A&P Final exam

A. Cholesterol is produced naturally by the liver, in addition to being ingested in foods.

Although his cholesterol levels were not high, Mr. Martinez read that cholesterol was bad for his health, so he eliminated all foods and food products containing this molecule. He later found that his cholesterol level dropped only 20%. Why did it not drop more? A. Cholesterol is produced naturally by the liver, in addition to being ingested in foods. B. Cholesterol is produced by the pancreas, and is essential for human life. C. Cholesterol is present in plasma membranes, and you can only eliminate 20% of your body's cells safely. D. Cholesterol is present in all foods. Mr. Martinez did not actually remove all cholesterol from his diet, although he thought he did. E. Cholesterol has a long half-life, and will take years to be broken down by the body.

E) Visual disturbances, paralysis, and weakness

What symptoms would a nurse focus on in his or her care of a patient with multiple sclerosis? A) Urinary incontinence, hearing disturbances, and depression B) Depression, paralysis, and speech disturbances C) Weakness and clumsiness D) Hearing disturbances, depression, and clumsiness E) Visual disturbances, paralysis, and weakness

A. A thin incision will leave a small amount of scar tissue. The surface epithelium regenerates, and as scar tissue matures, it contracts, leaving only a fine white line.

A 45-year-old woman is admitted to the hospital for surgical removal of a tumor on her thyroid gland. The surgeon informs her that she will have only a very small scar. How could this be possible? A. A thin incision will leave a small amount of scar tissue. The surface epithelium regenerates, and as scar tissue matures, it contracts, leaving only a fine white line. B. A thin incision will leave a small amount of scar tissue. As the surface epithelium regenerates the scar tissue will expand and merge with the adjacent tissue to become almost invisible. C. Epithelial tissues regenerate extremely well, and result in no scar tissue being formed. The only sign of the incision left is the area of new epithelium that looks slightly different. D. A thin incision will leave a small amount of scar tissue. As the scar tissue matures it is broken down by fibroblasts and replaced with new connective and epithelial tissues, resulting in no scar tissue and no scar.

E) The ilium, ischium, and pubic bones

A skeleton was found in a wooded area. It was brought to a forensic medicine laboratory for identification. The first thing the coroner did was determine the age, sex, and possible size of the person. What was examined in order to get this information? A) The humerus, cranial bones, and facial bones B) The femur, humerus, and facial bones C) The femur, skull, and ribcage D) The cranial and facial bones, and the femur E) The ilium, ischium, and pubic bones

C) Facial nerve damage on his left side

David, an aspiring baseball player, was struck on the left side of his face with a fastball pitch. He was not wearing a safety helmet. His zygomatic arch was crushed, as well as parts of the temporal bone. Following the accident and reconstructive surgery, he noted that his left lower eyelid was still drooping and the corner of his mouth sagged. What nerve damage did he sustain? A) Facial nerve damage on his right side B) Oculomotor nerve damage on his left side C) Facial nerve damage on his left side D) Trigeminal nerve damage on his right side E) Trigeminal nerve damage on his left side

A. By applying slight pressure to a tooth, the bone on the forward side will reabsorb, while the bone on the reverse side will be reformed.

How can a tooth be moved in a bony socket during orthodontic treatment? A. By applying slight pressure to a tooth, the bone on the forward side will reabsorb, while the bone on the reverse side will be reformed. B. By applying slight pressure to a tooth, the gums will be reabsorbed and reformed to the new position of the tooth. C. By applying slight pressure to a tooth, the bone on the forward side will reformed, while the bone on the reverse side will be reabsorbed. D.Teeth are avascular, allowing part of the tooth to be removed for repositioning.

C) Through the ethmoidal and sphenoid sinuses

Jason is a 14-year-old who recently had his nose pierced. He tells his mother that the area is very tender and warm to the touch. The area is also red. The mother calls the pediatrician's office and the nurse recommends that the mother bring Jason in for evaluation. The nurse explains to the mother that a local infection from the nose piercing can spread to the brain. What is the most likely route for the infection to spread to the brain? A) Through the frontal and maxillary sinuses B) Through the ethmoidal and nasal bones C) Through the ethmoidal and sphenoid sinuses D) Through the nasal and zygomatic bones, and then through the orbital fissure

C) She will show increasing cognitive deficits, including difficulties with memory and attention, and personality changes such as irritability, moodiness, and confusion.

Mrs. Sagalov has recently been diagnosed with Alzheimer's disease. What clinical symptoms is she likely to show? A) She will show visual disturbances, problems controlling muscles, speech disturbances, and urinary incontinence. B) She will show a persistent tremor, forward-bent walking posture, shuffling gait, and stiff facial expression. C) She will show increasing cognitive deficits, including difficulties with memory and attention, and personality changes such as irritability, moodiness, and confusion. D) She will show difficulty in communicating, forming relationships with others, and responding appropriately to the environment. E) She will show wild, jerky, and continuously "flapping" movements, and mental deterioration.

A) Demyelination interferes with saltatory conduction, which would result in a slowing down of nerve impulse propagation.

Multiple sclerosis (MS) is a disease in which the myelin sheaths are destroyed. What process does this interfere with, and what would be the consequence? A) Demyelination interferes with saltatory conduction, which would result in a slowing down of nerve impulse propagation. B) Blockage of the sodium and potassium channels impairs impulse propagation. C) Demyelination interferes with chemical transmission across the synapses between neurons. D) Demyelination completely prevents transmission of the action potentials along the axon. E) Blockage of the sodium channels impairs impulse propagation.

C) The heart rate would slow down because of stimulation of the parasympathetic system.

Sensory nerve endings that are located in the carotid bodies are rich in vagal fibers. How, and why, would external stimulation of the carotid artery, such as carotid massage, affect the heart rate? A) The heart rate would slow down because of stimulation of the sympathetic system. B) The heart rate would speed up because of stimulation of the parasympathetic system. C) The heart rate would slow down because of stimulation of the parasympathetic system. D) The heart rate would remain the same, as the neither the parasympathetic or sympathetic systems would be stimulated. E) The heart rate would speed up because of stimulation of the sympathetic system.

E. 9%; the legs

The Waldorf family was caught in a fire but escaped. Unfortunately, the father and daughter suffered burns. The father had second-degree burns on his chest, abdomen, and both arms, and third-degree burns on his entire left lower extremity. The daughter suffered first-degree burns on her head and neck and second-degree burns on both lower extremities. What percentage of the daughter's body received first-degree burns? What part of the daughter's body has burns to both the dermis and epidermis? A. 9%; the head and neck B. 4.5%; the legs C. 4.5%; the head and neck D. 13.5%; the legs E. 9%; the legs

C. Blood vessels in the skin dilated; sweat was secreted onto the skin's surface and evaporated, cooling the body.

The temperature yesterday was an uncomfortable 98° F. You unwisely chose to play tennis at noon, counting on your body's internal defenses to protect you against heat exhaustion. How did your body respond to this distress? A. Blood vessels in the skin constricted; sweat was secreted onto the skin's surface and evaporated, cooling the body. B. Blood vessels in the skin dilated, channeling the blood deeper in the body to avoid the heat from outside. C. Blood vessels in the skin dilated; sweat was secreted onto the skin's surface and evaporated, cooling the body. D. Blood vessels in the skin constricted, channeling the blood deeper in the body to avoid the heat from outside.

B. All of these answers are correct.

We are told that every surface we touch is teeming with bacterial cells, and bacteria are found in the pools we swim in, the water we wash with, and on the hands of friends. Why are we not inundated with bacterial infections on our skin? A. Not all bacteria are harmful or thrive on the skin. B. All of these answers are correct. C. The low pH of the skin secretions retards the multiplication of bacteria on the skin. D. Many bacteria are killed by bactericidal substances in the sebum and sweat.

E. Pain, swelling, redness, and heat

What are the local clinical signs and symptoms of the inflammatory stage of wound healing? A. Redness, heat, fever, and pain B. Fever, heat, pain, and swelling C. Redness, fever, swelling, and heat D. Swelling, redness, fever, and pain E. Pain, swelling, redness, and heat

A. The base will neutralize the acid on the skin that retards the growth of bacteria, and the removal of the normal microbiota of skin will leave the person exposed to opportunistic pathogens.

Why might soap that has an alkaline base not be healthy for some patients to use daily? A. The base will neutralize the acid on the skin that retards the growth of bacteria, and the removal of the normal microbiota of skin will leave the person exposed to opportunistic pathogens. B. The base will cause damage to the epidermis if used daily. C. The base will neutralize the acid on the skin that retards the growth of bacteria. D. The removal of the normal microbiota of skin will leave the person exposed to opportunistic pathogens.

B. Regeneration is the replacement of destroyed epithelial tissue cells by cells that are identical or similar in structure and function. Scaring would be minimal, if there are no complications such as infection.

A 19-year-old model for Glamour magazine tripped over an extension cord, causing injury to her epidermis. She is afraid the injury will leave a scar. What would be the best thing to say to the patient in response? A. It is likely that you will be left with a scar for the rest of your life, as the epidermis has a low regenerative ability. B. Regeneration is the replacement of destroyed epithelial tissue cells by cells that are identical or similar in structure and function. Scaring would be minimal, if there are no complications such as infection. C. The epidermis has a very high regenerative ability and will not leave a scar. D. Regeneration of the epidermis results in scar tissue eventually being broken down, and over time the scar will disappear.

