Patho Questions
Which hormone is the most significant stimulant for prostate growth, differentiation, and maintenance? A. 5-alpha reductase B. Dihydrotestosterone C. Luteinizing hormone D. Testosterone
B
Diabetes increases the risk of AD. True False
True
Please match the following hormones with functions: A. Enhance relaxation of the stomach and enhances peristalsis contractions of the stomach. B. Enhances peristalsis contractions of the stomach. C. Can inhibit peristaltic contractions of the stomach. Matching Items 1. Gastrin 2.Cholecystokinin 3. Motilin 4. Secretin
1. A 2. A 3. B 4. C
Which area of the brain is associated with which function related to language? A. Production of speech B. Receptive (comprehension) speech and reading Matching Items 1. Broca's area 2. Wernicke's area
1. A 2. B
Match the following processes with the site where they occur: A. Alveoli and Capillaries B. Central Nervous System, Musculoskeletal System, Airways C. Capillaries and Circulation Matching Items 1. Ventilation 2. Diffusion 3. Perfusion
1. B 2. A 3. C
Match the neurotransmitter with its function: A. Arousal, mood states, thought processes and physical movement. B. Learning, memory and muscle movement C. The main inhibitory neurotransmitter D. Heart rate, glucose availability, amount of oxygen that goes to the brain, respiratory rate, E. The main excitatory neurotransmitter F. Mood and social behavior, appetite and digestion, sleep, memory and sexual desire and function Matching Items 1. Acetylcholine 2. Dopamine 3. Serotonin 4. Norepinephrine 5. GABA 6. Glutamate
1. B 2. A 3. F 4. D 5. C 6. E
Please match the following terms with their definitions and potential impact: A. The percentage of end-diastolic ventricular volume ejected with each heart beat B. Pulse < 60 C. Pulse >100 arising from the ventricles due to pacemaker abnormalities D. Unsynchronized rapid heart movements that result from disordered electrical activity in the ventricles. E. An abnormal heart rhythm that originates in the Atrioventricular Node. Matching Items 1. sinus bradycardia 2. ventricular fibrillation 3. Ejection Fraction 4. ventricular 5. Junctional rhythm
1. B 2. D 3. A 4. C 5. E
A 53-year-old man presents with substernal chest pain that radiates to his left arm that occurred while he was watching TV and is associated with shortness of breath, nausea, and diaphoresis. When he arrives at the ED, his ECG shows ST elevation and his cardiac isoenzymes (Troponin) are increased. These findings indicate: A. this is STEMI B. this is non-STEMI. C. this is stable angina D. this is unstable angina E. you haven't the slightest idea what this is.
A
A client is admitted with an alteration in neurological status and is in the process of being diagnosed with hepatic encephalopathy. Which of the following is known about this diagnosis? A. It is caused by a buildup of ammonia. B. It is caused by a buildup of urea. C. It is caused by a carbohydrate metabolism dysfunction. D. It is caused by a fat metabolism dysfunction.
A
A patient diagnosed with Alzheimer disease (AD) is demonstrating signs of impaired reasoning. The healthcare provider suspects an alteration in which area of the brain? A. Frontal lobe B. Medulla C. Occipital lobe D. Amygdala
A
After discussing with a his nurse-practitioner, a male client still has questions about the results of a prostatic surface antigen (PSA) test and asks the office nurse what makes these levels rise. The nurse should explain which pathophysiological mechanism? A. As the prostate gland enlarges, its cells contribute more PSA in the circulating blood. B. The PSA levels rise and fall routinely, so multiple testings over time are important and necessary. C. Low PSA levels indicate that the prostate gland is not functioning properly. D. The PSA blood test is used to determine how much Viagra to prescribe.
A
An individual who is demonstrating elevated levels of troponin, creatine kinase-isoenzyme MB (CK-MB), and lactic dehydrogenase (LDH) is exhibiting indicators associated with which condition? A. Myocardial infarction (MI) B. Hypertension C. Coronary artery disease (CAD) D. Myocardial ischemia
A
Atherosclerotic plaque: A. has a fibrous cap of smooth muscle cells and collagen from fibroblasts B. is associated with low levels of Low-density lipoproteins (LDL) C. has lost its normal vasoconstriction capacity and tends to produce increased amounts of vasodilators D. has lost its normal thrombogenic ability and tends to resist platelet aggregation with resultant bleeding tendencies
A
Blepharitis is an infection or inflammation of: A. the eyelids B. the lens C. the eyebrow D. the cornea E. the conjunctiva
A
Diffuse axonal injury is a type of traumatic brain injury associated with all of the following except: A. Associated with open head injury as a result of not wearing helmets. B. There may not be any sign of injury on radiologic imaging. C. Causes injuries to the axons in the white matter. D. Occurs when the brain experiences acceleration/deceleration shearing forces.
A
Endothelial dysfunction is best described as: A. An imbalance between vasodilating and vasoconstricting substances produced by (or acting on) the endothelium. B. A problem involving altered vessel wall structure through processes of cell growth or changes in the function of the extracellular matrix. C. Usually due to increased peripheral vascular resistance but can also occur with aortic outlet obstruction and aortic stenosis. D. An imbalance in the metabolism of lipids in the bloodstream, resulting in too much LDL and VLDL accumulating on the vessel walls, impeding their function.
