who is taking a broad-spectrum antibiotic to treat a urinary tract infection
C)
A patient with a history of anxiety who takes benzodiazepines several times daily
D)
A patient who takes aspirin with each meal to control symptoms of osteoarthritis
16.
A patient’s complex and worsening pressure ulcer has necessitated the use of numerous antibiotics over the last several months. Which of the following consequences may result from this patient’s medication regimen?
A)
Impaired mucus production
B)
Vitamin K deficiency
C)
Impaired protein metabolism
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D) 17.
Excessive release of pepsin Which of the following aspects of gastrointestinal function is performed by the brush border enzymes of the villus structures?
A)
Fat metabolism
B)
Vitamin A synthesis
C)
Digestion of carbohydrates
D)
Maintenance of fluid and electrolyte balance
18.
A patient has been diagnosed with cholecystitis (gall bladder inflammation) that has impaired the normal release of bile. Which of the following gastrointestinal consequences is this patient likely to experience?
A)
Incomplete digestion of starches
B)
Impaired glucose metabolism
C)
Inadequate gastric acid production
D)
Impaired digestion of fats
19.
A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours. Vomiting results from stimulation of what site in the neurologic system?
A)
Myenteric plexus
B)
Intramural plexus
C)
Vagus nerve
D)
Chemoreceptor trigger zone
20.
A patient has been diagnosed with an incompetent pyloric sphincter. This patient will experience abnormal communication between which of the following components of the gastrointestinal tract?
A)
Stomach and duodenum
B)
Esophagus and stomach
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Rectum and anus
D)
Small intestine and colon
Answer Key 1.
D
2.
A
3.
D
4.
A
5.
B
6.
B
7.
B
8.
B
9.
A
10.
C
11.
D
12.
A
13.
B
14.
A
15.
D
16.
B
17.
C
18.
D
19.
D
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20.
A
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1.
A major complication of persistent gastroesophageal reflux is:
A)
strictures.
B)
heartburn.
C)
chest pain.
D)
hoarseness.
2.
Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with:
A)
diarrhea.
B)
food allergies.
C)
gastric reflux.
D)
alcohol intake.
3.
The Helicobacter pylori protobacteria cause peptic ulceration by producing:
A)
acids
B)
toxins
C)
ischemia
D)
bleeding
4.
A hallmark of irritable bowel syndrome is abdominal pain:
A)
relieved by defecation.
B)
most severe at night.
C)
with blood in the stool.
D)
after and between meals.
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5.
Inflammatory bowel diseases are accompanied by systemic manifestations that include:
A)
autoimmune anemia.
B)
rheumatoid arthritis.
C)
thrombocytopenia.
D)
lactose intolerance.
6.
Crohn’s type of inflammatory bowel disease is characterized by:
A)
granulomatous lesions.
B)
ulcerative erosions.
C)
fibrotic smooth muscle.
D)
necrotic crypt abscesses.
7.
Unlike the Crohn type of inflammatory bowel disease, the ulcerative colitis type is characterized by:
A)
skip lesions.
B)
steatorrhea.
C)
gastric ulcers.
D)
pseudopolyps.
8.
Diverticulitis, a complication of diverticulosis, is manifested by acute:
A)
rectal bleeding.
B)
abdominal distention.
C)
large-volume diarrhea.
D)
lower left quadrant pain.
9.
Major causes of mechanical bowel obstruction include:
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chemical irritation.
B)
ruptured appendix.
C)
abdominal distention.
D)
postoperative adhesions.
10.
As a protective measure to keep abdominal inflammation and infection localized, the peritoneum:
A)
constricts bowel contents.
B)
secretes fibrous exudate.
C)
increases intestinal motility.
D)
abdominal vasoconstriction.
11.
Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer?
A)
Heartburn after an individual consumes high-fat meals
B)
Dysphagia in an individual with no history of neurologic disease
C)
A new onset of gastroesophageal reflux in a previously healthy individual
D)
Recurrent episodes of gastritis that do not respond to changes in diet
12.
A 60-year-old male patient has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this patient’s pharmacologic treatment?
A)
Inhibiting gastric acid production
B)
Promoting hypertrophy of the gastric mucosa
C)
Increasing the rate of gastric emptying
D)
Increasing muscle tone of the cardiac sphincter
13.
Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis?
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A 55-year-old man who takes proton pump inhibitors for the treatment of peptic ulcers
B)
A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics
C)
A premature neonate who has developed hyperbilirubinemia and is receiving phototherapy
D)
A 30-year-old patient who has a history of Crohn disease and has been admitted to a hospital to treat a recent flare-up
14.
A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the patient’s following statements demonstrates an accurate understanding of this diagnosis?
A)
From now on, I’m going to stick to an organic diet and start taking more supplements.
B)
I think this might have happened because I’ve used enemas and laxatives too much.
C)
I’ve always struggled with heartburn and indigestion, and I guess I shouldn’t have ignored those warning signs.
D)
I suppose I should try to eat more fiber and become a bit more active.
15.
An ultrasound has confirmed appendicitis as the cause of a 20-year-old man’s sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis?
A)
Obstruction of the intestinal lumen
B)
Elimination of normal intestinal flora
C)
Sloughing of the intestinal mucosa
D)
Increased osmolality of intestinal contents
16.
Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type?
A)
Larger volume of diarrhea
B)
Electrolyte imbalances
C)
Absence of blood in the stool
D)
Infection of intestinal cells
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Which of the following patients should the nurse observe most closely for the signs and symptoms of paralytic ileus?
A)
A patient who is postoperative day 1 following gall bladder surgery
B)
A patient whose acute diarrhea has necessitated the use of antidiarrheal medications
C)
An obese patient who refuses to ambulate because he complains of shortness of breath
D)
A patient with a longstanding diagnosis of irritable bowel syndrome
18.
Which of the following meals is most likely to exacerbate an individual’s celiac disease?
A)
Spaghetti with meatballs and garlic bread
B)
Stir-fried chicken and vegetables with rice
C)
Oatmeal with milk, brown sugar, and walnuts
D)
Barbecued steak and a baked potato with sour cream
19.
Which of the following statements is true of colorectal cancer?
A)
Aspirin and NSAIDs are implicated in the etiology.
B)
It is one of the few cancers that is known to sometimes have an infectious etiology.
C)
Most cases are quite advanced before symptoms become apparent.
D)
Survival rates for colorectal cancer are less than 20%, but are increasing.
20.
Following the analysis of a recent barium enema and colonoscopy with biopsy, a patient has been diagnosed with colorectal cancer. Which of the following treatment modalities will be the mainstay of this patient’s treatment?
A)
Chemotherapy
B)
Radiation therapy
C)
Pharmacologic therapies
D)
Surgery
Answer Key
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1.
A
2.
D
3.
B
4.
A
5.
A
6.
A
7.
D
8.
D
9.
D
10.
B
11.
B
12.
A
13.
B
14.
D
15.
A
16.
D
17.
A
18.
A
19.
C
20.
D
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1.
Abnormally high accumulation of bilirubin in the blood causes:
A)
jaundice.
B)
cholestasis.
C)
xanthomas.
D)
biliary cirrhosis.
2.
The mechanisms of liver damage in viral hepatitis include:
A)
direct cellular injury.
B)
fatty liver changes.
C)
disrupted bile flow.
D)
bile duct inflammation.
3.
Alcoholic liver disease manifests in three stages. The intermediate stage, alcoholic hepatitis, is characterized by liver cell:
A)
necrosis.
B)
nodules.
C)
atrophy.
D)
hypertrophy.
4.
A major factor in the development of hepatic encephalopathy is:
A)
hypersplenism.
B)
high sodium level.
C)
neurotoxin accumulation.
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steroid hormone deficiency. Kupffer cells function as to remove harmful substances or cells from the portal blood as it moves through the venous sinusoids.
A)
filters
B)
channels
C)
phagocytes
D)
cytotoxic cells
6.
Both prehepatic and posthepatic causes of portal hypertension include the formation of:
A)
fibrous nodules.
B)
venous thrombosis.
C)
collateral circulation.
D)
portosystemic shunts.
7.
The late manifestations of cirrhosis are related to liver failure and:
A)
hepatomegaly.
B)
diffuse liver fibrosis.
C)
portal hypertension.
D)
hepatorenal syndrome.
8.
Factors that contribute to the formation of gallstones, or acute cholelithiasis, include:
A)
chronic pancreatitis.
B)
rapid elimination of bile.
C)
gallbladder inflammation.
D)
excessive alcohol intake.
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The patient has right upper quadrant pain caused by acute choledocholithiasis. If the common bile duct becomes obstructed, manifestations will also include:
A)
ascites.
B)
vomiting.
C)
bilirubinuria.
D)
hemorrhage.
10.
Acute pancreatitis involves activated pancreatic enzymes that escape into surrounding tissues to cause .
A)
fatty deposits
B)
autodigestion
C)
bowel obstruction
D)
abscess formation
11.
Individuals with liver disease often experience the effects of excess serum ammonia as a result of impairment of the liver’s ability to process ammonia. How does the liver process ammonia in healthy individuals?
A)
By converting it into bilirubin which is then excreted intestinally
B)
By processing ammonia into nitrogen and hydrogen ions for excretion
C)
By processing it into urea and releasing it into the circulation
D)
By combining it with oxygen to create ammonium oxide
12.
A patient’s longstanding diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this patient most likely experience?
A)
Prehepatic
B)
Intrahepatic
C)
Posthepatic
D)
Infectious
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13.
A decrease in the serum level of which of the following substances is suggestive of liver injury?
A)
g-Glutamyltransferase (GGT)
B)
Albumin
C)
Alanine aminotransferase (ALT)
D)
Alkaline phosphatase
14.
Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the patient’s statements suggests that he understands his new diagnosis?
A)
I guess I’m an example of why you should always use condoms.
B)
I’m embarrassed that I’ll be a carrier of hepatitis from now on.
C)
I’m still trying to deal with the fact that this will forever change my life.
D)
I don’t know why I didn’t bother to get vaccinated against this.
15.
A 16-year-old girl has been admitted to the emergency department after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this patient faces a severe risk of:
A)
acute fulminant hepatitis.
B)
hepatitis D virus infection.
C)
secondary biliary cirrhosis.
D)
portal hypertension.
16.
Which of the following factors accounts for the poor prognosis that typically accompanies a diagnosis of primary hepatocellular cancer?
A)
Surgical options do not exist because removal of all or part of the liver is a threat to health.
B)
Liver cancer typically metastasizes at a much earlier stage than other cancers.
C)
Liver tumors are poorly differentiated due to the low density of hepatic tissue.
D)
The nonspecific symptomatology of liver cancer means that diagnosis often happens at a late stage.
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17.
Which of the following factors is most strongly associated with the pathogenesis of gallstones?
A)
Excess serum ammonia and urea levels
B)
Portal hypertension
C)
Abnormalities or stasis of bile
D)
High cholesterol diet
18.
Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis?
A)
A woman who has six to eight drinks each evening
B)
A man who has become profoundly ill during a tropical vacation
C)
A woman who takes two Tylenol tablets five to six times a day
D)
An obese man who has a high-fat diet and has a sedentary lifestyle
19.
The nurse who is providing care for a patient with pancreatic cancer should prioritize which of the following assessments?
A)
Assessment for ascites and close monitoring of fluid balance
B)
Respiratory assessment and monitoring of arterial blood gases
C)
Vigilant monitoring of blood glucose levels
D)
Assessment for deep vein thrombosis
20.