A. High heat of vaporization; water was lost when evaporating from the skin to cool the body.

A 23-year-old male was riding his road bike in 100-degree heat, when he suddenly became nauseated and weak. He called 911 from his cell phone. When the ambulance came, the paramedics started intravenous therapy for severe dehydration. Which physical property and which physiological role of water caused the dehydration, and why? A. High heat of vaporization; water was lost when evaporating from the skin to cool the body. B. High heat capacity; water was lost when evaporating from the skin to cool the body. C. Reactivity; the increased temperature of water in the body made it unavailable for use by the body. D. High heat capacity; the heat from the sun was absorbed and 'neutralized' by the water within the body, making it unavailable for use by the body. E. High heat of vaporization; the heat from the sun was absorbed and 'neutralized' by the water within the body, making it unavailable for use by the body.

D) Levator ani and coccygeus; weakening of the pelvic floor muscles could cause this problem.

A 52-year-old woman states she has been "leaking urine" during such times as laughing, sneezing, or exercise. Which muscles are affected, and what can cause this problem? A) Ischiocavernosus, coccygeus, and gluteus maximus; an infection could cause this problem. B) Gluteus maximus, coccygeus, and levator ani; weakening of the pelvic floor muscles could cause this problem. C) Coccygeus and gluteus maximus; an infection could cause this problem. D) Levator ani and coccygeus; weakening of the pelvic floor muscles could cause this problem. E) Perineal muscle, levator ani, and coccygeus; an infection could cause this problem.

C. Inflammatory stage, characterized by dilation and increased permeability of capillaries, movement of white blood cells and plasma into the area, clot formation, and removal of foreign material and cell debris.

A 6-year-old child fell off his bike and scraped his knee. What is the first stage of wound healing, and what occurs during this stage? A. Organization stage, characterized by replacement of blood clot with granulation tissue, formation of collagen fiber networks to bridge the gap, and granulation tissue becoming scar tissue. B. Inflammatory stage, characterized by dilation and increased permeability of capillaries, movement of white blood cells and plasma into the area, replacement of blood clot with granulation tissue, and formation of collagen fiber networks to bridge the gap. C. Inflammatory stage, characterized by dilation and increased permeability of capillaries, movement of white blood cells and plasma into the area, clot formation, and removal of foreign material and cell debris. D. Regeneration stage, characterized by replacement of blood clot with granulation tissue, formation of collagen fiber networks to bridge the gap, and granulation tissue becoming scar tissue. E. Organization stage, characterized by dilation and increased permeability of capillaries, movement of white blood cells and plasma into the area, clot formation, and removal of foreign material and cell debris.

B) She most likely has a condition known as Ménière's syndrome. The cause of the syndrome is uncertain, but it may result from distortion of the membranous labyrinth by excessive endolymph accumulation.

A 60-year-old woman is experiencing vertigo. She ignores the symptoms initially, but now her attacks are accompanied by severe nausea and vomiting. Following an attack, she hears a crackling in her ears that causes temporary deafness for some time after. What do you think her problem is, and what is its suspected cause? A) She most likely has motion sickness. The cause is probably a sensory input mismatch. B) She most likely has a condition known as Ménière's syndrome. The cause of the syndrome is uncertain, but it may result from distortion of the membranous labyrinth by excessive endolymph accumulation. C) She most likely has tinnitus. The cause is cochlear nerve damage, or inflammation of the middle or inner ears. D) She most likely has labrynthitis. The cause is probably an inner ear infection. E) She most likely has presbycusis. The cause is loss of sensory hair cells faster than are replaced in the elderly.

D. Proteins, as they are the basic structural material of the body, and are essential for growth, repair, and maintenance of tissue.

A 64-year-old man is admitted to the hospital for nonhealing pressure ulcers in his heels. He has been bedridden for 10 years because of a degenerative muscle disease. Which type of organic compound would be an important part of his diet to promote wound healing, and why? A. Carbohydrates, as they are provide the main structural materials required for growth, repair, and maintenance of tissue. B. Proteins, as they provide the energy necessary for repair to take place. C. Lipids, as they protect the body from mechanical trauma. D. Proteins, as they are the basic structural material of the body, and are essential for growth, repair, and maintenance of tissue. E. Lipids, as they make up the major portion of the plasma membranes of the damaged cells that need to be repaired.

E. The pH would be high. Antacids are basic, and too many antacids would result in a relatively alkaline state.

A 65-year-old patient came to the emergency room with complaints of severe heartburn unrelieved by taking a "large handful" of antacids. Would you expect the pH to be relatively high, low, or normal for the patient's stomach contents, and why? A. The pH would be neutral. Antacids eliminate the stomach acid, leaving only water. B. The pH would be neutral. Antacids are basic, and would cause the acid to be neutralized. C. The pH would be low. Antacids are acidic buffers, and too many antacids would result in an acidic state. D. The pH would be high. Antacids eliminate the stomach acid, leaving only basic secretions. E. The pH would be high. Antacids are basic, and too many antacids would result in a relatively alkaline state.

A) The child has more organic material in her bones, which allows them to bend; her grandmother's bones are extensively calcified, and are less flexible.

A 75-year-old woman and her 9-year-old granddaughter were victims of a train crash. In both cases, trauma to the chest was sustained. X-rays of the grandmother revealed several fractured ribs, but her granddaughter had no fractured ribs. Why are the injuries different for the granddaughter and grandmother? A) The child has more organic material in her bones, which allows them to bend; her grandmother's bones are extensively calcified, and are less flexible. B) The child's bones were protected by a thicker cushioning layer of adipose tissue; the grandmother's cushioning layer of adipose tissue was thin due to old age. C) The child's bones were still growing and were repaired faster than the grandmother's bones. D) The child's ribcage was smaller and requires more pressure to cause it to break; the grandmothers ribcage was larger, and requires less pressure to cause it to break. E)The child has less organic material in her bones, which allows them to bend; her grandmother's bones contain more organic material, and are less flexible.

B) It is the alternating contraction and relaxation of the diaphragm, causing an increase in pressure in the abdominopelvic cavity and facilitating blood flow to the heart.

A nurse can facilitate respiratory functioning by encouraging deep breathing exercises such as diaphragmatic breathing. What is diaphragmatic breathing? A) It is the contraction of the internal intercostals muscles to depress the ribcage, aiding expiration. B) It is the alternating contraction and relaxation of the diaphragm, causing an increase in pressure in the abdominopelvic cavity and facilitating blood flow to the heart. C) It is the alternating contraction and relaxation of the diaphragm, causing a decrease in pressure in the abdominopelvic cavity and facilitating blood flow to the heart. D) It is the alternating contraction of the external and internal intercostals muscles to aid inspiration and expiration. E) It is the contraction of the external intercostal muscles to lift the ribcage, aiding inspiration.

E) Applying gentle pressure to the nasolacrimal duct prevents the delivery of the drug to the nasal mucosa and general circulation, where it could affect heart rate.

A nurse is administering Pilocarpine eye drops. The nurse instructs the patient to press on the nasolacrimal duct for 30 seconds because the medication can have some systemic side effects, such as affecting the heart rate. What is the rationale for pressing on the nasolacrimal duct? A) Applying gentle pressure to the nasolacrimal duct diverts the medication around the entire surface of the eye, so that it isn't washed away quickly. B) Applying gentle pressure to the nasolacrimal duct reduces secretions from the tarsal glands, preventing the drug from being washed away quickly. C) Applying gentle pressure to the nasolacrimal duct enhances the absorption of the eye drops into the eye. D) Applying gentle pressure to the nasolacrimal duct reduces secretions from the lacrimal gland, preventing the drug from being washed away quickly. E) Applying gentle pressure to the nasolacrimal duct prevents the delivery of the drug to the nasal mucosa and general circulation, where it could affect heart rate.

C) Shoulder dislocations are fairly common, as stability was sacrificed for range of movement; therefore, pressure in this area should be avoided.

A nurse is instructing the patient care assistants (PCAs) on transfer techniques. For patients requiring more assistance, the nurse tells the PCAs to reach through the patient's axillae and place their hands on the patient's scapulae during the transfer. She tells them to avoid placing hands or pressure in the axillae area. Based on your knowledge of the shoulder joint, why should this area be avoided? A) The rotator cuff can be severely overstretched if pressure is applied to the axillae area. B) Pressure on the axillae area could result in damage to the nerves serving the arms. C) Shoulder dislocations are fairly common, as stability was sacrificed for range of movement; therefore, pressure in this area should be avoided. D) The glenoid labrum provides stability to the shoulder joint, so there is no reason for avoiding the axillae area. E) The coracohumeral ligament provides stability to the shoulder joint, so there is no reason for avoiding the axillae area.

C) The patient would be unable to expel his or her stool, leading to intestinal obstruction.

A patient has no peristalsis in the gastrointestinal tract. Why would this be problematic? A) The patient would be unable to swallow food, leading to malnutrition. B) There would be no complications if a patient had no peristalsis. C) The patient would be unable to expel his or her stool, leading to intestinal obstruction. D) The patient would be unable to absorb the nutrients in the intestines, leading to malnutrition.

A) It acts at the postsynaptic membrane by competing with the ACh for the receptor sites, or by blocking depolarization.