A
In which type of pleural effusion does the fluid become watery and diffuse out of the capillaries as a result of increased blood pressure or decreased capillary oncotic pressure? A. Transudative B. Large C. Exudative D. Purulent
A
Neurofibrillary tangles characterize which neurologic disorder? A. Alzheimer disease B. Delirium C. Parkinson's disease D. Dementia syndrome
A
One characteristic of uterine leiomyomas is that they: A. Are associated with nulliparity and obesity. B. Contain glands, stoma, and blood vessels. C. Lodge in the endometrium. D. Require a hysterectomy.
A
Pulmonary edema and pulmonary fibrosis cause hypoxemia by which mechanism? A. Impairing alveolocapillary membrane diffusion B. a right-to-left shunt C. Creating alveolar dead space D. Decreasing the oxygen in inspired gas
A
Swollen parotid glands can be a sign of all of the following EXCEPT: A. Epiglotitis B. Sjögren syndrome C. Mumps D. Diabetes
A
The pathophysiology of stroke can include all of the following EXCEPT: A. Cell membrane disruption causes the cells to shrink due to the rapid outflow of potassium. B. The loss of cell membrane integrity leads to increased inflammation in the brain, and this causes neuron hyperpolarization. C. Release of glutamate and aspartate which are excitotoxins. D. Intracellular accumulation of Sodium and Calcium due to loss of Cell membranes. E. Cerebral vascular obstruction that leads to neural ischemia.
A
When the nurse is teaching the family of a client with acute conjunctivitis regarding the disease process, the nurse emphasizes which of the following statements as most important? A. Wash hands before and after instilling eye drops B. Use a cotton-tipped swab to cleanse the right eye and then the left eye C. Cleanse the client's contact lenses twice each day D. Ask client to gently rub eyes to circulate the eye drops after instillation
A
Which intervention is most appropriate for a person with portal hypertension? A. Monitor for hematoemesis B. Increase dietary fiber intake C. Eat small high protein meals D. Administer lactulose
A
Which of the following parts of the brain is most commonly associated with stress processing and emotions? A. The limbic system B. The hindbrain (cerebellum, pons and medulla) C. The forebrain (cerebrum-cerebral cortex and basal ganglia) D. The reticular formation
A
Which statement is FALSE regarding asthma pathophysiology? A. IL-17 is produced which recruits and activates eosinophils; IFN recruits neutrophils; TNF increases inflammation, mucus secretion, and epithelial cell irritation B. T helper cells (CD4 cells) are activated by binding to the allergen presented on the macrophage and produce interleukin 4 (IL-4) (Th2 cytokine) which stimulates B cells to make IgE C. IgE attaches to mast cells and initiates mast cell degranulation D. Allergen interacts with macrophages that present the antigen to the immune system; irritants contribute to epithelial cell inflammation and adaptive immune stimulation.
A
Which statement is false regarding the sources of increased ammonia that contribute to hepatic encephalopathy? A. Accumulation of short-chain fatty acids that are attached to ammonia is a source of increased ammonia. B. Digested blood leaking from ruptured varices can be a source of increased ammonia. C. End products of intestinal protein digestion are sources of increased ammonia. D. Ammonia-forming bacteria in the colon are sources of increased ammonia.
A
Which term is the most correct for a nurse use when documenting a detached blood clot? A. Thromboembolus B. Infarction C. Thrombus D. Embolism
A
You are caring for someone who has a subdural hematoma. The person becomes restless and confused, with dilation of the ipsilateral pupil. The most important thing for you to evaluate in this patient is: A. Intracranial pressure B. Renal functioning C. Vasculogenic edema D. Intraocular pressure
A
You are evaluating the status of a client who had a craniotomy 3 days ago. You suspect the client is developing meningitis as a complication of surgery if the client exhibits: A. A positive Brudzinski's sign B. A negative Kernig's sign C. Absence of nuchal rigidity D. A Glascow Coma Scale score of 15
A
You suspect that Mr. Kiteto has left-sided heart failure when you note which of the following signs/symptoms? A. Bilateral crackles in the lungs and shortness of breath, especially at night. B. Distended neck veins and weight gain of 2 lbs in the past 2 days. C. Pitting pedal edema and bilateral crackles in the lungs D. Weight gain of 6 lbs in the last 2 days and shortness of breath when walking up stairs.
