NR507 Pathophysiology Midterm Exam Week 1-4 (2020) – Chamberlain College of Nursing | NR 507 Pathophysiology Midterm Exam Week 1-4 (2020)

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NR507 Pathophysiology Midterm Exam Week 1-4 (2020) – Chamberlain College of Nursing Mid Term Weeks 1-4 Question 1 2 / 2 pts What is the most abundant class of plasma protein?    Globul... in      Albumin      Clotting factors      Complement proteins   Albumin (approximately 60% of total plasma protein at a concentration of about 4 g/dl) is the most abundant plasma protein.   IncorrectQuestion 2 0 / 2 pts Carcinoma in situ is characterized by which changes?    Cells have broken through the local basement membrane.      Cells have invaded immediate surrounding tissue.      Cells remain localized in the glandular or squamous cells.      Cellular and tissue alterations indicate dysplasia.   Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.   Question 3 2 / 2 pts Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man?    Ligase chain reaction (LCR)      Gram-stain technique      Polymerase chain reaction (PCR)      DNA testing   Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition.   Question 4 2 / 2 pts The Papanicolaou (Pap) test is used to screen for which cancer?    Ovarian      Uterine      Cervical      Vaginal   The Pap test, an examination of cervical epithelial scrapings, readily detects early oncogenic human papillomavirus (HPV)infection. The Pap test is not used for screening the other cancer sites listed.   IncorrectQuestion 5 0 / 2 pts Causes of hyperkalemia include:    Hyperparathyroidism and malnutrition      Vomiting and diarrhea      Renal failure and Addison disease      Hyperaldosteronism and Cushing disease   Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists. The other options are not known to be causes of hyperkalemia.   Question 6 2 / 2 pts What is the major concern regarding the treatment of gonococci infections?    Development of antibiotic resistance      Changes in virulence      Changes in pathogenicity      Mutations into different strains   Several types of drug-resistant strains have been identified; they are penicillinase-producing Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant N. gonorrhoeae (QRNG). The other options are not major concerns.   Question 7 2 / 2 pts Hypersensitivity is best defined as a(an):    Disturbance in the immunologic tolerance of self-antigens      Immunologic reaction of one person to the tissue of another person      Altered immunologic response to an antigen that results in disease      Undetectable immune response in the presence of antigens   Hypersensitivity is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity.   Question 8 2 / 2 pts Which immunoglobulin (Ig) is present in childhood asthma?    IgM      IgG      IgE      IgA   Included in the long list of asthma-associated genes are those that code for increased levels of immune and inflammatory mediators (e.g., interleukin [IL]–4, IgE, leukotrienes), nitric oxide, and transmembrane proteins in the endoplasmic reticulum. None of the other options are associated with childhood asthma.   Question 9 2 / 2 pts Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?    Parental history of asthma     Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels    Reduced expiratory flow rates confirmed by spirometry testing      Improvement on a trial of asthma medication   Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children.   Question 10 2 / 2 pts Continuous increases in left ventricular filing pressures result in which disorder?    Mitral regurgitation      Mitral stenosis      Pulmonary edema      Jugular vein distention   Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question.   Question 11 Which statement best describes a Schilling test?   Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency   Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia   Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia   Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia. The Schilling test indirectly evaluates vitamin B12 absorption by administering radioactive B12 and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test.   Question 12 2 / 2 pts How high does the plasma glucose have to be before the threshold for glucose is achieved?    126 mg/dl      150 mg/dl      180 mg/dl      200 mg/dl   When the plasma glucose reaches 180 mg/dl, as occurs in the individual with uncontrolled diabetes mellitus, the threshold for glucose is achieved.   Question 13 2 / 2 pts What is the ratio of coronary capillaries to cardiac muscle cells?    1:1 (one capillary per one muscle cell)      1:2 (one  capillary per two muscle cells)      1:4 (one  capillary per four muscle cells)      1:10 (one  capillary per ten muscle cells)   The heart has an extensive capillary network, with approximately 3300 capillaries per square millimeter (ca/mm2) or approximately one capillary per one muscle cell (muscle fiber).   Question 14 2 / 2 pts Deficiencies in which element can produce depression of both B- and T-cell function?    Iron      Zinc      Iodine      Magnesium   Of the options available, only deficient zinc intake can profoundly depress T- and B-cell function.   Question 15 2 / 2 pts Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?    