A patient is admitted for electroconvulsive treatment (ECT). The physician orders the neuromuscular blocking agent metocurine iodide (metubine) to reduce trauma by relaxing skeletal muscles. How does a neuromuscular blocking agent such as metubine interfere with muscle contraction? A) It acts at the postsynaptic membrane by competing with the ACh for the receptor sites, or by blocking depolarization. B) It acts at the postsynaptic membrane by permanently binding with the ACh receptor sites, or by permanently blocking depolarization. C) It acts on the presynaptic neuron to prevent the entry of calcium into the axonal terminal. D) It inhibits the propagation of the action potential along the sarcolemma by blocking depolarization. E) It acts on the presynaptic neuron to prevent release of the ACh.

D) The axons are not damaged; growing numbers of sodium channels appear spontaneously in the demyelinated fibers, allowing conduction to resume.

A patient is admitted to the hospital with exacerbation of multiple sclerosis (MS). She asks the nurse "Why did this have to happen to me again? I was doing so well." Why are some forms of MS characterized by periods of remission and exacerbation? A) The axons are damaged, and repair of the axons results in impulse propagation resuming. B) The myelin sheaths are damaged, and repair of the myelin sheaths results in impulse propagation resuming. C) The axons are not damaged; growing numbers of potassium channels appear spontaneously in the demyelinated fibers, allowing conduction to resume. D) The axons are not damaged; growing numbers of sodium channels appear spontaneously in the demyelinated fibers, allowing conduction to resume. E) The axons are damaged, and repair of the myelin sheath results in impulse propagation resuming.

E) There was damage to localized areas of the primary motor cortex in the left cerebral hemisphere.

A patient is admitted to the rehabilitation unit five days after having a stroke. The nurse assesses his muscle strength and determines that he has right-sided weakness. Based on this assessment data, what part of the brain was injured? A) There was damage to localized areas of the premotor cortex in the right cerebral hemisphere. B) There was damage to localized areas of the premotor cortex in the left cerebral hemisphere. C) There was damage to localized areas of the prefrontal cortex in the right cerebral hemisphere. D) There was damage to localized areas of the primary motor cortex in the right cerebral hemisphere. E) There was damage to localized areas of the primary motor cortex in the left cerebral hemisphere.

C) Electrical stimulation of the skin's large touch fibers causes the gates to close on the smaller pain fibers, thereby inhibiting pain.

A patient is receiving transcutaneous electrical nerve stimulation (TENS) for back pain. How will this help with the pain? A) Constant electrical stimulation of the area where the pain is located overloads the brain with sensory information, resulting in the loss of some signals, such as pain signals. B) Electrical stimulation into the area where the pain is located will result in inhibitory postsynaptic potentials (IPSPs) that prevent the action potential from being generated. C) Electrical stimulation of the skin's large touch fibers causes the gates to close on the smaller pain fibers, thereby inhibiting pain. D) Electrical stimulation into the area where the pain is located will short circuit the neurons, preventing transmission of the pain signals. E) Constant electrical stimulation to the area where the pain is located causes gradual destruction of the neurons in the area, resulting in decreased pain signals over time.

C) The nerve fibers were sutured back in the wrong orientation and may have grown back into different pathways.

A patient suffers nerve damage to the sciatic nerve, requiring surgery to suture the nerve back together. After surgery, the patient reports that sensation from the lateral and medial sides of the knee seem to be reversed. How could this happen? A) The nerve fibers were sutured back in the wrong orientation. B) The nerve fibers did not regenerate, and the sensations are coming from different fibers. The brain has to learn where the alternative fibers are connected, and then he will be fine. C) The nerve fibers were sutured back in the wrong orientation and may have grown back into different pathways. D The nerve fibers may have grown back into different pathways.

B) Serotonin is a biogenic amine neurotransmitter widely distributed in the brain; it plays a role in emotional behavior and mood, and helps to regulate the "biological clock."

A patient was admitted for depression. What class of neurotransmitter is serotonin, and what should the nurse explain to the patient regarding the role of serotonin in depression? A) Serotonin is an amino acid neurotransmitter widely distributed in the brain; it is a "feel good" neurotransmitter that is released in response to amphetamines. B) Serotonin is a biogenic amine neurotransmitter widely distributed in the brain; it plays a role in emotional behavior and mood, and helps to regulate the "biological clock." C) Serotonin is an amino acid neurotransmitter widely distributed in the brain; it plays a role in emotional behavior and mood, and helps to regulate the "biological clock." D) Serotonin is a biogenic amine neurotransmitter widely distributed in the brain; it is a "feel good" neurotransmitter that is released in response to amphetamines. E) Serotonin is a peptide neurotransmitter widely distributed in the brain; it is a "feel good" neurotransmitter that is released in response to amphetamines.

A) Difficulty swallowing and problems with urinary incontinence

A patient was admitted to the medical/surgical unit with a stroke that affected the motor neurons in the pyramidal pathway. This caused the loss of voluntary movement to his left side. What other problems would the patient experience? A) Difficulty swallowing and problems with urinary incontinence B) Loss of involuntary control of his left side C) Loss of involuntary control of his right side D) Loss of involuntary control of his left and right sides, and of voluntary control of his right side E) Loss of voluntary control of his right side

A) Levator ani and coccygeus; strengthening these muscles helps in the delivery of the child by resisting downward forces when "pushing."

A young pregnant woman went to a childbirth class and the instructor informed them about strengthening the muscles of the pelvic floor. What are these muscles, and why should she strengthen them? A) Levator ani and coccygeus; strengthening these muscles helps in the delivery of the child by resisting downward forces when "pushing." B) Perineal muscle, levator ani, and coccygeus; strengthening these muscles helps in the delivery of the child by resisting downward forces when "pushing." C) Coccygeus and gluteus maximus; strengthening these muscles helps in correctly positioning and orienting the child prior to birth. D) Ischiocavernosus, coccygeus, and gluteus maximus; strengthening these muscles helps in correctly positioning and orienting the child prior to birth. E) Gluteus maximus, coccygeus, and levator ani; strengthening these muscles helps in correctly positioning and orienting the child prior to birth.

D) Myasthenia gravis

Aaron arrived at the hospital with the following symptoms: drooping eyelids; fatigue and weakness of his muscles; and difficulty talking, breathing, and swallowing. What was his diagnosis? A) Sarcopenia B) Myotonic dystrophy C) Disuse atrophy D) Myasthenia gravis E) Duchenne muscular dystrophy

B) The frontal sinus located in the frontal bone, and the right maxillary sinus located in the right maxilla

After having a severe cold accompanied by nasal congestion, Jamila complained that she had a headache just above her eyes and that the right side of her face ached. What specific bony structures probably became infected by the bacteria or viruses causing the cold? A) The ethmoidal and sphenoid sinuses located the frontal bone, and the right frontal sinus located in the right maxilla B) The frontal sinus located in the frontal bone, and the right maxillary sinus located in the right maxilla C) The sphenoidal sinuses located in the sphenoid bone, and the right maxillary sinus located in the right maxilla D) The frontal sinuses located in the ethmoid bone, and the right sphenoid sinuses located in the right maxilla E) The ethmoidal sinuses in the ethmoid bone, and the right maxillary sinus located in the right maxilla

A) The immobilization of the arm caused some muscle mass to atrophy, and the loss of muscle was replaced with tough connective tissue that locked her arm in place.

After removal of an elbow cast, Lauren noticed her arm was immovable. What happened to her arm? A) The immobilization of the arm caused some muscle mass to atrophy, and the loss of muscle was replaced with tough connective tissue that locked her arm in place. B) The immobilization of the arm caused some muscle mass to atrophy. C) The loss of muscle was replaced with tough connective tissue that locked her arm in place. D) The loss of neural stimulation caused some muscle mass to atrophy.

C) It was probably inflammation of the bursa close to the olecranon process, because he overextended his abilities.

Akira, a 2.5-ranked tennis player (who thought he was a 4.5 player!), experienced severe pain in his elbow joint after playing for five straight hours, well beyond his limit. He told everyone it was due to a fall while diving to retrieve a difficult shot. What do you think? A) It was probably inflammation of the tendon sheath close to the olecranon process, because he overextended his abilities. B) He probably suffered a sprain, stretching or tearing of ligaments in the elbow, because he overextended his abilities. C) It was probably inflammation of the bursa close to the olecranon process, because he overextended his abilities. D) He probably suffered a strain, stretching or tearing of ligaments in the elbow, because he overextended his abilities. E) He is probably correct.

A. Albinos lack melanin and have thus lost their main defense against the damaging UV light that can cause skin cancer. They can cover all body areas and avoid bright sunlight.

Albinos commonly contract skin cancer. What seems to be the reason, and what can be done to reduce the risk of skin cancer? A. Albinos lack melanin and have thus lost their main defense against the damaging UV light that can cause skin cancer. They can cover all body areas and avoid bright sunlight. B. Albinos lack keratin and have thus lost their main defense against the damaging UV light that can cause skin cancer. They can cover all body areas and avoid bright sunlight. C. Albinos lack keratin that provide strength and resistance to the epidermis, resulting in more UV light penetrating the epidermis to the stratum basale cells and causing skin cancer. They can cover all body areas and avoid bright sunlight. D. Albinos lack melanin, which is responsible for protecting DNA from damage and repairing any damage to prevent cancer from forming. They can cover all body areas and avoid bright sunlight. E. Albinos lack carotene, which is responsible for repairing any damage to DNA, such as from UV light. They can cover all body areas and avoid bright sunlight.