A
Which of the following are considered to be risk factors for stroke? Select all that apply: A. Hypertension B. Hyperlipidemia C. Tobacco Use D. Alcohol Use E. Migraine headaches with aura F. Depression G. Cluster headaches
A, B, C, E, F
A nurse can use which of the following to help assess a patient's level of consciousness. Select all that apply: A. Pupillary Reflex and Oculomotor Response B. Verbal and motor responsiveness C. Breathing pattern D. Cerebral hemodynamics E. Facial expression during sleep F. Posture
A, B, C, F
A college student is required to be inoculated for hepatitis before beginning college. The nurse realizes this client will be inoculated to prevent the development of: A. Hepatitis C B. Hepatitis B C. Hepatitis D D. Hepatitis E
B
A person complains of headache and is found to have bilateral Papilledema (swelling of the optic discs). This may be a sign of: A. meningitis B. increased intracranial pressure C. keratitis D. status migrainous
B
A sudden, explosive, disorderly discharge of cerebral neurons is termed: A. A convulsion B. A seizure C. Epilepsy D. A reflex
B
A type of traumatic brain injury that occurs when there is a blow on the head but it remains closed A. A depressed open skull fracture B. A closed head injury C. A penetrating head injury
B
After a myocardial infarction, some myocytes will remain nonfunctional for a period of time, even if coronary perfusion is restored. This is called: A. hibernating myocardium B. stunned myocardium C. remodeled myocardium D. startled myocardium
B
Arousal is mediated by which of the following: A. Cerebrum B. Reticular activating system. C. Cerebral Cortex D. Medulla Oblongata
B
Chronic obstructive pulmonary disease (COPD) : A. Has an abrupt onset. B. Makes it hard to breathe and gets worse over time. C. Usually starts in childhood. D. Can be transmitted via inhalation (aerosolized particles)
B
Classic symptoms of meningitis usually include: A. Rash, inner ear pain, chronic itching B. Fever, headache, stiff neck C. Insomnia, fever and stiff neck D. Backache, fever and dehydration
B
A 24 year old woman has secondary amenorrhea. What is the most probable cause of this finding? A. Polycystic Ovarian Syndrome (PCOS) B. Pregnancy C. Turner Syndrome D. Hypothyroidism
B
A 29-year-old patient is admitted to the medical floor from the emergency room after being diagnosed with meningitis. Which assessment by the nurse has priority? A. Assess lung sounds. B. Assess level of consciousness. C. Assess apical pulse. D. Assess the six cardinal fields of gaze.
B
A 56-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is: A. Sacral edema B. Skin hyperpigmentation C. Deep vein thrombosis formation D. Gangrene
B
A client is admitted with an elevated serum ammonia level and iron-deficiency anemia. The nurse knows this client has some degree of liver failure because: A. The client's heart rate is 88 beats per minute with PACs. B. The liver converts ammonia to the harmless substance of urea. C. Conjugated bilirubin causes anemia and is only produced by the liver when it is failing. D. The liver is the storage center for ammonia and iron.
B
Which type of nerve fibers transmits pain impulses? A. A-alpha (Aα) fibers B. B fibers C. A-delta (Aδ) fibers D. A-beta (Aβ) fibers
C
During the normal cardiac cycle, which of the following occurs? A. The right atrium and right ventricles contract simultaneously while the left side relaxes, then the left atrium and left ventricle contract while the right side relaxes. B. The two atria contract simultaneously, as the two ventricles relax; then the two ventricles contract simultaneously, while the atria relax. C. All four chambers of the heart contract simultaneously. D. The right atria contracts, followed by the left ventricle, then the right ventricle contracts, followed by the left atria.
B
Identify the FALSE statement about asthma and the gut microbiome: A. Dysbiosis identified at 3 months of age is associated with increased rates of asthma and atopy later in childhood. B. Infants who go on to develop asthma have increased fecal acetate, a short chain fatty acid that regulates airway inflammation. C. Reductions in only 4 species characterized the dysbiosis seen in infants who go on to develop asthma and atopy,
B
Identify the normal sequence of an electrical impulsethrough the heart's conduction system: 1) Atrioventricular bundle 2) AV node 3) SA node 4) right and left bundle branches 5) Purkinje fibers A. 4,1,2,3,5 B. 3,2,1,4, 5 C. 3,2,4,1,5 D. 3,1,2,5,3 E. 3,2,1,5,4
B
It is appropriate to describe a patient's pain as chronic when it has been present for: A. 24 months B. 3-6 months C. 1 month D. 1-3 years
B
Massage therapy relieves pain by closing the pain gate with the stimulation which fibers? A. Aδ B. Aβ C. C D. B
B
Mr. Smith sustained damage to his upper brainstem, which leads to a pattern of breathing called Cheyne-Stokes respirations. This can be described as a: A. Sustained deep rapid but regular pattern of breathing B. Crescendo-decrescendo pattern of breathing, followed by a period of apnea C. Prolonged inspiratory period, gradually followed by a short expiratory period D. Completely irregular breathing pattern with random shallow, deep breaths and irregular pauses
B
One of the most important distinctions between restrictive and obstructive pulmonary diseases is: A. People with restrictive disease have normal Forced Vital Capacity (FVC) and decreased Forced Expiratory Volume in 1 second (FEV1); people with obstructive disease have the reverse. B. People with restrictive disease have decreased Forced Vital Capacity (FVC); people with obstructive disease have decreased Forced Expiratory Volume at 1 second (FEV1) C. People with obstructive disease have elevated PaO2 levels and low PaCO2 levels, and in restrictive disease it is reversed. D. People with restrictive disease have problems with diffusion; people with obstructive disease have problems with perfusion. E. People with restrictive disease have V/Q mismatch and people with obstructive disease do not; it is all a problem with PaCO2 and Forced Vital Capacity (FVC) being decreased
B
Pain threshold is best described as: A. The level of pain that interrupts a persons' activities of daily living. B. The lowest intensity of stimulus that the person will recognize as painful. C. The highest level of stimulus intensity that the person can endure. D. The amount of pain it takes before a person asks for drugs.
