FINAL TB

When acute tubular necrosis (ATN) has occurred instead of prerenal azotemia, laboratory test findings will show the presence of excessive urine: A: protein. B: glucose. C: calcium. D: sodium

A: protein.

Several hormones, including steroids and thyroid hormone, are bound to and carried by: A: proteins. B: target cells. C: cholesterol. D: prohormones.

A: proteins.

A major complication of persistent gastroesophageal reflux is: A: strictures. B: heartburn. C: chest pain. D: hoarseness.

A: strictures.

The difference between the end-diastolic and end-systolic volumes is the: A: stroke volume. B: cardiac output. C: ejection fraction. D: cardiac reserve.

A: stroke volume.

Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with: A: diarrhea. B: food allergies. C: gastric reflux. D: alcohol intake.

D: alcohol intake.

HLA-B27 antigen may be linked to other genes that determine the pathologic autoimmune phenomenon in: A: gout syndrome. B: rheumatoid arthritis. C: osteoarthritis syndrome. D: ankylosing spondylitis.

D: ankylosing spondylitis.

In the lactating woman, mastitis is usually the result of: A: intraductal papillomas. B: secretory cell hyperplasia. C: fibrocystic tissue changes. D: ascending bacterial infection.

D: ascending bacterial infection.

In the arterial-venous circulatory system, pressure is inversely related to: A) velocity. B) volume. C) tension. D) viscosity.

B) volume.

Abnormally high accumulation of bilirubin in the blood causes: A: jaundice. B: cholestasis. C: xanthomas. D: biliary cirrhosis.

A: jaundice.

In women, pelvic floor weakness may cause which type of incontinence? A: Urge B: Stress C: Overflow D: Overactive

B: Stress

The major adrenal cortical hormones are steroids and are synthesized from acetate and: A: ACTH B: albumin C: amino acids D: Cholesterol

D: Cholesterol

Rheumatoid arthritis is a systemic inflammatory disease with joint manifestations described as: A) dysplasia. B) polyarticular. C) asymmetrical. D) osteophytes.

B) polyarticular.

Whatever the mechanism of entry, the human-to-human transmission of infectious agents is directly related to the: A: source of contact. B: site of infection .C: number of pathogens absorbed. D: virulence factors.

.C: number of pathogens absorbed.

The effector function of activated members of the complement system includes all of the following EXCEPT: A: chemotaxis. B: opsonization. C: pathogen lysis .D: phagocytosis.

.D: phagocytosis.

According to Poiseuille law, airway resistance would be largest in which of the following? A: The trachea B: A bronchus C: A bronchiole D: An alveolus

C: A bronchiole

Skeletal tissue contains intercellular collagen fibers that provide ______ for tendons and ligaments. A: elastic recoil B: shape flexibility C: tensile strength D: inorganic calcium

C: tensile strength

A patient with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her: A) arms. B) bowels. C) bladder. D) perineal musculature.

A) arms.

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis is the result of: A) decreased oligodendrocytes. B) corticospinal injuries. C) atherosclerotic destruction .D) oligodendrocytic infection.

A) decreased oligodendrocytes.

Thyroid hormone deficit ___________, which alters the function of all major organs in the body. A) decreases metabolism B) increases protein synthesis C) causes vitamin deficiencies D) enhances absorption of glucose

A) decreases metabolism

Wasting syndrome, an AIDS-defining illness, is characterized by involuntary weight loss of at least10% of baseline body weight in the presence of: A) diarrhea B) hypermetabolism. C) weakness and fever. D) glucose intolerance.

A) diarrhea

A patients recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patients levels of: A) dopamine. B) acetylcholine. C) serotonin. D) adenosine.

A) dopamine.

A sudden traumatic complete transection of the spinal cord results in _______ below the level of injury. A) flaccid paralysis B) vasoconstriction C) deep visceral pain D) 3+ tendon reflexes

A) flaccid paralysis

Turbulent blood flow can be caused by a number of factors, including: A) increased velocity. B) short vessel length. C) high blood viscosity. D) layering of blood cells.

A) increased velocity.

The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense: A) muscle position. B) visceral fullness. C) temperature. D) painful touch.

A) muscle position.

The blood-brain and CSF-brain barriers control the chemical environment of the brain by allowing easy entrance to only a few chemicals that include: A) oxygen. B) protein. C) glutamate. D) potassium.

A) oxygen.

Disorders of the pyramidal tracts, such as a stroke, are characterized by: A) paralysis. B) hypotonia. C) muscle rigidity. D) involuntary movements.

A) paralysis.

More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by the ______ cortex in the frontal lobe. A) premotor B) primary motor C) reflexive D) supplementary

A) premotor

A patient has required mechanical ventilation following a traumatic head injury sustained in a motorcycle crash, during which he sustained damage to his respiratory center. Which of the patients brain structures has been injured? A) Brain stem B) Midbrain C) Diencephalon D) Frontal lobe

A) Brain stem

A clinician is assessing the muscle tone of a patient who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the patients diagnosis? A) Hypotonia B) Spasticity C) Tetany D) Rigidity

A) Hypotonia

What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli? A) Pattern B) Specificity C) Gate control D) Neuromatrix

A) Pattern

A patients primary care provider has prescribed a b-adrenergic receptor blocker. Which of the following therapeutic effects do the patient and care provider likely seek? A) Reduction in heart rate and blood pressure B) Slowing of gastrointestinal motility C) Increase in mental acuity D) Decreased production of gastric acid

A) Reduction in heart rate and blood pressure

A neuron has been hyperpolarized. How will this affect the excitability of the neuron? A) The neuron will have a membrane potential farther from the threshold. B) The neuron will be more difficult to repolarize after firing. C) The membrane potential of the neuron will be closer to the threshold. D) The neurons excitability will be significantly increased.

A) The neuron will have a membrane potential farther from the threshold.

Which of the following messages is most likely to be carried by general somatic afferent (GSA) neurons? A) The sensation of cold when touching ice B) The message to move a finger and thumb C) The message to move the larynx during speechD ) Information about the position of a joint

A) The sensation of cold when touching ice

Which of the following pain disorders is a manifestation of a disruption of cranial nerve function? A) Trigeminal neuralgia B) Complex regional pain syndrome C) Phantom limb pain D) Temporomandibular joint (TMJ) syndrome

A) Trigeminal neuralgia

Full localization, discrimination of intensity, and interpretation of somatosensory stimuli requires processing by the: A) somatosensory cortex. B) autonomic nervous system. C) Ruffini end-organ receptors. D) Pacinian corpuscle receptors.

A) somatosensory cortex.

When a person is stung on the index finger by a bee, the thalamus interprets the pain as: A) somewhere on the hand. B) a spot on the index finger. C) attributable to a bee stung. D) similar to a previous bee sting.

A) somewhere on the hand.

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement: A) without causing paralysis. B) posture and muscle tone. C) and cortical responses. D) of upper motor neurons.

A) without causing paralysis.

Which of the following residents of a long-term facility is exhibiting signs and symptoms that are indicative of hypothyroidism? A: An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold B: A 90-year-old woman with a history of atrial fibrillation whose arrhythmia has recently become more severe C: An 88-year-old man with a history of Alzheimer disease who has become increasingly agitated and is wandering more frequently D: A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis

A: An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold

Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination? A: An 81-year-old resident of a long-term care facility B: A 19-year-old man who was admitted to a hospital for an appendectomy C: A neonate who was born in a busy, inner-city hospital in late October D: An 86-year-old patient whose flu symptoms have required hospitalization

A: An 81-year-old resident of a long-term care facility

Which of the following individuals displays the precursors to acromegaly? A: An adult with an excess of growth hormone due to an adenoma B: A girl who has been diagnosed with precocious puberty C: An adult who has a diagnosis of Cushing syndrome D: A patient who has recently developed primary adrenal carcinoma

A: An adult with an excess of growth hormone due to an adenoma

A patient has a diagnosis of chronic renal failure secondary to diabetic nephropathy. Which of the following hematologic changes may result from this patient's kidney disorder? A: Anemia B: Leukocytosis C: Thrombocytopenia D: Leukopenia

A: Anemia

Serology testing includes the measurement of which of the following? A: Antibody titers B: Culture growth C: Direct antigen D: DNA sequencing

A: Antibody titers

A patient with a diagnosis of chronic kidney disease (CKD) may require the administration of which of the following drugs to treat the consequences of CKD? A: Antihypertensive medications B: Antiarrhythmic medication C: Opioid analgesics D: Nonsteroidal anti-inflammatory drugs (NSAIDs)

A: Antihypertensive medications

Which of the following individuals is experiencing a disorder of ventilation that has a restrictive rather than obstructive etiology? A: A 30-year-old African American man who has been diagnosed with sarcoidosis B: An infant whose routine screening is suggestive of cystic fibrosis C: An elderly, lifelong smoker who has been admitted to hospital with emphysema D: A 16-year-old girl who must limit her activity to prevent asthmatic attacks

A: A 30-year-old African American man who has been diagnosed with sarcoidosis

Which of the following patients should the nurse observe most closely for the signs and symptoms of paralytic ileus? A: A patient who is postoperative day 1 following gall bladder surgery B: A patient whose acute diarrhea has necessitated the use of antidiarrheal medications C: An obese patient who refuses to ambulate because he complains of shortness of breath D: A patient with a longstanding diagnosis of irritable bowel syndrome

A: A patient who is postoperative day 1 following gall bladder surgery

Which of the following individuals most likely faces the highest risk of developing chronic pancreatitis? A: A woman who has six to eight drinks each evening B: A man who has become profoundly ill during a tropical vacation C: A woman who takes two Tylenol tablets five to six times a day D: An obese man who has a high-fat diet and has a sedentary lifestyle

A: A woman who has six to eight drinks each evening

Which of the following is the primary role of fibrocartilage? A: Absorption of physical shock B: Provision of flexibility C: Facilitation of long bone growth D: Tissue hydration

A: Absorption of physical shock

The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of: A: Addison disease. B: Cushing disease. C: Cushing syndrome. D: Graves disease.

A: Addison disease.

Which of the following functions is performed by saliva? A: Antimicrobial protection B: Promotion of intestinal flora C: Buffering of gastric secretions D: Catalysis of brush border enzymes

A: Antimicrobial protection

Coronary artery bypass grafting (CABG) is a relevant treatment modality for which of the following disorders of cardiac function? A: Atherosclerosis with history of MI B: Pericardial effusion and cardiac tamponade C: Dilated cardiomyopathies D: Aortic valve regurgitation and aortic stenosis

A: Atherosclerosis with history of MI

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which of the following pathophysiologic processes underlies the patient's new diagnosis? A: Beta-cell exhaustion due to long-standing insulin resistance B: Destruction of beta cells that is not attributable to autoimmunity C: T-lymphocyte​mediated hypersensitivity reactions D: Actions of insulin autoantibodies (IAAs) and islet cell autoantibodies (ICAs)

A: Beta-cell exhaustion due to long-standing insulin resistance

A patient has entered hypovolemic shock after massive blood loss in a car accident. Many of the patient's peripheral blood vessels have consequently collapsed. How does the Laplace law account for this pathophysiologic phenomenon? A: Blood pressure is no longer able to overcome vessel wall tension. B: Decreasing vessel radii have caused a decrease in blood pressure. C: Wall thickness of small vessels has decreased due to hypotension. D: Decreases in wall tension and blood pressure have caused a sudden increase in vessel radii.

A: Blood pressure is no longer able to overcome vessel wall tension.

A patient's primary care provider has added 20 mg of Lasix (furosemide) to his medication regimen to treat his primary hypertension. How does this diuretic achieve its therapeutic effect? A: By decreasing vascular volume by increasing sodium and water excretion B: By blocking the release of antidiuretic hormone from the posterior pituitary C: By inhibiting the conversion of angiotensin I to angiotensin II. D: By inhibiting the movement of calcium into arterial smooth muscle cells

A: By decreasing vascular volume by increasing sodium and water excretion

Which of the following sexually transmitted infections (STIs) is associated with an increased risk of infertility in women due to asymptomatic infection? A: Chlamydial infection B: Herpes simplex virus C: Gonorrhea D: Syphilis

A: Chlamydial infection

Which of the following disorders of renal function primarily affects the proximal and distal tubules? A: Chronic pyelonephritis B: Polycystic kidney disease C: Acute nephritic disease D: Renal calculi

A: Chronic pyelonephritis

A patient is receiving homecare for the treatment of a wound on the inside of her lower leg which is 3 cm in diameter with a yellow wound bed and clear exudate. Assessment of the patient's legs reveals edema and a darkened pigmentation over the ankles and shins of both legs. What is this patient's most likely diagnosis? A: Chronic venous insufficiency B: Deep vein thrombosis C: Varicose veins D: Peripheral arterial disease

A: Chronic venous insufficiency

A patient who is quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the following actions performed by the patient's caregiver is likely to promote defecation? A: Digital stimulation of the patient's rectum B: Massage of the patient's abdomen C: Seating the patient in an upright position D: Administration of large amounts of free water

A: Digital stimulation of the patient's rectum

Which of the following comorbidities represents the greatest risk for the development of foot ulcers in a diabetic patient? A: Distal symmetric neuropathy B: Previous incidents of diabetic ketoacidosis C: Diabetic nephropathy D: Autonomic neuropathy

A: Distal symmetric neuropathy

Which of the following integumentary problems most often accompanies chronic kidney disease? A: Dry skin and pruritus B: Petechiae and purpura C: Hirsutism and psoriasis D: Alopecia4

A: Dry skin and pruritus

A patient has been diagnosed with an anterior pituitary tumor, and synthesis and release of follicle- stimulating hormone has become deranged. What are the potential consequences of this alteration in endocrine dysfunction? A: Dysfunction of spermatogenesis B: Overproduction of luteinizing hormone C: Inhibition of testosterone synthesis D: Impaired detumescence

A: Dysfunction of spermatogenesis

Which of the following hormones is produced by the anterior pituitary gland? A: Growth hormone (GH) B: Oxytocin C: Corticotropin-releasing hormone (CRH) D: Norepinephrine

A: Growth hormone (GH)

Which of the following processes is a component of the pathogenesis of proliferative breast lesions without atypia? A: Growth of ductile or lobular epithelial cells B: Cystic dilation of terminal ducts C: Increase in fibrous breast tissue D: Fat necrosis leading to lesion formation

A: Growth of ductile or lobular epithelial cells

A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury? A: Headaches and memory lapses B: Recurrent nosebleeds and hypersomnia C: Unilateral weakness and decreased coordination D: Neck pain and decreased neck range of motion

A: Headaches and memory lapses

A patient has recently received a pneumococcal vaccine and the patient's B cells are consequently producing antibodies. Which of the following cells may enhance this production of antibodies? A: Helper T cells B: Regulatory T cells C: Cytotoxic T cells D: Natural killer cells

A: Helper T cells

Which of the following statements most accurately describes the anatomy and physiology of the bone marrow? A: Hematopoiesis takes place in red bone marrow. B: Yellow bone marrow predominates in infants. C: By adulthood, all red bone marrow has been replaced by yellow bone marrow. D: Yellow bone marrow is hematopoietically active in infants, but not in adults.

A: Hematopoiesis takes place in red bone marrow.

Which of the following diagnoses is most likely to require surgical correction? A: Hypospadias B: Orchitis C: Erectile dysfunction D: Spermatocele

A: Hypospadias

A patient has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the patient integrate into his lifestyle to reduce the risk of recurrence? A: Increased fluid intake and dietary changes B: Weight loss and blood pressure control C: Regular random blood glucose testing D: Increased physical activity and use of over-the-counter diuretics

A: Increased fluid intake and dietary changes

Electrical burns over a large surface area of a patient's body have resulted in hypovolemic shock after the loss of large amounts of blood and plasma. Which of the following mechanisms is the patient's body likely to implement to compensate for this loss of fluid? A: Increased heart rate B: Vasodilation C: Diuresis D: Inhibition of ADH H

A: Increased heart rate

An 86-year-old male patient is disappointed to learn that he has class II heart failure despite a lifelong commitment to exercise and healthy eating. Which of the following age-related changes predisposes older adults to developing heart failure? A: Increased vascular stiffness B: Orthostatic hypotension C: Increased cardiac contractility D: Loss of action potential

A: Increased vascular stiffness

Histocompatability molecules are of primary importance to which of the following aspects of immunity? A: Induction of T-cell immunity B: T-cell maturation C: NK cell activation D: Phagocytosis by neutrophils

A: Induction of T-cell immunity

A 60-year-old male patient has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this patient's pharmacologic treatment? A: Inhibiting gastric acid production B: Promoting hypertrophy of the gastric mucosa C: Increasing the rate of gastric emptying D: Increasing muscle tone of the cardiac sphincter

A: Inhibiting gastric acid production

A hormone has been synthesized in the rough endoplasmic reticulum of an endocrine cell after which it has moved into the Golgi complex, been packaged in a vesicle, and been released into circulation. What hormone is synthesized and released in this manner? A: Insulin B: Cortisol C: Testosterone D: Estrogen

A: Insulin

Following a lengthy series of diagnostic tests, a patient's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this patient most likely to require? A: Joint replacement surgery B: Intravenous antibiotics C: Injections of corticosteroids into the synovial space D: Transfusion of packed red blood cells

A: Joint replacement surgery

hich of the following vision disorders is most likely to have an infectious etiology? A: Keratitis B: Cataracts C: Glaucoma D: Macular degeneration

A: Keratitis

An elderly female patient with complaints of increasing fatigue has been diagnosed with aortic stenosis, a disease which her primary care provider believes may have been long-standing. Which of the following compensatory mechanisms has most likely maintained the woman's ejection fraction until recently? A: Left ventricular hypertrophy B: Increased blood pressure C: Increased heart rate and stroke volume D: Aortic dilation

A: Left ventricular hypertrophy

Which of the following visual deficits would be categorized as homonymous hemianopia? A: Loss of the same side of the visual field in each eye B: Bilateral loss of peripheral vision C: Loss of vision in the right side of the left eye and the left side of the right eye D: Equal loss of central vision in each eye

A: Loss of the same side of the visual field in each eye

The most recent assessment of a patient with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk? A: Microalbuminuria B: Hematuria C: Orthostatic hypotension D: Diabetic retinopathy

A: Microalbuminuria

assessment finding in a neonate? A: Minimal or absent levels of IgA and IgM B: Absence of plasma cells in the lymph nodes and spleen C: Undetectable levels of all immunoglobulins D: Absence of mature B cells with normal T-cell levels and function

A: Minimal or absent levels of IgA and IgM

The digestive tract is a four-layered tube. Which layer consists of connective tissue and contains nerves, blood vessels, and structures for secreting the digestive juices? A: Mucosal B: Peritoneum C: Submucosal D: Circular muscle

A: Mucosal

An ultrasound has confirmed appendicitis as the cause of a 20-year-old man's sudden abdominal pain. Which of the following etiologic processes is implicated in the development of appendicitis? A: Obstruction of the intestinal lumen B: Elimination of normal intestinal flora C: Sloughing of the intestinal mucosa D: Increased osmolality of intestinal contents

A: Obstruction of the intestinal lumen

Which of the following is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma? A: Pet dander B: Cold weather C: Stress D: Respiratory tract infections

A: Pet dander

Which of the following disorders of the skeletal system occurs exclusively in older adults? A: Polymyalgia rheumatica B: Psoriatic arthritis C: Reiter syndrome D: Ankylosing spondylitis

A: Polymyalgia rheumatica

A patient's longstanding diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this patient most likely experience? A: Prehepatic B: Intrahepatic C: Posthepatic D: Infectious

A: Prehepatic

An 86-year-old female patient has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to prevent urinary incontinence. The patient's most recent laboratory results are suggestive of acute renal failure. How would this patient's renal failure be categorized? A: Prerenal B: Postrenal C: Intrinsic D: Intrarenal

A: Prerenal

As glomerular filtrate exits Bowman's capsule, it will enter the ___________, followed by the ___________ and then the _______________. A: Proximal tubule; loop of Henle; distal tubule B: Ascending limb of the loop of Henle; descending limb of the loop of Henle; distal tubule C: Glomerulus; proximal tubule; distal tubule D: Collecting tubule; distal tubule; loop of Henle

A: Proximal tubule; loop of Henle; distal tubule

A woman has sought care because of recurrent urinary tract infections, which have been increasing in both frequency and severity. Which of the following factors is likely to contribute to recurrent UTIs? A: Reflux flow of urine B: Fluctuations in urine pH C: Urethral trauma D: Inadequate fluid intake

A: Reflux flow of urine

Assessment of an elderly female patient reveals the presence of bilateral pitting edema of the patient's feet and ankles and pedal pulses that are difficult to palpate. Auscultation of the patient's lungs reveals clear air entry to bases, and the patient's oxygen saturation level is 93% and vital signs are within reference ranges. What is this patient's most likely health problem? A: Right-sided heart failure B: Left-sided heart failure C: Cardiogenic shock D: Cor pulmonale

A: Right-sided heart failure

Which of the following signs and symptoms is most indicative of Ménière disease? A: Rotary vertigo and tinnitus B: Nausea and vomiting C: Progressive hearing loss and frequent falls D: Otalgia and recurrent otitis media

A: Rotary vertigo and tinnitus

Despite differences in onset, involvement, and symptomatology, all of the spondyloarthropathies involve: A: Sacroiliitis. B: calcinosis. C: excessive bone turnover. D: autoimmune etiology.