C. The child most likely has rickets. Treatment is to increase the intake of calcium and vitamin D in the diet, and to get some sunshine every day.

Alice and James adopted a 3-year-old child from a developing country. They noticed that her legs were bowed and there were some deformities in her cranial and pelvic bones. They brought her to a physician for a diagnosis. What was the diagnosis, and what was the treatment for the disorder? A. The child most likely has osteomalacia. Treatment is to increase the intake of calcium and vitamin D in the diet, and to get some sunshine every day. B. The child most likely has Paget's disease. Treatment includes drug therapy with administration of calcitonin and bisphosphonates. C. The child most likely has rickets. Treatment is to increase the intake of calcium and vitamin D in the diet, and to get some sunshine every day. D. The child most likely has osteoporosis. Treatment is to increase the intake of calcium and vitamin D, and performance of weight-bearing exercises.

B) She is probably refusing or forgetting to eat or drink.

An 86-year-old patient with Alzheimer's disease was admitted to the hospital with dehydration. Her daughter states that her mother has been very confused and combative lately. Why did the patient develop dehydration? A) The area of the brain controlling the digestive tract has been damaged by the plaques, resulting in not enough water or nutrients being absorbed into the body. B) She is probably refusing or forgetting to eat or drink. C) The patient has not been able to hold the glass of water steady enough to be able to drink enough fluid. D) The patient is not aware that she requires water, as the neurons in the pathways controlling thirst are not functioning due to the Alzheimer's disease. E) The plaques in her brain have destroyed the thirst control center, resulting in her not wanting to drink any water.

E) The fainting episodes are a result of orthostatic hypotension. The condition is exaggerated when blood supply to the skin is increased, such as when the room is warm.

An elderly patient in a nursing home has recurrent episodes of fainting when he stands. An alert nurse notes that this occurs only when his room is fairly warm; on cold mornings, he has no difficulty. What is the cause of the fainting, and how does it relate to the autonomic nervous system and to room temperature? A) The fainting episodes are due Horner's syndrome. The condition is exaggerated when the blood supply to the vagus nerve is diverted to the skin, such as when the room is warm. B) The fainting episodes are a result of orthostatic hypertension. The condition is exaggerated when blood supply to the skin is decreased, such as when the room is warm. C) The fainting episodes are due to Raynaud's disease. The condition is exaggerated when blood supply is decreased to the skin and extremities, such as when the room is warm. D) The fainting episodes are a result of autonomic dysreflexia. The sympathetic system is slow to respond in the elderly when blood supply to the skin is increased, such as when the room is warm. E) The fainting episodes are a result of orthostatic hypotension. The condition is exaggerated when blood supply to the skin is increased, such as when the room is warm.

C. The increased availability of nutrients allows microorganisms to replicate. The skin and mucous membranes are body's first line of defense and are mostly impenetrable to microorganisms, unless broken or damaged by tissue injury.

An infection may occur in a tissue injury. Why? A. Once microorganisms gain entry to the body through a wound, they will always cause an infection. B. The skin and mucous membranes are body's first line of defense, and are mostly impenetrable to microorganisms unless broken. C. The increased availability of nutrients allows microorganisms to replicate. The skin and mucous membranes are body's first line of defense and are mostly impenetrable to microorganisms, unless broken or damaged by tissue injury. D. The increased availability of nutrients allows microorganisms to replicate.

C. Pleurisy is inflammation of the serous membranes covering the lungs. Inflamed pleural serous membranes create friction, resulting in pain as the lungs move during breathing.

Aunt Jessie woke up one morning with excruciating pain in her chest. She had trouble breathing for several weeks. Following a visit to the doctor, she was told she had pleurisy. What is this condition and what did it affect? A. Pleurisy is inflammation of the lungs. Inflamed lungs create friction when they move, resulting in pain. B. Pleurisy is inflammation of the serous membranes covering the lungs. Inflamed pleural serous membranes reduce friction, resulting in the lungs not being pulled to fully expand during breathing. C. Pleurisy is inflammation of the serous membranes covering the lungs. Inflamed pleural serous membranes create friction, resulting in pain as the lungs move during breathing. D. Pleurisy is inflammation of the lungs. Inflamed lungs reduce friction, resulting in the lungs not being pulled to fully expand during breathing. E. Pleurisy is inflammation of the thoracic cavity wall, resulting in compression of the lungs and pain.

E) Susie has strabismus. The doctor's recommendations are for eye exercises and/or placing a patch over the unaffected eye; in severe cases, the condition may require surgery.

Baby Susie's pediatrician notices that one of her eyes rotates outward and that she does not appear to be using it for vision. What is her condition, and what does the pediatrician recommend? A) Susie has strabismus. The doctor's recommendations are for eye exercises and/or placing a patch over the affected eye; in severe cases, the condition may require surgery. B) Susie has diplopia. The doctor's recommendations are for glasses or contact lenses, or laser surgery to correct the problem. C) Susie has astigmatism. The doctor's recommendations are for glasses or contact lenses, or laser surgery to correct the problem. D) Susie has astigmatism. The doctor's recommendations are for eye exercises and/or placing a patch over the affected eye; in severe cases, the condition may require surgery. E) Susie has strabismus. The doctor's recommendations are for eye exercises and/or placing a patch over the unaffected eye; in severe cases, the condition may require surgery.

C. Dietary fiber adds bulk that cannot be absorbed by the body. This results in more water remaining in the digestive tract, easing the movement of feces through the bowel.

Brenda is a 26-year-old female who is being discharged from the hospital after a vaginal delivery of an 8-pound healthy infant. Brenda is instructed by the nurse to eat a diet high in fiber and to drink 8 glasses of water per day to prevent constipation. Why? A. Fiber adds bulk to the diet that cannot be absorbed. This results in less water remaining in the digestive tract, easing the movement of feces through the bowel. B. Fiber interferes the absorption of the excess volume of water in the digestive tract, allowing the correct amount of water intake to be taken up into the body. C. Dietary fiber adds bulk that cannot be absorbed by the body. This results in more water remaining in the digestive tract, easing the movement of feces through the bowel. D. The increased water intake allows more of the fiber to be absorbed by the body. E. Fiber aids in the absorption of the excess volume of water in the digestive tract, allowing the increased water intake to be taken up into the body.

E) Brian has shin splints. This is a condition in which the anterior tibialis muscle is irritated, inflamed, and swollen. The circulation is impaired by the tight fascial wrappings, causing pain.

Brian decided to enter a 5-mile race designed to raise money for a class trip. He did not do any preconditioning, nor has he ever jogged before. The morning after the race, Brian had so much pain in both his legs that he was unable to go to school. What caused this pain, and why? A) Brian has a charley horse. This is a condition where the gastrocnemius muscle is torn and bleeding has occurred into the tissues, causing severe pain. B) Brian has ruptured his calcaneal tendon. When this tendon ruptures, the triceps surae bulges at the top of the calf, and severe pain is experienced. C) Brian has pulled his hamstring muscles. The quadriceps muscles or their tendons have torn, causing intense pain. D) Brian has torticollis in his gastrocnemius. This is a twisting of the muscles that tears muscle fibers, causing pain. E) Brian has shin splints. This is a condition in which the anterior tibialis muscle is irritated, inflamed, and swollen. The circulation is impaired by the tight fascial wrappings, causing pain.

C) When the lungs have difficulty fully expanding, secretions may develop, causing respiratory infection.

Death from amyotrophic lateral sclerosis usually results from respiratory infection secondary to compromised respiratory function. Why? A) When the impulses to the ciliated cells are inhibited, the ciliary escalator no longer functions, causing respiratory infection. B) The reflexes in the respiratory system for expelling particles will no longer function due to damage to the dorsal horn motor neurons, causing respiratory infection. C) When the lungs have difficulty fully expanding, secretions may develop, causing respiratory infection. D) It is actually more common for the person to die from paralysis of the muscles controlling breathing than from respiratory infection.

B) Gluteus maximus, coccygeus, and levator ani

Donna was rushing to class and slipped on a patch of ice and fell backward. An x-ray revealed a broken coccyx. All the associated muscles were bruised. Which muscles were they? A) Ischiocavernosus, coccygeus, and gluteus maximus B) Gluteus maximus, coccygeus, and levator ani C) Levator ani and coccygeus D) Coccygeus and gluteus maximus E) Perineal muscle, levator ani, and coccygeus

A. Emily has osteoporosis. She should lose weight because her bones may not be able to support her body mass.

Emily, a 64-year-old obese woman, was brought to the hospital suffering pain in her legs, and an x-ray revealed that she had a simple fracture in her right femur and a crack in her left tibia. Other tests revealed that her bones were brittle and porous. What might have happened to Emily, and what advice would she have been given by the physician? A. Emily has osteoporosis. She should lose weight because her bones may not be able to support her body mass. B. Emily has a fractured leg. She needs to have her legs placed in a cast to allow bone repair to occur. C. Emily has osteoarthritis. She should lose weight because her bones may not be able to support her body mass. D. Emily has osteomyelitis. She needs to take antibiotics to treat the bacterial infection that is making her bones porous, and needs to have her legs placed in a cast to allow bone repair to occur. E. Emily has osteoporosis. She needs to have her legs placed in a cast to allow bone repair to occur, and she will be fine after that.