B
REM (Rapid Eye Movement) Sleep is characterized by: A. increased muscle tone with the body moving about and muscle activity increased compared to Non REM sleep. B. Increased cerebral blood flow, and cortical activity associated with dreaming,absent spinal reflexes. C. paralysis with very regular heart rate and respiratory rate. D. brain waves (alpha) alternating between those of wakefulness and those associated with drowsiness (theta).
B
The children of a patient diagnosed with Alzheimer disease (AD) tell the healthcare provider, "Our mother seems better during the day, but she gets very confused and agitated in the late afternoon and evenings." How should the healthcare provider document the patient's behavior? A. Psychosis B. Sundowning C. Hallucinations D. Delirium
B
The most common type of stroke is: A. Hemorrhagic B. Ischemic C. Vascular Spasm D. Hydrocephalic
B
The nurse is still caring for that patient recovering from a broken femur. Remember that when assessing the affected leg, edema was noted and the patient complained of calf pain. After your initial response, which labs need to be drawn? A. Hemoglobin B. D-dimer C. Complete metabolic profile D. C-reactive protein
B
The pathophysiology of a migraine headache includes all of the following EXCEPT: A. There is a strong familial influence (it often "runs in families"). B. Widespread cortical activation and vasoconstriction occurs. C. Activation of the trigeminal/cervical afferent neurons occurs D. Cytokines cause perivascular neurogenic inflammation. E. Triggers lead to the release of nitric oxide.
B
The public health nurse is giving a lecture on potential outbreaks of infectious meningitis. Which population is most at risk for an outbreak? A. Clients recently discharged from the hospital. B. Residents of a college dormitory. C. Individuals who visit a third world country. D. Employees in a high-rise office building.
B
Tinnitus is associated with which of the following: A. Benign positional vertigo B. Meniere's disease C. ear wax buildup D. All of the above
B
What age group is at the highest risk for developing testicular cancer? A. 15-25 year olds B. 20-35 year olds C. 35-50 year olds D. Men older than 50
B
What causes conductive hearing loss? A. None of the above B. Fluid in the middle ear due to a cold or infection C. Structural issue within the inner ear (cranial nerve involvement) D. Old age
B
What medical term is used for a condition that results from pulmonary hypertension, creating chronic pressure overload in the right ventricle? A. Acute respiratory failure B. Cor Pulmonale C. Alveolar hypoxia D. Hypoxemia
B
When an individual aspirates food particles, where would the nurse expect to hear decreased or absent breath sounds? A. Left lung B. Right lung C. Carina D. Trachea
B
Which man is at higher risk for developing prostate cancer? A. A man of normal weight with a history of sexually transmitted disease. B. A man who is obese and has a brother with prostate cancer. C. A man taking oral testosterone to boost libido. D. A man with two cousins diagnosed with prostate cancer at ages 59 and 61.
B
Which of the following combinations of physical exam findings is highly specific for heart failure? A. Cyanosis and decreased urine output B. Third heart sound and jugular vein distention C. Jugular vein distension and cyanosis D. Hepatomegaly and Reduced peripheral pulses
B
Which of the following is NOT a common clinical manifestation of pneumonia A. Pleuritic Chest Pain B. Sore throat C. Increased sputum production D. Crackles E. Cough F. Diminished breath sounds G. Fever and chills H. Dypsnea
B
Which of the following is one of the most common causes of cirrhosis (chronic liver failure) in the United States today? A. Metabolic syndrome B. Viral hepatitis C. Alcoholic kidney disease D. Right-sided heart failure E. Bacterial hepatitis
B
Which of the following is recommended, according to the US Preventive Services Task Force (USPSTF) guidelines on colorectal cancer screening? A. Sigmoidoscopy every 5 years, with fecal occult blood testing every 3 years B. Colonoscopy every 10 years, beginning at age 50 years, until the end of life C. Fecal occult blood testing every 5 years after age 50 years D. Annual colonoscopy after the age of 65, until the end of life.
B
Which of the following statements about systolic heart failure is TRUE: A. It can be cured with drugs and other treatments. B. Treatment for heart failure with reduced ejection fraction is supportive and palliative C. Heart failure means the heart has stopped beating. D. Heart failure is caused by renal failure, hypertension or decreased angiotensin.
B
Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation (DIC)? A. Edema B. Hemorrhagic skin rash C. Dyspnea on exertion D. Cyanosis
B
Which statement about ventilation (V) / perfusion (Q) relationships is true? A. The normal average V/Q, over the whole lung, is about 7.35. B. A V/Q match requires normal function of alveoli and capillaries in the correct balance.