Which of the following signs and symptoms is most suggestive of acute cholecystitis?
A)
Upper right quadrant or epigastric pain
B)
Fever and sudden abdominal distention
C)
Appearance of undigested fat in feces
D)
Nausea resulting in greenish vomitus
Answer Key
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1.
A
2.
A
3.
A
4.
C
5.
C
6.
B
7.
C
8.
C
9.
C
10.
B
11.
C
12.
A
13.
B
14.
D
15.
A
16.
A
17.
C
18.
A
19.
D
20.
A
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1.
Hormones are chemical messengers that:
A)
regulate body functions.
B)
initiate immune reactions.
C)
transport fatty acids and lipids.
D)
cause one specific tissue effect.
2.
The release of insulin from the pancreatic beta cells can inhibit its further release from the same cells. This is an example of hormone action.
A)
retinoid
B)
autocrine
C)
juxtaposed
D)
arachidonic
3.
Several hormones, including steroids and thyroid hormone, are bound to and carried by:
A)
proteins.
B)
target cells.
C)
cholesterol.
D)
prohormones.
4.
Hormones exert their action by binding to high-affinity receptors on the surface or inside of the target cell. The response of the target cell varies with the and of the receptors present.
A)
numbers; affinity
B)
hormone size; location
C)
permeability; ionization
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saturation level; rate Release and synthesis of anterior pituitary hormones are mainly regulated by the inhibiting or releasing actions of the:
A)
cell receptors.
B)
thymus gland.
C)
hypothalamus.
D)
adrenal gland.
6.
When sensors detect a change in a hormone level, the hormonal response is regulated by mechanisms that will return the level to within normal range.
A)
metabolic
B)
feedback
C)
production
D)
action potential
7.
When hypofunction of an endocrine organ is suspected, a hormone administered to measure and assess target gland response.
A)
stimulation
B)
24-hour urine
C)
agglutination
D)
antibody-binding
8.
Hormones are usually divided into four categories according to their:
A)
function.
B)
precursor.
C)
structure.
D)
receptor.
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9.
Although both autocrine and paracrine hormonal actions occur without entering the blood stream, paracrine actions differ because they affect cells.
A)
self-
B)
local
C)
stored
D)
target
10.
As part of maintaining homeostasis, hormones secreted by endocrine cells are inactivated continuously to:
A)
free receptor sites.
B)
stimulate production.
C)
prevent accumulation.
D)
absorb metabolic waste.
11.
Hormones that cause the subsequent stimulation or release of another hormone, such as thyroidstimulating hormone and corticotropin-releasing hormone, typically belong to which of the following structural classifications?
A)
Amines and amino acids
B)
Peptides and proteins
C)
Steroids
D)
Fatty acid derivatives
12.
Paracrine action involves which of the following characteristics?
A)
Action on a distant target cell
B)
Autoregulation
C)
Action on the same cells that produced the hormone
D)
Action on nearby target cells
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13.
A hormone has been synthesized in the rough endoplasmic reticulum of an endocrine cell after which it has moved into the Golgi complex, been packaged in a vesicle, and been released into circulation. What hormone is synthesized and released in this manner?
A)
Insulin
B)
Cortisol
C)
Testosterone
D)
Estrogen
14.
Cyclic adenosine monophosphate (cAMP) performs which of the following roles in the functioning of the endocrine system?
A)
Mediating hormone synthesis by nonvesicle-mediated pathways
B)
Acting as a high-affinity receptor on the surface of target cells
C)
Inactivating hormones to prevent excess accumulation
D)
Acting as a second messenger to mediate hormone action on target cells
15.
Which of the following statement best describes the relationship between the hypothalamus and the posterior pituitary in the normal functioning of the endocrine system?
A)
Posterior pituitary hormones are constituted from components of both the hypothalamus and the pituitary gland itself.
B)
The posterior pituitary gland regulates the release of hypothalamic hormones.
C)
Posterior pituitary hormones are produced in the hypothalamus but released from the pituitary gland.
D)
The hypothalamus regulates the production and release of posterior pituitary hormones by the pituitary gland.
16.
Which of the following structures controls the functions of the greatest number of target glands and cells?
A)
Thyroid gland
B)
Pituitary gland
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Adrenal cortex
D)
Pancreas
17.
Which of the following physiologic processes best exemplifies a positive feedback mechanism?
A)
The increase in prolactin secretion that occurs with more frequent breast-feeding
B)
The regulation of blood glucose levels by insulin
C)
The release of parathyroid hormone in response to decreased serum calcium levels
D)
The release of antidiuretic hormone when sodium levels are higher than normal
18.
A patient has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for levels of thyroid-stimulating hormone (TSH). This patient has undergone which of the following diagnostic tests?
A)
Suppression testing
B)
Radioimmunoassay (RIA)
C)
Autoantibody testing
D)
Stimulation testing
19.
Thyroid and steroid hormones, which exert their effect on target cells by way of nuclear receptors, have which of the following characteristics?
A)
The selective use of a second messenger
B)
The ability to cross the cell membrane of target cells
C)
The ability to regulate surface receptor affinity
D)
Both lipid-solubility and water-solubility
20.
Which of the following hormones is produced by the anterior pituitary gland?
A)
Growth hormone (GH)
B)
Oxytocin
C)
Corticotropin-releasing hormone (CRH)
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D)
Norepinephrine
Answer Key 1.
A
2.
B
3.
A
4.
A
5.
C
6.
B
7.
A
8.
C
9.
B
10.
C
11.
B
12.
C
13.
A
14.
D
15.
C
16.
B
17.
A
18.
D
19.
B
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A
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https://studentmagic.indiemade.com/ Chapter 32 - Disorders of Endocrine Control of Growth and Metabolism
1.
A predominant effect of a prolonged excessive growth hormone level is:
A)
short stature with obesity.
B)
high androgen hormone levels.
C)
increased blood glucose levels.
D)
insulin-like growth factor (IGF) depletion.
2.
The most common cause of hypothyroidism is:
A)
goiter.
B)
myxedema.
C)
thyroidectomy.
D)
autoimmune thyroiditis.
3.
Thyroid hormone deficit
A)
decreases metabolism
B)
increases protein synthesis
C)
causes vitamin deficiencies
D)
enhances absorption of glucose
4.
, which alters the function of all major organs in the body.
The most common cause of thyrotoxicosis is Graves disease, which has the distinguishing characteristic of in addition to a diffuse goiter.
A)
muscle fatigue
B)
facial myxedema
C)
ophthalmopathy
D)
decreased cholesterol
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5.
The major adrenal cortical hormones are steroids and are synthesized from acetate and:
A)
ACTH.
B)
albumin.
C)
amino acids.
D)
cholesterol.
6.
Primary adrenal insufficiency is manifested by:
A)
truncal obesity and edema.
B)
hypokalemia and hypervolemia.
C)
hyponatremia and hypoglycemia.
D)
hypopigmentation and hypertension.
7.
One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisolreleasing hormone (CRH) and:
A)
GH.
B)
TSH.
C)
DHEA.
D)
ACTH.
8.
The iatrogenic form of Cushing syndrome is caused by:
A)
long-term cortisone therapy.
B)
pituitary tumor-secreting ACTH.
C)
benign or malignant adrenal tumor.
D)
ectopic ACTH secreting lung tumor.
9.
The major manifestations of Cushing syndrome include:
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A)
excessive salt loss.
B)
muscle hypertrophy.
C)
overt diabetes mellitus.
D)
hair and weight loss.
10.
The immune suppressive and anti-inflammatory effects of cortisol cause:
A)
moderate insulin resistance.
B)
increased capillary permeability.
C)
increased cell-mediated immunity.
D)
inhibition of prostaglandin synthesis.
11.
Which of the following individuals is experiencing the effects of a primary endocrine disorder?
A)
A patient with adrenal cortical insufficiency due to pituitary hyposecretion of ACTH
B)
A patient who has hypothyroidism as a result of low TSH production
C)
A patient whose dysfunctional hypothalamus has resulted in endocrine imbalances
D)
A patient who has low calcium levels because of the loss of his parathyroid gland
12.
Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary?
A)
Development of cartilage and bone
B)
Production of insulin-like growth factors (IGFs) by the liver
C)
Increase in overall metabolic rate and cardiovascular function
D)
Positive feedback of the hypothalamic-pituitary-thyroid feedback system
13.
Which of the following individuals displays the precursors to acromegaly?
A)
An adult with an excess of growth hormone due to an adenoma
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B)
A girl who has been diagnosed with precocious puberty
C)
An adult who has a diagnosis of Cushing syndrome
D)
A patient who has recently developed primary adrenal carcinoma
14.
Which of the following residents of a long-term facility is exhibiting signs and symptoms that are indicative of hypothyroidism?
A)
An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold
B)
A 90-year-old woman with a history of atrial fibrillation whose arrhythmia has recently become more severe
C)
An 88-year-old man with a history of Alzheimer disease who has become increasingly agitated and is wandering more frequently
D)
A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis
15.
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:
A)
Cushing syndrome.
B)
Graves disease.
C)
Addison disease.
D)
Cushing disease.
16.
A patient has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which of the following treatment modalities is most likely to benefit this patient?
A)
Synthetic preparations of T3 or T4
B)
b-Adrenergic blocking drugs and antithyroid drugs
C)
Corticosteroid replacement therapy
D)
Oral or parenteral cortisol replacement
17.
A 33-year-old patient has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the patient’s care team prioritize?
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A)
Assessment of the patient’s level of consciousness and neurologic status
B)
Assessment of the patient’s peripheral vascular system and assessing for thromboembolism
C)
Assessment of the patient’s vision and oculomotor function
D)
Cardiac monitoring and assessment of peripheral perfusion
18.
A patient who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive?
A)
Sudden changes in glucocorticoid dosing may reverse the therapeutic effects of the drug.
B)
Stopping the drug suddenly may shock the HPA axis into overactivity.
C)
Sudden cessation of a glucocorticoid can result in adrenal gland necrosis.
D)
Stopping the drug suddenly may cause adrenal insufficiency.
19.
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of:
A)
Addison disease.
B)
Cushing disease.
C)
Cushing syndrome.
D)
Graves disease.
20.
Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease?
A)
Hypopituitarism
B)
Excess ACTH production by a pituitary tumor
C)
Autoimmune destruction of the adrenal cortex
D)
Malfunction of the HPA system
Answer Key
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C
2.
D
3.
A
4.
C
5.
D
6.
C
7.
D
8.
A
9.
C
10.
D
11.
D
12.
B
13.
A
14.
A
15.
B
16.
A
17.
C
18.
D
19.
A
20.
B
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https://studentmagic.indiemade.com/ Chapter 33 - Diabetes Mellitus and the Metabolic Syndrome
1.
Type 1 diabetes mellitus results from destruction of the pancreatic beta cells by two mechanisms. The mechanism for type 1A diabetes is destruction.
A)
genetic
B)
resistant
C)
idiopathic
D)
autoimmune
2.
The metabolic abnormalities that lead to type 2 diabetes include:
A)
chronic overeating.
B)
insulin resistance.
C)
acute pancreatitis.
D)
recurrent hypoglycemia.
3.
Which test provides a way to monitor fluctuations of blood glucose levels over the previous 6 to 12 weeks?
A)
Glucose tolerance test
B)
Fasting blood glucose
C)
Capillary blood glucose
D)
Glycosylated hemoglobin
4.
Diabetic ketoacidosis (DKA) more commonly occurs in patients with type 1 diabetes, when the lack of insulin leads to the mobilization of that causes excess ketone production by the liver.
