NUR 239 Exam 4 - Questions with Verified Answers

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NUR 239 Exam 4 - Questions with Verified Answers When explaining genetic coding to a group of students, the instructor discusses gene activation and deactivation. It was stressed that inactivation o... f a gene requires which of the following processes? Methylation of histone amino acid When an infant is born with gene mutations in his cells, the nurse explains to the parents that accidental errors may be a result of: Select all that apply. Loss of one or more base pairs Substitution of one base pair for another Rearrangement of the base pairs Which of the following statements is true of genetic mutations? Mutations may result from environmental agents. While explaining the individual differences in physical traits in the family group, the health care provider states this is usually a result of: Small DNA sequence variation Which genetic disorders (body system) have a high requirement for oxidative metabolism associated with mitochondrial DNA? Neuromuscular disorders Which of the following statements is true of messenger RNA (mRNA)? mRNA provides the template for protein synthesis. When comparing and contrasting the various forms of RNA, the pathophysiology instructor identifies that ribosomal RNA (rRNA) is unique in that it: Is produced in the nucleolus A physiology instructor asks the students about the purpose of the promoter region on a DNA strand. Which student response is most accurate? Contains amino acids that the RNA polymerase recognized and binds to, thus starting the replication process Splicing of mRNA during processing permits a cell to: Form different proteins A genetic test result returns noting that the specimen (client) has inclusion bodies in the sample. The health care provider can associate this result with the development of which pathologic disease process? Select all that apply. Alzheimer disease Parkinson disease Which of the following would be an example of gene expression? Select all that apply. Control of insulin expression so it gives a signal for blood glucose regulation Increasing the amount of UV light exposure to end up with darker skin Identifying the genetic sex of a child is based on finding intracellular Barr bodies that consist of: Inactive chromatin material Prenatal genetic testing that counts the number of Barr bodies in a chromosome is able to determine: The genetic sex of a child Crossing-over of chromatid segments during meiosis division 1 results in: New gene combinations When discussing upcoming chromosome studies, a client asks, "What kind of sample are they going to take to do these tests?" The nurse replies, "The most common cells used for this purpose are: Lymphocytes from a venous blood specimen." While lecturing on inheritance patterns, a student asks, "My mother has blue eyes and my father has brown eyes. All my siblings have brown eyes except me. How can this happen?" Which of the following is the most accurate response? Phenotypically, the brown-eyed persons are the same, but genotypically they are different. The gene responsible for a particular congenital cardiac anomaly is said to have complete penetrance. What are the clinical implications of this fact? All the individuals who possess the gene will exhibit the anomaly. A pregnant female has been told she is a carrier for fragile X syndrome. She asks, "What does that mean?" The health care provider explains that she is heterozygous for fragile X recessive trait, but this will only be a problem if: The expressed pairing becomes homozygous. A child with cystic fibrosis (CF) asks the nurse why he has this disease, but his parents are perfectly healthy. The nurse explains: Both parents are carriers and have a recessive genotype with alleles for CF. When discussing linkage studies, the instructor mentions that colorblindness is found in a small section of the X chromosome and has been linked to development of which of the following diseases? Select all that apply. Hemophilia A Adrenal hyperplasia A client diagnosed with a cancer has been prescribed monoclonal antibodies as a treatment option. He asks the health care provider, "What are you talking about? I've never heard of this treatment. Is it experimental?" The health care provider explains somatic cell hybridization to the client by explaining that: Researchers inject mice with an antigen from human cancer cells. They then harvest the antibody-producing cells from the mice and individually fuse them with a cancerous cell. From the following list, which medications have been developed utilizing recombinant DNA technology? Select all that apply. Insulin, for clients with diabetes Erythropoietin to help the body generate more RBCs Tissue plasminogen activator (tPA) to dissolve a clot in the brain When a client with a kidney transplant develops graft versus host disease, a suicide gene transfer can be accomplished by: Infusion of donor lymphocytes Which of the following facts underlies the application of RNA interference in the treatment of disease? Faulty gene activity that produces unwanted proteins can sometimes be stopped. Which of the following is an application of recombinant DNA technology? Production of human insulin Genetic disorders that involve a single-gene trait are characterized by: Mendelian patterns of transmission In one family, a son was born with polydactyly toes while his sister had polydactyly fingers. In explaining this phenomenon in genetic terms to the parents, which concept