A: Sacroiliitis.

Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process? A: Secondary humoral response B: Cell-mediated immune response C: Primary humoral response D: Innate immunity

A: Secondary humoral response

Which of the four categories of bronchogenic carcinoma has the greatest association with tobacco smoking and tends to metastasize to the brain? A: Small cell B: Large cell C: Squamous cell D: Adenocarcinoma

A: Small cell

A patient who lives with a diagnosis of angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experienced while mowing his lawn. This drug has resulted in a release of nitric oxide, which will have what effect? A: Smooth muscle relaxation of vessels B: Decreased heart rate and increased stroke volume C: Increased preload D: Reduction of cardiac refractory periods

A: Smooth muscle relaxation of vessels

Which of the following meals is most likely to exacerbate an individual's celiac disease? A: Spaghetti with meatballs and garlic bread B: Stir-fried chicken and vegetables with rice C: Oatmeal with milk, brown sugar, and walnuts D: Barbecued steak and a baked potato with sour cream

A: Spaghetti with meatballs and garlic bread

The plaques in a patient's coronary arteries are plentiful and most have small- to moderate-sized lipid cores with thick fibrous caps. This form of atherosclerosis is most closely associated with which of the following diagnoses? A: Stable angina B: Non-ST-segment elevation MI C: ST-Segment elevation MI D: Unstable angina

A: Stable angina

A patient has been diagnosed with an incompetent pyloric sphincter. This patient will experience abnormal communication between which of the following components of the gastrointestinal tract? A: Stomach and duodenum B: Esophagus and stomach C: Rectum and anus D: Small intestine and colon

A: Stomach and duodenum

A 6-month-old infant has been hospitalized with acute bronchiolitis. Which of the following treatments should be prioritized in the infant's care? A: Supplementary oxygen therapy B: Intravenous antibiotics C: Transfusion of fresh frozen plasma D: Tracheotomy

A: Supplementary oxygen therapy

A patient's cell-mediated immune response has resulted in the release of regulator T cells. These cells will perform which of the following roles? A: Suppressing the immune response to limit proliferation of potentially harmful lymphocytes B: Presenting antigens to B cells to facilitate the production of antibodies C: Differentiating into subpopulations of helper T cells D: Destroying target cells by releasing cytolytic enzymes and other toxins

A: Suppressing the immune response to limit proliferation of potentially harmful lymphocytes

Which of the following factors accounts for the poor prognosis that typically accompanies a diagnosis of primary hepatocellular cancer? A: Surgical options do not exist because removal of all or part of the liver is a threat to health. B: Liver cancer typically metastasizes at a much earlier stage than other cancers. C: Liver tumors are poorly differentiated due to the low density of hepatic tissue D: .The nonspecific symptomatology of liver cancer means that diagnosis often happens at a late stage.

A: Surgical options do not exist because removal of all or part of the liver is a threat to health.

A patient has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which of the following treatment modalities is most likely to benefit this patient? A: Synthetic preparations of T3 or T4 B: b-Adrenergic blocking drugs and antithyroid drugs C: Corticosteroid replacement therapy D: Oral or parenteral cortisol replacement

A: Synthetic preparations of T3 or T4

Which of the following physiologic processes best exemplifies a positive feedback mechanism? A: The increase in prolactin secretion that occurs with more frequent breast-feeding B: The regulation of blood glucose levels by insulin C: The release of parathyroid hormone in response to decreased serum calcium levels D: The release of antidiuretic hormone when sodium levels are higher than normal

A: The increase in prolactin secretion that occurs with more frequent breast-feeding

Which of the following joints is classified as a synarthrosis? A: The joint between two vertebrae B: The joint between the femur and the pelvis C: The joint between the humerus and the radius and ulna D: An interphalangeal joint of the hand (knuckle)

A: The joint between two vertebrae

A nurse who provides weekly care in a homeless shelter has unknowingly inhaled airborneMycobacterium tuberculosis bacteria and has subsequently developed latent tuberculosis infection. Which of the following is true of this nurse? A: The nurse is likely asymptomatic. B: The nurse is now immune to more severe tuberculosis infection. C: The nurse can spread tuberculosis to others. D: The nurse has active tuberculosis infection.

A: The nurse is likely asymptomatic.

Which of the following traits is characteristic of saprophytes? A: They derive energy from decaying organic matter. B: They are beneficial components of human microflora. C: They have RNA or DNA, but never both. D: They are capable of spore production.

A: They derive energy from decaying organic matter.

An elderly patient who has been restricted to bed by numerous comorbidities for several weeks has been diagnosed with a large pleural effusion. Which of the following treatment modalities is most likely to resolve the patient's most recent health problem? A: Thoracentesis B: Supplementary oxygen therapy C: Administration of corticosteroids D: Administration of bronchodilators

A: Thoracentesis

Infected men may harbor ___________ but they are always asymptomatic. A: Trichomonas vaginalis B: Chlamydia trachomatis C: Neisseria gonorrhoeae. S: Treponema pallidum

A: Trichomonas vaginalis

Which of the following signs and symptoms in a 2-year-old child should prompt assessment for a urinary tract infection? A: Unexplained fever and anorexia B: Decreased urine output and irritability C: Production of concentrated urine and recurrent nausea D: Frank hematuria

A: Unexplained fever and anorexia

Which of the following signs and symptoms is most suggestive of acute cholecystitis? A: Upper right quadrant or epigastric pain B: Fever and sudden abdominal distention C: Appearance of undigested fat in feces D: Nausea resulting in greenish vomitus

A: Upper right quadrant or epigastric pain

Which of the following signs and symptoms is most likely to accompany a diagnosis of vulvodynia? A: Vulvar pain B: Purulent discharge C: Urinary incontinence D: Open lesions on the surface of the vulva

A: Vulvar pain

A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patient's diagnosis? A: Weakness in the muscular wall of an artery B: Impaired synthesis of clotting factors C: Deficits in the autonomic control of blood pressure D: Increased levels of cerebrospinal fluid

A: Weakness in the muscular wall of an artery

In contrast to synarthroses joints, synovial joints are linked to the bone by: A: a joint capsule. B: hyaline cartilage. C: connective tissue. D: interosseous ligaments.

A: a joint capsule.

Prions cause transmissible neurodegenerative diseases and are characterized by: A: a lack of reproductive capacity. B: hypermetabolism. C: enzyme production. D: chronic inflammation.

A: a lack of reproductive capacity.

In addition to regulating body fluids and electrolytes, the kidneys function in maintaining bone calcium levels by: A: activating vitamin D. B: excreting bicarbonate. C: stimulating bone marrow. S: synthesizing erythropoietin.

A: activating vitamin D.

A 16-year-old girl has been admitted to the emergency department after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this patient faces a severe risk of: A: acute fulminant hepatitis. B: hepatitis D virus infection. C: secondary biliary cirrhosis. D: portal hypertension.

A: acute fulminant hepatitis.

The most common causes of left-sided heart failure include: A: acute myocardial infarction. B: chronic pulmonary disease. C: impaired renal blood flow. D: tricuspid valve regurgitation.

A: acute myocardial infarction.

Acute onset bronchial asthma causes wheezing and breathlessness as a result of: A: airway inflammation. B: alveolar collapse. C: compression atelectasis. D: pulmonary hypertension.

A: airway inflammation.

Atelectasis is most commonly caused by: A: airway obstruction B: .pulmonary embolism. C: inflammation of the pleura. D: chronic forceful coughing.

A: airway obstruction

Premature osteoporosis is being seen increasingly in female athletes because of an increased prevalence of: A: amenorrhea. B: high protein intake. C: abnormal body fat. D: osteoarthritis.

A: amenorrhea.

Chlamydiaceae, a rather common sexually transmitted infectious organism, has characteristics of both viruses and bacteria. The infectious form of this organism's life cycle is _______ until it enters the host cell. A: an elementary body B: adhered to cholesterol C: propelled by filaments D: encapsulated hyphae

A: an elementary body

The most commonly occurring early symptoms of systemic lupus erythematosus (SLE) include: A: arthralgia B: tendon rupture. C: facial hair growth. \ D: pyelonephritis.

A: arthralgia

A patient fell off a ladder and sustained a spinal cord injury that has resulted in bladder dysfunction. During the period immediately after the spinal injury, spinal shock develops and the bladder has ____ function. A: atonic B: spasmodic C: uninhibited D: hyperactive

A: atonic

A genetically determined hypersensitivity to common environmental allergens causes ___________ reactions, such as: A: atopic; urticaria B: autoimmune; diarrhea. C: IgM-mediated; infections. D: delayed; poison ivy rash:

A: atopic; urticaria

Inflammatory bowel diseases are accompanied by systemic manifestations that include: A: autoimmune anemia. B: rheumatoid arthritis C: .thrombocytopenia. D: lactose intolerance.

A: autoimmune anemia.

Although urinary obstruction and urinary incontinence have almost opposite effects on urination, they can both result from: A: bladder structure changes. B: bladder wall atrophy. C: micturition reflex spasms. D: bladder distensibility loss.

A: bladder structure changes.

The carbon dioxide content in the blood affects the regulation of ventilation through its effect on the ___________ of the brain. A: cerebrospinal fluid pH B: peripheral chemoreceptors C: afferent impulse D: regulation motor and premotor cortex

A: cerebrospinal fluid pH

Long-term autoregulation of local blood flow in the microcirculation is mediated by: A: collateral circulation. B: arteriovenous shunting C: .autonomic nervous system. D: metabolic needs of the tissues.

A: collateral circulation.

Bronchial circulation differs from the pulmonary circulation by providing blood for the: A: conducting airways. B: alveolar gas exchange. C: mediastinum and pleural space. D: intrapulmonary pressure balance.

A: conducting airways.

The moderate stage of the progressive degenerative Alzheimer-type dementia is manifested by behaviors that include: A: confusion. B: incontinence. C: decreased level of consciousness. D: social withdrawal.

A: confusion.

With bronchiectasis, persistent airway obstruction and chronic infection results in bronchial: A: dilation. B: rupture. C: infarction. D: thickening.

A: dilation.

The mechanisms of liver damage in viral hepatitis include: A: direct cellular injury. B: fatty liver changes. C: disrupted bile flow. D: bile duct inflammation.

A: direct cellular injury.

A 29-year-old patient had a Papanicolaou smear performed during her most recent visit to her primary care provider. This diagnostic procedure aims to identify: A: dysplastic cervical cells. B: human papillomavirus (HPV) antibodies. C: cervical polyps. D: lesions at the transformation zone.

A: dysplastic cervical cells.

Systemic sclerosis (scleroderma) is an autoimmune disease of connective tissue characterized by: A: fibrosis. B: thin fragile skin. C: collagen deficiency. D: avascular necrosis.

A: fibrosis.

The cold viruses​ are rapidly spread from person to person. The greatest source of spread is: A: fingers. B: sneezing. C: plastic toys. D: eye mucosa.

A: fingers.

Chronic stable angina, associated with inadequate blood flow to meet the metabolic demands of the myocardium, is caused by: A: fixed coronary obstruction. B: increased collateral circulation. C: intermittent vessel vasospasms. D: excessive endothelial relaxing factors.

A: fixed coronary obstruction.

Disorders that affect cortical bone typically result in: A: fractures of long bones. B: impaired collagen synthesis C: .infection. D: vertebral fractures.

A: fractures of long bones.

A common symptom of the ischemia associated with gastrointestinal redistribution of blood flow is: A: gastric bleeding. B: nausea and vomiting. C: irritable bowel syndrome. D: copious high volume diarrhea.

A: gastric bleeding.

Developmental dysplasia of the hip (DDH), formerly known as congenital hip dislocation, is suspected when an infant has: A: gluteal fold asymmetry. B: lengthening of the thigh. C: joint capsule tightness. D: delay of knee crawling.

A: gluteal fold asymmetry.

Crohn's type of inflammatory bowel disease is characterized by: A: granulomatous lesions. B: ulcerative erosions. C: fibrotic smooth muscle. D: necrotic crypt abscesses.

A: granulomatous lesions.

High-risk factors for development of adult renal cell cancer include: A: heavy smoking. B: inherited renal disease. C: adrenal medulla tumors. D: anorexia/bulimia disorder.

A: heavy smoking.

A major cause of secondary hyperlipoproteinemia is _______, which increases the production of VLDL and conversion to LDL. A: high-calorie diet B: diabetes mellitus C: bile-binding resin D: cholesterol ingestion

A: high-calorie diet

A 22-year-old patient has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A: human papillomavirus (HPV). B: Chlamydia trachomatis. C: Candida albicans. D: Trichomonas vaginalis.

A: human papillomavirus (HPV).

Extreme cerebral edema may cause the brain to herniate into another compartment. Upward herniation from the infratentorial compartment against the aqueduct of Sylvius causes: A: hydrocephalus. B: cardiac arrest. C: tissue infarction. D: intracranial bleeding.

A: hydrocephalus.

Only the kidneys can eliminate ____ from the body as a means of regulating body acid-base balance, when urine buffers are present. A: hydrogen (H+) B: potassium (K+) C: ammonia (NH3) D: phosphate (HPO4)

A: hydrogen (H+)

The common results of respiratory failure are hypoxemia and: A: hypercapnia B: bradycardia. C: vasoconstriction. D: pulmonary emboli.

A: hypercapnia

The proteins and other materials used by the axon are synthesized _____ and then flow down the axon through its cytoplasm. A: in the cell body B: by Nissl bodies C: through dendrites D: across synapses

A: in the cell body

Cryptorchidism, or undescended testes, is a direct cause of: A: infertility. B: paraphimosis. C: prostate cancer. l D: ow testosterone.

A: infertility.

Type III hypersensitivity immune responses can be harmful when immune complex deposits in tissue activate ___________ that can directly damage area tissues. A: inflammation B: autoantibodies C: cytotoxic cells D: immunoglobulins

A: inflammation

The patient has a fractured tibia. After the cast is applied he is at high risk for compartment syndrome caused by: A: inflammation. B: joint immobility. C: muscle atrophy. D: extremity elevation.

A: inflammation.

People infected with HIV and tuberculosis lack a hypersensitivity response to the tuberculin test as a result of: A: inherent anergy. B: host cell depletion. C: poor lung perfusion. D: boosting phenomenon.

A: inherent anergy.

Dendritic cells, found in skin tissues and lymphoid tissues, are important for: A: initiation of adaptive immunity. B: deep-tissue phagocytosis. C: disposal of dead cells. D: delaying inflammation.

A: initiation of adaptive immunity.

Motility along the length of the gut, control of function, and communication of each segment are innervated by the ______ neurons of the enteric nervous system. A: intramural B: vasovagal C: sympathetic D: preganglionic

A: intramural

An intracranial epidural hematoma causes focal symptoms that can include: A: ipsilateral pupil dilation. B: ipsilateral hemiparesis. C: diffuse venous bleeding. D: commuting hydrocephalus.

A: ipsilateral pupil dilation.

As chronic kidney disease progresses, the second stage (renal insufficiency) is identified by: A: isotonic polyuria. B: metabolic acidosis. C: hyperparathyroidism. D: diminished renal reserve.

A: isotonic polyuria.

The major sites of aldosterone action on sodium and potassium, potassium regulation, and the final concentration of sodium in urine are the _______ tubule and the _________ tubule. A: late distal; cortical collectingthin B: ascending; thick ascending C: proximal; thin descending segment D: juxtamedullary; elbow diluting segment

A: late distal; cortical collectingthin

Women are screened regularly for risk factors and manifestations of breast cancer. High-risk women may have a history of: A: late menopause. B: leiomyoma tumors. C: STDs and vaginitis. D: multiple pregnancies.

A: late menopause.

Supporting cells of the nervous system, such as Schwann cells, satellite cells, and types of glial cells, function to provide neurons with: A: local protection. B: control functions. C: membrane permeability D: integrative metabolism.

A: local protection.

The iatrogenic form of Cushing syndrome is caused by: A: long-term cortisone therapy. B: pituitary tumor-secreting ACTH. C: benign or malignant adrenal tumor. D: ectopic ACTH secreting lung tumor.

A: long-term cortisone therapy.

Most respiratory disorders in infants produce a decrease in: A: lung compliance. B: airway resistance. C: oxygen demand. D: respiratory rate.

A: lung compliance.

The mediators involved in type I hypersensitivity allergic responses are released from: A: mast cells. B: plasma cells. C: monocytes. D: arachidonic acid.

A: mast cells.

One of the first renal manifestations of diabetic nephropathy is: A: microalbuminuria. B: oliguria. C: hypertension. D: hyperlipidemia.

A: microalbuminuria.

One of the principal mechanisms by which the heart compensates for increased workload is: A: myocardial hypertrophy. B: sodium and water retention. C: endothelin vasoconstrictors. D: ventricular wall tension increase.

A: myocardial hypertrophy.

Alcoholic liver disease manifests in three stages. The intermediate stage, alcoholic hepatitis, is characterized by liver cell: A: necrosis. B: nodules. C: atrophy. D: hypertrophy.

A: necrosis.

Symptomatic tertiary syphilis is characterized by: A: necrotic gummas. B: chancre papules. C: condylomata lata. D: maculopapular rash.

A: necrotic gummas.

Although there are no effective screening methods for ovarian cancer, and early symptoms are usually absent, there are high-risk indicators that include: A: nulliparity. B: lactation. C: mammary duct ectasia. D: oral contraceptive use.

A: nulliparity.

Hormones exert their action by binding to high-affinity receptors on the surface or inside of the target cell. The response of the target cell varies with the _____ and _____ of the receptors present. A: numbers; affinity B: hormone size; location C: permeability; ionization D: saturation level; rate

A: numbers; affinity

In growing bone, severe vitamin C deficiency slows bone growth by impairing: A: organic matrix formation. B: calcification of new bone. C: growth plate separation. D: widening of the cortex.

A: organic matrix formation.

Although both eukaryotes and prokaryotes are capable of causing infectious diseases in humans, eukaryotes are unique because they have a distinct: A: organized nucleus. B: circular plasmid DNA. C: cytoplasmic membrane. D: variation of shape and size.