B) Tendonitis

Farhad begins typing his term paper on his new computer early one morning. After 8 hours of typing, he notices that his wrists are stiff and very sore. The next morning, Farhad begins to finish his paper, but soon finds his wrists hurt worse than last night. What is Farhad suffering from? A) Student's elbow B) Tendonitis C) A sprain in the wrist D) Carpal tunnel syndrome E) A strain in the wrist

B) In denervation (disuse) atrophy, fibrous connective tissue replaces the muscle tissue that was lost. When atrophy is complete, fibrous tissue cannot be reversed to muscle tissue.

Gary was injured in an automobile accident that severed the motor neurons innervating his quadriceps. Even though he has had extensive physical therapy, he is still suffering muscle atrophy. Why is the therapy not working? A) In myotonic dystrophy, there is a gradual loss of muscle mass as muscle proteins degrade faster than they can be replaced. B) In denervation (disuse) atrophy, fibrous connective tissue replaces the muscle tissue that was lost. When atrophy is complete, fibrous tissue cannot be reversed to muscle tissue. C) In sarcopenia, there is a gradual loss of muscle mass as muscle proteins degrade faster than they can be replaced. D) In Duchenne muscular dystrophy, the muscle enlarges due to fat and connective tissue, but the muscle fibers atrophy and degenerate irreversibly. E) In myasthenia gravis, fibrous connective tissue replaces the muscle tissue that was lost. When atrophy is complete, fibrous tissue cannot be reversed to muscle tissue.

A) It would lower the uric acid concentrations in the blood by stopping absorption of uric acid in the kidneys.

How might probenecid be useful in treating gout? A) It would lower the uric acid concentrations in the blood by stopping absorption of uric acid in the kidneys. B) It would lower the uric acid concentrations in the blood by increasing the active secretion of uric acid in the kidneys. C) It would lower the nitric acid concentrations in the blood by increasing the active secretion of nitric acid in the kidneys. D) It would lower the nitric acid concentrations in the blood by stopping absorption of nitric acid in the kidneys.

E) With normal levels of calcium in the blood, she may still have osteoporosis. In osteoporosis the level of calcium in the blood is expected to be normal, but the calcium level in the bones will be low.

If your elderly patient's blood calcium level is normal, does that tell you anything about the likelihood that your patient has osteoporosis? Why or why not? A) Normal levels of calcium in the blood mean she does not have osteoporosis. Calcium is taken from the blood and deposited in bones to keep bones strong. B) Normal levels of calcium in the blood mean she does not have osteoporosis. With osteoporosis the level of calcium in the blood would be low, because osteoporosis is caused by low calcium levels. C) With normal levels of calcium in the blood, she may still have osteoporosis. The level of calcium in the blood is not related to the level in the bones. D) Normal levels of calcium in the blood mean she does not have osteoporosis. The level of calcium in the blood would be high with osteoporosis, because it is being removed from the bones. E) With normal levels of calcium in the blood, she may still have osteoporosis. In osteoporosis the level of calcium in the blood is expected to be normal, but the calcium level in the bones will be low.

E. Epithelial tissue: it is exposed to the environment and is constantly dividing, both factors allowing more opportunity for damage and overcoming growth control mechanisms.

In adult humans, most cancers are carcinomas or adenocarcinomas. These include cancers of the skin, lung, colon, breast, and prostate. Which of the four basic tissue types is involved, and why? A. Epithelial tissue: it is avascular and composed entirely of cells, both of which inhibit surveillance by the immune system. B. Connective tissue: it is found everywhere in the body, and is the only tissue common to the skin, lungs, colon, breasts, and prostate. C. Connective tissue: cancerous cells require high levels of nutrients, and connective tissue is well vascularized. D. Connective tissue: cancerous cells can move more freely and spread to other tissues more easily due to the high level of vascularization in connective tissue. E. Epithelial tissue: it is exposed to the environment and is constantly dividing, both factors allowing more opportunity for damage and overcoming growth control mechanisms.

E) The internal intercostal muscles aid active (forced) expiration by depressing the rib cage.

In emphysema, the lungs become overdistended with trapped air. Effective abdominal breathing is decreased. Which muscles are involved when breathing becomes an active process, such as in a patient who has emphysema? A) In emphysema, the lungs become overdistended with trapped air. Effective abdominal breathing is decreased. Which muscles are involved when breathing becomes an active process, such as in a patient who has emphysema? B) The external and internal intercostal muscles aid active (forced) inspiration and expiration by elevating and depressing the rib cage. C) The external intercostal muscles aid active (forced) inspiration by elevating the rib cage. D) The external and internal intercostal muscles, and diaphragm muscle, aid active (forced) inspiration and expiration by elevating and depressing the rib cage, and by changing the pressure in the thoracic cavity. E) The internal intercostal muscles aid active (forced) expiration by depressing the rib cage.

B. The hormonal changes are causing the sebaceous glands to become overactive, resulting in them becoming clogged and infected.

John, a younger teenager, notices that he is experiencing a lot of pimples and blackheads, which frequently become infected. What is causing this problem? A. The hormonal changes are causing the apocrine glands to become overactive, resulting in them becoming clogged and infected. B. The hormonal changes are causing the sebaceous glands to become overactive, resulting in them becoming clogged and infected. C. The sebaceous glands are starting to form in the epidermis/dermis with the onset of puberty, and are initially overactive. D. The hormonal changes are causing the eccrine glands to become overactive, resulting in them becoming clogged and infected. E. The eccrine glands are starting to form in the epidermis/dermis with the onset of puberty, and are initially overactive.

D. Removal of the soft tissue reduced blood flow to the affected area, resulting in a decreased supply of nutrients required for repair.

Johnny fractured the lower third of his right tibia in a skiing accident. The soft tissues in the area were severely damaged and their surgical removal was necessary. After prolonged immobilization, it was found that Johnny was healing very poorly. Why did Johnny have poor healing? A. Prolonged immobilization resulted in a decreased supply of nutrients required for repair. B. Prolonged immobilization reduced the stresses placed on the bone, and according to Wolff's law, without the stresses on the bone, repair will not occur. C. Removal of the soft tissue resulted in removal of the osteoblasts that could otherwise have repaired the bone. D. Removal of the soft tissue reduced blood flow to the affected area, resulting in a decreased supply of nutrients required for repair.

D) A cataract is a clouding of the lens. Some cataracts are congenital, but most are due to age-related hardening and thickening of the lens, diabetes mellitus, or exposure to UV rays over time. The lens can be removed and replaced with an artificial lens.

Ling, a 75-year-old grandmother, complained that her vision was becoming obscured. Upon examination by an ophthalmologist she was told she had cataracts. What are cataracts, how do they occur, and how are they treated? A) A cataract occurs when there are unequal curvatures in different parts of the cornea or lens. This is a congenital condition. Specially ground lenses or laser surgical procedures are used to correct this problem. B) A cataract is a clouding of the cornea. Some cataracts are congenital, but most are due to age-related hardening and thickening of the lens, diabetes mellitus, or exposure to UV rays over time. A corneal transplant can be performed to replace the damaged cornea. C) A cataract is increased intraocular pressure. This occurs when drainage of the aqueous humor is blocked. They are treated with eyedrops that increase the rate of aqueous humor drainage or decrease its production. D) A cataract is a clouding of the lens. Some cataracts are congenital, but most are due to age-related hardening and thickening of the lens, diabetes mellitus, or exposure to UV rays over time. The lens can be removed and replaced with an artificial lens.

C) Cramp in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have caused an electrolyte depletion.

Lynn has been waking up each night with intense pain in her calves. She has been playing tennis all summer for several hours each day. She does not feel that her problem is serious enough to seek medical attention. What is the diagnosis, and why? A) Cramp in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have caused low blood sugar levels. B) Cramp in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have irritated the spinal cord neurons. C) Cramp in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have caused an electrolyte depletion. D) A strain in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have caused the muscle to stretch or tear. E) A sprain in the gastrocnemius muscle; the fact that Lynn has been playing tennis for several hours each day may have caused the muscle to stretch or tear.

B) RA is a chronic, systemic, inflammatory disorder. Inflammation occurs in the joint, and the fluid that accumulates causes swelling, stiffness, impairment of joint movement, and extreme pain.

Maggie is a 28-year-old Caucasian woman who has newly diagnosed rheumatoid arthritis (RA). She complains of painful, stiff hands and feet, feeling tired all the time, and reports an intermittent low-grade fever. She asks the nurse if she is going to be "crippled." How should the nurse respond? A) Not all cases of RA result in fluid accumulation, swelling, stiffness, impairment of joint movement, and extreme pain. B) RA is a chronic, systemic, inflammatory disorder. Inflammation occurs in the joint, and the fluid that accumulates causes swelling, stiffness, impairment of joint movement, and extreme pain. C) RA arthritis is due to the accumulation of crystals in the joints that impair movement of the joint and cause extreme pain. D) RA results in the formation of bony spurs that enlarge the bone ends, restrict joint movement, and cause pain.

A) The doctor will perform arthroscopic surgery. If Mary has severely damaged the meniscus, it can be removed with little impairment to the knee except some loss in stability.