should be addressed? Variable expressivity of a gene 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? Neurofibromatosis A 16-year-old male presents to the clinic complaining of headaches, trouble hearing the teacher in the front of the classroom, and ringing in the ears. He also revealed that every time he goes swimming underwater, he gets disorientated (which never happened when he was younger). Given these manifestations, the health care provider is going to start testing for: Neurofibromas Which of the following statements is true of autosomal recessive disorders? Effects are typically the result of alterations in enzyme function. Following routine newborn testing, an infant has been diagnosed with an elevated phenylalanine level. The nurse teaches the parents to follow a strict low-protein diet to prevent which of the following major complications for the infant? Impaired brain development When a male child inherits an X-linked disorder from his heterozygous carrier mother: Some of his sisters will be carriers. When quizzing obstetrical nursing students regarding tissues affected by mitochondrial DNA mutations, the instructor accepts which of the following responses? Select all that apply. Retinal degeneration Deafness Which of the following statements about multifactorial inheritance disorders are accurate to share with a family of a child born with a cleft lip and palate? Multifactorial inheritance disorders: Select all that apply. Carry the same risk for recurrence with future pregnancies Have an increased risk among first-degree relatives of the affected person 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 parent's best conveys the probable cause of the infant's cleft lip? "Your child's cleft lip likely results from the interplay between environment and genes." Which of the following practitioners is most likely to be of immediate assistance in the first 24 hours following delivery of an infant with a cleft lip? Lactation consultant The newborn has been born with distinctive physical features of trisomy 21, Down syndrome. The mother asks the nurse, "What is wrong? My baby looks different than his brother." The nurse assesses the infant and notes which of the following characteristics that correlate with trisomy 21? Select all that apply. Upward slanting of eyes Large tongue sticking out the mouth Flat facial profile 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? Prenatal blood tests Aneuploidy of the X chromosome can result in a monosomy or polysomy disorder. The clinical manifestations of a female with monosomy X include: Select all that apply. A short-stature female individual Difficulty with fine motor skills Nonpitting lymphedema of the feet 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? The child: Is likely to have no manifestations of this chromosomal abnormality A teratogenic environmental agent can cause birth defects when: Exposed during early pregnancy Which of the following variables determine the extent of teratogenic drug effects? Select all that apply. Molecular weight of the drug Stage of pregnancy when the drug was taken Duration of drug exposure Fetal alcohol syndrome (FAS) is unlike other teratogens in that the harmful effects on the fetus: Extend throughout the pregnancy A woman who has just learned that she is pregnant for the first time has sought advice from her health care provider about the safe use of alcohol during pregnancy. What advice should the clinician provide to the woman? "It's likely best to eliminate alcohol from your diet while you're pregnant." A newly pregnant female is worried about her baby. She recently returned from a mission trip to Africa. She was told there was a rubella outbreak in the next village. She has been given a TORCH screening test. If she has exposed her fetus to rubella, the nurse would expect the infant to display which of the following possible birth defects? Blindness Which of the following meals would be considered high in folic acid intake? Green leafy salad, beef and bean burrito on whole-wheat shell A first-time pregnant mother asks, "Why do I need an ultrasound? I'm worried that my insurance won't cover it." The nurse responds that an ultrasonography can diagnose prenatal abnormalities like which of the following? Select all that apply. Skeletal defects like facial structural problems Congenital heart defects A pregnant client's α-fetoprotein (AFP) returns elevated. The couple ask the health care worker to explain what this means. Which of the following is the best response? "Elevated levels means your baby is at risk of having a neural tube defect like spina bifida (an opening in the spine)." An older mother (age 41) is worried about having a baby with birth defects. She wants to get tested so she can be prepared for the outcome. Which of the following tests should the clinic nurse prepare the client for? Select all that apply. A blood test (circulating cell-free DNA) will tell if the baby is mentally retarded. Withdrawing a sample of amniotic fluid will reveal any chromosomal defects. A pregnant mother (16 weeks' gestation) forgot and emptied her cat's litter box without gloves. She is extremely anxious and wants tested right away. Which test would the nurse prepare her for that would give rapid cytogenic analysis? Percutaneous umbilical cord blood sampling Which of the following clients are more than likely experiencing impairment of the mucociliary blank with cilia dysfunction? Select all that apply. A smoker who smokes 2 packs of cigarettes/day