A: organized nucleus.

A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of: A: pannus tissue. B: tophi deposits. C: subluxations. D: autoantibodies.

A: pannus tissue.

Endometriosis is characterized by painful hemorrhagic lesions in the pelvis and complications that include: A: pelvic adhesions. B: endometrial cancer. C: candidiasis vaginitis. D: bladder herniation

A: pelvic adhesions.

The somatic nervous system provides sensory and motor innervation for: A: peripheral nerves. B: abdominal viscera. C: secretory glands. D: smooth muscle.

A: peripheral nerves.

During the latent period before antibodies are detected in the humoral immune response, B cells differentiate into ________ cells. A: plasma B: cytotoxic C: stem D: helper

A: plasma

Gonorrhea is caused by Neisseria gonorrhoeae, a gram-negative diplococcus, and is characterized by: A: purulent exudates. B: painful small vesicles. C: cauliflower-shaped lesions. D: persistent perianal itching.

A: purulent exudates.

Neurologic control of bladder function consists of three main levels or centers. The lower motor neuron spinal cord centers control micturition: A: reflexes. B: backflow. C: inhibition. D: Coordination

A: reflexes.

Hormones are chemical messengers that: A: regulate body functions. B: initiate immune reactions. C: transport fatty acids and lipids. D: cause one specific tissue effect.

A: regulate body functions.

A hallmark of irritable bowel syndrome is abdominal pain: A: relieved by defecation. B: most severe at night. C: with blood in the stool. D: after and between meals.

A: relieved by defecation.

the distinguishing characteristic of chronic osteomyelitis is the presence of: A: sequestrum bone. B: abscess formation. C: severe bone pain. D: external drainage.

A: sequestrum bone.

When hypofunction of an endocrine organ is suspected, a hormone ____________ test can be administered to measure and assess target gland response. A: stimulation B: 24-hour urine C: agglutination D: antibody-binding

A: stimulation

A college baseball player has seen his season cut short by a rotator cuff injury. Rotator cuff injuries are frequent because of: A: the inherent instability of the shoulder. B: the absence of ligaments at the glenohumeral joint. C: the vulnerability of the shoulder menisci. D: the large mass of the humeral head.

A: the inherent instability of the shoulder.

Emphysema is characterized by hyperinflation of the lungs that produces increased: A: total lung capacity. B: alveolar wall thickness. C: a1-antitrypsin enzyme. D: submucosal gland hypertrophy.

A: total lung capacity.

The most damaging effects of urinary obstruction are the result of _____ and unrelieved obstruction of urine outflow. A: urinary stasis B: concentrated urine kidney C: hyperplasia D: renal hypertension

A: urinary stasis

The kidney assists in blood pressure regulation by releasing_______ from the juxtaglomerular cells in response to decreased renal blood flow, resulting in efferent arteriole A: vasoconstriction. B: renin angiotensin II C: aldosterone D: angiotensin I

A: vasoconstriction.

In addition to mucus, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous type fluid are secreted to act as a: A: vehicle for absorption B: .enzyme that splits sugars C: protection from acid content. D: parasympathetic stimulation.

A: vehicle for absorption

Preload represents the volume work of the heart and is largely determined by: A: venous blood return B: .vascular resistance. C: force of contraction. D: ventricular emptying.

A: venous blood return

Legionnaire disease is a form of bronchopneumonia caused by an organism frequently found in: A: warm, standing water B: .public restrooms. C: fermenting yogurt D: potted plant dirt.

A: warm, standing water

In right-sided heart failure, peripheral edema is evidenced by: A: weight gain. B: copious urination. C: shortness of breath. D: decreased blood pressure.

A: weight gain.

With otosclerosis, early hearing loss is identified by an inability to hear: A: whispering. B: one's own voice. C: on the cell phone. D: in a noisy environment.

A: whispering.

A patient with a recent diagnosis of renal failure that will require hemodialysis is being educated in the dietary management of the disease. Which of the patient's following statements shows an accurate understanding of this component of treatment? A: ​I've made a list of high-phosphate foods so that I can try to avoid them.​​ B: I'm making a point of trying to eat lots of bananas and other food rich in potassium.​​ C: I'm going to try a high-protein, low-carbohydrate diet. D: ​​I don't think I've been drinking enough, so I want to include 8 to 10 glasses of water each day.​

A: ​I've made a list of high-phosphate foods so that I can try to avoid them.​​

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the care provider give the patient? A: ​There is a chance that these will clear up on their own without any treatment.​ ​B: It's important to start treatment soon, so I will prescribe you pills today.​ C: ​Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease.​ ​D: I'd like to give you an HPV vaccination if that's okay with you.​

A: ​There is a chance that these will clear up on their own without any treatment.​

Which of the following is a nonmodifiable risk factor for the development of primary hypertension? A:African American race B: High salt intake C: Male gender D: Obesity

A:African American race

Which of the following assessment findings is most suggestive of nephrotic syndrome? A: Hematuria and anemia B: Proteinuria and generalized edema C: Renal colic and increased serum sodium D: Increased creatinine with normal blood urea nitrogen

B: Proteinuria and generalized edema

Acute pancreatitis involves activated pancreatic enzymes that escape into surrounding tissues to cause _______. A: fatty deposits B: autodigestion C: bowel obstruction D: abscess formation

B: autodigestion

A patient's recent history of emphysema has resulted in the functional loss of many alveoli. Which of the following physiologic functions is the primary role of type II alveoli? A: Facilitation of bronchial circulation B: Production of surfactant C: Gas exchange D: Production of macrophages

B: Production of surfactant

Although growth rate is variable among types of bacteria, the growth of bacteria is dependent on: A: biofilm communication. B: availability of nutrients. C: an intact protein capsid .D: individual cell motility.

B: availability of nutrients.

The mechanism by which humans recognize self-cells from one non-self (antigens) cell is A: autoimmunity B: self-tolerance C: non-self energy D: Immunocompatibility

B: self-tolerance

The ​window period​ of HIV infection refers to the period of time between infection and: A: transmission. B: seroconversion. C: initial symptoms. D: antibody screening.

B: seroconversion.

To maintain adequate serum calcium levels, parathyroid hormone reduces: A: activation of vitamin D. B: serum phosphate levels. C: calcium release from bone. D: intestinal absorption of calcium.

B: serum phosphate levels.

Which of the following patients may be experiencing the effects of neuropathic pain? A) A girl whose playground accident resulted in an arm fracture B) A man with pain secondary to his poorly controlled diabetes C) An elderly woman with a stage III pressure ulcer D) A man whose pain is caused by gastric cancer

B) A man with pain secondary to his poorly controlled diabetes

An elderly patient has been brought to his primary care provider by his wife who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the patients gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This patient requires further assessment for which of the following health problems? A) Muscle atrophy B) Cerebellar disorders C) Impaired spinal reflexes D) Lower motor neuron lesions

B) Cerebellar disorders

Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer? A) Opioids should be avoided in order to prevent liver and kidney insult. B) Dosing and timing should aim for a steady serum level of the drug that is chosen. C) Doses of analgesia should be given only when the patients pain becomes severe. D) Drugs from numerous classifications should be used to maximize pain control.

B) Dosing and timing should aim for a steady serum level of the drug that is chosen.

Which of the following substances provides the majority of the fuel needs of the neurologic system? A) Glycogen B) Glucose C) Amino acids D) Triglycerides

B) Glucose

Which of the following disorders of neuromuscular function typically has the most rapid onset? A) Duchenne muscular dystrophy (DMD) B) Guillain-Barr syndrome C) Parkinson disease D) Myasthenia gravis

B) Guillain-Barr syndrome

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of: A) Amyotrophic lateral sclerosis (ALS) B) Multiple sclerosis (MS) C) Duchenne muscular dystrophy (DMD) D) Paralysis caused by Clostridium botulinum

B) Multiple sclerosis (MS)

A common cause of bacterial pneumonia in both community and hospital setting is: A) E. coli B) S. aureus. C) Enterobacter. D) S. pneumoniae.

B) S. aureus.

A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron? A) The neurons between the womans finger and the womans spinal cord B) The neurons between the thalamus and the cortex C) The neurons between the CNS and the thalamus D) The neurons of the efferent pathway that causes muscle contraction

B) The neurons between the thalamus and the cortex

A pregnant womans most recent ultrasound is suggestive of spina bifida, and her primary care provider has subsequently order further diagnostic testing. The pathophysiologic effects of this disease are due to: A) malformation of the mesoderm. B) abnormal closure of the neural tube. C) lesions in the dorsal root ganglia. D) hypertrophy of the primary vesicles.

B) abnormal closure of the neural tube.

A distinguishing feature of viral influenza is: A) direct contact transmission. B) abrupt-onset, profound malaise. C) constant pounding headache. D) profuse watery nasal discharge.

B) abrupt-onset, profound malaise.

In contrast to the sympathetic nervous system, the functions of the parasympathetic nervous system include: A) sweating. B) anabolism. C) pupil dilation. D) vasoconstriction.

B) anabolism.

The cardinal symptoms of Parkinson disease include: A) hypotonia. B) bradykinesia. C) paresthesia. D) lack of sweating.

B) bradykinesia.

Proprioceptive somatosensory information from the limbs and trunk is transmitted by the: A) reflexive networks. B) dorsal root ganglion neurons. C) anterolateral pathway. D) trigeminal sensory neurons.

B) dorsal root ganglion neurons.

Nociceptors are sensory receptors that are activated by: A) cortisol. B) noxious stimuli. C) pressure and touch. D) sudden movements.

B) noxious stimuli.

The perception of where a stimulus is in space and in relation to body parts is a function of the: A) occipital lobe. B) parietal lobe. C) hypothalamus. D) prefrontal cortex.

B) parietal lobe.

Which of the following factors is most strongly associated with the pathogenesis of gallstones? A: Excess serum ammonia and urea levels B: Portal hypertension C: Abnormalities or stasis of bile D: High cholesterol diet

C: Abnormalities or stasis of bile

A hospital patient with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin? A: Promotion of fat breakdown B: Promotion of glucose uptake by target cells C: Promotion of gluconeogenesis and protein synthesis D: Initiation of glycogenolysis

B: Promotion of glucose uptake by target cells

As a protective measure to keep abdominal inflammation and infection localized, the peritoneum: A: constricts bowel contents B: .secretes fibrous exudate C: .increases intestinal motility. D: abdominal vasoconstriction.

B: .secretes fibrous exudate

Although an average of ____ glomerular filtrate is formed each minute, only _____ is excreted as urine and the rest is reabsorbed in the tubules. A: 250 mL; 15 mL B: 125 mL; 1 mL C: 200 mL; 5 mL D: 175 mL; 10 mL

B: 125 mL; 1 mL

A patient with a history of heart failure has been referred for an echocardiogram. Results of this diagnostic test reveal the following findings: heart rate 80 beats per minute; end-diastolic volume 120 mL; end-systolic volume 60 mL. What is this patient's ejection fraction? A: 200 mL B: 50% C: .80 D: 180 mL

B: 50%

A hospital patient has been complaining of increasing fatigue for several hours and his nurse has entered his room to find him unarousable. The nurse immediately checked the patient's blood glucose level, which is 22 mg/dL (1.2 mmol/L). The nurse should prepare to administer which of the following? A: A snack that combines simple sugars, protein, and complex carbohydrates B: A 50% glucose solution intravenously C: Infusion of rapid-acting insulin D: Oral solution containing glucagon and simple sugars

B: A 50% glucose solution intravenously

Which of the following individuals most likely faces the greatest risk of developing Clostridium difficile colitis? A: A 55-year-old man who takes proton pump inhibitors for the treatment of peptic ulcers B: A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics C: A premature neonate who has developed hyperbilirubinemia and is receiving phototherapy D: A 30-year-old patient who has a history of Crohn disease and has been admitted to a hospital to treat a recent flare-up

B: A 79-year-old hospital patient who is being treated with broad-spectrum antibiotics

Which of the following individuals is experiencing a health problem that is the result of a parasite? A: A college student who contracted Chlamydia trachomatis during an unprotected sexual encounter B: A man who acquired malaria while on a tropical vacation C: A hospital patient who has developed postoperative pneumonia D: A woman who developed hepatitis A from eating at an unhygienic restaurant

B: A man who acquired malaria while on a tropical vacation

Which of the following individuals is suffering the effects of acute coronary syndrome (ACS)? A: A patient whose most recent ECG indicates that silent myocardial ischemia has occurred B: A patient who occasionally experiences persistent and severe chest pain when at rest C: A patient who sometimes experiences chest pain when climbing stairs D: A patient who has recently been diagnosed with variant (vasospastic) angina

B: A patient who occasionally experiences persistent and severe chest pain when at rest

A patient with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which of the following has most likely resulted in the patient's increased blood pressure? A: Increased levels of adrenocortical hormones B: Activation of the renin-angiotensin-aldosterone mechanism C: Increased sympathetic stimulation by the autonomic nervous system (ANS) D: Coarctation of the patient's aorta

B: Activation of the renin-angiotensin-aldosterone mechanism

A patient with a diagnosis of secondary hypertension has begun to experience signs and symptoms that are ultimately suggestive of decreased cardiac output. Which of the following factors that determine cardiac output is hypertension likely to affect most directly? A: Preload B: Afterload C: Contractility D: Heart rate

B: Afterload

A decrease in the serum level of which of the following substances is suggestive of liver injury? A: g-Glutamyltransferase (GGT) B: Albumin C: Alanine aminotransferase (ALT) D: Alkaline phosphatase

B: Albumin

Which of the following characteristics differentiates cartilage from bone? A: Secretion of an extracellular matrix B: Avascularity C: Low tensile strength D: Rapid healing

B: Avascularity

Which of the following forms accounts for the greatest percentage of carbon dioxide transport? A: Free CO2 B: Bicarbonate C: Dissolved CO2 D: Attached to hemoglobin

B: Bicarbonate

A patient was diagnosed as HIV positive several years ago. Which of the following blood tests is most clinically useful for determining the stage and severity of her disease? A: Plasma levels B: CD4+ cell counts C: Viral load D: White blood cell count with differential

B: CD4+ cell counts

Assessment of a newborn infant reveals the presence of developmental dysplasia of the hip (DDH) that is currently demonstrated by subluxation of the baby's hip joint and a general laxity in the baby's ligaments. What measures should be emphasized in this infant's treatment? A: Corticosteroid therapy B: Close observation C: Open reduction D: Joint reconstruction

B: Close observation

The entrance of a microbe into an individual's vascular space has initiated opsonization. Which of the following processes is involved in opsonization? A: Stimulation of B cells by helper T cells B: Coating of a microbe to aid phagocyte recognition C: Release of proteins that stimulate cell production by the bone marrow D: Lysis of intracellular microbes by cytotoxic T cells

B: Coating of a microbe to aid phagocyte recognition

For which of the following types of shock might intravenous antibiotic therapy be indicated? A: Obstructive shock B: Distributive shock C: Cardiogenic shock D: Hypovolemic shock

B: Distributive shock

Which of the following characteristics differentiates open-angle glaucoma from angle-closure glaucoma? A: The potential for consequent blindness B: Dysfunction of the aqueous humor drainage system C: The presence of optic nerve cupping D: Infectious etiology

B: Dysfunction of the aqueous humor drainage system

Which of the following signs and symptoms most clearly suggests the need for endoscopy to rule out esophageal cancer? A: Heartburn after an individual consumes high-fat meals B: Dysphagia in an individual with no history of neurologic disease C: A new onset of gastroesophageal reflux in a previously healthy individual D: Recurrent episodes of gastritis that do not respond to changes in diet

B: Dysphagia in an individual with no history of neurologic disease

Patients with ischemic coronary vessel disease and acute coronary syndrome (ACS) are classified as low or high risk for acute myocardial infarction based on characteristics that include significant: A: heart murmurs. B: ECG changes. C: pulmonary disease. D: pericardial effusion.

B: ECG changes.

In the days following a tooth cleaning and root canal, a patient has developed an infection of the thin, three-layered membrane that lines the heart and covers the valves. What is this patient's most likely diagnosis? A: Pericarditis B: Endocarditis C: Myocarditis D: Vasculitis

B: Endocarditis

Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra. A: Pseudomonas B: Escherichia coli C: Staphylococcus aureus D: Group B Streptococcus

B: Escherichia coli

Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease? A: Hypopituitarism B: Excess ACTH production by a pituitary tumor C: Autoimmune destruction of the adrenal cortex D: Malfunction of the HPA system

B: Excess ACTH production by a pituitary tumor

A 60-year-old patient's long history of poorly controlled hypertension has culminated in a diagnosis of retinal detachment. What type of retinal detachment is this patient most likely to have experienced? A: Rhegmatogenous detachment B: Exudative retinal detachment C: Posterior vitreous detachment D: Traction retinal detachment

B: Exudative retinal detachment

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of: A: Cushing syndrome. B: Graves disease. C: Addison disease. D: Cushing disease.

B: Graves disease.

As with other ulcerative sexually transmitted infections (STIs), genital herpes (herpes simplex virus type 2, HSV-2) increases the risk of: A: cervical cancer. B: HIV transmission. C: localized necrosis. D: urinary tract infection.

B: HIV transmission.

Which of the following patient complaints most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma? A: Urinary urgency B: Hematuria C: Oliguria D: Cloudy urine

B: Hematuria

A 1-day-old infant was exposed to an infectious microorganism prior to discharge home from the hospital, but was able to effect a sufficient immune response in the hours and days following exposure. This immune response may have been due to the presence of which of the following immunoglobulins from the infant's mother? A: IgA B: IgG C: IgM D: IgD

B: IgG

The first circulating immunoglobulin to appear in response to a new antigen is: A: IgG. B: IgM. C: IgA. D: IgD.

B: IgM.