Mary has been suffering from a "bad knee" for several months. She is a tennis player who often slides in to attack a ball; she is an aerobic devotee and a jogger. She visited an orthopedic surgeon last week who told her that he would "like to have a look at her knee joint." He also told her that her symptoms indicated damage to the meniscus, which might have to be removed. What will the doctor do to see the joint and, if the meniscus is removed, will Mary's knee be healthy enough to enable her to play tennis again? A) The doctor will perform arthroscopic surgery. If Mary has severely damaged the meniscus, it can be removed with little impairment to the knee except some loss in stability. B) The doctor will perform arthroscopic surgery. If Mary has severely damaged the meniscus, it can be removed but the knee joint will lose significant stability. C) The doctor will perform knee surgery and open up the knee. If Mary has severely damaged the meniscus, it can be removed with little impairment to the knee except some loss in stability. D) The doctor will perform knee surgery and open up the knee. If Mary has severely damaged the meniscus, it can be removed but the knee joint will lose significant stability.

B. A = asymmetry, B = border, C = color, D = diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined.

Mary noticed a large, brown spot on her skin. She has been playing tennis in the sun for several years without sun protection. She reported the discovery to a friend, who told her to apply the ABCD rule to determine whether or not she had malignant melanoma. Her friend told her that if her answer was "no" to the questions that were asked by the ABCD rule, she had nothing to worry about. What is the ABCD rule, and should she ignore the spot if her answers are negative? A. A = asymmetry, B = brown/blue/black, C = contour, D = diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined. B. A = asymmetry, B = border, C = color, D = diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined. C. A = asymmetry, B = brown/blue/black, C = contour, D = diameter. Mary will only need to see a physician when the answer is "yes" to all parts. D. A = altitude, B = border, C = color, D = diameter. It is imperative that Mary have a physician examine the spot immediately. Any unusual lesion on the skin of a sun worshipper should be examined. E. A = asymmetry, B = border, C = color, D = diameter. Mary will only need to see a physician when the answer is "yes" to all parts.

D. Caucasians produce less melanin, resulting in less protection from the damaging effects of UV light. Dark brown or black skin does not guarantee against melanoma.

Melanoma is a form of skin cancer that arises from melanocytes. Melanoma is most common in Caucasians between 40 and 70 years of age. Why do Caucasians have a greater incidence of melanoma? A. Caucasians like to have a tan for appearances, and expose themselves to excessive UV light to achieve this. B. Caucasians lack melanin, resulting in less protection from the damaging effects of UV light. Dark brown or black skin shows the production of melanin and protects against melanoma. C. Caucasians produce more carotene, which in high levels is toxic, resulting in melanoma. D. Caucasians produce less melanin, resulting in less protection from the damaging effects of UV light. Dark brown or black skin does not guarantee against melanoma. E. Caucasians produce less melanin, resulting in less protection from the damaging effects of UV light. Dark brown or black skin guarantees against melanoma.

D. Surgical repair of this fracture may involve use metal items (such as rods, wire, screws, pins, or nails) that could trigger security alarms.

Mrs. Brown was outside on her patio cleaning windows when she fell off her step ladder and fractured her right hip. She had emergency surgery for an open reduction and internal fixation of the right hip. After surgery, she asks you if she will have trouble going through airport security. What has prompted her concern? A. Open reduction and internal fixation of the fracture may leave abnormal shapes on the surface of her hip that might raise concern with airport security. B. Open reduction and internal fixation of the fracture may use plastic items (such as rods, wire, screws, pins, or nails) that may trigger security alarms. C. Open reduction and internal fixation of the fracture may cause a loss in mobility that will make it difficult to walk through metal detectors. D. Surgical repair of this fracture may involve use metal items (such as rods, wire, screws, pins, or nails) that could trigger security alarms.

E. Sodas are strong acids that can dissolve the calcium phosphate in bone and teeth.

Mrs. Mulligan goes to her dentist and, after having a couple of cavities filled, her dentist strongly suggests that she reduce her intake of sodas and increase her intake of calcium phosphates in the foods she eats. Why? A. Sodas are strong bases that can dissolve the calcium phosphate in bone and teeth. B. Sodas contain lots of sugar that can dissolve the calcium carbonate in bone and teeth. C. Sodas are carbonated, and the increased carbon dioxide can dissolve the calcium carbonate in bone and teeth. D. Sodas contain lots of sugar that can dissolve the calcium phosphate in bone and teeth. E. Sodas are strong acids that can dissolve the calcium phosphate in bone and teeth.

E) The doctor will perform a sympathectomy, and the affected hand will suffer from anhidrosis.

Mrs. Oberhaus needs surgery to correct a severe case of Raynaud's disease, affecting one of her hands. What surgical procedure will be performed? After the surgery, will she be more likely to suffer from anhidrosis (lack of sweating) or hyperhidrosis (profuse sweating) in the affected hand? A) The doctor will perform both a parasympathectomy and sympathectomy, and the affected hand will suffer from hyperhidrosis. B) The doctor will perform a sympathectomy, and the affected hand will suffer from hyperhidrosis. C) The doctor will perform a parasympathectomy, and the affected hand will suffer from anhidrosis. D) The doctor will perform a parasympathectomy, and the affected hand will suffer from hyperhidrosis. E) The doctor will perform a sympathectomy, and the affected hand will suffer from anhidrosis.

E) Heart rate for bradycardia, and the blood pressure for hypertension

Propranolol hydrochloride (Inderal) is a beta-adrenergic blocker often used as an antianginal, antiarrhythmic, and antihypertensive drug. Before giving Inderal to a patient, what physiological parameters should the nurse assess? A) Temperature for low core temperature, blood pressure for hypertension, and heart rate for tachycardia B) Temperature for fever, and the blood pressure for hypotension C) Heart rate for tachycardia, and the blood pressure for hypertension D) Heart rate for bradycardia, and the blood pressure for hypotension E) Heart rate for bradycardia, and the blood pressure for hypertension

C) Compression of the radial nerve (in the region of the armpit) may cause temporary cessation of nervous transmission, often called "Saturday night paralysis."

Ralph sustained a leg injury in a bowling accident and had to use crutches. Unfortunately, he never took the time to learn how to use them properly. After two weeks of use, he noticed his fingers were becoming numb. Then he noticed his arms were getting weaker and had a tingling sensation. What could be his problem? A) The median nerve is being compressed, making it difficult to pick up small objects, and resulting in the tingling sensations in his fingers. B) Pulling on the brachial plexus is causing weakness in the muscles of his arms, and may lead to paralysis. C) Compression of the radial nerve (in the region of the armpit) may cause temporary cessation of nervous transmission, often called "Saturday night paralysis." D) Compression of the median nerve (in the region of the armpit) may cause temporary cessation of nervous transmission, often called "Saturday night paralysis." E) Compression of the musculocutaneous nerve (in the region of the armpit) may cause temporary cessation of nervous transmission, often called "Saturday night paralysis."

E. Loss of cell shape and movement of cellular organelles

Research shows that neurofibrillary tangles are the primary cause of Alzheimer's disease. Neurofibrillary tangles are associated with microtubules. What may happen if microtubules collapse to cause Alzheimer's disease? A. Loss in the strength of the cell surface and decreased resistance to compression of the cell B. Decreased resistance to mechanical forces acting on the cell C. Loss of cell shape, movement of cellular organelles, decreased resistance to mechanical forces acting on the cell, decreased strength of the cell surface, and decreased resistance to compression of the cell D. Maintenance of the shape of the cell with no movement of cellular organelles E. Loss of cell shape and movement of cellular organelles

D. A = asymmetry, B = border, C = color, D = diameter, E = elevation

Robert, a surfer, has a mole that has changed its shape and size. His doctor, applying the ABCD(E) rule, diagnosed a melanoma. What do the letters ABCD(E) represent? A. A = asymmetry, B = border, C = color, D = death, E = elevation B. A = asymmetry, B = boils, C = color, D = diameter, E = elevation C. A = asymmetry, B = brown/blue/black, C = contour, D = diameter, E = elevation D. A = asymmetry, B = border, C = color, D = diameter, E = elevation E. A = altitude, B = brown/blue/black, C = contour, D = diameter, E = elevation

E) The condition is glaucoma. Blindness could result if not treated or caught early. The eyedrops increase the rate of aqueous humor drainage or decrease its production.

Roger went for his yearly eye examination and was informed that his intraocular pressure was slightly elevated (at 22 mm Hg). The physician expressed concern over this condition and noted that if the condition got worse, eyedrops would be merited. What is wrong with Roger's eyes? What are the possible consequences of this condition? What is the function of the eyedrops? A) The condition is diplopia. Double vision, blurred vision, and loss of color perception may occur. The eyedrops will decrease the internal pressure, relaxing the lens and restoring normal vision. B) The condition is myopia. The increased pressure is causing the lens to bend, and will result in the need to wear glasses or contact lenses. The eyedrops will decrease the pressure, and in time he will not need to wear glasses or contact lenses. C) The condition is a cataract. Blindness could result if not treated. The eyedrops will gradually remove the clouding of the lens, restoring vision. D) The condition is retinal detachment. The increased pressure has caused the retina to detach from the choroid, resulting in light flashes and spots in the vision. The eyedrops will decrease the internal pressure. E) The condition is glaucoma. Blindness could result if not treated or caught early. The eyedrops increase the rate of aqueous humor drainage or decrease its production.