A)
cortisol
B)
fatty acids
C)
potassium
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D) 5.
bicarbonate Factors that contribute to the severe hyperglycemia that precipitates hyperglycemic hyperosmolar state (HHS) include:
A)
fluid retention and edema.
B)
thromboembolism formation.
C)
insulin overdose.
D)
glycosuria and water loss.
6.
A change in the circadian rhythm for glucose tolerance and an inappropriate increase in counterregulatory hormones can lead to in diabetics.
A)
hypoglycemia
B)
Somogyi effect
C)
hyperinsulinemia
D)
dawn phenomenon
7.
In people with type 1 diabetes, the beneficial effects of exercise also carry an increased risk of:
A)
rapid weight loss.
B)
respiratory disorders.
C)
rebound hyperglycemia.
D)
profound hypoglycemia.
8.
One of the first renal manifestations of diabetic nephropathy is:
A)
microalbuminuria.
B)
oliguria.
C)
hypertension.
D)
hyperlipidemia.
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9.
Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal:
A)
glaucoma.
B)
hemorrhages.
C)
dehydration.
D)
infections.
10.
Impaired and delayed healing in a person with diabetes is caused by chronic complications that include:
A)
ketoacidosis.
B)
Somogyi effect.
C)
fluid imbalances.
D)
chronic neuropathies.
11.
A hospital patient with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin?
A)
Promotion of fat breakdown
B)
Promotion of glucose uptake by target cells
C)
Promotion of gluconeogenesis and protein synthesis
D)
Initiation of glycogenolysis
12.
A patient with longstanding type 2 diabetes is surprised at his high blood sugar readings while recovering from an emergency surgery. Which of the following factors may have contributed to the patient’s inordinately elevated blood glucose levels?
A)
The tissue trauma of surgery resulted in gluconeogenesis.
B)
Illness inhibited the release and uptake of glucagon.
C)
The stress of the event caused the release of cortisol.
D)
Sleep disruption in the hospital precipitated the dawn effect.
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13.
The results of a 44-year-old obese man’s recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which of the following pathophysiologic processes underlies the patient’s new diagnosis?
A)
Beta-cell exhaustion due to long-standing insulin resistance
B)
Destruction of beta cells that is not attributable to autoimmunity
C)
T-lymphocytemediated hypersensitivity reactions
D)
Actions of insulin autoantibodies (IAAs) and islet cell autoantibodies (ICAs)
14.
Which of the following assessment findings of a male patient constitutes a criterion for a diagnosis of metabolic syndrome?
A)
The patient states that he does less than 30 minutes of strenuous physical activity each week.
B)
The patient’s resting heart rate is typically 85 to 95 beats per minute.
C)
The patient’s blood pressure is consistently in the range of 140/90 mm Hg.
D)
The patient has a family history of type 2 diabetes.
15.
Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes?
A)
A patient who was diagnosed with placenta previa early in her pregnancy.
B)
A patient who is gravida five (in her fifth pregnancy)
C)
A patient who has hypertension and elevated triglycerides
D)
A patient who is morbidly obese
16.
A patient’s primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the following instructions should the patient be given?
A)
The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals.
B)
You’ll have to refrain from eating after midnight and then go to the lab to have your blood taken first thing in the morning.
C)
They’ll take a blood sample and see how much sugar is attached to your red blood cells.
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D)
You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample.
17.
Which of the following insulin-administration regimens is most likely to result in stable blood glucose levels for a patient with a diagnosis of type 1 diabetes?
A)
One large dose of long-acting insulin each day before breakfast
B)
Intermediate-acting insulin at 8:00 AM and 8:00 PM with rapid-acting insulin before each meal
C)
Six to eight small doses of rapid-acting insulin each day, with capillary monitoring before each
D)
Long-acting insulin twice daily (breakfast and bedtime), with intermediate-acting insulin in the afternoon
18.
A hospital patient has been complaining of increasing fatigue for several hours and his nurse has entered his room to find him unarousable. The nurse immediately checked the patient’s blo od glucose level, which is 22 mg/dL (1.2 mmol/L). The nurse should prepare to administer which of the following?
A)
A snack that combines simple sugars, protein, and complex carbohydrates
B)
A 50% glucose solution intravenously
C)
Infusion of rapid-acting insulin
D)
Oral solution containing glucagon and simple sugars
19.
A diabetic patient’s most recent blood work indicated a decreased glomerular filtration rate and urine testing revealed microalbuminuria. Which of the following self-care measures should the patient’s care team suggest to the patient?
A)
Use of over-the-counter diuretics
B)
Increased fluid intake
C)
Decreased oral sugar intake
D)
Measures to lower blood pressure
20.
A)
Which of the following comorbidities represents the greatest risk for the development of foot ulcers in a diabetic patient? Distal symmetric neuropathy
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Previous incidents of diabetic ketoacidosis
C)
Diabetic nephropathy
D)
Autonomic neuropathy
Answer Key 1.
D
2.
B
3.
D
4.
B
5.
D
6.
D
7.
D
8.
A
9.
B
10.
D
11.
B
12.
C
13.
A
14.
C
15.
D
16.
A
17.
B
18.
B
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19.
D
20.
A
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https://studentmagic.indiemade.com/ Chapter 34 - Organization and Control of Neural Function
1.
The somatic nervous system provides sensory and motor innervation for:
A)
peripheral nerves.
B)
abdominal viscera.
C)
secretory glands.
D)
smooth muscle.
2.
The proteins and other materials used by the axon are synthesized through its cytoplasm.
A)
in the cell body
B)
by Nissl bodies
C)
through dendrites
D)
across synapses
3.
Supporting cells of the nervous system, such as Schwann cells, satellite cells, and types of glial cells, function to provide neurons with:
A)
local protection.
B)
control functions.
C)
membrane permeability.
D)
integrative metabolism.
4.
and then flow down the axon
Neurons are characterized by the ability to communicate with other neurons and body cells through:
A)
astrocytes.
B)
axon hillocks.
C)
nodes of Ranvier.
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action potentials.
5.
Chemical synapses rely on
A)
diffusion
B)
gap junctions
C)
satellite cells
D)
transmitter molecules
6.
The blood-brain and CSF-brain barriers control the chemical environment of the brain by allowing easy entrance to only a few chemicals that include:
A)
oxygen.
B)
protein.
C)
glutamate.
D)
potassium.
7.
The perception of where a stimulus is in space and in relation to body parts is a function of the:
A)
occipital lobe.
B)
parietal lobe.
C)
hypothalamus.
D)
prefrontal cortex.
8.
in order to provide communication between neurons.
The pia mater is a connective tissue sheath that covers the spinal cord and also contains:
A)
spinal fluid.
B)
fibrocartilage.
C)
blood vessels.
D)
segmental nerves.
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Which of the following is the neurotransmitter for most postganglion sympathetic neurons?
A)
Enkephalin
B)
Glutamic acid
C)
Catecholamines
D)
Acetylcholine
10.
In contrast to the sympathetic nervous system, the functions of the parasympathetic nervous system include:
A)
sweating.
B)
anabolism.
C)
pupil dilation.
D)
vasoconstriction.
11.
Which of the following substances provides the majority of the fuel needs of the neurologic system?
A)
Glycogen
B)
Glucose
C)
Amino acids
D)
Triglycerides
12.
A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the patient’s central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely be affected by this disease process?
A)
Oxygen metabolism
B)
Neurotransmitter synthesis
C)
Nerve conduction
D)
Production of cerebrospinal fluid
13.
A neuron has been hyperpolarized. How will this affect the excitability of the neuron?
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A)
The neuron will have a membrane potential farther from the threshold.
B)
The neuron will be more difficult to repolarize after firing.
C)
The membrane potential of the neuron will be closer to the threshold.
D)
The neuron’s excitability will be significantly increased.
14.
A pregnant woman’s most recent ultrasound is suggestive of spina bifida, and her primary care provider has subsequently order further diagnostic testing. The pathophysiologic effects of this disease are due to:
A)
malformation of the mesoderm.
B)
abnormal closure of the neural tube.
C)
lesions in the dorsal root ganglia.
D)
hypertrophy of the primary vesicles.
15.
Which of the following messages is most likely to be carried by general somatic afferent (GSA) neurons?
A)
The sensation of cold when touching ice
B)
The message to move a finger and thumb
C)
The message to move the larynx during speech
D)
Information about the position of a joint
16.
Which of the following processes is most likely to occur as a result of a spinal reflex?
A)
Peristalsis of the small and large bowel
B)
Control of oculomotor function in changing light levels
C)
Pain sensation from a potentially damaging knee movement
D)
Withdrawal of a hand from a hot stove element
17.
A patient has required mechanical ventilation following a traumatic head injury sustained in a motorcycle crash, during which he sustained damage to his respiratory center. Which of the patient’s
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Brain stem
B)
Midbrain
C)
Diencephalon
D)
Frontal lobe
18.
A patient with a diagnosis of epilepsy has required surgical removal of part of her prefrontal cortex. Which of the following effects should her family and care team anticipate?
A)
Lapses in balance and coordination
B)
Deficits in regulation of the endocrine system
C)
Sensory losses
D)
Changes in behavior and judgment
19.
A patient’s primary care provider has prescribed a b-adrenergic receptor blocker. Which of the following therapeutic effects do the patient and care provider likely seek?
A)
Reduction in heart rate and blood pressure
B)
Slowing of gastrointestinal motility
C)
Increase in mental acuity
D)
Decreased production of gastric acid
20.
Neurotrophic factors contribute to the maintenance of homeostasis in which of the following ways?
A)
By catalyzing the effects of neurotransmitters
B)
By increasing the sensitivity of receptors on postsynaptic cells
C)
By promoting the growth and survival of neurons
D)
By selectively increasing or decreasing the release of neurotransmitters
Answer Key
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A
2.
A
3.
A
4.
D
5.
D
6.
A
7.
B
8.
C
9.
C
10.
B
11.
B
12.
C
13.
A
14.
B
15.
A
16.
D
17.
A
18.
D
19.
A
20.
C
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https://studentmagic.indiemade.com/ Chapter 35 - Somatosensory Function, Pain, and Headache
1.
The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense:
A)
muscle position.
B)
visceral fullness.
C)
temperature.
D)
painful touch.
2.
Proprioceptive somatosensory information from the limbs and trunk is transmitted by the:
A)
reflexive networks.
B)
dorsal root ganglion neurons.
C)
anterolateral pathway.
D)
trigeminal sensory neurons.
3.
Full localization, discrimination of intensity, and interpretation of somatosensory stimuli requires processing by the:
A)
somatosensory cortex.
B)
autonomic nervous system.
C)
Ruffini end-organ receptors.
D)
Pacinian corpuscle receptors.
4.
What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli?
A)
Pattern
B)
Specificity
C)
Gate control
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D) 5.
Neuromatrix Nociceptors are sensory receptors that are activated by:
A)
cortisol.
B)
noxious stimuli.
C)
pressure and touch.
D)
sudden movements.
6.
When a person is stung on the index finger by a bee, the thalamus interprets the pain as:
A)
somewhere on the hand.
B)
a spot on the index finger.
C)
attributable to a bee stung.
D)
similar to a previous bee sting.
7.
Pain assessment is likely to be most challenging when providing care for which of the following older adult patients?
A)
A 90-year-old patient who takes multiple medications for cardiac and respiratory conditions
B)
A 77-year-old man who has sustained burns on the lower part of his body
C)
An 82-year-old woman who has been diagnosed with diabetes and an anxiety disorder
D)
An 87-year-old man with vascular dementia and numerous other health problems
8.