Coarctation of the aorta (COA) and pulmonary stenosis (PS)      Tetralogy of Fallot and persistent truncus arteriosus      Atrial septal defect (ASD) and dextrocardia      Ventricular septal defect (VSD) and patent ductus arteriosus (PDA)   Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome.   Question 16 2 / 2 pts Which of the following is classified as a megaloblastic anemia?    Iron deficiency      Pernicious      Sideroblastic      Hemolytic   Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias.   Question 17 2 / 2 pts The lung is innervated by the parasympathetic nervous system via which nerve?    Vagus      Phrenic      Brachial      Pectoral   Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung.   Question 18 2 / 2 pts Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?    Adrenal cortex      Hypothalamus      Anterior pituitary      Limbic system   The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS.   Question 19 2 / 2 pts Which type of antibody is involved in type I hypersensitivity reaction?    IgA      IgE      IgG      IgM   Type I reactions are only mediated by antigen-specific IgE and the products of tissue mast cells (see Figure 9-1).   Question 20 2 / 2 pts What is the life span of an erythrocyte (in days)?    20 to 30      60 to 90      100 to 120      200 to 240   Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days.   Question 21 2 / 2 pts What is the life span of platelets (in days)?    10      30      90      120   A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.   Question 22 2 / 2 pts Perceived stress elicits an emotional, anticipatory response that begins where?    Prefrontal cortex      Anterior pituitary      Limbic system      Hypothalamus   Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition.   Question 23 2 / 2 pts What is the final stage of the infectious process?    Colonization      Invasion      Multiplication      Spread   From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread. Question 24 2 / 2 pts The coronary ostia are located in the:    Left ventricle      Aortic valve      Coronary sinus      Aorta   Coronary arteries receive blood through openings in the aorta, called the coronary ostia.   Question 25 2 / 2 pts Which hepatitis virus is known to be sexually transmitted?    A      B      C      D   Only hepatitis B virus (HBV) is known to be sexually transmitted.   Question 26 2 / 2 pts What process allows the kidney to respond to an increase in workload?    Glomerular filtration      Secretion of 1,25-dihydroxyvitamin D3    Increased heart rate      Compensatory hypertrophy   Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload.   Question 27 2 / 2 pts Which cardiac chamber has the thinnest wall and why?   The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.   The right and left atria; they are not directly involved in the preload, contractility, or afterload of the heart.   The left ventricle; the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure.   The right ventricle; it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation. The two atria have the thinnest walls because they are low-pressure chambers that serve as storage units and conduits for blood that is emptied into the ventricles. This selection is the only option that correctly identifies which heart chambers have the thinnest walls and why that helps cardiac function.   Question 28 2 / 2 pts Which hormone is synthesized and secreted by the kidneys?    Antidiuretic hormone      Aldosterone      Erythropoietin      Angiotensinogen   Erythropoietin is produced by the fetal liver and in the adult kidney and is essential for normal erythropoiesis. This statement is not true of the other options.   Question 29 2 / 2 pts If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute) can the atrioventricular (AV) node depolarize?    60 to 70      40 to 60      30 to 40      10 to 20   If the SA node is damaged, then the AV node will become the heart’s pacemaker at a rate of approximately 40 to 60 spontaneous depolarizations per minute.   Question 30 2 / 2 pts What is the purpose of the spirometry measurement?    To evaluate the cause of hypoxia      To measure the volume and flow rate during forced expiration      To measures the gas diffusion rate at the alveolocapillary membrane      To determine pH and oxygen and carbon dioxide concentrations   Spirometry measures volume and flow rate during forced expiration. The alveolar-arterial oxygen gradient is used to evaluate the cause of hypoxia. Diffusing capacity is a measure of the gas diffusion rate at the alveolocapillary membrane. Arterial blood gas analysis can be used to determine pH and oxygen and carbon dioxide concentrations.   Question 31 2 / 2 pts Fetal hematopoiesis occurs in which structure?    Gut      Spleen      Bone marrow      Thymus   The spleen is the largest of the secondary lymphoid organs and the site of fetal hematopoiesis.   Question 32 2 / 2 pts What effects do exercise and body position have on renal blood flow?   Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction.    They activate renal sympathetic neurons and cause mild vasoconstriction.      Both activate renal parasympathetic neurons and cause mild vasodilation.      They activate renal sympathetic neurons and cause mild vasodilation.   Exercise and change of body position activate renal sympathetic neurons and cause mild vasoconstriction. The other options do not have these effects on renal blood flow.   