B
Within a physiologic range, what does an increase in left ventricular end-diastolic volume (preload) result in? A. Increase in afterload B. Increase in force of contraction C. Decrease in repolarization D. Decrease in refractory time
B
Please select all of the functions/activities of gastrointestinal flora: A. It is the exclusive determinant of intestinal motility. B. Vitamin synthesis C. Digestion of fiber D. Modulates neuroendocrine/immune cross-talk with the immune system E. Cholesterol metabolism and ion absorption F. Participates in the bile acid cycle G. Regulates permeability of tight junctions between intestinal epithelial cells. H. Stimulates switch to IgA production in B cells
B, C, D, E, F, G, H
Which of the following diseases is not known to be caused by or associated with hypertension? A. Coronary Artery Disease B. Aortic Aneurysm C. Atrial Septal Defect D. Stroke
C
Which term is used to identify the descent of the posterior bladder into the vaginal canal? A. Vaginocele B. Rectocele C. Cystocele D. Enterocele
C
A 39 year old is diagnosed with a duodenal ulcer. Which of the following behaviors may have contributed to the development of the ulcer? A. Consuming limited fiber B. Drinking too much coffee C. Regular NSAID use D. Antacid consumption
C
A 55 year old man presents with complaints of urinary frequency especially at night, with difficulty initiating a stream of urine and occasionally seeing blood in his urine. The most probable cause of these symptoms is: A. Testicular Cancer B. Wet dreams (nocturnal emissions) C. BPH (Benign Prostatic Hyperplasia) D. Prostate cancer
C
A client had a myocardial infarction after having stable angina for several years. The client tells the nurse, "I don't understand it. I know my heart arteries have those atherosclerotic plaques, but they have been there for years. What happened to make the heart attack occur right now?" Which information by the nurse is best? A. Some of your artery muscle cells probably moved into the inner lining of one of your heart arteries and blocked it. B. Some of your artery muscles probably went into spasm and closed off an artery that brings oxygen to your heart muscle. C. One of the atherosclerotic plaques probably ruptured and a clot formed and blocked one of your heart arteries. D. Your blood pressure probably was high, and that made your left ventricle enlarge, which squeezed off one of your heart arteries
C
A client with acute liver failure is admitted with ascites and pruritus. Which of the following is the nurse most concerned about? A. Risk of left sided congestive heart failure B. Fluid Volume Deficit C. Potential for breathing difficulties D. Difficulty performing Activities of Daily Living
C
Which of the following is not a sign of decompensating cirrhosis of the liver? A. Bleeding varices B. Hepatic encephalopathy C. Hypocholesterolemia D. Jaundice E. Ascites
C
A nurse is explaining determinants of preload to the staff. Which information should the nurse include in the teaching session? A. Amount of blood ejected with each beat B. Resistance to ejection of blood from the left ventricle C. End-systolic volume D. Volume of blood ejected per beat during systole
C
A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care? A. No precautions are required as long as antibiotics have been started B. Maintain enteric precautions C. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics D. Maintain neutropenic precautions
C
A patient is admitted to the mental health unit with a diagnosis of vascular dementia. Which of the following describes the brain alteration involved in this disorder? A. Enlargement of the ventricles B. Formation of beta-amyloid plaques C. Hypoxic damage to brain tissue D. Decreased choline acetyltransferase
C
A sore throat without other signs or symptoms of an upper respiratory infection (a runny nose, nasal congestion, sneezing, cough, and sputum production) is more likely to be caused by: A. A virus such as rhinovirus B. Medication side effect C. Bacteria such as streptococcus D. A fungus
C
As you prepare a poster for display at the Albemarle County fair on rapid response to stroke, you are going to list which of the following: A. STOP: Slurred speech, Transient ischemic attack, Only one side, Pain in the jaw B. STOP: Slurred speech, Tremors, One sided weakness, Pain in joints C. FAST: Facial drooping, Arm weakness, Slurred speech, Time to call Emergency Services D. FAST: Facial drooping, Anterior weakness, Slurred speech, Tremors
C
Atherosclerosis impedes coronary blood flow through which of the following mechanisms? A. Hardened vessels dilate to allow the blood to flow through. B. Blood clots form outside the vessel walls. C. Plaque obstructs blood vessels. D. Very low density lipoproteins deliver excessive amounts of triglycerides to the cardiac muscle.
C
Compared with arteries, veins: A. are located more deeply in the body B. blood flow occurs under high pressure C. are more collapsible D. recoil quickly after distension
C
Decreased lung compliance means that the lungs are demonstrating which characteristic? A. Inability to diffuse oxygen B. Easy inflation C. Stiffness D. Difficult deflation
C
J (juxtacapillary) receptors (or pulmonary C-fiber receptors) are sensory nerve endings located within the alveolar walls in juxtaposition to the pulmonary capillaries of the lung and are innervated by fibers of the vagus nerve. Which of the following is true about these receptors? A. They are muscle cells located within alveolar septa and are "juxtaposed" to the pulmonary capillaries B. They respond to events such as pulmonary edema, pneumonia or pulmonary embolism by causing a reflex decrease in ventilation rate. C. They respond to increases in pulmonary capillary pressure, which leads to an increase in ventilation rate. D. They are stimulated by dypsnea leading to decreased breathing and possibly bradycardia.
C
John is a 68 year old who has a diagnosis of pulmonary hypertension. What clinical manifestations might you expect to find? A. Dypsnea on exertion, rhonchi bilaterally and peripheral edema B. Dypsnea at rest, rhonchi bilaterally and jugular vein distention C. Dypsnea on exertion, peripheral edema, jugular vein distention D. Dypsnea on exertion, jugular vein distention and systemic blood pressure >130/90 mm Hg
C
Medication overuse headaches_______________. A. Affect Men more than Women. B. Are often caused by naproxen. C. Are persistent and often worse upon awakening. D. Are the most common type of headache in the United States.