In contrast to acute pain, persistent chronic pain:
A)
serves as a warning system.
B)
raises the pain threshold.
C)
imposes physiologic stresses.
D)
causes secondary reflexive spasms.
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The sites of referred pain are determined by:
A)
intensity-coding receptors.
B)
location of the noxious stimuli.
C)
visceral embryonic development.
D)
stimulation that activates C fibers.
10.
Complex regional pain syndrome is characterized by:
A)
repetitious dermatome pain attacks.
B)
trigeminal neuralgia with facial tics.
C)
severe limb pain after amputation.
D)
disproportionate pain with mobility.
11.
An otherwise-healthy patient has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This patient is likely to be diagnosed with which of the following health problems?
A)
Visceral pain
B)
Hypoalgesia
C)
Allodynia
D)
Primary hyperalgesia
12.
A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron?
A)
The neurons between the woman’s finger and the woman’s spinal cord
B)
The neurons between the thalamus and the cortex
C)
The neurons between the CNS and the thalamus
D)
The neurons of the efferent pathway that causes muscle contraction
13.
A patient with a diagnosis of lung cancer has developed bone metastases resulting in severe and
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The appearance of grimacing, guarding, or wincing
B)
The presence of changes in vital signs that correspond to pain
C)
The patient’s subjective report of the character and severity of pain
D)
The results of a detailed neurologic assessment
14.
A hospital patient has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the patient reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the patient’s concern?
A)
You might become addicted, but there are excellent resources available in the hospital to deal with that development.
B)
You should likely prioritize the control of your pain over any fears of addiction that you have.
C)
If you start needing higher doses to control your pain, then we’ll address those concerns.
D)
There’s only a minute chance that you will become addicted to these painkillers.
15.
Which of the following patients may be experiencing the effects of neuropathic pain?
A)
A girl whose playground accident resulted in an arm fracture
B)
A man with pain secondary to his poorly controlled diabetes
C)
An elderly woman with a stage III pressure ulcer
D)
A man whose pain is caused by gastric cancer
16.
Which of the following statements is true of migraine headaches?
A)
Non-pharmacologic treatments and lifestyle modifications can control migraines in most patients.
B)
Surgical treatments for migraines are indicated if pharmacologic treatments are unsuccessful.
C)
Migraines may have a hormonal etiology in some patients.
D)
Opioid analgesics achieve adequate pain control in most patients.
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Which of the following pain disorders is a manifestation of a disruption of cranial nerve function?
A)
Trigeminal neuralgia
B)
Complex regional pain syndrome
C)
Phantom limb pain
D)
Temporomandibular joint (TMJ) syndrome
18.
Which of the following characteristics differentiates a migraine with aura from a migraine without aura?
A)
Gastrointestinal involvement in the hours leading up to the headache
B)
A decrease in mood and affect prior to the headache
C)
Lack of response to non-pharmacologic treatments
D)
Visual symptoms that precede the headache
19.
A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency, and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize?
A)
Weight loss and exercise are very important components of your treatment.
B)
Stopping all of your current medications, even temporarily, should provide some relief.
C)
It would be helpful for you to take control of your diet, sleep schedule, and stress levels.
D)
Your headaches are likely a result of nerve disorder and, unfortunately, cannot be treated successfully.
20.
Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?
A)
Opioids should be avoided in order to prevent liver and kidney insult.
B)
Dosing and timing should aim for a steady serum level of the drug that is chosen.
C)
Doses of analgesia should be given only when the patient’s pain becomes severe.
D)
Drugs from numerous classifications should be used to maximize pain control.
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Answer Key 1.
A
2.
B
3.
A
4.
A
5.
B
6.
A
7.
D
8.
C
9.
C
10.
D
11.
C
12.
B
13.
C
14.
D
15.
B
16.
C
17.
A
18.
D
19.
C
20.
B
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1.
More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by the cortex in the frontal lobe.
A)
premotor
B)
primary motor
C)
reflexive
D)
supplementary
2.
Disorders of the pyramidal tracts, such as a stroke, are characterized by:
A)
paralysis.
B)
hypotonia.
C)
muscle rigidity.
D)
involuntary movements.
3.
Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of:
A)
periorbital muscles.
B)
thymus gland cells.
C)
skeletal muscle fibers.
D)
acetylcholine receptors.
4.
A patient has wrist inflammation causing compression of the median nerve in the carpal tunnel. Manifestations of this syndrome include:
A)
little finger numbness.
B)
forearm paresthesia.
C)
loss of tendon reflexes.
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precision grip weakness. The cardinal symptoms of Parkinson disease include:
A)
hypotonia.
B)
bradykinesia.
C)
paresthesia.
D)
lack of sweating.
6.
The patient has a traumatic complete spinal cord transection at the C5 level. Intact motor and somatosensory function will include control.
A)
bladder
B)
finger flexion
C)
diaphragm
D)
trunk muscle
7.
Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement:
A)
without causing paralysis.
B)
posture and muscle tone.
C)
and cortical responses.
D)
of upper motor neurons.
8.
The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis is the result of:
A)
decreased oligodendrocytes.
B)
corticospinal injuries.
C)
atherosclerotic destruction.
D)
oligodendrocytic infection.
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A sudden traumatic complete transection of the spinal cord results in
A)
flaccid paralysis
B)
vasoconstriction
C)
deep visceral pain
D)
3+ tendon reflexes
10.
Autonomic dysreflexia (autonomic hyperreflexia) is characterized by:
A)
severe spinal shock.
B)
tachycardia and pale skin.
C)
lack of sweat above injury level.
D)
vasospasms and hypertension.
11.
A clinician is assessing the muscle tone of a patient who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the patient’s diagnosis?
A)
Hypotonia
B)
Spasticity
C)
Tetany
D)
Rigidity
12.
below the level of injury.
An elderly patient has been brought to his primary care provider by his wife who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the patient’s gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This patient requires further assessment for which of the following health problems?
A)
Muscle atrophy
B)
Cerebellar disorders
C)
Impaired spinal reflexes
D)
Lower motor neuron lesions
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Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing?
A)
Impaired sensory perception and frequent wounds
B)
Spasticity and hypertonic reflexes
C)
Muscle atrophy with decreased coordination
D)
Frequent falls and increased muscle size
14.
A patient with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the patient has gone into a myasthenic crisis on postoperative day one. Which of the following measures should the care team prioritize in this patient’s immediate care?
A)
Positioning the patient to minimize hypertonia and muscle rigidity
B)
Seizure precautions
C)
Respiratory support and protection of the patient’s airway
D)
Monitoring the patient for painful dyskinesias
15.
Which of the following disorders of neuromuscular function typically has the most rapid onset?
A)
Duchenne muscular dystrophy (DMD)
B)
Guillain-Barré syndrome
C)
Parkinson disease
D)
Myasthenia gravis
16.
A patient who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury?
A)
Cerebellar dystaxia
B)
Cerebellar tremor
C)
A lower motor neuron lesion
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D) 17.
A vestibulocerebellar disorder A patient’s recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patient’s levels of:
A)
dopamine.
B)
acetylcholine.
C)
serotonin.
D)
adenosine.
18.
A patient is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on:
A)
upper motor neurons.
B)
the vestibulocerebellar system.
C)
upper and lower motor neurons.
D)
neuromuscular junctions.
19.
Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:
A)
Amyotrophic lateral sclerosis (ALS)
B)
Multiple sclerosis (MS)
C)
Duchenne muscular dystrophy (DMD)
D)
Paralysis caused by Clostridium botulinum
20.
A patient with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:
A)
arms.
B)
bowels.
C)
bladder.
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D)
perineal musculature.
Answer Key 1.
A
2.
A
3.
D
4.
D
5.
B
6.
C
7.
A
8.
A
9.
A
10.
D
11.
A
12.
B
13.
D
14.
C
15.
B
16.
D
17.
A
18.
C
19.
B
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A
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https://studentmagic.indiemade.com/ Chapter 37 - Disorders of Brain Function
1.
The intracranial volume that is most capable of compensating for increasing intracranial pressure is the:
A)
brain cell tissue.
B)
intravascular blood.
C)
surface sulci fluid.
D)
cerebrospinal fluid.
2.
A late indicator of increased intracranial pressure is:
A)
tachycardia.
B)
right-sided heart failure.
C)
narrow pulse pressure.
D)
high mean arterial pressure.
3.
Extreme cerebral edema may cause the brain to herniate into another compartment. Upward herniation from the infratentorial compartment against the aqueduct of Sylvius causes:
A)
hydrocephalus.
B)
cardiac arrest.
C)
tissue infarction.
D)
intracranial bleeding.
4.
Coup and contrecoup cerebral contusion caused by blunt head trauma against a fixed object results in:
A)
diffuse axonal injuries.
B)
cerebrovascular infarction.
C)
momentary unconsciousness.
D)
permanent brain tissue damage.
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5.
An intracranial epidural hematoma causes focal symptoms that can include:
A)
ipsilateral pupil dilation.
B)
ipsilateral hemiparesis.
C)
diffuse venous bleeding.
D)
commuting hydrocephalus.
6.
The earliest signs of decreased level of consciousness include:
A)
stupor.
B)
lethargy.
C)
delirium.
D)
inattention.
7.
Metabolic factors that increase cerebral blood flow include:
A)
increased oxygen saturation.
B)
increased carbon dioxide level.
C)
decreased serum sodium level.
D)
decreased hydrogen ion concentration.
8.
Transient ischemic attacks (TIAs) are characterized by ischemic cerebral neurologic deficits that:
A)
indicate aneurysm leakage.
B)
cause minor residual deficits.
C)
affect diffuse cerebral functions.
D)
resolve within one hour of onset.
9.
Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include:
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A)
diplopia.
B)
petechiae.
C)
papilledema.
D)
focal paralysis.
10.
The moderate stage of the progressive degenerative Alzheimer-type dementia is manifested by behaviors that include:
A)
confusion.
B)
incontinence.
C)
decreased level of consciousness.
D)
social withdrawal.
11.
A patient’s recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem?
A)
Aggressive diuresis
B)
Placement of a shunt
C)
Administration of hypertonic intravenous solution
D)
Lumbar puncture
12.
A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury?
A)
Headaches and memory lapses
B)
Recurrent nosebleeds and hypersomnia
C)
Unilateral weakness and decreased coordination
D)
Neck pain and decreased neck range of motion
13.
An elderly male patient has been brought to the emergency department after experiencing stroke-like
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Failure to restore blood flow creates a severe risk for future transient ischemic attacks.
B)
Necrosis will continue unabated throughout the brain unless blood flow is restored.
C)
Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.
D)
Unless blood flow is restored, the patient faces the risk of progressing to hemorrhagic stroke.
14.
A patient’s emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient’s most likely diagnosis?
A)
Status epilepticus
B)
Subarachnoid hemorrhage
C)
Ischemic stroke
D)
Encephalitis
15.
A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patient’s diagnosis?
A)
Weakness in the muscular wall of an artery
B)
Impaired synthesis of clotting factors
C)
Deficits in the autonomic control of blood pressure
D)
Increased levels of cerebrospinal fluid
16.
Which of the following pathophysiologic processes occurs in cases of bacterial meningitis?
A)
Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia.
B)
Trauma introduces skin-borne pathogens to the cerebrospinal fluid.
C)
Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits.
D)
Inflammation allows pathogens to cross into the cerebrospinal fluid.