An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this patient's decline in health? A: A mismatch between bone resorption and remodeling B: Immunologically mediated joint inflammation C: Excessive collagen production and deposition D: Cytokine release following mechanical joint injury

B: Immunologically mediated joint inflammation

A 55-year-old male patient has reported joint pain in his feet. Which of the following blood work results should prompt further testing to rule out primary gout? A: Increased C-reactive protein (CRP) B: Increased serum uric acid C: Increased polymorphonuclear leukocytes D: Increased serum cortisol

B: Increased serum uric acid

Which of the following insulin-administration regimens is most likely to result in stable blood glucose levels for a patient with a diagnosis of type 1 diabetes? A: One large dose of long-acting insulin each day before breakfast B: Intermediate-acting insulin at 8:00 AM and 8:00 PM with rapid-acting insulin before each meal C: Six to eight small doses of rapid-acting insulin each day, with capillary monitoring before each D: Long-acting insulin twice daily (breakfast and bedtime), with intermediate-acting insulin in the afternoon

B: Intermediate-acting insulin at 8:00 AM and 8:00 PM with rapid-acting insulin before each meal

Which of the following respiratory pressures is always negative in relation to alveolar pressure? A: Airway pressure B: Intrapleural pressure C: Intrathoracic pressure D: Intrapulmonary pressure

B: Intrapleural pressure

Which of the following signs and symptoms should prompt a 29-year-old woman's primary care provider to assess for systemic lupus erythematosus (SLE)? A: Chronic nausea and vomiting that is unresponsive to antiemetics B: Joint pain and increased creatinine and blood urea nitrogen C: A history of thromboembolic events and varicose veins D: Dysmenorrhea and recent spontaneous abortion

B: Joint pain and increased creatinine and blood urea nitrogen

A patient has been admitted to a medical unit of a hospital for the treatment of pneumonia that is attributable to S. pneumonia. Which of the following considerations is the priority in this patient's treatment? A: Maintaining the patient's activities of daily living B: Maintaining the patient's airway C: Monitoring and treating the patient's pain D: Preventing and treating the patient's fever

B: Maintaining the patient's airway

A motor vehicle accident has resulted in a tension pneumothorax for the driver of the car. Which of the following manifestations is associated with tension pneumothorax? A: Audible friction rub over the affected lung B: Mediastinal shift C: Metabolic alkalosis D" Atrial fibrillation

B: Mediastinal shift

Which of the following physiologic processes results from the synthesis and release of testosterone? A: Protein catabolism B: Musculoskeletal growth C: Release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) D: Prostatic hyperplasia

B: Musculoskeletal growth

An elderly patient who experiences chronic pain takes opioid analgesics on a regular basis, a practice that has resulted in frequent constipation and occasional bowel obstructions. Which of the following problems may directly result from these gastrointestinal disorders? A: Urinary tract infections B: Overflow urinary incontinence C: Bladder cancer D: Neurogenic bladder

B: Overflow urinary incontinence C: Bladder cancer

Hormones that cause the subsequent stimulation or release of another hormone, such as thyroid- stimulating hormone and corticotropin-releasing hormone, typically belong to which of the following structural classifications? A: Amines and amino acids B: Peptides and proteins C: Steroids D: Fatty acid derivatives

B: Peptides and proteins

Which of the following processes occurs in the pathophysiology of infection by herpes simplex virus (HSV)? A: Replication of the squamous epithelium B: Periods of latency in the nervous system C: Inhibition of cell-mediated immunity D: Production of exotoxins

B: Periods of latency in the nervous system

Which of the following structures controls the functions of the greatest number of target glands and cells? A: Thyroid gland B: Pituitary gland C: Adrenal cortex D: Pancreas

B: Pituitary gland

A patient's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem? A: Aggressive diuresis B: Placement of a shunt C: Administration of hypertonic intravenous solution D: Lumbar puncture

B: Placement of a shunt

Which of the following vision deficits is a clinician justified in attributing to the normal aging process? A: Conjunctivitis B: Presbyopia C: Strabismus D: Angle-closure glaucoma

B: Presbyopia

A patient with a diagnosis of aplastic anemia has undergone allogenic bone marrow transplantation. Which of the following signs and symptoms would most clearly suggest the existence of graft-versus- host disease (GVHD)? A: Shortness of breath, audible crackles, and decreasing PaO2 B: Presence of a pruritic rash that has begun to slough off C: Development of metabolic acidosis D: Diaphoresis, fever, and anxiety

B: Presence of a pruritic rash that has begun to slough off

Which of the following physiologic processes is performed by the kidneys and contributes to increased blood pressure? A: Catalysis of the conversion of angiotensin I to angiotensin II B: Production and release of renin C: Secretion of aldosterone D: Conversion of aldosterone to angiotensin

B: Production and release of renin

Which of the following physiologic processes is a direct effect of the release of growth hormone by the anterior pituitary? A: Development of cartilage and bone B: Production of insulin-like growth factors (IGFs) by the liver C: Increase in overall metabolic rate and cardiovascular function D: Positive feedback of the hypothalamic-pituitary-thyroid feedback system

B: Production of insulin-like growth factors (IGFs) by the liver

A child's thymus gland is fully formed and proportionately larger than an adult's. Which of the following processes that contribute to immunity takes place in the thymus gland? A: Differentiation of B cells B: Production of natural killer (NK) cells C: Proliferation of T cell D: Filtration of antigens from the blood

B: Production of natural killer (NK) cells

An athlete has become dehydrated during a long race in hot weather. Which of the following physiologic processes will occur in an attempt to protect the athlete's extracellular fluid volume? A: Dilation of the afferent and efferent arterioles B: Release of ADH from the posterior pituitary C: Increased water reabsorption in the ascending limb of the loop of Henle D: Increased water reabsorption in the distal convoluted tubule

B: Release of ADH from the posterior pituitary

A female patient with rheumatoid arthritis has taken high doses of aspirin for several years, a practice that has resulted in damage to her hearing due to the drug​s ototoxic effects. What type of hearing loss has this patient experienced? A: Conductive hearing loss B: Sensorineural hearing loss C: Presbycusis D: Mixed hearing loss

B: Sensorineural hearing loss

Which one of the following blood tests reflects the glomerular filtration rate (GFR) and is used to estimate renal function? A: Blood protein B: Serum creatinine C: Serum ammonia D: Blood urea nitrogen

B: Serum creatinine

Which of the following characteristics of the lungs of infants and small children creates an increased risk of respiratory disorders? A: Type II alveoli in children may overproduce surfactant. B: Smaller airways create a susceptibility to changes in airway resistance and airflow. C: The pneumotaxic center in the pons in underdeveloped until 8 years of age. D: There are fewer chemoreceptors in the young medulla.

B: Smaller airways create a susceptibility to changes in airway resistance and airflow.

International travel has contributed to increased prevalence and incidence of nonindigenous diseases by increasing which of the following? A: Portals of entry B: Sources of infection C: Virulence D: Disease course

B: Sources of infection

Gastrin production, a task that is performed by the stomach, results in which of the following effects? A: Simulation of pancreatic enzyme secretions B: Stimulation of HCl secretions by parietal cells C: Conversion of polysaccharides to monosaccharides D: Release of insulin in response to glucose load

B: Stimulation of HCl secretions by parietal cells

What role do osteoblasts play in the physiology of bone tissue? A: Differentiation into mature bone cells B: Synthesis and secretion of bone matrix C: Maintenance of calcium balance D: Resorption of the bone matrix

B: Synthesis and secretion of bone matrix

Thyroid and steroid hormones, which exert their effect on target cells by way of nuclear receptors, have which of the following characteristics? A: The selective use of a second messenger B: The ability to cross the cell membrane of target cells C: The ability to regulate surface receptor affinity D: Both lipid-solubility and water-solubility

B: The ability to cross the cell membrane of target cells

Which of the following events would suggest that an individual's physiologic response to an obstruction has progressed beyond the compensatory stage and is now in the decompensatory stage? A: The bladder muscle hypertrophies. B: The detrusor loses its power of contraction. C: The ability to suppress urination is diminished. D: The individual experiences urgency.

B: The detrusor loses its power of contraction.

Shortly after being diagnosed with HIV, a patient has begun highly active antiretroviral therapy (HAART). What is the primary goal of the patient's drug regimen? A: To limit the latent period of HIV B: To slow the progression of the disease C: To minimize opportunities for transmission D: To prevent seroconversion

B: To slow the progression of the disease

A patient has provided a routine urine sample during a scheduled visit to his primary care provider. Which of the following results is an expected finding in a healthy individual? A: Low to moderate amount of glucose in the urine B: Urine specific gravity of 1.020 C: Presence of moderate amounts of albumin with the absence of other proteins D: Presence of urinary casts

B: Urine specific gravity of 1.020

A patient's complex and worsening pressure ulcer has necessitated the use of numerous antibiotics over the last several months. Which of the following consequences may result from this patient's medication regimen? A: Impaired mucus production B: Vitamin K deficiency C: Impaired protein metabolism D: Excessive release of pepsin

B: Vitamin K deficiency

For many patients, the first indication that they have osteoporosis is: A: bone pain that is not alleviated by rest. B: a bone fracture. C: craving high-calcium foods. D: decreased range of motion in the hip and knee joints.

B: a bone fracture.

Both high-turnover and low-turnover renal osteodystrophy, the skeletal complications of chronic kidney disease, are manifested by abnormal _________ and defective bone __________. A: shape; joint motion B: absorption; remodeling C: matrix density; marrow D: parathyroid hormone; surface

B: absorption; remodeling

On the second or third day after an acute myocardial infarction, the area of necrosis is: A: soft and yellow. B: acutely inflamed. C: granulation tissue. D: fibrous scar tissue.

B: acutely inflamed.

Respiratory movement of air that does not participate in alveolar gas exchange is known as alveolar dead space. Dead space increases when alveoli: A: carbon dioxide level is high. B: air supply exceeds blood flow. C: contain pulmonary edema fluid. D: collapse onto the capillary bed.

B: air supply exceeds blood flow.

Although both vertigo and dizziness can result from peripheral or central vestibular disorders, vertigo is distinctly different because it causes: A: light-headedness. B: an illusion of motion. C: loss of consciousness. D: permanent hearing loss.

B: an illusion of motion.

Mismatched blood transfusion reaction with hemolysis of blood cells is an example of type II, _____ mediated hypersensitivity reaction. A: T-cell B: antibody C: leukotriene D: complement

B: antibody

Organ rejection is a complication of organ transplantation caused by recipient immune cells: A: destroying the host T cells. B: attack on the donor cells. C: combining with grafts HLA. D: being recognized as foreign.

B: attack on the donor cells.

The release of insulin from the pancreatic beta cells can inhibit its further release from the same cells. This is an example of _______ hormone action. A: retinoid B: autocrine C: juxtaposed D: arachidonic

B: autocrine

In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum: A: during bile secretion. B: between contractions. C: with a mucosal surface. D: under gaseous pressure.

B: between contractions.

Cardiac output is the ________ each minute. A: volume load B: blood pumped C: stroke volume D: force generated

B: blood pumped

Whereas PTH increases blood calcium levels, the hormone _____ lowers blood calcium levels and decreases bone resorption. A: vitamin D B: calcitonin C: prolactin D: phosphate

B: calcitonin

Atherosclerotic peripheral vascular disease is symptomatic with at least 50% occlusion. The primary peripheral symptom, due to ischemia, is: A: edema. B: calf pain. C: varicosities. D: strong pulse.

B: calf pain.

Prolonged urethral outlet obstruction causes chronic high bladder pressure and overdistension, resulting in the formation of: A: detrusor dyssynergia. B: cellules C: interstitial cystitis. D: sphincter dystonia.

B: cellules

Human papillomavirus (HPV) infection is directly associated with: A: testicular cancer. B: cervical dysplasia C: genital herpes lesions D: UTIs

B: cervical dysplasia

An increase in the level of RANKL would result in: A: fusing of the epiphysis and metaphysic in long bones. B: changes in the rate of bone remodeling. C: decreased production of PTH. D: increased vitamin D activation.

B: changes in the rate of bone remodeling.

Common risk factors for erectile dysfunction due to generalized penile arterial insufficiency include: A: cryptorchidism. B: cigarette smoking. C: testicular torsion. S: benign prostate hypertrophy.

B: cigarette smoking.

The pathophysiology of heart failure involves an interaction between decreased pumping ability and the ________ to maintain cardiac output. A: aortic hypertrophy B: compensatory mechanisms C: electrical conductivity D: parasympathetic system

B: compensatory mechanisms

In addition to being the site of gas exchange, the lungs also: A: activate vasoactive substances. B: contain cells that produce heparin. C: empty extra blood volume into the left heart. D: use water vapor pressure to inflate alveoli.

B: contain cells that produce heparin.

In contrast to structural scoliosis, postural scoliosis: A: compresses vertebrae. B: corrects with bending. C: is apparent at birth. D: becomes painful.

B: corrects with bending.

Above the glottis that opens and closes for speech, the epiglottis functions to _______ the larynx during swallowing. A: open B: cover C: collapse D: constrict

B: cover

Symptoms of difficulty in emptying the bladder, frequency, and urgency of urination are common in women with: A: rectocele. B: cystocele. C: endometritis. D: prolapsed uterus.

B: cystocele.

Once T helper cells are activated, they secrete ____________ that activate and regulate nearly all of the other cells of the immune system. A: complement proteins B: cytokines C: leukotrienes D: bradykinins

B: cytokines

Manifestations of childhood renal disease are varied and may differ from adult onset renal failure. Features of childhood chronic kidney disease include: A: mental retardation. B: developmental delays. C: bladder incontinence. D: early sexual maturity

B: developmental delays.

Treponema pallidum, the cause of syphilis, is a spirochete bacterium that is spread from human to human by: A: tick or lice vector bites B: direct physical contract C: exposure of infected urine D: inhaling airborne particles

B: direct physical contract

A patient is beginning to recover from acute tubular necrosis. The recovery phase of ATN is characterized by: A: edema. B: diuresis. C: proteinuria. D: hypokalemia.

B: diuresis.

The effector cells of the immune system have the primary function of: A: activating phagocytic cells. B: eliminating the antigens. C: processing antigen into epitopes. D: controlling the immune response.

B: eliminating the antigens.

Priapism is a condition that causes ischemia as a result of: A: circumcision trauma. B: failure of detumescence C: tight retracted foreskin. D: fibrous plaque in the penis.

B: failure of detumescence

A serious complication of chlamydial infections in women is: A: uterine cancer. B: fallopian tube damage. C: amenorrhea. D: nongonococcal urethritis

B: fallopian tube damage.

Diabetic ketoacidosis (DKA) more commonly occurs in patients with type 1 diabetes, when the lack of insulin leads to the mobilization of _____ that causes excess ketone production by the liver. A: cortisol B: fatty acids C: potassium D: bicarbonate

B: fatty acids

When sensors detect a change in a hormone level, the hormonal response is regulated by _________ mechanisms that will return the level to within normal range. A: metabolic B: feedback C: production D: action potential

B: feedback

The vaginal discharge characteristic of trichomoniasis is described as: A: thick cheesy B: frothy green. C: fishy smelling. D: mucopurulent.

B: frothy green.

In men, urethral pain and a creamy yellow, bloody discharge from the penis is characteristic of the sexually transmitted infection: A: candidiasis. B: gonorrhea. C: chancroid. D: trichomoniasis.

B: gonorrhea.

The stomach is the source of two hormones produced by the gastrointestinal tract: gastrin and ghrelin. Ghrelin is a peptide hormone produced in the mucosal layer that has an important role in regulation of ________ secretion. A: gastric acid fluid B: growth hormone C: biliary bicarbonate D: pancreatic enzyme

B: growth hormone

Cartilage is a firm but flexible type of connective tissue that is essential for: A: calcium salt storage. B: growth of long bones. C: bone surface perfusion. D: reduced friction on tendons.

B: growth of long bones.

A patient with significant burns on his lower body has developed sepsis on the third day following his accident. Which of the following developments is most clearly suggestive of ischemic acute tubular necrosis rather than prerenal failure? A: The patient exhibits pulmonary and peripheral edema.T B: he patient's GFR does not increase after restoration of renal blood flow. C: Emergency hemodialysis does not result in decreased BUN and creatinine. D: The patient exhibits oliguria and frank hematuria.

B: he patient's GFR does not increase after restoration of renal blood flow.

In order to initiate the cellular events essential to bone healing, there must be ________ formation at the fracture site. A: callous B: hematoma C: ossification D: fibrin meshwork

B: hematoma

Diabetic retinopathy, the leading cause of acquired blindness in the United States, is characterized by retinal: A: glaucoma. B: hemorrhages. C: dehydration. D: infections.

B: hemorrhages.

The oxyhemoglobin buffer system changes with the metabolic needs of the tissues. When the change causes a shift to the right in the dissociation curve, it is often the result of: A: decreased CO2 levels. B: increase tissue metabolism. C: decreased body temperature. D: increase red blood cell volume.

B: increase tissue metabolism.

Metabolic factors that increase cerebral blood flow include: A: increased oxygen saturation. B: increased carbon dioxide level. C: decreased serum sodium level. D: decreased hydrogen ion concentration.

B: increased carbon dioxide level.

The course of any infectious disease progresses through several distinct stages after the pathogen enters the host. Although the duration may vary, the hallmark of the prodromal stage is: A: tissue inflammation and damage B: initial appearance of symptoms. C: progressive pathogen elimination. D: containment of infectious pathogens.

B: initial appearance of symptoms.

The metabolic abnormalities that lead to type 2 diabetes include: A: chronic overeating. B: insulin resistance. C: acute pancreatitis. D: recurrent hypoglycemia.

B: insulin resistance.

Chronic pyelonephritis, a significant cause of renal failure, is most commonly caused by: A: viral organisms. B: intrarenal reflux. C: renal hyperplasia. D: abscess formation.

B: intrarenal reflux.

A child has been hospitalized for the treatment of hematogenous osteomyelitis. The defining characteristic of this type of osteomyelitis is: A: the presence of dead bone tissue. B: introduction of microorganisms from the bloodstream. C: bacterial proliferation in the absence of the classic signs of infection. D: destruction of the vascular network in the endosteum.

B: introduction of microorganisms from the bloodstream.

Atherosclerotic plaque is most likely to be unstable and vulnerable to rupture when the plaque has a thin fibrous cap over a: A: red thrombus. B: large lipid core. C: calcified lesion. D: vessel wall injury.

B: large lipid core.

Although both autocrine and paracrine hormonal actions occur without entering the blood stream, paracrine actions differ because they affect ______ cells. A: self- B: local C: stored D: target

B: local

Pleuritic chest pain associated with respiratory movements is usually described as: A: bilateral. B: localized. C: continuous. D: substernal.

B: localized.

Adaptive immune responses, also called acquired or specific immunity, are composed of _____________ and their products. A: granulocytes B: lymphocytes C: epithelial cells D: Toll-like receptors

B: lymphocytes

Innate immunity, also called natural or native immunity, consists of mechanisms that respond specifically to: A: self-cells. B: microbes. C: antibodies. D: inflammation.

B: microbes.

Acute cervicitis is an inflammation of the cervix characterized by: A: abscess formation. B: mucopurulent drainage. C: thick gray-white plaques. D: persistent pruritic vulvitis.

B: mucopurulent drainage.

Reduced glomerular filtration rate (GFR), with a serum creatinine level that remains in the normal range, is associated with aging because _______ is reduced in elderly persons. A: calcium intake B: muscle mass C: drug tolerance D: renal perfusion

B: muscle mass

In order to maintain fixation on stable objects during head rotation, compensatory ______ movements occur. A: vertigo B: nystagmus C: conjugate D: gaze eyelid vacillation

B: nystagmus

Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include: A: diplopia. B: petechiae. C: papilledema. D: focal paralysis.

B: petechiae.

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to: A: red blood cells. B: plasma proteins. C: inflammatory cells. D: antibody complexes.

B: plasma proteins.

An acute episode of angle-closure glaucoma is preceded by: A: central visual field loss. B: prolonged pupil dilation. C: corneal surface trauma. D: vitreous humor fluid loss.

B: prolonged pupil dilation.

In men, the condition of nonrelaxing external sphincter with urine retention is commonly caused by: A: psychosocial disorders. B: prostate enlargement. C: chronic stress response. D: pelvic inflammatory disease.

B: prostate enlargement.

The function of the mucociliary blanket that lines the conducting airways is to: A: dehumidify inhaled air. B: remove foreign materials. C: warm the moving gases. D: spread antibacterial enzymes.

B: remove foreign materials.

The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects: A: obstruction and reflux. B: salt and water retention. C: inability to concentrate urine. D: decreased glomerular permeability.

B: salt and water retention.

Cystic fibrosis (CF), the major cause of severe chronic respiratory disease in children, is characterized by: A: constipation. B: salt depletion. C: watery mucus. D: high cholesterol.

B: salt depletion.

When the glomerular transport maximum for a substance such as blood glucose is exceeded and its renal threshold has been reached, the substance will: A: reabsorb quickly. B: spill into the urine. C: counter-transport sodium. D: attach to protein carriers.

B: spill into the urine.

Dilated cardiomyopathy with left ventricular dysfunction is characterized by increased wall: A: rigidity. B: thinning. C: thickness. D: contractility.

B: thinning.

The most important complication of atherosclerosis is _________, which may cause occlusion of small heart vessels. A: ulceration B: thrombosis C: fatty streaks D: fibrous plaque

B: thrombosis

he Helicobacter pylori protobacteria cause peptic ulceration by producing: A: acids B: toxins C: ischemia D: bleeding

B: toxins

A man sustained a puncture injury to his chest that caused a tension pneumothorax to form. This is a life-threatening condition because: A: expired air exits the bleeding wound. B: trapped, inspired air collapses the lung. C: the opposite lung hyperinflates D: .blebs on the lung surface rupture.