Question 33 2 / 2 pts Which primary characteristic is unique for the immune response?    The immune response is similar each time it is activated.      The immune response is specific to the antigen that initiates it.      The response to a specific pathogen is short term.      The response is innate, rather than acquired.   Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a memory function. The other options are not unique characteristics of the immune response.   Question 34 2 / 2 pts What is the most common cause of insufficient erythropoiesis in children?    Folic acid deficiency      Iron deficiency      Hemoglobin abnormality      Erythrocyte abnormality   Similar to the anemias of adulthood, ineffective erythropoiesis or premature destruction of erythrocytes causes the anemias of childhood. The most common cause of insufficient erythropoiesis is iron deficiency. The other options may be causes but are not common ones.   Question 35 2 / 2 pts What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?   Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)   Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)    Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α     Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)   Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF.   Question 36 2 / 2 pts Decreased lung compliance means that the lungs are demonstrating which characteristic?    Difficult deflation      Easy inflation      Stiffness      Inability to diffuse oxygen   A decrease in compliance indicates that the lungs or chest wall is abnormally stiff or difficult to inflate. This selection is the only option that accurately identifies the meaning of decreased compliance.   Question 37 2 / 2 pts What is the action of urodilatin?    Urodilatin causes vasoconstriction of afferent arterioles.      It causes vasodilation of the efferent arterioles.      Urodilatin inhibits antidiuretic hormone secretion.      It inhibits salt and water reabsorption.   Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options.   IncorrectQuestion 38 0 / 2 pts The function of the foramen ovale in a fetus allows what to occur?    Right-to-left blood shunting      Left-to-right blood shunting      Blood flow from the umbilical cord      Blood flow to the lungs   The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options.   IncorrectQuestion 39 0 / 2 pts Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?    Retropharyngeal abscess      Laryngospasms      Rupturing of the tonsils      Gagging induced aspiration   Examination of the throat may trigger laryngospasm and cause respiratory collapse. Death may occur in a few hours. This selection is the only option that accurately identifies the life-threatening complication that can result from an examination of the throat of a child who demonstrates the signs and symptoms of acute epiglottitis.   Question 40 2 / 2 pts Which statement concerning benign tumors is true?    The resulting pain is severe.      Benign tumors are not encapsulated.      Benign tumors are fast growing.      The cells are well-differentiated.   A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor.   Question 41 2 / 2 pts What is the role of collagen in the clotting process?    Initiates the clotting cascade.      Activates platelets.      Stimulates fibrin.      Deactivates fibrinogen.   In the clotting process, collagen provides a particularly strong stimulus to activate platelets. Collagen does not bring about any of the other options. Question 42 2 / 2 pts What effect do natriuretic peptides have during heart failure when the heart dilates?    Stimulates antidiuretic hormones.      Inhibits antidiuretic hormones.      Stimulates renin and aldosterone.      Inhibits renin and aldosterone.   Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure.   Question 43 2 / 2 pts Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate?    Principle cells      Podocin cells      Mesangial cells      Intercalated cells   Mesangial cells and the mesangial matrix, secreted by mesangial cells, lie between and support the glomerular capillaries. Different mesangial cells contract like smooth muscle cells to regulate glomerular capillary blood flow. They also have phagocytic properties similar to monocytes. The other options are not capable of these functions.   Question 44 2 / 2 pts During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?    Neutrophils      Monocytes      Eosinophils      T lymphocytes   Of the options provided, only eosinophils are activated during IgE-mediated hypersensitivity reactions.   Question 45 2 / 2 pts The most common site of metastasis for a patient diagnosed with prostate cancer is which location?    Bones      Brain      Bladder      Kidney   The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer.   Question 46 2 / 2 pts Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?    Liver      Endometrial      Stomach      Colon   The World Cancer Research Fund summarizes the effects as convincingfor cancers of the colon and probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options.   Question 47 2 / 2 pts When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected?    