C
Norepinephrine contributes to the regulation of hypertension by doing which of the following things? A. increasing excretion of sodium from the kidneys B. inhibiting the release of renin C. stimulating smooth muscle contraction, thus increasing vascular resistance through receptor mediated binding D. dilation of blood vessels and increased incidence of vasospasm
C
The diagnostic workup for AD should include: A. Blood tests to rule out vitamin D deficiency B. A CT scan to visualize neuritic plaques in the brain C. Thyroid function tests to rule out hypothyroidism D. Biopsy of brain tissue to visualize neurofibrillary tangles E. A spinal tap to test the cerebrospinal fluid for the presence of -amyloid peptide fragments
C
The most common clinical manifestation of portal hypertension is what type of bleeding? A. Intestinal B. Duodenal C. Rectal D. Esophageal
C
The nurse is caring for a patient recovering from a broken femur. When assessing the unaffected leg, edema is noted and the patient complains of calf pain. Which of the following interventions should be included in the plan of care? A. Apply ice to the patient's calf B. Massage the sore area C. Perform a complete respiratory assessment D. Encourage the patient to do range of motion exercises for 20 minutes every two hours.
C
What effect does atherosclerosis have on the development of an aneurysm? A. It obstructs the vessel. B. Atherosclerosis causes ischemia of the intima. C. Atherosclerosis erodes the vessel wall. D. It increases nitric oxide.
C
What is the initiating event that leads to the development of atherosclerosis? A. Release of the platelet-derived growth factor B. Release of the inflammatory cytokines C. Injury to the endothelial cells that line the artery walls D. Macrophages adhere to vessel walls.
C
What is the main source of bleeding in extradural (epidural) hematomas? A. Sinus B. Venous C. Arterial D. Capillary
C
What is the most common predisposing factor to obstructive sleep apnea in adults? A. Adenotonsillar hypertrophy B. Obligatory mouth breathing C. Obesity D. Paradoxic breathing E. Chronic respiratory infections
C
Where are nociceptors found? A. spinal cord B. hypothalamus C. skin D. cerebral cortex
C
Which condition is considered a clinical cause of amenorrhea? A. Dysfunction of the uterine endometrium B. Obstruction of the fallopian tubes C. Anovulation D. Lack of exercise
C
Select all that apply: The oculomotor response.... A. indicates the level of brain stem dysfunction. B. is a good indicator of intracranial hypertension. C. should only be checked after ruling out potential spinal cord injury. D. is used to determine if the brainstem pathways are intact. E. is not present in people who are awake.
C, D, E
You are talking to a patient with who came into the ER and received a diagnosis of a transient ischemic attack (TIA). Which of the statements by the patient indicates that the patient understands the information? A. "Since TIAs don't cause permanent damage, it is okay if I keep having these" B. "A TIA is the result of a vessel in the brain rupturing and bleeding a large amount, but it will all get reabsorbed on its' own without need for further treatment" C. "A TIA is the result of a vessel in the brain rupturing and bleeding a small amount, but it will all get reabsorbed on its' own without need for further treatment" D. "It is important for you to seek medical attention immediately if you experience these symptoms again because they could mean that you are having a stroke."
D
What statement concerning the pathogenetic mechanisms of polycystic ovarian syndrome (PCOS) is true? A. PCOS causes a decrease in leptin levels; this decrease reduces the hypothalamic pulsatility of gonadotropin-releasing hormone, which reduces the number of follicles that mature. B. PCOS is a result of a disorder in the anterior pituitary that increases the follicle-stimulating hormone, which reduces the luteinizing hormone released, causing infertility and lack of periods, especially over the age of 35. C. PCOS inhibits testosterone, which stimulates androgen secretion by the ovarian stroma and indirectly reduces sex hormone-binding globulin, making a woman have increased dysfunctional bleeding. D. PCOS is a result of a combination of conditions that include oligo-ovulation or anovulation, elevated levels of androgens, or clinical signs of hyperandrogenism and polycystic ovaries that are associated with the eventual development of metabolic syndrome and diabetes.
D
When thought content and arousal level are intact but a patient cannot communicate and is immobile, the patient is experiencing: A. Dysphagia B. Cerebral death C. Cerebellar-ataxic syndrome D. Locked-in syndrome
D
Where in the CNS does a person's learned pain response occur? A. Frontal lobe B. Limbic system C. Thalamus D. Cerebral cortex
D
Which of the following are risk factors for nasal polyps? A. tobacco smoking B. seasonal allergies C. working in a factory with poor ventilation and lots of particulate matter in the air D. all of the above
D
Which of the following describes nociceptive pain? A. Prickling, itching pain caused by damaged tissue B. A burning pain with electric shock-like quality C. Feeling aching and burning everywhere in your body D. Sharp, aching throbbing pain caused by damaged body tissue
D
Which of the following is considered the key pathophysiologic event triggering secondary neuronal injury following an acute head injury? A. Central nervous system acidosis B. Increased cerebral blood flow C. Systemic hypotension D. Central nervous system ischemia
D
Which of the following is the main concern after someone has experienced a blow to the head? A. Short term memory loss B. Mental confusion C. Emotional lability D. Increased intracranial pressure
D
Which of the following statements best describes Heart Failure with reduced ejection fraction? A. Ejection fraction >55, Decreased Left Ventricular End Diastolic Volume Decreased Left ventricle size Pulmonary Congestion Cardiac Hypertrophy B. Ejection fraction >55, Increased Left Ventricular End Diastolic Volume Dilated Heart Pulmonary Congestion Cardiac Hypertrophy C. Ejection fraction <40, Increased Left Ventricular End Diastolic Pressure Stiff, noncompliant heart Pulmonary Congestion No Cardiac Hypertrophy D. Ejection fraction <40, Increased Left Ventricular End Diastolic Volume Dilated Heart Pulmonary Congestion Cardiac Hypertrophy
D
The nurse is evaluating the direct end effect of the renin-angiotensin-aldosterone system. Which principle should the nurse remember? A. Renin promotes the excretion of sodium and water in the renal tubules. B. Aldosterone increases renal retention of water only. C. Angiotensin I promotes sodium and water reabsorption by the kidneys. D. Angiotensin II causes systemic vasoconstriction.