B: trapped, inspired air collapses the lung.

The most likely vaginal infection to be spread through sexual contact is: A: candidiasis. B: trichomoniasis. C: vulvovaginitis. D: bacterial vaginosis.

B: trichomoniasis.

The leading cause of death for people with HIV is opportunistic _________. A: leukemia B: tuberculosis C: pneumonia D: toxoplasmosis

B: tuberculosis

In a hydrocele, excess fluid is present in the: A: epidiymis B: tunica vaginalis C: paminoiform plexus D: cas deferens ampulla

B: tunica vaginalis

The body compensates for obstructed urine outflow. Compensatory changes to chronic obstruction include: A: bladder spasms. B: urinary frequency. C: high residual volume. D: overflow incontinence.

B: urinary frequency.

In shock, one of the best indicators of blood flow to vital organs is: A: warm legs. B: urine output. C: blood pressure. D: consciousness.

B: urine output.

The patient chews an apple and starts the three phases of swallowing. As food enters the patient's esophagus, stretching and _____ nerve impulses initiate _______ that are controlled by the swallowing center. A: phrenic; gag reflexes B: vagus; peristaltic waves C: hypoglossal; contractions D: trigeminal; tactile receptors

B: vagus; peristaltic waves

Both prehepatic and posthepatic causes of portal hypertension include the formation of: A: fibrous nodules B: venous thrombosis. C: collateral circulation. D: portosystemic shunts.

B: venous thrombosis.

Because intestinal secretions are mainly ______ and are derived from the extracellular fluid, excessive secretion or impaired absorption can lead to extracellular _____. A: nitrogen; acidosis B: water; dehydration C: anaerobic; hypotonicity D: electrolytes; hypervolemia

B: water; dehydration

In contrast to the descending limb, the ascending limb of the loop of Henle is impermeable to _____ and the tubular filtrate becomes more _____ as a result. A: potassium; acidic B: water; hypoosmolar C: sodium; concentrated D: chloride; reabsorbed

B: water; hypoosmolar

A pathologic stress fracture occurs in bones subjected to: A: sudden direct force. B: weakening by disease. C: repeated excessive use. D: massive muscle contraction.

B: weakening by disease.

Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis? ​A: Have you recently begun a new sexual relationship? B: ​​Have you been on antibiotics recently?​​ C: Have you noticed any new growths on your vagina in recent months?​ ​ D: Do you use condoms during sexual activity?​

B: ​​Have you been on antibiotics recently?​​

Polycystic ovary syndrome (PCOS) is ovarian dysfunction caused by a combination of hormone imbalances that include______ levels. A: absent FSH B: insulin deficit C :elevated D: LH low androgen

C :elevated

An otherwise-healthy patient has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This patient is likely to be diagnosed with which of the following health problems? A) Visceral pain B) Hypoalgesia C) Allodynia D) Primary hyperalgesia

C) Allodynia

Neurotrophic factors contribute to the maintenance of homeostasis in which of the following ways? A) By catalyzing the effects of neurotransmitters B) By increasing the sensitivity of receptors on postsynaptic cells C) By promoting the growth and survival of neurons D) By selectively increasing or decreasing the release of neurotransmitters

C) By promoting the growth and survival of neurons

Which of the following is the neurotransmitter for most postganglion sympathetic neurons? A) Enkephalin B) Glutamic acid C) Catecholamines D) Acetylcholine

C) Catecholamines

A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency, and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize? A) Weight loss and exercise are very important components of your treatment. B) Stopping all of your current medications, even temporarily, should provide some relief. C) It would be helpful for you to take control of your diet, sleep schedule, and stress levels. D) Your headaches are likely a result of nerve disorder and, unfortunately, cannot be treated successfully.

C) It would be helpful for you to take control of your diet, sleep schedule, and stress levels.

Which of the following statements is true of migraine headaches ?A) Non-pharmacologic treatments and lifestyle modifications can control migraines in most patients. B) Surgical treatments for migraines are indicated if pharmacologic treatments are unsuccessful. C) Migraines may have a hormonal etiology in some patients. D) Opioid analgesics achieve adequate pain control in most patients

C) Migraines may have a hormonal etiology in some patients.

A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the patients central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely be affected by this disease process? A) Oxygen metabolism B) Neurotransmitter synthesis C) Nerve conduction D) Production of cerebrospinal fluid

C) Nerve conduction

A patient with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the patient has gone into a myasthenic crisis on postoperative day one. Which of the following measures should the care team prioritize in this patients immediate care? A) Positioning the patient to minimize hypertonia and muscle rigidity B) Seizure precautions C) Respiratory support and protection of the patients airway D) Monitoring the patient for painful dyskinesias

C) Respiratory support and protection of the patients airway

A patient with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which of the following assessment components should the nurse prioritize when assessing the patients pain? A) The appearance of grimacing, guarding, or wincing B) The presence of changes in vital signs that correspond to pain C) The patients subjective report of the character and severity of pain D) The results of a detailed neurologic assessment

C) The patients subjective report of the character and severity of pain

Heart muscle differs from skeletal muscle tissue by being able to generate: A) contractions. B) calcium influx. C) action potentials. D) sarcomere binding.

C) action potentials.

The pia mater is a connective tissue sheath that covers the spinal cord and also contains: A) spinal fluid. B) fibrocartilage. C) blood vessels. D) segmental nerves.

C) blood vessels.

The patient has a traumatic complete spinal cord transection at the C5 level. Intact motor and somatosensory function will include ______ control. A) bladder B) finger flexion C) diaphragm D) trunk muscle

C) diaphragm

Primary adrenal insufficiency is manifested by: A) truncal obesity and edema. B) hypokalemia and hypervolemia. C) hyponatremia and hypoglycemia. D) hypopigmentation and hypertension.

C) hyponatremia and hypoglycemia.

In contrast to acute pain, persistent chronic pain: A) serves as a warning system. B) raises the pain threshold. C) imposes physiologic stresses. D) causes secondary reflexive spasms.

C) imposes physiologic stresses.

During ventricular systole, closure of the atrioventricular (AV) valves coincides with: A) atrial chamber filling. B) aortic valve opening. C) isovolumetric contraction. D) semilunar valves opening.

C) isovolumetric contraction.

The most common cause of thyrotoxicosis is Graves disease, which has the distinguishing characteristic of _____ in addition to a diffuse goiter. A) muscle fatigue B) facial myxedema C) ophthalmopathy D) decreased cholesterol

C) ophthalmopathy

A patient is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on: A) upper motor neurons. B) the vestibulocerebellar system. C) upper and lower motor neurons. D) neuromuscular junctions.

C) upper and lower motor neurons.

The sites of referred pain are determined by: A) intensity-coding receptors. B) location of the noxious stimuli. C) visceral embryonic development. D) stimulation that activates C fibers.

C) visceral embryonic development.

Paracrine action involves which of the following characteristics? A: Action on a distant target cell B: Autoregulation C: Action on the same cells that produced the hormone D: Action on nearby target cells

C: Action on the same cells that produced the hormone

Which of the following phenomena is thought to underlie the decreased reported incidence of some STIs? A: Increased knowledge of the correct use of condoms B: Increased public funding for health promotion activities C: Decreased reporting of cases of certain STIs D: Decreased numbers of sexual partners among young adults

C: Decreased reporting of cases of certain STIs

In comparison to children with acute otitis media (AOM), those with otitis media with effusion (OME) have: A: systemic infection. B: earache and fever. C: excess middle ear fluid. D: sensorineural hearing loss.

C: excess middle ear fluid.

A patient with a diagnosis of heart failure has returned from a visit with his primary care provider with a prescription for a change in his daily medication regimen. Which of the following drugs is likely to improve the patient's cardiac function by increasing the force and strength of ventricular contractions? A: A b-adrenergic blocker B: A diuretic C: A cardiac glycoside D: An ACE inhibitor

C: A cardiac glycoside

A college student is lamenting the fact that she has developed a cold on the weekend prior to exam week. Which of the following statements shows that the student has an accurate understanding of her upper respiratory infection? ​A: I'm just going to try to rest as much as I can until these bacteria clear up.​​ B: I think I'll go to the campus clinic and see if I can get a prescription for antibiotics C: .​​I suppose I should have been washing my hands more in the past few days.​​ D: If I can just start some antihistamines as soon as possible I bet I'll get over this faster

C: .​​I suppose I should have been washing my hands more in the past few days.​​

By definition, hypertension is systolic blood pressure of ____ mm Hg or higher or diastolic blood pressure of ____ mm Hg or higher. A: 129; 85 B: 138; 89 C: 140; 90 D: 155; 95

C: 140; 90

Which of the following assessment findings of a cardiac patient would be suggestive of cardiac tamponade? A: Increasing PaCO2 and decreasing PaO2 B: Audible crackles on chest auscultation and presence of frothy sputum C: 20 mm Hg Drop in systolic blood pressure during respiration D: Normal ECG combined with complaints of chest pain and shortness of breath

C: 20 mm Hg Drop in systolic blood pressure during respiration

A patient who is in a room at one atmosphere (760 mm Hg) is receiving supplementary oxygen therapy that is being delivered at a concentration of 50%. What is the consequent PO2? A: 38,000 mm Hg B: More data are needed C: 380 mm Hg D: 15.2 mm Hg

C: 380 mm Hg

Which of the following individuals has the highest chance of having a medulloblastoma? A: An 88-year-old man who has begun displaying signs and symptoms of increased ICP B: A 60-year-old woman who is soon to begin radiation therapy for the treatment of breast cancer C: A 4-year-old child who has become uncoordinated in recent months D: A 68-year-old man who is a smoker and has a family history of cancer

C: A 4-year-old child who has become uncoordinated in recent months

Because of its location, the presence of an abdominal aortic aneurysm may first be noticed as: A: constipation. B: indigestion C: .a pulsating mass. D: mid-abdominal pain.

C: .a pulsating mass.

Which of the following patients is likely at the greatest risk of developing a urinary tract infection? A: A pregnant woman who has been experiencing urinary frequency B: A patient with a diagnosis of chronic kidney disease who requires regular hemodialysis C: A 79-year-old patient with an indwelling catheter D: A confused, 81-year-old patient who is incontinent of urine

C: A 79-year-old patient with an indwelling catheter

Which of the following patients should most likely be assessed for orthostatic hypotension? A: A 78-year-old woman who has begun complaining of frequent headaches unrelieved by over-the- counter analgesics. B: A patient whose vision has become much less acute in recent months and who has noticed swelling in her ankles. C: An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom. D: A patient who has a history of poorly controlled type 1 diabetes.

C: An elderly patient who has experienced two falls since admission while attempting to ambulate to the bathroom.

A child's history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child? A: Cardiac catheterization and corticosteroid therapy B: Implanted pacemaker and b-adrenergic blockers C: Antibiotics and anti-inflammatories D: Pain control and oxygen therapy

C: Antibiotics and anti-inflammatories

A 33-year-old patient has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the patient's care team prioritize? A: Assessment of the patient's level of consciousness and neurologic status B: Assessment of the patient's peripheral vascular system and assessing for thromboembolism C: Assessment of the patient's vision and oculomotor function D: Cardiac monitoring and assessment of peripheral perfusion

C: Assessment of the patient's vision and oculomotor function

Prolonged immobility is implicated in the development of which of the following disorders? A: Bronchitis and bronchiectasis B: Sarcoidosis and idiopathic pulmonary fibrosis C: Atelectasis and pulmonary embolism D: Pulmonary hypertension and cor pulmonale

C: Atelectasis and pulmonary embolism

Which of the following would participate in the innate immune response to an infectious microorganism? A: T lymphocytes B: Antibodies C: B lymphocytes D: Neutrophils

C: B lymphocytes D: Neutrophils

Which of the following statements about screening for prostate cancer is most accurate? A: Digital rectal examination detects the majority of new cases of prostate cancer. B: A positive prostate-specific antigen (PSA) test is definitive for prostate cancer. C: BPH and prostatitis can confound prostate screening results. D: Digital rectal examination and PSA testing have been proven ineffective.

C: BPH and prostatitis can confound prostate screening results.

A 78-year-old female patient has been scheduled for outpatient cataract surgery. Which of the following signs and symptoms most likely prompted the patient to initially seek care? A: Unilateral redness and purulent exudate B: Eye pain coupled with photosensitivity C: Bilateral blurred vision and visual distortion D: Lack of accommodation and increased intraocular pressure

C: Bilateral blurred vision and visual distortion

Which of the following assessments is most likely to reveal a potential exacerbation in a 70-year-old patient's diagnosis of benign prostatic hyperplasia (BPH)? A: Urine testing for microalbuminuria B: Blood test for white blood cells and differential C: Bladder ultrasound D: Sperm morphology testing

C: Bladder ultrasound

Individuals with liver disease often experience the effects of excess serum ammonia as a result of impairment of the liver's ability to process ammonia. How does the liver process ammonia in healthy individuals? A: By converting it into bilirubin which is then excreted intestinally B: By processing ammonia into nitrogen and hydrogen ions for excretion C: By processing it into urea and releasing it into the circulation D: By combining it with oxygen to create ammonium oxide

C: By processing it into urea and releasing it into the circulation

Which of the following measures should a public health nurse recommend to middle-aged women to reduce their chances of developing osteoporosis later in life? A: Weight-control and daily use of low-dose corticosteroids B: Genetic testing and range of motion exercises C: Calcium supplementation and regular physical activity D: Increased fluid intake and use of vitamin D supplements

C: Calcium supplementation and regular physical activity

Which of the following factors is the primary governor of the local control of blood flow? A: Action potential B: The nutritional needs of the tissue involved C: Cardiac contractility and preload D: Feedback from arterial baroreceptors and chemoreceptors

C: Cardiac contractility and preload

An elderly male patient has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation? A: Failure to restore blood flow creates a severe risk for future transient ischemic attacks. B: Necrosis will continue unabated throughout the brain unless blood flow is restored. C: Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored. D: Unless blood flow is restored, the patient faces the risk of progressing to hemorrhagic stroke.

C: Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

Which of the following physiologic changes results in menopause? A: Changes in anterior pituitary function that alter ovarian hormone production B: Gradual resistance of ovarian target cells to LH and FSH stimulation C: Cessation of ovarian function and decreased estrogen levels D: Decreased levels of gonadotropin-releasing hormone (GnRH)

C: Cessation of ovarian function and decreased estrogen levels

A hospital patient was swabbed on admission for antibiotic-resistant organisms and has just been informed that methicillin-resistant Staphylococcus aureus (MRSA) is present in his groin. The patient has a normal core temperature and white blood cell count. This patient is experiencing which of the following? A: Infection B: Proliferation C: Colonization D: Inflammation

C: Colonization

Contact with poison ivy has resulted in intense pruritus, erythema, and weeping on a patient's forearm. Which of the following processes resulted in the patient's signs and symptoms? A: IgE-mediated mast cell degranulation B: Formation of antigen-antibody complexes C: Cytokine release by sensitized T cells D: Formation of antibodies against cell surface antigens

C: Cytokine release by sensitized T cells

A patient has just been admitted to the postsurgical unit following a below-the-knee amputation. Which of the following measures should her care team prioritize to prevent atelectasis during the patient's immediate recovery? A: Bedrest and supplementary oxygen by nasal cannula B: Administration of bronchodilators by nebulizer C: Deep-breathing exercises and early mobilization D: Adequate hydration and a high-humidity environment

C: Deep-breathing exercises and early mobilization

A patient's most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (normal range 8 to 25 mg/dL). Which of the following factors may have contributed to this finding? A: Increased salt intake B: Action of ADH C: Dehydration D: Parasympathetic nervous stimulation

C: Dehydration

Which of the following aspects of gastrointestinal function is performed by the brush border enzymes of the villus structures? A: Fat metabolism B: Vitamin A synthesis C: Digestion of carbohydrates D: Maintenance of fluid and electrolyte balance

C: Digestion of carbohydrates

Implantation of a pacemaker is most likely to benefit a patient with which of the following cardiomyopathies? A: Myocarditis B: Takotsubo cardiomyopathy C: Dilated cardiomyopathy (DCM) D: Primary restrictive cardiomyopathy

C: Dilated cardiomyopathy (DCM)

A pregnant woman who is beginning her third trimester has been diagnosed with a urinary tract infection (UTI). Which of the following factors most likely predisposed this patient to the development of a UTI? A: Increased urine alkalinity during pregnancy B: Hypertrophy of the bladder wall C: Dilation of the upper urinary structures D: Spastic peristalsis of the ureters

C: Dilation of the upper urinary structures

A public health nurse should recognize that sexually transmitted infections (STIs) are typically spread by which of the following mechanisms? A: Penetration B: Vertical transmission C: Direct contact D: Ingestion

C: Direct contact

Which of the following acute respiratory infections in children poses the greatest threat of severe hypoxia caused by inflammatory edema? A: Croup B: Asthma C: Epiglottitis D: Bronchiolitis

C: Epiglottitis

Which of the following respiratory infections in children is associated with the poorest outcomes? A: Viral croup B: Rhinosinusitis C: Epiglottitis D: Spasmodic croup

C: Epiglottitis

A 9-month-old infant has been diagnosed with botulism after he was fed honey. The child's mother was prompted to seek care because of this child's sudden onset of neuromuscular deficits, which were later attributed to the release of substances by Clostridium botulinum bacteria. Which virulence factor contributed to this child's illness? A: Endotoxins B: Adhesion factors C: Exotoxins D: Evasive factors

C: Exotoxins

A 70-year-old female patient has had her mobility and independence significantly reduced by rheumatoid arthritis. Which of the following processes likely contributed to the development of her health problem? A: Delayed-type hypersensitivity (DTH) reaction B: Proliferation of cytotoxic T cells C: Failure of normal self-tolerance D: Deletion of autoreactive B cells

C: Failure of normal self-tolerance

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to ​an enlarged heart.​ Which of the following disorders was the player's most likely cause of death? A: Takotsubo cardiomyopathy B: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) C: Hypertrophic cardiomyopathy (HCM) D: Dilated cardiomyopathy (DCM)

C: Hypertrophic cardiomyopathy (HCM)

The nurse is providing care for a patient who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this patient's diagnosis? A: Metabolic alkalosis B: Hypophosphatemia C: Hypocalcemia D: Hypokalemia

C: Hypocalcemia

An adult patient has been diagnosed with polycystic kidney disease. Which of the patient's following statements demonstrates an accurate understanding of this diagnosis? ​A: I suppose I really should have paid more attention to my blood pressure. B: ​​I've always been prone to getting UTIs, and now I know why.​​ C: I suppose I should be tested to see if my children might inherit this.​​ D: I had a feeling that I was taking too many medications, and now I know the damage they can do.​

C: I suppose I should be tested to see if my children might inherit this.​​

A 52-year-old man who is moderately obese has recently been diagnosed with hypertension by his primary care provider. Which of the patient's following statements indicates a need for further health- promotion teaching? ​A: I've starting going to the gym before work three times a week. B: ​​I'm trying to cut back on the amount of salt that I cook with and add to my food.​ ​ C: I'm resolving to eat organic foods from now on and to drink a lot more water.​ D: ​I'm planning to lose 15 pounds before the end of this year.​

C: I'm resolving to eat organic foods from now on and to drink a lot more water.​

A predominant effect of a prolonged excessive growth hormone level is: A: short stature with obesity. B: high androgen hormone levels C: Increased blood glucose levels. D: insulin-like growth factor (IGF) depletion

C: Increased blood glucose levels.