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17.
Which of the following individuals has the highest chance of having a medulloblastoma?
A)
An 88-year-old man who has begun displaying signs and symptoms of increased ICP
B)
A 60-year-old woman who is soon to begin radiation therapy for the treatment of breast cancer
C)
A 4-year-old child who has become uncoordinated in recent months
D)
A 68-year-old man who is a smoker and has a family history of cancer
18.
A patient with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the patient appears confused and is oriented to person and place but not time. What type of seizure did this patient most likely experience?
A)
Simple partial seizure
B)
Atonic seizure
C)
Myoclonic seizure
D)
Complex partial seizure
19.
A patient with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The patient’s psychomotor deficits are likely the result of:
A)
Alzheimer disease.
B)
frontotemporal dementia (FTD).
C)
vascular dementia.
D)
Wernicke-Korsakoff syndrome.
20.
Which of the following statements by the husband of a patient with Alzheimer disease demonstrates an accurate understanding of his wife’s medication regimen?
A)
I’m really hoping these medications will slow down her mental losses.
B)
We’re both holding out hope that this medication will cure her Alzheimer’s.
C)
I know that this won’t cure her, but we learned that it might prevent a bodily decline while she declines mentally.
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I learned that if we are vigilant about her medication schedule, she may not experience the physical effects of her disease.
Answer Key 1.
D
2.
D
3.
A
4.
D
5.
A
6.
D
7.
B
8.
D
9.
B
10.
A
11.
B
12.
A
13.
C
14.
C
15.
A
16.
D
17.
C
18.
D
19.
C
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A
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1.
During accommodation, pupillary dilation partially compensates for the reduced size of the retinal image by:
A)
thickening the lens.
B)
contracting the ciliary muscle.
C)
increasing light entering the pupil.
D)
narrowing the palpebral opening.
2.
With aging, progressive inelasticity and thickening of the lens causes which accommodation disorder?
A)
Cataracts
B)
Hyperopia
C)
Presbyopia
D)
Astigmatism
3.
In order to maintain fixation on stable objects during head rotation, compensatory occur.
A)
vertigo
B)
nystagmus
C)
conjugate gaze
D)
eyelid vacillation
4.
The red eyes of bacterial conjunctivitis are accompanied by red eyes of acute glaucoma.
A)
mydriasis and headaches
B)
blurred or iridescent vision
C)
tearing, itching and burning
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D) 5.
cloudy, painful corneas An acute episode of angle-closure glaucoma is preceded by:
A)
central visual field loss.
B)
prolonged pupil dilation.
C)
corneal surface trauma.
D)
vitreous humor fluid loss.
6.
Diabetic and hypertensive retinopathy are both characterized by the appearance of:
A)
macular edema.
B)
cloudy corneas.
C)
microinfarctions.
D)
intraretinal hemorrhages.
7.
Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes:
A)
light-headedness.
B)
an illusion of motion.
C)
loss of consciousness.
D)
permanent hearing loss.
8.
One of the causes of conductive hearing loss is:
A)
sudden loud noise.
B)
ototoxic medication.
C)
auditory nerve damage.
D)
excess middle ear fluid.
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With otosclerosis, early hearing loss is identified by an inability to hear:
A)
whispering.
B)
one’s own voice.
C)
on the cell phone.
D)
in a noisy environment.
10.
In comparison to children with acute otitis media (AOM), those with otitis media with effusion (OME) have:
A)
systemic infection.
B)
earache and fever.
C)
excess middle ear fluid.
D)
sensorineural hearing loss.
11.
Which of the following vision disorders is most likely to have an infectious etiology?
A)
Keratitis
B)
Cataracts
C)
Glaucoma
D)
Macular degeneration
12.
A 78-year-old female patient has been scheduled for outpatient cataract surgery. Which of the following signs and symptoms most likely prompted the patient to initially seek care?
A)
Unilateral redness and purulent exudate
B)
Eye pain coupled with photosensitivity
C)
Bilateral blurred vision and visual distortion
D)
Lack of accommodation and increased intraocular pressure
13.
A 60-year-old patient’s long history of poorly controlled hypertension has culminated in a diagnosis of retinal detachment. What type of retinal detachment is this patient most likely to have experienced?
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A)
Rhegmatogenous detachment
B)
Exudative retinal detachment
C)
Posterior vitreous detachment
D)
Traction retinal detachment
14.
An elderly woman has been diagnosed with macular degeneration following a visit to an ophthalmologist. Which of the woman’s following statements best demonstrates an accurate understanding of her new diagnosis?
A)
I suppose this goes to show that I should have controlled my blood pressure better.
B)
I think this is something that I might have caught from my husband.
C)
My friend had this problem and a transplant did wonders for her vision.
D)
I suppose that this might be one of those things that happens when you get older.
15.
Which of the following characteristics differentiates open-angle glaucoma from angle-closure glaucoma?
A)
The potential for consequent blindness
B)
Dysfunction of the aqueous humor drainage system
C)
The presence of optic nerve cupping
D)
Infectious etiology
16.
Which of the following visual deficits would be categorized as homonymous hemianopia?
A)
Loss of the same side of the visual field in each eye
B)
Bilateral loss of peripheral vision
C)
Loss of vision in the right side of the left eye and the left side of the right eye
D)
Equal loss of central vision in each eye
17.
Which of the following vision deficits is a clinician justified in attributing to the normal aging process?
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Conjunctivitis
B)
Presbyopia
C)
Strabismus
D)
Angle-closure glaucoma
18.
Frustrated by her worsening tinnitus, a 55-year-old female patient has sought care. Which of the following teaching points should the clinician provide to the patient?
A)
I know this can be very difficult to live with, but it normally fades over time.
B)
I will prescribe some medication that will probably help quite well.
C)
This might be a sign of a more serious neurologic problem that we will assess for.
D)
Initially, there are some changes in your diet that you should implement.
19.
A female patient with rheumatoid arthritis has taken high doses of aspirin for several years, a practice that has resulted in damage to her hearing due to the drugs ototoxic effects. What type of hearing loss has this patient experienced?
A)
Conductive hearing loss
B)
Sensorineural hearing loss
C)
Presbycusis
D)
Mixed hearing loss
20.
Which of the following signs and symptoms is most indicative of Ménière disease?
A)
Rotary vertigo and tinnitus
B)
Nausea and vomiting
C)
Progressive hearing loss and frequent falls
D)
Otalgia and recurrent otitis media
Answer Key 1.
C
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2.
C
3.
B
4.
C
5.
B
6.
D
7.
B
8.
D
9.
A
10.
C
11.
A
12.
C
13.
B
14.
D
15.
B
16.
A
17.
B
18.
D
19.
B
20.
A
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1.
Smooth muscle relaxation and shunting of blood into the sinusoids is mediated by in a penile erection.
A)
norepinephrine
B)
nitroglycerine
C)
nitric oxide
D)
nicotinic acid
2.
Priapism is a condition that causes ischemia as a result of:
A)
circumcision trauma.
B)
failure of detumescence.
C)
tight retracted foreskin.
D)
fibrous plaque in the penis.
3.
Common risk factors for erectile dysfunction due to generalized penile arterial insufficiency include:
A)
cryptorchidism.
B)
cigarette smoking.
C)
testicular torsion.
D)
benign prostate hypertrophy.
4.
and results
Squamous cell cancer of the penis is more likely to develop in men with chronic:
A)
erectile dysfunction.
B)
herpes ulcerations.
C)
Peyronie disease.
D)
smegma accumulation.
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5.
In a hydrocele, excess fluid is present in the:
A)
epididymis.
B)
tunica vaginalis.
C)
pampiniform plexus.
D)
vas deferens ampulla.
6.
Testicular torsion, a serious disorder affecting young male individuals, causes:
A)
inguinal herniation.
B)
cancer of the scrotum.
C)
dartos muscle atrophy.
D)
loss of testicular perfusion.
7.
Men older than age 50 are at high risk for prostatic hypertrophy with complications that include:
A)
hypospadias.
B)
scrotal edema.
C)
urine retention.
D)
testicular cancer.
8.
The major cause of acute prostatitis is:
A)
prostate hyperplasia.
B)
acute pyelonephritis.
C)
gram negative
D)
mucous gland overgrowth.
E)
coli.
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The most important factor in the evaluation and treatment of benign prostatic hypertrophy (BPH) is considered to be:
A)
frequency of erectile dysfunction.
B)
testosterone level management.
C)
prostate cancer prevention measures.
D)
subjective symptoms reported by the patient.
10.
Cryptorchidism, or undescended testes, is a direct cause of:
A)
infertility.
B)
paraphimosis.
C)
prostate cancer.
D)
low testosterone.
11.
Which of the following physiologic processes results from the synthesis and release of testosterone?
A)
Protein catabolism
B)
Musculoskeletal growth
C)
Release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
D)
Prostatic hyperplasia
12.
A 41-year-old patient has undergone a vasectomy. What is the physiologic basis for this contraception technique?
A)
Spermatogenesis is inhibited because sex hormones may no longer stimulate the Sertoli cells.
B)
Spermatozoa can no longer reach the epididymis and do not survive.
C)
The rete testis becomes inhospitable to sperm.
D)
Sperm can no longer pass through the ductus deferens.
13.
A patient has been diagnosed with an anterior pituitary tumor, and synthesis and release of folliclestimulating hormone has become deranged. What are the potential consequences of this alteration in
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Dysfunction of spermatogenesis
B)
Overproduction of luteinizing hormone
C)
Inhibition of testosterone synthesis
D)
Impaired detumescence
14.
Which of the following factors constitutes the most significant risk for balanitis xerotica obliterans?
A)
Multiple sexual partners
B)
Androgen deficiency
C)
Uncircumcised penis
D)
Chronic prostatitis
15.
Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive medical treatment?
A)
Spermatocele
B)
Benign prostatic hyperplasia (BPH)
C)
Intravaginal testicular torsion
D)
Erectile dysfunction
16.
A 30-year-old man has been diagnosed with mumps orchitis, a disease that has the potential to result in:
A)
hematuria.
B)
hematocele.
C)
sterility.
D)
penile atrophy.
17.
After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which of the patient’s following statements indicates the need for further teaching?
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A)
I can’t shake this feeling like I’ve received a death sentence.
B)
I have to admit that the prospect of losing a testicle is a bit overwhelming.
C)
I really hope the cancer hasn’t spread anywhere, because I’ve read that it’s a possibility.
D)
I guess there’s some solace in the fact that this cancer wasn’t a result of an unhealthy lifestyle.
18.
Which of the following assessments is most likely to reveal a potential exacerbation in a 70-year-old patient’s diagnosis of benign prostatic hyperplasia (BPH)?
A)
Urine testing for microalbuminuria
B)
Blood test for white blood cells and differential
C)
Bladder ultrasound
D)
Sperm morphology testing
19.
Which of the following statements about screening for prostate cancer is most accurate?
A)
Digital rectal examination detects the majority of new cases of prostate cancer.
B)
A positive prostate-specific antigen (PSA) test is definitive for prostate cancer.
C)
BPH and prostatitis can confound prostate screening results.
D)
Digital rectal examination and PSA testing have been proven ineffective.
20.
Which of the following diagnoses is most likely to require surgical correction?
A)
Hypospadias
B)
Orchitis
C)
Erectile dysfunction
D)
Spermatocele
Answer Key 1.
C
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2.
B
3.
B
4.
D
5.
B
6.
D
7.
C
8.
C
9.
D
10.
A
11.