D) Incorrect posture when sitting at a desk can result in kyphosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain the proper thoracic vertebral curve.

Sam is an accountant who is especially busy during tax season. By the end of each day he complains of shoulder stiffness and tightness, as well as some upper back pain. What might be Sam's problem, and how could he prevent the discomfort? A) Incorrect posture when sitting at a desk can result in kyphosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain the proper lumbar vertebral curve. B) Incorrect posture when sitting at a desk can result in scoliosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain prevent an abnormal lateral curve in his spine. C) Incorrect posture when sitting at a desk can result in lordosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain the proper thoracic vertebral curve. D) Incorrect posture when sitting at a desk can result in kyphosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain the proper thoracic vertebral curve. E) Incorrect posture when sitting at a desk can result in lordosis. Sam needs to practice good posture and/or invest in an ergonomic chair to help him maintain the proper lumbar vertebral curve.

E) The cranial bones enclose and protect the fragile brain. A helmet would add extra protection in sports such as this, where there is an increased risk for head injury.

Sharon is a 32-year-old horse trainer. While training a young horse, she was thrown off of the horse and suffered a mild head injury. The nurse inquires about the use of a helmet. Sharon replies, "This is the first time I have ever had a head injury from a horse. I don't think I need a helmet." Based on your understanding of the skull, how should the nurse respond to the patient? A) The cranial and facial bones enclose and protect the brain. A helmet would add extra protection in sports such as this, where there is a increased risk for head injury. B) The cranial bones enclose and protect the fragile brain. A helmet is not necessary in sports where there is an increased risk for head injury. C) The cranial and facial bones enclose and protect the brain. A helmet is not necessary in sports where there is an increased risk for head injury. D) The facial bones enclose and protect the fragile brain. A helmet would add extra protection in sports such as this, where there is an increased risk for head injury. E) The cranial bones enclose and protect the fragile brain. A helmet would add extra protection in sports such as this, where there is an increased risk for head injury.

E) The reticular activating system awakened the parents, who were responsible for the safety of their children. The children ignored the stimuli, confidant that their parents were in charge of the situation.

Susan and Robert are the parents of three children. One night while the family was sleeping, a fire broke out next door. Susan and Robert heard the fire trucks and rushed out to see what was happening. None of the children woke up, even with the sound of sirens close to the house. Why did the parents wake up, but the children didn't wake up? A) The limbic system awakened the parents, who were responsible for the safety of their children. The children ignored the stimuli, since they knew that the parents were in charge of the situation. B) The hippocampus in children is still developing, and is not strong enough to wake them in response to external stimuli. C) The limbic system in children is still developing, and is not strong enough to wake them in response to external stimuli. D) The reticular activating system in children is still developing, and is not strong enough to wake them in response to external stimuli. E) The reticular activating system awakened the parents, who were responsible for the safety of their children. The children ignored the stimuli, confidant that their parents were in charge of the situation.

E. Cyanosis is a dusky bluish or grayish discoloration of the skin and mucous membranes that occurs with reduced oxygen levels.

The 68-year-old patient was admitted to the hospital medical floor with a diagnosis of chronic bronchitis. His wife asks the nurse why his skin looks blue. How would you explain cyanosis to this patient and his wife? A. Cyanosis is a reddening of skin due to fever, hypertension, inflammation, or an allergy. B. Cyanosis leaves blue to black marks on the skin due to ruptured blood vessels and pooling of blood beneath the skin. C. Cyanosis is a whitening of the skin due to anemia or accumulation of bile pigments. D. Cyanosis is a bronzing of the skin that occurs when the adrenal gland produces an inadequate amount of steroids. E. Cyanosis is a dusky bluish or grayish discoloration of the skin and mucous membranes that occurs with reduced oxygen levels.

E. 54%. The nerve endings were damaged or destroyed in third degree burns, but in second degree burns the nerve endings are only irritated.

The Waldorf family was caught in a fire but escaped. Unfortunately, the father and daughter suffered burns. The father had second-degree burns on his chest, abdomen, and both arms, and third-degree burns on his entire left lower extremity. The daughter suffered first-degree burns on her head and neck and second-degree burns on both lower extremities. What percentage of the father's body was covered by burns? The father experiences a good deal of pain in the area of the chest and abdomen, but little pain in the leg. Why? A. 45%. The nerve endings were damaged or destroyed in third degree burns, but in second degree burns the nerve endings are only irritated. B. 36%. The nerve endings were damaged or destroyed in third degree burns, but in second degree burns the nerve endings are only irritated. C. 36%. The nerve endings were damaged or destroyed in second degree burns, but in third degree burns the nerve endings are only irritated. D. 54%. The nerve endings were damaged or destroyed in second degree burns, but in third degree burns the nerve endings are only irritated. E. 54%. The nerve endings were damaged or destroyed in third degree burns, but in second degree burns the nerve endings are only irritated.

A) The contraction of the muscles in these activities helps maintain the shape, size, and strength of muscles, as well as joint mobility.

The nurse encourages the patient to do his own activities of daily living such as bathing, eating, dressing, and toileting activities. How do these activities promote physical conditioning? A) The contraction of the muscles in these activities helps maintain the shape, size, and strength of muscles, as well as joint mobility. B) The contraction of the muscles in these activities reverses myotonic dystrophy and rebuilds muscle mass. C) It does not. Only weight-bearing exercises maintain the shape, size and strength of muscles. D) The contraction of the muscles in these activities reverses sarcopenia and rebuilds muscle mass.

B) Aging, multiple births, and decreased estrogen production

The nurse is explaining Kegel exercises to strengthen the pelvic floor muscles. What factors may contribute to a weakening of the pelvic floor muscles? A) Multiple births B) Aging, multiple births, and decreased estrogen production C) Decreased estrogen production D) Aging E) Aging and multiple births

C) The suprahyoid muscles (digastrics, stylohyoid, mylohyoid, and geniohyoid muscles); weakness or paralysis in these muscles will make it difficult to swallow.

The patient has a stroke and has weakness on his right side. Which muscles are involved in swallowing, and how will the patient's weakness affect his ability to swallow? A) The infrahyoid muscles (sternohyoid, sternothyroid, omohyoid, thyrohyoid, and pharyngeal constrictor muscles); weakness or paralysis in these muscles will make it difficult to swallow. B) The infrahyoid muscles (sternohyoid, sternothyroid, omohyoid, thyrohyoid, and pharyngeal constrictor muscles); weakness or paralysis in these muscles will make it easier to swallow. C) The suprahyoid muscles (digastrics, stylohyoid, mylohyoid, and geniohyoid muscles); weakness or paralysis in these muscles will make it difficult to swallow. D) The suprahyoid muscles (digastrics, stylohyoid, mylohyoid, and geniohyoid muscles); weakness or paralysis in these muscles will make it easier to swallow.

B. Fluid is initially lost from the intravascular compartment due to sweating, which is replaced by fluid from the interstitial compartment by osmosis, which then pulls fluid from the intracellular compartment by osmosis.

The patient was admitted to the hospital on a hot day (100oF) for severe dehydration. What changes occur in extracellular and intracellular fluid compartments during dehydration, and what specific processes are involved at each step? A. Fluid is lost from the intravascular compartment due to sweating, and this is replaced by fluid from the interstitial compartment by osmosis. B. Fluid is initially lost from the intravascular compartment due to sweating, which is replaced by fluid from the interstitial compartment by osmosis, which then pulls fluid from the intracellular compartment by osmosis. C. Fluid is lost from the interstitial compartment by sweating, which is replaced by fluid from the intracellular compartment by osmosis. D. Fluid is lost from the intracellular compartment due to sweating, which is replaced by fluid from the interstitial compartment by osmosis, which then pulls fluid from the intravascular compartment by osmosis. E. Fluid is initially lost from the intravascular compartment due to osmosis, which is replaced by fluid from the interstitial compartment by diffusion, and finally fluid comes from the intracellular compartment by active transport.

C) Disuse atrophy, where fibrous connective tissue replaces the muscle tissue that was lost. This can be prevented by regular weight-bearing exercise, unless atrophy is complete.

When a geriatric patient is admitted to the rehabilitation unit, an important nursing measure is to prevent the loss of muscle mass. What is the term used for loss of muscle mass, and how can the patient prevent it? A) Myotonic dystrophy, where there is a gradual loss in muscle mass and in control of the muscles. This is irreversible. B) Myasthenia gravis, where generalized muscle weakness occur. This can be reversed by weight-bearing exercise, unless atrophy is complete. C) Disuse atrophy, where fibrous connective tissue replaces the muscle tissue that was lost. This can be prevented by regular weight-bearing exercise, unless atrophy is complete. D) Sarcopenia, where there is an increase in the amount of connective tissue and a decrease in the number of muscle fibers. This is irreversible.

D) The xiphoid process could break off and potentially puncture internal organs.

When administering cardiopulmonary resuscitation, the nurse should locate the tip of the xiphoid by placing two fingers on the xiphoid process and then placing the heel of the other hand just above this site on the lower half of the sternum. What complications, if any, do you think could occur if the nurse places his or her hand on the xiphoid process? A) The xiphoid process is used to give cardiopulmonary resuscitation, and there are no complications. B) The xiphoid process would bend up and down, but not result in pumping the heart. C) The xiphoid process could break off and puncture the spinal cord. D) The xiphoid process could break off and potentially puncture internal organs. E) The xiphoid process could break off and puncture the trachea.