The most recent blood work of a patient with a diagnosis of heart failure indicates increased levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). What are the most likely effects of these peptides on the patient's physiology? A: Water retention B: Increased tubular sodium reabsorption C: Inhibition of the renin-angiotensin-aldosterone system D: Sympathetic nervous stimulation

C: Inhibition of the renin-angiotensin-aldosterone system

Which of the following disorders of the male genitourinary system creates the most urgent need for prompt and aggressive medical treatment? A: Spermatocele B: Benign prostatic hyperplasia (BPH) C: Intravaginal testicular torsion D: Erectile dysfunction

C: Intravaginal testicular torsion

A patient's emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient's most likely diagnosis? A: Status epilepticus B: Subarachnoid hemorrhage C: Ischemic stroke D: Encephalitis

C: Ischemic stroke

Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male patient? A: Presence of purulent, whitish discharge from the penis B:Emergence of hard, painless nodules on the shaft of the penis C: Itching, pain, and the emergence of pustules on the penis D: Production of cloudy, foul-smelling urine

C: Itching, pain, and the emergence of pustules on the penis

Because cholesterol is insoluble in plasma, it is mainly carried by the lipoprotein: A: IDL. B: HDL. C: LDL. D: VLDL.

C: LDL.

Which of the following statements is true of colorectal cancer? A: Aspirin and NSAIDs are implicated in the etiology. B: It is one of the few cancers that is known to sometimes have an infectious etiology. C: Most cases are quite advanced before symptoms become apparent. D: Survival rates for colorectal cancer are less than 20%, but are increasing.

C: Most cases are quite advanced before symptoms become apparent.

A patient who developed a deep vein thrombosis during a prolonged period of bedrest has deteriorated as the clot has dislodged and resulted in a pulmonary embolism. Which of the following types of shock is this patient at risk of experiencing? A: Cardiogenic shock B: Hypovolemic shock C: Obstructive shock D: Distributive shock

C: Obstructive shock

How are the oxygenation needs of the articulating areas in a synovial joint met? A: Capillaries release oxygenated blood into the synovial cavity at a controlled rate. B: The cartilage of the articulating areas uses anaerobic metabolism exclusively. C: Oxygen is provided to the articulating areas by synovial fluid rather than by blood. D: The epiphyses of long bones provide oxygen to the articulating areas.

C: Oxygen is provided to the articulating areas by synovial fluid rather than by blood.

Which of the following disorders of the female genitourinary system is most likely to result from a disruption in normal endocrine function? A: Ovarian cancer B: Pelvic inflammatory disease (PID) C: Polycystic ovary syndrome (PCOS) D: Cervicitis

C: Polycystic ovary syndrome (PCOS)

Which of the following statement best describes the relationship between the hypothalamus and the posterior pituitary in the normal functioning of the endocrine system? A: Posterior pituitary hormones are constituted from components of both the hypothalamus and the pituitary gland itself. B: The posterior pituitary gland regulates the release of hypothalamic hormones. C: Posterior pituitary hormones are produced in the hypothalamus but released from the pituitary gland. D: The hypothalamus regulates the production and release of posterior pituitary hormones by the pituitary gland.

C: Posterior pituitary hormones are produced in the hypothalamus but released from the pituitary gland.

Harmful effects on cardiac action potential are most likely to result from a deficit of which of the following electrolytes? A: Magnesium (Mg2+) B: Chloride (Cl-) C: Potassium (K+) D: Hydrogen carbonate (HCO3)

C: Potassium (K+)

A patient has been experiencing increasing fatigue in recent months, a trend that has prompted an echocardiogram. Results of this diagnostic test suggest that the patient's end-diastolic volume is insufficient. Which of the following parameters of cardiac performance will directly decrease as a result of this? A: Inotropy B: Cardiac contractility C: Preload D: Afterload

C: Preload

With aging, progressive inelasticity and thickening of the lens causes which accommodation disorder? A: Cataracts B: Hyperopia C: Presbyopia D: Astigmatism

C: Presbyopia

A patient with a diagnosis of small cell lung carcinoma has developed bone metastases, a finding that has prompted a series of new interventions. What are the primary goals of the treatment regimen for this patient's bone cancer? A: Prevention of brain metastasis and early identification of osteonecrosis B: Promotion of bone remodeling at tumor sites through calcium and vitamin D supplements C: Prevention of pathologic fractures and maximization of function D: Pain management and prevention of osteomyelitis

C: Prevention of pathologic fractures and maximization of function

Which of the following physiologic processes is caused by estrogens? A: Increased release of gonadotropin-releasing hormone (GnRH) B: Stimulation of lactation in the postpartum period C: Promotion of ovarian follicle growth D: Progesterone synthesis

C: Promotion of ovarian follicle growth

Which of the following physiologic processes contributes most to the long-term regulation of blood pressure? A: Actions of the renin-angiotensin-aldosterone system B: Release of antidiuretic hormone (vasopressin) by the posterior pituitary C: Renal monitoring and adjustment of extracellular fluid volume D: Integration and modulation of autonomic nervous system (ANS)

C: Renal monitoring and adjustment of extracellular fluid volume

Pelvic inflammatory disease, an inflammation of the female upper reproductive tract, is caused by: A: chronic endometriosis. B: ruptured tubal pregnancy. C: STD polymicrobial infection. D: serous luteal ovarian cysts.

C: STD polymicrobial infection.

A patient has experienced a bout of coughing after aspirating some of his secretions. The patient's coughing was triggered by which of the following? A: Sudden ventilation-perfusion mismatch B: Sudden rise in PCO2 C: Signals from receptors in the tracheobronchial wall D: Signals from central chemoreceptors

C: Signals from receptors in the tracheobronchial wall

Which of the following types of lung cancer is associated with the best prognosis in the majority of patients? A: Small cell lung cancer B: Adenocarcinoma C: Squamous cell carcinoma D: Large cell carcinoma

C: Squamous cell carcinoma

A patient with a long-standing diagnosis of Crohn disease has developed a perianal abscess. Which of the following treatments will this patient most likely require? A: Antiviral therapy B: Antibiotic therapy C: Surgical draining D: Pressure dressing

C: Surgical draining

A patient with a diagnosis of cirrhosis has experienced an acute rejection of a donor liver. Which of the following cells is central to the rejection of the patient's transplanted organ? A: Natural Killer cells B: Mast cells C: T cells D: Neutrophils

C: T cells

The red eyes of bacterial conjunctivitis are accompanied by ________, which differentiates it from the red eyes of acute glaucoma. A: mydriasis and headaches B: blurred or iridescent vision C: tearing, itching and burning D: cloudy, painful corneas

C: tearing, itching and burning

An elderly female patient has been hospitalized for the treatment of acute pyelonephritis. Which of the following characteristics of the patient is most likely implicated in the etiology of her current health problem? A: The patient was diagnosed with type 2 diabetes several years earlier. B: The patient takes a diuretic and an ACE inhibitor each day for the treatment of hypertension. C: The patient recently had a urinary tract infection. D: The patient has peripheral vascular disease.

C: The patient recently had a urinary tract infection.

Which of the following assessment findings of a male patient constitutes a criterion for a diagnosis of metabolic syndrome? A: The patient states that he does less than 30 minutes of strenuous physical activity each week. B: The patient's resting heart rate is typically 85 to 95 beats per minute. C: The patient's blood pressure is consistently in the range of 140/90 mm Hg. D: The patient has a family history of type 2 diabetes.

C: The patient's blood pressure is consistently in the range of 140/90 mm Hg.

A patient with longstanding type 2 diabetes is surprised at his high blood sugar readings while recovering from an emergency surgery. Which of the following factors may have contributed to the patient's inordinately elevated blood glucose levels? A: The tissue trauma of surgery resulted in gluconeogenesis. B: Illness inhibited the release and uptake of glucagon. C: The stress of the event caused the release of cortisol. D: Sleep disruption in the hospital precipitated the dawn effect.

C: The stress of the event caused the release of cortisol.

A patient's exposure to an antibiotic-resistant microorganism while in the hospital has initiated an immune response, a process that is mediated and regulated by cytokines. Which of the following statements is true of cytokines? A: They are stored in the peripheral lymphoid tissues until required. B: They have a long half-life that contributes to an ongoing immune response. C: They are normally released at cell-to-cell interfaces, binding to specific receptors .D: They are capable of performing phagocytosis in the response to viral invasion.

C: They are normally released at cell-to-cell interfaces, binding to specific receptors

Which of the following factors constitutes the most significant risk for balanitis xerotica obliterans? A: Multiple sexual partners B: Androgen deficiency C: Uncircumcised penis D: Chronic prostatitis

C: Uncircumcised penis

Which of the following components of glomerular filtrate can cross the tubular epithelial cell membrane passively? A: Sodium B: Potassium C: Urea D: Glucose

C: Urea

An obese, male patient with a history of gout and a sedentary lifestyle has been advised by his primary care provider to avoid organ meats, certain fish, and other foods that are high in purines. The care provider is demonstrating an awareness of the patient's susceptibility to which of the following types of kidney stones? A: Calcium stones B: Magnesium ammonium phosphate stones C: Uric acid stones D: Cystine stones

C: Uric acid stones

A male patient with a history of angina has presented to the emergency department with uncharacteristic chest pain and his subsequent ECG reveals T-wave elevation. This finding suggests an abnormality with which of the following aspects of the cardiac cycle? A: Atrial depolarization B: Ventricular depolarization C: Ventricular repolarization D: Depolarization of the AV node, bundle branches, and Purkinje system

C: Ventricular repolarization

A patient with persistent, primary hypertension remains apathetic about his high blood pressure, stating, ​I don't feel sick, and it doesn't seem to be causing me any problems that I can tell.​ How could a clinician best respond to this patient's statement? ​A: Actually, high blood pressure makes you very susceptible to getting diabetes in the future.​ ​ B: That's true, but it's an indicator that you're not taking very good care of yourself.​​ C: You may not sense any problems, but it really increases your risk of heart disease and stroke.​ ​ D: You're right, but it's still worthwhile to monitor it in case you do develop problems.​

C: You may not sense any problems, but it really increases your risk of heart disease and stroke.​ ​

In adults, sudden death from an acute myocardial infarction is usually caused by: A: acute myocarditis B: high troponin levels. C: acute ventricular arrhythmia. D: hypertrophic cardiomyopathy.

C: acute ventricular arrhythmia.

Glomerulonephritis is usually caused by: A: vesicoureteral reflux. B: catheter-induced infection. C: antigen-antibody complexes. D: glomerular membrane viruses.

C: antigen-antibody complexes.

The patient has right upper quadrant pain caused by acute choledocholithiasis. If the common bile duct becomes obstructed, manifestations will also include: A: ascites. B: vomiting. C: bilirubinuria. D: hemorrhage.

C: bilirubinuria.

In aortic regurgitation, failure of aortic valve closure during diastole causes an abnormal drop in diastolic pressure. This change in pressure causes decreased: A: stroke volume B: left ventricular size. C: coronary perfusion. D: arterial pulse pressure.

C: coronary perfusion.

The primary care provider for a newly admitted hospital patient has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The patient's GFR will be extrapolated from serum levels of: A: urea. B: protein. C: creatinine. D: myoglobin

C: creatinine.

Osteoarthritis is a degenerative form of joint disease that is often evidenced by: A: spongy joints. B: cartilage hypertrophy. C: crepitus and grinding. D: systemic inflammation.

C: crepitus and grinding.

A large increase in heart rate can cause: A: increased blood viscosity. B: loss of action potential. C: decreased stroke volume. D: reduced cardiac contractility.

C: decreased stroke volume.

Factors that may adversely affect bone healing include______ of the bone. A: immobilization B: weight bearing C: delayed union D: tight alignment

C: delayed union

Dysfunction of the _____ muscle contraction can disrupt the ability to expel urine from the bladder. A: trigone B: sphincter C: detrusor D: trabeculae

C: detrusor

Regardless of the cause, chronic kidney disease results in progressive permanent loss of nephrons, glomerular filtration and renal: A: tubule dysplasia. B: vascular pressure. C: endocrine functions. D: hypophosphatemia.

C: endocrine functions.

When the kidneys have decreased perfusion or increased sympathetic nervous system stimulation, renal blood flow goes mainly to the medulla in order to decrease ______ while maintaining the ______ of urine. A: pressure; adequate output B: electrolyte loss; acidic pH C: filtration rate; concentration D: buffer loss; glucose level

C: filtration rate; concentration

Factors that contribute to the formation of gallstones, or acute cholelithiasis, include: A: chronic pancreatitis. B: rapid elimination of bile. C: gallbladder inflammation. B: excessive alcohol intake.

C: gallbladder inflammation.

The major cause of acute prostatitis is: A: prostate hyperplasia. B: acute pyelonephritis. C: gram negative D: mucous gland overgrowth. E: coli.

C: gram negative

Carcinoma of the cervix is often considered to be a sexually transmitted disease associated with_____ viral infection. A: Chlamydia trachomatis B: herpes simplex C: human papilloma D: varicella zoster

C: human papilloma

Release and synthesis of anterior pituitary hormones are mainly regulated by the inhibiting or releasing actions of the: A: cell receptors. B: thymus gland. C: hypothalamus. D: adrenal gland.

C: hypothalamus.

During accommodation, pupillary dilation partially compensates for the reduced size of the retinal image by: A: thickening the lens. B: contracting the ciliary muscle. C: increasing light entering the pupil. D: narrowing the palpebral opening.

C: increasing light entering the pupil.

A patient had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute: A: prerenal inflammation. B: bladder outlet obstruction. C: ischemic tubular necrosis. D: intrarenal nephrotoxicity.

C: ischemic tubular necrosis.

The adverse effects of emboli on the pulmonary circulation and airways include: A: excess surfactant. B: area bronchodilation. C: local vasoconstriction D: .lower lobe consolidation.

C: local vasoconstriction

Lung compliance is a measure of the change in ________that occurs with a change in intrapulmonary pressure. A: elastic recoil B: surface tension C: lung volume D: vital capacity

C: lung volume

Increased upper airway resistance and decreased airflow into the lungs in neonates (0 to 4 weeks of age) can result from: A: frequent crying. B: sleeping supine. C: nasal congestion. D: productive coughing.

C: nasal congestion.

A child with a diagnosis of Legg-Calvé-Perthes disease will exhibit: A: defective synthesis of type I collagen. B: congenital dislocation of the acetabulofemoral joint. C: necrosis of the proximal femoral head. D: intoeing due to metatarsus adductus.

C: necrosis of the proximal femoral head.

A major factor in the development of hepatic encephalopathy is: A: hypersplenism. B: high sodium level. C: neurotoxin accumulation. D: steroid hormone deficiency.

C: neurotoxin accumulation.

Smooth muscle relaxation and shunting of blood into the sinusoids is mediated by _______ and results in a penile erection. A: norepinephrine B: nitroglycerine C: nitric oxide D: nicotinic acid

C: nitric oxide

Because dermatophytes are capable of growing _________, the infection is mainly found on cutaneous surfaces of the body. A: a powdery colony B: in moist skin folds C: on cooler tissues D: branching filaments

C: on cooler tissues

The clinical course of osteoarthritis (OA) culminates in: A: osteonecrosis and loss of synovial fluid. B: formation of tophi in the synovial space. C: osteophyte formation and erosion of cartilage. D: separation of the epiphyseal plate.

C: osteophyte formation and erosion of cartilage.

The major manifestations of Cushing syndrome include: A: excessive salt loss. B: muscle hypertrophy. C: overt diabetes mellitus. D: hair and weight loss.

C: overt diabetes mellitus.

Kupffer cells function as ______ to remove harmful substances or cells from the portal blood as it moves through the venous sinusoids. A: filters B: channels C: phagocytes D: cytotoxic cells

C: phagocytes

The late manifestations of cirrhosis are related to liver failure and: A: hepatomegaly. B: diffuse liver fibrosis. C: portal hypertension D: hepatorenal syndrome.

C: portal hypertension

As part of maintaining homeostasis, hormones secreted by endocrine cells are inactivated continuously to: A: free receptor sites. B: stimulate production. C: prevent accumulation. D: absorb metabolic waste.

C: prevent accumulation.

As a result of hypoxemia and polycythemia, persons with chronic obstructive bronchitis are prone to: A: breakdown of elastin. B: left-sided heart failure. C: pulmonary hypertension. D: expiratory airway collapse.

C: pulmonary hypertension.

The tendons and ligaments of the joint capsule are sensitive to position and movement as a result of having _______ to help maintain muscle support. A: autonomic nerve fibers B: supporting bursa sacs C: reflexive proprioception D: elastic articular cartilage

C: reflexive proprioception

The joint capsule consists of an outer fibrous layer and an inner synovium, which ______ to facilitate movement. A: senses position B: connects to tendons C: secretes synovial fluid D: covers articular cartilage

C: secretes synovial fluid

The tissue factor that contributes to humoral control of blood flow by causing vasoconstriction is: A: histamine B: .bradykinin. C: serotonin. D: nitric oxide.

C: serotonin.

The intestinal absorption of glucose and amino acids is facilitated by a ________ transport system. A: bile-salt micelles B: fat emulsification C: sodium-dependent D: brush border enzyme

C: sodium-dependent

A 30-year-old man has been diagnosed with mumps orchitis, a disease that has the potential to result in: A: hematuria. B: hematocele. C: sterility. D: penile atrophy

C: sterility.

Hormones are usually divided into four categories according to their: A: function. B: precursor. C: structure. D: receptor.

C: structure.

Congenital heart defects can cause a right heart to left heart shunting of blood that results in increased: A: pulmonary blood volume. B: right ventricle workload. C: unoxygenated blood flow. D: right atrial blood volume.

C: unoxygenated blood flow.

Men older than age 50 are at high risk for prostatic hypertrophy with complications that include: A: hypospadias. B: scrotal edema. C: urine retention. D: testicular cancer.

C: urine retention.

The parasympathetic nervous system causes a slowing of the heart rate by increasing: A: norepinephrine. B: vessel constriction. C: vagus nerve activity. D: smooth muscle tone.

C: vagus nerve activity.

A patient with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The patient's psychomotor deficits are likely the result of: A: Alzheimer disease. B: frontotemporal dementia (FTD). C: vascular dementia. D: Wernicke-Korsakoff syndrome.

C: vascular dementia.

A patient who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? A) Cerebellar dystaxia B) Cerebellar tremor C) A lower motor neuron lesion D) A vestibulocerebellar disorder

D) A vestibulocerebellar disorder

Pain assessment is likely to be most challenging when providing care for which of the following older adult patients? A) A 90-year-old patient who takes multiple medications for cardiac and respiratory conditions B) A 77-year-old man who has sustained burns on the lower part of his body C) An 82-year-old woman who has been diagnosed with diabetes and an anxiety disorder D) An 87-year-old man with vascular dementia and numerous other health problems

D) An 87-year-old man with vascular dementia and numerous other health problems

A postsurgical patient's complaints of calf pain combined with the emergence of swelling and redness in the area have culminated in a diagnosis of deep vein thrombosis. What treatment options will be of greatest benefit to this patient? A) Analgesics and use of a pneumatic compression device B) Massage followed by vascular surgery C) Frequent ambulation and the use of compression stockings D) Anticoagulation therapy and elevation of the leg

D) Anticoagulation therapy and elevation of the leg

A patient with a diagnosis of epilepsy has required surgical removal of part of her prefrontal cortex. Which of the following effects should her family and care team anticipate? A) Lapses in balance and coordination B) Deficits in regulation of the endocrine system C) Sensory losses D) Changes in behavior and judgment

D) Changes in behavior and judgment

Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing? A) Impaired sensory perception and frequent wounds B) Spasticity and hypertonic reflexes C) Muscle atrophy with decreased coordination D) Frequent falls and increased muscle size

D) Frequent falls and increased muscle size

A hospital patient has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the patient reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the patients concern? A) You might become addicted, but there are excellent resources available in the hospital to deal with that development. B) You should likely prioritize the control of your pain over any fears of addiction that you have. C) If you start needing higher doses to control your pain, then well address those concerns. D) Theres only a minute chance that you will become addicted to these painkillers.