B
12.
D
13.
A
14.
C
15.
C
16.
C
17.
A
18.
C
19.
C
20.
A
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1.
Acute cervicitis is an inflammation of the cervix characterized by:
A)
abscess formation.
B)
mucopurulent drainage.
C)
thick gray-white plaques.
D)
persistent pruritic vulvitis.
2.
Carcinoma of the cervix is often considered to be a sexually transmitted disease associated with viral infection.
A)
Chlamydia trachomatis
B)
herpes simplex
C)
human papilloma
D)
varicella zoster
3.
Pelvic inflammatory disease, an inflammation of the female upper reproductive tract, is caused by:
A)
chronic endometriosis.
B)
ruptured tubal pregnancy.
C)
STD polymicrobial infection.
D)
serous luteal ovarian cysts.
4.
Endometriosis is characterized by painful hemorrhagic lesions in the pelvis and complications that include:
A)
pelvic adhesions.
B)
endometrial cancer.
C)
candidiasis vaginitis.
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bladder herniation. Leiomyomas are smooth muscle fibroid tumors that usually develop in:
A)
fibrocystic breasts.
B)
postmenopause.
C)
uterosacral ligaments.
D)
the corpus of the uterus.
6.
Symptoms of difficulty in emptying the bladder, frequency, and urgency of urination are common in women with:
A)
rectocele.
B)
cystocele.
C)
endometritis.
D)
prolapsed uterus.
7.
Although there are no effective screening methods for ovarian cancer, and early symptoms are usually absent, there are high-risk indicators that include:
A)
nulliparity.
B)
lactation.
C)
mammary duct ectasia.
D)
oral contraceptive use.
8.
Polycystic ovary syndrome (PCOS) is ovarian dysfunction caused by a combination of hormone imbalances that include levels.
A)
absent FSH
B)
insulin deficit
C)
elevated LH
D)
low androgen
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9.
In the lactating woman, mastitis is usually the result of:
A)
intraductal papillomas.
B)
secretory cell hyperplasia.
C)
fibrocystic tissue changes.
D)
ascending bacterial infection.
10.
Women are screened regularly for risk factors and manifestations of breast cancer. High-risk women may have a history of:
A)
late menopause.
B)
leiomyoma tumors.
C)
STDs and vaginitis.
D)
multiple pregnancies.
11.
Which of the following signs and symptoms is most likely to accompany a diagnosis of vulvodynia?
A)
Vulvar pain
B)
Purulent discharge
C)
Urinary incontinence
D)
Open lesions on the surface of the vulva
12.
A 21-year-old college student has sought care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which of the clinician’s assessment questions is most likely to apply to a diagnosis of vaginitis?
A)
Have your periods been regular in the last few months?
B)
Have you ever had a sexually transmitted infection?
C)
Are you using oral contraceptives?
D)
Have you ever been pregnant?
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A 29-year-old patient had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify:
A)
dysplastic cervical cells.
B)
human papillomavirus (HPV) antibodies.
C)
cervical polyps.
D)
lesions at the transformation zone.
14.
Which of the following physiologic processes is caused by estrogens?
A)
Increased release of gonadotropin-releasing hormone (GnRH)
B)
Stimulation of lactation in the postpartum period
C)
Promotion of ovarian follicle growth
D)
Progesterone synthesis
15.
Which of the following disorders of the female genitourinary system is most likely to result from a disruption in normal endocrine function?
A)
Ovarian cancer
B)
Pelvic inflammatory disease (PID)
C)
Polycystic ovary syndrome (PCOS)
D)
Cervicitis
16.
Which of the following complaints by middle-aged women should prompt a care provider to rule out the possibility of ovarian cancer?
A)
I’m having a lot of vaginal discharge lately and it’s quite foul.
B)
My periods have become quite irregular since last winter.
C)
I have a sharp, stabbing pain on my side for the last few days.
D)
I’m having a lot of indigestion and bloating, which are both new to me.
17.
A nurse is conducting a healthy living workshop to a group of younger women. Which of the following
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Monthly breast self-examination (BSE)
B)
BSE or mammography each year starting at age 40
C)
Annual clinical breast examination until age 65
D)
Mammography and clinical breast examination every 3 years until age 40
18.
Which of the following processes is a component of the pathogenesis of proliferative breast lesions without atypia?
A)
Growth of ductile or lobular epithelial cells
B)
Cystic dilation of terminal ducts
C)
Increase in fibrous breast tissue
D)
Fat necrosis leading to lesion formation
19.
Which of the following physiologic changes results in menopause?
A)
Changes in anterior pituitary function that alter ovarian hormone production
B)
Gradual resistance of ovarian target cells to LH and FSH stimulation
C)
Cessation of ovarian function and decreased estrogen levels
D)
Decreased levels of gonadotropin-releasing hormone (GnRH)
20.
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment?
A)
Blocking the effects of progesterone on tumor growth
B)
Increasing serum hormone levels to promote tumor cell lysis
C)
Blocking the entry of malignant cells into the axillary lymph nodes
D)
Blocking receptors on the surface of malignant cells
Answer Key
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B
2.
C
3.
C
4.
A
5.
D
6.
B
7.
A
8.
C
9.
D
10.
A
11.
A
12.
B
13.
A
14.
C
15.
C
16.
D
17.
D
18.
A
19.
C
20.
D
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1.
Human papillomavirus (HPV) infection is directly associated with:
A)
testicular cancer.
B)
cervical dysplasia.
C)
genital herpes lesions.
D)
urinary tract infections.
2.
The vaginal discharge characteristic of trichomoniasis is described as:
A)
thick cheesy.
B)
frothy green.
C)
fishy smelling.
D)
mucopurulent.
3.
In men, urethral pain and a creamy yellow, bloody discharge from the penis is characteristic of the sexually transmitted infection:
A)
candidiasis.
B)
gonorrhea.
C)
chancroid.
D)
trichomoniasis.
4.
A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is:
A)
chancroid.
B)
candidiasis.
C)
Trichomonas vaginalis.
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Chlamydia. Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative diplococcus, and is characterized by:
A)
purulent exudates.
B)
painful small vesicles.
C)
cauliflower-shaped lesions.
D)
persistent perianal itching.
6.
Symptomatic tertiary syphilis is characterized by:
A)
necrotic gummas.
B)
chancre papules.
C)
condylomata lata.
D)
maculopapular rash.
7.
As with other ulcerative sexually transmitted infections (STIs), genital herpes (herpes simplex virus type 2, HSV-2) increases the risk of:
A)
cervical cancer.
B)
HIV transmission.
C)
localized necrosis.
D)
urinary tract infection.
8.
While in its dormant state, herpes simplex virus resides and replicates in the:
A)
local lymph nodes.
B)
subcutaneous tissue.
C)
mucous membrane.
D)
dorsal root ganglia.
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A serious complication of chlamydial infections in women is:
A)
uterine cancer.
B)
fallopian tube damage.
C)
amenorrhea.
D)
nongonococcal urethritis.
10.
The most likely vaginal infection to be spread through sexual contact is:
A)
candidiasis.
B)
trichomoniasis.
C)
vulvovaginitis.
D)
bacterial vaginosis.
11.
Which of the following phenomena is thought to underlie the decreased reported incidence of some STIs?
A)
Increased knowledge of the correct use of condoms
B)
Increased public funding for health promotion activities
C)
Decreased reporting of cases of certain STIs
D)
Decreased numbers of sexual partners among young adults
12.
A 22-year-old patient has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with:
A)
human papillomavirus (HPV).
B)
Chlamydia trachomatis.
C)
Candida albicans.
D)
Trichomonas vaginalis.
13.
A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of
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There is a chance that these will clear up on their own without any treatment.
B)
It’s important to start treatment soon, so I will prescribe you pills today.
C)
Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease.
D)
I’d like to give you an HPV vaccination if that’s okay with you.
14.
Which of the following processes occurs in the pathophysiology of infection by herpes simplex virus (HSV)?
A)
Replication of the squamous epithelium
B)
Periods of latency in the nervous system
C)
Inhibition of cell-mediated immunity
D)
Production of exotoxins
15.
Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male patient?
A)
Presence of purulent, whitish discharge from the penis
B)
Emergence of hard, painless nodules on the shaft of the penis
C)
Itching, pain, and the emergence of pustules on the penis
D)
Production of cloudy, foul-smelling urine
16.
Which of the following STIs is most likely to respond to treatment with the antibiotics tetracycline or doxycycline?
A)
Human papillomavirus (HPV) infection
B)
Herpes simplex virus type 2 (HSV-2) infection
C)
Candidiasis
D)
Lymphogranuloma venereum (LGV)
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Which of the following assessment questions is most likely to address the causation of a woman’s new case of candidiasis?
A)
Have you recently begun a new sexual relationship?
B)
Have you been on antibiotics recently?
C)
Have you noticed any new growths on your vagina in recent months?
D)
Do you use condoms during sexual activity?
18.
Infected men may harbor
A)
Trichomonas vaginalis
B)
Chlamydia trachomatis
C)
Neisseria gonorrhoeae.
D)
Treponema pallidum
19.
but they are always asymptomatic.
Which of the following events is associated with the primary stage of syphilis?
A)
Development of gummas
B)
Development of central nervous system lesions
C)
Palmar rash
D)
Genital chancres
20.
Which of the following sexually transmitted infections (STIs) is associated with an increased risk of infertility in women due to asymptomatic infection?
A)
Chlamydial infection
B)
Herpes simplex virus
C)
Gonorrhea
D)
Syphilis
Answer Key
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B
2.
B
3.
B
4.
D
5.
A
6.
A
7.
B
8.
D
9.
B
10.
B
11.
C
12.
A
13.
A
14.
B
15.
C
16.
D
17.
B
18.
A
19.
D
20.
A
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1.
Skeletal tissue contains intercellular collagen fibers that provide
A)
elastic recoil
B)
shape flexibility
C)
tensile strength
D)
inorganic calcium
2.
Cartilage is a firm but flexible type of connective tissue that is essential for:
A)
calcium salt storage.
B)
growth of long bones.
C)
bone surface perfusion.
D)
reduced friction on tendons.
3.
Whereas PTH increases blood calcium levels, the hormone decreases bone resorption.
A)
vitamin D
B)
calcitonin
C)
prolactin
D)
phosphate
4.
for tendons and ligaments.
lowers blood calcium levels and
Cancellous bone is relatively light, but its lattice-like structure gives it:
A)
rigidity.
B)
thickness.
C)
a growth plate.
D)
tensile strength.
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5.
To maintain adequate serum calcium levels, parathyroid hormone reduces:
A)
activation of vitamin D.
B)
serum phosphate levels.
C)
calcium release from bone.
D)
intestinal absorption of calcium.
6.
In contrast to synarthroses joints, synovial joints are linked to the bone by:
A)
a joint capsule.
B)
hyaline cartilage.
C)
connective tissue.
D)
interosseous ligaments.
7.
The joint capsule consists of an outer fibrous layer and an inner synovium, which movement.
A)
senses position
B)
connects to tendons
C)
secretes synovial fluid
D)
covers articular cartilage
8.
to facilitate
The tendons and ligaments of the joint capsule are sensitive to position and movement as a result of having to help maintain muscle support.
A)
autonomic nerve fibers
B)
supporting bursa sacs
C)
reflexive proprioception
D)
elastic articular cartilage
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In growing bone, severe vitamin C deficiency slows bone growth by impairing:
A)
organic matrix formation.
B)
calcification of new bone.
C)
growth plate separation.