A) The prevention of osteoporosis should begin with children while bones are still growing. Children should increase their bone mass to provide additional protection from osteoporosis in the future.

When should prevention of osteoporosis start? A) The prevention of osteoporosis should begin with children while bones are still growing. Children should increase their bone mass to provide additional protection from osteoporosis in the future. B) The prevention of osteoporosis should start in middle age, to counter the gradual loss of bone density as we get old. C) The prevention of osteoporosis should begin young adults, to increase the bone mass to provide additional protection from osteoporosis. D) The prevention of osteoporosis should start in early old age, to prevent a decrease in bone density in the future.

C) Regular heart beat, unlabored breathing, warm and dry skin, constricted or normal pupils

Which of the following outcome criteria show that a patient is effectively coping with a stressful problem? A) Increased heart rate, labored breathing, cold and sweaty skin, dilated pupils B) Regular heart rate, regular blood pressure, cold and sweaty skin, dilated pupils C) Regular heart beat, unlabored breathing, warm and dry skin, constricted or normal pupils D) Increased heart rate, labored breathing, warm and dry skin, constricted or normal pupils E) Regular heart rate, warm and dry skin, dilated pupils, unlabored breathing

E) June probably has "bony spurs," which are abnormal projections from a bone due to bone overgrowth.

While on vacation last spring, June, a 24 year old woman, fell on the pavement and broke her wrist. At the emergency room, a resident placed a cast on her wrist after manipulating the bones. It seemed to heal within a few months. However, recently she has noticed hard lumps in the area where the break happened and she has been complaining of pain. What could be causing the lumps and the pain? A) June probably has Paget's disease, where bone undergoes excessive remodeling. B) June probably has carpal tunnel syndrome, inflammation of the tendon sheaths in the wrist, due to the healing process from the broken wrist. C) June probably has osteitis, which is pain in a bone. D) June probably has an osteomyelitis, which is inflammation and infection of the bone, often occurring after formation of new bone. E) June probably has "bony spurs," which are abnormal projections from a bone due to bone overgrowth.

C. The sequence and fragmentation pattern of a person's DNA is unique to that individual.

Why can DNA be used to "fingerprint" a suspect in a crime? A. DNA cannot be used to identify a suspect: all humans contain the same genes and DNA is, therefore, not unique to an individual. B. The DNA determines the pattern of an individual's fingerprint, and can be 'read' to determine the fingerprint pattern for matching in a database. C. The sequence and fragmentation pattern of a person's DNA is unique to that individual. D. The sequence, but not fragmentation pattern, of a person's DNA is unique to that individual.

B. Granulation tissue forms new capillary beds that provide oxygen-rich blood for the healing process.

Why does an open wound need a bed of granulation tissue for wound healing to occur? A. Granulation tissue releases inflammatory chemicals, making the local capillaries dilate and become more permeable. B. Granulation tissue forms new capillary beds that provide oxygen-rich blood for the healing process. C. Granulation tissue seals the edges of the wound together, preventing substances from entering the site. D. Granulation tissue acts as the scaffolding for repairing the tissue. E. Granulation tissue contracts to pull the damaged tissue together to allow repair.

C) Strokes are commonly caused by clots blocking a cerebral artery, and heparin would prevent more clots from forming. In contrast, you want clots to form in hemorrhages to stop the bleeding.

Why is heparin used as an anticoagulant in the treatment of thrombotic strokes but contraindicated in a subarachnoid hemorrhage? A) Strokes are commonly caused by excessive bleeding, and heparin would cause clots to form. Heparin would not have any effect on hemorrhages. B) Strokes are commonly caused by clots blocking a cerebral artery, and heparin would prevent more clots from forming. Heparin would not have any effect on hemorrhages. C) Strokes are commonly caused by clots blocking a cerebral artery, and heparin would prevent more clots from forming. In contrast, you want clots to form in hemorrhages to stop the bleeding. D) Strokes are commonly caused by excessive bleeding, and heparin would cause clots to form. Hemorrhages are caused by clots blocking a cerebral artery, where you do not want clots to form.

E.Salt and water are formed when a strong acid and base are mixed.

Why is it possible to safely drink a solution that contains a 50:50 mixture of equal concentrations of a strong acid and a strong base, either of which, if ingested separately, would be very caustic and damaging? A. The damage caused by the acid is undone by the base. B. A reaction occurs, resulting in a mixture of only weak acids and bases. C. The mixture of a strong acid and base will still be very caustic if ingested. D. The strong acid and base each act as a buffer for one another. E. Salt and water are formed when a strong acid and base are mixed.

C) People who live in the north have a decreased amount of sunlight exposure. Vitamin D is manufactured by skin cells when exposed to sunlight, and is needed for absorption of dietary calcium.

Why should people who live in the north take supplemental calcium with vitamin D? A) People who live in the north have an increased amount of sunlight exposure. Vitamin D is destroyed by sunlight, and thus more is required to be absorbed from the diet. B) People who live in the north have a decreased amount of sunlight exposure. Vitamin D is manufactured by sunlight and is a required component of bone. C) People who live in the north have a decreased amount of sunlight exposure. Vitamin D is manufactured by skin cells when exposed to sunlight, and is needed for absorption of dietary calcium. D) People who live in the north have less melanin in their skin. Vitamin D is activated by melanin and is a required component of bone. E) People who live in the north have less melanin in their skin. Vitamin D is activated by melanin and is needed for absorption of dietary calcium.

C) Swimming is not recommended to prevent osteoporosis, as it is not considered a weight-bearing exercise.

Why, or why not, is swimming recommended as an exercise to prevent osteoporosis? A) Swimming is not recommended to prevent osteoporosis, as forces are applied in all directions on the bones simultaneously in swimming. B) Swimming is recommended to prevent osteoporosis, as it is considered a weight-bearing exercise. C) Swimming is not recommended to prevent osteoporosis, as it is not considered a weight-bearing exercise. D) Swimming is recommended to prevent osteoporosis, as forces are applied in all directions on the bones simultaneously.

A. Macrophages phagocytose many foreign materials, as well as cell debris and dead cells. This cleans the wound, allowing granulation tissue to form.

Without macrophages, wound healing is delayed. Why? A. Macrophages phagocytose many foreign materials, as well as cell debris and dead cells. This cleans the wound, allowing granulation tissue to form. B. Macrophages only remove the bacteria from the area, preventing infections from causing more damage. C. Macrophages break down the scar tissue, allowing the correct tissue to be formed in its place. D. Macrophages form the capillary beds and repair the connective tissue in the wound. Both of these are essential for wound healing. E. Macrophages phagocytose many foreign materials, as well as cell debris and dead cells. This cleans the wound, allowing scar tissue to form.

C) The child is observed from behind and the nurse would note any asymmetry of the shoulders and hips.

You are a school nurse in a middle school. You are responsible for screening the children for scoliosis. What is involved in this screening? A) The child is observed from the side and the nurse would note any asymmetry of the shoulders and hips. B) The child is observed from behind and the nurse would note any dorsally exaggerated thoracic curvatures. C) The child is observed from behind and the nurse would note any asymmetry of the shoulders and hips. D) The child is observed from behind and the nurse would note any accentuated lumbar curvatures.

A. Tap water is a hypotonic solution, and thus more water moves into the body and the cells, causing water intoxication.

You are giving a tap water enema to a patient. An adverse effect of the tap water enema is water intoxication. Why does tap water cause water intoxication? A. Tap water is a hypotonic solution, and thus more water moves into the body and the cells, causing water intoxication. B. Tap water is a hypotonic solution, and thus more water leaves the body and cells, causing water intoxication. C. Tap water is a hypertonic solution, and thus more water moves into the body and the cells, causing water intoxication. D. Tap water is an isotonic solution, and thus more water moves into the body and the cells, causing water intoxication. E. Tap water is a hypertonic solution, and thus more water leaves the body and cells, causing water intoxication.

A. If cilia are paralyzed then mucus-containing particles, including bacteria, will remain in the lungs and may cause a respiratory infection.

Your patient has a respiratory disease that has literally paralyzed the cilia. Why would this patient be at an increased risk for a respiratory infection? A. If cilia are paralyzed then mucus-containing particles, including bacteria, will remain in the lungs and may cause a respiratory infection. B. If cilia are paralyzed then the phagocytosed particles, including bacteria, cannot be moved to fuse with the lysosomes for destruction; the bacteria will remain in the cells and may cause a respiratory infection. C. If cilia are paralyzed then the particles, including bacteria, cannot be moved to the bottom of the lungs and cannot be phagocytosed by the cells in the lungs; bacteria remain in the lungs and may cause a respiratory infection. D. The patient would not be at an increased risk of respiratory infection. E. If cilia are paralyzed then the cells of the respiratory system cannot phagocytose the particles, including bacteria; these bacteria will remain in the lungs and may cause a respiratory infection.

D. Water and electrolytes are lost in equal proportions.

Your patient has the flu and reports 5 to 6 loose stools a day. He has experienced an isotonic fluid volume loss. What does "isotonic fluid loss" mean? A. Less water is lost than enters the body. B. Water is lost at the same rate as it enters the body. C. No water is lost: the body water content remains the same. D. Water and electrolytes are lost in equal proportions. E. More water is lost than enters the body.