Genital herpes      Chancroid      Syphilis      Chlamydia   If symptoms occur, the individual may have small (1 to 2 mm), multiple, vesicular lesions that are generally located on the labia minora, fourchette, or penis. They may also appear on the cervix, buttocks, and thighs and are often painful and pruritic. These lesions usually last approximately 10 to 20 days. The other options do not demonstrate these symptoms.   Question 48 2 / 2 pts The glomerular filtration rate is directly related to which factor?    Perfusion pressure in the glomerular capillaries      Diffusion rate in the renal cortex      Diffusion rate in the renal medulla      Glomerular active transport   The filtration of the plasma per unit of time is known as the glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries.   Question 49 2 / 2 pts Which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura, bleeding, and fever?    Idiopathic thrombocytopenic purpura (ITP)      Acute lymphocytic leukemia (ALL)      Non-Hodgkin lymphoma (NHL)      Iron deficiency anemia (IDA)   Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the most common symptoms reflecting the consequence of bone marrow failure, which results in decreased red blood cells and platelets and changes in white blood cells. This selection is the only option that correctly identifies the disease with the symptoms described.   Question 50 2 / 2 pts Which complex (wave) represents the sum of all ventricular muscle cell depolarizations?    PRS      QRS      QT interval      P   Only the QRS complex represents the sum of all ventricular muscle cell depolarizations.   Question 51 2 / 2 pts Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?    IL–1 and IL-6      IL-2 and TNF-α      IFN and IL-12      TNF-ß and IL-4   Although a number of stress factors initiate the production of CRH, of the options available, only high levels of IL-1 and IL-6 initiate such a response.   Question 52 2 / 2 pts Innervation of the bladder and internal urethral sphincter is supplied by which nerves?    Peripheral nerves      Parasympathetic fibers      Sympathetic nervous system      Tenth thoracic nerve roots   The innervation of the bladder and internal urethral sphincter is supplied by parasympathetic fibers of the autonomic nervous system. The process is not dependent on any of the other options.   Question 53 2 / 2 pts Which T-lymphocyte phenotype is the key determinant of childhood asthma?    Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes    CD4 T-helper Th2 lymphocytes    CD8 cytotoxic T lymphocytes      Memory T lymphocytes   Asthma develops because the Th2 response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype.   Question 54 2 / 2 pts What is the primary site for uncomplicated local gonococci infections in men?    Epididymis      Lymph nodes      Urethra      Prostate   Uncomplicated local infections are observed primarily as urethral infections in men.   Question 55 2 / 2 pts What is the trigone?    A smooth muscle that comprises the orifice of the ureter      The inner mucosal lining of the kidneys     A smooth triangular area between the openings of the two ureters and the urethra      One of the three divisions of the loop of Henle   The trigone is a smooth triangular area lying between the openings of thetwo ureters and the urethra. The other options do not accurately identify the trigone.   Question 56 2 / 2 pts What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?    Macula densa      Visceral epithelium      Juxtaglomerular apparatus (JGA)      Filtration slits   Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options.   Question 57 2 / 2 pts What is the primary problem resulting from respiratory distress syndrome (RDS) of the newborn?    Consolidation      Pulmonary edema      Atelectasis      Bronchiolar plugging   The primary problem is atelectasis, which causes significant hypoxemia and is difficult for the neonate to overcome because a significant negative inspiratory pressure is required to open the alveoli with each breath. None of the other options are considered a primary problem associated with RDS.   Question 58 2 / 2 pts Infants are most susceptible to significant losses in total body water because of an infant’s:    High body surface–to–body size ratio      Slow metabolic rate      Kidneys are not mature enough to counter fluid losses      Inability to communicate adequately when he or she is thirsty   Renal mechanisms that regulate fluid and electrolyte conservation are often not mature enough to counter the losses; consequently, dehydration may rapidly develop. Infants can be susceptible to changes in total body water because of their high metabolic rate and the turnover of body fluids caused by their greater body surface area in proportion to their total body size. The inability to communicate their thirst is a problem only when they are poorly cared for.   IncorrectQuestion 59 0 / 2 pts What is the first stage in the infectious process?    Invasion      Colonization      Spread      Multiplication   From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread.   Question 60 2 / 2 pts It has been determined that a tumor is in stage 2. What is the meaning of this finding?    Cancer is confined to the organ of origin.      Cancer has spread to regional structures.      Cancer is locally invasive.      Cancer has spread to distant sites   Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4. Quiz Score: 110 out of 120 PreviousNext [Show More]

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