D)
widening of the cortex.
10.
Bones are covered, except at their articular ends, by a
A)
canaliculi
B)
endosteum
C)
synovial
D)
periosteum
11.
Which of the following is the primary role of fibrocartilage?
A)
Absorption of physical shock
B)
Provision of flexibility
C)
Facilitation of long bone growth
D)
Tissue hydration
12.
Which of the following characteristics differentiates cartilage from bone?
A)
Secretion of an extracellular matrix
B)
Avascularity
C)
Low tensile strength
D)
Rapid healing
13.
membrane.
A long bone, such as the humerus of the upper arm, has which of the following structural characteristics?
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A perichondrium that overlies most of the bone surface
B)
A durable outer shell made of cancellous bone
C)
A diaphysis at each end
D)
An endosteum composed of osteogenic cells
14.
Which of the following statements most accurately describes the anatomy and physiology of the bone marrow?
A)
Hematopoiesis takes place in red bone marrow.
B)
Yellow bone marrow predominates in infants.
C)
By adulthood, all red bone marrow has been replaced by yellow bone marrow.
D)
Yellow bone marrow is hematopoietically active in infants, but not in adults.
15.
What role do osteoblasts play in the physiology of bone tissue?
A)
Differentiation into mature bone cells
B)
Synthesis and secretion of bone matrix
C)
Maintenance of calcium balance
D)
Resorption of the bone matrix
16.
An increase in the level of RANKL would result in:
A)
fusing of the epiphysis and metaphysic in long bones.
B)
changes in the rate of bone remodeling.
C)
decreased production of PTH.
D)
increased vitamin D activation.
17. A)
How are the oxygenation needs of the articulating areas in a synovial joint met? Capillaries release oxygenated blood into the synovial cavity at a controlled rate.
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The cartilage of the articulating areas uses anaerobic metabolism exclusively.
C)
Oxygen is provided to the articulating areas by synovial fluid rather than by blood.
D)
The epiphyses of long bones provide oxygen to the articulating areas.
18.
Magnetic resonance imaging of a patient’s knee has revealed the presence of bursitis. What is the primary purpose of bursae?
A)
To maintain close articulation between the two long bones at a synovial joint
B)
To strengthen the attachment between skeletal muscles and bones
C)
To strengthen the integrity of the articulating capsule
D)
To prevent friction at a tendon in a synovial joint
19.
A basketball player fell awkwardly when attempting to claim a rebound, a mishap that resulted in a tear to the anterior cruciate ligament of his left knee. What characteristic of ligaments makes them particularly susceptible to injury?
A)
Ligaments are incapable of accommodating lateral movement.
B)
Ligaments are exclusive to the knee, which is the most frequently injured joint.
C)
Ligaments are superficial to the synovial capsule and are consequently vulnerable to impacts.
D)
Ligaments are incapable of stretching when exposed to unusual stress.
20.
Which of the following joints is classified as a synarthrosis?
A)
The joint between two vertebrae
B)
The joint between the femur and the pelvis
C)
The joint between the humerus and the radius and ulna
D)
An interphalangeal joint of the hand (knuckle)
Answer Key 1.
C
2.
B
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3.
B
4.
D
5.
B
6.
A
7.
C
8.
C
9.
A
10.
D
11.
A
12.
B
13.
D
14.
A
15.
B
16.
B
17.
C
18.
D
19.
D
20.
A
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1.
Characteristics of a patient that is at high risk for falling and fracturing a hip include:
A)
obesity and short stature.
B)
excessive sugar intake.
C)
hearing impairment.
D)
chronic osteoporosis.
2.
A pathologic stress fracture occurs in bones subjected to:
A)
sudden direct force.
B)
weakening by disease.
C)
repeated excessive use.
D)
massive muscle contraction.
3.
Shortly after a closed fracture has occurred, early manifestations include localized:
A)
tetany.
B)
deformity.
C)
necrosis.
D)
numbness.
4.
In order to initiate the cellular events essential to bone healing, there must be the fracture site.
A)
callous
B)
hematoma
C)
ossification
D)
fibrin meshwork
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5.
In contrast to structural scoliosis, postural scoliosis:
A)
compresses vertebrae.
B)
corrects with bending.
C)
is apparent at birth.
D)
becomes painful.
6.
Factors that may adversely affect bone healing include
A)
immobilization
B)
weight bearing
C)
delayed union
D)
tight alignment
7.
The distinguishing characteristic of chronic osteomyelitis is the presence of:
A)
sequestrum bone.
B)
abscess formation.
C)
severe bone pain.
D)
external drainage.
8.
Developmental dysplasia of the hip (DDH), formerly known as congenital hip dislocation, is suspected when an infant has:
A)
gluteal fold asymmetry.
B)
lengthening of the thigh.
C)
joint capsule tightness.
D)
delay of knee crawling.
9.
of the bone.
Osteonecrosis is most often caused by:
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A)
stress fractures.
B)
bacterial infection.
C)
synovial inflammation.
D)
bone marrow ischemia.
10.
The patient has a fractured tibia. After the cast is applied he is at high risk for compartment syndrome caused by:
A)
inflammation.
B)
joint immobility.
C)
muscle atrophy.
D)
extremity elevation.
11.
A college baseball player has seen his season cut short by a rotator cuff injury. Rotator cuff injuries are frequent because of:
A)
the inherent instability of the shoulder.
B)
the absence of ligaments at the glenohumeral joint.
C)
the vulnerability of the shoulder menisci.
D)
the large mass of the humeral head.
12.
A patient’s clavicular fracture has healed in the weeks following a bicycle accident. Which of the following events takes place in the remodelling stage of bone healing?
A)
Formation of granulation tissue
B)
Development of fibrocartilage that resembles the appearance of the original bone
C)
Deposition of mineral salts into the callus
D)
Reduction in the size of the callus
13.
A child has been hospitalized for the treatment of hematogenous osteomyelitis. The defining characteristic of this type of osteomyelitis is:
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A)
the presence of dead bone tissue.
B)
introduction of microorganisms from the bloodstream.
C)
bacterial proliferation in the absence of the classic signs of infection.
D)
destruction of the vascular network in the endosteum.
14.
Following a lengthy series of diagnostic tests, a patient’s chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this patient most likely to require?
A)
Joint replacement surgery
B)
Intravenous antibiotics
C)
Injections of corticosteroids into the synovial space
D)
Transfusion of packed red blood cells
15.
Which of the following neoplasms of the skeletal system is likely to require the most timely and aggressive treatment?
A)
Exostosis
B)
Osteochondroma
C)
Endochondroma
D)
Osteosarcoma
16.
A patient with a diagnosis of small cell lung carcinoma has developed bone metastases, a finding that has prompted a series of new interventions. What are the primary goals of the treatment regimen for this patient’s bone cancer?
A)
Prevention of brain metastasis and early identification of osteonecrosis
B)
Promotion of bone remodeling at tumor sites through calcium and vitamin D supplements
C)
Prevention of pathologic fractures and maximization of function
D)
Pain management and prevention of osteomyelitis
17.
Metastatic bone disease is most closely associated with:
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A)
cervical cancer and ovarian cancer.
B)
acute myelogenous leukemia (AML) and malignant melanoma.
C)
non-Hodgkin lymphoma and bladder cancer.
D)
breast cancer and prostate cancer.
18.
A couple has just learned that their newborn infant has been diagnosed with osteogenesis imperfecta, and they have responded by seeking out as much information as possible about their child’s diagnosis. What should the clinician teach the couple about their child’s health problem?
A)
This is something that your child may have inherited from one or both or you.
B)
This might have been caused by something you were exposed to during the early part of your pregnancy.
C)
You’ll have to be vigilant of your child’s safety for the next few years, but the disease often resolves spontaneously.
D)
With aggressive treatment, most children with osteogenesis imperfecta are cured within several months.
19.
A child with a diagnosis of Legg-Calvé-Perthes disease will exhibit:
A)
defective synthesis of type I collagen.
B)
congenital dislocation of the acetabulofemoral joint.
C)
necrosis of the proximal femoral head.
D)
intoeing due to metatarsus adductus.
20.
Assessment of a newborn infant reveals the presence of developmental dysplasia of the hip (DDH) that is currently demonstrated by subluxation of the baby’s hip joint and a general laxity in the baby’s ligaments. What measures should be emphasized in this infant’s treatment?
A)
Corticosteroid therapy
B)
Close observation
C)
Open reduction
D)
Joint reconstruction
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Answer Key 1.
D
2.
B
3.
D
4.
B
5.
B
6.
C
7.
A
8.
A
9.
D
10.
A
11.
A
12.
D
13.
B
14.
A
15.
D
16.
C
17.
D
18.
A
19.
C
20.
B
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https://studentmagic.indiemade.com/ Chapter 44 - Disorders of the Skeletal System
1.
Disorders that affect cortical bone typically result in:
A)
fractures of long bones.
B)
impaired collagen synthesis.
C)
infection.
D)
vertebral fractures.
2.
The condition that contributes to the pathology of all metabolic bone diseases is:
A)
impaired vitamin D synthesis.
B)
osteosarcoma.
C)
infection.
D)
osteopenia.
3.
In contrast to osteoporosis, osteomalacia causes
A)
stress fractures
B)
calcium excretion
C)
bone cortex thinning
D)
defective mineralization
4.
without the loss of bone matrix.
Rheumatoid arthritis is a systemic inflammatory disease with joint manifestations described as:
A)
dysplasia.
B)
polyarticular.
C)
asymmetrical.
D)
osteophytes.
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5.
A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of:
A)
pannus tissue.
B)
tophi deposits.
C)
subluxations.
D)
autoantibodies.
6.
HLA-B27 antigen may be linked to other genes that determine the pathologic autoimmune phenomenon in:
A)
gout syndrome.
B)
rheumatoid arthritis.
C)
osteoarthritis syndrome.
D)
ankylosing spondylitis.
7.
Osteoarthritis is a degenerative form of joint disease that is often evidenced by:
A)
spongy joints.
B)
cartilage hypertrophy.
C)
crepitus and grinding.
D)
systemic inflammation.
8.
Systemic sclerosis (scleroderma) is an autoimmune disease of connective tissue characterized by:
A)
fibrosis.
B)
thin fragile skin.
C)
collagen deficiency.
D)
avascular necrosis.
9.
The most commonly occurring early symptoms of systemic lupus erythematosus (SLE) include:
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A)
arthralgia.
B)
tendon rupture.
C)
facial hair growth.
D)
pyelonephritis.
10.
Premature osteoporosis is being seen increasingly in female athletes because of an increased prevalence of:
A)
amenorrhea.
B)
high protein intake.
C)
abnormal body fat.
D)
osteoarthritis.
11.
For many patients, the first indication that they have osteoporosis is:
A)
bone pain that is not alleviated by rest.
B)
a bone fracture.
C)
craving high-calcium foods.
D)
decreased range of motion in the hip and knee joints.
12.
Which of the following measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life?
A)
Weight-control and daily use of low-dose corticosteroids
B)
Genetic testing and range of motion exercises
C)
Calcium supplementation and regular physical activity
D)
Increased fluid intake and use of vitamin D supplements
13.
A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the patient notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the patient’s medication administration record. The nurse should conclude that
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scleroderma.
B)
osteoarthritis.
C)
rheumatoid arthritis.
D)
osteoporosis.
14.
An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this patient’s decline in health?
A)
A mismatch between bone resorption and remodeling
B)
Immunologically mediated joint inflammation
C)
Excessive collagen production and deposition
D)
Cytokine release following mechanical joint injury
15.