D
The pathophysiology of Gastroesophageal reflux disease (GERD) includes all but which of the following? A. Reflux of stomach or duodenal contents into the esophagus due to a change in tissue structure or other clinical condition. B. The reflux contents damage the esophageal mucosa, causing and inflammatory response to this injury. C. Factors that may exacerbate the symptoms of GERD in some patients include smoking, caffeine, chocolate, fatty foods, overeating with gastric distention, tight clothing, the presence of a hiatal hernia,; certain medications (calcium channel blockers, narcotics, progestins, anticholinergics) D. Esophageal tissue is relatively easy to repair itself after stomach contents splash onto the mucosa, even if it is a repetitive event.
D
Ventricular remodeling in a patient with heart failure results in: A. Dilated heart in diastolic heart failure and hypertrophied heart in systolic heart failure. B. No change in volume of the heart until the ejection fraction is <10. C. Eventual atrial remodeling and pulmonary remodeling that leads to pulmonary fibrosis. D. Hypertrophied heart in diastolic heart failure and dilated heart in systolic heart failure.
D
A 58-year-old is referred for a sleep study to gather information about potential sleep disturbance. The patients spouse will no longer sleep in the same bed due to the patient's loud snoring. The patient also reports being tired most of the day. What is the most likely diagnosis to be listed in the chart after the study? A. Jet- lag syndrome B. Somnambulism C. Insomnia D. Obstructive sleep apnea
D
A client with normal liver enzymes continues to demonstrate signs of worsening liver function. Which additional diagnostic tests might be indicated for this client? A. C-reactive protein B. Serum creatinine C. Serum sodium D. Serum albuminC. Are live organisms that can be introduced into the gut.
D
Characteristics of serum lipoproteins include: A. HDL's primary function is to carry cholesterol from the liver to the tissues. B. Chylomicrons main job is to collect foam cells and return to the liver C. VLDL's primary function is to carry triglycerides from the tissues to the liver D. LDL's primary function is to carry cholesterol from the liver to the tissues
D
Enkephalins and endorphins act to relieve pain by which process? A. Stimulating the descending efferent nerve fibers B. Inhibiting cells in the substantia gelatinosa C. Blocking transduction of nociceptors D. Attaching to opiate receptor sites
D
Generally, patients who live a healthy lifestyle are at decreased risk of stroke. Blood sugar spikes, high sodium and high fat diets, and sedentary lifestyles increase the risk of stroke. The pathophysiology behind these increased risks involve: A. the burden placed on the renal system that can lead to dehydration of the brain B. neurofibrillary tangles and glial cells growing out of control C. the impact of progressive liver disease on healthy neurologic functioning. D. the impact of atherosclerosis on vessels in the brain.
D
How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)? A. By reducing the contractility of the myocardium B. By causing dysrhythmias as a result of hyperkalemia C. By stimulating the sympathetic nervous system D. By increasing the peripheral vasoconstriction
D
Oxygenated blood flows through which vessel? A. Coronary veins B. Pulmonary artery C. Superior vena cava D. Pulmonary veins
D
Select the answer that best describes Traumatic Brain Injury (TBI): A. Physical damage to some part of the brainstem due to sudden force of the head. B. Physical damage to some part of the skull due to sudden force of the head. C. Physical damage to some part of the neck, skull or face due to sudden force of the head. D. Physical damage to some part of the brain due to a sudden force to the head.
D
Several years after an amputation a patient continues to occasionally feel pain in the absent limb. The correct term for this is: A. Mixed nociceptive-neuropathic pain. B. Inflammatory pain. C. Nociceptive pain D. Phantom limb pain.
D
The best way to distinguish between a hemorrhagic stroke and an ischemic stroke is: A. A head ultrasound with doppler flow B. A stroke assessment by a licensed health-care provider C. A complete neurologic exam D. A non-contrast head CT
D
The best way to measure VENTILATION is: A. Respiratory Rate B. VQ scan C. Pulse oximetry (SaO2) D. Arterial Blood Gas E. Forced Vital Capacity
D
Your 56 year old patient has colon cancer and recently sprained both of his ankles, leaving him immobile for the past 4 days. The localized edema that has been present in both legs now spreads up to his knee on his left leg. What does this suggest? A. A negative Wells score, indicating that the patient is unlikely to be able to walk anytime soon. B. A positive Wells score, making it likely that the patient will experience or may be experiencing chronic venous insufficiency. C. A positive Wells score, making it likely that chemotherapy will not be effective as long as there are additional sources of inflammation (ankle injuries). D. A positive Wells score, making it likely that the patient will experience or may be experiencing a deep vein thrombosis.