and currently hospitalized with pneumonia A mountain skier who spends all day outside teaching ski lessons A nursing home client diagnosed with H1N1 influenza with fever of 102°F Above the glottis that opens and closes for speech, the epiglottis performs which physiologic functions during swallowing? Cover the larynx A child with asthma is walking outside and develops a bronchospasm. The school nurse knows this bronchospasm has what effects on bronchioles with airflow? Select all that apply. Narrowing of bronchioles Impairs airflow A client with a history of emphysema from long-term cigarette smoking has loss of many alveoli. When comparing the type I alveolar cell physiologic function with the primary role of type II alveoli, the nurse would be aware that the type II alveoli are responsible for: Production of surfactant Bronchial circulation differs from the pulmonary circulation by providing blood for the: Conducting airways When a client with a history of asthma takes a walk outside on a windy day with high pollen counts, she may experience an asthma attack, resulting in an increase in respiration rate and wheezing. The body's response is likely related to which pathophysiological principle? Parasympathetic nervous system stimulation resulting in airway constriction A client who is in a room at 1 atmosphere (760 mm Hg) is receiving supplemental oxygen therapy that is being delivered at a concentration of 50%. What is the consequent PO2? 380 mm Hg. A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happened. The nurse states, "For unknown reasons, you lose intrapleural negative pressure. This means your lungs collapsed and expelled its air when you lose negative pressure." A respiratory therapist has asked a client to breathe in as deeply as possible during a pulmonary function test. Inspiration is normally the result of which of the following phenomena? Decreased intrathoracic pressure The client with emphysema should be educated about changes in lung tissue that may include which of the following changes? Select all that apply. Loss of elastic recoil Difficulty exhaling due to inability to recoil Increased lung compliance Clients who have been bed-ridden for a long time likely will experience: Shallow, quiet breathing, which impairs the spreading of surfactant When thinking in terms of airway radius with regard to resistance, the lung structure responsible for the most airway resistance to airflow would be: The bronchioles near the trachea Completion of a client'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 client's inspiratory capacity? 3600 mL. A client 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 client's forced vital capacity (FVC)? "I'll ask you to breathe in as deep as you can, and then blow out as much of that air as possible." Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal instead of low lung volumes, which result in: Trapping of large amounts of air that cannot participate in gas exchange Respiratory movement of air that does not participate in alveolar gas exchange is known as alveolar dead space. Dead space increases when alveolar/alveoli: Air supply exceeds blood flow. Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes pulmonary: Vasoconstriction Following surgery, a client had a chest x-ray that reported some opacities in the lung bases likely due to atelectasis. Which of the following pathophysiologic processes will result from this condition? Perfusion without ventilation Diffusion of gases in the lung is decreased, as in pulmonary edema or pneumonia, by causing an increase in alveolar: Capillary membrane thickness Which of the following clients are likely experiencing a shift to the right in the dissociation curve? Select all that apply. A client with respiratory influenza with a temperature of 102.6°F A COPD client with pneumonia with blood gas pH level of 7.31 A renal failure client with admitting hemoglobin level of 8.0 mg/dL While discussing carbon dioxide transport within the body, the instructor asks, "What enzyme helps carbon dioxide with water to form bicarbonate?" Which student response is correct? Carbonic anhydrase A client arrives in the emergency department suffering a traumatic brain injury as a result of a car accident. While assessing this client, the nurse notices the client has an irregular breathing pattern consisting of prolonged inspiratory gasps interrupted by expiratory efforts. The underlying physiological principle for these signs would include: Damage has occurred at the connection between the pneumotaxic and apneustic centers. COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population? PO2 level of 50 mm Hg A client has experienced a bout of coughing after aspirating some of his secretions. The client's coughing was triggered by which of the following? Signals from receptors in the tracheobronchial wall The sensation of chest tightness due to an impending asthmatic attack appears to be related to which of the following physiological causes? Input from lung receptors that monitor bronchial constriction. A client 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? Increased heart rate An elderly client 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 client's most recent health problem? Thoracentesis Pleuritic chest pain associated with respiratory movements is usually described as: Localized A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because: Trapped, inspired air collapses the lung. [Show More]

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