Which of the following signs and symptoms should prompt a 29-year-old woman’s primary care provider to assess for systemic lupus erythematosus (SLE)?
A)
Chronic nausea and vomiting that is unresponsive to antiemetics
B)
Joint pain and increased creatinine and blood urea nitrogen
C)
A history of thromboembolic events and varicose veins
D)
Dysmenorrhea and recent spontaneous abortion
16.
A 26-year-old woman has sought care for increasing pain at the back of her ankle and the bottom of her foot over the past 2 weeks. The patient states that she is generally in good health, although she completed a course of antibiotics for a chlamydial infection 6 weeks earlier. This patient’s recent history suggests the possibility of:
A)
systemic sclerosis.
B)
ankylosing spondylitis.
C)
osteoarthritis.
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reactive arthritis. A 55-year-old male patient has reported joint pain in his feet. Which of the following blood work results should prompt further testing to rule out primary gout?
A)
Increased C-reactive protein (CRP)
B)
Increased serum uric acid
C)
Increased polymorphonuclear leukocytes
D)
Increased serum cortisol
18.
Despite differences in onset, involvement, and symptomatology, all of the spondyloarthropathies involve:
A)
sacroiliitis.
B)
calcinosis.
C)
excessive bone turnover.
D)
autoimmune etiology.
19.
The clinical course of osteoarthritis (OA) culminates in:
A)
osteonecrosis and loss of synovial fluid.
B)
formation of tophi in the synovial space.
C)
osteophyte formation and erosion of cartilage.
D)
separation of the epiphyseal plate.
20.
Which of the following disorders of the skeletal system occurs exclusively in older adults?
A)
Polymyalgia rheumatica
B)
Psoriatic arthritis
C)
Reiter syndrome
D)
Ankylosing spondylitis
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A
2.
D
3.
D
4.
B
5.
A
6.
D
7.
C
8.
A
9.
A
10.
A
11.
B
12.
C
13.
D
14.
B
15.
B
16.
D
17.
B
18.
A
19.
C
20.
A
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https://studentmagic.indiemade.com/ Chapter 45 - Structure and Function of the Integumentum
1.
The basal lamina, between the epidermis and dermis, is involved in skin disorders that cause:
A)
blister formation.
B)
conical projections.
C)
prickle cell lesions.
D)
hyperpigmentation.
2.
Cells that form a network to bind and process antigens in the epidermis are known as:
A)
Merkel cells.
B)
reticular dermis.
C)
Langerhans cells.
D)
dermal dendrocytes.
3.
The pilosebaceous unit of the skin consists of:
A)
eccrine secretions.
B)
sebaceous glands.
C)
keratinized plates.
D)
connective tissues.
4.
The
are the skin structures that become inflamed in acne.
A)
follicular bulbs
B)
dermal papillae
C)
apocrine glands
D)
sebaceous glands
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5.
Unlike hair, nails grow:
A)
strata.
B)
outward.
C)
cyclically.
D)
continuously.
6.
Lichenification is caused by:
A)
epidermal breakage.
B)
repeated scratching.
C)
chronic area pressure.
D)
decreased skin shedding.
7.
In addition to keratinocytes, the epidermis has radiation.
A)
melanocyte
B)
Langerhans
C)
subcutaneous
D)
protein granule
8.
Sebaceous glands secrete sebum, which is a:
A)
skin lubricant.
B)
fibrous protein.
C)
watery secretion.
D)
nutritional source.
9.
cells that protect against damage from ultraviolet
The basement membrane between the epidermis and dermis provides for adhesion and serves as a:
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selective filter.
B)
nutritional source.
C)
ground substance.
D)
pressure receptor.
10.
Pruritus, a symptom common of many skin disorders, is a(an):
A)
temporary rash.
B)
itching sensation.
C)
nociceptor response.
D)
result of repeated scratching.
11.
Mitosis that results in the production of new epidermal cells occurs in which of the following layers of the epidermis?
A)
Stratum lucidum
B)
Stratum granulosum
C)
Stratum germinativum
D)
Stratum spinosum
12.
Which of the following statements about the structure of the skin is correct?
A)
Nerve fibers originate in the dermis and terminate in the stratum corneum of the epidermis.
B)
All five layers of the epidermis lack a blood supply.
C)
The epidermis is composed of connective tissue.
D)
The dermis is composed of skeletal muscle tissue.
13. A)
What is physiologic basis for albinism? Accelerated keratinization
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Lack of tyrosinase
C)
Lichenification
D)
Separation of the epidermis from the dermis
14.
Which of the following skin disorders is likely to result from the localized lack of melanin production by melanocytes?
A)
Rash
B)
Bullae
C)
Vitiligo
D)
Melasma
15.
Due to the increasing dryness of her skin in recent years, a 70-year-old woman has needed to reduce the number of baths that she takes. Which of the following factors has resulted in this age-related change in skin function?
A)
Slower keratinization
B)
Changes in sebaceous secretions
C)
Dehydration of epidermal cells
D)
Increased production of bile salts
16.
Dark skin tone is genetically determined and is primarily the result of:
A)
high production of melanin.
B)
dense distribution of melanosomes.
C)
superficial distribution of melanocytes.
D)
high levels of tyrosinase.
17.
Which of the following skin lesions is categorized as a type of blister?
A)
Bulla
B)
Wheal
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C)
Nodule
D)
Plaque
18.
A 22-year-old male college student has presented to his campus medical clinic distraught at the emergence of numerous small blisters on the shaft of his penis. On examination, the clinician notes that the lesions are between 2 and 4 mm in diameter and are filled with serous fluid. The clinician would document the presence of:
A)
pustules.
B)
macules.
C)
vesicles.
D)
papules.
19.
Which of the following characteristics differentiates apocrine sweat glands from eccrine sweat glands?
A)
Apocrine secretions contain oils.
B)
Apocrine secretions help maintain skin pH.
C)
Apocrine glands are more numerous and widely distributed than eccrine glands.
D)
Apocrine glands are primarily thermoregulatory .
20.
Most of the body’s hair follicles are paired with:
A)
a Langerhans cell.
B)
an eccrine sweat gland.
C)
a nerve ending.
D)
a sebaceous gland.
Answer Key 1.
A
2.
C
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B
4.
D
5.
D
6.
B
7.
A
8.
A
9.
A
10.
B
11.
C
12.
B
13.
B
14.
C
15.
B
16.
A
17.
A
18.
C
19.
A
20.
D
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1.
Manifestations of superficial dermatophytosis of the skin include:
A)
scaling.
B)
erythema.
C)
vesicles.
D)
infiltration.
2.
Onychomycosis initially causes the toenail to appear
A)
black
B)
cracked
C)
opaque
D)
eroded
3.
as the fungus digests the nail keratin.
A yeast-like Candida albicans fungal infection can be differentiated from a tinea fungal infection by the presence of:
A)
circular patches.
B)
satellite lesions.
C)
fungal spores.
D)
raised borders.
4.
Warts develop when
A)
melanocytes
B)
keratinocytes
C)
sebaceous glands
D)
subcutaneous cells
are invaded by human papillomavirus (HPV).
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5.
Allergic and hypersensitivity dermatoses are characterized by:
A)
target lesions.
B)
dark erythema.
C)
epidermal edema.
D)
silver-white scale.
6.
Papulosquamous dermatoses, such as psoriasis, are a group of skin disorders characterized by:
A)
scaling papules.
B)
granular scabbing.
C)
raised red borders.
D)
nodular ulcerations.
7.
A thermal burn described as involving the entire epidermis and dermis is classified as:
A)
full third-degree.
B)
deep first-degree.
C)
partial second-degree.
D)
full-thickness second-degree.
8.
The main cause of decubitus ulcers (bedsores) is
A)
external pressure
B)
shearing forces
C)
tissue edema
D)
thrombosis
9.
that impairs the flow of blood and lymph.
Dysplastic nevi are precursors of malignant melanoma that are:
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larger than other nevi.
B)
oval epidermal nests.
C)
dermal cords of cells.
D)
brown rounded papules.
10.
Which one of the following skin disorders seen in elderly persons is considered a premalignant lesion?
A)
Cherry angiomas
B)
Actinic keratosis
C)
Solar lentigines
D)
Telangiectases
11.
Which of the following disorders of the skin is most likely to respond to treatment with systemic antibiotics?
A)
Acne vulgaris
B)
Urticaria
C)
Atopic dermatitis
D)
Verrucae
12.
Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the patient with psoriasis, a disorder that results from:
A)
increased epidermal cell turnover.
B)
an IgE-mediated immune reaction.
C)
hormonal influences on sebaceous gland activity.
D)
human papillomaviruses (HPV).
13.
A patient has been admitted to the intensive care unit of the hospital after developing toxic epidermal necrolysis (TEN) consequent to the administration of a sulfonamide antibiotic. What pathophysiologic phenomenon is likely the greatest immediate threat to this patient’s health?
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The development of bacterial cellulitis on compromised skin surfaces
B)
Fluid and electrolyte imbalances resulting from the loss skin integrity
C)
A cascading autoimmune response that may result in shock
D)
The presence of diffuse lesions and skin sloughing on the patient’s mucous membranes
14.
A man’s winter vacation to a tropical destination has been accompanied by repeated sunburns. What process accounts for the damaging effects of the sun’s radiation?
A)
Initiation of an autoimmune response
B)
Compensatory increases in melanin production
C)
Damage to epidermal cell DNA and free radical production
D)
Hyperkeratinization and the formation of microscopic, subcutaneous lesions
15.
A 44-year-old man has been brought to the emergency department by emergency medical services with severe electrical burns resulting from a workplace accident. The most immediate threat to this patient’s survival at this time is:
A)
infection.
B)
hemodynamic instability.
C)
acute pain.
D)
decreased protein synthesis and impaired healing.
16.
A 79-year-old patient has been confined to bed after a severe hemorrhagic stroke that has caused hemiplegia. Which of the following measures should his care team prioritize in the prevention of pressure ulcers?
A)
Prophylactic antibiotics
B)
Repositioning the patient on a scheduled basis
C)
Applying protective dressings to vulnerable areas
D)
Parenteral nutrition
17.
Which of the following actions involves the greatest risk of skin shearing?
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A)
Inserting a peripheral intravenous catheter
B)
Rolling the patient from a supine to side-lying position
C)
Pulling the patient up in bed
D)
Helping the patient ambulate after surgery
18.
What neoplasm of the skin is associated with the poorest prognosis?
A)
Malignant melanoma
B)
Basal cell carcinoma
C)
Intraepidermal squamous cell carcinoma
D)
Invasive squamous cell carcinoma
19.
The transition of a melanoma from radial growth to vertical growth is associated with:
A)
failure of the integrity of the basement membrane.
B)
involvement of the nonkeratinizing cells.
C)
spontaneous resolution.
D)
an increased risk of metastasis.
20.
A 5-year-old girl has been presented for care by her father due to her recent development of macules on her trunk, extremities, and mucous membranes. The child is mildly febrile but her primary symptom is extreme pruritus. What disorder of the skin should the clinician who is assessing the child first suspect?
A)
Varicella
B)
Lichen planus
C)
Rosacea
D)
Impetigo
Answer Key 1.
A
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2.
C
3.
B
4.
B
5.
C
6.
A
7.
D
8.
A
9.
A
10.
B
11.
A
12.
A
13.
D
14.
C
15.
B
16.
B
17.
C
18.
A
19.
D
20.
A
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