D) Theres only a minute chance that you will become addicted to these painkillers.

Which of the following characteristics differentiates a migraine with aura from a migraine without aura? A) Gastrointestinal involvement in the hours leading up to the headache B) A decrease in mood and affect prior to the headache C) Lack of response to non-pharmacologic treatments D) Visual symptoms that precede the headache

D) Visual symptoms that precede the headache

Which of the following processes is most likely to occur as a result of a spinal reflex? A) Peristalsis of the small and large bowel B) Control of oculomotor function in changing light levels C) Pain sensation from a potentially damaging knee movement D) Withdrawal of a hand from a hot stove element

D) Withdrawal of a hand from a hot stove element

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of: A) periorbital muscles. B) thymus gland cells. C) skeletal muscle fibers. D) acetylcholine receptors.

D) acetylcholine receptors.

Neurons are characterized by the ability to communicate with other neurons and body cells through: A) astrocytes. B) axon hillocks. C) nodes of Ranvier. D) action potentials.

D) action potentials.

In contrast to osteoporosis, osteomalacia causes _______ without the loss of bone matrix. A) stress fractures B) calcium excretion C) bone cortex thinning D) defective mineralization

D) defective mineralization

Complex regional pain syndrome is characterized by: A) repetitious dermatome pain attacks. B) trigeminal neuralgia with facial tics. C) severe limb pain after amputation D) disproportionate pain with mobility.

D) disproportionate pain with mobility.

Testicular torsion, a serious disorder affecting young male individuals, causes: A) inguinal herniation. B) cancer of the scrotum. C) dartos muscle atrophy. D) loss of testicular perfusion.

D) loss of testicular perfusion.

A patient has wrist inflammation causing compression of the median nerve in the carpal tunnel. Manifestations of this syndrome include: A) little finger numbness. B) forearm paresthesia. C) loss of tendon reflexes. D) precision grip weakness.

D) precision grip weakness.

Chemical synapses rely on ____ in order to provide communication between neurons. A) diffusion B) gap junctions C) satellite cells D) transmitter molecules

D) transmitter molecules

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by: A) severe spinal shock. B) tachycardia and pale skin. C) lack of sweat above injury level. D) vasospasms and hypertension.

D) vasospasms and hypertension.

A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours. Vomiting results from stimulation of what site in the neurologic system? A: Myenteric plexus B: Intramural plexus C: Vagus nerve D: Chemoreceptor trigger zone

D: Chemoreceptor trigger zone

A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is: A: chancroid. B: candidiasis. C: Trichomonas vaginalis. D: Chlamydia

D: Chlamydia

While in its dormant state, herpes simplex virus resides and replicates in the: A: local lymph nodes. B: subcutaneous tissue. C: mucous membrane. D: dorsal root ganglia.

D: dorsal root ganglia.

Completion of a patient's pulmonary function study has yielded the following data: tidal volume: 500 mL; inspiratory reserve: 3100 mL; expiratory reserve: 1200 mL; residual volume: 1200 mL; functional residual capacity: 2400 mL. What is this patient's inspiratory capacity? A: 5500 mL B: 2600 mL C: More data are needed D: 3600 mL

D: 3600 mL

Bile and pancreatic juices enter the ______ through the common bile duct and the pancreatic duct. A: ileum B: antrum C: jejunum D: duodenum

D: duodenum

A patient with a long history of ​hay fever​ has recently begun a series of immunotherapy (allergy shots). How will this treatment potentially achieve a therapeutic effect? A: By blocking cytokine release from sensitized mast cells B: By preventing mast cells from becoming sensitized C: By causing T cells to be sequestered in the thymus for longer periods D: By stimulating production of IgG to combine with antigens

D: By stimulating production of IgG to combine with antigens

A serum marker for systemic inflammation, _______, is now considered a major risk factor marker for atherosclerosis, and vascular disease. A: leukocytosis B: homocysteine C: serum lipoprotein D: C-reactive protein

D: C-reactive protein

The earliest signs of decreased level of consciousness include: A: stupor. B: lethargy. C: delirium D: .inattention.

D: .inattention.

n elderly woman has been diagnosed with macular degeneration following a visit to an ophthalmologist. Which of the woman's following statements best demonstrates an accurate understanding of her new diagnosis? ​A: I suppose this goes to show that I should have controlled my blood pressure better.​ B: ​I think this is something that I might have caught from my husband.​​ C: My friend had this problem and a transplant did wonders for her vision D: .​​I suppose that this might be one of those things that happens when you get older.​

D: .​​I suppose that this might be one of those things that happens when you get older.​

Which of the following individuals is most clearly in need of diagnostic testing for lung cancer? A: A patient who has required hospitalization with a fever and the production of copious lung secretions B: A patient with a history of secondary tuberculosis who failed to complete his prescribed course of antibiotics C: A woman who complains of recurrent lower respiratory infections and who has sought care for increasing shortness of breath D: A man who demonstrates wasting of the pelvic and shoulder muscles combined with signs of hypercalcemia

D: A man who demonstrates wasting of the pelvic and shoulder muscles combined with signs of hypercalcemia

Which of the following individuals is experiencing the effects of a primary endocrine disorder? A: A patient with adrenal cortical insufficiency due to pituitary hyposecretion of ACTH B: A patient who has hypothyroidism as a result of low TSH production C: A patient whose dysfunctional hypothalamus has resulted in endocrine imbalances D: A patient who has low calcium levels because of the loss of his parathyroid gland

D: A patient who has low calcium levels because of the loss of his parathyroid gland

Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes? A: A patient who was diagnosed with placenta previa early in her pregnancy. B: A patient who is gravida five (in her fifth pregnancy) C: A patient who has hypertension and elevated triglycerides D: A patient who is morbidly obese

D: A patient who is morbidly obese

Which of the following patients likely faces the greatest risk of a gastrointestinal bleed? A: A man whose hypertension requires him to take a diuretic, an ACE inhibitor, and a b-adrenergic blocker B: A patient who is taking a broad-spectrum antibiotic to treat a urinary tract infection C: A patient with a history of anxiety who takes benzodiazepines several times daily D: A patient who takes aspirin with each meal to control symptoms of osteoarthritis

D: A patient who takes aspirin with each meal to control symptoms of osteoarthritis

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease? A: A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage B: A patient whose diagnosis of thyroid cancer necessitated a thyroidectomy C: A patient who experienced a hemorrhagic stroke and now has sensory and motor deficits D: A patient with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

D: A patient with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol- releasing hormone (CRH) and: A: GH B: TSH C: DHEA D: ACTH

D: ACTH

HIV-positive persons that display manifestations of laboratory category 3 or clinical category C are considered to have: A: zero viral load. B: seroconversion. C: complete remission. D: AIDS-defining illnesses.

D: AIDS-defining illnesses.

Cyclic adenosine monophosphate (cAMP) performs which of the following roles in the functioning of the endocrine system? A: Mediating hormone synthesis by non​vesicle-mediated pathways B: Acting as a high-affinity receptor on the surface of target cells C: Inactivating hormones to prevent excess accumulation D: Acting as a second messenger to mediate hormone action on target cells

D: Acting as a second messenger to mediate hormone action on target cells

A long bone, such as the humerus of the upper arm, has which of the following structural characteristics? A: A perichondrium that overlies most of the bone surface B: A durable outer shell made of cancellous bone C: A diaphysis at each end D: An endosteum composed of osteogenic cells

D: An endosteum composed of osteogenic cells

The nurse who is providing care for a patient with pancreatic cancer should prioritize which of the following assessments? A: Assessment for ascites and close monitoring of fluid balance B: Respiratory assessment and monitoring of arterial blood gases C: Vigilant monitoring of blood glucose levels D: Assessment for deep vein thrombosis

D: Assessment for deep vein thrombosis

A patient has been admitted to the hospital for the treatment of HIV infection, which has recently progressed to overt AIDS. Which of the following nursing actions should the nurse prioritize when providing care for this patient? A: Frequent neurologic vital signs and thorough skin care B: Hemodynamic monitoring and physical therapy C: Careful monitoring of fluid balance and neurologic status D: Astute infection control and respiratory assessments

D: Astute infection control and respiratory assessments

Following several weeks of increasing fatigue and a subsequent diagnostic work-up, a patient has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which of the following consequences? A: Backup of blood from the right atrium into the superior vena cava B: Backflow from the right ventricle to the right atrium during systole C: Inhibition of the SA node's normal action potential D: Backflow from the left ventricle to left atrium

D: Backflow from the left ventricle to left atrium

A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone therapy. What is the goal of this pharmacologic treatment? A: Blocking the effects of progesterone on tumor growth B: Increasing serum hormone levels to promote tumor cell lysis C: Blocking the entry of malignant cells into the axillary lymph nodes D: Blocking receptors on the surface of malignant cells

D: Blocking receptors on the surface of malignant cells

Persistent cyanosis has led an infant's care team to suspect a congenital heart defect. Which of the following assessment findings would suggest coarctation of the infant's aorta? A: The child has a split S2 heart sound on auscultation. B: ECG reveals atrial fibrillation. C: The child experiences apneic spells after feeding. D: Blood pressure in the child's legs is lower than in the arms

D: Blood pressure in the child's legs is lower than in the arms

A patient with a longstanding diagnosis of chronic kidney disease has been experiencing increasing fatigue, lethargy, and activity intolerance in recent weeks. His care team has established that his GFR remains at a low, but stable, level. Which of the following assessments is most likely to inform a differential diagnosis? A: Blood work for white cells and differential B: Cystoscopy and ureteroscopy C: Assessment of pancreatic exocrine and endocrine function D: Blood work for hemoglobin, red blood cells, and hematocrit

D: Blood work for hemoglobin, red blood cells, and hematocrit

A patient with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the patient appears confused and is oriented to person and place but not time. What type of seizure did this patient most likely experience? A: Simple partial seizure B: Atonic seizure C: Myoclonic seizure D: Complex partial seizure

D: Complex partial seizure

A respiratory therapist has asked a patient to breathe in as deeply as possible during a pulmonary function test. Inspiration is normally the result of which of the following phenomena? A: Decreased intrapulmonary pressure B: Increased airway pressure C: Increased intrapleural pressure D: Decreased intrathoracic pressure

D: Decreased intrathoracic pressure

Which of the following events is associated with the primary stage of syphilis? A: Development of gummas B: Development of central nervous system lesions C: Palmar rash D: Genital chancres

D: Genital chancres

Which test provides a way to monitor fluctuations of blood glucose levels over the previous 6 to 12 weeks? A: Glucose tolerance test B: Fasting blood glucose C: Capillary blood glucose D: Glycosylated hemoglobin

D: Glycosylated hemoglobin

Release of which of the following humoral factors will result in vasodilation? A: Norepinephrine B: Angiotensin II C: Serotonin D: Histamine

D: Histamine

Which of the following manifestations typically accompanies an asthmatic attack? A: Decreased residual volume B: Decreased pulmonary arterial pressure C: Prolonged inspiration D: Hyperinflation of the lungs

D: Hyperinflation of the lungs

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the patient's statements suggests that he understands his new diagnosis? ​A: I guess I'm an example of why you should always use condoms.​​ B: I'm embarrassed that I'll be a carrier of hepatitis from now on.​​ C: I'm still trying to deal with the fact that this will forever change my life.​ ​ D: I don't know why I didn't bother to get vaccinated against this.​

D: I don't know why I didn't bother to get vaccinated against this.​

A nurse is performing patient health education with a 68-year-old man who has recently been diagnosed with heart failure. Which of the following statements demonstrates an accurate understanding of his new diagnosis? ​A: I'll be sure to take my beta blocker whenever I feel short of breath. B: ​​I'm going to avoid as much physical activity as I can so that I preserve my strength.​​ C: I know it's healthy to drink a lot of water, and I'm going to make sure I do this from now on.​ ​ D: I'm trying to think of ways that I can cut down the amount of salt that I usually eat.​

D: I'm trying to think of ways that I can cut down the amount of salt that I usually eat.​

A patient has been diagnosed with cholecystitis (gall bladder inflammation) that has impaired the normal release of bile. Which of the following gastrointestinal consequences is this patient likely to experience? A: Incomplete digestion of starches B: Impaired glucose metabolism C: Inadequate gastric acid production D: Impaired digestion of fats

D: Impaired digestion of fats

Parasympathetic stimulation results in which of the following gastrointestinal effects? A: Increase in smooth muscle tone B: Enhancement of sphincter function C: Decrease in gastrointestinal motility D: Increase in enteric nervous system activity

D: Increase in enteric nervous system activity

A patient with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which of the following physiologic phenomena will occur as a consequence of hypoxemia? A: Peripheral vasodilation B: Necrosis C: Hypoventilation D: Increased heart rate

D: Increased heart rate

Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type? A: Larger volume of diarrhea B: Electrolyte imbalances C: Absence of blood in the stool D: Infection of intestinal cells

D: Infection of intestinal cells

Which of the following pathophysiologic processes occurs in cases of bacterial meningitis? A: Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia. B: Trauma introduces skin-borne pathogens to the cerebrospinal fluid. C: Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits. D: Inflammation allows pathogens to cross into the cerebrospinal fluid.

D: Inflammation allows pathogens to cross into the cerebrospinal fluid.

A patient has begun taking acyclovir, an antiviral medication, to control herpes simplex outbreaks. What is this drug's mechanism of action? A: Inhibition of viral adhesion to cells B: Elimination of exotoxin production C: Antagonism of somatic cell binding sites D: Interference with viral replication processes

D: Interference with viral replication processes

A patient's primary care provider has ordered direct antigen detection in the care of a patient with a serious symptomatology of unknown origin. Which of the following processes will be conducted? A: Detecting DNA sequences that are unique to the suspected pathogen B: Growth of biofilms on various media in the laboratory setting C: Quantification of IgG and IgM antibodies in the patient's blood D: Introduction of monoclonal antibodies to a blood sample from the patient

D: Introduction of monoclonal antibodies to a blood sample from the patient

A basketball player fell awkwardly when attempting to claim a rebound, a mishap that resulted in a tear to the anterior cruciate ligament of his left knee. What characteristic of ligaments makes them particularly susceptible to injury? A: Ligaments are incapable of accommodating lateral movement. B: Ligaments are exclusive to the knee, which is the most frequently injured joint. C: Ligaments are superficial to the synovial capsule and are consequently vulnerable to impacts. D: Ligaments are incapable of stretching when exposed to unusual stress.

D: Ligaments are incapable of stretching when exposed to unusual stress.

Which of the following STIs is most likely to respond to treatment with the antibiotics tetracycline or doxycycline? A: Human papillomavirus (HPV) infection B: Herpes simplex virus type 2 (HSV-2) infection C: Candidiasis D: Lymphogranuloma venereum (LGV)

D: Lymphogranuloma venereum (LGV)

Bacteria on a sliver in a boy's finger have initiated an adaptive immune response. The boy's lymphocytes and antibodies recognize immunologically active sites on the bacterial surfaces known as: A: Toll-like receptors. B: opsonins. C: chemokines. D: epitopes

D: epitopes

A nurse is conducting a healthy living workshop to a group of younger women. Which of the following screening recommendations should the nurse provide to the participants? A: Monthly breast self-examination (BSE) B: BSE or mammography each year starting at age 40 C: Annual clinical breast examination until age 65 D: Mammography and clinical breast examination every 3 years until age 40

D: Mammography and clinical breast examination every 3 years until age 40

Which of the following aspects of kidney function is performed by the juxtaglomerular complex? A: Regulating urine concentration B: Facilitating active transport to reabsorb electrolytes C: Regulating sodium and potassium elimination D: Matching changes in GFR with renal blood flow

D: Matching changes in GFR with renal blood flow

After reviewing the 24-hour intake and output of a hospital patient, the nurse suspects that the patient may be experiencing flaccid bladder dysfunction. Which of the following diagnostic methods is most likely to confirm or rule out whether the patient is retaining urine? A: Blood test for creatinine, blood urea nitrogen, and glomerular filtration rate B: Urine test for culture and sensitivity C: Routine urinalysis D: Measurement of postvoid residual (PVR) by ultrasound

D: Measurement of postvoid residual (PVR) by ultrasound

A diabetic patient's most recent blood work indicated a decreased glomerular filtration rate and urine testing revealed microalbuminuria. Which of the following self-care measures should the patient's care team suggest to the patient? A: Use of over-the-counter diuretics B: Increased fluid intake C: Decreased oral sugar intake D: Measures to lower blood pressure

D: Measures to lower blood pressure

A patient has developed pericarditis after developing acute glomerulonephritis, a development that may be attributable to the presence of similar epitopes on group A, b-hemolytic streptococci and the antigens in the patient's heart tissue. Which of the following has most likely accounted for this patient's autoimmune response? A: Breakdown of T-cell anergy B: Release of sequestered antigens C: Superantigens D: Molecular mimicry

D: Molecular mimicry

Which of the following health problems is associated with heart failure as a result of diastolic dysfunction? A: Uncontrolled hypertension B: Chronic bradycardia C: Ischemic heart disease D: Myocardial hypertrophy

D: Myocardial hypertrophy

Which of the following neoplasms of the skeletal system is likely to require the most timely and aggressive treatment? A: Exostosis B: Osteochondroma C: Endochondroma D: Osteosarcoma

D: Osteosarcoma

A 33-year-old patient who is a long-term intravenous user of heroin has been recently diagnosed with hepatitis C. Which of the following portals of entry most likely led to the patient's infection? A: Direct contact B: Vertical transmission C: Ingestion D: Penetration

D: Penetration

A patient has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems? A: Take a sputum sample for culture and sensitivity. B: Compare the patient's oral, tympanic, and axillary temperatures and order a white blood cell count. C: Palpate the patient's lymph nodes and inspect the ears with an otoscope. D: Perform transillumination and ask the patient if bending forward exacerbates the headache.

D: Perform transillumination and ask the patient if bending forward exacerbates the headache.

A patient with a diagnosis of community-acquired pneumonia is producing copious secretions that are physically obstructing her airway. Which of the following pathophysiologic processes will result from this condition? A: Compensatory vasoconstriction B: Ventilation without perfusion C: Dead air space D: Perfusion without ventilation

D: Perfusion without ventilation

What body part is the largest serous membrane in the body, constitutes the outer wall of the intestine, and contains a serous fluid between its two layers? A: Mesentery B: Omentum C: Haustration D: Peritoneum

D: Peritoneum

Pain is an expected assessment finding in patients who have which of the following lung diseases? A: Asthma B: Pleural effusion C: Pulmonary arterial hypertension (PAH) D: Pleuritis

D: Pleuritis

Reabsorption of electrolytes such as Na+, K+, Cl, and bicarbonate (HCO3) from glomerular filtrate takes place primarily in which of the following locations? A: Descending limb of the loop of Henle B: Ascending limb of the loop of Henle C: Bowman's capsule D: Proximal convoluted tubule

D: Proximal convoluted tubule

A patient's clavicular fracture has healed in the weeks following a bicycle accident. Which of the following events takes place in the remodelling stage of bone healing? A: Formation of granulation tissue B: Development of fibrocartilage that resembles the appearance of the original bone C: Deposition of mineral salts into the callus D: Reduction in the size of the callus

D: Reduction in the size of the callus

An infant has been diagnosed with autosomal recessive polycystic kidney disease (ARPKD). Which of the following treatments is the priority in the care of this child? A: Rehydration therapy B: Total parenteral nutrition C: Prophylactic antibiotics D: Respiratory support

D: Respiratory support

A 41-year-old patient has undergone a vasectomy. What is the physiologic basis for this contraception technique? A: Spermatogenesis is inhibited because sex hormones may no longer stimulate the Sertoli cells. B: Spermatozoa can no longer reach the epididymis and do not survive. C: The rete testis becomes inhospitable to sperm. D: Sperm can no longer pass through the ductus deferens.