D
Your patient is diagnosed with meningococcal meningitis. Which preventive measure would you expect the health-care provider to order for the significant others in the home? A. The Haemophilus influenzae vaccine. B. A gamma globulin injection. C. A 10-day dose pack of corticosteroids. D. Antimicrobial chemoprophylaxis.
D
A patient who has experienced a traumatic brain injury may require support of all of the following systems/ functions EXCEPT: A. Temperature maintenance B. Respiratory status C. Renal perfusion and dialysis D. Blood pressure support and active management E. The patient is likely to require support in all of the above systems.
E
Heart failure with preserved ejection fraction (HFpEF or diastolic) refers to the condition where: A. angiotensin converting enzyme (ACE) inhibitors should never be used because they can cause worsening hypertrophy B. the heart cannot perfuse the kidneys or brain adequately so syncope and renal failure are common C. the left ventricle generates such a low cardiac output that there is no room in the left ventricle for diastolic inflow thus left ventricular end-diastolic pressure (LVEDP) falls D. the right ventricle generates such a high cardiac output that it floods the lungs E. the left ventricle generates a normal cardiac output but is stiff so that a normal left ventricular end-diastolic volume (LVEDV) results in an increased left ventricular end-diastolic pressure (LVEDP), thus congesting the lungs
E
Mr. Russell is a 25 year old who presents to the emergency room with complaints of an extremely severe, unilateral, burning pain located behind the his left eye. He denies any nausea, vomiting, aura or chills. Which type of headache does this most closely resemble in this particular client? A. Sinus B. Migraine C. Tension type D. Medication-overuse (rebound) E. Cluster
E
Primary sleep disorders involve all of the following EXCEPT: A. disturbances in the pattern and periodicity of REM and Non-REM sleep. B. result from an endogenous disturbance in sleep-wake generating or timing mechanisms C. are often complicated by behavioral conditioning D. include parasomnias and dyssomnias E. All of the above
E
Risk factors for hypertension include all of the following EXCEPT: A. Sedentary Life-style B. Diabetes/Glucose intolerance C. Cigarette smoking D. Advancing Age E. High dietary intake of Potassium F. High dietary sodium intake G. Heavy alcohol use H. Positive family history
E
Which of the following statements about the causes of secondary hypertension is NOT true? A. Renovascular issues and renal parenchymal disease are both potential contributors to secondary hypertension. B. Medications associated with secondary hypertension include corticosteroids and oral contraceptives C. Potential causes of secondary hypertension include hyperthyroidism, Cushing's syn- drome, and primary aldosteronism D. Cocaine and methamphetamine use may cause secondary hypertension E. Dietary factors that may cause secondary hypertension include excessive intake of caf- feine, licorice, or alcohol F. Causes of secondary hypertension occur more frequently than do those of essential hypertension
F
Bilirubin that is deposited in the skin is most likely to be conjugated. True False
False
Gastritis can be defined as an inflammation of the mucosa that completely penetrates the muscularis mucosa. True False
False
Glial cells directly transmit signals along nerves in the neurological system. True False
False
Regarding Necrotizing enterocolitis of the newborn: A. This is a life threatening condition that occurs usually between the 4th and 6th week of life, more commonly in babies that weigh between 1800 and 2500 grams. B. The pathophysiology involves both ischemia/reperfusion injury and immature gut microbiome colonization C. Symptoms include bloated abdomen, and feeding difficulties. D. Many cases may be prevented by the use of probiotics in the NICU. E. NEC patients have much less diversity in their microbiome, which is proteobacteria dominant. F. All but A. G. All but E H. All of the above
F
Sleep architecture is determined in part by: A. the suprachiasmatic nucleus of the hypothalamus B. body size/weight C. what you eat and drink D. age E. All except D F. All of the above
F
Steps in the pathogenesisis of STEMI include: A. rupture of an unstable atherosclerotic plaque B. complex atherosclerotic plaque absorbed by endocardium over the course of several weeks, months or years C. thrombus formation that has lysed in less than 10 minutes and blood flow restored D. Infarction that extends all the way through the myocardium E. A and B F. A and D
F
Women who develop Polycystic Ovarian Syndrome (PCOS) do not have to worry about developing long term health problems from the PCOS if they have a normal or low Body Mass Index (BMI). True False
False
A person who has been diagnosed with Hepatitis C virus infection is likely to be asymptomatic during the acute phase of the infection, and may not be symptomatic for decades. True False
True
Chest pain is the most common symptom of a pulmonary embolism. True False
True
Heavy alcohol use (alcoholism) is a risk factor for bacterial meningitis. True False
True
REM sleep rebound effect refers to a significant increase in the proportion of REM sleep following deprivation of REM sleep. It is often associated with very vivid dreams. True False
True
Seizure initiation is characterized by two simultaneous events in a group of neurons. 1) high frequency bursts of action potentials and 2) hypersynchronization. True False
True
Sliding hiatal hernias are the most common type. These involve the proximal portion of the stomach sliding up into the esophagus above the lower esophageal sphincter True False
True
The production of lippolysaccarides (LPS) can contribute to chronic tissue inflammation in humans which in turn decreases insulin sensitivity and increases production of short chain fatty acids that contribute to obesity. True False
True