D: Sperm can no longer pass through the ductus deferens.

A patient has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for levels of thyroid-stimulating hormone (TSH). This patient has undergone which of the following diagnostic tests? A: Suppression testing B: Radioimmunoassay (RIA) C: Autoantibody testing D: Stimulation testing

D: Stimulation testing

One of the causes of conductive hearing loss is: A: sudden loud noise. B: ototoxic medication. C: auditory nerve damage. D: excess middle ear fluid.

D: excess middle ear fluid.

Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _______ and ______ the heart. A: ruptures; releases B: thickens; stretches C: contracts; friction rubs D: fills rapidly; compresses

D: fills rapidly; compresses

A patient who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive? A: Sudden changes in glucocorticoid dosing may reverse the therapeutic effects of the drug. B: Stopping the drug suddenly may ​shock​ the HPA axis into overactivity. C: Sudden cessation of a glucocorticoid can result in adrenal gland necrosis. D: Stopping the drug suddenly may cause adrenal insufficiency.

D: Stopping the drug suddenly may cause adrenal insufficiency.

Following the analysis of a recent barium enema and colonoscopy with biopsy, a patient has been diagnosed with colorectal cancer. Which of the following treatment modalities will be the mainstay of this patient's treatment? A: Chemotherapy B: Radiation therapy C: Pharmacologic therapies D: Surgery

D: Surgery

Which of the following factors is likely to result in decreased renal blood flow? A: Action of dopamine B: Release of nitric oxide C: Action of prostaglandins D: Sympathetic nervous stimulation

D: Sympathetic nervous stimulation

Which of the following assessment findings of a cyanotic infant is incongruent with a diagnosis of tetralogy of Fallot? A: The child has ventricular septal defect. B: The infant's pulmonary outflow channel is narrowed. C: The child has right ventricular hypertrophy. D: The infant's aorta is narrowed

D: The infant's aorta is narrowed

A young child has been diagnosed with Wilms tumor after his mother discovered an unusual mass, prompting a diagnostic workup. Which of the following characteristics is typical of Wilms tumor? A: The tumor is usually asymptomatic. B: The tumor is usually self-limiting. C: The tumor is usually a secondary neoplasm. D: The tumor is usually encapsulated.

D: The tumor is usually encapsulated.

Magnetic resonance imaging of a patient's knee has revealed the presence of bursitis. What is the primary purpose of bursae? A: To maintain close articulation between the two long bones at a synovial joint B: To strengthen the attachment between skeletal muscles and bones C: To strengthen the integrity of the articulating capsule D: To prevent friction at a tendon in a synovial joint

D: To prevent friction at a tendon in a synovial joint

Which of the following descriptions is true of peritoneal dialysis? A: Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt. B: Treatments typically occur three times each week for three to four hours. C: The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes. D: Treatment involves the introduction of a sterile dialyzing solution, which is drained after a specified time.

D: Treatment involves the introduction of a sterile dialyzing solution, which is drained after a specified time.

Hypovolemic shock occurs as a result of: A: myocardial infarction. BL excessive vasoconstriction. C: chronic intracellular fluid shift. D: acute intravascular volume loss.

D: acute intravascular volume loss.

Type 1 diabetes mellitus results from destruction of the pancreatic beta cells by two mechanisms. The mechanism for type 1A diabetes is _______ destruction. A: genetic B: resistant C: idiopathic D: autoimmune

D: autoimmune

The most common cause of hypothyroidism is: A: goiter. B: myxedema. C: thyroidectomy. D: autoimmune thyroiditis.

D: autoimmune thyroiditis.

Major histocompatibility complex (MHC) molecules, with human leukocyte antigens (HLAs), are markers on all nucleated cells and have an important role in: A: identifying blood types. B: cell membrane transport. C: suppressing viral replication. D: avoiding transplant rejections.

D: avoiding transplant rejections.

The most common indicator of acute renal failure is: A: anemia. B: uremia. C: edema. D: azotemia.

D: azotemia.

Alterations in the structure and function of the glomerular _________ are responsible for protein and blood cell leakage into the filtrate that occurs in many forms of glomerular disease. A: renal corpuscle B: Bowman's capsule C: peritubular network D: basement membrane

D: basement membrane

Osteonecrosis is most often caused by: A: stress fractures. B: bacterial infection. C: synovial inflammation. D: bone marrow ischemia.

D: bone marrow ischemia.

Metastatic bone disease is most closely associated with: A: cervical cancer and ovarian cancer. B: acute myelogenous leukemia (AML) and malignant melanoma. C: non-Hodgkin lymphoma and bladder cancer. D: breast cancer and prostate cancer

D: breast cancer and prostate cancer

Diffusion of gases in the lung is decreased, as in pulmonary edema or pneumonia, by causing an increase in alveolar: A: gas pressure difference. B: size and surface area. C: anatomic shunting of blood. D: capillary membrane thickness.

D: capillary membrane thickness.

The intracranial volume that is most capable of compensating for increasing intracranial pressure is the: A: brain cell tissue. B: intravascular blood. C: surface sulci fluid. D: cerebrospinal fluid.

D: cerebrospinal fluid.

Impaired and delayed healing in a person with diabetes is caused by chronic complications that include: A: ketoacidosis. B: Somogyi effect. C: fluid imbalances. D: chronic neuropathies

D: chronic neuropathies

haracteristics of a patient that is at high risk for falling and fracturing a hip include: A: obesity and short stature. B: excessive sugar intake. C: hearing impairment. D: chronic osteoporosis.

D: chronic osteoporosis.

A change in the circadian rhythm for glucose tolerance and an inappropriate increase in counterregulatory hormones can lead to _______ in diabetics. A: hypoglycemia B: Somogyi effect C: hyperinsulinemia D: dawn phenomenon

D: dawn phenomenon

The patient is immobilized following a hip injury and has begun demonstrating lower leg discoloration with edema, pain, tenderness, and increased warmth in the mid-calf area. He has many of the manifestations of: A: stasis ulcerations. B: arterial insufficiency. C: primary varicose veins. D: deep vein thrombosis.

D: deep vein thrombosis.

Factors that contribute to the severe hyperglycemia that precipitates hyperglycemic hyperosmolar state (HHS) include: A: fluid retention and edema. B: thromboembolism formation. C: insulin overdose. D: glycosuria and water loss.

D: glycosuria and water loss.

A late indicator of increased intracranial pressure is: A: tachycardia. B: right-sided heart failure. C: narrow pulse pressure. D: high mean arterial pressure

D: high mean arterial pressure

Small-vessel vasculitides, a group of vascular disorders that cause vasculitis, are mainly mediated by: A: infectious agents. B: tissue necrosis. C: mononuclear cells. D: hypersensitivity reactions.

D: hypersensitivity reactions.

A characteristic manifestation of polycystic kidney disease is: A: massive proteinuria. B: renal colic. C: alkaline urine. D: hypertension.

D: hypertension.

Impaired skin integrity and skin manifestations are common in persons with chronic kidney disease. Pale skin and subcutaneous bruising are often present as a result of: A: thrombocytopenia. B: anticoagulant therapy. C: decreased vascular volume. D: impaired platelet function.

D: impaired platelet function.

Although bacterial toxins vary in their activity and effects on host cells, a small amount of gram- negative bacteria endotoxin: A: is released during cell growth. B: inactivates key cellular functions. C: uses protein to activate enzymes D: in the cell wall activates inflammation

D: in the cell wall activates inflammation

The immune suppressive and anti-inflammatory effects of cortisol cause: A: moderate insulin resistance. B: increased capillary permeability. C: increased cell-mediated immunity. D: inhibition of prostaglandin synthesis.

D: inhibition of prostaglandin synthesis.

Diabetic and hypertensive retinopathy are both characterized by the appearance of: A: macular edema. B: cloudy corneas. C: microinfarctions. D: intraretinal hemorrhages.

D: intraretinal hemorrhages.

Diverticulitis, a complication of diverticulosis, is manifested by acute: A: rectal bleeding. B: abdominal distention. C: large-volume diarrhea. D: lower left quadrant pain.

D: lower left quadrant pain.

Shortly after a closed fracture has occurred, early manifestations include localized: A: tetany. B: deformity. C: necrosis. D: numbness.

D: numbness.

The condition that contributes to the pathology of all metabolic bone diseases is: A: impaired vitamin D synthesis. B: osteosarcoma. C: infection. D: osteopenia.

D: osteopenia.

A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the patient notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the patient's medication administration record. The nurse should conclude that this patient likely has a history of: A: scleroderma. B: osteoarthritis. C: rheumatoid arthritis. D: osteoporosis.

D: osteoporosis.

The most common sign of epithelial cell bladder cancer is: A: severe oliguria. B: hyperproteinuria. C: hyperphosphaturia. D: painless hematuria.

D: painless hematuria.

Bones are covered, except at their articular ends, by a ______ membrane. A: canaliculi B: endosteum C: synovial D: periosteum

D: periosteum

Coup and contrecoup cerebral contusion caused by blunt head trauma against a fixed object results in: A: diffuse axonal injuries. B: cerebrovascular infarction. C: momentary unconsciousness. D: permanent brain tissue damage.

D: permanent brain tissue damage.

Major causes of mechanical bowel obstruction include: A: chemical irritation. B: ruptured appendix. C: abdominal distention. D: postoperative adhesions.

D: postoperative adhesions.

Activation of lymphocytes is dependent upon the ________ and ________ of the antigens by macrophages. A: memory; clustering B: capture; destruction C: recognition; grouping D: processing; presentation

D: processing; presentation

In people with type 1 diabetes, the beneficial effects of exercise also carry an increased risk of: A: rapid weight loss. B: respiratory disorders. C: rebound hyperglycemia. D: profound hypoglycemia.

D: profound hypoglycemia.

Unlike the Crohn type of inflammatory bowel disease, the ulcerative colitis type is characterized by: A: skip lesions. B: steatorrhea. C: gastric ulcers. D: pseudopolyps.

D: pseudopolyps.

A 26-year-old woman has sought care for increasing pain at the back of her ankle and the bottom of her foot over the past 2 weeks. The patient states that she is generally in good health, although she completed a course of antibiotics for a chlamydial infection 6 weeks earlier. This patient's recent history suggests the possibility of: A: systemic sclerosis. B: ankylosing spondylitis. C: osteoarthritis. D: reactive arthritis.

D: reactive arthritis.

Transient ischemic attacks (TIAs) are characterized by ischemic cerebral neurologic deficits that: A: indicate aneurysm leakage. B: cause minor residual deficits. C: affect diffuse cerebral functions. D: resolve within one hour of onset.

D: resolve within one hour of onset.

Squamous cell cancer of the penis is more likely to develop in men with chronic: A: erectile dysfunction. B: herpes ulcerations. C: Peyronie disease. D: smegma accumulation.

D: smegma accumulation.

The most important factor in the evaluation and treatment of benign prostatic hypertrophy (BPH) is considered to be: A: frequency of erectile dysfunction. B: testosterone level management C: prostate cancer prevention measures. D: subjective symptoms reported by the patient.

D: subjective symptoms reported by the patient.

Cancellous bone is relatively light, but its lattice-like structure gives it: A: rigidity. B: thickness. C: a growth plate. D: tensile strength.

D: tensile strength.

Leiomyomas are smooth muscle fibroid tumors that usually develop in: A: fibrocystic breasts. B: postmenopause. C: uterosacral ligaments. D: the corpus of the uterus.

D: the corpus of the uterus.

The pathogenic capacity of the tubercle bacillus is related to: A: formation of a Ghon's focus lesion. B: its inherent destructive capabilities. C: rapid viral replication in host cells. D: the initiation of a cell mediated immune response

D: the initiation of a cell mediated immune response

Anaphylactic shock is directly associated with: A: loss of blood volume B: bacterial blood infection. C: failure of the heart as a pump. D: type I hypersensitivity response.

D: type I hypersensitivity response.

Of the four types of kidney stones, the formation of magnesium ammonium phosphate (struvite) stones is directly associated with: A: hyperuricemia. B: hydronephrosis. C: high urine calcium. D: urinary tract infections.

D: urinary tract infections.

Many factors contribute to the incontinence that is common among the elderly. A major factor is increased: A: detrusor muscle function. B: intake of liquids and water. C: urethral closing pressure. D: use of multiple medications.

D: use of multiple medications.

Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes pulmonary: A: vasospasms. B: hypertension. C: emboli formation. D: vasoconstriction.

D: vasoconstriction.

Although both are characterized by ischemia, Raynaud phenomenon is caused by _________, and thromboangiitis obliterans is caused by: A: occlusion; compression. B: thrombi; vasoconstriction. C: vasculitides; hypertension. D: vasospasm; inflammation.

D: vasospasm; inflammation.

Endocarditis and rheumatic heart disease are both cardiac complications of systemic infections. Characteristics include a new or changed heart murmur caused by: A: chronic atrial fibrillation. B: myocardial inflammation. C: left ventricle hypertrophy. D: vegetative valve destruction.

D: vegetative valve destruction.

Severe shock can be followed by acute lung injury/acute respiratory distress syndrome (ALI/ARDS) characterized by: A: hyperventilation B: excessive surfactant. C: hyperinflated alveolar sacs. D: ventilation-perfusion mismatch.

D: ventilation-perfusion mismatch.

Although the distal portion of the urethra often contains pathogens, the urine formed in the kidney and found in the bladder is sterile because of the: A: alkaline urine. B: glomerular filtering. C: warm temperature. D: washout phenomenon.

D: washout phenomenon.

A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the patient's following statements demonstrates an accurate understanding of this diagnosis? ​A: From now on, I'm going to stick to an organic diet and start taking more supplements.​ ​ B: I think this might have happened because I've used enemas and laxatives too much.​ ​C: I've always struggled with heartburn and indigestion, and I guess I shouldn't have ignored those warning signs.​ D: ​I suppose I should try to eat more fiber and become a bit more active.​

D: ​I suppose I should try to eat more fiber and become a bit more active.​

Frustrated by her worsening tinnitus, a 55-year-old female patient has sought care. Which of the following teaching points should the clinician provide to the patient? ​A: I know this can be very difficult to live with, but it normally fades over time.​​ B: I will prescribe some medication that will probably help quite well.​​ C: This might be a sign of a more serious neurologic problem that we will assess for.​ D: ​Initially, there are some changes in your diet that you should implement

D: ​Initially, there are some changes in your diet that you should implement

Which of the following complaints by middle-aged women should prompt a care provider to rule out the possibility of ovarian cancer? ​A: I'm having a lot of vaginal discharge lately and it's quite foul.​​ B: My periods have become quite irregular since last winter.​​ C: I have a sharp, stabbing pain on my side for the last few days D: ​​I'm having a lot of indigestion and bloating, which are both new to me.​

D: ​​I'm having a lot of indigestion and bloating, which are both new to me.​

After seeking care due to recent history of testicular enlargement and scrotal pain, a 22-year-old college student has been diagnosed with testicular cancer. Which of the patient's following statements indicates the need for further teaching? ​A: I can't shake this feeling like I've received a death sentence.​​ B: I have to admit that the prospect of losing a testicle is a bit overwhelming C: ​​I really hope the cancer hasn't spread anywhere, because I've read that it's a possibility.​​ D: I guess there's some solace in the fact that this cancer wasn't a result of an unhealthy lifestyle.​

​A: I can't shake this feeling like I've received a death sentence.​​

A patient with a history of chronic obstructive pulmonary disease (COPD) is undergoing pulmonary function testing. Which of the following instructions should the technician provide in order to determine the patient's forced vital capacity (FVC)? ​A: I'll ask you to breathe in as deep as you can, and then blow out as much of that air as possible.​ B: ​I'd like you to take a deep breath, and then blow out as much air as you can during one second.​ ​C: I want you to breathe as normally as possible and I'm going to measure how much air goes in and out with each breath.​ ​D: Breathe normally, and then exhale as much as you possibly can when I tell you

​A: I'll ask you to breathe in as deep as you can, and then blow out as much of that air as possible.​

Which of the following statements by the husband of a patient with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen? ​A: I'm really hoping these medications will slow down her mental losses.​ ​ B: We're both holding out hope that this medication will cure her Alzheimer's.​ ​C: I know that this won't cure her, but we learned that it might prevent a bodily decline while she declines mentally.​ D: ​I learned that if we are vigilant about her medication schedule, she may not experience the physical effects of her disease.​

​A: I'm really hoping these medications will slow down her mental losses.​ ​

A 51-year-old man has been diagnosed with chronic bronchitis after a long history of recurrent coughing. Which of the man's following statements demonstrates a sound understanding of his new diagnosis? ​A: If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis.​ B: ​I'm pretty sure that I first caught bronchitis from the person who has the cubicle next to mine at work.​ ​C: I read on the Internet that I might have got bronchitis because I was born with an enzyme deficiency.​ D: ​I think that I probably could have prevented this if I had got in the habit of exercising more when I was younge

​A: If I had quit smoking earlier than I did, I think I could have avoided getting bronchitis.​

A patient's primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which of the following instructions should the patient be given? ​A: The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals.​ ​B: You'll have to refrain from eating after midnight and then go to the lab to have your blood taken first thing in the morning.​ ​C: They'll take a blood sample and see how much sugar is attached to your red blood cells.​ D: ​You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample.​

​A: The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals.​

A couple has just learned that their newborn infant has been diagnosed with osteogenesis imperfecta, and they have responded by seeking out as much information as possible about their child's diagnosis. What should the clinician teach the couple about their child's health problem? ​A: This is something that your child may have inherited from one or both or you.​ ​B: This might have been caused by something you were exposed to during the early part of your pregnancy.​ ​C: You'll have to be vigilant of your child's safety for the next few years, but the disease often resolves spontaneously.​ ​D: With aggressive treatment, most children with osteogenesis imperfecta are cured within several months.​

​A: This is something that your child may have inherited from one or both or you.​

A 29-year-old woman who considers herself active and health conscious is surprised to have been diagnosed with preeclampsia-eclampsia in her second trimester. What should her care provider teach her about this change in her health status? ​A: We don't really understand why some women get high blood pressure when they're pregnant.​ B: ​This is likely a result of your nervous system getting overstimulated by pregnancy.​ ​ C: Hypertension is a common result of all the hormonal changes that happen during pregnancy.​ ​ D: Even though you're a healthy person, it could be that you have an underlying heart condition.​

​A: We don't really understand why some women get high blood pressure when they're pregnant.​

A 21-year-old college student has sought care because of the vaginal burning, itching, and redness that have become worse in recent weeks. Which of the clinician's assessment questions is most likely to apply to a diagnosis of vaginitis? ​A: Have your periods been regular in the last few months?​ ​B: Have you ever had a sexually transmitted infection?​ ​ C: Are you using oral contraceptives? D: ​​Have you ever been pregnant?​

​B: Have you ever had a sexually transmitted infection?​ ​

A public health nurse is conducting a health promotion class for a group of older adults. Which of the participants' following statements demonstrates an accurate understanding of the risk factors for bladder cancer? ​A: I suppose I should listen to my doctor and drink more cranberry juice.​ ​B: More than ever, I guess it would worthwhile for me to quit smoking.​ ​C: I can see that preventing bladder cancer is one more benefit of a healthy diet.​ ​D: I think I should be okay because there's no history or bladder cancer in my family that I'm aware

​B: More than ever, I guess it would worthwhile for me to quit smoking.​